Balance Difficulties with Geriatric Patients

Balance Difficulties with Geriatric Patients

We often see geriatric patients with balance difficulties. The problem lies when challenges with vision, when they find it hard to feel their feet in space, or when their inner ear is not working properly.

Parts of the sensory system that contributes directly to balance are the eyes (visual), ears (vestibular) and touch (somatosensory) systems.  The use of multiple systems allows us to learn new movements quickly and to fine tune and easily repeat familiar movements.

  • The Visual System allows us to identify objects and know their movements and tells us where we are in relation to other objects
  • The Vestibular System is responsible for processing information about movement with respect to gravity specifically rotation, acceleration/deceleration, and head stabilization during gait.  It also works in conjunction with the visual system to stabilize the eyes and maintain posture during walking.  Vestibular disorders cause a feeling of dizziness and unsteadiness.
  • The Somatosensory System is the sensory input from touch and proprioception which allows the muscle to make constant, automatic adjustments to maintain balance and avoid falls.

There are movement strategies for balance that our patients can use to avoid falls and accidents.  Three forward and backward movement strategies have been identified: the ankle, hip and stepping strategies:

  • Ankle Strategy is called the ankle sway and uses length of the foot as a lever to correct for minor losses of balance.  In the ankle strategy, activation of the leg muscles is from the floor up.  A small loss of balance in the forward direction causes contraction of the gastrocnemius, hamstrings and the lower back muscles, in that order to bring the body back into balance.  A small loss of balance in the back ward direction causes contraction of the anterior tibialis, quadriceps and lower abdominal musculature.
  • Hip Strategy is movement in the hip in response to larger losses of balance or when the support surface does not allow the use of ankle lever, such as on a slippery surface or when the surface is shorter than the length of the foot.  In the hip strategy, activation of the muscle is from the trunk down.  A loss of balance in the forward direction causes contraction of the lower back and hamstrings to regain balance
  • Stepping strategy is used when the loss of balance exceeds the area of stability and the person is forced to step or fall.

If you or somebody you know suffers from loss of balance – call OSR at 808-488-555! We offer complimentary consultations that include a complimentary adjustment, x-rays (if indicated), and a consultation with our medical department. While it is important to implement the strategies above, don’t feel like you have to go through it alone. Our team of highly skilled Physical Therapists and Rehabilitation Therapists are here to make sure you get the care you need and learn the above strategies the correct way.

REFERENCE: Physical Rehabilitation by Susan B. O’Sullivan

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