Balance and coordination

Balance is the ability to maintain body in upright position when body is in motion or static state. Coordination is the capability of body parts to carry out controlled, smooth and efficient movement. Balance is subdivided into two categories that is static and dynamic. Static balance is body’s ability to maintain equilibrium  on a stable surface. While  dynamic balance is retaining equilibrium on unstable or when in motion. Eyes and ears are the main  parts that helps in maintaining balance and coordination.

A child needs age appropriate balance and coordination to get engaged in physical skill  performance and sports. It is necessary to get engaged in sports for achieving  developing social interaction and get sense of belonging in community or social settings. Appropriate balance and coordination is required to control the body movement while performing the task effectively, thus limiting loss of energy leading to fatigue. The part of the brain  that is responsible for balance and coordination is cerebellum. It controls balance, coordination, fine muscle movement. It also maintain posture and equilibrium. If coordination is affected these symptoms are visible as ataxia, dysmetria, scanning speech, nystagmus also tremor.

Pre-requisites to develop balance and coordination

1.Adequate attention span is required for accomplishment of specific task .

2.Adequate understanding of body’s movement in space, kinesthetic sense, proprioceptive sense, body part identification is essential for skills such as cycling, ball games.

3.Another key ability is bilateral  coordination. It’s the usage of both hands with one hand dominance. The skill required in tennis, cricket.

4..The child should be able to cross the midline  which is required in reach ,cross crawls.

5.Eye hand coordination skill is required to hit ball ,target ball, writing

6.The consistent use of one hand is necessary to carry out refined skills which is hand dominance.

7.Appropriate muscle strength is needed to exert force against gravity to push and pull activities, climbing ladder etc.

8.Muscle endurance is required to lessen fatigue

9.Child should be self regulated

10.The child should be able to process sensory stimulation appropriately

11.Individual or isolated muscle movement is required to carry out coordinated tasks.

Areas the child will show issues

  • Frequent accident or falls while performing movement in static or dynamic activities.
  • The child show stiff movement to obtain equilibrium.
  • Withdrawal from challenging activities.
  • Poor gross motor skill
  • Praxis issues
  • Difficulty in learning cycling ,skating
  • Inconsistent hand preference
  • Gets easily tired
  • Trouble in walking through uneven surfaces or slopes

Few activities given to improve balance and coordination

  • Attention with gross motor activities
  • Alerting activities
  • Core muscle strengthening activities
  • Muscle endurance improving activities
  • Muscle strengthen activities for weak muscle groups
  • Animal walks
  • Brain Gym activities
  • Sensory stimulation
  • Targeting activities
  • Activities bon stable and unstable surfaces using therapeutic equipment
  • Hopscotch
  • Stepping stone
  • Cycling
  • Swimming
  • Unilateral weight bearing with activities
  • Sit to stand with or without support
  • Squat to stand with or without support
  • Half squat position
  • Cross crawls
  • Increasing duration of activities
  • Pose while in motion
  • Blindfold activities
  • Breaking up the task or grading the activity

Certain assessment and scales used to assess balance and coordination

  • Berg balance scale
  • Performance oriented mobility assessment
  • Timed get up and go test
  • Gait and balance analysis
  • Point to point movement evaluation
  • Heel to shin test
  • Finger to nose test
  • Romberg test

Importance to start intervention

 Early intervention and detection is necessary to build child’s confidence in challenging environment. To prevent accidents and fall while performing the movements. To obtain maximal independence in daily living tasks. To retain social interaction and physical well being. If the child is having difficulty in the mentioned areas it should be addressed to physical therapist and occupational therapist. Physical therapist will address the gross motor skill, gait training. Occupational therapist  will work for functional independence, eye hand coordination, bilateral coordination, muscle strengthening, proximal stability etc.