Health care providers recommend physical therapy for a number of balance issues. But after the therapy ends, patients are encouraged to continue building their strength with exercises of their own. Classes and community programs can help.
Geisinger offers A Matter of Balance, an eight-week program that helps reduce fall risk factors and strengthen muscles through simple exercises. As part of Geisinger’s 65 Forward membership, the program is offered at no cost and is open to the public. Participants can be referred by their health care provider or can sign up themselves.
The first two weeks are more informative, discussing factors that lead to decreased balance and strategies to make homes safer, said Carmela Carr, wellness specialist at Geisinger Health Plan.
“In sessions three through eight, that’s when they start doing the exercises, and they love it,” she said. “It’s something that definitely can be done to help improve their strength and their endurance for their lower body, their legs and their ankles.”
Importantly, the program promotes manageable goals. “Not, ‘I’m going to start walking a mile a day,’” Carr said, but action plans that are broken down in achievable steps.
UPMC Centers for Rehab Services offers a variety of treatments and strategies for balance issues beyond immediate therapy.
“We teach people to better prepare their surroundings to prevent loss of balance,” said Cailin McCullion, physical therapist at UPMC. “So, making sure they have lights on in the house. Clearing a path, not having things you can trip on in your home. It’s a little more challenging in the community because we can’t always manage our surroundings out there, but just teaching them little tricks to help prevent a fall or injury.”
Carr, McCullion and Janine Fee, certified vestibular physical therapist at Evangelical Community Hospital, recommended simple fixes like making sure throw rugs are not curled or easily slid upon the floor, carrying laundry downstairs in a backpack instead of a basket and making sure to wear sturdy shoes like sneakers.
Physical Therapy of Evangelical is located in the Lewisburg YMCA at the Miller Center for Recreation and Wellness, making it easy for patients to transition from therapy to exercise classes. Yoga, tai chi, Silver Sneakers and other programs can all help improve balance, and Fee said she also recommends exercise videos for people to do in their own homes.
“Once we get you on a program, our goal is to discharge you and inspire you to continue on with a fitness program or videos at home,” she said.
Balance specialists don’t have to look far when asked to share success stories. When patients follow instructions and do the appropriate exercises, a steadier gait can be achieved.
One woman Fee worked with at Physical Therapy of Evangelical wanted to walk her dog, but bending over to pick up after it made her feel wobbly. She was afraid she might fall. Fee helped her with leg strengthening exercises and learning to be aware of where her body is in space.
“She was really happy with her progress,” Fee said. “She said, ‘I can bend over and pick up things and not feel like falling.’”
Bilateral neuropathy made both feet drop when another of Fee’s patients walked. Even standing still made him unsteady. As a veteran, he wanted to attend military funerals to pay his respects to the fallen, but that required standing at ease during the ceremonies and firing his rifle for the salute.
The neuropathy might never go away, but Fee taught him to use his hips to stop himself from falling. With determined work, the man is now able to stand without holding on to something and doesn’t feel like he’s going to fall.
“I just can’t believe how good he’s doing,” Fee said, noting that she placed him on an uneven surface and had him use his cane to demonstrate firing his rifle, and he did great. “He’s excited. He has a funeral coming up this weekend and said, ‘I’m pretty confident I can do it.’”
McCullion worked with a woman at UPMC who had neck and back issues along with weakness and some vestibular problems. The woman used to walk two to three miles with her husband but had stopped because poor balance made her feel unsafe.
Even with some discouraging setbacks, the woman kept working on the program McCullion had devised for her, and after two months she arrived at therapy delighted to tell McCullion she’d gone on a two-mile walk and hadn’t needed her husband’s help at all.
“She was thrilled. I was thrilled,” McCullion said. “It was pretty cool.”
At A Matter of Balance, Carr receives feedback from many clients saying the exercises in the class gave them confidence and motivation to move more without fear of falling and breaking a hip — one of the biggest concerns of people with unsteady balance.
One participant said the program gave them the tools to problem solve by breaking down their problems and fears into manageable steps.
Balance problems don’t have to stop people from living the life they want. As long as they’re motivated enough to seek help and follow therapists’ instructions, they can usually find at least some degree of improvement to get them back to doing the things they love.
“I tell people, we can coach you and guide you,” Fee said, “but you have to do the work.”
Cindy O. Herman lives in Snyder County. Email comments to her at CindyOHerman@gmail.com