Balance Training For the Elderly

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April 09, 2005 | 35,885 views

By Paul Chek, HHP, NMT
Founder, C.H.E.K.Institute

Whether you are in the 65 or older crowd today or not, chancesare you know someone who is already there. And, as much as you maytry to fight it, someday you will be too! Nowadays, "growingold gracefully" means more than it used to, because fallingis the leading cause of death among people age 65 or older. 1The fact is, balance is something that begins to fail as we growolder. Unless we take steps to improve or maintain our balance,we may end up as one of the unfortunate statistics after a fall.

Though there are numerous exercise programs available for the elderly,many of these utilize fixed-axis machines, which may help with age-relateddecreases in muscle mass and strength, but offer inadequate loadingof the spine and long bones and do almost nothing to improve balanceor functional strength on your own feet.

To be successful in any balance-improving training program, peoplemust perform movements that closely approximate their everyday activitiesand those movements that commonly result in falls. What followsare some exercises to improve your balance and stability as wellas reduce your chances of falls.

Gait: The Toe-Touch Drill

Gait or walking deficiencies are most commonly seen in the stancephase while standing firmly on one foot while walking. The mostcommon problem is the inability to resist the pronation (interiorrotational) forces of gravity on the body, resulting in the internalrotation of the femur, tibia and foot/ankle complex associated withdistension of the abdominal wall. This muscle imbalance often resultsin flat feet.

The Toe Touch Drill performed on the Total Gym Target Grid (orother similar apparatus) improves the function of the stabilizersystem while improving balance and coordination on one leg, providinga high functional carryover to both gait and stepping activities.

To perform this exercise, start by standing on one leg. Pretendyou are standing in the middle of a clock face. Then, with yourbelly button drawn in and standing in good upright posture, slowlybend the leg you're standing on while attempting to reach the oppositeleg's toe out as far as possible in front of you.


Figure 1

You must keep your working knee directly over your second toe.Once you cannot keep it in this position, stop the exercise andmark the spot your toe reached. Perform this in all the positionsof the clock with one leg, then the other. (Figure 1) After youhave every position marked, you should stop just short of the markfor a while, performing 1-3 repetitions of the movement. Retestyourself to see if you've improved every week after performing theexercise every other day. If one leg is stronger, always limit theamount you do on that leg to match the weaker leg until they matchand develop from there.

Squatting: The Bench Squat

The Bench Squat affords you the confidence and support that comeswith knowing you won't fall on the floor if you can't hold yourselfup.


Figure 2

To increase your functional base of support and improve confidence,hold a wooden dowel in one hand to aid balancing as needed. Forthose with very poor balance, I allow one dowel in each hand, althoughI have never had an elderly patient -- including those as old as84 -- who needed a second dowel rod. Straddle the bench as low asis comfortable for you with good form. (Figure 2)

Repeat to fatigue 1-3 times, and repeat 2-3 times a week. As youbuild your strength, endurance and confidence, you'll be able toremove the dowel rods and bench, and progress into traditional squatting.

Posture: The Supine Lateral Ball Roll

Although it looks hard, the Supine Lateral Ball Roll is only challengingin proportion to how far you deviate laterally on the Swiss Ball.This excellent exercise allows you to integrate the upper and lowerextremities via the trunk, improves stability and balance and providesa functional carryover to gait and any pushing or pulling activitythat requires integration of the anterior and posterior muscle systemsof the body.

Activation of the extensor muscles from shoulder to contralateralhip aids in strengthening the muscles across the apex of the thoracic(middle back) curvature, improving posture. With just a short periodof practice, you should become much more confident on the SwissBall.


Figure 3

From a seated position, roll down the Swiss Ball so your shouldersrest in the middle of the ball. Keep your palms to activate yourshoulder girdle retractor muscles. Extend your hips upward untilyour knees, hips and shoulders are all in the same horizontal plane.(Figure 3) Draw your belly button inward enough to activate yourinner unit and place your tongue on the roof of your mouth.

Move laterally from side-to-side without twisting or tipping. Ensureyour hips and arms do not drop and your chin stays tucked in slightly.Hold at the end position and return to the middle of the ball.

Seated Posture Trainer

With a soft 5-pound diver's weight on your head, the Seated PostureTrainer will help you develop an increased sense of proprioception(body awareness) while learning proper seated postural alignment.


Figure 4

To perform the Seated Posture Trainer, sit on a properly sizedSwiss ball and, while holding a neutral curve in your lower back,gently draw in your belly button while sitting in good posture.As you become more confident with this exercise, one foot can belifted off the ground, shifting your center of gravity and increasingthe amount of balance you need. (Figure 4)

With this one exercise posture, your balance and confidence shouldimprove ! Eventually, you should be able to sit on the ball withgood upright posture for one minute without allowing your feet totouch the ground or allowing the diver's weight to move from thetop of your head.

Conclusion

The chart that follows below features a sample workout for thoseinterested in incorporating these exercises into your program. Whetheror not you've reached the "Golden Years," these exerciseswill do wonders toward maintaining a good sense of balance and preventyou from becoming a statistic.

Exercise Rest Intensity Reps Tempo Sets
Toe Touch Drill Body Weight.+/- 1-3 ea. Medium-Slow 1-3
Squatting Body Weight.+/- 12-16 Slow 1-4
Supine Lateral Ball Roll ~ 60% Max 6-8 ea. Hold 1-3 sec. 1-3
Seated Posture Trainer
1:00 Variable 1 Hold 1-3:00 1-3

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Suggested reading/viewing and equipment for balance exercises:

  1. Scientific Balance Training (Audio)
  2. Swiss Ball Training (Correspondence Course)
  3. Duraball Swiss Balls (Balance Training Equipment)
  4. Functional Testing and Training Grid (Balance Training Equipment)

Paul Chek, HolisticHealth Practitioner and certified Neuromuscular Therapist, isthe founder of the C.H.E.K Institute in Vista, Calif. He is alsosought-after consultant to sporting organizations, his serviceshave benefited numerous professional sports teams, athletes andindividuals seeking optimal health worldwide.

Paul has produced more than 60 videos, 17 correspondencecourses and is the author of several books, audio programs andarticles. For more information on Paul's popular "You AreWhat You Eat" audio/workbook program, or for any of his otherhealth/exercise courses, videos and books, call 800/552-8789,800/552-8789 (New Zealand or Australia), 44 (0)1273-856-860 (GreatBritain) or visit online at theCHEK Institute Web site. Please feel free to request a catalogof CHEK Institute products.

References:

  1. Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final Data for 1997. National vital statistics reports; vol. 47 no. 19. Hyattsville, Maryland: National Center for Health Statistics, 1999.

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