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Three ways we Stay Balanced
Several systems control our balance. They are:
Visual: We use our eyes to help us figure out where we are in space, to see what is in front of us, and to avoid obstacles. As we age, visual acuity is reduced and we are more likely to fall as a result. Poor vision may lead to a loss of balance; we also may fall when it's dark and we can't see well.
Somatosensory: This system is about touch and sensations. (e.g. The bottoms of our feet tell us where we are connected to the ground.) The inner ear has two functions, one for hearing, the other for balance. Our internal spatial orientation — known as proprioceptors (which means "sense of self" — tell us where our arms and legs are positioned in space. They provide information to our brain about joint angle, muscle length, and muscle tension. As soon as you move your arm or leg, the proprioceptors provide you with information about how you moved in space.
- Vestibular: Located in the inner ear, the vestibular system helps us to know where we are in space even when our head is tilted or turning. The inner ear is made up of small tubes filled with fluid; they are encased within the temporal bone of the skull. It has three sections: the cochlea helps us to hear; the other two — the canals and the vestibule — help us with our balance. The inner ear is particularly helpful when we turn our head, especially while we are walking. Within the inner ear are two other balance and equilibrium structures. One is the saccule which translates head movements into neural impulses which the brain can interpret. The other is the utricle: small stones and a viscous fluid stimulate hair cells to detect motion and orientation, especially when we turn our head.
Why do we lose our balance?
As long as we have an even distribution of weight over our base of support (two legs), we are stable.
Static balance is standing still: there is some postural sway but it is under control.
When we interact with our environment — walking, pushing a grocery cart, or opening a door — we are using our dynamic balance. As we move, our centre of gravity shifts and the base of support changes. It’s harder to maintain our dynamic balance because moving means constant changes in the base of support.
Many things inside and outside our bodies affect our balance — they are sometimes referred to as intrinsic forces (muscles, joints, our brain, and changes in our body as we age) and extrinsic forces (from objects in our way to noise and lighting). Because loss of balance is often considered a part of the aging process, people don’t always seek medical attention, but each person must decide if a visit to the doctor for further diagnosis is necessary. Loss of balance can be caused by many things, and some of these are:
- Moving too fast;
- Poor visibility and lighting;
- Fatigue, poor concentration, drugs or alcohol;
- Attempting too many tasks at once;
- Changes in gait, lack of muscle strength, loss of joint mobility, foot disorders, visual impairments, and poor circulation.
What do we do to prevent ourselves from falling?
The three strategies that we employ to prevent falling involve our joints:
- Ankle strategy: As soon as the base of support changes, the muscles that control the ankle work. These muscles are in the lower leg and pass over the ankle and connect with the foot, the most noticeable being the gastrocnemius (calf), soleus, posterior tibialis and anterior tibialis (shin).
- Hip Strategy: If the ankles can’t keep us steady, and the base of support and our centre of gravity wavers, the hips go into action. We may move our hips left to right, or forward or backward. Our arms will also go out to try to level everything. The key muscles involved here are the abdominals, hip flexors, gluteals, hamstrings, and the erector spinae (lower back).
- Step Strategy: Our final line of defence is to step — it may be forward, to the side, or backward — but we will move. If all goes well, our base of support will become solid again under the centre of gravity.
What can be done to keep our balance as we get older?
Most research on this subject is finding that balance can be improved through routine group-based exercise classes. One such study looked at 165 people over the age of 65. Half the group did not exercise; the other half did a weekly exercise class and some at-home exercises.
According to the abstract, "The intervention subjects attended a median of 23 exercise classes over the year, and most undertook the home exercise sessions at least weekly. At retest, the exercise group performed significantly better than the controls in three of six balance measures; postural sway on the floor with eyes open and eyes closed and coordinated stability."
The researchers concluded that "participation in a weekly group exercise programme with ancillary home exercises can improve balance and reduce the rate of falling in at-risk [older adults]."
Loss of muscle strength and flexibility as we age can be stopped or reversed...if we want to work at it and if we do some activities regularly. A good balance program should be for all ages, include both stationary and moving activities, be performed slowly, be well-lit, and have minimal distractions. While doing balance activities, good posture is a priority. Recently, researchers found that music may have benefits for our health and specifically for our balance. This research with the long title caught my eye: The Effect of Music-Based Multitask Training on Gait, Balance, and Fall Risk in Elderly People.
The researchers of this study already knew that “falls occur mainly while walking or performing concurrent tasks.” They wondered “if a music-based multitask exercise program could improve gait and balance and reduce fall risk in elderly individuals.” They conducted a 12-month study involving 134 individuals older than 65 years, who were at increased risk of falling. They were divided into two groups: One group was involved in a “six-month multitask exercise program performed to the rhythm of piano music.” The other group received no special instruction or training for six months, and then were given the same instruction as the first group. Participants were tested for their gait and balance stability at the beginning and the end of the programme.
