Most often, we take our ability to balance for granted. Balance is just one of those things we do when we walk, move, and go about our daily lives. When it’s affected by a variety of different health concerns, however, it can make everyday things difficult. From standing to sitting to maneuvering from one side of a room to the other, these important functions can be much harder when you experience balance impairment such as dizziness or poor balance. Balance issues are more common in older adults, but that doesn’t mean it’s a normal part of aging. Balance issues can occur in people of any age, putting them at increased risk.

Chances are, you’ve experienced a sudden bout of dizziness or spinning at some point. If this occurs regularly and with similar symptoms, it’s important to see a Doctor of Audiology soon. At NYHD, we understand that balance disorders can be complex and have a lot of different causes, so it’s important to determine what’s causing your balance disorder. Many times, balance is affected by health conditions that should be treated promptly. During an appointment with our Doctors of Audiology, we can assess your symptoms and recommend the best course of management for you and your lifestyle.

What is a Balance Assessment?

A balance assessment or balance test is a set of tests that look at possible causes of balance problems. Balance is intricately linked to the mechanisms of the ears, eyes, brain, muscles, and nerves. Often, a Doctor of Audiology can assess your balance ability by looking at the functions of your inner ear, nerves, and other contributing systems to see whether something might be affecting your body’s ability to sense its position and location in the space around it. During a balance assessment, we can perform some of the following tests:

Comprehensive Audiological Evaluation

This is a complete hearing assessment that can look at many different ear functions and types of hearing loss you might be experiencing. Often, balance deficiencies accompany types of hearing loss or inner ear abnormalities. This test usually includes a physical examination where we can look at your ear canal for any wax impactions or anatomical problems. Then, we’ll perform some tests to see how well your inner ear functions. This might include listening to sounds or using some instruments that can measure whether your inner ear responds to stimuli.

ABR (Auditory Brainstem Response)

This test assesses the nerve that connects from the inner ear to the brainstem. This is done by placing some electrodes on the scalp that measure the nerve’s natural response when sounds are played through an earpiece. This test can ensure that balance and positional signals from the inner ear are being transmitted appropriately.

ECochG (Electrocochleography)

This test uses electrodes to measure electrical signals generated in the auditory nerve and inner ear when sound is received. It can also assess the environment of the inner ear and nerve.

VNG (Videonystagmography)

This test uses special goggles to monitor your eyes’ responsiveness and movements when you’re put in special positions and undergo different movements. By seeing which positions cause certain eye movements, we can get a better understanding of your inner ear function and different parts of your balance system.

What is a Balance Assessment?

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VEMP (Vestibular Evoked Myogenic Potentials)

This test is used to assess the function of the vestibular system by measuring the utricle, saccule, and vestibular nerve while simultaneously recording muscle activation based on the signals the brain sends in response to vestibular activity. This test can complement other auditory and vestibular tests to help diagnosis.

Rotary Chair Assessment

The rotary chair test may be used to help our Audiologists understand a patient’s vestibulo-ocular reflex—how your eyes respond to changes in head and body position. The test involves measuring eye movement as the patient sits in a computerized, mechanical chair that spins at varying speeds.

CDVAT (Computerized Dynamic Visual Acuity Test)

Dynamic Visual Acuity tests are designed to measure gaze stability in three dimensions to assess whether vestibulo-ocular reflex function is different when moving compared to standing still. This test tracks eye movement as a patient focuses on computer-generated images on a distant monitor while moving at a specified speed.

Why is a Balance Assessment Important?

A balance assessment with our Doctors of Audiology includes more than some tests— we also look at your medical history and discuss any health concerns that might be causing you to lose balance. These can often include cardiovascular problems, endocrine problems (like diabetes), neurological problems, visual problems, hearing problems, or proprioception problems. Additionally, some medications can cause balance issues; so can things like head trauma, concussion, and spine or neck issues. Often, balance problems can be indicative of untreated medical issues. Many patients are also concerned about a future fall or fall related injuries because of poor balance, so it’s important to partner with a Doctor of Audiology who can make a full assessment of your balance health and recommend a course of action.

What Can I Expect at NYHD?

