Living Fearless: Exercise, Balance & Core Strength

Living Fearless: Exercise, Balance & Core Strength

Balance Program Goals The goal of any balance and fall prevention program should be to get the participant out of their chair and on their feet. If independent living and a high level of function are the goals the client must walk, carry things, weight shift, react, respond, slow down and stop, all while staying upright!

Understanding the Aging Process Falling does not have to be an inevitability for seniors. Fall risk is more a matter of deconditioning, not age. Fall prevention programs for seniors challenge the body to physical strength with age-appropriate modifications.

Seniors & Fall Risk If a senior falls once, falling again is a near-inevitability 2.8 million ER visits due to falls (2015) 27,000 seniors died as a direct result of a fall (2015) Over age 65 fall risk per year is 33%; over age 85, risk is 50% 80% of all fall victims will not return to previous activity/health level

Balance, Falls & Fractures 95% of hip fractures are caused by falls Most commonly injured sites after a fall: Hip Patella Distal radius/ulna

Risk Factors for Falls Unsafe home environment Poor shoes Alcohol abuse Poor eyesight Poor lighting Dehydration Taking foolish risks Medication

6 Common Medications That Impair Balance Harvard, 2015 Antidepressants Anti-anxiety drugs Antihistamines prescribed to relieve allergy symptoms Blood pressure and other heart medications Pain relievers, both prescription and nonprescription, especially narcotics Sleep aids (over-the-counter and prescription forms)

There is no shame in using a cane. A poorly sized cane or walker increases fall risk. Here s how to size a cane or walker. Stand up with normal posture Wearing usual walking shoes, arms to side Measure from crease of wrist to floor This is the optimal height for canes & walkers

Empowering Your Client: Is There a Better Way to Fall? The main concern in a fall is injury to the head or hip. If there is a better way to fall, sit into the fall. Falling onto hands & knees is better than falling onto the hip. Best option? Stay strong; don t fall!

Getting Up After a Fall: Scenario 1 1. Make sure you re not hurt 2. Roll to your side 3. Get on all fours 4. Crawl to stable object 5. Kneel 6. Stand or sit

Getting Up After a Fall: Scenario 2 1. Make sure you re not hurt 2. Roll to your side 3. Get on all fours 4. Put one leg out to side 5. Put other leg out, wide apart 6. Put hands on thighs & stand up

Balance vs. Stability Stable & balanced. Balanced, not stable.

Progressing the Core Understand neutral spine Starting w/ proper breathing strategies Improve firing sequence of the core muscles Progress through developmental stages, adding resistance, exercise in all 3 planes

Maintaining Neutral Core: Seated & Standing Balloon Hold Once neutral can be maintained, add arm lift or marching actions.

Maintaining Neutral Spine

Core Stabilization: Ball Squeeze Using any kind of soft ball, squeeze it for a count of 5. Do NOT hold your breath Keep your chin up Start seated, and progress to standing if you can

Core Stabilization: Resisted Pull Using any kind of elastic resistance, pull it apart for a count of 5. Do NOT hold your breath Keep your chin up Start seated, and progress to standing if you can

Where Balance Comes From Three systems responsible for balance: Visual System Vestibular System Somatosensory System A disruption in any or all will impair balance. Training programs should alter different systems to enhance balance completely.

The Visual System Visual signals sent to the brain about body s position in relation to surroundings. Compared to information from the vestibular and somatosensory systems.

The Vestibular System The vestibular organ is located in the inner ear. Responsible for maintaining equilibrium. Receptors detect head movement and direction changes. Sends information to the brain to correct position or posture.

Somatosensory System Receptors in the skin, muscles, and joints provide information about stretch or pressure to the nervous system. Skin sensitivity is reduced with increasing age leading to lack of input from tactile, pressure and vibration receptors.

Balance Strategies 1) Ankle Strategy; 2) Hip Strategy; 3) Step Strategy 1. 2. 3.

1. Seated Balance Progressions 2. Seated on unstable surface 3. Standing 4. Standing on unstable surface 5. Walking 6. Walking on unstable surface

Balance Training: At Least 3 Times/Week; Daily is Better!

Assessing Balance: One Leg Stand Time how long client can stand on each leg on Stable & unstable surface. Hang on the first time!

Sample Fall Prevention Strength Program GOAL Strengthen core Strengthen toes Strengthen calf muscles Exercise Resisted squeezes Resisted pulls Toe scrunches Standing heel lifts Strengthen glutes & hamstrings Strengthen quads Deadlifts Chair squats Lunges

1) Seated Drills The airplane can be done sitting or standing.

Seated Balance Drill: Alternating Heel/Toe Lift & March

Seated Crawling

Stability Ball Arm & Leg Lifts Stability ball exercises are quite advanced. Use caution when putting your seniors on a stability ball.

Standing Balance Drills: Aluminum Can Balance Drill

Circle of Stability: 10 seconds at each station; rest for 10 seconds & then move left on spot. Repeat. Start with double leg, then single Thick foam mat On floor Bosu Balance board Balance disc Dinosaur Eggs

Advanced One legged Stands Add challenges: Stand on an unstable object. When stable, bat a balloon, play catch, move head up & down or side to side. Always have support available.

Balloon Taps

Vestibular Challenges Look Up & Down, Side to Side

Integrated Core Conditioning: Stability Ball Bounce Pair people up & have them roll, bounce or throw ball to each other. Put participants in a circle and have them roll or bounce (but not throw) the ball to each other. They can call out a name or roll/bounce the ball randomly.