Body balance and postural control in patients with dizziness

The ability to maintain body balance and postural control is regulated by a central integration process of afferent inputs received from peripheral sensory components such as the somatosensory, visual, and vestibular apparatus, which control the tonic postural system by modulating efferent information. It is widely recognized that stimuli from the visual and the vestibular systems provide information on the position of the head relative to the trunk and contribute to the orientation and the movement of the body in the environment. For these reasons, the vestibular system plays a key role in controlling body balance. Indeed, several studies have shown the presence of imbalance, postural instability and, more generally, postural disorders in vestibular disorders such as in patients suffering from dizziness. Furthermore, in the eleventh revision of the International Classification of Diseases it was included a chronic vestibular disorder named persistent postural perceptual dizziness (PPPD) characterized by such symptoms as persistent dizziness, non-spinning vertigo, and unsteadiness that are exacerbated by standing position, movement, and visual stimuli. Since it was demonstrated that vestibular disorders are a predictor of increased postural instability and the latter condition increases the risk of falling and affects negatively the daily activities, the purpose of the present chapter is to report knowledge on the role of the vestibular system on body balance and postural control focusing on the relationship between vestibular dysfunctions and postural disorders.