Balance

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Balance
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Balance Definition

• Balance is a multidimensional process and is the
  result of interactions between the individual,
  the task, and the environment. ANNE
  SHUMWAY-COOK

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Normal Postural Control (Balance)

• Balance requires keeping the Center of Mass
  (COM) over the Base of Support (BOS) during
  static and dynamic situations.
• Neural components of postural control
• Sensory processes
• visual, vestibular, somatosensory
• Central processing
• a higher-level integrative process
• Effector component
• sometimes referred to as the neuromuscular
  component
• postural alignment, ROM, muscle force, power
  endurance

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This system has 3 categories of sensory inputs
into our brain to provide spatial orientation
cues Visual (from the eyes). Vestibular
Two types of sensors in the inner ear. Rotation
sensors in the semicircular canals, provide our
sense of head turning. Gravity sensors in the
otolith organs, provide our sense of which way is
straight down, like a plumb line. Somatosensory
(body sense) Pressure and muscle sense from the
skin and extremities.
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How Common is Visual impairment?
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• Impaired vision is highly prevalent and commonly
• unreported in the elderly population
• Keane EM, OConnor M, Coakley D, Walsh JB. Eye
  screening in the elderly. Ir Med J 1997 90
  1412.

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• In a screening study of the senior citizens in
  the community, the visual acuity was measured
  with a standard Snellens chart.
• Nearly 72 had impaired vision.
• There was a significant association between
  visual impairment and
• female sex,
• history of diabetes or glaucoma, cataract,
• infrequent eye examination
• Wun YT, Lam CC, Shum WK. Impaired vision in the
  elderly a preventable condition. Fam Pract 1997
  14 28992.

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• A North London Study of 1547 people showed that
  30 of the sample population aged 65 years and
  older were visually impaired (less than 6/12) in
  both eyes and
• More than 72 of this bilateral visual impairment
  could potentially be improved by surgery or
  spectacles

Reidy A, Minassian DC, Vafidis G et al,
Prevalence of serious eye disease and visual
impairment in a North London population
population-based, cross sectional study. BMJ
1998316 1643-1646
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• In a recent study visual acuity was measured in
  population based nationwide samples of British
  elderly people.
• Such measurements were carried out in the context
  of the national diet and nutrition survey (NDNS)
  of people aged 65 years or over.
• NDNS participants were visited at their home by a
  nurse who measured visual acuity at 3 meters,
  using the Glasgow acuity card (GAC) method.
• Prevalence of visual impairment increased
  significantly with age
• (6574 years 3.1
• 7584 years 11.6
• 85 years 35.5, ( p-0.001).

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Visual Impairment and Fall