In the United States, unintentional falls are the most common cause of nonfatal injuries for people older than 65 years. According to the National Institute of Health, up to 32 percent of community-dwelling individuals over the age of 65 fall each year, and females fall more frequently than males in this age group. Balance disorders in patients increases a risk for falls and subsequent injury. Some of these risk factors include:
- History of Falls
- Gait disorder, use of a assistive device
- Balance disorder
- Muscle Weakness
- Visual deficits
- Neurologic deficits
- Cognitive impairment
- Over 80 years old
- More than four medications
A balance training program will focus on multiple factors that can lead to increased fall risk. Patients will be evaluated to determine risk of falling and having balance impairment. Treatment may include: core strengthening, balance retraining and functional activity training.
The goals of treatment would be to provide information on creating a safe environment and decreasing, eliminating or managing fall risk factors. Additional goals would be to build strength and endurance with an exercise program and implement lifestyle changes that address ongoing risk factors.
Each year over 10 million patients visit a physician due to a vestibular problem. It is the most common complaint of patients over the age of 75, but can occur in patients of any age. The vestibular system includes the parts of the inner ear and brain that process the sensory information involved with controlling balance and eye movements. If disease or injury damages these processing areas, vestibular disorders can result. Vestibular disorders can also result from or be worsened by genetic or environmental conditions, or occur for unknown reasons.
The most commonly diagnosed vestibular disorders include benign paroxysmal positional vertigo (BPPV), labyrinthitis or vestibular neuritis, and Ménière’s disease. Other problems related to vestibular dysfunction include complications from aging, autoimmune disorders, and allergies.
Your physical therapist will evaluate your symptoms and review your medical history. He or she will identify any problems with your balance, your gait (how you walk), neck motion, visual stability, as well as examine other potential problem areas. Based on the findings, a plan of care is developed. The goal of your treatment plan is to improve any deficits that were identified. This, in turn, will improve your ability to function in activities of everyday living, reduce your risk for falling, and ultimately, improve your quality of life. Common symptoms of that can be helped with vestibular rehabilitation include:
- Dizziness or blurry vision with head movements
- Neck tightness, stiffness and/or pain
- Imbalance or the need to hold onto objects when walking
- Frequent falls
- Generalized “dizziness, wooziness and foggy head” feelings
Expected goals of vestibular rehabilitation include decreased fall risk, decreased dizziness symptoms, improved balance, improved ability to stabilize vision/gaze, increase in confidence in ability to maintain balance, improved neck motion and reduced symptoms.