Postural Strategy TrainingPostural Strategy Training

Debbie Rose, Ph.D.Debbie Rose, Ph.D.

Co-Director, Center for Successful AgingCo-Director, Center for Successful Aging

California State University, FullertonCalifornia 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 TrainingPostural Strategy Training

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

Ankle Strategy: ExamplesAnkle Strategy: ExamplesStand on floor and sway between closely

placed objects (i.e. wall and table)

Use metronome or music to drive slow pacing

Postural Strategy TrainingPostural Strategy Training

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

Hip Strategy: ExamplesHip 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 TrainingPostural Strategy Training

Stepping StrategyStepping 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: Stepping Strategy: ExamplesExamples

• 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