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

2. 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)

3. 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.

4. 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

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

6. 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

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

8. 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

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

11. Forward step strategy from bench surface

12. 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

15. Start Position
Crossover
Open Step

16. 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