Movement is defined as a change in body position or location. In addition to stance and surface variables, movement has a primary impact on balance, e.g., the more challenging the movement, the harder it is to stay balanced. The following 5 movement parameters can be easily manipulated to help achieve an ideal level of balance intensity (see 20:20 Clarity on Balance Intensity for more information on balance intensity):
- Direction is plane of motion, or point in space, to which changes in body position or location occur. Balance is challenged more by movements that occur low (near the ground), high (overhead), or across midline (rotations or lateral reaches). In contrast, balance is challenged less by movements that occur in front of patient or in near-reach zones.
- Arc is the range or distance through which the body position or location is changed. Harder balance challenges occur from bigger arcs (full ranges of motion), further reaches (low, far, high, etc.), and/or larger amplitudes (more weight shifting, higher steps, longer strides, etc.). In contrast, easier balance challenges occur from smaller ranges (partial motions), closer reaches, and/or smaller amplitudes.
- Speed is how fast a movement occurs. Slow and fast speeds are more challenging for balance, as they respectively emphasize stability and agility. In contrast, movements at self-selected or normal speeds are less challenging.
- Anticipation is how well one can expect, predict, or plan for a movement. Balance is challenged more when movements are anticipated less. Adding random cues, sudden tilts/shifts, unexpected nudges, quick start/stops, and/or erratic travel patterns (when catching/throwing an object), help reduce anticipation when performing balance exercises. In contrast, it is easier to maintain balance when there are no “surprises.”
- Targets are points or borders that direct movements, either for aiming or avoiding. Balance is challenged more by targets that are small, high, low, or moving. In contrast, balance is challenged less by targets that are large, stable, and near the patient.
For more information on balance training exercises in rehab, consider ordering our soon-to-be-released book The Haas Balance Book: 100+ Exercises for PT's and OT's. Release date is March 15, 2019 - order now for discounted "pre-order" price!