Balance is a highly complex and multi-factorial skill, where the body’s centre of mass must be controlled within the limits of stability. Through different combinations of muscle actions, being able to balance allows performance of everyday mobility tasks (standing, walking, reaching, stair climbing etc). Maintaining balance during such activities relies essentially on the integration of sensory stimuli either from internal sources (joint position awareness, i.e. proprioception) or from external sources (i.e. visual input).
Integral also is a well-functioning musculoskeletal system; one that is not affected by muscle weakness or limited by pain or contractures. Further challenges to balance may be secondary to the effects of medications, post acute events (such as stroke or hip fracture) or acute illnesses. Moreover, ageing, inactivity and many diseases can contribute to balance impairments. Thus, for balance training to be effective, it must be tailored to address each individual’s balance requirements.
Though active individuals experience fewer balance impediments and have less falls, research shows that simply increasing physical activity does not minimize one’s likelihood of falling. For effective falls prevention, exercise programs must specifically challenge balance. Moreover, exercises must be performed for at least two hours per week, with a recommendation that they are continued lifelong. If combined with high level balance training, strengthening exercises can be included in falls prevention programs.
However, muscle strengthening alone or walking as a sole intervention cannot prevent falls. Falls prevention guidelines for residential aged care facilities suggest that exercises challenging balance delivered in conjunction with ongoing exercises to be more effective. There are a range of evidence-based exercise programs targeting balance and providing ongoing exercise; such as the Otago Exercise Program of home-based balance and strength training and group-based Tai Chi. Participation in group-based exercises may offer the additional benefit of social interaction; ensuring greater enjoyment and compliance.
If you would like more information on Falls and Balance programs for seniors across Australia, do not hesitate to contact us.
Aged Care Physiotherapist
Revita – Health For Seniors