My older population are frequently modifying their activities and gait patterns due to a fear of falling. This manifests itself in a shorter stride gait and slower cadence. Many express an unwillingness to use a cane or device and find themselves wall walking and reaching out for furniture.

A recent study evaluated the effectiveness of cane use on postural recovery from a slip due to repeated surface disruptions in people with Parkinson’s Disease compared with more healthy individuals. The evaluators measured a lateral displacement of the person’s center of mass due to the slip and the resultant next step width and length.

The results showed that those Parkinson’s Individuals that had the largest displacement from the slip also showed that biggest improvement when using the cane. Both groups also showed lesser lateral displacements with repeated trials, but the PD group had a slower learning rate.

The conclusion of the study is that the use of a cane improved the recovery of the person’s posture from slipping in the Parkinson’s group. In addition, balance in people with PD can be improved by training with repeated exposures to perturbations.

I have been having excellent results with applying Balance Training Strategies recently acquired from a continuing education seminar called “Fall Proof”.  The idea is first to perform the proper screening and assessment and identify the possible causes of the impairment. Fall risk is measured through functional ability tests so that gains can be properly measured after physical therapy interventions are applied. Exercises are performed in sitting, standing, kneeling or on balance compromising balls and foam to further challenge the individual. For some people, balance exercises are then performed while being distracted by another task. This course changed the way I train my patients and it is all very exciting to progress to more advanced exercises.