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Balance is taken for granted until someone loses it. It is indeed essential, and it is balance and adaptation that constantly provides safety and decreases fall risk. Balance is a term used to describe how one can remain stable in certain postures when stationary but particularly in movement. Success requires the coordination of many bodily systems such as sight, the ears and vestibular system, and peripheral and central nervous systems, along with joint and neuromuscular responses to certain stimuli that allow the body to know where it is in space and just how to respond. A study published by OJ Surgent in 2019 has documented that many areas of the brain coordinate and are responsible for balance.
As a person ages there are changes that can occur physiologically and biologically. For example, arthritic changes in the neck may affect the nerves providing sensory and motor information to the brain. Also, circulation plays a big role in the ability to maintain the body in a state of equilibrium and the circulation gets carried to the brain when it passes the neck. Another example is that when someone injures a joint or has surgery on a joint, the joint sensors relay information to know just where a joint is at any given time and what is needed to stay in a balanced position. These feedback systems allow the body to maintain a state of equilibrium.
The eyes make it easier to focus on objects. If a person feels imbalanced, trying to focus on a particular stationary object in front of them can be helpful. The vestibular system deals with straight lines, and angular and rotational movements. The semicircular canals in the ear deal with the rotational components. This system maintains equilibrium provided that the system is working properly and the fluid flows freely as it should when the head is moved. When there is an issue in this portion of the ear, vertigo and spinning can result. In most cases, this can be corrected but balance can definitely be affected because it is the inner ear that orients a person. Many people are diagnosed with benign positional vertigo (BPPV). There are techniques, the most common called Eppley’s Maneuver, that can get the semicircular canals flowing and functioning normally. If there are issues higher up in the brain and cerebellum, accommodation exercises can be done to help lessen symptoms and allow for the patient to be safer in balance.
The one thing that most people participate in on a daily basis is walking whether it be for simple activities of daily living or for exercise. Many muscles are used when walking but particularly the muscles that perform movements forward and backward (flexion and extension) are recruited to execute this activity. Usually, the muscles promoting side-to-side activities and rotations are also used but these muscles sometimes are weakened or not recruited in a timely manner with aging because of limited use and thus decrease demand on these specific muscles.
Exercise can be done to promote better balance in most situations. Starting the exercises before there are any balance issues may help to avoid any issues in balance and thus any risk for falls would be diminished.
In normal alignment of the body, muscles do not have to work too hard to maintain good posture because the body structures are lined up with the line of gravity. Activities cause the center of gravity of the body to shift, and the body reacts to these positions to keep balance. Core strength is vital to the execution of safe and proper balance.
Here are some exercises that can be done every day to help to maintain balance:
Sit to stand and back (essentially a squat)
Closing the eyes and trying to remain stationary with arms across the body
Rising up on toes
Raising toes up off the ground while only heals are on the ground
Stepping side to side
Getting up from a chair and walking around the whole chair to sit back down then reverse and go the opposite way
Step and lunge forward and back
Step forward and back using the clock as a guide, stepping to one o’clock then back and to two o’clock, etc.
Stand and move the arms from side to side while maintaining the stance.
Stand on one leg while keeping the shoulders level, can add arm motions side to side for this.
Stand and then reach down to pick up using a pendulum-type motion
As a person does better with balance, perturbation exercises can be added to further challenge the body. Placing foam under the feet can add imbalance and thus step up the challenge. To your Health!