Functional Sequence of Balance Training Exercises

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

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. 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 . 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.

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

• • Vestibular Disorders
  • Lower limb amputatee rehabilitation
  • Stroke rehabilitation
  • Fracture rehabilitation
  • Parkinson's diseases
  • Multiple sclerosis
  • Neuropathies
  • Postural dysfunction
  • Head trauma

Assessment of Balance

Balance Training exercises are graded.Depending on the size and variability of postural sway, exercises could be categorized in easy, mid and hard .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. 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 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.

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	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, 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.

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 

Below are links to videos demonstrating balance training exercises,

Description This video shows a progression of balance exercises including a sequence of standing stability exercises that target the core muscles, glutes, visual acuity,proprioception,

Resources

Balance

Postural Assessment Scale for Stroke

Base of Support

Gait

Older People

References

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