Reactive balance training is rapidly gaining recognition as an effective way to reduce the risk of falling. The goal of this kind of training is to challenge your balance enough that you begin to fall, and your body must react to prevent that from happening.
You may be wondering how this can be achieved in a safe and supportive environment. Here at FYZICAL Grand Lake Oakland, we have an overhead rail and harness system (Safety Overhead Support system – SOS), that allows you to challenge your balance without the fear of falling.
So, why is this so important? The data is clear. Loss of balance is the #1 complaint of patients over age 70. Every 11 seconds, an older adult is treated in the ER for a fall. Ninety-five percent of hip fractures are caused by falls. And, every 19 minutes, and older adult dies from a fall or the consequences thereof.
Balance depends largely on 3 main factors: 1) the vestibular system - like a mini gyroscope in the inner ear that informs the brain about your position in space, 2) vision, and 3) proprioception – the body’s ability to know where limbs are in space at any one time.
Balance training can address all three of these factors. Through a series of simple tests, we are able to determine whether a patient over-relies on any one (or more) of these systems. We identify the system that is not performing well and challenge it specifically so the patient can improve their function in this area. For example, challenges to the vestibular system could be quick head nodding or turning. Challenges to vision could mean decreased visual input (like closing eyes) or focusing on a moving target. Challenges to proprioception could be standing or walking on an unstable surface such as a foam pad or wobble platform. And, all this while doing stationary or moving activities, based on ability.
Most balance therapies focus on anticipatory balance control, which helps maintain balance. Reactive balance training takes this further
and challenges the balance system to react as an individual starts to fall. Reactive balance training is appropriate for all levels of function, from younger athletes to the elderly population.
A double-bind, randomized, controlled study from 2010 found that reactive balance training reduced the chances of falling for older adults. In 2014, a study found that a single session of reactive balance training among healthy adults age 65 and older reduced fall risk by half. A 2020 study looked at high-risk older adults that walked on a treadmill – reactive balance training did not reduce their falls, but they had notably fewer fall-related injuries, leading the authors to speculate that the training allowed them to partially recover their balance, resulting in a more controlled fall.
In terms of sports, reactive balance training benefits any athletes whose sports require dynamic balance, such as tennis players, skiers, and trail runners. There is evidence to support that this type of training of college soccer players in warmups reduced knee injury rates by nearly half, compared to those who did not. Reactive balance training increases core muscle activation, creating a state of readiness, or anticipation.
Frequency of training sessions will vary based on age and nature of balance problem, but generally 2 sessions a week for 3-4 weeks should result in some measurable changes and improvements in areas where you notice balance challenges in your life or sporting activity. The SOS will allow you to challenge your balance perhaps more than you would otherwise, without the fear of falling!
Author: Kathryn Thornburg DPT, OCS, FAAOMPT
