Balance Your Abilities Compiled By: June Chewning MA, BS The information provided in this article is from the continuing education course “Exercise Guidelines for Balance and Fall Prevention” authored by Symbria Rehab and produced by Fitness Learning Systems. To learn more about balance and fall prevention science and strategies, see Symbria Rehab’s continuing education course “Exercise Guidelines for Balance and Fall Prevention” produced by Fitness Learning Systems and found at https://fitnesslearningsystems.com/51101/product_page.php?course_id=W013 FLS is proud to be an IACET accredited continuing education provider for the Aquatic Exercise Association. For more information go to www.aeawave. com, click on Education, CE Providers, eLearning. Use Coupon Code “BALANCE” at check out to receive a 20% discount on “Exercise Guidelines for Balance and Fall Prevention.” For help or questions, call 888.221.1612. Balance is the foundation of stability in an upright, sitting, and kneeling pos- ture for humans. If balance is not prac- ticed and promoted, balance can be compromised even as early as the teen years. Balance is of particular impor- tance to older adults and is a large part of the fall prevention equation. Balance can be defined as the ability to control the body’s center of mass with respect to the base of support, whether it is stationary or moving (Rose 2003). Good balance exists because multi- ple systems interact automatically to provide accurate information to our nervous system. We constantly pro- cess information about the strength, force, timing, and speed of movement to keep ourselves upright (Rose 2003). Balance is a complicated body function requiring information from the inner ear (vestibular system), the eyes (visual system), and the pressure sensors of the joints, muscles, and skin (somato- sensory system). Two of these three systems must be working well to main- tain balance (Shumway-Cook 2001). In addition, an individual’s brain must be alert, and you must have adequate muscle strength and joint flexibility. 6 | Akwa | December 2017 / January 2018 The foundation of balance stems from posture, stability and mobility. Posture Posture is the relative position of the various parts of the body with respect to one another and the envi- ronment. While standing in space, the objective is to align each of the body parts vertically while using the least amount of energy to maintain an upright and stable position relative to gravity. There is a distinct relationship between good posture, good balance, and fall prevention. While many activities that rely on bal- ance and mobility allow us to inten- tionally plan our actions beforehand, there will be times when an unforeseen event forces us to respond automat- ically. To correct for these expected and unexpected challenges to bal- ance, the central nervous system may employ anticipatory and/or reactive postural responses. Anticipatory pos- tural control describes those actions that are planned, such as avoiding obstacles while walking to the store. Reactive postural control describes sit- uations that cannot be planned prior to the action being required, such as stepping in an unnoticed hole. Three fundamental strategies have been identified to assist with regaining balance: • The Ankle Strategy: adequate range of motion and strength in the ankle joints; firm, broad sur- face below the feet; adequate level of sensation in feet and ankles. If the ankle strategy is successful, no stepping action is needed to maintain balance. Several com- mon balance devices (rocker boards, foam rollers, and balance pads) elicit the ankle response. • The Hip Strategy: adequate range of motion and strength in the hip region. This involves activation of the larger hip muscles and is used when the center of gravity must be moved more quickly back over the base of support as the speed or distance of the sway increases. The upper body moves in a direc- tion that is opposite of the lower body. This strategy is important when we are standing on a sur- face that is narrower than the length of our feet, because there is not enough surface to push
