September is recognised internationally as Balance Awareness Month, an opportunity to raise awareness of vestibular disorders and the profound impact balance problems can have on people’s lives.
When we think about our ears, we naturally think about hearing. Yet hidden within the inner ear is another remarkable system that quietly works every second of every day to
For most people, balance is something they never think about until they lose it.
Whether it’s the room spinning when turning over in bed, feeling unsteady while walking through a shopping centre, or becoming fearful of falling, balance disorders can profoundly affect confidence, independence, work, family life and overall quality of life.
As healthcare professionals, Balance Awareness Month reminds us that hearing is only part of what the inner ear does. Understanding balance and recognising the important role audiology plays in assessing and managing vestibular disorders is essential if we are to provide truly person-centred care.
Standing upright seems effortless.
In reality, it is one of the most complex processes the human body performs.
Every step we take depends on our brain continuously integrating information from three major sensory systems:
Vision tells us where we are in relation to our environment.
Proprioception provides information from our muscles and joints about body position and movement.
The vestibular system detects head movement, acceleration and orientation in space.
These three systems constantly communicate with one another.
When they all provide accurate information, movement feels smooth and automatic.
But when one system begins to fail, the brain has to work much harder to compensate. If compensation is incomplete, or more than one system is affected, people may experience dizziness, imbalance or falls.
Balance is therefore not a single function.
It is the result of remarkable teamwork.
Deep inside the inner ear lies one of the body’s most sophisticated navigation systems.
The vestibular organs contain tiny fluid-filled canals and sensory receptors that
detect movement in every direction.
Every time you turn your head, look up, bend down, walk across a room,
climb stairs or step off a curb the vestibular system is sending
thousands of signals to your brain. These signals allow you to
maintain your balance, keep your eyes focused while moving,
coordinate posture, judge movement and direction and navigate
your environment safely without us ever noticing, this system works
continuously to keep us upright.
Vestibular disorders are surprisingly common and affect people of all ages.
Some of the most frequently encountered conditions include:
Many patients struggle to describe exactly what they are experiencing.
Some say, “It feels like I’m walking on a boat.”
Others explain, “I just don’t feel steady anymore.”
Listening carefully to the patient’s story often provides the first clues towards an accurate diagnosis.
Falls are among the leading causes of injury, disability and loss of independence worldwide.
When discussing falls, we often think about:
These factors certainly contribute.
However, hearing and vestibular function are frequently overlooked.
Research increasingly shows that hearing loss and vestibular dysfunction may increase fall risk through several mechanisms, including:
For many older adults, the consequences extend beyond physical injury.
Fear of falling often leads to reduced activity, social isolation and declining independence.
Preventing falls therefore requires us to think beyond mobility alone.
One of the greatest challenges in vestibular care is remembering that dizziness is a symptom, not a diagnosis.
Two patients may both describe feeling dizzy yet have completely different underlying causes.
Modern clinical assessment begins with understanding why the patient is dizzy.
This may include:
Rather than making assumptions, a systematic approach helps clinicians identify the true source of the problem and guide effective management.
Advances in vestibular diagnostics now allow clinicians to assess different parts of the balance system objectively.
Depending on the patient’s presentation, testing may include:
Each investigation answers a different clinical question.
Just as no single hearing test provides every answer, no single vestibular test tells the whole story.
Good clinical practice lies in selecting the right assessment for the right patient.
One of the greatest shifts in modern healthcare has been moving from diagnosing disease to understanding how that disease affects everyday life.
The International Classification of Functioning, Disability and Health (ICF) encourages clinicians to ask:
How does this condition affect this person’s ability to live, work and participate?
For someone with a vestibular disorder, this may involve:
The ICF reminds us that success is measured not only by normal test results but by helping people return to meaningful participation in everyday life.
Vestibular disorders rarely fit neatly within one profession.
The best patient outcomes occur when healthcare professionals work together.
This may include collaboration between:
Each professional contributes a different perspective.
Together, they create care that is more comprehensive, coordinated and person-centred.
Audiology has evolved considerably over the past two decades.
Today’s audiologists contribute far more than hearing assessment.
They play an increasingly important role in:
As healthcare continues to shift towards function and participation, audiologists are uniquely positioned to help patients move safely and confidently through their world.
Balance is one of those remarkable abilities we rarely appreciate until it changes.
For some people, dizziness lasts only a few hours.
For others, it changes how they work, drive, socialise and experience everyday life.
As we recognise Balance Awareness Month, perhaps the greatest message is this:
Balance problems should never simply be accepted as “part of getting older.”
They deserve careful assessment, thoughtful investigation and person-centred management.
Because helping someone remain steady on their feet is about far more than preventing falls.
It is about protecting independence.
Supporting participation.
Maintaining confidence.
And ultimately, improving quality of life.
At Amtronix Diagnostics, we believe that precision in assessment leads to better clinical decisions and better patient outcomes.
Because Precision is Key.
Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of Balance and Vestibular Function in US Adults: Data From the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med. 2009;169(10):938–944. doi:10.1001/archinternmed.2009.66
Hall, C. D., Herdman, S. J., Whitney, S. L., et al. (2022). Vestibular rehabilitation for peripheral vestibular hypofunction: An updated clinical practice guideline. Journal of Neurologic Physical Therapy, 46(2), 118–177.
McDonnell, M. N., & Hillier, S. L. (2015). Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database of Systematic Reviews, (1), CD005397.
World Health Organization. (2001). International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization.
World Health Organization. (2021). World Report on Hearing. Geneva: World Health Organization.
The most common misconception in hearing screening? That OAE and AABR are interchangeable. They are not. They answer different clinical questions, assess different parts of the auditory system, and should be used strategically, not interchangeably. Understanding this distinction is what separates basic screening from clinically effective screening programmes.
As audiologists, we are trained to care deeply for each patient we see. We refine our assessments. We improve our counselling. We strive to provide the best possible care in every consultation.
