Acting on your balance system

Today’s column will focus on our balance system and what helps maintain its integrity. In order to keep things interesting, we thought we could start with a test of your own static balance. Make sure this test is safe for you and that you don’t have dizziness or joint instability. Choose a place in your home where it is safe for you and time your balance on one leg. Focus on a spot in front of you and when you are ready, stand on one foot without letting your legs touch together. Give yourself three trials and sufficient time to rest in between. Did you make it more than ten seconds? Thirty seconds? What do you think influences your ability to maintain your balance?

When we ask our patients to try this test in the clinic, we often get two different types of responses; the first being, “Oh, my balance has never been great,” or the second being complete surprise to the fact that they have trouble balancing on one leg. Balance control is the foundation of a person’s ability to move and function efficiently. The truth is, balance is not a simple feat. It involves the complex coordination of your muscles, joints, nervous system (somatosensory system), vision, and vestibular system (inner ear).

In healthy adults moving on firm ground, the balance system relies on 70 percent of the nervous system but will also depend on 20 percent vestibular information and 10 percent on vision. However, if the surface is unstable, more emphasis will be placed on vision.

Now all this unconscious, rapidly processed information is needed to maintain balance with our day-to-day activities such as bending down to tie our shoes, recovering our footing on a moving bus, or with an unexpected bump by a rushed passerby.

Falls are more common with ageing and the feeling of insecurity that ensues can have tremendous impact on one’s quality of life. Some factors associated with ageing that can impact balance are changes in eyesight and depth perception, decline in cognitive ability, disease or injuries in weight bearing joints, and vestibular abnormalities causing dizziness. Certain medication also can impact your balance. However, all too often, these concerns, as well as the fear of falling, will lead people into a vicious cycle of inactivity. Sedentary behaviour over time is known to speed up the process of these age-related changes. Without strong muscles and bones, we are left with a fragilized system that is more prone to injury when falling.

The great news is that keeping active on a regular basis, maintaining strong muscles, and working on you balance with specific exercises can help prevent the risk of falls. Activities that require positions with a narrow base of support or balancing on one foot are important, mixing both static and dynamic movements. For example, a static balance challenge for some people would be standing still with their feet one in front of the other. A dynamic challenge would be doing the same task while walking a straight line. It is most beneficial to eventually progress the balance movements to dual-task conditions. An example of this is a situation where your attention is divided between a movement task and a thinking task. You may have noticed with some of your senior counterparts that they sometimes stop walking when you talk to them. This is a typical scenario that proves that loading the system with cognitive (talking) and motor tasks (walking) at the same time can be challenging for many.

In order to truly reduce the risk of fall, studies support that people must dedicate themselves to these types of movements two hours per week for a period of three to 12 months. Certain example of activities that can target the balance system in a fun environment are yoga, Tai Chi or other martial arts, balance and postural stability classes, bowling, outdoor hiking, and dancing. It is essential that the approach you choose be challenging and specific to your needs. A good teacher or coach will help you adapt the balance movements and help keep it interesting!

Now, to come back to our initial test! Here are the normal average values for each age group.

Single leg balance test

Age 40-49: 40 seconds

Age 50-59: 37 seconds

Age 60-69: 27 seconds

Age 70-79: 15 seconds

Age 80-99: 6 seconds.

Are you within normal range? It is never too late to start acting on your balance system!

Amy and Karine are registered physiotherapists, both holding a master’s degree in Physiotherapy and bachelor of science in Exercise Science.