Whether you are in the 65 or older crowd yet or not, chances are you know someone who is and, as much as you may try to fight it, someday you will too. Nowadays, ‘growing old gracefully’ means more than it used to, as seen by the fact that falling is the leading cause of death among people age 65 or older (1). The fact is, balance is something that begins to fail as we grow older and, unless we take steps to improve and/or maintain our ability to balance, we may end up as one of the unfortunate statistics after a fall.

Though there are numerous exercise programs available for the elderly, many of these utilize fixed-axis machines, which may help with age-related decrease in muscle mass and strength, but offer inadequate loading of the spine and long bones and do almost nothing to help improve balance. Therefore to be successful in any balance-improving training program, people must perform movements that closely approximate their every day activities and those movements that commonly result in falls. Here are some exercises to help improve balance and stability to help reduce your chance of falls.

Gait - Toe Touch Drill

Gait deficiencies are most commonly seen in the stance phase, or while standing firmly on one foot while walking. The most common problem is inability to resist the pronation forces of gravity on the body, resulting in internal rotation of the femur, tibia and foot/ankle complex, concomitant with distension of the abdominal wall. The “Toe Touch Drill” performed on the Total Gym Target Grid (or other similar apparatus) improves the function of the stabilizer system while improving balance and coordination on one leg, providing a high functional carryover to both gait and stepping activities.

To perform this exercise, start by standing on one leg. Then with your belly button drawn in and standing in good upright posture, slowly bend the leg you’re standing while attempting to reach the opposite leg’s toe out as far as possible in front of you. You must keep your knee directly over your second toe on the leg you’re standing on and once you cannot keep it in this position, stop the exercise and mark the spot your toe reached to. Perform this in all the positions of the clock with one leg then the other. Once you have every position marked, you should stop just short of the mark for while performing repetitions of the movement and then retest yourself to see if you’ve improved.

Squatting - Bench Squat

The “Bench Squat” affords the client the confidence of knowing they will not fall on the floor if they can’t hold themselves up. To increase their functional base of support and improve confidence, a wooden dowel can be held in one hand to aid balancing as needed; for those with very poor balance, I allow one dowel in each hand, although I have never had an elderly patient, including those as old as 84 that needed a second dowel rod! As their strength/endurance and confidence build, the dowel rods and finally the bench are removed and they are progressed into traditional squatting.

Posture - Supine Lateral Ball Roll

Although it looks hard, the “Supine Lateral Ball Roll” is only challenging in proportion to how far the client deviates laterally on the ball. This excellent exercise necessitates integration of the upper and lower extremities via the trunk, serves to improve stability and balance and has a functional carryover to gait and any pushing or pulling activity that requires integration of the anterior and posterior muscle systems of the body. Activation of the extensor muscles from shoulder to contralateral hip aids in strengthening the muscles across the apex of the thoracic curvature, improving posture. With just a short period of coaching, the client becomes much more confident on the Swiss Ball. (For an explanation of how to perform this exercise, please visit the article “More Than Just Crunches”.)

Seated Posture Trainer

The seated posture trainer with a soft five pound weight on your head will help you develop an increased sense of proprioception while learning proper seated postural alignment. As you become more confident with this exercise, one foot can be lifted off the ground, shifting their center of gravity and increasing the amount of balance you need. With this one exercise posture, balance and confidence are improved!

To perform the Seated Posture Trainer, sit on a properly sized Swiss ball and, while holding a neutral curve in your lower back, gently draw in your belly button while sitting in good posture. As noted above, when sitting in good posture becomes easier, you can challenge yourself by lifting one foot off the ground and alternating feet every few seconds.

Conclusion

I’ve included a sample workout for those interested in incorporating these exercises into your program. Whether or not you’ve reached the Golden Years, these and other similar exercises will do wonders toward maintaining a good sense of balance and prevent you from becoming a statistic.

References:

1. Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final Data for 1997. National vital statistics reports; vol. 47 no. 19. Hyattsville, Maryland: National Center for Health Statistics, 1999.