Postural Control – How the Systems Work Together

Postural control is a term used to describe the way our central nervous system regulates sensory information from other systems in order to produce adequate motor output or muscle activity to maintain a controlled, upright posture. The visual, vestibular, and somatosensory systems are the main sensory systems involved in postural control.

The visual system contributes to postural control by delivering information from the retina to different areas in the brain that allow for object identification and movement control.  Therefore, if your child has a visual impairment, it may be affecting their ability to control their posture and balance especially during movement.

The vestibular system, which consists of organs located in the inner ear, contributes by interpreting changes in movement, direction and velocity or speed of movements. This information is sent to the brain stem, which then creates a response that allows your postural muscles to activate and increases your body awareness.  The vestibular system can be affected in children with various syndromes and disabilities.

The somatosensory system contributes by relaying information about body position to the brain, allowing it to activate the appropriate motor response or movement.  Specific receptors or gauges called proprioceptors are located in our muscles, tendons, and joints.  These are the receptors that are able to tell our brain whether our knee is bent or straight, whether we are bearing weight or not, and which muscles are contracting and which are relaxing at any moment. Inadequate somatosensation will affect postural control as well.

So you can see that all three of these systems play an important role in maintaining postural control and balance.  To ensure proper postural control, the sensory information from these three systems must be regulated by the central nervous system in order to produce an appropriate motor response.  So what does proper postural control look like? This is when an individual is able to engage in various static and dynamic activities, such as sitting, standing, kneeling, quadruped, crawling, walking, and running with the ability to contract the appropriate muscles required for a controlled midline posture, as well as the ability to make small adjustments in response to changes in position and movement, without the use of compensatory motions. If even one of the mentioned systems is not working the way it is supposed to it can affect postural control and balance.  However, when one system is affected the other two can be trained to compensate.  If more than one system is affected in combination with central nervous system involvement postural control will be more greatly affected.  Talk with your therapist for ways to assist your child achieve improved postural control.