Whole Body Dynamic Balance Training

Martin Krause (Musculoskeletal Physiotherapist). B Appl Sc (Physio), M Appl Sc (Manip Physio), Gad Dip Ex Sp Sc, Grad Cert Hlth Sc Edu

Whole body balance

Whole body balance (WBB) is a necessary aspect of life, if we wish to function within the realms of gravity. Very large co-morbidity exists in people with poor balance, including risk of fractures and reduced cardiovascular fitness. This in turn can lead to activity levels, below that, which is conducive to health. Poor balance, isn't restricted to old age, but has a spectrum in line with various sporting activities to the ability to simply stand and walk.

Fear of injury

Fear of falling and injury further restrict physical activity. Ultimately, perception, interpretation and learning are all affected by, as well as affect balance. 

Perception and interpretation

Balance has multiple dimensions and is influenced by interoceptive and exteroceptive perception and processing. For example, the dynamic balance of an orienteer, running and navigating through unfamiliar terrain, encompasses both cognitive map reading skills, expectations of the environment, as well as sure footedness on uneven ground. This requires the development of motor engrams

Perceptions and Interpretations

A person walking down a corridor or walking in the park, needs to use similar, forward thinking skills, at a subconscious level, to navigate their way through the environment.

Whole body co-ordination

Whole body co-ordination, requires several elements, such as interlimb coordination and postural control, as well as eye gaze stability.

Dynamic balance training

Several investigations have demonstrated the beneficial effects of dynamic balance training. These include changes in neural processing at the level of the cortex and brainstem, as well as increased grey matter in areas attributed to motor control. These neurological changes occur in a task dependent manner, called motor engrams or motor memory trace. Resting state functional connectivity (rs-FC) has been used to assess these engrams before and after dynamic balance training using a slackline (Ueta et al, 2022 Med Sc Sp Ex, 54, 4, 598-608) 

These investigators, demonstrated for the first time, that slack training, increased the the rs-FC between the left lateral PFC (pre frontal cortex) and the bilateral SM1 (somatosensory) foot areas. This was also associated with 'off line' learning, in changes in the M1 (motor) cortex, required for motor learning memory trace (engram). Learning appears to be contextual as well as affected by previous motor learning experiences. Another, useful model would be to examine motor learning in novice vs experienced football jugglers, or compare retired footballers with a novice ball juggling skill.

These investigators observed changes in areas associated with memory, such as the hippocampus and cingulate cortex, including the anterior area (ACC). The cingulate cortex also ahs functions in mood regulation, cognition, attention and social function. The lateral PFC has important executive and cognitive functions 

Conclusion

These results highlight the significant brain neuronal change which can take place with a balancing task. Although, healthy young individuals were the subjects tested, their results can potentially be extrapolated into any population where a 'balance challenge' is being used, to improve memory (perception, interpretation and execution) of a motor task, in both a constrained and open environment. The latter, i.e. the transference of learning, is what needs to be ascertained at a clinical level, to be able to demonstrate a functional outcome. 

Uploaded : 20 June 2022