Stephen V. Rapposelli, PT, OCS
Balance can mean different things to different people. To a 5-year-old, balance is learning to ride a bike without training wheels. To an adult, balance can mean catching yourself while tripping over that bike, while carrying groceries. To the older adult, balance is hopefully not losing it while walking, but also being able to regain it without falling down. Balance is exceptionally important to older adults in maintaining independence. In our practice, it is one of the top fears of our elderly. When you fall, you can break a bone, which they fear will lead to loss of independence and even death. This can be a very valid fear, but like anything else in healthcare, benefits from attention early on to address the potential problem.
Balance can begin to slowly diminish in the 40’s (don’t get depressed yet!), so all middle aged adults need to add some sort of balance training to their routines. In terms of importance, it is right up there with cardio and strength and flexibility. It is interesting to note that cardio, strength, and flexibility have a big part in how good your balance is, and how you react to challenges to your balance
Before we continue, I want to emphasize that balance is a very complex task that can be affected by lots of different things. Medication, inner ear problems, visual problems, and blood pressure issues are just some examples of causes of balance problems. In physical therapy, we concentrate on the role that bones, joints, muscles, and nerves play in having good balance. I want to give you some simple tests that can be done at home to assess your balance. If you have trouble
doing some of these tests, it is time to visit your physical therapist for a more comprehensive exam, and see your doctor for a full check up.
1-legged standing balance test. This is pretty self explanatory. Stand on 1 leg without holding onto anything. Normal balance is one minute, less than 30 seconds will need some work.
Standing reach test. Stand next to a wall, arm raised to shoulder height. Reach forward along the wall as far as you can without falling, and note the distance between the starting position, and finishing position. A standing reach of less than 6 inches indicates a higher risk of falling.
Timed up and go test. Place a chair against a wall and measure out 10 feet. Mark this spot. The test is how long it takes to get up out of the chair, walk 10 feet, turn around, and sit back down. If it takes longer than 14 seconds, there is a high risk for falling.
The 5 times sit to stand test. ( I do love some of these names!). Sit in a chair. Whenever ready, stand up and down 5 complete times as fast as possible. You have to stand up fully, and sit down with your butt touching the chair. Persons without balance problems can do this test in less than 13 seconds.
Ok, so there are 4 simple tests to determine if you or someone you love needs further evaluation for balance problems. Understand that these tests are not for everyone, but between the 4 of them, most people can get an idea of how well they are in balance. Once the problem can be identified, the solution is just behind it!