by Sarah Apple Kingsley, pt, dpt
I have worked as a physical therapist for over 10 years, with the majority of my career having been with a geriatric population. Over that time I have worked in a variety of settings and levels of care including inpatient skilled nursing facilities, assisted living facilities, independent living facilities, and general outpatient independent home settings. Regardless of the level of care or a particular patient’s independence, for the geriatric population the most important factor is always BALANCE. During an assessment or evaluation a physical therapist will almost always test for balance in some way and is typically required to record their findings as indicators of fall risk. Goals are set to improve balance using functional scales as a measure of improving safety, independence, function, and quality of life.
So what makes up balance?! Balance consists of 3 major centers of the body. Our visual system utilizes our eyes to see what we are standing or stepping on. Have you ever tried standing on one leg and then closing your eyes? Harder right? This is vision’s role in balance. Second, our vestibular system is in our inner ear, using tiny hair follicles as a way for our body to know where we are in space especially when turning the head and changing focus of the eyes. This system helps our body know we are not actually moving when we are sitting in a car watching our surroundings go by. When it is malfunctioning, vertigo symptoms become apparent. Try walking in a straight line and turning your head left and right. Can you keep a straight line, without falling over or getting dizzy? If so, then your vestibular system is functioning well.
The final and in my opinion most important component of balance is PROPRIOCEPTION! The tiny little somatosensory receptors on our feet send signals to our brain and the rest of our body, joints and muscles about where we are in space. It is responsible for keeping our balance on a variety of different surfaces, narrowing our base of support, or changing where our limbs are in space. This is the one system that I believe we have the greatest ability to control and improve upon with physical therapy. Typical forms of physical therapy use a variety of tools and exercises to work on this system such as standing on a pillow or foam airex, a wobble board or half foam roller, single leg or tandem stance positions, and my personal old and new favorites the BOSU and a vibration plate. While each of these methods have their advantages, it wasn’t until I started using yoga techniques in my practice that I started seeing completely different results.
The LYT yoga method explains in detail which parts of the body are meant to move and which are meant to stabilize, which helps target smaller muscle activation strategies that are important for functional movement patterns. Fun poses like airplane, single leg bridging and half moon, as well as transitions such as high crescent lunge into knee to chest all require the ability to stabilize on one limb. One legged stability is a huge balance challenge that works to improve your center, which most forms of common exercise do not. I have learned that you can’t simply tell someone to practice standing on one leg repetitively while expecting them to improve their single leg balance times. A variety of different movements are needed with targeted activation of different muscle groups that aid in supporting the body when in a single leg standing position, all of which need to be working in coordination. The LYT yoga method helps yogis gain these activation strategies as we build upon each move, starting small and working our way up. Progressing this way gets the body ready to support single limb standing positions as opposed to trying to go right into it and risk a fall or injury. By “training” or practicing in this manner, we can prepare the body to be more ready on a daily basis to support a load or react to a potential fall situation.
Speaking of fall risk, being more rigid in the body (such as my patients with Parkinson’s Disease) puts you at a much greater risk for experiencing a fall. Yoga helps to open up the muscles, increase joint mobility and expand on ranges of motion to collectively experience movement in a more fluid way. Patients with this diagnosis may initially find yoga to be foreign and very difficult. When new ranges of motion become available and the body is able to move more fluidly, walking patterns improve, walking speed improves, and fall risk drastically decreases!
All of this to say, my practice as a therapist has been changed for the better since I implemented strategies, poses and movements that I have learned in my LYT yoga training. Whether you have Parkinson’s Disease or another diagnosis, this method can change your body for the better!