Strength and balance training: a program for older …

1 The Journal on Active Aging September October2003 27 Continued on page 28 Accompanying figures appear onpages 28, 30 and Center for Physical Activity andAging s Strength and balance exerciseprogram starts with a 10-minute warm-up, which includes flexibility exercisesperformed in seated and standingpositions. Thirty minutes of band andbalance training follows, then fiveminutes of cooldown and relaxationactivities. The balance exercises start with placingthe feet in a series of positions thatgradually reduce the base of support,holding the stance for 10 30 seconds(Figure 1): Semi-tandem (one foot ahead of the other as if taking a step); Full tandem (heel of one foot directlyin front of the toes of the other foot); Standing up on the toes; and Standing on one foot.

2 These exercises provide subtle changesin balance similar to the challengesexperienced in everyday life. And theyallow the body to learn how to makeappropriate responses to maintainbalance while standing still. Gradually, additional exercises that dothe following are introduced: Add dynamic movements to perturb the center of gravity, such as leaning or stepping in different directions, lateral and forward reaching, picking up an object from the floor (Figure 2)and tandem walking (Figure 3); Reduce visual input by closing the eyes or dimming the lights; Challenge the vestibular system by moving the head side to side; and Challenge the somatosensory system by standing on foam pads.

3 These exercises can also be performed ina wide variety of combinations, on foam pads in the tandemposition, standing on foam pads andmoving the head, stepping onto a foampad, exercises using bands are addedto strengthen each major muscle groupin the upper- and lower-body. Specialemphasis is given to muscles that play animportant role in the maintenance ofbalance, such as those of the lower Strength exercise is performed withone set of 12 15 repetitions, eventuallyprogressing to two or three sets. Initially, Strength exercises alternate with balanceexercises; eventually, they are performedin tandem.

4 For example, participantsmay perform the chest press whilestanding in a semi-tandem position(Figure 4), lateral pulldowns standing ina full-tandem position (Figure 5), chairsquat (Figure 6), leg press standing onone leg (Figure 7), and leg kicks indifferent directions (Figure 8). Strengthexercises can also be performed with apartner and combined with additionalbalance activities (Figure 9). Strength andbalancetraining: aprogram forolder adults28 The Journal on Active Aging September October2003 Strength and balance training : a program for older adultsContinued from page 27 Continued on page 30 Figure 3: tandem walkingFigure 2: center of gravity shiftsStepping in different directionsReachingObject on floorPlace one foot directly in front ofthe other, touching heel to toe,and hold.

5 Repeat with other footin to taking a step or twoby placing your heel to your toewith each step. Eventually trywalking across the tandemUp on toes One footFigure 1: static balance stances Photographs courtesy of Hygenic Corporation, Akron, Ohio30 The Journal on Active Aging September October2003 Start FinishFigure 5: lateral pulldowns in full-tandem stanceStart: stand in full-tandem position with band held above thehead at shoulder width. Finish:keeping elbows straight, slowly bring the arms down tothe sides, stopping at shoulder-level.

6 Slowly return to startingposition and repeat 12 15 FinishFigure 6: chair squatStart: begin with center of band under feet. Grasp ends ofbands with hands by sides. Keep tension in the band withelbows :slowly bend knees while leaning forward slightly at thehips. Keep back straight. Slowly return to starting positionand repeat 12 15 FinishFigure 4: chest press in semi-tandem stanceStart:stand on foam with one foot in front of the other in thesemi-tandem position.

7 Put band behind back and grasp bothends close to chest. Finish:slowly push forward, like a bench press exercise, andreturn to starting position. Repeat 12 15 times. Photographs courtesy of Hygenic Corporation, Akron, OhioStrength and balance training : a program for older adultsContinued from page 28 Continued on page 3232 The Journal on Active Aging September October2003 Start FinishFigure 8: leg kicksLoop center of band around one ankle and stabilize other endunder the other foot. Kick band backward 12 15 times,keeping the knee straight.

8 Repeat on other leg. These kickscan also be performed to the FinishFigure 9: exercises with a partnerTie band in a loop. Wrap around one of your and yourpartner s ankles. Hold your partner s shoulders. Kick bandbackward 12 times, keeping your knee straight. Repeat onother FinishFigure 7: leg press on one footStart:loop middle of band around foot with your knee bent,standing on opposite foot. Hold both ends of the band abovewaist. Finish:slowly straighten knee to touch foot to floor.

9 Keepback straight. Slowly return to starting position and repeat12 15 times. Repeat on other courtesy of Hygenic Corporation, Akron, OhioStrength and balance training : a program for older adultsContinued from page 30