Your PT will likely prescribe specific exercises that can improve posture and positioning, strength, and proprioception. One specific exercise program for balance that your PT may teach you is called Otago exercises.
Otago exercises are a specific set of exercises that can improve balance. The program was developed in New Zealand and has been proven to improve mobility and prevent falls due to balance problems.
The Otago exercise program is easy to learn and implement, and it includes components for mobility, proper posture, strength, and balance. It is quickly becoming a staple in the physical therapy exercise toolbox for people with balance and mobility impairments.
Components
There are various components of the Otago exercise program for balance. These include:
Posture Spinal mobility Hip and core stability Lower extremity strengthening Balance training
The exercises may be simple for some people and more difficult for others. They are usually done three times each week for several weeks, and they can be used as a balance maintenance program to prevent falls.
Effectiveness of Otago Exercises
The Otago exercises have been proven to be an effective program to help improve balance, reduce the risk of falls, and improve overall mobility.
When it was first introduced in the early 1990s, four clinical trials were performed to assess the effectiveness of Otago exercises. In total, 1016 men and women participated in the research, and they ranged in age from 65 to 97 years.
The main takeaway results from the research into Otago exercises include:
Falls among people participating in the Otago were reduced by 30% to 66% when compared to controls who were not doing Otago exercises. After one year, injuries due to falls were reduced by 28% in participants performing Otago exercises. The Otago exercise program was most effective at reducing falls for people over the age of 80 years, but people who were younger still found some benefit. Seventy percent of patients performing Otago exercises continued doing the program after one year.
Research concludes that the Otago exercise program is safe, effective, and can provide a long-term self care strategy for reducing falls and reducing injuries due to falls.
Getting Started With Otago Exercises
Before starting any exercise program for falls or mobility problems, you must see your physician. A visit to a physical therapist trained in the Otago exercise program may also be helpful. Your PT can assess your personal condition and provide instruction and guidance as you begin the exercise program.
Before exercising, it is recommended your warm up a bit. Move around your house, get your blood pumping, and find a safe place to exercise.
Improving balance with exercise may mean creating situations that challenge your balance. Therefore, you must remain safe while exercising. Be sure something stable, like the kitchen counter, a table, or a chair, is nearby to grab onto while exercising.
The exercises start with spinal movements and postural control, and they progress through seated and standing lower extremity strengthening and, finally, to functional balance exercises.
Slowly turn your head to one side. Hold the end position for 3 secondsSlowly turn your head to the other side. Hold for 3 seconds. Repeat the sequence 5 times.
If standing is difficult or unsafe, sit in a comfortable chair with upright posture while performing the exercise.
Place one hand on your chin. Pull your head and neck straight back, being sure not to nod your chin up or down. Imagine a long straight neck as you guide your head backward. Hold this position for 3 seconds, and then release the stretch. Repeat 5 times.
If standing is not possible, sit in a comfortable chair with upright posture as you exercise.
Place both hands on your low back just above your buttocks. Slowly bend backward. Hold the end position for 3 seconds. Come back up to full, upright posture. Repeat 5 times.
It is often helpful to perform this exercise while standing in front of a bed. That way you can have a safe place to quickly sit if you lose your balance.
Stand in front of a stable kitchen counter with your feet shoulder-width apart and your hands on your hips. Turn your body, torso, and shoulders to one side. Hold for 3 seconds. Rotate to the other direction. Hold for three seconds. Repeat 5 times.
Sit in a chair with upright postureStraighten one knee as far as possible. Tighten your quadriceps muscle (front of thigh) when your knee is fully straight. Hold for 3 seconds. Slowly lower your leg back to the starting position. Repeat the seated leg extension exercise 10 times.
Stand next to something stable like a kitchen counter or table. Hold onto the table with one hand. Lift one leg to out to the side while keeping your knee straight. Hole the end position for three seconds, and then release back to starting position. Repeat 10 times.
Be sure to keep your posture upright as you lift your leg to the side.
To perform the sit-to-stand exercise:
Sit upright in a supportive chair. Stand up. Slowly sit back down. Be sure to sit slowly; it should take you a couple of seconds to fully sit. Repeat 10 times.
It may be necessary to use your hands when doing the sit to stand. Progress from using two hands to help you rise, to then using one hand. As you continue exercising, you should be able to rise from sitting with no upper extremity support.
To perform the standing heel raise:
Stand with upright posture and hold onto something stable like the kitchen counter or the back of a chair. Keeping both knees straight, rise up onto your toes, lifting your heels off the ground. Hold this position for 2 seconds. Slowly lower down. Repeat the heel raise 10 times.
This exercise can be made more challenging by holding onto a stable with only one hand or by performing this while not holding on.
To perform the standing toe raise:
Stand up tall and hold onto something stable. Keeping your knees straight, lift your toes and the balls of your feet off the floor. Hold this position for 2 seconds. Slowly lower your toesRepeat 10 times.
The standing toe raise can be made more challenging by only holding on to a stable object with one hand or not holding on at all.
Stand up tall and hold onto a stable object. Slowly bend your knees into a mini squat; be sure to not bend too far. Hold the squat position for 2 seconds. Return to the starting position. Repeat 10 times.
Walk around the objects in a figure 8 pattern. Be sure to keep your steps even, and keep your head and eyes forward while walking. Walk in the figure 8 pattern 10 times
Be sure something stable is nearby to grab on to in case you lose your balance.
Simply find a staircase with a railing, and walk up and down the stairs 10 times. Be sure to hold on to the railing for safety.
With one hand resting on the counter, simply walk backward along the kitchen counter. When you run out of space, turn around and walk backward in the other directionRepeat 10 laps.
If it is easy to walk backward along the kitchen counter, you can try to make it more challenging by not using any upper extremity support.
To perform tandem standing:
Stand upright next to your kitchen counter, hold on, and place one foot in front of the other. Be sure your toes and heel are just barely touching. Hold this position for 10 seconds. Switch feet. Repeat three times for each foot forward.
Tandem standing can be made more challenging by not holding on while remaining in the tandem stance position.
When tandem standing becomes easy, you can try tandem walking. Simply hold onto the kitchen counter, and walk forward with one heel just in front of your toes. Walk along the length of your kitchen counter, turn around, and tandem walk back.
Tandem walking can be made more challenging by performing the walking without any upper extremity support. If that becomes easy, try tandem walking forward and then in reverse in a toe-to-heel pattern.
To perform the single leg stance exercise:
Stand upright in front of a stable object, like a table or kitchen counter. Hold onto the table. Raise one leg off the floor. Hold this position for 10 to 15 seconds. Lower your leg. Repeat standing on one foot 3 times for each foot.
To make the single leg stance more challenging, perform the exercise while holding on with only one hand. Advanced exercisers can do it without holding on at all.
If you are able to stand on one foot for 15 seconds without holding on, you can try it with your eyes closed; removal of visual input challenges your muscles and nervous system even more.
Another way to increase the challenge is to stand on a small pillow or folded towel. Just be sure to remain safe while performing the exercise.
A Word From Verywell
Falling down can be a scary thing, and it can cause injury and create a situation where your confidence with mobility is shaken. Performing Otago exercises three times a week has been shown to help improve balance and mobility and prevent falls.
The Otago exercise program is a simple, effective, and fun way to improve your balance and hopefully prevent falls.
