Balance Training with the Older Adult Client

by Evan Osar, D.C. |  Date Released : 30 Jan 2017

Developing a Strategy for Balance

The goal is to develop a strategy for balance that helps improve the function of the trunk in maintaining and controlling balance. Incorporating the principles of alignment, breathing, and control to improve function of the thoracopelvic canister is an effective way to develop an optimal strategy for balance. How are these principles related to improving balance and reducing the chances of falling?

  • Aligning the TPC enables the joints to be placed in the best position for loading the body, allows for proper muscle co-activation, and diminishes chances of compensations. This allows the nervous system to coordinate muscle activity to control balance both in stationary positions and throughout movement.
  • Three-dimensional breathing develops internal pressures that stabilize the TPC and activate the deep myofascial system. This provides TPC (core) stability without the need for gripping, bracing, or rigidity allowing the body to be both stabile and mobile. Achieving trunk mobility and stability allows for adaptations to sudden changes in a senior’s center of mass thereby preventing a fall.
  • Developing proper control of both static posture and dynamic balance requires coordination between the deep and superficial myofascial system. Being able to preferentially activate the deep myofascial system and layer on the superficial myofascial without resorting to a gripping or rigidity strategy is the key to maintaining that subtle balance between TPC stability, mobility and adaptability. 

For more information and applications of developing the deep and superficial myofascial system, the reader is encouraged to review the information in the following link:  http://www.ptonthenet.com/articles/the-functional-role-of-fascia-in-posture-and-movement-part-1-3871

Incorporating the Principles into a Balance Progression

While there are an infinite number of exercise patterns and progressions that can be used, the step/lunge pattern will be used for purposes of this article. By adjusting variables such as the amount of movement, velocity of movement, degree of support, adding resistance, or adding dynamic variables such as throwing and catching a ball, the step/lunge pattern can be used by virtually any ambulatory client.

To ensure proper development of balance, the following guidelines will apply to the exercise progression:

  • The thorax should symmetrically aligned over the pelvis and the entire TPC should be controlled over the feet
  • The hip, knee, and ankle-foot should remain aligned during both loading (eccentric) and unloading (concentric) phases of the exercises
  • The client should maintain three-dimensional breathing throughout the patterns 

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Evan Osar, D.C.

About the author: Evan Osar, D.C.

Dr. Evan Osar is the developer of the Integrative Movement Specialist™ certification designed specifically to aid the fitness professional establish themselves as an invaluable part of their client’s health care team. In addition to his chiropractic degree, Dr. Osar has earned national certifications through the American Council on Exercise (ACE), National Academy of Sports Medicine (NASM), National Strength and Conditioning Association (NSCA), and The Soma Institute – National School for Clinical Massage Therapy.

He is the founder of Fitness Education Seminars, DBA: The Institute for Integrative Health and Fitness Education, an education company with the mission of helping trainers and therapist recognize their role as a part of the solution to the health care crisis. An internationally renowned speaker, Dr. Osar presents for several national and international organizations including American Council on Exercise, Club Industry, SCW ECA 360, IDEA, NSCA, Perform Better, Medical Fitness Association, Asia Fit, FILEX, AECC, British Chiropractic Association and Norwegian Chiropractic Association.

He specializes in bringing advanced training and rehabilitation strategies to the fitness and bodywork professional that works with the pre and post-rehabilitation and general population client. Additionally, he has developed over a dozen resources including courses, manuals, and DVD’s to support the educational needs of the next generation of health care professional. His mission is to help fitness professionals think bigger about their role in the lives of their clients.

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