with photos….

By Steve Bigham

Christine Krebs is one of millions of older Americans who suffer from dizziness and balance problems. The Southbury resident has experienced occasional wobbliness since she was a kid, but her prism glasses (to stop double vision) and weakening muscles have only made matters worse.

But she is getting help at the Physical Medical Center of Southbury, a division of Danbury Hospital. There, physical therapist Debbie Howard is applying a variety of drug-free techniques to help her patient regain her balance.

Balance disorders and dizziness are usually caused by problems in one of three body systems: vision, proprioception or vestibular.

“We get information about keeping our balance from what we see,” Mrs Howard explained. “We also get information proprioceptively, which means from our joints, muscles, and sensations. Our inner ear mechanisms also help us keep our balance. Problems in this area can present vestibular problems, such as vertigo.”

Eighty-five percent of those who suffer from dizzy spells have the vestibular disorder, which, according to researchers, is found in 40 percent of people over 65.

Fortunately, the most common vestibular type, benign paroxysmal positional vertigo (BPPV) is also the most treatable. This is believed to be caused by tiny bony fragments and calcium deposits that become dislodged and are floating in the inner ear. Therapists like Debbie Howard or Christine Talarico, who works out of the Danbury office, can perform a maneuver that removes this debris so that the patient can recover more quickly from these dizzy periods.

Physical therapists can also help with balance problems that are caused by other things, such as decreased flexibly, strength, balance, and proprioception. After an evaluation, a treatment can be developed. This usually involves home exercise and in-office therapy. Therapists will often take away one sensory system (like having patients close their eyes) to challenge another. Using a wobble board, patients are forced to rely more on their vision and less on their muscles.

Mrs Krebs, who has trouble walking, tends to keep her feet wide apart in an effort to maintain her balance. Her therapist is working to narrow that base so that she can more easily put one foot in front of the other.

“We want her to eventually be able to stand with just one foot on the floor. When walking, eventually you are on one foot [while the other is moving forward],” Mrs Howard explained.

The therapy can be difficult, often involving head and body positioning techniques, eye exercises, and gait training.

“You have to challenge their central nervous systems,” explained Mrs Talarico. “I tell people they’re going to get worse before they get better.”

But they do get better eventually and are able to return to a normal life, avoiding falls and other accidents.

The human body’s balance system involves many different parts, including the eyes, feet, and inner ears. As we move, the brain is taking in large amount of information from the world around us. When that information is incomplete, it tends to throw off our balance, often times spinning it out of control.

Older people experience loss of balance more frequently and are less equipped to deal with it since many already have problems with their vision. (Close your eyes while standing for a moment and you will discover how vital eyesight is to maintaining your balance.)

Older people also have slower reaction times and decreased muscle strength. This makes them even more vulnerable to falls, which are the leading cause of injury to those over 65. Falls cause 200,000 hip fractures in older Americans each year. Half of them die within a year of the injury.

Today, dizziness is one of the three most common complaints physicians hear, making it almost as common as headaches and backaches.

“In the past, people were told to just rest and were given medicine,” Mrs Talarico explained.

Fortunately, there are new diagnostic techniques and awareness of the effectiveness of vestibular rehabilitation, which can successfully treat most patients.

Take the dizziness out of your world. Ask your doctor about what can be done for you.