This article is a transcribed edited summary of a video Bob and Brad recorded in February of 2024. For the original video go to https://youtu.be/49139ljPAUM
Mike: Today we're going to show you a simple test you can do at home to see if you're at a fall risk.
Brad: And if you fail this test, we're going to show you four specific exercises to get you better and back to where you can balance very well.
Mike: So the test we're talking about in this video is called the Single Leg Stance Test. So what it does is it challenges your postural balance and awareness.
Brad: This test has been used widely by therapists across the country, including myself. I've used it for years. It really does the job and is something that you can do at home. All right, let's go about how this test is performed. Again, it's a single-leg balance test to see how you can balance on one leg, you'll do both legs. Now when I do it in the clinic, I always have my patient in the parallel bars so it's safe. They have something to grab onto when they lose their balance because you're going to go until you lose your balance. That's part of the test. Now at home, you don't have parallel bars. So I'm going to ask you to go to a cupboard, countertop, a solid chair, or probably the best thing is going to the corner of a room so that you have the walls to catch yourself when you lose balance or have in the corner and add something in front so that you have something all the way around so that you can get your balance. And it's a very safe test. Mike, you want to carry on with it. We'll take that out.
Mike: If you use a front-wheeled walker, you can certainly place that in front of you instead.
Brad: Good point.
Mike: Now in order to do the test, I'm just going to stand in the corner and the test begins immediately when you bring one foot off the ground. You'll start the timer or have someone else start the timer.
Mike: Now if you cannot stand for more than five seconds, you're at a greater fall risk. If this seems easy for you, what you can try to do is close your eyes. If you're falling over without your eyes closed, do not close your eyes, you're unsafe. Now the test also suggests when you're doing it to actually place your hands on your hips. Some people are going to feel very unsafe doing this. So if you want to keep your hands just hovering by the wall or above the chair, that is perfectly acceptable as well.
Brad: Mike, let's go into some detail about what establishes a loss of balance. So we're not going to go until you fall over. That's why you're on the wall. If you touch the other foot on the ground to catch your balance, that's it, you stop the timer. If you have to touch your shoulder on the wall, a hand on the wall, or if you have a walker or a chair in front and you touch it with your hands, that's it, that's where the timer stops. So we don't go until you fall over. It's when you catch your balance with your leg, shoulders, hands, whatever it may be.
Mike: And it's important to notice that you're going to do both sides separately. You may notice one side is better than the other, especially if you have an old injury or possibly surgery on one side.
Brad: And chances of you being able to go to the eyes closed part, you know that's more for younger people, the athlete, that kind of thing.
Mike: It is challenging.
Brad: Yeah. Okay, now we've got a really nice chart that gives average values for people in certain age groups. They call that normative values. This is scientifically done. If you look at the chart, the age groups are there. There's another chart to the right. Eyes open, gives you the time that the average time person can stand up with eyes open and then eyes close. So simply look for your age group with your eyes open and compare it. It gives you a good idea of where you are with the average person. And then do the exercises. And we're looking for progress in one or two weeks.
Mike: So we're going to go through four balance exercises that Bob actually does himself to work on his balance. You want to do each exercise because they're each going to work different proprioception balance parts within your body and your feet. So the first one we're going to do is actually just standing on one leg, actually practicing the test itself. Again, I am in the corner that way I have a wall here in case I lose my balance. If you are a beginner and really can't do this, it's okay to have your hands on the wall while practicing. Eventually, try to not support yourself if you are able, or if you have a chair in front of you, you can certainly hold onto that. Work each leg three different times for as long as you can tolerate. I typically would have patients try to go 10 to 15 seconds with support if needed and eventually work up to not holding on.
Brad: If you feel more advanced, you certainly can use a cane or a Booyah Stik while you do your balance. When you have your left leg, it's a good idea to put it in your right hand. When you do your right leg, hold it in your left hand, you'll find that works much better.
Mike: Now the second exercise is going to be a static standing exercise. Again, we're not going to be moving. Again, you can either be in the corner like I am or Brad will show it with a cane or possibly at a countertop. So this is going to be a heel-to-toe stance. You put one foot directly in front of the other. Again, if you need support, go ahead and do it. This is again, is going to be for a time, how long you can hold it. You're going to want to do both legs, so could switch and do the other leg in front. You can do this three times per leg again. Now, if this is challenging and you cannot cross your legs, if say a staggered stance is challenging, then start there. Eventually, over time, try to get them to cross at a midsection.
Brad: Good, nice work Mike.
Mike: Now the third balance activity is going to be a dynamic balance exercise, meaning we're actually going to move. So Brad is going to demonstrate it. He's going to go sideways. You typically do this by holding onto a countertop or maybe a railing in your house, or you could certainly do it with a cane. Just something for support. Now Brad is just going to go sideways and notice that his feet are facing straight ahead as he's doing this. Typically in the clinic, we would pick a countertop that was roughly 10, or 15 feet long, have them walk in one direction, and then back the other way. Typically we'd have them do it two to three times.
Brad: And keep in mind, like Mike said, your toes are forward not turned to the side. And oftentimes people will have a tendency to drag a foot or the other one of your toes. Be really cognizant of that and make sure you do not drag your feet. We want to keep them in the air. It's a good safety thing.
Mike: And the last balance activity is going to be heeled-to-toe walking. So it's going to take a progression from the static stance we did earlier. So Brad's going to demonstrate putting one foot in front of the other directly and he's going to hold on for support again, as needed. It's like you're walking a tightrope. So pretend you're going to join the circus soon.
Brad: Right, and make sure we want to try to touch the heel to the toe and be aware of that. That's called proprioception. It really can make a big difference in your balance when you're not doing this. For example, in the real world, when you're walking throughout your kitchen or up and down the steps, et cetera, proprioception is key. This is really good for it. All right, so these four balance exercises are comprehensive and they all complement each other. Do all of them just like we did. You'll get through them in a few minutes after you've done them a couple of times and then measure your progress from week to week. And you should see those times improve.
Mike: If you would like to check out more videos on how to improve your balance, check out the video "25 Second Balance Exercises That Stop Falls (PDF Printout)."
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