Core concepts of balance
1. The ability to sustain or return the body’s center of mass or line of gravity over its base of support.
2. When the body is in equilibrium and stationary, meaning no linear orangular movement.
- Dynamic Balance
The ability to move and change directions under various conditions without falling.
- Balance is dependent on both internal and external factors to maintain the body’s center of gravity over its base of support
Scientific Rationale for Balance Training
- Research shows that specific kinetic chain imbalances(such as altered length-tension relationships, force-couple relationships, and arthrokinematics) can lead to altered balance and neuromuscular inefficiency.
- Prime movers may be slow to activate, whereas synergists and stabilizers substitute and become overactive (Synergistic Dominance)
- Joint dysfunction creates muscle inhibition. Leads to joint injury, swelling, interruption of sensory input from articular, ligamentous, and muscular mechanoreceptors to the central nervous system, results in clinically evident disturbance in proprioception.
- It has been demonstrated that sensory feedback to the CNS is altered after ankle sprains, ligamentous injuries to the knee, and LBP.
Importance of Properly Training the Balance Mechanism
- Balance training should stress individual’s limit of stability(or balance threshold). Limit of stability is distance outside of the base of support that he or she can move into without losing control of his or her center of gravity.
- This threshold must be stressed in multiplanar, proprioceptively enriched(unstable yet controlled) environment, using functional movement patterns to improve dynamic balance and neuromuscular efficiency.
- The design and implementation of balance exercises into a training program is critical for developing, improving, and restoring the synergy and synchronicity of muscle firing paterns required for dynamic balance and optimal neuromuscular efficiency.
- Individuals with altered neuromuscular control likely have specific kinetic chain imbalances
- Joint dysfunction creates muscle inhibition, which alters balance and leads to tissue overload and injury. The majority of fitness clients have decreased neuromuscular efficiency and problems with balance and thus can benefit from balance training programs
- Training should progress to include unstable environments in which an individual can still safely control movements.
Benefits of Balance Training
- Balance training programs are frequently used to help prevent lower extremity injuries by improving balance abilities in individuals
Balance training Effects on Injuries
- Research shows performing exercises that demand balance can reduce rate of ankle sprains and other lower extremity injuries.
- Balance training is often integrated into ACL injury prevention programs- which have shown promise to reduce the rate of annual ACL injuries.
Balance Training Effects on Balance Ability
- Balance training programs that are performed for at least 10 minutes a day, 3 times per week for the duration of 4 weeks, appear to improve both static and dynamic balance ability.
Level of Balance Training
- Three levels of training – stabilization, strength, and power. Proper balance training program follows same systematic progression.
- Surfaces change in difficulty as individual moves from stable surface(floor) to unstable surfaces(half foam roll, foam pad, balance disc). Eyes open is easier than eyes closed or moving head around to look at various objects or performing cognitive task(s) simultaneously.
- Moving the contralateral limb, trunk, or arms also makes a balance exercise more challenging, whereas standing on two legs versus a single leg simplifies the exercies
- Caution should be used to change one variable at a time.
Balance Stabilization Exercises
- These exercises involve little joint motion; instead they are designed to improve reflexive (automatic) joint stabilization contractions to increase joint stability
- Sample exercises:
2.single-leg balance reach,
3.single-leg hip internal and external rotation,
4.single-leg lift and chop,
5.single-leg throw and catch
Balance Strength Exercises
- Involve dynamic eccentric and concentric movement of balance leg, through full range of motion.
- Sample exercises:
single-leg squat touchdown,
single-leg romanian deadlift,
multiplanar step-up to balance,
multiplanar lunge to balance
Balance Power Exercises
- Designed to develop proper deceleration ability to move body from dynamic state to a controlled stationary position, as well as high levels of eccentric strength, dynamic neuromuscular efficiency,and reactive joint stabilization.
- Exercises include:
multiplanar hop with stabilization,
multiplanar sing-leg box hop-up with stabilization,
multiplanar single-leg box hop-down with stabilization.