The Wall Street Journal just published this article citing new research on how humans maintain their balance.
What was of particular interest to me was that foot placement is the primary mechanism for maintaining side-to-side balance or sway. Going along with that researchers found the biggest reason for falling, accounting for 41% of all falls, was due to incorrect weight shifting.
Clinically, I have found the same thing when I have evaluated and treated the foot and ankle;
- patient's improved their balance by at least 1 grade
- persons who could not perform single leg balance now could
- individuals who were chronic fallers, no longer fell
In both the Foot and Ankle and Balance Enhancement and Fall Prevention Classes we evaluate and treat sway using a diagnostic motion evaluation called Foot Clocks.
The article also mentions that the body has three main systems that help us stay balanced; The visual, proprioceptive and vestibular system.
The research has shown if at least two of these systems are impaired, people tend to have trouble with balance.
As we know older individuals rely more on the visual system and report difficulty walking as well as experiencing a higher rate of falls at night secondary to the dark conditions. This problem is easily diagnosed and managed by prescribing glasses, surgery for cataracts, and improving home lighting. I believe that our health care system is doing an adequate job in addressing the visual component of balance.
Unfortunately, the proprioceptive and vestibular systems are not routinely evaluated nor treated by health care professionals for the following reasons:
- Little is know about these systems when compared to the visual system
- They are expensive to diagnosis and manage
- When we consider proprioception with regard to balance the most important structure is the foot. Health care professionals do not learn how to evaluate and treat the feet for balance and function
- Health care professionals rarely evaluate or treat the vestibular system unless there is a blatant dysfunction, like vertigo.
The article mentions that improved diagnostic measures need to be incorporated by health care professionals to maintain the integrity of all 3 systems responsible for balance.
To read the full article click the link below:
http://online.wsj.com/article/SB10001424052702303983904579093560173066446.html?goback=%2Egde_2499430_member_276495644#%21
