It may not sound exciting, but striving for balance in everyday activities can promote great benefits! Balance is defined as the ability to maintain one’s line of gravity within their base of support. In the literature, there are different terminologies used that target balance; postural control, postural stability, and equilibrium. Balance training is extremely important to pay attention to because it is an activity of daily living that you do every day. When you are walking you are balancing. When you are getting in and out of a car, you are balancing. When you are reaching for a plate, you are balancing. There are many things we do without even thinking about it that involve some sort of balancing component.

WHAT IS INVOLVED IN BALANCING?

The brain and spinal cord (which comprise the Central Nervous System) received input about the body’s orientation from these three systems and integrates sensory feedback to generate corrective stabilization by activating selective muscles. A healthy individual relies on 70% of the somatosensory system, 20% vestibular and 10% on vision on a stable surface. Interestingly, on an unstable surface, a healthy individual will then rely 60% on vestibular information, 30% on vision and 10% on somatosensory.  

Two Types of Balance Categories

Static Balance: the ability to maintain the body in a fixed posture with center of mass over the base of support. For example, standing on one foot.   

Dynamic Balance: The ability to transfer the center of gravity around the base of support while the body parts are in motion. For example, reaching down to pick up an object whilst walking.   

When there is a lack of correlation between static and dynamic balance, this may impose challenges to the maintenance of postural stability. Thus, it is important to establish equilibrium by obtaining feedback from the three systems: vision, vestibular and somatosensory.  

Management for Balance Training in the Elderly 

It is important to challenge your balance to promote the use of all three systems. A randomized control trial in 72 prefrail adults (65 yrs and above) with mild-to-moderate fall risk found significant improvement in fall risk, proprioception, muscle strength, reaction time, postural sway, and health-related quality of life. Their exercises consisted of proprioceptive, muscle strengthening, reaction time, and balance training exercises. A few examples of some strategies are as follows:  

1. Cognitive Movement Strategies 

   This is used to improve transfers. Complex and automatic movements are broken down into simple movement components. This way, the person can consciously focus on each movement so that they are consciously controlled. For example, a sit to stand. First, place hands on chair, then place feet appropriately, then move forward, then flex trunk and now rise to a stand.

2. Static Balance Exercises 

   Squats, double leg stance and single-leg stance movements fall under this category.

3. Dynamic Balance Exercises 

   Sidestep walking, grapevine. Safety is key! Ensure that you have someone present to assist you and that you complete the exercises within acceptable limits.

4. Making it Fun!  

   Tai Chi- has been proven to be an economic and effective way for training balance in older people. Music-based multitask exercise programs are also great! These are basic exercises consisting of walking in time to the music and responding to changes in the music’s rhythmic patterns. Exercises that focus on the balance control system mainly by requiring multidirectional weight shifting, walk-and-turn sequences, and exaggerated upper body movements when walking and standing.

5. Core Strengthening  

   Balance begins in your core. Persons with weak core muscles are more prone to falls, decreased mobility in the spine, slower reflexes, and lower back injuries.

6. Fall Prevention Classes 

   By attending a class, not only is there a social incentive, but there are other people experiencing similar feelings. These classes focus on functional balance stability exercises to assist and build confidence with completing daily activities.

This article touched base on the different systems and their involvement in balance, the types of balance, and some management tips on how to improve your balance and what exercises the older adult population should be working on every day. As the population is aging, it is important that one has confidence and strength in their balance to enhance one’s quality of life!

To book a session with our Registered Physiotherapists, and knock your balance outta the park, click the link below or call our office at 604-828-2610!