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Table 4 Guidelines for dynamic steady-state, reactive, and proactive balance exercises

From: A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial

Balance (dynamic)

Exercise variables

Recommendations

Steady-state

Base of support

Stable to instable: normal gait – narrow gait – overlapping gait – tandem gait (Figure 3)

Position of feet

i.e., lateral or medial weight shift, on heels or toes, toe angle in or out

Surface

i.e., from soft to hard (e.g., grass to concrete), from stable to instable (e.g., concrete to sand)

Sensory input

Impede vision or hearing

Dual-/Multi-tasking

Additional motor task – additional cognitive task – additional motor and cognitive tasks

Speed of movement

Decrease or increase of execution speed (i.e., walking speed)

Equipment

Use of i.e., free weights, elastic bands, balls

Direction

Forwards – backwards – to the left or right – diagonal

Rhythm

Slow – fast – intermittent slow and fast

Reactive

Controlled perturbations applied by therapist

Reaction to external thread (push or pull) varying in speed, amplitude and direction on ankle, hip, trunk or shoulder level

Proactive

ADL

Combination of steady-state (dynamic) balance tasks with mobility in daily life (e.g., walking upstairs backwards while counting backwards aloud from 50 minus 2)

  1. ADL activities of daily living.