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Selecting balance and mobility activities for older adults

This is an excerpt from ABLE Bodies Balance Training 2nd Edition With HKPropel Access by Sue M. Scott.

Selecting Balance and Mobility Activities

Balance and mobility activities make up the lion’s share of this book. Activities in this part of the ABLE Bodies toolbox are first divided into two compartments of balance: sensory training and agility or mobility training. Each compartment is further divided into subcompartments with their own activities. These subcompartments are particularly useful for personal training. For group training, a multifaceted program works best as it offers broader benefits. Instructors should select a variety of progressive activities from each component to ensure there is something for everyone. All activities in each section progress from easy to more difficult, as much as possible. Instructors can start at the beginning of each subsection and work their way through to address specific needs. Other suggestions for selecting activities are provided next.

Themes
Consider building activities around themes, such as gait training, Belly Button Training, Walk the Line, and Rhythm and Moves (chapter 8), or Games (chapter 9). Or focus on visual, vestibular, or somatosensory training. Tying activities to a theme creates cognitive links to the activity by providing multiple pathways for learning. Later, the instructor will be able to tie these themes to other activities and balance challenges.

Variety
Variety is important. Offering a variety of components is what makes ABLE Bodies multimodal. Instructors can choose to add variety over several classes or during one class. For example, pick two balance ideas: one from visual activities (tandem walking or balance pads to encourage use of visual targets) and one from vestibular activities (dimming the room or using head movements). On another day, pick activities from two other areas. Isolating and engaging different sense receptors and balance systems uses variety to improve overall function and balance.

Ability
Training by ability has risks and benefits. Instructors are responsible for making appropriate training choices and supervising participants, which should guide their choices in balance training. Like Goldilocks and the Three Bears, the activities should not be too hard or too easy, but just right. Participants do not want to be bored by activities that are too easy or scared by activities that make them anxious. Both instructors and participants must consider the challenge to be safe, doable, appropriate, and purposeful. For group training, aim for activities to be somewhere in the mid-range of class ability. Zoom in to modify activities if participants appear overwhelmed or add more challenge if they seem ready. Watch their body language and listen to their comments. Consider splitting classes into two levels. Or split one class, with two groups each doing slight variations. If for any reason a participant refuses a turn or an activity, instructors should respect that choice. To be maximally effective when training by ability, the activities should have a purpose that participants value and should be doable but challenging. Effort connects mind and body and garners better results in learning and performance.

Class Size
For large classes, take turns doing most balance challenges. Taking turns adds a fun social component and gives participants little breaks. While participants rest between turns, they watch, reflect, laugh, and learn from each other. They plan how they will do the activity (which is excellent for cognition). Instructors may notice that people almost always try a little harder during their turn when others are watching. Any time participants give their best effort, this is a win-win.

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