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Published on January 10, 2017

Testing, improving and maintaining your balance

Sometimes the use of a device can make you more independent, not less, because you are safer and abler to go out and about.

Sometimes the use of a device can make you more independent, not less, because you are safer and abler to go out and about.

By Karen Collins | Lawrence Memorial Hospital

Tuesday, January 10, 2017

The fear of falling is common as we age. We feel the loss of freedom of movement as our joints become tighter and we need to work harder to maintain strength and balance.

How do we balance as we walk and avoid falling? How can we measure the level of our balance skills today? How do we improve our balance when it declines? Physical and occupational therapists work on balance problems and have the tools to help you answer these questions.

The body has three sensory systems that test, improve and maintain balance:

  1. Somatosensory: how we feel the ground under our feet.
  2. Visual: how we use our vision to sense where we are in space.
  3. Vestibular: how we use our inner ear system like a gyroscope.

Every day you are sensing and maintaining your own balance. Our bodies constantly use our three systems even when we are lying down or just sitting. These systems work together to maintain stability and prevent falls, and, amazingly, they work without us even knowing.

As we age, unfortunately these systems can start to weaken just like the rest of our bodies, and a decline in just one of these three systems can cause a fall.

How can you tell which system is having problems? This requires testing of your senses: the sensation in your feet, your eyesight and the health of your inner ear. Therapists can use a balance platform called a NeuroCom Balance Master System to perform a sensitive set of tests that can detect small issues with your balance.

This machine was developed to help therapists test the specific degree of your balance problem, as well as if any of the three balance systems (sensation, vision, inner ear) have issues. These measurements and specific details about which balance systems are most impaired guide your therapist to develop an exercise program to help improve your balance.

There are many ways you can work to improve your balance, and if balance is a concern, you should talk to your doctor about working with a physical or occupational therapist. There also are some simple things you can do on your own to improve your balance.

• Practice feeling your balance throughout your day. Stand in a safe space such as in the bedroom with a chair directly behind you, or in the kitchen with use of a countertop near you. Stand with your feet apart, eyes open and press your feet into the floor. Shift your weight slowly to one foot and then the other. This is a nice way to start just feeling how your body reacts to challenges in your balance without using your arms to help or support you.

• Don’t rule out the use of an assistive device, such as a cane or walker. Many people are hesitant for various reasons, such as the stigma of using a cane, or maybe there’s not enough room in your house to use a walker, or you think a cane makes you less independent. Think about it through a new lens: Sometimes the use of a device can make you more independent, not less, because you are safer and abler to go out and about, using less energy to do your basic tasks with use of the device, as well as preventing falls.

• Take a Tai chi class. There are many offered in the community, including at LMH.

Tai chi uses slow, controlled movements to work on balancing and shifting your weight in all directions. There are also water aerobics classes offered through Lawrence Parks and Recreation. The pool is a great place that is safe to work on balance and strengthening.

• Review your current medications with your doctor or pharmacist. There are medications or combinations of medications that can affect your balance or inner ear function.

Here a few things that you can do in your home to help maintain your balance, or more importantly prevent a fall.

• Take a look at your home and outdoor areas. Throw rugs are a big reason that people can trip and fall. Please remove them from underfoot.

• Pick up the clutter. Objects around the house that are in the hallways or common pathways to the bathroom can be trip hazards.

• Handrails in the hallways can assist people with safety in the home. In addition, grab bars in the bathroom can be a big help, as falls are more likely to happen there. Install grab bars around the toilet, as well as in and around the shower or bathtub. Anti-slip mats in the shower or bathtub as well as outside the tub can help prevent falls, too.

• Be careful on uneven surfaces such as grass, gravel, uneven or icy sidewalks. Our bodies have a tougher time balancing on these uneven surfaces than they do on even surfaces, so use caution. Move slowly and look carefully where you are stepping.

You use a lot of different systems to maintain your balance, and your balance can be improved through exercise and training. Safety is always No. 1, and you should always consult with your doctor, physical therapist or occupational therapist before beginning a new exercise routine.

— Karen Collins, PT, DPT, c/NDT is a licensed physical therapist who specializes in treating patients with neurological disorders, balance problems, and dizziness/vestibular problems at Lawrence Memorial Hospital. She has a certification that specializes in treating patients with neurological disorders, such as stroke and brain injury.

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