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New Frontier in Balance Training: Upper Extremity Target Tasks

Upper Extremity Target Task Training

Balance is the ability to remain upright and steady in a given posture (standing, sitting, kneeling, etc.) without a significant reliance on postural strategies or arm support. Balance training has historically relied on unsteady surfaces, such as foam pads and rocker boards, to challenge balance. While these tools are effective in improving balance, they fall short in replicating activities of daily living (ADLs). For example, reaching/placing movements are a big part of ADLs (meal preparation, dressing, housekeeping, showering, etc.), but are not directly replicated with unsteady-surface balance training. This post highlights a new frontier in balance training; a frontier that replicates the reaching/placing movements of ADLs. The new frontier is called upper extremity target task training.

Upper extremity target task training involves reaching and placing movements to specific points in space. Reaching directly challenges balance: the further the reach is away from the body, the greater the balance challenge. By using specific points in space, e.g. targets, reaches can be measured and consistently reproduced from treatment to treatment. Although therapists routinely assess reaching ability (Functional Reach, Berg, etc.), we struggle to find meaningful ways to integrate it into treatments. Upper extremity target tasks are the answer. However, outside of placing cones on a therapist’s outstretched hands, there has been a lack of proper training equipment for upper extremity target tasks: this is why I invented the ADL Balance Trainer.

The ADL Balance Trainer uses moveable platforms that slide and lock in a wide range of possible locations around the patient. Platforms become the targets for a variety reaching, placing, and retrieving tasks. Functional examples of target tasks include putting away cups in a cabinet, taking milk out of the fridge, or off picking up a shoe from the floor. The targets in these tasks are the cabinet, fridge, and floor, respectively.
Platforms can be moved and located in positions that directly replicate the reaching and balancing demands of ADLs. As such, balance training with the ADL Balance Trainer is very functional.

Because the platforms are adjustable, they can be moved progressively further away from the patient as balance improves. This allows for continuous challenges to balance throughout the rehabilitation process. For patients with poor balance, the platforms are moved nearby. However, as balance improves, the platforms are moved further away from the patient. It should be additionally noted that stance and surface can also be introduced and manipulated to further challenge balance.

Break out of the rut of boring balance exercises. Offer your patients new and functional ways to improve their balance. Join the new frontier in balance training by adding upper extremity target tasks to your balance rehabilitation programs today.

For more information about bringing the ADL Balance Trainer or Better Balance Training (in-house con. ed. for PTs and OTs) to your facility, contact ADL 365, Inc. at (806) 785-6300 or email