If you have ever experienced a balance disorder, you know how quickly your life can turn upside down—literally. Balance disorders (dizziness, vertigo, spinning, feeling of falling) can be caused by something wrong in the brain, the nervous system (joints and muscles), the eyes, or the inner ear. The brain receives, interprets, and processes information from those other systems. Balance is the result for anyone who has a normal, healthy body. A balance disorder is the result for those with a dysfunction in any one or more of these feedback systems.

A study in 2006 indicates that both types of disorders (peripheral balance disorder and central balance disorder) benefit greatly from physical therapy, though the patients with peripheral disorders appeared to receive the greater benefit of the two. Peripheral balance disorder (peripheral vestibular dysfunction) can be caused by viral infection or lack of oxygen to the vestibular nerve, labrynthitis (inflammation or infection of the balancing canals in the inner ear), Meniere's Disease, tumor of the cranial nerve controlling the hearing and balance system of the ear, certain medications, head injury, or vertigo that results from changes in position but is benign (BPPV). Central balance disorder (central vestibular dysfunction) can be caused by diseases such as MS or Parkinson's disease, stroke, or head/brain injury.   

Although physical therapy (PT) programs have proven successful for peripheral vestibular dysfunction, PT results for central vestibular dysfunction had not been as well described prior to the study published in January of 2006, in which there was a chart review of 48 patients having a diagnosis of central vestibular dysfunction. The different diagnoses included in this study were stroke, cerebellar degeneration, cerebellar stroke, posttraumatic central disorders, mixed central and peripheral vestibulopathy, or central vestibulopathy that was not specified. Therapy was administered by physical therapists skilled in treating patients with vestibular and neurologic disorders.

They customized therapy programs for each individual patient. The authors of this review concluded that patients with central vestibular disorders did show significant improvement in their functional limitations caused by dizziness and imbalance—even if they suffered from severe dysfunction. However, since improvement was not as remarkable as that of patients with peripheral vestibular disorders, the authors suggest that larger studies with emphasis on outcomes for each diagnostic group would help prove which patients benefit the most from PT. Meanwhile, PT is indicated for all persons with balance disorders. 

For further information, refer to: "Physical Therapy for Central Vestibular Dysfunction," Brown, K MS PT NCS; Whitney, S PhD, PT NCS ATC; Marchetti, G PhD PT; Wrisley, D PhD PT NCS; Furman, J MD PhD; Archives of Physical Medicine and Rehabilitation, Volume 87, Issue 1, January 2006.