A sense of balance means plenty to a gymnast or circus tightrope performer, but many of us take the neuromuscular skill for granted. It also means a lot to the more than 250,000 older Americans who fall and break their hips each year.
Research shows such falls can be life-threatening for people of advanced age with serious health conditions. It is estimated about 15 to 35 percent of hip-fracture patients will die within 12 months because the injury sets off a chain of adverse events. Other people so fear another fall they stop living in an independent fashion.
Yet anyone in decent health can recover from hip fractures, even people in their 80s. In fact, it is never too late to begin a program to improve your balance to help prevent falls and provide greater mobility in later years.
“We can lose what’s called `functional reserve’ as we get older,” said Pamela Duncan, an epidemiologist and director of aging research at the University of Kansas Medical Center. “While once it was easy for a person to be distracted by a noise and keep walking, or maybe find their way with less sufficient light, now these tasks are difficult.”
Risk factors for falls among older adults include poor vision, especially macular degeneration that reduces the central visual field. Other kinds of sensory loss can also have an impact; some people, for example, lose feeling in their feet. Illnesses that discourage or prevent normal activities are another risk, since even the simple physical act of walking needs to be practiced for the muscles to fully “remember” how to do it.
Cardiovascular disease can lead to fainting spells and related falls. Alcohol use can lead to mishaps among aging persons. Stooped posture or improper spinal alignment are other concerns among geriatric practitioners.
Sometimes balance disorders are not age-related. Individuals with inner ear problems can experience a range of problems, along with people who have such debilitating illnesses as multiple sclerosis and Parkinson’s disease. Patients recovering from brain surgery can experience difficulties. Certain medications, especially strong antibiotics, can induce dizziness and balance irregularities in patients young and old.
“We see a whole range of clients,” said Jim Buskirk, chief physical therapist at Balance Centers of America, which has offices in Wilmette and Chicago’s Andersonville neighborhood. “The majority of individuals are coming to us with inner ear dysfunction.”
Buskirk compares the inner ears to a stereo system in reverse. The inner ears send messages back to the brain about balance needs. The electrical nerve impulses in both inner ears must match when communicating with the brain, but can get out of sync. The brain attempts to compensate and adjust, only to make it worse with even less harmonious neurological signals.
The result is dizziness, which can be accompanied by vision distortion, headaches, inability to focus, pressure in the skull, nausea, excessive sweating or an overall feeling of something similar to motion sickness.
There are therapies and preventive measures available to anyone with balance problems. For older adults losing balance capabilities, a physical fitness regimen is highly recommended. Duncan said research is overwhelmingly clear on this positive link.
“Exercise can be simple things rather than some concept of a major workout,” said Duncan, a spokeswoman for the 75,000-member American Physical Therapy Association in Alexandria, Va. “You can make it a goal to walk a bit farther distance each day or maybe practice getting out of a chair five times without using your hands.
“Another exercise is to stand at the sink holding on at the sides, then come to your tip-toes and lower yourself slowly.”
Some studies show tai chi, the ancient Chinese martial arts practice, affords tremendous improvement in balance. It is a gentle series of movements that both strengthen and stretch the muscles, which in turn support the joints. Other research indicates resistance training with light weights or elastic tubing can significantly improve balance and mobility among people in their 70s, 80s and even 90s.
The American Physical Therapy Association is sponsoring a special hotline Friday and Saturday from 9 a.m. to 5 p.m. to help seniors avoid falls and get answers to questions about their balance. One possible subject is how to eliminate home hazards, such as misplaced electrical cords, slippery surfaces in the bathroom, inadequate night light in the bedroom and general clutter around the house — particularly near the stairs and high-traffic areas. The hotline number is 800-955-7848.
In more than 10 years of practice, Buskirk has developed many successful therapies for non-age related balance disorders. Balance Centers of America was recently awarded a four-year contract to help address balance problems in pilots and sailors. Buskirk uses state-of-the-art approaches, including vision stimulation exercises and virtual reality devices.
He and other therapists also do the nitty-gritty work of customized standing and weight-shift exercises, depending on the diagnosis. One common therapy is to require clients to move from hard surfaces to less stable footing such as foam pads or mini-trampolines.
“The balance reflex mechanism can always be made to work better,” said Buskirk, who also serves as physical therapist for the Chicago Wolves minor league hockey club, whose players currently are playing for the Turner Cup championship and constantly pulling amazing feats of balance with every shift on the ice. “The same concepts we apply to the abilities of superior athletes can be beneficial for anyone with balance problems.”
