Why balance matters

Introduction

Consider riding a bicycle, standing on one leg, or walking along a narrow beam. All of these tasks require active control of balance. In order to successfully complete these tasks one may have to make a conscious effort to keep from falling and practice may be necessary to improve performance. Next consider sitting on a stool, standing quietly, or walking across the floor. It may not be immediately obvious that these tasks also require active balance control and practice, as these tasks can often be performed without devoting attention specifically to the maintenance of an upright posture. However, all of the tasks mentioned above and most other tasks that we perform on a daily basis require the ability to maintain balance. Whether consciously or more automatically controlled, balance is a key, complex skill for successful movement within our changing environments. Although balance is generally viewed as a function of the cerebellum and the vestibular system, balance skills can be compromised by a variety of central neurologic pathologies, such as stroke and Parkinson disease (PD), and by peripheral pathologies such as sensory loss or musculoskeletal injuries. In fact, damage or pathology to almost any part of the body may affect balance because it is a complex skill requiring many resources. Balance performance is a very sensitive measure of health, although it is often not a very specific diagnostic indicator of particular diseases.

Statistics on the incidence and cost of falls

Loss of balance, and the falls that result, are serious problems. Although all age groups are subject to falls, the risk of falling increases exponentially with age (Samelson et al., 2002).