Balance is maintained through the center of mass being over the base of support. There are four main strategies for maintaining balance: 1) The ankle strategy uses small movements of the ankle joints to counter slight changes in balance. 2) The hip strategy engages when perturbations are too large for the ankles, using hip movements to sway the trunk back over the base of support. 3) The step strategy is a last resort, taking a step to broaden the base of support when the ankle and hip strategies cannot restore balance. 4) The suspensory strategy involves bending the knees to lower the center of mass during perturbations, enhancing stability.

1. BALANCE AND ITS TRAINING
Dr. Simranjeet Kaur (PT)
Assistant Professor
MMIPR,MMDU

2. • An even distribution of weight enabling
someone or something to remain upright and
steady is called Balance.
• Balance: Control of centre of mass over base
of support .
• COM: Centre point of each body segment
combined.
• COG: Vertical projection of centre of mass.
• BOS : Area of object that is in contact with the
ground

16. Ankle Strategies
• The first of our strategies is the ankle strategy.
It works in quiet standing. The ankle joint it
self is designed to move in all directions,
therefore it is a great first line defence against
falls. The ankle strategy is designed to use its
surrounding musculature to keep you standing
upright. If we look at an individual without
shoes on standing still, you will see their foot
making tiny movements to counter any
changes in the body’s centre of gravity.

17. • Think of the ankle strategy too when you step
on uneven ground, you will notice sometimes
your foot will autocorrect before you can even
consciously realize you are starting to get out
of your centre of balance. Once it goes beyond
a small perturbation that the ankles cannot
correct, we move onto the hip strategy.

19. Hip Strategies
• Defensive mechanism number two is that of the hip
strategies. These come into play when the perturbation is too
large for the ankles to control, but yet not big enough that a
step would need to be taken to correct it. The hip joint can
also move in all directions, therefore the hip is also a great
joint to defend against falling because it can correct any
medium to large perturbation in any direction. The hips work
by swaying and moving the trunk to wherever it needs to go
so that we don’t fall outside of our cone of stability. A
perturbation that would elicit a hip strategy might be
something like stepping on uneven ground unexpectedly or
tripping over a rock. In this cases, you might extend at the
hips to correct against the forward moment from tripping.

21. Step Strategies
• This is our last line of defence against a fall.
This strategy is a last resort, and only kicks in
when the perturbation is so large that the
ankle or the hip cannot help. The only option
is the take a step, broadening our base of
support, to correct this kind of perturbation.
This is the first and only of the strategies that
modifies the base of support, and the strategy
that kicks in once we fall outside of the cone
of stability

23. Suspensory strategy
• The Suspensory strategy includes bending
knees during standing or ambulation for the
purpose of maintaining a stable position
during a perturbation. Bending of the knees
usually lowers the COG to be closer to the
BOS, thereby enhancing postural stability