Benefits of Balance Training
Incorporating Balance Training into Your Daily Routine
Before we start our discussion on benefits of balance, I'm going to ask you to take 2 minutes of your time to assess your own balance. You may have challenged yourself in the past to balance on one leg. Since good balance is so important, I'm going to ask you to do that again. This assessment is designed to challenge your balance in two ways - first with your eyes open and then with your eyes closed.
I am going to recommend starting the assessment on the left foot. Starting with the left leg you'll want to position your body with your arms across your chest with your hands resting on/near the opposite shoulder (See Photo 1). Whenever you are ready, lift your right foot so it's just barely touching your left ankle. The clock stops if any of the following occur 1) lifted foot touches the ground 2) arms leave shoulders or 3) your raised foot remains in contact with grounded foot. If you exceed 1 minute you can stop and switch legs. Repeat the balance test on your opposite foot.
Photo 1
Now if you are up for a more serious challenge do the same task as discussed above, however this time do the exercises with your eyes closed - this will make the challenge more difficult as it takes away vision which is one of the sensory inputs the human body uses to maintain balance.
Below is a link to a study that was used to assess balance in the exact way we tested above. You'll find data for both genders ages 18 and older Journal of Geriatric Physical Therapy Vol. 30;1:0 (1).
A quick glance at the data will illustrate that older adults balances times were significantly less than those subjects who were younger. The decline in balance times are mainly due to the overall decline of the sensory inputs that the human body uses to maintain balance. This leads to a overall decline that can lead to an overall decline in cognitive abilities. Two examples of this are as follows.
Example 1: Perform a demanding task that your body isn't used to i.e. dribbling a basketball while running for the first time. You likely aren't thinking about anything other than dribbling and running - and the task is performed very poorly despite the outmost attention given to the task
Example 2: "Stops walking when talking" phenomena - this can be seen in older adults and it displays the reduction in ability to perform multiple tasks during a given moment.
Without a doubt, we will all have to deal with a reduction in cognitive ability over the course of our life. However, the decline doesn't have to be rapid or drastic. Research has demonstrated that those who maintain an active lifestyle and exercise into older age can benefit in a number of ways such as - maintain or improve balance, coordination, spatial awareness, cognition, and the many benefits of physical activity i.e. reduction in risk of CVD, diabetes, etc (2,3,4,5).
While being active and exercising throughout life is preferred, it is never too late to start. Being sedentary especially into older adulthood can be problematic when it comes to CVD, diabetes, fall risk and much more. By becoming more active regardless of age, the body is challenged to become a more robust system. This process can be explained by the SAID principle (Specific Adaptation to Imposed Demands). This principle explains how the body adapts overtime to a stressor.
If the body is introduced once a month to a stressor, it'll have no reason to adapt. It's the repeated exposure to the stressor (i.e. 2-4 times a week of strength training) that provides enough demand to cause the body to adapt positively. However, too much exposure too soon or an inadequate recovery time will cause too much overload and could lead to a negative response within the body, i.e. injury or sickness. Additionally, as the body becomes more robust, the same stressor that caused positive responses at the beginning of training will no longer cause additional adaptions. This ultimately leads to a plateau in which the body will not adapt any further. Additionally, if the stressor is discontinued (1-2 weeks) the body will begin to reverse the adaptions and eventually return to baseline over the next 6 - 12 weeks depending on training status. These phenomenon are known as the overload principle and the principle of reversibly, respectively.
The last principle I am going to discuss is the the principle of specificity. The most simplified version of this principle is to determine what the goals of the program are. For some it may be as simple as improving balance to prevent falls and for another it may be to become a professional surfer. Identifying the goals of the individual could make the difference between success or injury. Now that we have a basic understanding of exercise and sport physiology, let's take a dive into how the body maintains balance and coordination.
Balance and Coordination with the Body
Balance and coordination within the human body is complex. Balance is a mix of sensory and motor inputs that allow us to maintain an upright body position. The sensory inputs are made up of the visual, proprioceptive (touch) and vestibular systems - with each providing valuable information on location of the body within the environment. This information is then relied to the brain, specifically the cerebellum and cerebral cortex, which processes the sensory information. Once processed (this process takes a few milliseconds) the brainstem transmits the impulses to the muscles that control the eyes, head, neck, and rest of body that allow a person to maintain balance, coordination and attention to the sensory input in the environment. It's the constant back and forth of information that allows us to maintain an upright position. As you may have learned from the original balance test, take away one of the three sensory inputs and balance will suffer.
