For Seniors, Balance Issues can Impact Overall Health

At the Atlanta Sport and Spine Center, Laurel Brigham, a physical therapist with specialized training in balance issues, is helping several of her older clients to stay on their feet. As they move around the specialized balance equipment in her exercise room, they are challenged to tap randomly with one foot while studying themselves with the other. Or they practice walking on a narrow foam tube, their arms extended to the side, one foot following closely immediately behind the other. To steady themselves, they can touch a nearby wall.

For those in their sixties and beyond, practicing the skills to help walk with confidence and avoid falls is an important part of staying healthy. According to the National Institute on Aging, one out of every four older Americans will fall this year and, according to the Centers for Disease Control and Prevention in Atlanta, one out of five of these falls will lead to a serious condition, like a broken arm or leg or a head injury.

Laurel Brigham works one-on-one with a client to improve balance.

Moreover, the lengthy hospital stay or rehabilitation in a medical center can weaken a person’s health and make another fall much more likely. As Brigham works one-on-one with clients to help them master the exercises they’re practicing, her concern is how to make life easier and longer for them.

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“I want people to see that working on important things like balance and strength can be fun,” she says. “We’ve got music playing to create a fun atmosphere and different station focused on balance challenges and strength needed for functional activities.”

For seniors, staying safely on their feet as they move through their days can be difficult. As we age the muscles in our legs and back slowly lose their strength. This process, called sarcopenia, can start decades before we notice it. Brigham says the familiar phrase, “if you don’t use it, you lose it,” is an important part of staying steady on our feet.

“If we stay sedentary or don’t work to regain lost strength, we run the risk of losing important muscle mass needed to perform daily tasks such as going for a long walk, walking up stairs and the endurance to move over an extended period of time.”

Conditions like arthritis or osteoporosis, which affect bones and joints, can slow us down and affect our range of motion.

Medical researchers say that as we age, we also begin to lose the sensitivity we’ve developed about how our body is moving in the space around us. What they call proprioception may change. Problems with our feet and ankles may also make it difficult to walk normally.

A big factor in keeping our balance is a healthy inner ear. What is called the vestibular system plays an important role in maintaining our equilibrium. A common cause of dizziness and vertigo is BPPV, which stands for benign paroxysmal positional vertigo. According to medical experts, the condition is caused when calcium carbonate crystals break free in the inner ear and become part of the fluid in semicircular canals there. A technique has been developed to move the crystals back to where they belong and out of the canals of the inner ear.

Better balance may be possible just with more exercise, like walking.

At Emory Brain Health Center’s Dizziness and Balance Clinic, Alli Nogi, with a doctorate in physical therapy, sees patients for whom balance issues have taken much of the joy out of life. The fear of falling can keep affecting us psychologically as well as physically.

“If individuals start feeling unsteady,” Nogi says, “whether they do it consciously or unconsciously, they start limiting their movement, first inside the house and then also out in the community. They might not be walking as much or do anything that over time can challenge their balance.”

At Emory, they use a team approach to diagnose balance issues. In addition to the physical therapy component of care, a neurologist may be involved, or a vestibular technician may be called upon to test the inner ear. With proper care, Nogi feels balance issues can get better.

“I wouldn’t be doing what I’m doing if I didn’t believe that they were correctable, you know, we always want to be 100 percent but I think with different simple intervention, like just going for a walk, or even standing in the corner, having your eyes open and then closing your eyes, that can actually start challenging your balance in a very safe way and start improving it a lot of times.”

Being more active carries its own rewards. Walking for as little as 10 minutes a day, Nogi says, can be what she calls good homework for her patients. It strengthens the legs and all those muscles that get a workout when we put one foot in front of another.