Balance is a problem for many adults, regardless of their health status. Simply put, it is not something many people focus on. Most of the clients I work with are chronically ill or disabled, and balance is frequently an issue. By the time we factor in any type of neural or movement dysfunction, the likelihood of balance impairment is extremely high. Falls are a serious concern for my clients, and many more like them: I would like to offer a little information here for trainers to help them programme to meet this impairment.

Factors that will contribute to balance difficulties:

Deterioration in vision

Weakening of muscles in legs and hips

Curved spine

Spinal degeneration

Inability to lift foot, leading to stumbling

Reaction times reduced

Effect of certain medications

Tendency to dizziness

Rehab programmes therefore need to incorporate elements of:

Strength training

Endurance training

Balance training

The balance system is an enigma, and although there is research on the subject, little has been proven. What is fairly apparent is that our balance system allows for some co-operation between the brain, nervous system, muscles and bones to assist the body in maintaining balance.

Three factors involved in maintaining balance are:

1. Visual cues: which help us become aware of and react to danger

2. Internal spatial awareness: which delivers a sense of where our arms and legs are in space

3. The inner ear: which gives out information on where our head is in space, and how to move it with ease.

When the body is functioning well, with the nervous and musculoskeletal system working together without effort or thought, balance can be achieved unconsciously. With dysfunction, balance becomes less spontaneous, and it may require exercise and re-programming to retrieve it. For many, balance can be retrieved, improving confidence and stability.