Equilibrium Strategies
Lesson 4 - Stepping Strategy
Stepping exercise based on the article ‘A Novel Square-Stepping Exercise Program for Older Adults (StepIt): Rationale and Implications for Falls Prevention’ by Eleftheria Giannouli et al.
The difficulty level can be systematically and gradually increased following the four principles:
1. Execution speed
2. Pattern complexity
3. Pattern length
4. Execution in [Dual-Task (DT)/Multi-Task (MT)].
- Execution speed: The clock yourself app allows you to adjust the speed. (In this video example, this client started at 60 stepping forward and 50 stepping backwards. You can also monitor the # of steps taken if you stepped every time the command was made. Great to make goals especially during this time!
- Pattern complexity: Step forward with right or left (heel-toe), side step to the left and right (clicker needs to be activated for correct weight-shift). We worked on gait mechanics for forward and backwards stepping and in another exercise can work on stepping strategy (i.e. straight knee when stepping forward for gait vs bent knee for stepping strategy)
- Pattern length: Balance Matters footpads provide feedback for correct step length using the footpads for feedback to ensure step length to be maintained during exercise and measurements to monitor progress. Can also perform maximal step length test prior to training to set up appropriate step length and goals (step at 80% MSL). We focused on step length forward but can also work on improving side step with 2 mats or changing the direction of the mat.
- Dual task
(Motor) reach with opposite hand to touch the same color target as command.
(Cognitive)listen to command and react to follow directions.
When you hear red, step forward to the red footpad and touch with your opposite hand to the red target on the wall.
When you hear blue, step forward to the blue footpad and touch with your opposite hand the blue target on the wall.
When you hear green, take a large step off the mat to the right and return to middle
When you hear yellow, take a large step to left and return to middle