Sensory Motor / Coordination / Balance


Balance is the ability to maintain the body’s position over the base of support.

Balance may be static or dynamic (stationary or moving). Changing posture, gait, vision, and hearing all have an effect on balance. While balance is a complicated process involving many systems of the human body, work on improving balance is actually quite simple.

One third of individuals over 65 fall each year. Common serious injuries from falls include hip, wrist and skull fractures. Falls are a major cause of disability, loss of independence and even death among elderly people. Let’s start by identifying three of the major body systems that affect one’s balance.

The Vestibular System is located in the inner ear and detects the position and motion of the head. Participants with a reduced vestibular function will likely sway excessively and are at a greater risk of falling.

The Somatosensory System provides information about touch, position of the extremities and the body as a whole. Disease such as peripheral neuropathy due to diabetes or congestive heart failure can impact sensation at the extremities. It is difficult to balance on feet where there is no sensation.

The Visual System provides information about the environment and the movement taking place around you. Vision plays an important role, especially when the surface is unsteady or when one of the other systems isn’t giving complete information.

One of the keys to improving balance is postural alignment. You’ve all probably heard the saying “ears over shoulders, shoulders over hips, chin level, back of the neck long, chest lifted, knees relaxed and abdomen pulled in.” If you haven’t heard it – it’s time to memorize it and use it daily in all of your classes! The most serious aging impact on posture is the degeneration of the spine. You’ve seen it – the forward flexion of the upper back causing the upper back to round out (kyphosis).

According to the National Council on Aging and U.S. Centers for Disease Control and Prevention

  • 1/3 of the population over 65 falls each year
  • Every 11 seconds, an older adult is treated in an emergency room for a fall
  • Every 19 minutes, an adult in America dies from a fall
  • Falls are the leading cause of both fatal and non-fatal injuries among older adults
  • In 2013, 2.5 million nonfatal falls among older adults were treated in emergency departments
  • Most fractures among older adults are caused by falls
  • The financial toll for older adults falls is expected to increase as population ages and may reach $67.7 billion by 2020

Falls Prevention Facts – National Council on Aging…/falls-prevention-facts/

Common Risk Factors for Falling

  • Decrease in muscular strength
  • Medication interactions
  • Loss of joint mobility
  • Visual impairment
  • Foot disorders
  • Gait changes
  • Stroke
  • Dizziness and fainting
  • Parkinson’s disease
  • Osteoarthritis
  • Poor circulation
  • Neuropathy
  • Fear of falling
  • Past falls

Common changes in gait include a shorter stride, reduced step height (shuffling), wider stance and slowed pace. These changes may be due to muscle weakness in the legs and hips, joint issues, fear, or lack of flexibility. It is important that you identify these risks for your participants and focus time on “balance work”. Work on weight shifts, step height, ankle flexion and extension.