Functional Sequence of Balance Training Exercises: Difference between revisions

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== Introduction  ==
== 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<ref name=":0">[https://www.webmd.com/fitness-exercise/a-z/balance-training#:~:text=Balance%20training%20involves%20doing%20exercises,some%20very%20challenging%20yoga%20poses.]Balance Training | Fitness and Exercise| WEBMD</ref>. It is popular in the treatment plan of geriatric patients, as it prevents falls; the second leading cause of accidental or unintentional injury deaths worldwide <ref>[https://www.who.int/news-room/fact-sheets/detail/falls#:~:text=Falls%20are%20the%20second%20leading,%2D%20and%20middle%2Dincome%20countries.]Falls |WHO NEWS</ref>. In some cases, balance training exercises are recommended to patients with debilitating ailments affecting ,vestibular inputs, and muscle strength. An example of its application is in an below knee amputation, where the change of center of gravity and base of support affects functional equilibrium in dynamic activities<ref>[[Base of Support]]</ref>. Balance training is also used during recreation for individuals,especially athletes, who wish to improve posture strength,coordination and stability.<br>  
'''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<ref name=":0">Stephanie W.Balance Training.Fitness and Exercise.WEBMD. Available from;https://www.webmd.com/fitness-exercise/a-z/balance-training#:~:text=Balance%20training%20involves%20doing%20exercises,some%20very%20challenging%20yoga%20poses. [accessed September 18th,2020]</ref>. It is popular in the treatment plan of geriatric patients, as it prevents falls; the second leading cause of accidental or unintentional injury deaths worldwide <ref>World Health Organization (WHO).Falls.2018. 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 18th,2020)</ref>. In some cases, balance training exercises are recommended to patients with debilitating ailments affecting ,vestibular inputs, and muscle strength.An example of its application is in an below knee amputation, where the change of center of gravity and base of support affects functional equilibrium in dynamic activities. Balance training is also used during recreation for individuals,especially athletes, who wish to improve posture strength,coordination and stability as it is  effective for postural and neuromuscular control improvements<ref>Astrid Z, PhD,* Markus H, PhD,† Lutz V, PhD,† Winfried B, MD, PhD,† Frank H, PhD,‡ and Klaus P, PhD*. Balance Training for Neuromuscular Control and Performance Enhancement: A Systematic Review. Journal Of Athletic Training.2010 Jul-Aug; 45(4): 392–403</ref>.<br>  


== Indications ==
== Indication ==


Balance training exercises is included across several treatment plans. this is because [[balance]] is a vital part of the human kinetics. The following are indications of Balance training
Balance training exercises is included across several treatment plans. this is because [[balance]] is a vital part of the human kinetics. The following are indications of Balance training
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== Assessment of Balance  ==
== Assessment of Balance  ==


Balance Training exercises are graded<ref name=":0" />. This implies that the intensity of the exercise is dependent on consideration of the patients abilities, disabilities and treatment goals.
Balance Training exercises are graded<ref name=":0" />.Depending on the size and variability of postural sway, exercises could be categorized in easy, mid and hard<ref>Muehlbauer, Thomas; Roth, Ralf; Bopp, Micha; Granacher.An Exercise Sequence for Progression in Balance Training.Journal of Strength and Conditioning Research: February 2012 - volume 26 - issue 2 - p 568-574.doi: 10.1519/JSC.0b013e3</ref> .This implies that the intensity of the exercise is dependent on 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 patient's balance itself.  This assessment is done in consideration of the presented symptoms and diagnosis.
The determination of the intensity of balance training exercises can be determined with an assessment of patient's balance itself.  This assessment is done in consideration of the presented symptoms and diagnosis.
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== Functional Sequence of Balance Training  ==
== Functional Sequence of Balance Training  ==


In 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.<ref name=":1">[https://www.nsca.com/education/articles/kinetic-select/safe-progression-for-balance-exercises/]Safe Progression for Balance Exercises|NASCA.COM</ref>
In 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.<ref name=":1">National Strength and Conditioning Association. NSCA'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/<nowiki/>(accessed September 18,2020)</ref>


The following is a basic sequence in balance training,
The following is a basic sequence in balance training,
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<br>In athletics, balance training exercises to improve coordination and strength, in both the presence and absence of a diagnosis of infirmities.In programs for sport-injury prevention, rate of movement should slowly progress toward the speeds used in the sport, enabling 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.<ref name=":1" />
<br>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, rate of movement is recommend to slowly progress toward the speeds used in the sport, enabling 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.<ref name=":1" />
 
In consideration of older patients, who are more suspictable 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 <ref>Wong A. M., Lin Y. C., Chou S. W., Tang F. T., Wong P. Y. (2001). Coordination exercise and postural stability in elderly people: effect of Tai Chi Chuan. Arch. Phys. Med. Rehabil. 82, 608–612. 10.1053/apmr.2001.22615. Available from https://pubmed.ncbi.nlm.nih.gov/11346836/</ref>


== Related topics and videos    ==
== Related topics and videos    ==
[[Balance]]


