Synergy Rehab and Wellness
HOW TO MANAGE YOUR DIZZINESS AND BALANCE PROBLEM Dr. Tobin Forbus DPT
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TABLE OF CONTENTS
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THE PROBLEM WHAT ARE THE CAUSES AND SYMPTOMS OF DIZZINESS? HOW DO I KNOW IF I AM AT RISK? THE SOLUTION TO YOUR DIZZINESS AND BALANCE PROBLEMS DISCLAIMER
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The Problem
Dizzinesss and falling is not only a problem for the elderly, there are inner ear problems that can cause dizziness and falls in people of any age. A common cause of dizziness is known as benign paroxysmal positional vertigo (BPPV). On average, about 1.6% of the population has BPPV each year (Neuhauser and Lempert, 2009) About 20% of all dizziness seen in medical offices is due to BPPV. About 50% of all dizziness in older people is due to BPPV.
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WHAT ARE THE CAUSES AND SYMPTOMS OF DIZZINESS?
A chieving good balance when walking, getting out of the chair and getting out of bed in the middle of the night is one of those things like a sixth sense; we just know how to do it. However, when we are getting older, some people find this sixth sense doesn’t work as well as it used to. Doctors report that people over sixty-five years of age often complain of difficulty in balancing; they feel unsteady at times. Unfortunately, it’s not unusual for people to fall, and that can lead to much more serious problems and consequences.
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SYMPTOMS OF DIZZINESS These can vary. Some people complain of a sensation of spinning or vertigo. Some people feel light-headed, all the room spinning around or a feeling of floating rather than being steady on the ground; a feeling something like being on a ship or boat. The practical problem is that these feelings can cause problems walking or they might bring on feeling sick or finding it hard to concentrate or even depressed. People can become afraid to move about and develop a fear of falling that affects everything they do. And worst of all, it makes it much more likely that they will fall again and putting them at a greater risk of injury and the consequences that relate to falling. WHAT ARE THE CAUSES OF THIS DIZZINESS? In many cases, these symptoms are the result of some defect in the functioning of the inner ear. Sometimes the symptoms are due to some disorder in the nervous system of the body, which is responsible for balance, and also the sense
of where we are in the space around us (called proprioception). Dizziness is feeling light-headed or not steady or feeling faint. Vertigo is a feeling of spinning around or the feeling that things around us seems to be moving when they are stationary in reality.
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Mostpeoplecanfeel occasionallyunsteadyordizzy. Just seeingamovieshowing a car or airplane whizzing through the mountains can make us feel dizzy or unsteady even though we are firmly seated. These are not the sensations that we are concerned about. Of course, there are other causes for lack of balance and dizziness. Car accidents, infections in the inner ear, diseases like Ménière’s disease, brain or nervous system conditions like Parkinson’s disease and even side effects from medication use can all cause balance problems and/or dizziness. Older people often usemedicationsmore frequently and the side effects which often include dizziness are, of course, then more likely to be felt by older people.
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Feeling dizzy and unbalanced is not necessarily simply part of getting older. There are specific conditions where there are diseases or mechanical issues of the inner ear which can cause us to feel dizzy. While this is true, in many cases the cause is due to, or made worse by, a person’s poor posture, a reduction in their strength, movements and stability. Physical therapists like us, who have expertise in treating balance problems, can perform an expert evaluation to assess your walking, strength, posture, balance, andmovement patterns to assess your risk for falling. We will be able to find out the most likely reason why you are getting dizzy and develop a research-based plan to correct the problem. If appropriate, we will recommend that you see a doctor if it appears there are medication concerns or issues related to your brain or central nervous system. We can quickly screen and help you assess the cause of your dizziness. We are the neuromuscular and balance specialists.
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• Balance is a skill – a learned motor pattern… you can keep it or relearn it by PRACTICING IT!!! • Falling and fear of falling as you age should NOT be accepted as a “normal” process of aging. • The causes of falls can be found and addressed.
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HOW DO I KNOW IF I AM AT RISK?
Test 1 Single Leg Stance Test
1. Stand near a sturdy surface (table or counter) 2. Without holding on, lift one leg off the ground 3. Count how many seconds you can stand without putting your foot down or touching with your hand Check how you compare with others your age
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Age
Average Balance Time
40-59
25-27 sec
60-69
20-25 sec
70-79
10-15 sec
80
5-6 sec
Do not attempt to do this test alone—make sure that you have someone next to you to decrease the potential risk of falling.
