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 a sense of belonging in the community or social settings. Appropriate balance and coordination are 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
- An adequate attention span is required for the accomplishment of a specific task.
- Adequate understanding of the body’s movement in space, kinesthetic sense, proprioceptive sense, and body part identification is essential for skills such as cycling, and ball games.
- Another key ability is bilateral coordination. It’s the usage of both hands with one-hand dominance. The skill required in tennis, and cricket.
- The child should be able to cross the midline which is required in reach, and cross crawls.
- Eye-hand coordination skill is required to hit the ball, target the ball, writing
- The consistent use of one hand is necessary to carry out refined skills which are hand dominance.
- Appropriate muscle strength is needed to exert force against gravity to push and pull activities, climbing ladders, etc.
- Muscle endurance is required to lessen fatigue
- The child should be self-regulated
- The child should be able to process sensory stimulation appropriately
- Individual or isolated muscle movement is required to carry out coordinated tasks.
Areas the child will show issues
- Frequent accidents or falls while performing the movement in static or dynamic activities.
- The child shows 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 walking through uneven surfaces or slopes
Few activities are given to improve balance and coordination
- Attention to 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 on stable and unstable surfaces using therapeutic equipment
- Stepping stone
- 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 the duration of activities
- Pose while in motion
- Blindfold activities
- Breaking up the task or grading the activity
Certain assessments 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 starting intervention
Early intervention and detection are necessary to build a child’s confidence in a challenging environment. To prevent accidents and falls 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 a physical therapist and occupational therapist. A physical therapist will address gross motor skills and gait training. An occupational therapist will work for functional independence, eye-hand coordination, bilateral coordination, muscle strengthening, proximal stability, etc.