Fall prevention is a vital part of functional training for your aging clients. Why? Falling is a leading cause of death and injuries among older adults.

So what’s happening?  One factor is that changes in communication between the nervous and muscular systems as we age are likely to result in a loss of balance.

In 2014, almost one-third of this group reported a fall, and approximately 27,000 fatalities were related to falls (Bergen, Stevens & Burns 2016). The good news is that there are studies which suggest that balance training can mitigate the risks associated with neuromuscular changes.

See also: Effects of Aging on the Neuromuscular System

Kyle Stull, DHSc,  a content development manager at NASM and an instructor for the Department of Health and Human Performance at Concordia University, offers some practical advice in training clients for fall prevention.

The Role of Balance Training for Fall Prevention

There are three levels of balance training (for any age group): stabilization, strength and power. These are also the three levels in the integrated training system known as the NASM Optimum Performance Training model, created by the National Academy of Sports Medicine.

Here are examples of balance training for each levels.

Tip: Balance training in NASM’s OPT model is not performed in isolation. Flexibility, core and resistance training are included, all of which support the effectiveness of balance training.

See also: Training for Balance and Function Reduces Falls Among Older Adults

Balance Stabilization

The goal of balance training at the stabilization level is to teach the client how to maintain a neutral and stable static joint position.

Exercises include basics, such as holding a single-leg stance for a period of time (from several seconds up to 30 seconds, depending on ability and comfort). Progressions include adding movements by other extremities, such as a reach with the floating leg. This slightly shifts the center of mass and increases the challenge.

Helpful tools may include vibrating devices such as foam rollers. Applying a low-level vibration to the plantar surface of the foot and lower-leg muscles before training may improve mechanoreceptive function. Turn the roller to the lowest setting. Then, have the client roll the foot and lower leg for about 30 seconds each on both sides.

For each exercise: Perform 1–3 sets of up-to-30-second holds.

Sample move: Single-leg balance with reach.

Balance Strength

The goal of balance training for fall prevention at the strength level is to add more dynamic eccentric and concentric movement to the stance leg.

Exercises could include a single-leg squat or a step-up to balance.  Note: Full range of motion isn’t necessary or expected in the older population. For example, in the single-leg squat, you can ask the client to slightly flex the knee and lower just a few inches, then return to the starting position. The key is to ensure that the client maintains optimal posture and control through whatever range is chosen.

For each move: Perform 2–4 sets of 8–12 repetitions.

Sample move: Single-leg squat with small range of motion.

Balance Power

The goal of balance training at the power level is to begin developing the ability to decelerate increased forces.

Exercises for younger populations might include a move like a single-leg hop with stabilization. However, if the older client is unable to hopsafely, a more appropriate exercise is a quick box step-down with stabilization. Stepping off a small box will increase the deceleration demands of the exercise.

For each exercise: Perform 2–3 sets of 8–12 repetitions.

Sample move: Box jump-down or step-down.

Including these exercises in your programming will help your clients achieve and maintain better balance and quality of life.