Clinical evaluation of the organ of equilibrium

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Clinical evaluation of the organ of equilibrium



Balance disorders and dizziness are subjective perceptions associated with symptoms of damage or abnormalities in the balance system. As the quality of life of patients complaining of disequilibrium disorders is significantly reduced, early diagnosis and rehabilitation is important, since, on the one hand, such abnormalities may indicate a minor problem, but, on the other hand, they may suggest the development of a serious condition. Both functional tests and balance platforms can be used for the clinical diagnosis of balance disorders.


The posture of our body when it adopts a vertical orientation - with the help of balanced forces that act on the body - is referred to as balance. It is a feature of the body that ensures that the body returns to its initial state after performing various types of movement activities. As can be seen from the above description, equilibrium is not a single-aspect state/trait - on the one hand, thanks to equilibrium, we are able to maintain a correct/straight posture of the body (static aspect), and on the other hand, it provides the ability to return to its state after performing a specific movement (dynamic aspect) [1]

Stability versus balance

In the context of understanding a concept such as balance, it is important to refer to the definition of the word 'stability', which encompasses a much broader meaning, which includes the ability/capacity to regain body position in space, lost under the influence of various types of factors that initiate destabilisation of body position. Neither equilibrium nor stability are fixed states, but are subject to constant change over the course of our lives, so that the mechanisms for controlling these characteristics are formed. The fact that we maintain the body in a standing position is the result of coordination between muscles and nerves, although the position itself is characterised by high instability - a small base in relation to the support of the body height, a lack of fixation in the ground or even a multi-segmented body structure. [1]


Adisorder of equilibrium, like vertigo, is the subjective perception of abnormalities in the functioning of the balance system, which consists of components such as the vagus, vestibular nerve, vestibular nuclei and the set of channels connecting them in the cerebellum, trunk and cortex, as well as the organ of vision and deep sensory receptors located in muscles, joints, ligaments and joint capsules. Due to the non-specific nature of these complaints, on the one hand, they may be indicative of harmless diseases and lesions, but on the other hand, they may be indicative of dangerous ongoing diseases in the body [2].

According to sociomedical research data, a quarter of people with vestibular disorders and dizziness were found to have damage to the peripheral part of the vestibular system, 88% had recurrent vestibular disorders and 80% had a reduced quality of life due to their symptoms [2].

Mechanism of balance maintenance

Incoming information from the periphery, based on the principle of feedback, is processed and coordinated, and as a result of this integration, information is sent to the musculoskeletal system via the nervous system. As a result of such a process, posture correction is brought about. The ability to respond appropriately (postural correction) decreases with age due to the fact that impairments in performance occur, resulting in reduced stability. It is not only age that compromises stability and balance abilities, factors such as co-morbidities, medication, reduced muscle strength, fatigue, depression or pain can also contribute to imbalance [3].

A certain small range of deviation of the human body is observed even when standing calmly and this is a kind of reference - a control indicator in the context of maintaining balance, and due to the fact that it occurs in all people, it is considered the optimum [3].

photo: panthermedia

Assessment of balance

A comprehensive, holistic assessment of balance and its disorders is a difficult and problematic task. The development of IT and modern technology has largely contributed to the proliferation of specialised, sophisticated tools aimed at obtaining the most objective data possible. Another type of investigation of imbalance disorders are clinical tests based on conditions strongly resembling everyday life [1].