Medical Conditions Related to Brain Injury
Balance Problems After Brain Injury
Last Updated:
Balance is a very important component to being able to perform everyday activities, such as standing up, bending over to pick up something off the floor, reaching for something on the top shelf, driving a car, or going to the store. The responses the body has to maintain balance generally occur automatically, yet these automatic responses can be impaired for people after a head trauma. Those who have had brain injuries commonly have balance problems that make it difficult for them to participate in everyday activities like they used to.
Maintaining balance is a complex process in which information coming in from the eyes, inner ear, and sense of touch tells the brain what position the body is in, as related to its surroundings. The brain then processes the information and passes it on to the muscles and joints in the body to coordinate the movements needed to maintain balance. The brain also passes on information to the eye muscles to help position the eyes so the person can see clearly while moving.
After a brain injury, there can often be a slowing or a break in the information process coming into or going out of the brain. This may make it difficult for the person to maintain balance while sitting up, standing up, walking, moving around in a busy environment or doing normal everyday activities. Balance may be worse with certain activities or if the person is trying to multi-task (for example, attempting to walk and talk at the same time).
If balance is a problem while the person with a brain injury is in the hospital, ask the doctor to explain the severity of the problem. Also ask what type of impact the balance issues may have on the person’s ability to return to his or her previous activities. Some additional questions to ask the doctor or physical therapist are:
- What situations or environments may make the person unstable?
- What precautions should be taken to help the person better maintain balance?
- What changes should be made in the home to reduce the risk of the person falling?
- What type of supervision will the person need to be able to perform certain activities safely?
If the person with a brain injury has never received therapy, and there are problems with balance that were not there before the head injury, then it is important to inform the doctor about these problems. It will be helpful to give some specific examples of when the person loses balance. A primary doctor, even if not a specialist in balance issues, should be able to direct you to a qualified person to perform a complete balance assessment. The specialist will be able to assess and determine where the breakdown in the balance process is occurring.
The specialist may not always be a medical doctor. Sometimes, the primary physician may refer you to a physical or occupational therapist that has experience working with people with balance problems. The therapist will ask questions about personal and family medical history and perform a balance evaluation. After determining the areas of difficulty, a customized treatment plan can then be created to address the problems. With treatment, improvements can be made to increase a person’s ability to maintain balance.
If a person did not receive any therapy to help improve balance at the initial onset of the injury, it’s not too late to explore what options are available at this time. Successful therapy for balance issues can be started at many stages in the recovery process of a brain injury.
For more information on balance issues and to find local therapists specializing in balance therapy, visit www.balanceandmobility.com
Sary H. Korrick PT is the Physical Therapy Clinical Education Supervisor at Shepherd Pathways, a post-acute facility specializing in brain injury in Decatur, Georgia. Ms. Korrick is a 1981 graduate of the Ithaca College Physical Therapy program. She has worked at Shepherd Pathways since it began 5 years ago. She has completed a competency course in Vestibular Therapy.