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How can we help you?

Balance problems: what to do?

Interview with Sandrine Duay

To keep our balance, our brain takes three parameters into account: proprioception, the vestibular system and vision. If all the information sent to our brain matches up, we can keep our balance without even realising it. Unfortunately, due to certain pathologies, the brain sometimes receives the wrong information. The body's balance is then compromised, leading to dizziness and falls.

However, loss of balance is not inevitable, and it is possible to recover and maintain this ability through physiotherapy. Interview with Sandrine Duay, physiotherapist at Clinique Valmont.

Why is it important to work on balance?

Above all, balance training helps to maintain patients' functional independence, whether or not they are able to walk. Many of the activities of daily life involve sitting and standing, and require the maintenance of static or dynamic balance. For example, if we want to pick up an object from a cupboard, before raising our arms, our brain automatically increases our base of support, anchors our feet to the ground and readjusts our body position so that we have the necessary stability and can carry out the movement safely.

Working on balance also reduces the risk of falling. Nowadays, we know that falls are harmful: as well as causing physical trauma, such as fractures, they also cause psychological trauma, with the appearance of «fears of falling», which gradually leads to a sedentary lifestyle. Indeed, when a person is afraid of falling, they move less and less and tense up. They find themselves caught up in a vicious circle, which considerably increases the risk of falls through muscle wasting and other problems caused by a sedentary lifestyle.

What conditions can cause balance problems?

Balance problems can arise from a variety of causes.

They may be orthopaedic in nature, with the onset of joint wear or instability and progressive muscle weakness.
They may also be caused by a neurological disorder, which alters motor control, movement control, proprioception, muscle coordination, body schema, and so on.
These may be vestibular problems, governed by the inner ear.
Sometimes it's simply a question of natural ageing. Over time, the sense of balance and limb coordination deteriorate, and nerve signals are transmitted more slowly to the brain, which also processes the information more slowly. Reaction time is then longer to re-establish balance, increasing the risk of loss of balance and falls.

What do you offer in physiotherapy?

In physiotherapy, we work on the various problems associated with balance disorders. We begin by carrying out a full assessment to identify the main problems and highlight the areas that need to be improved to overcome – or even compensate for – these balance problems. To do this, there are several areas of action, depending on the patient's problem:

Strengthening muscles
Improving joint stability
Restoring maximum responsiveness to posture adjustments and catch-up reactions
Work on proprioception, to facilitate the transmission of body receptors
Restore confidence in balance
Teach patients at high risk of falling to fall as «well as possible».

Können die Übungen auch zu Hause durchgeführt werden?

Ja, wir empfehlen, die Übungen auch zu Hause durchzuführen, um die Progression zu erhöhen, das Erreichte zu erhalten und eine Verschlechterung der Beschwerden zu vermeiden. Es ist jedoch darauf zu achten, dass die Übungen so gewählt werden, dass sie keine Sturzgefahr für den Patienten darstellen. Daher sollte die Vermittlung der Übungen von einer Fachkraft beaufsichtigt werden.

Wir empfehlen folgende Übungen: einfache Propriozeptionsübungen auf einem oder beiden Füßen, mit offenen oder geschlossenen Augen; Verwendung eines Kissens oder eines Balancebretts; regelmäßige Aktivitäten wie Qi Gong; tägliches Spazierengehen usw.