Strength and balance training: a program for older adults

The Journal on Active Aging • September October2003 27
Continued on page 28
Accompanying figures appear on
pages 28, 30 and 32.
The Center for Physical Activity and
Aging's strength and balance exercise
program starts with a 10-minute warm-
up, which includes flexibility exercises
performed in seated and standing
positions. Thirty minutes of band and
balance training follows, then five
minutes of cooldown and relaxation
activities.
The balance exercises start with placing
the feet in a series of positions that
gradually 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 directly
in front of the toes of the other foot);
• Standing up on the toes; and
• Standing on one foot. These exercises provide subtle changes
in balance similar to the challenges
experienced in everyday life. And they
allow the body to learn how to make
appropriate responses to maintain
balance while standing still.
Gradually, additional exercises that do
the 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.
These exercises can also be performed in
a wide variety of combinations, i.e.
standing on foam pads in the tandemposition, standing on foam pads and
moving the head, stepping onto a foam
pad, etc.
Strength exercises using bands are added
to strengthen each major muscle group
in the upper- and lower-body. Special
emphasis is given to muscles that play an
important role in the maintenance of
balance, such as those of the lower leg.
Each strength exercise is performed with
one set of 12-15 repetitions, eventually
progressing to two or three sets. Initially,
strength exercises alternate with balance
exercises; eventually, they are performed
in tandem. For example, participants
may perform the chest press while
standing in a semi-tandem position
(Figure 4), lateral pulldowns standing in
a full-tandem position (Figure 5), chair
squat (Figure 6), leg press standing on
one leg (Figure 7), and leg kicks in
different directions (Figure 8). Strength
exercises can also be performed with a
partner and combined with additional
balance activities (Figure 9).
Strength and
balance
training: a
program for
older adults
28The Journal on Active Aging • September October2003
Strength and balance training:
a program for older adults
Continued from page 27
Continued on page 30
Figure 3: tandem walking
Figure 2: center of gravity shifts
Stepping in different directions Reaching Object on floor
Place one foot directly in front of
the other, touching heel to toe,
and hold. Repeat with other foot
in front.
Progress to taking a step or two
by placing your heel to your toe
with each step. Eventually try
walking across the room.
Semi-tandem Full tandem Up on toes One foot
Figure 1: static balance stances
Photographs courtesy of Hygenic Corporation,Akron, Ohio
30The Journal on Active Aging • September October2003
Start Finish
Figure 5: lateral pulldowns in full-tandem stance
Start: stand in full-tandem position with band held above the
head at shoulder width.
Finish:keeping elbows straight, slowly bring the arms down to
the sides, stopping at shoulder-level. Slowly return to starting
position and repeat 12-15 times.
Start Finish
Figure 6: chair squat
Start: begin with center of band under feet. Grasp ends of
bands with hands by sides. Keep tension in the band with
elbows straight.
Finish:slowly bend knees while leaning forward slightly at the
hips. Keep back straight. Slowly return to starting position
and repeat 12-15 times.
Start Finish
Figure 4: chest press in semi-tandem stance
Start:stand on foam with one foot in front of the other in the
semi-tandem position. Put band behind back and grasp both
ends close to chest.
Finish:slowly push forward, like a bench press exercise, and
return to starting position. Repeat 12-15 times.
Photographs courtesy of Hygenic Corporation,Akron, Ohio
Strength and balance training:
a program for older adults
Continued from page 28
Continued on page 32
32The Journal on Active Aging • September October2003
Start Finish
Figure 8: leg kicks
Loop center of band around one ankle and stabilize other end
under the other foot. Kick band backward 12-15 times,
keeping the knee straight. Repeat on other leg. These kicks
can also be performed to the front.
Start Finish
Figure 9: exercises with a partner
Tie band in a loop. Wrap around one of your and your
partner's ankles. Hold your partner's shoulders. Kick band
backward 12 times, keeping your knee straight. Repeat on
other leg.
Start Finish
Figure 7: leg press on one foot
Start:loop middle of band around foot with your knee bent,
standing on opposite foot. Hold both ends of the band above
waist.
Finish:slowly straighten knee to touch foot to floor. Keep
back straight. Slowly return to starting position and repeat
12-15 times. Repeat on other side.
Photographs courtesy of Hygenic Corporation,Akron, Ohio
Strength and balance training:
a program for older adults
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