The Role of the Spine in Posture and Balance

Nerve centers and pathways within the spinal cord act as central pattern generators (CPG). These CPGs drive the unconscious sequence of muscle contraction and relaxation during routine activities such as walking (gait), running or riding a bike. The proper pattern of nerve signal transmission is required to coordinate the sequence of muscle activity required for stability and movement. There are individual central pattern generators for each limb.

Evaluation of Balance

Balance refers to the ability to maintain and/or return to a posture. Healthcare providers have a variety of methods they can use to assess balance. It ranges from simple to complex. The most widely used method is to evaluate station and gait during the course of an office examination. Station refers to the posture assumed when asked to stand up straight and look forward. Gait can be assessed on the floor or on a variable speed treadmill. There are very sophisticated devices which record and print out balance testing results. Many of them involve a computerized platform which can be adjusted to different levels of difficulty. 

 Postural Instability:

Postural instability refers to the inability to keep the body in stable or balanced position. Postural instability is a sign of a number of different disorders including Parkinson’s disease. Postural instability is often associated with increased risk for falling. The term ataxia refers to a loss of the ability to coordinate muscular movement. Ataxia can arise from neurological compromise of the spinal cord. Other causes of ataxia include infection, injury, and degenerative diseases such as multiple sclerosis, Parkinson's disease, genetic factors and brain tumors.