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ODHHS Information
How the Balance System Works
(Source: Boystown Research Registry)
Human beings keep their balance when nerve signals from three different systems are accurately sent to and processed by the brain. The three different systems are the eyes (vision), pressure sensors in the legs and torso (proprioception), and inner ear balance organs (vestibular system).
VISION Vision provides necessary information to the brain about our relationship to the environment. As we move and see how objects in our world are changing, our brains calculate our body´s relationship to those objects.
PROPRIOCEPTION Humans seem to rely primarily on signals from the pressure sensors in the legs and torso (proprioceptors) to maintain good balance. Birds and fish rely primarily on their inner ears (vestibular) system for balance. Since humans stand on only two legs, we must continually use muscles to remain stable.
VESTIBULAR The inner ear balance organs (vestibular systems) send signals to the brain about head and body movements relative to gravity. The brain selects the most accurate signals from the three balance systems and sends messages back to the muscles of the limbs, torso and neck to keep us stable and to keep our view of the world upright. The more signals the brain receives and sends, the better the balance. Sometimes the signals the brain receives or sends are disturbed, so balance becomes difficult.
BALANCE PROBLEMS AND HEARING LOSS In most individuals, the brain receives appropriate and intact signals from all three systems. However, the temporary loss of one of these systems can result in a period of instability. For example, changes in signals from a damaged inner ear vestibular system can result in a sensation of dizziness; or a visual problem that causes blurring or double vision may cause a sensation of unsteadiness or disequilibrium. The hearing and balance organs are connected to each other within the inner ear. Because they are connected, about 30% of profoundly deaf persons are estimated to have vestibular (inner ear balance) problems. Hard of hearing persons may also have vestibular problems. Some of the signs of impaired vestibular function can include: infants who cannot sit unsupported by 6-7 months; infants who are not walking by 15 months; clumsiness; difficulty walking on uneven surfaces; poor balance in darkness; difficulty riding a bicycle; disorientation when swimming with eyes closed; and difficulty keeping a stable view of the world when you are jogging or riding in a car over a bumpy road.
IMPROVING BALANCE To help overcome balance problems due to impaired vestibular function, the brain needs to receive added information from the visual and proprioceptive systems. The more signals the brain receives from the two remaining systems, the better the balance will be. Here are some suggestions for improving signal strength and interaction from vision and proprioception (muscles) systems:
  1. Use your eyes as much as possible.
  2. Place nightlights in bedrooms, halls, and bathrooms.
  3. Train your leg muscles and increase signals from both the legs and feet by walking barefoot on a variety of uneven surfaces (grass, sand, trails, hills, etc.).
  4. Practice sitting on a narrow beam with your feet dangling in the air. This helps your hips and upper body to help the legs to maintain balance. Again, use a partner.
  5. Swim with the eyes open, wearing goggles if necessary.
  6. Increase your muscle strength with exercise and sports (Wear good, stable, flat shoes).
  7. Do balance exercises. Stand on one leg with eyes open and closed. Try to walk on a straight line (Practice with a friend to prevent falling).
  8. When it is dark, use a flashlight. The reasons are obvious: we cannot see very well in the dark, so the brain only receives signals from the muscles; this makes the person unstable.
Although our current knowledge concerning dizziness and balance function is limited, it is apparent that the brain has an incredible capacity to improve balance by finding new pathways and developing new strategies when one or two of the systems are impaired.

Date Originally Created: Summer of 1988.
The information presented here first appeared in publications of the Boys Town National Research Register for Hereditary Hearing Loss, the National Institute on Deafness and Other Communication Disorders (NIDCD), Hereditary Hearing Impairment Resource Registry (HHIRR), or the Boys Town Research Registry for Hereditary Hearing Loss.
The Boys Town Research Registry for Hereditary Hearing Loss  
The Boys Town Research Registry for Hereditary Hearing Loss (Registry) is designed to foster a partnership between families, clinicians and researchers in the area of hereditary hearing loss/deafness through three primary functions. First, the Registry disseminates information to professionals and families about clinical and research issues related to hereditary deafness/hearing loss. Second, the Registry collects information from individuals interested in supporting and participating in research projects. This information is used to support the third function of the Registry - matching families with collaborating research projects.
For more information, contact:
Research Registry for Hereditary Hearing Loss
555 N. 30th Street
Omaha, NE 68131
800 320-1171 (V/TDD)
402 498-6331 (FAX)