Being able to control the body’s position in space is fundamental to every task we perform. Standing quietly (static balance) has specific balance demands. These demands require us to keep our center of mass (COM) within stability limits, typically defined by the length of the feet and the distance between them. In addition to static balance, we must maintain our stability during movement (dynamic balance). The body’s postural sensory systems—visual, somatosensory and vestibular—control static and dynamic balance. The visual system reports information regarding speed and position of the head with respect to surrounding objects. The somatosensory system provides information about the body’s position in space with reference to supporting surfaces. The vestibular system relays information about the position and movement of the head with respect to gravity and inertial forces.
B.A.S.E. (Balance And Stability Exercise) Training challenges the three postural sensory systems and provides an effective training regimen for the musculature important in maintaining balance as we age. The aging process causes impairments in the postural sensory systems, which can contribute to a loss of balance in older adults. This increases the risk of falling and subsequent fracture. Muscular conditioning, dynamic flexibility and balance exercises help participants of all ages develop better balance-control strategies.
In a group setting, the instructor must provide options for progression, allowing individuals to move from the most stable to the least stable positions for each balance activity. This provides a safe environment for all participants, regardless of their previous training experience.
Note: This format is not intended for frail older adults or those who experience dizziness upon standing or during rhythmic COM changes (e.g., squats). B.A.S.E. Training can be added to an existing class or designed as a separate class.
B.A.S.E. Training Details
Format: balance training
Total Time: approximately 30 minutes
Equipment: exercise/yoga mats
Music: 122–26 beats per minute
Warm-Up (5–8 minutes)
For enhanced somatosensory input, perform the entire workout without shoes. Begin movements at the neck, and progress downward. Direct participants to stand with feet slightly wider than the shoulders. The abdominal wall is engaged, and the shoulders maintain a neutral, set position.
1. Alternating head tilt (8x): Gently tilt head and move ear toward shoulder; switch to opposite side.
2. Alternating “look” (8x): Gently rotate neck so that face turns toward right; switch sides.
3. Alternating “look” with chin drop (8x): Same as above, but drop chin toward shoulder and raise it back up before switching direction.
4. Shoulder roll (8x): Roll shoulders backward.
5. Wide squat (8x): Separate feet slightly wider than shoulder width.
6. Wide squat with circle arms (8x): Same as above, but add arms circumduction.
7. Wide squat static hold in down position (8–16 counts): Hold squat position while arms are held in static, lateral abduction.
8. Wide squat static hold in down position with alternating heel lifts (16x): Same as above, but add alternating heel lifts. Reach both arms overhead as each heel is raised.
Training Segment (10–15 minutes)
During this portion, introduce balance training as one-legged work. The dynamic movements and single-leg positions challenge all three postural-control sensory systems. Always demonstrate a less challenging movement prior to working up to the advanced one-legged balance work. For example, the sagittal plane lunge (see below) is first performed with a toe tap before progressing to a knee lift. If participants feel unstable or uncomfortable with any of the one-legged movements, encourage them to touch a toe on the floor for increased stability instead of lifting the entire foot. Remind participants to maintain a stable pelvis during all balance work, especially as the limbs move in opposition.
1. Sagittal-plane lunge toe tap with biceps curls (8x): Starting with feet side-by-side and elbows flexed at sides, lunge backward with left foot and then bring it forward to meet right foot (as in starting position). Tap left toe gently on floor after returning to starting position; this is to discourage participants from placing body weight on left foot. Extend elbow as foot lunges backward, and flex elbow as foot moves forward.
2. Sagittal-plane lunge with knee lift and biceps curls (8x): Same as above, but replace toe tap with knee lift; this requires participants to balance on right leg throughout most of the movement.
3. Knee lift with static hold (8–16 counts): Support body weight on right leg while left hip and knee maintain static flexion. Elbows are flexed and held close to rib cage.
4. Static hip flexion with dynamic knee extension and flexion (8x): Same as above, but add left-leg knee extension and flexion. Arms press forward (like a chest press) as knee extends. For added challenge, return arms as knee flexes.
5. Perform movements 2 and 4 as a fluid combination (8x).
6. Repeat movements 1 through 5, leading with the opposite leg.
7. Leg abduction with toe tap (8x): Support body weight on right leg as left leg lifts and lowers in lateral abduction. Hold right arm in static, lateral abduction.
8. Static-hold leg abduction (8–16 counts): Support body weight on right leg as left leg maintains lateral abduction. Hold right arm in static, lateral abduction with left hand on left hip.
9. Leg abduction with forward circumduction (8x): Same as above, but add forward circumduction of left leg; right arm simultaneously performs forward circumduction for added challenge.
10. Leg abduction with backward circumduction (8x): Same as above, but reverse the circumduction.
11. Repeat 7 through 10 using opposite limbs.
12. Standing quietly on balls of feet (16 counts): Rise up on balls of feet (hip width apart) and hold for 8 counts. Maintain static hold and close eyes for 8 counts. Goal is to slightly increase amount of time spent balancing with eyes closed. (Performing exercises with eyes closed removes visual sensory input and requires participants to rely more on the vestibular and somatosensory systems.)
Cool-down and Stretch (10 minutes)
Use this time to relax and breathe deeply into the movements. Remind participants to maintain good posture and keep breathing throughout the stretches. Repeat stretches two to three times.
1. Cat and camel (16x): On hands and knees, slowly move spine into flexion and slight extension while maintaining abdominal wall engagement.
2. Modified hurdler hamstrings stretch (16 counts): Sit with right knee extended and left knee flexed, with left sole placed alongside right inner thigh. (Do seated pretzel stretch (below) before stretching other side.)
3. Seated pretzel stretch (16 counts): Cross left leg over right leg and gently rotate spine toward left. Hold left leg close to chest and lengthen spine. Repeat on opposite side after performing modified hurdler stretch (above).
4. Side-bend lat stretch (16 counts): Sit cross-legged holding a towel or stretch strap with arms extended above head. Slowly bend trunk to right side, gently pulling down on towel or strap with right hand. Do not allow left hip to lift off mat; repeat on opposite side.
B.A.S.E. Training challenges the three postural sensory systems and provides an effective training regimen for the musculature important in maintaining balance as we age.