Balance problems make it difficult for people to maintain stable, up right positions with standing, walking, and even sitting. Older people are at higher risk of having balance problems; 75% of Americans older than 70 years are diagnosed as having “abnormal" balance. Physical therapists develop individualized physical activity plans to help improve the strength, stability, and mobility for patients with balance impairments. Improving balance and walking skills can help to decrease risk of injury, while at the same time improving confidence and independence.
Conditions that can cause decreased balance and increased fall risk:
- Traumatic brain injury
- Spinal cord injuries
- Generalize weakness
- Post surgery
- Medication changes
- Neurological diseases, i.e. Parkinson’s, Multiple Sclerosis, ALS
- Vestibular disorders or dizziness
Vestibular therapy is performed by specially trained therapists and involves treating patients with inner ear dysfunction. Vestibular therapy resolves dizziness through positional maneuvers, eye coordination exercises, and habituation exercises. Vestibular therapy restores balance through static and dynamic balance training tasks, often involving activities such as head turns and opening and closing eyes, and standing on a variety of surfaces.
Conditions commonly treated by vestibular physical therapy services:
- Benign Paroxysmal Positional Vertigo (BPPV)
- Vestibular Hypofunction (resulting from vestibular neuritis or a labyrinthitis)
- Ménière’s disease
- General dizziness
- Concussions/Head injuries
- Headaches and migraines
- Balance disorders
Caring for Brain Injuries including Concussions
Hastings Physical Therapy is available to help prevent and treat concussion and more severe brain injuries such as stroke, brain tumor, falls resulting in head trauma and other traumatic events resulting in damage to the brain. In recent years, the proper treatment of brain injuries has continued to develop and change to promote safety in returning to prior level of function. At HPT, we can play an important role in helping you get back to your normal routine and activity level following trauma to the brain.
What causes a concussion?
Your brain is cushioned inside your skull to protect it from impact or trauma. However, when the skull receives a violent force, this can cause your brain to hit the inside of your skull and receive damage. An indirect force such as from whiplash can also cause a concussion. This trauma to the brain tissue results in it needing more energy than normal. Because of this decreased supply of energy, symptoms such as fogginess, headaches, dizziness, etc. can occur. This is known as an “energy crisis”. It is important to know the signs of a concussion in order to avoid further injury during this period of time.
What are the symptoms of a concussion?
Detecting a concussion can be difficult as everyone has different symptoms. In addition, imaging such as an MRI or CT scan often do not detect concussions. It is important to remember that just because there are not visible signs on imaging, it does not mean it is not a serious injury. Because of this, it is important to be aware of common symptoms to prevent further injury. Be sure to talk to your doctor if any of these occur:
- Emotional: anger, sadness, anxiety, and irritability
- Mental: confusion, feeling foggy, poor memory, and poor concentration
- Physical: headaches, dizziness, nausea, vision changes, and loss of balance
- Sleep: trouble falling asleep, difficulty staying awake, too much or too little sleep
What role does physical therapy play in concussion management?
Once you have had a concussion or brain injury, you are 3x more likely to have a second, and once you have had a second, you are 8x more likely to have a third concussion. Because of this, it is important ensure you are completely ready to return to sport or activity to prevent future reinjury.
At HPT, we have a vestibular-trained therapist who is certified in brain injury and concussion management. We will screen the cervical spine, assess vestibular function and overall visual function, and begin slowly introducing physical activity to return to sport without symptoms.
We will also work to educate current patients involved in sports on the importance of reporting concussion and concussion-like symptoms. There is a low reporting rate as athletes want to return to sport as quickly as possible. We will educate them on the possibility of having a second concussion and prolonged recovery rate.
1Mucha and Whitney. Medbridge