How Balance Physical Therapy and Vestibular Rehab Lowers Your Fall Risk

People of all ages can experience a fall that leads to injuries ranging from minor bruises to head trauma and even death, especially in older adults. About 3 million older adults are treated in the emergency room for fall-related injuries, and of these, about 800,000 must be hospitalized.

Even if a person has not experienced a fall, the risk can still reduce their quality of life. Fears of falling can lead to anxiety and loss of independence. A person may limit their movement or social interactions, which can negatively affect both physical and mental health.

Understanding what causes falls and loss of balance can help you reduce your own risk of falling. This can raise your quality of life, encourage independence, and help preserve your physical and mental health.

What Counts as a Fall?

Different organizations may have their own definitions of what is considered a “fall.” In general, a “fall” means that a person unintentionally came to rest on a lower level. Besides the ground or floor, this can also mean a chair, table, or step.

Even if a person does not slip and fall completely, it can still be considered a “fall.” For example, if a person loses their balance and someone else helps them remain upright, medical professionals still count that as a fall, even if there was no injury.

When there is an external force, such as one person pushing another person down, it does not count as a fall.

How Does Your Body Stay Balanced?

Falling occurs when the body’s balance systems are disrupted. There are three main balance systems:

• Visual system, which uses information taken in through eyesight
• Proprioception, which involves awareness of where and how the body is oriented in the environment; this information comes from the joints and muscles
• Vestibular system, which affects balance and spatial orientation so a person can coordinate movement; this involves sensory information processed by the inner ear and brain to help sense motion and equilibrium to control balance and eye movements

The brain uses input from all three systems to send information to the different parts of the body involved in balance.

Sometimes, different sources may send conflicting information. For example, the eyes may incorrectly perceive motion when the body is actually standing still. The brain may be able to correct this conflicting information in time to prevent falling, but sometimes a person may lose their balance and fall.

With age, the body’s ability to adapt to conflicting information can weaken. This can reduce reflexes and general agility, ultimately leading to a fall if balance is lost or altered.

What Can Negatively Affect Your Balance?

Many different things can reduce balance and make a person more likely to slip and fall. These can be physical conditions, behaviors, or environmental influences.

Vestibular disorders

Vestibular disorders commonly cause balance problems that can lead to falls. Vestibular disorders may result from disease or injury in the inner ear or certain parts of the brain.

Vestibular disorders can cause many side effects, such as:

• Vertigo, dizziness, lightheadedness, or spinning sensations
• Imbalance and spatial disorientation, such as difficulty walking straight
• Vision problems, such as light sensitivity, difficulty focusing, or poor depth perception
• Hearing issues, such as tinnitus (ringing or buzzing in the ears)
• Cognitive or psychological changes, such as difficulty concentrating, forgetfulness, or anxiety
• Other symptoms, including ear pain, nausea, or headaches

Vestibular disorders can occur in individuals at any age. While vestibular issues significantly impact older adults, they are increasingly reported in children. This can impair a child’s motor development and balance.

Other effects on balance

Other physical conditions and risk factors can affect balance and increase fall risk. These include:

• Reduced physical fitness
• Chronic conditions, such as arthritis or Parkinson’s, that cause physical weakness
• Poor vision
• Medications that cause drowsiness or dizziness
• Changes to blood pressure or blood sugar
• Neurological disorders, such as seizure disorders
• Head injuries
• Urinary incontinence that may lead to nighttime trips to the bathroom or hurrying to the bathroom

Different behavioral or environmental factors may affect balance. Drug and alcohol use, or lack of sleep, can cause dizziness that may reduce balance. Certain clothing, such as unsupportive shoes, or environmental factors, such as uneven floors in the home, can cause someone to trip or slip and fall.

Improve Balance at Home

Physical therapy is the best way to improve your strength and balance in the long term. However, there are ways to improve balance and reduce your fall risk at home.

Reduce your physical risk factors

• Keep up with your regular physical exams, including vision and hearing exams. Talk to a healthcare provider if you experience blurry vision or tinnitus, or believe you have experienced a change in your hearing.
• Make sure you get plenty of sleep at night.
• If your medication makes you dizzy or sleepy, talk to your prescriber or pharmacist to see if you can switch medication or change your medication schedule.
• Increase your physical activity, based on your abilities.

Practice fall prevention at home

• Keep clutter off floors, hallways, and stairs.
• Make sure you have sufficient lighting around your entryways and walkways.
• Consider installing grab bars or handrails in the shower or bathtub, or on both sides of staircases or long hallways.
• Keep throw rugs secured.
• Make sure your shoes have slip-resistant soles and adequate heel support.

