Weight shifting exercises involve the rhythmical progression of one's center of pressure back and forth over a fixed base. For example, in forward and back weight shifting, the patient stands with one foot forward and one foot back (fixed base) and moves their body forward and back, shifting weight from one foot to the other.
Trunk movements are typically minimized as motion is emphasized in the feet and legs. Patients should feel the heaviness switch from foot to foot (or from the front of the foot to the back of the foot) as their body weight is rhythmically shifted back and forth.
A suggested loading point is 80 percent of one's body weight. For example, in forward and back weight shifting, the patient would move forward until they feel about 80 percent of their weight in the front foot. Then, they would switch directions and shift their weight back until they feel about 80 percent of their weight in the back foot.
Loading may be reduced to 60 or 70 percent of bodyweight if the patient is unable to demonstrate steadiness throughout the exercise. Steadiness is defined as the ability to complete the exercise without obvious postural reactions, unwanted movements, or need for touching or support.
A helpful tip for proper technique is to have the patient feel the movement from the ground up, e.g., the motion starts in the feet and progresses up the legs to the hips. This cue will help correct a natural tendency of the patient to begin weight shifting movements with their arms and torsos.
Weight shifting exercises can occur in different directions and are useful for improving balance in a variety of activities of daily living (Table 1).Table 1. Weight shifting directions and functional implications.
|Forward and Back||Stability when walking, reaching into pantry or fridge, retrieving/placing item on floor, or opening/closing a door.|
|Lateral||Steady when walking, stepping over an obstacle, going up/down a curb or stair.|
|Rotational||Sturdy when reaching across or behind midline during meal preparation, putting away dishes, vacuuming.|
EXAMPLE 2. Unstable surface and use of targets to shift weight laterally to one side.
EXAMPLE 3. Weight shifting forward and back in split stance.
EXAMPLE 4. Weight shifting in rotational direction.
EXAMPLE 5. Weight shifting in lateral (side to side) direction.
EXAMPLE 6. Weight shifting with emphasis on hips in normal stance.
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