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ACE Fitness | Balance Training: Should Your Customer's Age Affect Your Programming?



In everyday life, proper posture control is required to safely manage activities of daily life (eg walking or climbing stairs without falling). The ability to effectively perform equilibrium activities throughout the lifetime is important for both health and daily activities. Individuals who experience deficits in balance performance increase the risk of falling and suffering injury. Therefore, training to improve balance performance becomes a critical element of exercise programming. The question is: should the balance be trained in older adults as well as in younger adults?

Equilibrium performance includes both static conditions, where the base of support, such as the feet, and the ground remain stationary, as well as dynamic conditions, where both the support base and the center of gravity shift. Balance can be further subdivided to static equilibrium stability balance, dynamic equilibrium stability balance, proactive equilibrium (also referred to as anticipatory equilibrium) and reactive equilibrium (definitions in Table 1

).

With age, certain physiological systems begin to decline. This can greatly affect the ability to maintain proper postural control or balance. Age-related decreases in the vestibular (inner ear), visual, somatosensory, musculoskeletal, and central nervous systems as well as in orthopedic problems and cognitive impairment all contribute to a worsening of balance (da Silva Borges et al., 2014, Lord et al., 1994). As a result, older adults may experience balance and stability impairments, increasing the risk of falling under both static and dynamic conditions.

The ability to maintain balance and perform activities of daily life effectively depends on the person's ability to effectively regulate the relationship between the center of gravity of the body and the support base. The postural control system must integrate the sensory information about the body's sway and activate the muscles according to their order and intensity.

Let's look at how younger adults and older adults differ in the way they try to keep their balance. In equilibrium steady state, such as. For example, when they are standing still, older adults activate up to three times more muscle in comparison to young adults to maintain their balance (Laughton et al., 2003). It is believed that weakness of the leg muscles, especially the tibialis anterior and the vastus lateralis, may affect the ability to correct a shift in the center of gravity of the body. An elderly adult may need to keep these leg muscles in an activated state to provide additional stability with increased muscle weakness. Strengthening the leg muscles can help an older adult to correct shifts in the body's center of gravity.

If we look at the dynamic balance in equilibrium, such as We also see differences in the way younger and older adults keep their balance. If an external disturbance occurs, such. Slippage, a common strategy is one step, either as anterior-posterior or medial-lateral movement. In anterior-posterior movements, older adults tend to follow similar recovery strategies to younger adults, but they spend significantly more time implementing the pacing strategy, which can lead to a fall (Porter and Nantel, 2015). In a medial-lateral motion, older adults tend to step forward in a medial-lateral direction, which may affect their ability to recover and lead to a lateral fall (Porter and Nantel, 2015). In addition, older adults tend to move their arms and use safety handrails more frequently than younger adults, and they tend more often to collide between the panning foot and the foot in a medial-lateral disorder (Maki et al., 2000). The lack of lateral stability can cause the older adult to fall aside, which can lead to debilitating hip fracture. As we get older, we also tend to take more steps to restore our balance from a lateral step than when we were younger.

Finally, we can look at anticipatory and reactive balance strategies. Older adults rely more on reactive balance strategies than on proactive strategies, which means they are more likely to respond to a balance imbalance compared to a younger adult who expects a disorder and makes appropriate adjustments to maintain balance (Paxton et al., 2008

While static, dynamic, proactive, and reactive balances require the integration and coordination of the same systems, each system places different demands on the control systems, for example, the center of gravity of the body moves during a static posture. at standstill), slowly with small fluctuations created by small external forces acting on the body, but with dynamic activities there are greater external forces and more variations in the environment, which are more demanding all balance control systems n (Hrysomallis et al., 2006; Winter et al., 1996).

Therefore, several exercises that provoke dynamic / static, stationary, proactive, and reactive balance types should be used during training to tailor each balance dimension individually. Older adults may need to perform additional activities at the frontal level to promote stability in a medial-lateral disorder. The proposed activities for each type of balance can be found in Table 2.

Table 1: Definition of the types of scales

Term

Definition

Example

Static stationary balance

Maintenance stable position during standstill

Maintaining balance while sitting or standing

Dynamic equilibrium in equilibrium

Maintaining a stable position during movement

Maintaining equilibrium during walking

Proactive balance

Forecasting postural disturbance

Maintaining equilibrium up to the shelf

Reactive balance

Compensation of unforeseen postural disturbances

Maintaining equilibrium after slipping on wet soil

Table 2: Example activities for different types of equilibrium

Balance Component [19659028] Example activities

Static balance of equilibrium

Standing with changes in the support base (feet shoulder width apart; close attitude; staggered) attitude; Stance posture)

Dynamic Balance in Balance

Walking with changes of support base (feet shoulder-width apart, half-tandem; heel to toe); lateral gradation

Proactive balance

Ball trap with changes in the support base; Obstacle course

Reactive Balance

Unexpected impulse; Use of foam pillows

References

da Silva Borges, E.G. et al. (2014). Postural balance and falls in elderly nursing home residents participating in a dance program. Archive of Gerontology and Geriatrics 59, 2, 312-316.

Hrysomallis, C. et al. (2006). Link between static and dynamic balance tests between Australian elite footballers. Journal of Science and Medicine in Sports 9, 4, 288-291.

Laughton, C.A. et al. (2003). Aging, muscle activity and balance control: Physiological changes associated with balance disorders. Gait and Attitude. 18, 101-108.

Lord, S.R. et al. (1994). Physiological factors related to falls in older women in the community. Journal of the American Geriatrics Society 42, 10, 1110-1117.

Maki, B.E. et al. (2000). Age-related differences in lateral compensatory step behavior. The Journal of Gerontology Series, Biological Sciences and Medical Sciences 55, M270-M277

Paxton, J. et al. (2008). Cognitive control, goal preservation and prefrontal function in healthy aging. Cerebral Cortex, 18, 1010-1028

Porter, S. and Nantel, J. (2015). Older adults prioritize postural stability in the anterior-posterior direction to restore balance after an arbitrary lateral step. Gait and Attitude, 41, 666-669.

Winter, D.A. et al. (1996). Uniform theory regarding A / P and M / L balance in a calm attitude. Journal of Neurophysiology 75, 6, 2334-2343


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