Dynamic Balance Exercises for Fall Prevention

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Summary: Dynamic balance (moving balance) requires you to effectively move with good balance as your center of gravity shifts, like when you walk, and is important for fall prevention.

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Having good balance is a crucial skill for promoting a healthy and active life. It might be obvious that having good balance will decrease your risk of falling, but what isn’t obvious is the injuries that could result from those falls. In people with osteoporosis, a simple fall from the standing position could lead to life-altering fractures. For this reason, addressing balance to prevent falls is critical for protecting your body as you age.

When people think about balance exercises, they usually imagine standing on one leg, or other static balance exercises. What’s not as easily understood or achieved, is dynamic balance. 

Dynamic balance, or maintaining balance while you move, is vital for older adults to reduce the risk of falling and to help ensure safety and independence around the home and community. 

What is dynamic balance?

As mentioned, your body is capable of two types of balance: static and dynamic balance. Static balance (or stationary balance) is the ability to hold yourself in one position or posture, whether standing or sitting. Dynamic balance (moving balance) is the ability to maintain an upright position while moving, including during activities such as walking, turning, climbing stairs or standing up from a chair (Dunsky, 2017).

Static balance is essential for movements such as standing in place (for example: standing to wash the dishes) or standing on one leg (such as lifting your foot to put on a sock). This is known as standing balance. Sitting balance is vital to maintain an upright body when seated in a chair to eat a meal or sit in a vehicle. Both standing and sitting balance are relatively easy to achieve once the body knows where it needs to be, but strength and body awareness are important to help maintain this balance as we age.

Dynamic balance, on the other hand, requires good static balance and reaction time to deal with changes to your body’s position in space and your center of gravity. Good dynamic balance also requires good proprioception. Proprioception is the body’s ability to sense where its parts are located and how they are moving. Therefore, dynamic (moving) balance is more applicable to everyday movements. 

Balance exercises and your center of gravity

Both types of balance involve maintaining your center of gravity over your base of support. Your center of gravity is the average of where your body weight is located. Your base of support is your contact with the ground, which could mean your feet on the floor, or your seat in a chair. 

If you can imagine yourself standing, your feet are your base of support. The wider your feet are positioned, the wider your base of support is. If you are standing completely upright, your center of gravity will be right in the center of your base of support (feet). In this case, if you have good static balance, you are likely to stay there. If you were to lean your trunk forward, your center of gravity would shift forward of your base of support. If you lack good dynamic balance and proprioception, your body won’t be able to right itself, and you could fall forward. 

Proprioception helps with dynamic balance

Proprioception is often called the “sixth sense” since it is vital for safe and smooth movements. When your body innately knows where it is in space and where it is going, you will have good dynamic balance. Without this sense, it will be difficult to stop yourself from falling when confronted with changes in your center of gravity.

What contributes to good balance?

Other than proprioception, a few body components must be strong to have good balance. This includes:

  1. Core strength: Your core muscles brace your trunk and support your back. These muscles are an integral part of postural control (Kahle, 2014).
  2. Lower body strength: Muscles like the glutes help you hold a solid standing position through the hips. They also adjust your center of gravity to every weight shift as you move (Carter, 2002).
  3. Back strength: Balance requires good posture and strong back muscles to hold your spine upright (Pata, 2002).

Because several muscles must be strong to ensure good balance, strength training may also be necessary to improve balance.

Why is balance training important?

Balance training is essential for older adults since this demographic is more likely to fall. One in four adults over the age of 65 will fall (Bergen, 2016). In addition, those with osteopenia or osteoporosis have fragile bones, making falls increasingly risky since they are more likely to fracture a bone.

Balance training, specifically dynamic balance exercises, is an integral part of a fall prevention program. For example, balance training can help you prepare for navigating unstable surfaces or a sudden bump from a stranger on a busy sidewalk. 

These types of exercises can also improve your quality of life. Exercises that target the bones of the hips, wrists and spine can help reduce your risk of osteoporotic fractures in these regions and help you maintain your independence (Bergen, 2016).

5 dynamic balance examples

Dynamic balance exercises mimic complex scenarios, such as movements and shifts in your center of gravity that happen during daily life. If you are at a high risk of falling, you should perform these exercises under the supervision and guidance of a physical therapist.

It should also be noted that those with known vestibular impairments should seek help from their doctor or physical therapist to ensure they do not reproduce symptoms while attempting the exercises mentioned below. 

1. Stationary Marching

This dynamic standing balance exercise, also known as standing alternate hip flexion, aims to maintain single-leg balance while moving the other leg, therefore shifting your weight from side to side. Your legs will move similarly to walking but with increased time spent on only one leg, which is more challenging than walking. The goal is to improve your balance during that single leg balance phase and ultimately improve your balance during activities such as walking or going upstairs.

