“It’s funny how this is so hard when I close my eyes,” the patient says as I stand guard ready at any moment should a sway turn into a fall. Actually it makes sense. Our balance relies on input from our eyes, muscles, and inner ear. When you take one of those three inputs away it makes the system work that much harder to determine where your body is in space so that it can keep you upright. When I’m testing someone’s balance I first start with the person on a firm surface with their eyes open. At this point all systems of input are working, sending feedback to your brain as to where your body is in space. If this isn’t a problem, I have them close their eyes, thus taking away one system. If this isn’t a problem, I try to dimish input from the muscles and make them stand on a piece of foam, relying the most on the inner ear for input. This then gives me an idea of where problems lie. If it’s hard to maintain your balance when you stand over ground with your eyes closed, then it means you might be relying more and more on your vision for feedback to maintain balance. As we get older, our eyesight declines and if we have relied on this system the most to maintain balance, falling could start to be a problem.
At this point in physical therapy we try to strengthen other areas of input including muscles and the inner ear to compensate for bad vision. I also recommend that if the person relies heavily on their vision that they make sure they have adequate lighting and turn on the lights in the middle of the night in order to help prevent a fall.
I’ve wondered what it’s like for someone who suddenly loses their vision to maintain balance. I would imagine they go through a period of feeling a little clumsy moving around due to losing one input to the brain on balance, though if anyone has anything to share on going through this, comment at the bottom.
How would you fair? Try closing your eyes while standing. What does it feel like? Are you swaying more? Don’t notice anything and feel completely stable? Try to lift one leg up. Can you do this and hold yourself upright?
MoniqueSerpasPT
My name is Monique Serpas, PT, DPT, OCS. I am a physical therapist and board-certified Orthopaedic Clinical Specialist practicing at the Southeast Louisiana Healthcare System in New Orleans, LA. I realize how difficult it can be to overcome an injury or manage a chronic condition and am focused on helping my clients achieve wellness through a physically active lifestyle. I treat orthopaedic, balance, and vestibular disorders and practice using a combination of hands-on manual therapy, therapeutic exercise, and education. This enables my patients to assist in their own recovery and injury prevention. I also have developed fall prevention and golf-related rehab programs in the past. I hold a Doctor of Physical Therapy from Concordia University Wisconsin (2008) and a Bachelor of Science in Kinesiology from Louisiana State University (2004). I am a member of the American Physical Therapy Association (APTA), Louisiana Physical Therapy Association (LPTA), and the Orthopaedic and Neurology sections of the APTA.
If you want to connect beyond the blog, m...@geaux2pt.com or click on the following social network icons:
October 8, 2010
Neurologic