Vestibular
Amy deBuhr, physical therapist at On With Life, discusses the vestibular system and how it can be affected by a brain injury.
What is the vestibular system and how does it affect balance?
Your vestibular system, also known as your "inner ear," includes three semicircular canals (detects when you move at an angle) and two small organs called otoliths (detects when you move forward/backward and side-to-side). The information your brain receives as fluid moves within these organs lets you know your position in space. The information you receive from your inner ear is combined in your brain with additional information from your visual system (what you see) and your proprioceptive system (the sensations you receive from your joints and muscles as you move). It is the combination of information from these three systems that gives you your sense of "balance!"
Can the vestibular system be affected after brain injury?
Yes! When your brain has incomplete or inaccurate information from any of these systems you will experience balance changes and may be more likely to fall. In the case of a high-velocity traumatic brain injury, damage can occur to the fragile hairs in the inner ear that detect fluid movement. In non-traumatic injuries such as stroke, the vestibular system can be damaged if the structures in the brain that interpret the information from the inner ear are injured. If the information your brain receives from your vestibular system is not accurate, your brain will try to compensate using the information it receives from the other two systems (vision and proprioception).
How can problems with my vestibular system be treated?
During rehabilitation, we look at the balance system as a whole, how vestibular, visual and proprioceptive systems working together. We combine treatments to address vestibular dysfunction with targeted treatment for the other two components of balance. To address the visual system, we work together with optometrists who specialize in vision rehabilitation to target the exercises and/or adaptive devices needed to specifically address each person served's visual challenges. The proprioceptive system is rehabilitated through strengthening and feedback-based therapies along a progression from stationary balance activities, progressing to movement-based balance activities and finally advancing to high-level coordination. Having the right equipment is also an important component of any balance assessment and rehabilitation program. At On With Life, we are fortunate to have devices such as vestibular assessment goggles, the Biodex balance system, Dynavision, overhead gait system and aquatic therapy pool to help persons served achieve the safest balance possible.