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

Postural Strategy Training Purpose: Improve each participant’s ability to appropriately select and execute each of the three movement strategies (i.e., ankle, hip, step)

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.

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

Postural Strategy Training Ankle strategy Broad, stable surfaces Anterior/Posterior sway Slow speeds Small distances Small perturbations

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

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

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

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

Forward step strategy from bench surface

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

Start Position Crossover Open Step

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