Improve your balance with home exercises

Brian Werner, PT, MPT, FYZICAL’s National Balance Director, suggests the following home exercises to improve balance and reduce dizziness:

1. Stand in the corner of a room, with a chair in front of you for stabilization and safety.
2. Make sure your feet are side-by-side.
3. With eyes closed, perform the following head movements in this order:
   1. Look up (hold for 5 counts)
   2. Look straight ahead, turn your head so you look to the left (hold)
   3. Return to center, turn your head so you look to the right (hold)
   4. Look straight ahead, then look down (hold)
   5. Return to center, tilt your head to the left (hold)
   6. Return to center, tilt your head to the right (hold)
4. Open your eyes.
5. Place one foot next to, and just in front of, the other foot. The instep of one foot should touch the big toe of the second foot.
6. With eyes closed, repeat the same head motions listed above.
7. Switch feet, and repeat the head motions with your eyes closed.
8. Place one foot in front of the other so that the heel of one foot is touching the toes of the second foot.
9. With eyes open, repeat the head motions. 
10. Switch feet, and repeat the head motions with eyes open.
11. Stand on one foot, holding onto the chair if necessary. 
12. Repeat the head motions above with your eyes open.
13. Switch feet, and repeat the same head motions with eyes open.

Try and do these exercises twice a day for maximum effect.

Using Physical Therapy and Vestibular Rehab to Improve Balance and Fall Prevention

Home exercises and fall prevention techniques can significantly improve balance and reduce the risk of slipping and falling. However, physical therapy and vestibular rehab can offer long-lasting solutions.

What is vestibular rehab therapy?

Vestibular rehab, also known as vestibular rehabilitation therapy or vestibular therapy, is a highly specialized form of physical therapy that helps to address and resolve symptoms of vestibular dysfunction or disorders. This includes:

• Dizziness
• Tinnitus
• Vision problems
• Difficulty focusing
• Imbalance when walking

Vestibular rehab can help people function and feel better, whether they are experiencing temporary symptoms or permanent damage.

FYZICAL uses a Vestibular/Balance Retraining Physical Therapy model that helps reduce and even eliminate many symptoms that contribute to balance and fall risk. This model can address vertigo, disequilibrium, motion sensitivity, visual instability, and lightheadedness to reduce the risk for future falls.

The vestibular rehab program at FYZICAL has three primary aims:

1. Decrease dizziness and visual symptoms
2. Increase balance and walking functions
3. Increase general activity levels

If one part of your balance system is injured, your brain tends to overcompensate with the other two balance systems. FYZICAL’s vestibular and balance therapy program uses specifically prescribed movements to initiate, restart, and complete your body’s natural healing process.

Balance therapy also combines strength, cardio, and flexibility to encourage your overall health. Working on your balance with physical therapy and vestibular rehab can make you stronger and more agile at any age, improving your health and confidence.

The benefits of combined physical therapy and vestibular rehab include:

• Strength, which helps your body’s nervous system work more efficiently to communicate with your muscles
• Joint stability, which can improve your ability to control and maintain joint movements while reducing stress on your knees, ankles, hips, or shoulders
• Coordination, which gives you greater control over your body and improves communication between your brain and the other parts of your body
• Agility, which helps you react and change position faster so you can have a better chance of catching or bracing yourself
• Body awareness, which helps you understand how your body and limbs are oriented in your environment so you can move smoother and faster.

What to expect from balance therapy and vestibular rehab

The first step in FYZICAL’s vestibular and balance therapy program is an initial consultation and evaluation to determine your specific symptoms, conditions, and needs.

Then, the FYZICAL Physical Therapist and Physical Therapist Assistants will work with you to create a Plan of Care.

During therapy, you will complete various balance, gaze stability, and general conditioning and strengthening exercises to improve your balance.

Some people experience a temporary increase in dizziness while performing these exercises. This is actually what you want! Just as building strength can make your muscles sore, you may also experience imbalance and dizziness as you work on balance retraining.

Each time you complete a balance exercise, you are training your brain to re-learn and improve how to maintain equilibrium, stabilize your eyes during head and body movement, and normalize balance reaction. As you progress in your vestibular therapy plan, you will see your dizziness improve and even resolve. Patience is important here!

Your physical therapy team may periodically update your home exercises and perform reevaluations to check your progress. Finally, your team will help to discharge you from therapy.

Get the physical therapy and vestibular rehab you need to improve balance and prevent falls

The experts at FYZICAL Therapy & Balance Centers can offer the most effective solution for balance and vestibular patients. Our clinicians receive world-class training from vestibular dysfunction and balance experts.

While many physical therapists may treat balance based on what they “feel” is right, FYZICAL therapists offer a customized program based on research and evidence. This takes the guesswork out of your balance program and gives you a progressive framework with a clear direction based on your specific conditions and needs.

Just as physicians prescribe a specific dose of medication for their patients, FYZICAL “prescribes” an appropriate balance and vestibular therapy program to our clients.

The best part? You can receive a consultation and physical therapy sessions without needing a referral.

Contact one of our many convenient locations to request an appointment and take the first step toward a healthier, more confident, better balanced life!