Balance Exercises

The following information discusses information from the Centers for Disease Control about the importance of regular physical activity including balance to enhance healthy aging. Balance is the ability to remain upright and keep the body within the base of support  with minimal change. By improving physical strength through exercises, and performing balance exercises, one can lessen the risk for falls. Along with balance exercises, walking is an activity that has been shown to have many benefits such as lowering blood pressure, improving blood sugars in diabetic patients, improving thinking abilities, and overall health.

Before starting to exercise it important to evaluate readiness and safety. Many people have medical conditions that can limit their ability to perform an exercise routine. If you have a medical condition, be sure to check with your provider prior to starting a new exercise program. If your provider says it is ok, try to fit the exercises for strength and balance into your daily routine. This may assist you to remain motivated to continue over a longer period of time. Remember that some muscle soreness or tenderness may occur as you begin to exercise. Always wear shoes that are not slick, flat soled and comfortable.

Below are two rating scales to assist you in measuring the exercises you are performing. The following information is given to assist you in evaluating your performance.

Remember SAFETY first!

Flat soled shoes
Flat floors
A chair to hold onto in front of your and/or a chair to sit down on behind you. Another option is  a counter top to use for balance as necessary to hold onto to steady.

The FITT Principle

FITT is an acronym for Frequency, Intensity, Time, and Type and is a useful tool to help participants set goals and achieve the most from their STEP activities.

• F = Frequency (how often to exercise)

o             Older adults should aim to walk or perform other aerobic exercise about 5 times a week and attend a strength training class at least once a week.

o             The frequency of both walking and strength training can gradually increase over time, as tolerated by participants and as their abilities improve.

• I=Intensity (how hard is the exercise time)

o             Use the Rate of Perceived Exertion (RPE) scale to evaluate your exercise intensity (explanation below).

o             Participants should aim for an RPE of 11 to 13 for aerobic activity such as walking.

o             For strength training, participants should maintain an RPE of 15 or 16.

• T=Time (how long to exercise)

o            Participants should aim for about 30 minutes of aerobic physical activity on most days of the week. Brisk walking accounts for this, again keeping in mind that your RPE is 15-16

o             Participants, especially not active ones, can increase the amount of time based on how they feel and as their abilities improve.

o             Participants may choose to perform physical activity in short bursts, such as five 10-minute walks, if that suits them better than fewer, longer episodes of activity.

o             Participants should take a few minutes to warm up and cool down before and after their aerobic activities. This can take the form of activities such as seated stretches or walking in place.

• T=Type (what kind of exercise to do)

o             This mobility training will stress two types of exercise: walking and lower extremity strength training.

o             At the end of 3 months, the goal is for participants to be exercising a total of 150 minutes each week, with most of that time being independent or group walking at a medium level of intensity. The rest of the time should be spent in the area of improved strength or balance exercises.

Rating of Perceived Exertion Scale (RPE)

Proper intensity increases the benefit of exercise, so it is important to engage in regular exercise, but also challenge yourself to increase the intensity, either by more minutes or adding weights. This mobility program aims to have you walking and doing strength training exercises at more than a “light” level of intensity.

The Borg Rating of Perceived Exertion (RPE) Scale is a subjective method of measuring exercise intensity based on how you see your own level of effort. The scale runs from a low of 6 to a high of 20, with midrange targets for walking and strength training. Individuals should think about and evaluate their own “exertion” based on their experience of muscle weakness, feeling out of breath, and emotions or “sense” of how hard they are exercising.

Because RPE is assessed through perception, not weights, speed, time, or distance, this rating is entirely individual and it may take time for you to understand. It will require practice and a level of honesty and best if you track this using a calendar to rate yourself. You must rate the difficulty as you perceive it, and only you will know if you are over challenging or under challenging yourself.

The target intensity for walking is an RPE of 11 to 13. Exercising at this level, you should perceive the exercise as “not especially hard.” You are exerting yourself but are comfortable and have no problem continuing (RPE 11), or “somewhat hard” (you are tired but not excessively tired and you do not have great difficulty continuing to exercise (RPE 13). 

The target intensity for strength exercises is 15 or 16, meaning that exercise should feel “hard.” You can still go on, but you  have to push yourself to continue and you do feel tired. For example:

An individual who wants to walk at a moderate intensity level would aim for an RPE of “somewhat hard” (13). If they describe their muscle fatigue and breathing as very light (RPE of 8), they would want to increase their movements. on the other hand, if they describe their intensity level as “very, very hard” (RPE of 19), then they should slow down in order to achieve their targeted intensity level and to ensure safety.

Remember that perceived intensity is how difficult the exercise feels to you. Think about the strain and fatigue of your muscles and your sense of breathlessness and describe how it feels. Refer to both the FITT scale and the RPE scale for further understanding.