How do we maintain our balance?
Balance is a complex process that depends on three major components:
1) Our sensory system, which gives us information about our surrounding environment
2) Our motor system, which helps us coordinate motion and balance
3) Our brain, which integrates sensory and motor inputs so we can
adjust to changes in our surroundings as we move. To illustrate, we rely
on our eyes to tell us if our surroundings are moving, and we use the
sensation in our feet to tell us if we are on an unsteady or moving
surface.
When we age or suffer an injury, these systems do not
work as effectively as before. We may notice less steadiness in our
posture or gait, feel less confident, and become less active and mobile.
These adjustments often make the problem worse.
How your balance is evaluated?
The Center for Balance and Mobility at MidHudson Regional
Hospital identifies the causes of vertigo and balance impairments using a
series of tests:
• Sensory impairment is evaluated using
Computerized Dynamic Posturography (CDP). CDP tests postural stability
in a controlled environment.
• Dynamic Vision Impairment Evaluation, including Dynamic Visual Acuity (DVA) and Gaze Stabilization Test (GST).
• Autonomic Motor Impairment Evaluation using two different tests;
Motor Control Test & Adaptation Test. They evaluate an individual’s
ability to sense and react quickly to unanticipated surface changes,
often before symptoms are present.
• Voluntary Motor Impairment
Evaluation using three different tests; Limits of Stability, Rhythmic
Weight Shift, & Weight Bearing Squat. Together they evaluate an
individual’s directional control; weight bearing symmetry; ability to
shift weight; and ability to react quickly.
• Evaluation for vertigo
is completed using specific postural maneuvers (canalith repositioning)
designed to reproduce vertigo. Positional dizziness is most commonly a
result of benign paroxysmal positional vertigo (BPPV).
• Evaluation
for concussion or head injury using Sensory Organization Testing.
Lingering effects of even a simple concussion or head injury are
evaluated, providing an objective basis for recommendations for
returning to work or participation in athletics.
What treatments and training are available?
Based on the evaluation results, a customized therapy program is
designed to target identified sensory, visual, or vestibular problems.
Using CDP, visual biofeedback maximizes learning and adaptation,
allowing patients to identify and adjust balance responses in ways
traditional approaches cannot. The training sessions allow both the
patient and the balance specialist to objectively monitor progress and
make adjustments. Recommendations for lifestyle modifications may also
be provided. Treatment sessions are designed to be tolerated by all ages
and at all functioning levels. Both athletes and the frail can be
trained equally well to address the impairments that are identified.
How can you begin receiving help from the Center for Balance and Mobility?
Speak with your doctor about your balance problems or dizziness and
request a referral to the Center for a balance evaluation. Most health
plans, including Medicare, Medicaid, and NYS Workers Compensation, cover
these specialized tests and treatment.
What can you expect when you come to the Center for Balance and Mobility?
A specially trained clinician will use computerized testing, including
CDP, to identify underlying impairments and functional limitations. A
detailed report will be sent back to your referring doctor along with
recommendations for treatment. By accurately identifying your underlying
sensory, motor, and vestibular impairments, treatments can be designed
to significantly improve your functioning. We will also work closely
with you and your physician if further testing or coordination with
other health care providers is needed.
Balance Self Test
If you answer yes to any of these questions, you could be at risk for a fall.
1) Have you fallen more than once in the past year?
2) Do you take medicine for two or more of the following: heart disease, hypertension, arthritis, anxiety, or depression?
3) Do you feel dizzy or unsteady making sudden movements such as turning quickly or bending forward?
4) Do you have blackouts, dizzy spells, or seizures?
5) Have you suffered a stroke or other neurologic problem that has affected your balance?
6) Do you experience numbness or loss of sensation in your legs and/or feet?
7) Do you use a cane, walker or wheelchair to get around?
8) Are you inactive? (answer yes if you do not participate in regular
exercise such as walking 20-30 min at least three times per week)
9) Do you feel unsteady when walking or climbing stairs?
10) Do you have difficulty sitting down or rising from a seated or lying down position?