The researchers concluded that “a 6-month music-based multitask exercise program improved gait under dual-task conditions, improved balance, and reduced both the rate of falls and the risk of falling,” particularly in older people. This was a small study, but an interesting one. And, if music — in this case, piano music — helps older adults to improve their balance, might it also be helpful to younger people? And if piano music works, why not other kinds of music? There’s no clear answer to those questions without further research, but logic suggests that we can extrapolate from this that there may be many benefits from moving to music. It’s worth keeping in mind.
Remember: falls often occur when we are multi-tasking. When we are trying to do too many things at once, we are more likely to fall and injure ourselves. Just as drivers should not be texting or talking on the phone, walkers should be extra cautious when carrying something, walking fast, or distracted by noises or other people.
What activities will help improve balance?
Let's divide this into three basic training categories: core, strength, and cardiovascular. Here is a short list of some activities that will help.
- Standing: Use of the 55-cm utility balance ball, BOSU 2, half-roller, or heavy foam. There are various challenges one can do on these pieces of equipment, and it can be enhanced if one does another task while standing on the equipment (such as leaning forward, throwing a ball, or moving one's arms).
- Sitting: Use of the dynadisc, chair walking (moving forward and backward in the seat), lifting of hips independently, leg extensions.
- Walking/Moving Exercises: Marching to music, walking and turning head.
- Using a small ball: Tossing, throwing, catching (while standing, sitting, or walking).
- Free-standing squats and lunges. Also useful to hold positions for 15-30 seconds.
- Stepping up and down on a step.
- One-leg standing exercises such as standing on one leg.
- Two-feet standing exercises such as putting feet together, semi-tandem, or tandem, and holding for 30 seconds. (For a greater challenge, try closing your eyes.
- Climbing a flight of stairs, or coming down a flight of stairs.
- At least 30-minutes a week of moderate-intensity aerobic exercise (notice the study below regarding "more minutes of physical activity may lead to better balance").
- Walking, fitness classes, cycling, swimming. You can choose the activity you wish to do.
Some other activities to challenge your balance
Stork Stand: Stand on one foot and try to maintain your balance as long as possible. Repeat on the other leg. Once mastered, try standing on one leg for up to a minute with your eyes closed. Stand in the corner of a room or near a chair for support, especially if you close your eyes.
Walk the Line: Walk a straight line on the floor by placing one foot in front of the other (heel-to-toe). Try walking backwards in the same fashion. Advanced students: turn your head while walking or close your eyes! Have someone nearby to assist you if you are doing something with your eyes closed.
Stair Lowering: Hold a handrail for support, stand on a stair and lower your heel down to the next step. Before letting your heel touch the stair below, immediately raise your leg back up to the stair above. When you feel safe, try doing it without the handrail. Have a friend nearby for assistance.
Half-Roller: Stand on the device and challenge your balance. Don’t do this unless you already have fairly good balance and you want to maintain or improve it. Stand near a wall for support if you have any concerns about your stability.
This article is part of a series about various health conditions and the benefits of exercise. The other articles are:
- Exercise and Allergies
- Exercise and Arthritis
- Exercise and Asthma
- Exercise and Cancer
- Exercise and Chronic Pain
- Exercise and Circulation
- Exercise and COPD
- Exercise and Dementia
- Exercise and Diabetes
- Exercise and Heart Disease
- Exercise and Hypertension
- Exercise and Lifestyle and Older Adults: Recent Research
- Exercise and Mood
- Exercise and Osteoporosis
- Exercise and Our Brain
- Exercise and Pain vs. Burn: Will it ever stop hurting?
- Exercise and Parkinson's
- Exercise and Sleep
- Exercise and Stroke
- Exercise and Viruses: Exercise Immunology
I am a BCRPA-certified fitness instructor in Vancouver, BC. I teach four classes at the West End Community Centre in Vancouver, BC, mostly designed for the older adult. The Inevitable Disclaimer: Everything published here expresses only my opinion, based on my training and research. What you do with the information is entirely your own responsibility. I am not liable for any injury you suffer that seems to be related to anything you read here. Always consult your doctor before beginning an exercise program. For other articles, return to the table of contents.
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BOSU is an acronym for "BOth Sides Up" a reference to the two ways a BOSU ball can be positioned. The device is often used for balance training. When the dome side faces up, the BOSU ball provides an unstable surface while the device remains stable. ↩︎