Balance and Vestibular Program

Balance Image | Balance and Vestibular Program

ProActive Physical Therapy & Rehabilitaiton offers fall risk screening, balance training, vestibular rehabilitation and aquatic-based balance programs for people who feel they are at risk for falling. Good balance depends on correct sensory information, accurate processing of the information in your brain, and effective response of your muscles.

Diagnosing balance and dizziness problems is a complex task for many reasons: First, dizziness is often a symptom of other common diagnoses (e.g. headache, Parkinson’s, Meniere’s, whiplash) and can be a side effect of many medications. Second, many chronic balance problems are often multifactorial, not a single disease process. Third, each of us have three separate sensory systems that give information to the brain about the position of their head and body in space; completing a balance evaluation requires that each of the systems be examined individually, as well as the way they interact.

  • Visual: We learn as babies that walls are vertical and the floor is horizontal. If the walls appear tilted or the floor sloped, the brain interprets that to mean that you are tilted and sends signals to your muscles to correct the situation before you fall. If everything around you is moving, your brain tells you that you are moving. When this happens at a stop light, your brain might tell your foot to slam on the brake, even though its the car next to you that's moving!
  • Somatosensory system: All throughout your body are sensors that tell your brain where all your body parts are, without you even having to think about it. The sensors in your upper neck (at the base of your skull) are particularly important in balance and dizziness because they are connected to your eyes and inner ears by reflex loops. Individuals with diabetic neuropathy may have loss of function in the sensors in their ankles and feet, placing them at higher risk for falling.
  • Vestibular system: Balance organs in your inner ears sense head movement in any direction. Much like a carpenters level can tell you if a surface is level by the position of the bubble in the fluid, the inner ears contain fluid and small crystals that tell your brain when your head is level, and the speed and direction of movement. When head is in the neutral position (not tilted or turned) the crystals are in the normal position. When you move your head, the crystals move and give information to the brain about the movement and the new position.

Sensory information from these systems is continually going to an area in your brainstem that organizes and prioritizes it, and puts it in the context of your current situation. As long as all the systems are giving congruent information, you do not get dizzy or lose your balance. When they are not synchronized, you may feel dizzy or lose your balance. Once the information is processed, the brain sends messages to your muscles to help you keep your balance.

Every client who comes to ProActive will receive a complimentary fall risk screening. If any risk factors are identified, your therapist will perform follow up testing and/or refer you to other health care providers (such as an audiologist, ENT specialist or primary care physician.) Upon completion of the evaluation, your therapist will discuss your treatment options with you and develop a treatment plan. Many clients with balance/dizziness problems can be treated in one or two visits.

ProActive offers the only aquatic-based balance program in the CSRA. Several properties of water make the pool an ideal environment for working on balance reactions. The buoyancy of the water decreases joint loading, making it possible for individuals who are otherwise unable to tolerate prolonged standing (e.g. spine problems) to work on standing balance. Because water is denser than air, you fall slower in the pool, making for a safe environment for developing fall recovery reactions. Therapy in the water provides constant buffeting, stimulating small balance reactions. Upon completion of the pool balance program, clients are instructed in a home program to maintain the balance improvements.