Review Article

Effect of somatosensory impairments on balance control


Background and Aim: The somatosensory system is one of the most effective systems in balance control. It consists of peripheral and central components. Knowing the role of these components in balance control assists the developing of effective rehabilitation protocols. In some diseases peripheral components and in others central components are impaired. This paper reviews the effect of impairment of peripheral and central components of the somatosensory system on balance control.
Methods: In this study publication about somatosensory impairments from 1983 through 2011 in PubMed, Scopus, ProQuest, Google Scholar, Iran Medex, Iran Doc and Magiran were reviewed. Medical subject headings terms and keywords related to balance, somatosensory, somatosensory loss, and sensory integration/processing were used to perform the searches.
Conclusion: Somatosensory impairments either with peripheral or central origin, can cause problems in balance control. However, these problems are not considered in some patients. In these impairments, balance training is recommended to be used alongside other routine treatments in the patients' rehabilitation programs.

1. Nashner LM. Practical biomechanics and physiology of balance. In: Jacobson GP, Newman CW, Kartush JM, editors. Handbook of balance function and testing. 1st. Louis: Mosby Year Book; 1993. p. 261-79.
2. Hijmans JM, Geertzen JH, Dijkstra PU, Postema K. A systematic review of the effects of shoes and other ankle or foot appliances on balance in older people and people with peripheral nervous system disorders. Gait Posture. 2007;25(2):316-23.
3. Maurer C, Mergner T, Bolha B, Hlavacka F. Human balance control during cutaneous stimulation of the plantar soles. Neurosci Lett. 2001;302(1):45-8.
4. Guskiewicz Km, Perrin DH. Research and clinical applications of assessing balance. J Sport Rehabil. 1996;5(1):45-63.
5. Schiffman HR. Sensation and perception: an integrated approach. 5th ed. New York: John Wiley & Sons; 2001.
6. Kars HJ, Hijmans JM, Geertzen JH, Zijlstra W. The effect of reduced somatosensation on standing balance: a systematic review. J Diabetes Sci Technol. 2009;3(4):931-43.
7. Peterka RJ. Sensorimotor integration in human postural control. J Neurophysiol. 2002;88(3):1097-118.
8. Bray JJ, Cragg PA, Macknight ADC, Mills RG. Lecture notes on human physiology. 4th ed. Oxford: Blackwell Science; 1999.
9. Kavounoudias A, Roll R, Roll JP. The plantar sole is a ‘dynamometric map’ for human balance control. Neuroreport. 1998;9(14):3247-52.
10. Bohannon RW. Evaluation and treatment of sensory and perceptual impairments following stroke. Top Geriatr Rehabil. 2003;19(2):87-97.
11. Marigold DS, Eng JJ, Tokuno CD, Donnelly CA. Contribution of muscle strength and integration of afferent input to postural instability in persons with stroke. Neurorehabil Neural Repair. 2004;18(4):222-9.
12. Oliveira CB, Medeiros IR, Greters MG, Frota NA, Lucato LT, Scaff M, et al. Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke. Clinics (Sao Paulo). 2011;66(12):2043-8.
13. Gillen G, Burkhardt A. Stroke rehabilitation: a function-based approach. 2nd ed. St. Louis Mosby; 2004.
14. Smith DL, Akhtar AJ, Garraway WM. Proprioception and spatial neglect after stroke. Age Ageing. 1983;12(1):63-9.
15. Nogaki H, Ohba Y, Matsumoto K, Morimatsu M, Fukuoka Y. Statistical analysis of post-stroke patients in a rehabilitation institution. Nihon Ronen Igakkai Zasshi. 1991;28(5):678-82. Japanese.
16. Adams RW, Gandevia SC, Skuse NF. The distribution of muscle weakness in upper motoneuron lesions affecting the lower limb. Brain. 1990;113(Pt 5):1459-76.
17. Ghotbi N, Olyaei GR, Hadian MR, Ansari NN, Bagheri H. Is there any relationship between the Modified Ashworth Scale scores and alpha motoneuron excitability indicators? Electromyogr Clin Neurophysiol. 2006;46(5):279-84.
