As we age, multiple physiological and neurological changes happen due to many reasons:
- Muscle Atrophy: Loss of muscle mass as we get older due to reduced activities
- Loss of Neural Adaptation: The neural system is the communication channel of our body to communicate and make effective movements
- Lack of muscular coordination due to no exercise activity
- Increase in non-contractile connective tissues with aging (Létocart et al., 2021)
- Lack of joint stability due to a sedentary lifestyle
While strength training itself could have a huge positive carryover in dealing with these side-effects of aging, the inclusion of Balance training could help improve posture control, reduce the falling rate and overall performance in an individual(Zech et al., 2010; Gillespie et al. , 2012; Lesinski et al. , 2015)
So how do you approach Balance training?
Balance training can be divided into two types:
- Static Balance : The ability to maintain the center of mass of the body in a static position
- Dynamic Balance: The ability to maintain the center of mass of the body while the body is performing a movement
Before we start addressing the balance training, it is important to conduct a balance test. The best and simple test that can be done
The 4 Stage Balance Test (by CDC):
Purpose of the Test: This test measures the static balance of an individual and is relatively a safer way to test your balancing ability.
Equipment needed: A Stopwatch
Directions:
- Understand the 4 different foot positions which needs to be maintained to complete the assessment.
- The Four Different foot positions are:
- Stand with feet side to side
- Place the instep of one foot to touch the toe of the other foot
- Place one foot in front of the other, heel touching toe (Tandem stand)
- Stand on one foot
- The timeline for each foot position is 10 seconds and you have to maintain the position for the given timeline.
- Record the timeline for each position in seconds
- You could move your arm to maintain Balance in each position
The test could be repeated to evaluate the improvement in balance and coordination. Hence, it is important to maintain the records.
Like we approach all training types, we should keep the training progressive. Here are a few guidelines on making Balance training safe and progressive:
· Focus on maintaining balance on a stable surface and once the balancing skills get better, you can move on to unstable surfaces like Bosu ball, balance beam, etc
· Prioritize moving from two limb balance to single-limb balance. Example: Full Plank to one arm plank
· Balance training can also be done using closed eye movements but before we try this, we need to ensure that the open eye balance is good enough.
· Initiate balance training with supported training and then move to unsupported training
Here is a progression sample:
| Exercise | Progression |
|---|---|
| Full Plank | Single Arm Plank |
| Single Leg Balance | Closed Eye Single Leg Balance |
| Lunges | Single leg squat |
| Balance on bosu ball | Balance on balance board |
References:
- Gillespie, L. D. et al. (2012) ‘Interventions for preventing falls in older people living in the community’, Cochrane Database of Systematic Reviews, 2021(6). doi: 10.1002/14651858.CD007146.pub3.
- Lesinski, M. et al. (2015) ‘Effects of Balance Training on Balance Performance in Healthy Older Adults: A Systematic Review and Meta-analysis’, Sports Medicine, 45(12), pp. 1721–1738. doi: 10.1007/s40279-015-0375-y.
- Létocart, A. J. et al. (2021) ‘Muscles adaptation to aging and training: architectural changes – a randomised trial’, BMC Geriatrics, 21(1), p. 48. doi: 10.1186/s12877-020-02000-0.
- Zech, A. et al. (2010) ‘Balance Training for Neuromuscular Control and Performance Enhancement: A Systematic Review’, Journal of Athletic Training, 45(4), pp. 392–403. doi: 10.4085/1062-6050-45.4.392.
