by James A. Heuer, PA
Between 30% to 65% of people suffer from dizziness and lack of balance, or disequilibrium, following a traumatic brain injury (TBI). Balance is the ability to keep your body centered over your feet. One’s physical strength, cognitive ability, and coordination all play a role in balance.
Following a TBI, many people also experience difficulties with gait, which is defined as a person’s manner of walking. A common symptom, vertigo, makes you feel like your surroundings are moving, which can result in an imbalance in a person’s gait.
Many factors help gauge the impact a TBI has on a person’s balance, including where the actual injury occurred within the brain, how serious the injury was, and any other additional injuries. Medications used to manage pain can also cause balance problems due to the common side effects of dizziness and lightheadedness.
Eyesight is often a cause of poor balance and, in the case of TBIs, serious accidents can result in injuries to the eyes with resulting double vision, partial loss of vision, depth-perception problems, and/or convergence insufficiency, which is when your eyes don’t work together. In addition to ocular injuries, vestibular (inner ear) impairments can also have a great impact following a TBI. The vestibular system is the sensory system that provides the leading influence to the sense of balance and spatial direction when coordinating movement with balance.
The vestibular system is made up of tiny organs and semicircular canals inside the inner ear. The canals contain fluid and fine hair-like sensors that monitor your head’s rotations. When the head moves, particles of calcium carbonate, called otoliths, pull on the hair cells, stimulating the vestibular nerve, which signals the position of the head with respect to the rest of the body. The particles, or crystals, are sensitive to gravity and linear movement. Any damage to the vestibular system from a TBI will affect your balance and gait.
After the common causes of balance impairment are initially ruled out, an array of different medical providers can assist in the diagnosis and treatment such as physiatrists, neurologists, and otolaryngologists, aka ear, nose, and throat (ENT) specialists. Two tests that are commonly used to identify balance difficulties are the Berg Balance Scale and the Dynamic Gait Index. Both exams will be used to test and keep track of the progress made in the process of regaining balance and gait.
There are multiple methods you can try to improve your balance on your own and/or under the direction of a physical therapist. You can practice walking in different conditions and different inclines, on various structures, such as grass, wood, and asphalt. Challenging yourself to walk longer distances and in different venues such as parks or shopping malls can help.
Every case is individual and each person’s recovery is unique. Research shows that three months is the common timeframe in which people with a TBI can walk on their own, but progress and improvements can continue for years. Individual pre-existing impairments can add a significant time extension to the recovery and the degree of success in regaining one’s balance and gait. The key is to remember every improvement, as small as it may seem, is progress.
James A. Heuer, PA is a personal injury attorney helping individuals with TBI after suffering one himself. He is located in Minneapolis, Minnesota.