[[Postural Assessment Scale for Stroke]]
===== [[Balance]] =====
 
===== [[Postural Assessment Scale for Stroke]] =====
 
===== [[Base of Support]] =====


[[Base of Support]]
===== [[Gait]] =====


[[Gait]]
===== [[Older People - An Introduction|Older People]] =====
{{#ev:youtube|AWuKEt96Jjs}}<ref>Fabio Comana, Balance Training Exercises,ACE Exercise Physiologist, 2011. Available from https://www.youtube.com/watch?v=AWuKEt96Jjs&app=desktop</ref>{{#ev:youtube|FgzjxOnWYvA}}<ref>American Heart Association,2019.Available from https://www.youtube.com/watch?v=FgzjxOnWYvA&app=desktop</ref>{{#ev:youtube|JQJDerb1eCg}}<ref>Dynamic Sitting Balance Exercises For Older Adults, ICDPT, 2019. Avalable from https://www.youtube.com/watch?v=JQJDerb1eCg&app=desktop</ref>{{#ev:youtube|rbUmG8c5YM8}}<ref>Bob Schrupp and Brad Heineck, Bob and Brad, 2015. Available from https://www.youtube.com/watch?v=rbUmG8c5YM8&app=desktop</ref>
{{#ev:youtube|AWuKEt96Jjs}}<ref>Fabio Comana, Balance Training Exercises,ACE Exercise Physiologist, 2011. Available from https://www.youtube.com/watch?v=AWuKEt96Jjs&app=desktop</ref>{{#ev:youtube|FgzjxOnWYvA}}<ref>American Heart Association,2019.Available from https://www.youtube.com/watch?v=FgzjxOnWYvA&app=desktop</ref>{{#ev:youtube|JQJDerb1eCg}}<ref>Dynamic Sitting Balance Exercises For Older Adults, ICDPT, 2019. Avalable from https://www.youtube.com/watch?v=JQJDerb1eCg&app=desktop</ref>{{#ev:youtube|rbUmG8c5YM8}}<ref>Bob Schrupp and Brad Heineck, Bob and Brad, 2015. Available from https://www.youtube.com/watch?v=rbUmG8c5YM8&app=desktop</ref>



Revision as of 15:21, 18 September 2020

Original Editor - Anthonia Abraham
Top Contributors - Anthonia Abraham, Lucinda hampton and Kim Jackson

Introduction[edit | edit source]

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 popular in the treatment plan 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.An example of its application is in an below knee amputation, where the change of center of gravity and base of support affects functional equilibrium in dynamic activities. Balance training is also used during recreation for individuals,especially athletes, who wish to improve posture strength,coordination and stability as it is effective for postural and neuromuscular control improvements[3].

Indication[edit | edit source]

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


Assessment of Balance[edit | edit source]

Balance Training exercises are graded[1].Depending on the size and variability of postural sway, exercises could be categorized in easy, mid and hard[4] .This implies that the intensity of the exercise is dependent on 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 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[edit | edit source]

In 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 Walking
Prone lying (neck extension) 4 point kneeling High sitting with food on ground Double limb stance
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, rate of movement is recommend to slowly progress toward the speeds used in the sport, enabling 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 more suspictable 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]

Related topics and videos[edit | edit source]

Balance[edit | edit source]
Postural Assessment Scale for Stroke[edit | edit source]
Base of Support[edit | edit source]
Gait[edit | edit source]
Older People[edit | edit source]

[7]

[8]

[9]

[10]


References[edit | edit source]

  1. 1.0 1.1 Stephanie W.Balance Training.Fitness and Exercise.WEBMD. Available from;https://www.webmd.com/fitness-exercise/a-z/balance-training#:~:text=Balance%20training%20involves%20doing%20exercises,some%20very%20challenging%20yoga%20poses. [accessed September 18th,2020]
  2. World Health Organization (WHO).Falls.2018. 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 18th,2020)
  3. Astrid Z, PhD,* Markus H, PhD,† Lutz V, PhD,† Winfried B, MD, PhD,† Frank H, PhD,‡ and Klaus P, PhD*. Balance Training for Neuromuscular Control and Performance Enhancement: A Systematic Review. Journal Of Athletic Training.2010 Jul-Aug; 45(4): 392–403
  4. Muehlbauer, Thomas; Roth, Ralf; Bopp, Micha; Granacher.An Exercise Sequence for Progression in Balance Training.Journal of Strength and Conditioning Research: February 2012 - volume 26 - issue 2 - p 568-574.doi: 10.1519/JSC.0b013e3
  5. 5.0 5.1 National Strength and Conditioning Association. NSCA'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 September 18,2020)
  6. Wong A. M., Lin Y. C., Chou S. W., Tang F. T., Wong P. Y. (2001). Coordination exercise and postural stability in elderly people: effect of Tai Chi Chuan. Arch. Phys. Med. Rehabil. 82, 608–612. 10.1053/apmr.2001.22615. Available from https://pubmed.ncbi.nlm.nih.gov/11346836/
  7. Fabio Comana, Balance Training Exercises,ACE Exercise Physiologist, 2011. Available from https://www.youtube.com/watch?v=AWuKEt96Jjs&app=desktop
  8. American Heart Association,2019.Available from https://www.youtube.com/watch?v=FgzjxOnWYvA&app=desktop
  9. Dynamic Sitting Balance Exercises For Older Adults, ICDPT, 2019. Avalable from https://www.youtube.com/watch?v=JQJDerb1eCg&app=desktop
  10. Bob Schrupp and Brad Heineck, Bob and Brad, 2015. Available from https://www.youtube.com/watch?v=rbUmG8c5YM8&app=desktop

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