An Exercise Sequence for Progression in Balance Training

Abstract

Compared with resistance training, information concerning the progressive configuration of balance training (BT) is rare and lacks scientific validation. Therefore, a study was designed to determine participants' ability to perform balance exercises with increasing level of difficulty. The task required the participants (N = 20) to stand as stable as possible on a computerized balance platform. The experiment was performed on 3 testing days using different stance and sensory conditions. On each day, bipedal, step, tandem, and monopedal stands were performed 3 times while sensory conditions changed from firm ground, eyes opened (day 1) over foam ground, eyes opened (day 2) to firm ground, eyes closed (day 3). The results showed that total center of pressure displacements significantly increased when the use of sensory information (comparison between testing days: all p < 0.001) or when the base of support (comparison within testing days: all p < 0.001) was gradually reduced. Based on the observed pattern of increased postural sway across all testing conditions and the levels of trial variability, exercises were categorized into several stages of training. Findings indicate that balance performance decreased in response to an increased level of task difficulty introduced by narrowing the base of support and by limiting the use of sensory information. Practitioners can use the derived exercise ranking to select exercises for BT appropriate to the level of participants' balance ability and to implement progression in balance training.

Core muscle activity in a series of balance exercises with different stability conditions

“…These results and the higher balance requirements achieved by narrowing the base of support [9] suggests that progressive postural control disruptions may involve an increment amount of core muscle activity to maintain balance and perform the exercise with the correct technique. Notwithstanding, unipedal/ bipedal stance during a seated position showed no significant difference except during the addition of elastic resistance.…”

Electroencephalography to Assess Motor Control During Balance Tasks in People with Diabetes

“…6,8,32 As such, impairment of the visual, vestibular, and somatosensory systems can result in increased postural sway and a loss of balance, resulting in falls. [33][34][35][36][37] In the elderly, falls are a leading cause of morbidity and mortality. 1 In people with diabetes, the impairments in all three systems make the likelihood of falls even more extreme.…”

Exercise-Based Fall Prevention in the Elderly: What About Agility?

“…To translate these findings into specific best practice recommendations for balance training, practitioners should employ exercises that (1) include standing exercises with a gradually reduced base of support (e.g., two-legged stand, semi-tandem stand, tandem stand, one-legged stand), (2) include dynamic movements that perturb the center of gravity (e.g., tandem walk, circle turns), (3) stress postural muscle groups (e.g., heel stands, toe stands), and (4) modify sensory inputs (e.g., standing with eyes closed) [18,19]. Although less extensively studied, it appears useful to combine gait and balance training with cognitive and/or motor interference tasks [20,21].…”

“…Based on the above, fall prevention likely requires a successful interplay between perception, cognitive function [20], and Muehlbauer et al [19]. In static situations, balance can be regarded as an inverse pendulum where ankle moments control the center of mass position relative to the base of support, whereas in static-dynamic exercises the body moves as a double pendulum and changes in angular momentum contribute relative to the base of support, and in dynamic exercises changes in location of the center of mass require changes of the base of support.…”