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Table 4 Guidelines for dynamic steady-state, reactive, and proactive balance exercises

From: A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial

Balance (dynamic) Exercise variables Recommendations
Steady-state Base of support Stable to instable: normal gait – narrow gait – overlapping gait – tandem gait (Figure 3)
Position of feet i.e., lateral or medial weight shift, on heels or toes, toe angle in or out
Surface i.e., from soft to hard (e.g., grass to concrete), from stable to instable (e.g., concrete to sand)
Sensory input Impede vision or hearing
Dual-/Multi-tasking Additional motor task – additional cognitive task – additional motor and cognitive tasks
Speed of movement Decrease or increase of execution speed (i.e., walking speed)
Equipment Use of i.e., free weights, elastic bands, balls
Direction Forwards – backwards – to the left or right – diagonal
Rhythm Slow – fast – intermittent slow and fast
Reactive Controlled perturbations applied by therapist Reaction to external thread (push or pull) varying in speed, amplitude and direction on ankle, hip, trunk or shoulder level
Proactive ADL Combination of steady-state (dynamic) balance tasks with mobility in daily life (e.g., walking upstairs backwards while counting backwards aloud from 50 minus 2)
  1. ADL activities of daily living.