The Importance of Balance Training

Staying Active

History

▪ Improving sport performance

▪ Important component for older adults – Fall prevention

1 out of 4 adults fall each year ▪ Falls are the leading cause of injury

▪ Steadily risen over the years

– Performing activities of daily living

– Maintaining functional independence

What is balance?

Ability to keep center of gravity within abase of support

Static- standing or sitting

Dynamic- moving

Reactive-compensating and recovery

Functional- ability to perform daily movement tasks

Body Systems Effecting Balance

Visual System

• Sight

• Body’s location related to the environment

Somatosensory System

• Skin receptors

• Position and movement of body parts

Vestibular system

• Inner ear

• Head position related to gravity, direction, and acceleration

Other Factors Effecting Balance

Balance

Muscle Tone

Strength

Range of Motion

Environment

Body Size Gender

Foot Size

Fall Risk

What happens after a fall?

▪ Possible injury

▪ Recovery time

▪ Less physical activity

– Weight gain

– Other chronic conditions

▪ Decreased self-confidence and fear

– Limits daily activities and independence

▪ Effects on activities of daily living

▪ Possible medical costs

The Fall Cycle

Fall AssessmentBalance Assessment

Exercise Rx Balance

Extrinsic Factors

▪ Lighting

▪ Obstacles

▪ Floor type Intrinsic Factors

▪ Muscle weakness

▪ Gait

▪ Balance

▪ Muscle power – Greatly effects reactive balance

Intrinsic Factors Extrinsic Factors

Assessing Fall Risk

Reactive balance &

steady- state balance

Gait speed test

Muscle power test

Biosway

Assessing Balance

▪ Complex

▪ Static Tests – Single leg stance

– Wii Balance board- assesses displacement of center of mass

▪ Poorly correlated with functional mobility

▪ Exergaming and virtual reality

– Slightly less effective then traditional training

Assessing Balance

▪ Reactive Balance – Ability to recover after an unexpected external force

– Controlling posture

Assessing Balance

▪ Dynamic balance- maintaining postural stability while moving – Prevents falls and sport injuries

– Functional reach test

– Timed up and go

– Star excursion balance test

– Gait velocity test

▪ Slower speed = less balance

Balance Training Program

Balance + flexibility + resistance training > endurance training

Program to reduce falls should include: 1. Movement around the center of mass2. Use of narrow base of support 3. Minimal upper extremity support

Exercise Effects Fall Risk

Exercise Effects Balance

▪ Older adults are encouraged to exercise regularly and engage in physical activity– Improve strength, power, and neuromotor

training

▪ Neuromotor training = motor skills and proprioception ‘functional fitness’ – Agility – Balance – Coordination – Gate – Proprioception – awareness of position and body

movement

▪ 2x a week is effective for reducing fall risk

Exercise Prescription

▪ ACSM guidelines for balance training

– F: 3 days a week for adults over 65

– I : hold each exercise for 21-40 seconds

– T: 30-45 minute sessions for old

▪ 10-15 minute sessions for young

– T: target specific deficiencies with balance

Strength, Power, and Flexibility

▪ Strength training alone does not improve balance

Strength + Power + Proprioception = Improved Balance

▪ Muscle power and proprioception help us catch our balance – Utilize power training with low loads

▪ Strengthen leg muscles improves static balance – Quadriceps, hamstrings, & ankle musculature

The best strategy is to train multiple components

Tai Chi

Yoga

Pilates

Examples of Balance Exercises

▪ Static – Tandem stance

– Standing on one leg

Examples of Balance Exercises

▪ Dynamic – Tandem walking

– Walking backwards

▪ Increasing difficulty – Add upper body movement

▪ Arm circles, throwing a ball

– Add a cognitive task

▪ Talking, counting, reading