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Overview

Balance means being able to control and maintain your body's position, whether you are moving or remaining still. With normal balance, one can walk without staggering, get up from a chair without falling, climb stairs without tripping.

A balance disorder is a disturbance that causes an individual to feel unsteady, possibly giddy, woozy, or have a sensation of movement, spinning, or floating. An organ in our inner ear, the labyrinth, is an important part of our vestibular (balance) system. The labyrinth interacts with other systems in the body, such as the eyes and bones and joints, to maintain the body's position. These systems, along with the brain and the nervous system, can be the source of balance problems.

When balance is impaired, an individual has difficulty maintaining orientation and stability. For example, an individual may experience the "room spinning" and may not be able to walk without staggering, or may not even be able to arise. It is common for people with balance disorders to describe the problem as “dizziness.”

Symptoms

Some of the symptoms a person with a balance disorder may experience are:

  • A sensation of dizziness or vertigo (spinning)
  • Falling or a feeling of falling
  • Nausea
  • Lightheadedness or feeling woozy
  • Visual blurring
  • Disorientation
  • Fatigue
  • Difficulty concentrating
  • Blurred vision after quick head movements

Some individuals may also experience diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. The symptoms may appear and disappear over short time periods or may last for a longer period of time.

Who Is Affected

  • It has been estimated that 65% of individuals older than 60 years of age experience dizziness or loss of balance, often on a daily basis.
  • 23-30% of adults have experienced at least one episode of dizziness and 3.5% of adults experience a chronic recurrent episode greater than a one-year duration by age 65.

Reasons for Balance Disorders

The reasons for balance disorders vary widely. Balance problems may be an immediate and transitory response to a brain injury or a medication. It can be also be a long-term condition. Many older people experience chronic balance problems and it is one of the most common reasons for falling.

There are four general categories of balance problems:

  • A disturbance in the labyrinth, a structure in the inner ear,
  • A problem in the brain or its connecting nerves,
  • A problem of the body other than the head and brain,
  • Blood flow problems.

Many different conditions and situations can cause balance problems. They include but are not limited to:

  • Infections, both viral and bacterial
  • Brain injury
  • Stroke
  • Multiple Sclerosis and other kinds of neurological conditions
  • Medication side-effects
  • Meniere's Disease (say "men-ears") disease is the name of a problem of the inner ear that is a "chronic" problem, which means that it lasts a long time. Attacks may happen often, or only sometimes. Attacks usually last from 20 minutes to 2 hours or longer.
  • Aging - Many older people may move slowly, deliberately and unsteadily in order to prevent onset of dizziness caused by blood pressure disorders.
"A majority of individuals over 70 years of age report problems of dizziness and imbalance, and balance-related falls account for more than one-half of the accidental deaths in the elderly. . . . Furthermore, in a sample of persons age 65-75, one-third reported that dizziness and imbalance degraded the quality of their lives."

Looking at the Impacts

Activity Limitation

Anyone with a balance problem may experience limitations when trying to do the ordinary activities of daily living. It can be particularly acute for someone with a brain injury. For her, there can be a slowing or a break in the information process coming into or going out of the brain. This may make it difficult to maintain balance while sitting up, standing up, walking, moving around in a busy environment or doing normal tasks. Multi-tasking – even something as simple as walking and talking – may be very difficult or impossible.

Falling

The risk of falling for people with balance problems requires a mix of personal and environmental strategies to reduce the risk. Having access to a cane or walker may help. Reducing clutter in the personal and public environment cuts the number of risks for someone unable to navigate around things. Lighting on stairs or any other level change, including ramps, helps orientation and safety.

Reduced Physical Reaction Time

For someone with balance problems, their reduced reaction time will make them vulnerable in an emergency situation. Evacuation may be very difficult and require planning for safe movement from the building such as a buddy system.