Balance disorders are amongst the most common reasons why people over the age of 65 consult their health-care professionals. A loss of balance also increases the risk of falls. This is a serious and even life-threatening complications. Falls are the leading cause of injuries – including fatal injuries – for people who are older than 65.
Balance disorders are severe owing to the risk of falls. However, occasionally balance problems may warn of another health condition such as a heart disorder or a problem in the brain or, alternatively, other parts of the nervous system.
As a result of all the possible causes as well as overlapping symptoms, balance problems can be quite tricky to diagnose. For these reasons, it is important to see a health-care professional so that the source of your balance problem can be properly and promptly identified. Treatments, when needed, are usually simple and effective.
The most common types of balance problems
The most common symptoms of balance problems are:
- Vertigo which is a sensation that everything around you is spinning or moving or that you yourself are spinning around.
- Light headedness or ‘near-fainting’ (presyncope). This is a feeling of weakness or dizziness.
- This presents as a feeling of imbalance and disorientation. Occasionally, a loss of your feeling of time or place may be felt.
Balance problems may be related to:
- Inner ear problems (which are the most common sources of vertigo)
- Headache (as well as migraines)
- Anxiety or panic
- Ringing in your ears
- Allergies or, alternatively, infections
- Getting up quickly from sitting lying position
- A growth on the auditory nerve (such as an acoustic neuroma)
- Problems with the nerves in your legs and feet
- Low blood pressure
- Dehydration
Exercises for balance
A programme that includes exercises for balance should contain movements that:
- Increase flexibility in the neck and torso,
- Strengthen the lower body, ankle complex, quadriceps, arms, back and abdominals,
- Force you to weight-shift,
- Gradually decrease your base of support and go from a table surface to an unstable surface.
These balance exercises should be adjusted to suit each specific population group.
A balance programme should progress from a two-legged stance that minimally challenges stability to a more complex stance. The progression evolves in this manner:
- Two-legged exercise with minimal challenge to stability
- Staggered stance
- Single-leg base of support
- Two-legged exercise, unstable surface
- Single-leg exercise, unstable surface
The arm progression goes as follows:
- Two arms
- Alternate arms
- One arm
- One arm with movement
After a client assessment and medial clearance, a programme might contain some of the following exercises and stances:
- Warm-up
- Walking forward and backward
- Side to side/carioca
- Walking forward and backward on heels/toes
- Squats to single-leg balance
- Step-ups, front/side
Head turns and warm movements can be added when the client is ready.
During the resistance work the client should begin with easy exercises and gradually progress to more challenging ones. Here, the easiest exercises are listed first followed by more challenging ones:
- Standing on one leg, eyes open; standing on one leg, eyes closed
- Two-legged wall ball squat; single-leg squat with reach
- Prone dumbbell row on stability ball; single-leg cable row
- Seated PNF (proprioceptive neuromuscular facilitation) on stability ball; seated PNF on ball with side reach
- Cable triceps extension on stability ball, single-leg triceps kickback
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