Test 2 5 Time Sit To Stand Test 1. Sit in a standard chair with your back against the back of the chair (make sure the chair isn’t touching a wall 2. Cross your arms over your chest 3. Stand up and sit back down 5 times as fast as you can. Check how you scored compared to others your age.
Age Average
Time To Complete
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60-69
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70-79
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80-89
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What it means: If you took longer than the average you may be at higher risk of falling. On the single leg stance test, scoring 5 seconds or less automatically places you at risk of injurious falls. Seek help very soon! Other scores that are less than average are still a great reason to be evaluated to determine the cause and make sure you are doing what you can to avoid falling.
THE SOLUTION TO YOUR DIZZINESS AND BALANCE PROBLEMS W hether your issue is due to an inner ear problem or a lack of strength and balance, there are effective treatments that can help! Do not settle for living a life of fear or limitation. After performing a thorough assessment, your Physical Therapist will develop a plan to address the causes identified that may put you at risk of falling or address the inner ear issue causing you to feel dizzy. When it comes to reducing fall risk, PTs are truly the experts and have a large body of research showing the benefits of skilled physical therapy at reducing your fall risk. We are able to develop an exercise program for you that will be appropriate for your condition and specific to the systems causing your problem. PTs will evaluate your posture, your strength, your range of
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motion, your conditioning status and the 3 major systems that contribute to balance and control. We then work with you to set goals and develop a plan to make consistent progress towards achieving them. One common treatment performed by Physical Therapists is called Vestibular Rehabilitation Therapy (VRT). VRT is a program based on exercise meant to encourage compensation in the nervous system that help correct problems from the inner ear. Our physical therapists will first do a thorough evaluation of your medical history, balance, gait and any movements you commonly need to do to compensate for your balance problems.
We will then develop a treatment plan ‘tailor-made’ to your condition. This planmay include such things as specific head, body and eye exercises and these will be intended to retrain the brain to better process signals from the inner
ear and coordinate these signals from the eyes and nerves with your muscles and joints to help you move more safely. There will be home-based activities for you to perform and a steady progression of challenges to make your nervous system steadily improve. In a certain common condition that we treat, called Benign Paroxysmal Positional Vertigo (BPPV), research shows that we can correct the cause of your dizziness on 1-2 sessions 81- 85% of the time! Imagine headaches, nausea, dizziness, fear, and unsteadiness better after 1-2 sessions! Even in rare cases where other intervention is required, VRT will still be important because
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the brain will still need retraining and home-based exercises will still be needed. We will determine the appropriate areas that require strengthening, identify why you are having loss of balance and develop a very specific plan that addresses your particular needs to help you get the best results in the shortest amount of time.
WHAT ELSE CAN I DO TO HELP PREVENT FALLS?
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Exercise regularly.
• Review your medications with your health care provider or pharmacist. • Have your vision and hearing checked. • Wear proper footwear. • Correct common home safety hazards. • Often multiple disciplines (PT, MD, ENT, Pharmacist) working together provides the best outcomes.
Don’t rush when performing activities. Don’t ignore the problem, get help!
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Summary : We help people just like you with balance and dizziness issues every day. Don’t just settle for living in fear or avoiding things you love to do, we can help you regain your active life style. Contact us today!
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Don’t Delay – Schedule An Appointment With Us So That We Can Help You With Your Balance Problems.
Phone - # 540-416-0503 Email - information@synergyrehabandwelthness.com Have more questions? We love to answer them. Call to schedule a free phone consultation if you’re not sure about your specific problem.
References:
The American Physical Therapy Association: http://www.moveforwardpt.com/ Centers for Disease Control and Prevention: http://www.cdc.gov/Homeandrecreationalsafety/Falls/adultfalls.html/ Home Safety Council: http://www.homesafetycouncil.org/SafeSeniors/sen_safeseniors_ w001.asp Center for Healthy Aging: http://www.healthyagingprograms.com/content. asp?sectionid=107 National Council on Aging: http://www.ncoa.org/ National Safety Council: http://www.nsc.org/safety_home/Resources/Pages/Falls.aspx The National Blueprint: http://www.agingblueprint.org/tips.cfm www.dizziness-and-balance.com disclaimer The author and publisher disclaim any warranties (express or implied) or fitness for any particular purpose. The author and publisher shall in no event be held liable to any party for any direct, indirect, punitive, special, incidental or other consequential damages arising directly or indirectly from any use of this material, which is provided “as is”, and without warranties. As always, the advice of a competent medical professional should be sought. The author and publisher do not warrant the performance, effectiveness or applicability of any sites listed or linked to in this report. All links are for information purposes only and are not warranted for content, accuracy or any other implied or explicit purpose.
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