What Balance Exercises Are Most Effective in Physical Therapy for Fall Prevention?

    Authored By

    Nurse Magazine

    What Balance Exercises Are Most Effective in Physical Therapy for Fall Prevention?

    Preventing falls is a critical aspect of physical therapy. We've gathered expert advice, starting with a simple-but-crucial technique from a seasoned Physical Therapist. Alongside these expert recommendations, we've included additional practices that holistically approach all the phases of fall preparedness. From eyes-closed progressions to practical use of the Functional Reach Test, discover a spectrum of techniques to improve balance and prevent falls.

    • Standing With Eyes Closed
    • Four-Phase Fall Preparedness
    • Sit-to-Stand and Heel Raises
    • Tai Chi for Proprioception
    • BOSU Ball for Balance
    • Single-Leg Stances
    • Yoga for Body Awareness
    • Functional Reach Test

    Standing With Eyes Closed

    The most important thing about any good physical exercise is that the exercise can be modified to adapt to the physical level of each individual by progressing or regressing the exercise.

    My favorite balance exercise is standing with eyes closed. This exercise is easy to progress and does not require any equipment.

    1) Stand with your eyes closed. If this is challenging, perform the exercise near a table or chair for support if necessary.

    2) Stand with your eyes closed and slowly turn your head from side to side.

    3) Stand with your eyes closed and slowly lift one foot from the floor, so that all or part of the weight is transferred to the standing leg.

    Find your level by testing where you can perform the exercise calmly and safely without large fluctuations in balance.

    Thea Johansen
    Thea JohansenPhysical Therapist, VELA Chairs

    Four-Phase Fall Preparedness

    Most of the focus on decreasing falls looks specifically at Fall Prevention or trying to prevent a fall from occurring in the first place. However, falls still happen anyway, even with the best training. Because of this, we focus on Fall Preparedness and break it down into four phases: Pre-Fall, Near-Fall, Fall Landing, and Completed Fall.

    Pre-Fall exercises work to strengthen the legs and improve static and dynamic balance. Near-Fall exercises work to improve your balance reflexes, making it more likely you will catch yourself if you lose your balance. Fall Landing focuses on techniques to minimize the risk of injury if you have a fall and get your body ready for falling. Completed Fall exercises ensure you have the ability to get up off the floor after a fall. By covering all phases of the fall cycle, participants not only demonstrate improved balance but also report increased confidence.

    Dr. Beth TemplinOwner, HouseFit

    Sit-to-Stand and Heel Raises

    As simple as it seems, transferring from sit to stand is an important assessment tool, exercise, and outcome measure (the 5-times sit-to-stand test has outcome measures for age/gender norms as well as posture/form/safety during this activity). Heel raises (lifting heels off the ground in a controlled manner, both going up and down) show strength, coordination, and balance, especially if done while on one leg. Many of us rely heavily on our sense of vision for balance, so with safety measures in place, attempting activities with eyes closed is beneficial (normal stance, narrow base of support, and/or standing on soft/uneven surfaces). Lastly, attempting to engage our deeper core muscles starts at rest with gravity assisting (lying down, bringing the belly button into the spine), then progresses to more challenging functional activities such as walking, lifting, and reaching.

    Emily Davies
    Emily DaviesPhysical Therapist

    Tai Chi for Proprioception

    Tai Chi is widely recognized as an effective method for enhancing stability and sharpening proprioception, which is the body's ability to sense movement, action, and location. It's a gentle practice that focuses on slow, graceful movements and deep breathing, making it ideal for individuals of all ages, especially those at risk of falls. Studies suggest that Tai Chi can reduce the risk of falls by improving balance and coordination.

    Engaging in this form of martial art encourages mindfulness and fosters a serene mental state, which can contribute further to fall prevention. If you're concerned about maintaining balance as you age, consider joining a Tai Chi class in your local community.

    BOSU Ball for Balance

    Incorporating BOSU ball routines into therapy can yield significant improvements in dynamic balance and overall flexibility. A BOSU ball, which is a flat platform on one side and a rubber dome on the other, creates an unstable surface that challenges the body to maintain stability. Such routines involve various exercises that require the individual to adjust their center of gravity continuously, thereby engaging and strengthening core muscles.

    This form of exercise is particularly beneficial for those looking to not only prevent falls but also to enhance athletic performance. Look into incorporating BOSU ball exercises into your workout routine for a more dynamic and challenging balance training experience.

    Single-Leg Stances

    Single-leg stances are a simple yet highly effective exercise for challenging equilibrium and improving muscular control. By standing on one leg, the small, stabilizing muscles in the foot, ankle, and hip are activated and strengthened, building a more resilient foundation. This unilateral stance promotes balance and symmetry in the body, important factors in reducing the risk of falls.

    Such stances can easily be practiced at home or incorporated into a workout regime. Start practicing single-leg stances today to strengthen your stabilizing muscles and enhance your balance.

    Yoga for Body Awareness

    Yoga, a mind-body practice with ancient roots, offers a plethora of poses that serve to increase muscular strength and enhance body awareness, which are vital components in fall prevention. Regular participation in yoga builds flexibility and encourages a focus on alignment and breath control, contributing to a sense of inner tranquility. The poses can vary in difficulty and can be modified to suit any level, making it accessible for all.

    Through improved body awareness, become more attuned to your own physical space, which can significantly reduce the likelihood of falls. Try integrating yoga into your daily routine to elevate your physical and mental well-being while working towards better balance.

    Functional Reach Test

    The Functional Reach Test (FRT) is a simple and predictive screening tool used in physical therapy to assess and improve an individual's limits of stability, or how far one can reach beyond their base of support without losing balance. This test not only provides a baseline for balance abilities but also serves as a means of tracking improvement over time. By regularly assessing reach distance and practicing this test, patients can work on extending their reach safely, thereby potentially lowering their susceptibility to falls.

    Clinicians often use the results of this test to tailor specific balance exercises for their patients. Consider speaking with a healthcare professional about FRT to monitor and improve your balance.