Benefits of Balance Exercises
Balance is an important aspect to activities of daily living, sport performance and physical activity. The types of exercises that are commonly selected for developing balance are focused on core muscles, multiple joints and are specific to the individual. As we've discussed specificity is key, choosing exercises for a 75 year old woman, won't help a professional surfer in the slightest and having the 75 year old woman perform the surfers program will likely result in injury. Therefore assessing the needs of the individual are key to a successful program, regardless of whether the program is being designed for strength, endurance, balance, etc.
Activities such as yoga, tai chi, and multi joint exercises, i.e. squats are activities that should be selected to improve balance. Additionally, these activities are generally safe for most populations to engage in. It's important to remember that whenever you begin an exercise program you should talk to a health care professional to ensure the program would be safe for you. Performing balance training and other forms of physical activity challenge the body in several ways. As previously discussed balance training will require individuals to utilize both sensory and motor inputs to maintain an upright position. For beginners exercises such as balancing on one leg, heel to toe walking and tai chi may prove to difficult. Overtime, the body will begin to adapt and the activities performed will begin to become less difficult.
The first adaptions to occur are neurological, and as previously hinted at these occur rapidly over the first few weeks. Over time, these neurological adaptations begin to occur more slowly. From there musculoskeletal adaptations such as muscle fibers changes, muscular hypertrophy, muscular endurance, etc will begin to occur. The 6-10 week delayed onset of these musculoskeletal changes are why individuals do not see physical changes (i.e. increase in muscle/decrease in fat) at the beginning of an exercise program. The delay is just a normal part of human physiology, and this is why most people stop an exercise routine - as they do not see any changes within the first 6-10 weeks. Unfortunately if they had just "stuck with it" for a bit longer they would have began to see the changes they were looking for.
Enough about muscle physiology, let's close our discussion on balance.
By carefully selecting exercises to improve balance, individuals could reduce their fall risk, improve posture, increase coordination and improve lower body stability. The types of exercises selected should be specific to the individuals needs and provide enough overload but not too much. It's the balance (pun intended) of the variables discussed in section one that allow the human body to develop over time. Lastly, studies that it is never too late to start balance training, so what are you waiting for - take the steps to improve your balance today.
Do you need help selecting exercises specific for your needs? We can help. Russel is a certified strength and conditioning coach and has had the opportunity to provide education on body composition, cardiovascular health, sport performance, sports nutrition, exercise and metabolic testing, and pulmonary function testing across a variety of applied and clinical applications.
Learn more about Russel and Allison
References:
1) Springer, B.A, Marin R. COL, Cyhan T., Roberts H., Gill N.W. MAJ. (2005). Normative Values for the Unipedal Stance Test with Eyes Open and Closed. Journal of Geriatric Physical Therapy Vol. 30;1:07
2)Hafström, A., Malmström, E. M., Terdèn, J., Fransson, P. A., & Magnusson, M. (2016). Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program: A Randomized Single Arm Crossover Study. Gerontology & geriatric medicine, 2, 2333721416644149. https://doi.org/10.1177/2333721416644149
3) Martínez-Amat A, Hita-Contreras F, Lomas-Vega R, Caballero-Martínez I, Alvarez PJ, Martínez-López E. Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial. J Strength Cond Res. 2013 Aug;27(8):2180-8. doi: 10.1519/JSC.0b013e31827da35f. PMID: 23207891.
4) Galloza J, Castillo B, Micheo W. Benefits of Exercise in the Older Population. Phys Med Rehabil Clin N Am. 2017 Nov;28(4):659-669. doi: 10.1016/j.pmr.2017.06.001. PMID: 29031333.
5) Mittaz Hager AG, Mathieu N, Lenoble-Hoskovec C, Swanenburg J, de Bie R, Hilfiker R. Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial. BMC Geriatr. 2019 Jan 14;19(1):13. doi: 10.1186/s12877-018-1021-y. PMID: 30642252; PMCID: PMC6332592.
