POSTURAL PERTURBATIONS - NEW INSIGHTS FOR TREATMENT OF BALANCE DISORDERS

This article reviews the neural control of posture as understood throu gh studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new vie w of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implication s for rehabilitation of balance disorders and demonstrate how an under standing of the specific systems underlying postural control can help to focus and enrich our therapeutic approaches. By understanding the b asic systems underlying control of balance, such as strategy selection , rapid latencies, coordinated temporal spatial patterns, force contro l, and context-specific adaptations, therapists can focus their treatm ent on each patient's specific impairments. Research on postural respo nses to surface translations has shown that balance is not based on a fu;ed set of equilibrium reflexes but on a flexible, functional motor skill that can adapt with training and experience. More research is ne eded to determine the extent to which quantification of automatic post ural responses has practical implications for predicting falls in pati ents with constraints in their postural control system.