Balance Awareness Week has been established to educate the community regarding the symptoms of vestibular disorders so that individuals experiencing problems can seek help to receive an accurate diagnosis and get effective treatment.
Vestibular disorders can affect anyone and with the proper intervention and treatment (usually 1-3 physical therapy treatments) provided by a therapist trained in addressing vestibular disorders, individuals improve and the dizziness and vertigo symptoms are resolved. The most common vestibular disorder is BPPV: Benign Paroxysmal Positional Vertigo. BPPV produces a sensation of spinning called vertigo that is both paroxysmal and positional, meaning it occurs suddenly and with a change in head position.
In addition to vertigo, symptoms of BPPV may include imbalance, difficulty concentrating, and nausea. Activities that bring on symptoms can vary in each person, but symptoms are precipitated by changing the head’s position with respect to gravity such as looking up, or rolling over and getting out of bed. It can be tremendously disruptive to a person’s work and social life, as well as pose a health hazard due to an increased risk of falls associated with dizziness and this imbalance.
BPPV is the most common vestibular disorder; 2.4% of all people will experience it at some point in their lifetimes. BPPV accounts for at least 20% of diagnoses made by physicians who specialize in dizziness and vestibular disorders, and is the cause of approximately 50% of dizziness in older people.
Vestibular tests include the Dix-Hallpike maneuver and the Supine Roll test. These tests allow a therapist or physician to observe the nystagmus (eye movement) elicited in response to a change in head position. Recommended treatment for most forms of BPPV employs repositioning head maneuvers that move the displaced otoconia (particles) out of the affected semicircular canal.
Falls are the leading cause of injury deaths, the most common cause of non-fatal injuries, and the most common reason for hospital admission due to trauma in older adults. Research shows that a cumulative effect of multiple interacting factors increases fall risk in any one individual. The factors may include:
- Muscle weakness
- Gait deficits
- Balance deficits
- Visual deficits
- History of falls
- Neurologic deficits
- Cardiovascular deficits
- Other Medical issues
What to do:
Physical therapists use a number of tests and measures to determine an individual’s risk of falling. Within the initial examination the clinician will focus in on range of motion, muscle strength and sensory integrity. The therapists will look at foot and ankle flexibility, strength, as well as weakness around the knee and hip. Additionally the therapists will get a strong understanding of the individuals recent fall history as well as environmental hazards especially within the home. The therapist along with the individual being treated will devise a treatment approach based on the exam and the risk factors identified. The plan can include: balance retraining, gait training, exercises, education and environmental assessment.
Four Quick Tips to Help Avoid Falls at Home:
- Clear Pathways
- Make sure Lighting is good
- Make sure most used or needed items are within reach
- Move Slow and Steady