Postural sway refers to the movements a person’s body makes to maintain an upright posture. Age and health conditions affecting the systems that control balance can increase postural sway.

Postural sway describes the movements the body makes to remain balanced and upright when standing or moving.

Certain health conditions may increase postural sway, including attention deficit hyperactivity disorder (ADHD), anxiety, and neurological diseases.

Age may also affect postural sway. Developing children and older adults may have more significant postural sway than young adults.

This article looks at the factors that may affect postural sway, diagnosis, and ways to reduce postural sway.

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Postural control is the ability to keep an upright, stable posture. Certain muscles in the body contract to maintain posture and stabilize the body against the effects of gravity.

The postural control system involves many functions in the body in order to work properly. These include:

  • the peripheral nervous system
  • vision
  • the vestibular system, which helps create balance

How well these systems function can affect how much postural control people have. A lack of postural control causes postural sway.

Certain health conditions, such as ADHD or Parkinson’s disease, may exaggerate postural sway due to their impact on the various systems involved in postural control and balance.

Aging can also impair the bodily systems that maintain balance and may increase postural sway.

Everyone experiences postural sway at some level. The body is constantly working to maintain balance and counteract its predisposition to be unsteady due to the effects of gravity.

However, some people have more significant postural sway than others. Certain health conditions, disabilities, and age can all increase postural sway.

Younger children may have increased postural sway because they are still developing, while older adults may have increased postural sway due to degeneration of the musculoskeletal and nervous systems, which all relate to balance.

Lower levels of postural sway indicate better balance, as the body uses less effort to maintain good balance. A higher amount of postural sway can indicate reduced balance and may increase the risk of falls.

Increased postural sway may cause people to sway from side to side or around in small circles, as the body has to work harder to maintain proper balance and upright posture.

People may notice extreme postural sway themselves, but certain tests can also diagnose increased postural sway.

Doctors may use postural stability exercises to test a person’s postural sway levels. This could involve standing in various positions for several seconds while wearing a sensor on the lower back.

The sensor measures a person’s sway to help doctors assess if the amount of postural sway is typical.

Researchers in a 2020 study used force plates to measure postural sway. A force plate is a device that measures the forces the ground and body exert when in contact with each other.

To measure postural sway, people may stand still on a force plate in different positions, with their hands by their sides and their eyes closed or open.

Below are some health conditions that may affect a person’s postural sway.

ADHD

According to a 2020 article, research suggests that children with ADHD may have poor postural control and increased postural sway.

Children with ADHD may have difficulties with physical activities, motor skills, and coordination compared with those without ADHD. They may also have less balance control than children without ADHD.

Reduced balance and increased postural sway in people with ADHD may occur due to:

  • damage to the cerebellum in people with ADHD, which is the part of the brain that helps control balance, posture, and coordination
  • abnormalities in other areas of the brain, including the prefrontal cortex and basal ganglia, which can reduce sensory-motor control and negatively affect balance

Anxiety

According to a 2022 study, anxiety may link to increased postural sway.

Anxiety may affect regions of the brain involved in balance and sensory processing, including areas of the prefrontal cortex, the amygdala, and the hypothalamus.

Anxiety affects the vestibular system and the parabrachial nucleus network, an area of the brainstem that helps communicate sensory information and contains cells that help the body react to gravity.

As a result, high levels of anxiety may reduce balance control and increase postural sway.

Parkinson’s disease

Neurological diseases, including Parkinson’s disease, may increase postural sway.

Parkinson’s disease causes changes in the reflexes that help a person maintain an upright posture.

Multiple sclerosis

Multiple sclerosis (MS) is a condition that affects the central nervous system. It can cause poor postural control and may increase postural sway. This may be due to:

  • stiff or rigid muscles in the lower limbs
  • reduced sensation in the feet
  • delays in sensory and motor functions

According to a 2020 article, balance exercises may help improve postural sway in children with ADHD. These may include:

  • using an exercise ball
  • balancing on one leg
  • walking in set patterns
  • hopping, skipping, and jumping
  • walking on a balance beam
  • performing balance exercises with eyes open and closed

Performing regular physical exercise may help a person maintain good postural control and reduce postural sway.

Physical activity helps prevent the sensory, musculoskeletal, and nervous systems from deteriorating, which can all help support good postural control.

People can talk with a healthcare professional about training programs and exercises to improve postural sway.

If postural sway becomes noticeable or people experience increased unsteadiness, they may want to contact a doctor.

Increased postural sway and balance issues may increase the risk of falls, so it is best to consult a doctor if people experience difficulties maintaining balance.

A doctor can assess postural sway and balance control, determine the underlying cause of increased postural sway, and suggest a treatment plan to address any issues.

Postural sway is the movement the body makes to remain in an upright posture and maintain balance.

Some people may have more significant postural sway than others, which may cause noticeable swaying movements, either in a circle or from side to side.

Younger children and older adults may also have increased postural sway, as well as people with ADHD, anxiety, or neurological conditions.

People with increased postural sway can contact a doctor to find the underlying cause. Treating the underlying cause and practicing therapies such as balance training may help reduce postural sway.