18. Ghotbi N, Hadian MR, Olyaei GR, Bagheri H, Talebian S, Nakhostin-Ansari N, Nafissi S. The investigation of criterion validity of the Modified Ashworth Scale using the alpha motoneuron excitability indicators. Acta Medica Iranica. 2007;45(4):290-4.
19. Desrosiers J, Hébert R, Bravo G, Dutil E. Hand sensibility of healthy older people. J Am Geriatr Soc. 1996;44(8):974-8.
20. Kaplan FS, Nixon JE, Reitz M, Rindfleish L, Tucker J. Age-related changes in proprioception and sensation of joint position. Acta Orthop Scand. 1985;56(1):72-4.
21. for people with multiple sclerosis, June 2009.
22. Cameron MH, Horak FB, Herndon RR, Bourdette D. Imbalance in multiple sclerosis: a result of slowed spinal somatosensory conduction. Somatosens Mot Res. 2008;25(2):113-22.
23. Schmierer K, Niehaus L, Röricht S, Meyer BU. Conduction deficits of callosal fibres in early multiple sclerosis. J Neurol Neurosurg Psychiatry. 2000;68(5):633-8.
24. Citaker S, Gunduz AG, Guclu MB, Nazliel B, Irkec C, Kaya D. Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait Posture. 2011;34(2):275-8.
25. Frzovic D, Morris ME, Vowels L. Clinical tests of standing balance: performance of persons with multiple sclerosis. Arch Phys Med Rehabil. 2000;81(2):215-21.
26. Rougier P, Faucher M, Cantalloube S, Lamotte D, Vinti M, Thoumie P. How proprioceptive impairments affect quiet standing in patients with multiple sclerosis. Somatosens Mot Res. 2007;24(1-2):41-51.
27. Cameron MH, Lord S. Postural control in multiple sclerosis: implications for fall prevention. Curr Neurol Neurosci Rep. 2010;10(5):407-12.
28. Finlayson ML, Peterson EW, Cho CC. Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Arch Phys Med Rehabil. 2006;87(9):1274-9.
29. Kars HJ, Hijmans JM, Geertzen JH, Zijlstra W. The effect of reduced somatosensation on standing balance: a systematic review. J Diabetes Sci Technol. 2009;3(4):931-43.
30. Simoneau GG, Ulbrecht JS, Derr JA, Becker MB, Cavanagh PR. Postural instability in patients with diabetic sensory neuropathy. Diabetes Care. 1994;17(12):1411-21.
31. Nardone A, Tarantola J, Miscio G, Pisano F, Schenone A, Schieppati M. Loss of large-diameter spindle afferent fibres is not detrimental to the control of body sway during upright stance: evidence from neuropathy. Exp Brain Res. 2000;135(2):155-62.
32. Runge M, Rehfeld G, Resnicek E. Balance training and exercise in geriatric patients. J Musculoskeletal Neuronal Interact. 2000;1(1):61-5.
33. Carter ND, Kannus P, Khan KM. Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports Med. 2001;31(6):427-38.
34. Perrin PP, Gauchard GC, Perrot C, Jeandel C. Effects of physical and sporting activities on balance control in elderly people. Br J Sports Med. 1997;33(2):121-6.
35. Lord SR, Clark RD, Webster IW. Postural stability and associated physiological factors in a population of aged persons. J Gerontol. 1991;46(3):M69-76.
36. Shumway-Cook A, Gruber W, Baldwin M, Liao S. The effect of multidimensional exercises on balance, mobility and fall risk in community-dwelling older adults. Phys Ther. 1997;77(1):46-57.
37. Hinman RS, Bennell KL, Metcalf BR, Crossley KM. Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests. Rheumatology (Oxford). 2002;41(12):1388-94.
38. Soriano TA, DeCherrie LV, Thomas DC. Falls in the community-dwelling older adult: a review for primary-care providers. Clin Interv Aging. 2007;2(4):545-53.
39. Shaffer SW, Harrison AL. Aging of the somatosensory system: a translational perspective. Phys Ther. 2007;87(2):193-207.
IssueVol 21 No 3 (2012) QRcode
SectionReview Article(s)
Balance disorder/balance impairment somatosensory loss sensory processing

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Ghotbi N, Hassanpour A. Effect of somatosensory impairments on balance control. Aud Vestib Res. 2017;21(3):1-8.