In my previous post, I talked about how observing how a person walks can give insight to their balance. I followed that with suggestions for normalizing how someone walks as one way to improve on their balance.
In this post, I will talk about how observing how someone gets in and out of a chair can also tell us about their balance. I will follow that with a plan to improve someone’s balance by improving their ability to transition from sitting to standing, and vice versa.
A person with good balance can get up from sitting without using their hands. They can rise on their first attempt. They are steady on their feet when they first get up. Someone with poor balance will use their arms to help lift themselves up, may fall back into their seat before standing up successfully, and may be unsteady once they are up. (That unsteadiness is typically evidenced by a need to move their feet to find a steady position, typically with the feet wide apart.)
A person with good balance can sit down in a controlled fashion with minimal use of their hands (or without using their hands.) Someone with poor balance will rely on their arms to steady themselves as they sit down, and may “plop” down into a seat due to a lack of strength in their legs needed to control that motion.
When I see someone having this difficulty, typically recommend what I refer to as “sit to stand exercises”. It’s rather simple, really. In the clinic, I use an adjustable height table to find how high a seat needs to be for them to rise from sitting without using their hands, on the first attempt. I then check that they can sit down in a controlled fashion at this height. I then will ask if the person has someplace at home that’s about the same height where they can practice this. Sometimes it’s the side of the bed that is the right height. Sometimes stacking pillows on a chair allows someone to find degree of challenge.
Gains in strength and balance are typically noted after a week or so. At that time, the exercise is progressed by having the person practice transitioning from sitting to standing from a lower height. The goal is for them to become capable of transferring from sitting to standing from a regular chair height without having to use their hands.
This can easily be progressed to a squatting exercise. To squat, touch your bottom to the chair and stand up without pausing to sit down.
I have seen many people benefit from this type of exercise. While these instructions are meant to be simple, often people do require personalized instruction in order to perform the sit to stand or squatting exercise properly.