Elite Physique The New Science of Building a Better Body

Assess to Impress
5
Tricking Your Balance
Balance is controlled by three different systems: visual, vestibular, and somatosensory.
Put another way, it’s your eyes, inner ears, and feet that keep you from falling
over, and you never know which could be throwing off your balance. As a physical
therapist, I remove sensory input from each system one at a time by using the modified
Romberg test to assess how my patient responds (Agrawal et al. 2011). I also
use this test to assess the balance of patients who have trouble standing on one leg.
First, you will stand on a firm surface, feet together, with your eyes open. This
allows all three systems (i.e., visual, vestibular, and somatosensory) to contribute
to the task. If you are able to easily maintain balance in this first step, the second
step is to close your eyes while maintaining the same posture. If your body immediately
starts swaying, this means your visual system is playing a huge—often excessive—role
in your balance. If your balance is still maintained, the third step is to
stand on a thick, soft pad with your eyes open, thus requiring input from the visual
and vestibular systems. Finally, you’ll stand on that soft pad with your eyes closed,
which limits sensory information to the vestibular system. This final step is where I
want to see my patients able to maintain their balance (i.e., minimal trunk sway) for
at least 20 seconds. Any duration less than that and your risk of falling significantly
increases by more than threefold (Agrawal et al. 2011).
Research indicates that somatosensory information from your feet is the preferred
way for your body to maintain balance (Shumway-Cook and Horak 1986). Here is a
list of test conditions as they correlate with each sensory system:
Test condition
Firm surface, eyes open
Firm surface, eyes closed
Soft surface, eyes open
Soft surface, eyes closed
Sensory input
Visual, vestibular, somatosensory
Vestibular, somatosensory
Visual, vestibular
Vestibular
Second, the vestibular system transmits information from your inner ear to the
brain stem to coordinate head and eye movement. Third, the somatosensory
system feeds information from proprioceptors, joints, and cutaneous nerves
in your feet to your cerebellum to control posture and gait, among many other
functions.
Sufficient single-leg balance will help you perform better in the gym, and it’s
also necessary for preventing falls out in the real world. This assessment determines
how well you can maintain balance and postural control while standing
on one leg (Riemann 2002). If you find this difficult, there’s still good news. All
forms of exercise, from light to vigorous intensity, have a positive impact on
balance (Loprinzi and Brosky 2014).