  • Start by standing upright with your feet hip-width apart. Stand near a chair or countertop if needed for balance. 
  • Lift your right foot off the floor until your knee is at hip height. Hold for 1-2 seconds before slowly returning your right foot to the floor. 
  • Next, do the same on the left leg. 
  • Do this repeatedly until you have performed 10-15 repetitions with each leg.
  • Remember to move slowly and with control while maintaining an upright trunk. 
  • Rest for 30 seconds. Then, perform 2-3 more sets.

2. Heel-Toe Walk

Another dyanamic standing balance, heel-toe walking challenges your balance by narrowing your base of support while walking. Imagine walking along a tightrope. This could mimic walking down a narrow walkway but can also make regular walking easier.

  • Start by standing normally. If needed, you may stand by a railing, wall, or countertop for balance.
  • Place your right foot directly in front of the left foot, touching the heel of your right foot to the toes of your left foot. 
  • Now step your left foot in front of your right foot.
  • Continue to walk forward by stepping one foot directly in front of the other, like you're walking on a tightrope. 
  • You may place your arms out to the sides for balance. 
  • Perform this for 20-30 seconds using the space you have available. 
  • Rest for 30 seconds. Then, perform 2-3 more sets.

3. Single Leg Balance with Weight Pass

This exercise challenges your single-leg balance while the weight constantly shifts your center of gravity. 

  • Begin standing with feet hip-width apart and a free weight or kettlebell in both hands. 
  • Lift one leg, so you are balancing on one foot. 
  • Then, slowly pass the weight around your body. 
  • Try to maintain your single-leg balance as you circle the weight around you.
  • Perform 10 passes in a clockwise position and 10 in a counterclockwise position. 
  • Rest for 30 seconds. Perform 2-3 more sets.

4. Standing Lunge

Standing Lunge, also known as a static lunge, aims to improve balance by handling a shifting center of gravity with a relatively narrow base of support. Lunges also strengthen the legs. 

  • Start by standing with your feet hip-width apart. You can stand next to the back of a chair or a countertop for support and balance if needed. 
  • Take a large step forward with your right leg, keeping your feet hip-width apart. Do not step forward as if you were on a tightrope. 
  • Next, bend both knees by lowering your back knee towards the floor. 
  • Keep lowering your body towards the floor until your knees are bent to about 90 degrees.
  • Maintain an upright spine the entire time. 
  • Lastly, stand upright and push off your front leg to return both feet under your hips. 
  • Repeat with the left leg. 
  • Perform 6-10 repetitions on each leg.
  • Rest for 30 seconds. Perform 2-3 more sets.

5. Standing Hip Abduction

Standing Hip Abduction aims to work on single-leg and dynamic standing balance by shifting the center of gravity and improving hip strength.

  • Start by standing upright with your feet hip-width apart. Stand near a chair or countertop if needed for balance. 
  • Lift your right leg off the ground, standing on your left leg.
  • Kick your right leg to the side. Imagine standing on a clock and kicking your right leg towards 3 o’clock.
  • Perform 10-15 repetitions without resting your right foot on the ground.
  • Do the same on the left side.
  • Rest for 30 seconds. Perform 2-3 more sets.

For an added challenge, try standing hip abduction with band. This exercise adds a resistance band loop around the ankles, which creates more resistance and acts to further strengthen the muscles of the lateral hip that are necessary for maintaining good balance.

Static balance exercises

Static balance training exercises are also valuable for improving balance. They can be an excellent place to start if you know you have poor balance or are just beginning a balance program. 

Common static balance exercises include: single-leg stance, standing with a narrow base of support, tandem stance, and tai chi exercises such as tiger balancing on front paws. These are typically done on an even surface, such as a hardwood, tile, or gym floor. They can also be made more challenging when performed on an unstable surface such as a carpet, yoga mat, foam pad or a bosu ball. Always start by practicing on a flat and even surface before attempting the more challenging options. 

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  1. Dunsky A, Zeev A, Netz Y. Balance Performance Is Task Specific in Older Adults. Biomed Res Int. 2017;2017:6987017. doi: 10.1155/2017/6987017. Epub 2017 Sep 5. PMID: 29018817; PMCID: PMC5605868.
  2. Kahle N, & Tevald MA. Core muscle strengthening’s improvement of balance performance in community-dwelling older adults: A pilot study. JAPA. 2014;22(1):65–73. doi:10.1123/japa.2012-0132
  3. Carter ND, Khan KM, Mallinson A, et al. Knee extension strength is a significant determinant of static and dynamic balance as well as quality of life in older community-dwelling women with osteoporosis. J Gerontol. 2002;48(6):360–368. doi:10.1159/000065504
  4. Pata RW, Lord K, & Lamb J. The effect of pilates based exercise on mobility, postural stability, and balance in order to decrease fall risk in older adults. J Bodw. Mov. 2014;18(3):361–367. doi:10.1016/j.jbmt.2013.11.002
  5. Bergen G, Stevens MR, Burns ER. Falls and Fall Injuries Among Adults Aged ≥65 Years - United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(37):993-998. doi: 10.15585/mmwr.mm6537a2. PMID: 27656914.

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