Balance plays an important role in conducting everyday activities such as walking, getting out of chairs, bending down to put on shoes and shopping for groceries. Older adults who have impaired balance are at great risk of falling.
As part of the natural ageing process, balance and strength can decline from the age of 40, with changes such as reduced muscle and ability to balance, which influences the risk of having a fall. Older adults with muscle weakness, gait deficits, or mobility limitations are three to five times more likely to fall than individuals without these impairments.
Fortunately, participation in exercise is one of the most effective strategies to reduce the risk of having a fall due to maintaining muscle and strength, increasing endurance, and improving gait, balance, and mood. Older adults should aim to complete at least three hours of exercise a week, or 30 minutes of physical activity on most days, to help maintain strength and independence. Exercise should include strength exercises two to five times a week and balance exercises most days of the week.
How can I assist older adults to build their balance?
Balance can be improved by practising balance exercises regularly. Exercise programs targeting older adults should aim to challenge balance, whilst also safely reducing the individual’s base of support or moving their centre of gravity. Conducting these exercises should prompt the individual to gain control of their body position while standing with and without their arms for support. Older adults can maintain safety whilst challenging their balance by having a stable surface nearby in the case of needing something to hold onto.
Activities that older adults can do to improve their balance include exercises which involve leaning forwards, backwards, and to the side such as Tai Chi, Lawn bowls, Dancing, and Prime Movers or Strength for Life. Balance exercises that can be completed at home include standing on one leg, stepping over objects, walking heel to toe, or using the Stay On Your Feet® Build Your Balance Exercise Flyer to guide at-home exercises.
It is important to assess an older adult’s current capabilities before prescribing a balance exercise program. This assessment can help to identify the most suitable exercises and can be used to measure improvements in balance over time.
Click here to view and download validated balance assessment tools such as the; timed up and go (tug) test, the 4-stage balance test and the 30-second chair stand test.
How to challenge balance safely
In order to improve balance, an exercise program needs to be challenging yet safe. To ensure that the exercises pose a sufficient challenge to the individual’s balance, the program should include:
- Exercise in a standing position
- Minimal upper limb support (minimise the use of rails or chairs for support while exercising; however it is useful for older people to exercise near supportive objectives so they can steady themselves when necessary)
- A minimal base of support (i.e. exercise that involves standing or walking with the feet close together or standing on one leg)
- Controlled movements of the body’s centre of mass, such as stepping, reaching or dancing
Exercises that challenge an older adult’s balance have the potential to cause a fall. To reduce this risk, only prescribe exercises suitable for the individual’s capabilities, ensure exercises are set up in a safe way (e.g. next to a wall or counter for support), and supervise exercises if necessary. These recommendations are particularly important if the older adult is frail.