Postural Strategy Training

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Postural Strategy Training

• Debbie Rose, Ph.D.
• Co-Director, Center for Successful Aging
• California State University, Fullerton

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Postural Strategy Training

• Purpose
• Improve each participants ability to
  appropriately select and execute each of the
  three movement strategies (i.e., ankle, hip,
  step)

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Age-Related Changes

• More frequent use of the stepping strategy, even
  before the BOS is exceeded.
• Disappearance and/or ineffective use of
  strategies particularly hip and step.
• The step strategy requires the greatest
  allocation of attention.
• Selection and/or execution of appropriate
  movement strategy is delayed, particularly among
  older adults with balance and mobility problems.

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Movement Strategies

• Different movement strategies can be elicited by
• Changing task demands
• Speed of Sway
• Distance of sway
• Minimize sway in response to progressively larger
  applications of force
• Changing environmental constraints
• Support surface manipulations

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Postural Strategy Training

• Ankle strategy
• Broad, stable surfaces
• Anterior/Posterior sway
• Slow speeds
• Small distances
• Small perturbations

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Ankle Strategy Examples

• Stand on floor and sway between closely
• placed objects (i.e. wall and table)
• Use metronome or music to drive slow pacing

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Postural Strategy Training

• Hip Strategy
• Surface shorter than foot length
• Unstable surfaces
• Movement near LOS boundary
• Fast sway
• Larger perturbations

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Hip Strategy Examples

• Stand sideways on balance beam or Half foam
  roller
• Stand on rocker board, dyna disk, or foam
• Sway between objects further apart
• Metronome or music to drive faster pacing

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Postural Strategy Training

• Stepping Strategy
• COG must exceed the LOS boundary
• Voluntary to involuntary activities
• Down vs. Level vs. Up vs. Over

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Forward step strategy from bench surface
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Stepping Strategy Examples

• May fix stance foot to force swing with
  opposite leg
• Tape on floor provides visual cue for step
  length/width
• Provide large perturbations
• Practice stepping in posterior and lateral
  directions

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Start Position
Crossover
Open Step
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Postural Strategy Training

• Center of Gravity Control Section
• Exercises can serve multiple purposes -
• Standing Training on altered support surfaces
• Pass the Potato
• Multidirectional Weight Shifts