There are a number of strategies and exercises a physical therapist can implement to help reduce fall risk—one of which is to improve balance. There are three types of balance to consider: static postural control, dynamic anticipatory, and dynamic reactionary.
Static Postural Control
Static postural control is the ability to maintain stability while at rest or in a steady position. Think of sitting upright without a chair back or standing without support—you may think those are easy to do, but try with your eyes closed, or feet together in standing, and you might just find them challenging. And many of us do.
Typically we start working on static control early in the rehab process. We focus on your body’s postural control with and without help from your eyes. Many of us become visually dependent, and once we are in a visually challenging environment—think of the dark hallway at night—we lose our balance. By enhancing posture and muscle strength, we can thereby reduce the chances of stumbling when standing or walking.
Some ways to challenge this system are as follows:
- Standing with your feet wide apart and eyes open for 60 seconds
- Standing with your feet wide apart and eyes closed for 60 seconds
- Standing with your feet close together and eyes open for 60 seconds
- Standing with your feet close together and eyes closed for 60 seconds
Dynamic Anticipatory Control
Dynamic anticipatory control is the ability to prepare for or adjust during planned movements. It is an internal perturbation that challenges postural control and is critical for everyday activities like walking or climbing the stairs.
Some exercises to improve anticipatory balance would be walking through an obstacle course or on known unstable surfaces. The key here is that you have the ability to understand what the challenge is in front of you and adequate time to make internal adjustments to tackle them.
Dynamic Reactionary Control
Dynamic reactionary control is the ability to maintain stability in response to unexpected changes such as a slip or a sudden obstacle. It is an unplanned external challenge that challenges our postural control. Physical therapy improves reactionary balance by honing reflexes and muscle coordination.
Some exercises to improve reactionary balance would be walking through an obstacle course where the challenges change or on unfamiliar or unstable surfaces. The key here is that you can’t anticipate the challenges in front of you and you have minimal time to make internal adjustments to tackle them.
Other articles in this series: