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We start 2021 off continuing with the series of posts that describe in detail different motor and cognitive functions. This week is the turn of dynamic balance. Just as in previous occasions, we will start this post with a definition, which will be very useful to better understand the topic that we are about to discuss. So, what is dynamic balance?
The usual definition of dynamic balance is the ability to remain standing and stable while performing movements or actions that require displacing or moving oneself. In this way, each time that we take a step in any direction, we will be testing this type of balance. And, of course, the ability to walk requires its continuous use. It is for this reason that any disorder or condition that affects this type of balance will have a great effect on our level of autonomy. Moreover, a good dynamic balance will enable individuals to safely move around their surroundings, without crashing into objects or other people and, of course, without falling. Without a good dynamic balance it is difficult to remain physically active which, as we know, will have a direct effect on our health.
Differences between Dynamic and Static Balance
The differences between dynamic and static balance are easy to explain. The first one, as we saw in the previous paragraph, involves moving around a person’s own surroundings. On the contrary, static balance refers to the ability of individuals to remain standing and stable without displacing their bodies. That is, static balance can be defined as the ability to remain standing on one’s feet in a controlled manner without moving one’s body. Both are important and necessary to achieve a greater level of autonomy when performing the activities of daily living. Furthermore, static balance is fundamental to achieve a good dynamic balance. In a way, it can be seen that static balance corresponds to the “basics” of a person’s balance. It will be difficult to perform more complex movements around one’s surroundings or to participate in physical activities if what is the most basic element, is affected.
It’s for this reason that both must be approached -when required- during the rehabilitation process. Furthermore, both types of balance are necessary to walk (one of the main objectives of most patients and their families) so we could say that, without static balance, a person would be able to perform very few of the activities of daily living.
Dynamic Balance Exercises
There are several types of dynamic balance exercises. The objective of the majority of them is to train the coordination between those performed movements and to strengthen those muscles that must resist the weight transfered during those movements. In this way, training will take place in three steps: improvement of static balance, improvement of coordination while performing small displacements of the patient’s center of gravity and improvements to coordination and strengthening while performing greater and faster displacements of the patient’s center of gravity. A few examples:
Reaching Out Exercises with Hands: will ask patients to reach out with their hands to grab objects that are placed around them without moving from their initial position.
Coordination Tasks: to move one’s hands and feet in a coordinated manner.
Unipodal Balance Tasks: patients will have to maintain their balance while standing on one foot.
Reaching Out Exercises for Feet: this type of exercise will ask patients to step on objects that are placed around them moving only one foot from their initial position.
Stepping Tasks: in this activity, patients will have to take one or more steps around their immediate surroundings.
Fortunately, Rehametrics has more than 35 exercises to train these tasks.
Dynamic Balance Diagnosis and Improvement
There are several tests that are used to diagnose and to measure any improvements in a patient’s dynamic balance. In general, rehabilitation professionals use functional scales to assess a patient’s functional level from a static balance, dynamic balance or mobility perspective. These standardized scales will be used to provide rehabilitation professionals with a more objective measure of their patients current state. A few examples of the main scales used are:
Romberg’s Test: determines if patients can maintain static balance.
Berg’s Balance Scale: measures skills related to static and dynamic balance using functional tasks. This is the most used evaluation test to assess balance after a stroke.
Timed Up and Go Test: evaluates one’s capability to maintain dynamic balance and mobility.
Rehametrics generates quantitative measures for the displacement of the patient’s center of gravity, the number of steps completed (including the time required to take a step) and the average step height and width values. Moreover, all of these measures will be taken while any exercises previously-prescribed exercises by clinicians are completed by patients.