How does scoliosis influence balance?

(photo credit: Sharon Mollerus)

Balance is created through 4 main mechanisms in the body.

-Proprioception of the muscles: The length of muscles helps your brain understand where a body part is in space. For example the length of your biceps and triceps together helps to tell if you elbow is flexed or extended based on the length of the muscles.

-Visual cues: What your eyes see helps to determine if you are rightside up or upside down

-Pressure sensors in your feet: Differences in the pressure at different points on the sole of your foot tells you where your centre of mass is leaning. You then contract muscle in your legs to keep you standing.

-Vestibular response: Balance coming for your inner ear works like a gyroscope and accelerometer. When you turn your head quickly to look at something to your right, This system recalibrates your body’s visual and head position cues quickly so you can focus on what you are trying to see. This is the system that makes you feel dizzy after spinning around.

If you take one of these systems away, maintaining balance is increasingly difficult. For example try standing still for one minute. You might sway slightly. Now try standing still on one leg. You have now taken away pressure sensation in one foot and reduced your base of support making, it more difficult to maintain balance. Now stand on both feet with your eyes closed. As you take away visual cues you loose some balance information and again, sway slightly more. You can now attempt both standing on one foot with your eyes closed. You will notice the it is even more difficult to keep your balance when you take away 2 balance systems.

Now, imagine that your brain does not receive the correct information from one of these systems. This can be found in patients with idiopathic scoliosis. They demonstrate trouble with balance and mobility and more sensitive auditory canals than those without scoliosis. The information regarding head movements and vestibular response is altered. Further research studies have shown that patients with scoliosis have altered perception to visual placement of objects.

So what does this mean?

Several studies have shown that changes in your vestibular system are linked to scoliosis.   This puts you at a disadvantage when it comes to balance, walking, vision and mobility. Has we have seen, if you reduce the input from one of these systems, we are relying on the other systems to keep our balance.

How can this be fixed?

In order for you body and nervous system to understand that there is a deficiency and that it needs more information from the vestibular system it needs to be stressed. It functions in a “If you don’t use it you loose it” way. The more you stress the vestibular system, the more your body and nervous system need to give more information and attention to this system. Vestibular rehabilitation stresses this system and has been shown to improve balance, vision and walking. It uses a series of progressive exercises to improve deficiencies in the vestibular system, thereby improving balance.