The STAB:LE Program
@stable_program
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Systematically developing the essential movement skills that older adults need at home, outside, and in the community
Joined February 2022
Physios… teach your clients to get off the floor. Even if they’re 90. No, ESPECIALLY if they’re 90. This is Bill. Bill is 97. Be like Bill.
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Holiday tip: When you’re spending time with your older parents or relatives, gently ask them: "If you ended up on the floor, are you 100% confident you'd be able to get up again by yourself?" Their response can reveal a lot about what support they may need
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If you find you’re routinely using your hands to maintain a position, it often means the exercise is just a bit too tough right now... ...and you should adjust to something slightly easier and build up from there. Happy balancing!
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It’s a gentle reminder to let your ankles, hips, and natural step responses do the work they are supposed to be doing
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Why do we say that? Because we want you to challenge yourself *just enough* so that if you wobble, you can take a step to recover your balance (rather than automatically reaching out with your hands) But if it gets too hard then at least it's there for safety ⚠️
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Exercises like this may actually be reinforcing a bad habit of relying on your hands for balance, rather than your feet This is the opposite of what we're trying to achieve! Here’s a little trick we love: 👉 Pretend the bench or bar next to you is covered in wet paint! 🎨
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🖐️ Balance Tip: Imagine the Wet Paint Trick! Ever tried a balance exercise and found yourself holding onto something for dear life? Or just touching it to try to hold the position? Well, this could actually be preventing you from improving your balance 😮
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The key rule is simple: 👉 Stop when the movement quality starts to drop. Good balance practice is about quality first, quantity second.
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So when you do balance exercises, instead of aiming for a fixed number like 10 or 15, the right number of repetitions depends on the exercise and the person. For one movement, it might be 5 good repetitions. For another, it might be 20 or even more.
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But we also don’t want to keep going once you’re tired & your movement starts to get sloppy. When we practise movements while we’re fatigued, the body can actually learn the wrong pattern, and that’s the opposite of what we want: 👉 Research show fatigue impairs motor learning
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Balance is a skill. And like any skill, it improves by practising the movement well, not just doing a set number of reps We don’t want to stop too early before your body has had a chance to learn the movement...
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When it comes to balance exercises, we’re not trying to build endurance. What we’re really trying to do is teach your body how to move better.
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How many times should you repeat each exercise if your goal is to improve your balance? Here’s a hint: the answer is not “10 to 15.” A thread 🧵
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Q: If you want to improve your balance, how many reps should you do of each exercise? A: The answer is almost NEVER 10! 🚩 You should do as many as you can before fatigue starts to impair performance (or you're out of time to share between your other movement skill goals)
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If you're trying to improve your balance you must remember these 3 key principles: 1. Learn to move your feet in every direction 2. Train to develop movement skills 3. Prioritise your sessions based on the skills you need most 👉 Balance is more than doing a few static holds
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Exercises like this are great if you want to rehab and ankle injury or improve your static balance on a dynamic surface... ...but does little to develop an integrated ankle-hip-step response Great for surfing/skating. Terrible for reducing the risk of falls
Would this improve your balance ??? Is it functionally relevant or specific ? Is it beneficial to reducing falls ??? Will it waste your money & time?? Can you guess which one is a yes..... @PhysioNetwork
@stable_program
@age_uk
@DementiaUK
@thecsp
@LeicsCares
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There's 2 ways to help an older adult improve balance: 1) Prioritise functional deficits, then systematically improve performance in select task(s) before moving onto the next one 2) Simultaneous address all skill deficits & achieve gradual improvements across the board
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Physios: Whenever prescribing balance rehabilitation exercises it's important to consider that context is a form of progression... ...and that anxiety affects not just performance, but motor learning
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Static exercises that isolate ankle strategy only train ankle strategy... ...while balance exercises that include stepping simultaneously train ankle, hip and step strategies One of these is effective at replicating real world balance needs, one of these is a vanity exercise
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You can judge the effectiveness of a balance & mobility rehab program by not just what's included, but also what's included: 🛑 Ineffective & overused: 👎 Standing hip abduction 👎 SLS behind a chair ✅ Necessary but neglected: 👍 Stepping in all directions 👍 Cross-and-step
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There’s no perfect balance exercise. Rehab needs to be individualised. But not over-complicated. It’s simple: Practice scaled versions of each movement skill that needs to be improved & then progressively increase the challenge until the client reaches their movement goal
@Matthew_Rupiper @glittervandit @stable_program Its not as complex as some make out yet it need to be challenging for each individual although whilst maintaining safety. Balance task with upper limb support limits hip/ankle reactions so attempt facilitate/reassure pts to not hold them old school parallel bars...
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