water. You may however get your hair wet… • The water constantly moves cre- ating a dynamic environment. You can create class movement to help train for balance, or have participants create water pertur- bation with their own limbs. • The water gives kinesthetic feed- back creating more kinesthetic awareness. • The water’s buoyancy supports limbs and the body, and the water’s resistance adds work- load for muscular endurance and strength needed for good balance. For an exercise program to be effec- tive, it must meet individual partici- pants’ needs, consider any individual impaired abilities, and adhere to cur- rent standards of fitness programming for older adults. Try the following sup- port progression (easiest to hardest) in the water using the pool side, foam hand bars, a kickboard or other buoy- ant devices that can be easily held. You can also have participants work with the hands and arms at the surface of the water for support, or at the sides which is more difficult. • Hold on firmly with two hands. • Hold on gently with two hands. • Hold on firmly with one hand. • Hold on gently with one hand. • Hold on gently with four fingers, then three, then two, then one. • Do not hold on. Have support within easy reach. Use the following foot and leg posi- tions to change the base of support to challenge clients. The stances are listed from easiest to hardest. • Stand with feet hip width apart. • Stand with feet together. • Semi-Tandem: move front foot ahead of the rear foot with feet hip-width apart (take a step for- ward and hold). • Tandem Stand: stand in heel-to- toe position (as if standing on a line). • One Leg Stance: raise one leg to the back, side, or front. Following are a few exercises you can incorporate into classes or training to 8 | Akwa | December 2017 / January 2018 promote balance by stimulating the visual, vestibular, and/or somatosen- sory systems. Standing in Place Stop performing any exercise if the participant becomes dizzy or disori- ented. Try different base of support positions to add challenge. • Stand in chest deep water and close the eyes for 3 seconds and open for 5. Try different arm posi- tions: out to side, at sides, over- head. (visual system) • Turn the head slowly side to side, look slowly up and down. (vestib- ular system) • Reach right, left, front, and back. (somatosensory system) • Have a partner gently and slowly push on the right, left, front, back shoulders to elicit the step strategy response. • Add cognitive tasks to the stand- ing exercises such as counting backward, reciting tongue twist- ers, counting in 3s, etc. • Perform knee lifts or hamstring curls in place while repeating any of the exercises above. • Perform back, front, and side toe touches. • Balance on one leg and swing the other straight leg forward and back, and side to side. Walking • In waist to chest deep water, with or without balance support, mov- ing forward, backwards, and side- ways. • Create water perturbation: n Other students walking past, behind, around. n Movements of the hands and arms to resist travel. • Walk in a circle, square, or an “X.” • Walk across pool while throwing and catching an object to oneself or a partner. Overhead Ball Pass Stand in a line in shallow water. • Have the participants stand in a line and pass the ball overhead to the person behind them. • Once the ball has reached the end of the line, have them pass the ball overhead in a forward manner. • Repeat two to three times. Ball Pass to Side • Have the group stand in a circle, pass the ball with both hands to the person on the right. • That person should grab the ball with both hands as well. • Once the ball is passed around the circle, switch directions. Pass the Kickboard • Have the group stand in a circle and pass a kickboard along the surface of the water to the person standing next to them. • Gradually add objects and weight to the kickboard and continue passing it to the next person. • Reverse directions. Although aging is inevitable, exercise can help make the journey of life eas- ier and more enjoyable! Balance your abilities, and those of your exercise participants, by developing aquatic programming that addresses balance through posture, stability, and mobil- ity activities. n Resources Rose, R.J. 2003. FallProof!: A Comprehen- sive Balance and Mobility Training Pro- gram Human Kinetics, Champaign, IL. Shumway-Cook, A. and M.H. Woollacott. 2001. Motor Control. Theory and Practical Applications, 2nd Ed. Phila- Lippincott Williams & Wilkins. Symbria Rehab. 2013. Exercise Guidelines for Balance and Fall Prevention. eLearning Continuing Education Course: Fitness Learning Systems. www.FitnessLearningSystems.com. Author June Chewning, MA, BS, has served as an educator since 1978 as an elementary physical education teacher, a college ad- junct professor, an instructor for community fitness and wellness, children’s courses, as a master trainer, and an instructor for con- tinuing education lectures and workshops internationally. June has created curriculum for accredited college courses, continuing education courses and workshops, wellness courses, certification/certificate programs, and community education. She is current- ly the education director of Fitness Learning Systems, a continuing education company for health-fitness professionals.