Functional Sequence of Balance Training Exercises

Original Editor - Anthonia Abraham
Top Contributors - Anthonia Abraham and Lucinda hampton

Introduction

Balance training is the practice of using exercises to improve stability. This includes exercises that strengthen the muscles that help keep you upright, including your legs and core[1].

  • It is included in most treatment plans of geriatric patients, as it prevents falls; the second leading cause of accidental or unintentional injury deaths worldwide [2].
  • In some cases, balance training exercises are recommended to patients with debilitating ailments affecting vestibular inputs, and muscle strength.

Another example of the application of balance training exercises is in a below-knee amputation. The alteration in the center of gravity and base of support affects functional equilibrium in dynamic activities. Balance training is also used during recreation, athletes, who wish to improve posture, strength, coordination, and stability. This is because it is effective for postural and neuromuscular control improvements[3].

Balance-board-benefits.jpg


Indication

Balance training exercises are included across several treatment plans. This is because balance is established as a vital part of the human kinetics. The following are indications of Balance training exercises.


Assessment of Balance

Balance Training exercises are graded[1]. Depending on the size and variability of postural sway. These exercises could be categorized in easy, mid, and hard[4]. This implies that the intensity of the exercise is dependent on the consideration of the patients' abilities, disabilities, and treatment goals.

The determination of the intensity of balance training exercises can be determined with an assessment of the patient's balance itself. This assessment is done in consideration of the presented symptoms and diagnosis.

The assessment includes,

  1. An evaluation of the visual system.
  2. An evaluation of the somatosensory system.
  3. An evaluation of the vestibular sytem.
  4. An assessment of musculoskeletal element.
  5. Balance Evaluation Systems Test.
  6. Special tests such as Rombergs test.

Functional Sequence of Balance Training

In the rehabilitation of debilitating cases, balance training activities start from lying to kneeling to sitting and then progresses to static and dynamic standing and walking. Progression from less to more demanding tasks is suggested.[5]

The following is a basic sequence in balance training,

Lying to Kneeling Kneeling to Sitting Sit to standing Sit to stand Stand to Walk
Prone lying (neck extension) 4 point kneeling High sitting with food on the ground Double limb stance Wobbling board
Prone lying on elbows Kneel sitting weight shifts (without arm support and foot touching the ground Single leg stance Treadmill
Prone lying on hands 2 point kneeling Sit walking Tandem position Tandem Walking
Half kneeling long sitting


For recreational purposes, balance training exercises are adapted to improve coordination and strength, in both the presence and absence of a diagnosis of infirmities. In programs for sport-injury prevention, the rate of movement is recommended to slowly progress toward the speeds used in the sport. This enables joint stabilization during fast, sport-specific actions. For example, stabilization exercises of the shoulder joint for throwing athletes should progressively move toward more explosive movements, enabling adaptation of the neuromuscular system to appropriately stabilize the joint during pitching, throwing the ball in cocked position, and ending a throw.[5]

In consideration of older patients, who are prone to falls due to impaired coordination and body instability, Coordination exercise with low velocity, low impact, and a high-interest level, which also provides a good training effect is preferred for most older persons [6]

Below are links to videos demonstrating balance training exercises,

This video shows a progression of balance exercises including a sequence of standing stability exercises that target the core muscles, glutes, visual acuity, proprioception.
[7]
This video shows a sequence of sit to stand balance exercises for stroke survivors.
[8] This video explains the features of dynamic stability and its effect on body posture with an exercise sequence featuring items such as the balance board.
[9]

This video shows a sequence of stability exercises that can be done lying.

[10]

References

  1. 1.0 1.1 WebMD. Balance Training. Fitness and Exercise. Available from:https://www.webmd.com/fitness-exercise/a-z/balance-training#:~:text=Balance%20training%20involves%20doing%20exercises,some%20very%20challenging%20yoga%20poses [accessed18 September 2020]
  2. World Health Organization (WHO). Falls. Available from:https://www.who.int/news-room/fact-sheets/detail/falls#:~:text=Falls%20are%20the%20second%20leading,%2D%20and%20middle%2Dincome%20countries. (accessed on September 18 September 2020)
  3. Astrid Z, Markus H, Lutz V, Winfried B, Frank H, Klaus P. Balance Training for Neuromuscular Control and Performance Enhancement: A Systematic Review. Journal Of Athletic Training. 2010;45:392–403
  4. Thomas M, Ralf R, Micha B, Urs G.An Exercise Sequence for Progression in Balance Training. Journal of Strength and Conditioning Research. 2012;26::568-574.
  5. 5.0 5.1 National Strength and Conditioning Association's Guide to Program Design. Safe Progression for Balance Exercises. Available from:https://www.nsca.com/education/articles/kinetic-select/safe-progression-for-balance-exercises/(accessed 18 September 2020)
  6. Wong A, Lin Y, Chou S, Tang F, Wong P. Coordination exercise and postural stability in elderly people: Effect of Tai Chi Chuan. Arch. Physical Medical Rehabilitation. 2001; 8:608–612.
  7. ACE Exercise. Balance Training Exercises.Available from https://www.youtube.com/watch?v=AWuKEt96Jjs&app=desktop (last accessed on 9/10/2020)
  8. American Heart Association. Balance Training Exercises. Available from https://www.youtube.com/watch?v=FgzjxOnWYvA&app=desktop (last accessed 07/10/20)
  9. Dynamic Sitting Balance Exercises For Older Adults. ICDPT. Available from https://www.youtube.com/watch?v=JQJDerb1eCg&app=desktop(last accessed 7/10/2020)
  10. Bob Schrupp and Brad Heineck. Balance Training. Available from https://www.youtube.com/watch?v=rbUmG8c5YM8&app=desktop(last accessed 07/10/20)
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