A balance assessment begins with a full medical history so we can look for specific medical conditions that might be causing poor balance. We’ll also discuss your symptoms like dizziness, vertigo, motion intolerance, or tinnitus. It can be helpful to keep a record of these symptoms with notes like when and where you experience them. If you notice symptoms during specific positions, this can also be helpful for us. Once we have a better vision of your experience, we can perform the right tests to look for causes. When we have some results and a good idea of your balance deficiency causes, we can articulate it to the rest of your balance healthcare team.

Balance Assessment FAQs

Does walking improve balance?

Having a regular fitness routine which includes walking/ running, yoga, tai chi, stretching/ mobility, breathwork, and some form of resistance training, is ideal for keeping all elements of the balance system functioning well. Its found that those who spend a considerable amount of time sitting every day start to see their systems decompensate over time. This can lead to reduced balance function, and in some cases falls.

How can I improve my balance with age?

You can work to improve your balance by doing regular balance exercises and by undergoing a balance assessment to confirm any predispositions to problems.

How do you know if you have balance problems?

Some common signs of balance problems include vertigo, a sense of spinning or motion, loss of balance, unsteadiness, and lightheadedness.

How can I check my balance at home?

Stand with your feet together (or on one foot if able) and see if you can stay straight. Next, close your eyes and try again. Then, open your eyes and shake your head to disturb your vestibular sense.

How do doctors test for balance?

Depending on what we believe might be causing your balance issue, we will determine what series of tests might be appropriate. For most patients, a comprehensive evaluation with their primary care physician is the first step. Other physicians, including an otolaryngologist, cardiologist, or neurologist, may also be consulted. An in-depth case history is critical in the diagnostic process, followed by specific tests of the inner ear, the balance nerve, as well as the visual system. It is critical to understand because the balance system is complex in nature, there is not just one test that will provide us with all the answers. For this reason, a comprehensive test protocol, along with a multi-disciplinary collaborative approach is most beneficial.

At what age does balance decline?

Your natural ability to balance can start to decline as young as age 50 or 60.

Can balance problems be cured?

There are many potential causes of balance issues. This can range from benign and simple to correct, to complex including a variety of contributing/ interacting factors. Due to the complex nature of balance issues, it is always recommended to seek out a specialist who can work to appropriately diagnose your issue. Equally as important, is to have a multidisciplinary team that works collaboratively to identify potential causes as well as the path(s) to feeling better.

How do you measure body balance?

During a balance assessment, we test balance by evaluating your inner ear, the connections between your brain and your inner ear, and eye movements connected to proper balancing movements.

How do I know if I have good balance?

One simple balance test is to stand with your feet touching and close your eyes. You should be able to stand for thirty seconds or longer without losing your balance or swaying.

How do you prepare for a balance test?

Before your balance test, do not take any anti-dizzy or anti-nausea medications for at least 48 hours. It is also best not to eat for about two hours before the test.

How does a sense of balance work?

Your sense of balance is controlled by a mechanism in the inner ear known as the vestibular system which works with your visual system to stop objects from blurring when your head moves and help you maintain an awareness of the bodys positioning.

What part of the body controls balance?

Our sense of balance takes into account sensations from at least three parts of our body: 1) the inner ears, 2) the eyes, and 3) our sense of the ground with our feet (proprioception). Other components, including blood pressure, blood glucose levels, (de)hydration, migraine, and anxiety can also contribute to our sense of balance.

How do I get my balance back?

Even if your balance problems are due to a vestibular disorder, you can revitalize your balance through rehab or at-home balance training exercises.

How long does the balance test take?

Depending on where you have your balance assessment completed, this might vary. That said, a comprehensive balance assessment in a specialty balance center will typically include a series of tests taking approximately 2+ hours.

What causes poor balance?

Poor balance may be caused by issues including ear infections, head injuries, poor circulation, side effects of medication, or aging.

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Schedule a Consultation

Balance can be integral to your daily life and your ability to move, maneuver, and navigate. If you find that you’re having trouble with these things, our Doctors of Audiology can help find the right diagnosis and recommend your next steps. To schedule a balance assessment at our New York City office, contact us by calling  (212) 784-6125 or filling out our online form.