3 Ways to Better Use Therapy Cones for Balance

If you use cones in therapy for reaching and/or balance exercises, check out the following 3 low and no cost ways listed below to help you get more out of them:

1. Add colored targets for reaching/placing tasks. Cones already come in different colors, so it is a natural extension to add colored targets (red, yellow, green, blue, etc.). The use of colors makes it easy to add matching elements. For example, ask patients to place cones on matching targets, e.g., place blue cones on the blue targets, green cones on the green targets, etc. If you are crafty, targets can be easily made from laminating construction paper or painting pie plates. If you’d rather not make targets, or want more durable targets, rubber ones are a low cost alternative. The balance challenge comes not from the cones, but from placing the targets in locations that challenge the patient (high, low, across midline, etc.). The further the targets are placed away from a patient, the bigger the balance challenge, e.g., it is easier to reach in front of the body than it is to the ground or overhead



2. Add balance games by using combinations of colored cones and targets. Balance games engage patients through cognitive challenges (memory, visual discrimination, pattern recognition, etc.) and motivational enhancements (patients want to complete games properly). Three common balance games are noted below (additional games listed in Haas Balance Book: 100+ Exercises for PTs and OTs or viewed online at www.ADLbalance.com): 
  • Match Maker: Using a diagram as a guide, the patient selects and places items on corresponding targets, e.g., items shown on diagram are placed on targets. It is possible all available items will not be used. At end of game, the items that are not used will remain in front of patient.
Match Maker Example Diagram

 

  • Line Up: Using a diagram as a guide, the patient retrieves cones. In the same color order, or “lineup,” as shown on diagram, patient places cones on flat surface (counter, table, etc.).

Line Up Example

  • Cashier: Therapist explains the assigned values for colors to the patient: Red = 1₵, Yellow = 5₵, Blue = 10₵, Green = 25₵. The therapist then picks an arbitrary value between 1₵ and 123₵ (range of available values based on number of items) and instructs the patient to place the equivalent value in cones on the flat surface in front of patient (counter, table, etc.). For example, therapist picks 7₵ and patient sets 1 yellow & 2 red cones on flat surface. 

Cashier

3. Add equipment that incorporates use of cones. Instead of using bolsters, boxes, or stools (to set cones on), get more from equipment that is designed to challenge balance through reaching/placing tasks. Below are 2 pieces of equipment that emphasize use of cones, targets, and reaching/placing tasks: 

  • ADL Reach Trainer: A portable frame with four fixed-position targets. Place it on a table to simulate high reaches (cupboard, cabinets, closets, etc.) or set it on the floor for low reaches (shower, dishwasher, shoes, etc.). With four colored targets, the ADL Reach Trainer is compatible with balance games.

  • ADL Balance Trainer: A large and sturdy frame with four adjustable-position targets. Adjustable targets allow for easy set ups (reaching high, low, across midline, or toward areas of neglect) and to grade/adjust levels of difficulty (turn knob and slide target higher, lower, nearer, or farther away). With sturdy construction and versatility for therapist to closely spot/facilitate patient, the ADL Balance Trainer is ideal for early reaching challenges in patients just learning to stand and balance again without help. 

Stop the menial madness of making and moving random stacks of cones in therapy. Rather, get more from your cones, targets, colors, games, and equipment and provide patients a better training experience by following the 3 tips above the next time you work on reaching to improve balance.