Balance Ability: Function, Tasks, Role & Diseases

Many top athletic performances are characterized by exceptional balance ability. On the other hand, disorders can significantly affect quality of life.

What is the ability to balance?

The ability to maintain the body in a state of equilibrium or to return to it after a change is called balance ability. The ability to keep the body in a state of equilibrium or to bring it back there after a change is called equilibrium ability. It is classified under the coordinative qualities. The sense of balance in the ear and the responsible centers in the cerebellum together with the other information systems form the basic prerequisite for good balance ability. In addition, however, individual motor skills and training status also determine whether someone is able to successfully perform balance reactions. There are 3 types of balance ability. Static describes the ability to maintain a relative resting position for a period of time. A total resting position is not possible in body positions such as standing, standing on one leg or kneeling. Small corrective movements are always necessary. Dynamic balance ability is characterized by the ability to maintain a stable balance position during a change of position or to resume it afterwards. The ability to balance an object with the body is called object-related balance ability. The general bodily reactions required to maintain balance during common activities of daily living are completely automated and unconscious.

Function and task

The ability to maintain balance is required to a greater or lesser degree during all movements and static demands. The maintenance of a state of equilibrium must be defended against acting forces in order to make the execution of movement sequences and the assumption and stabilization of positions purposeful and as economical as possible and to minimize the risk of injury. In normal activities of everyday life, it is above all gravity and the inertia of the body that must be overcome. This can be well illustrated by the example of walking, but applies in principle to all movement processes. In normal walking, the trunk is stabilized in the upright position with only little deviation to the side, while the legs are moved in a coordinated manner with the most sparing movement amplitudes possible. The projection of the body’s center of gravity remains as close as possible to the support surface. The gait can thus be performed safely and over a long period of time without much effort, if the motor properties are available accordingly. Changes in environmental characteristics can significantly increase the demands on balance. Uneven, wobbly surfaces in various terrains or walking or climbing on narrow paths place significantly greater demands on the motor capabilities and result in the control no longer being fully automatic; consciousness is then switched on. Occupational groups such as roofers are particularly exposed to such balance requirements. In sports activities, especially for top athletes, the ability to balance is often a decisive factor that determines success or non-success. The corresponding motor characteristics must be trained again and again in connection with the required movement sequences in sport-specific situations. Often, it is fast turning movements such as somersaults, handstand somersaults or pirouettes, extreme stabilization requirements such as handstands, or a combination of both that place the highest demands on the ability to balance. Such top performances require appropriate skills in the areas of strength, quickness, speed and coordination. In addition, communication with the neuronal control systems must function optimally and be trained. For this purpose, it is not enough to practice the motion sequences that are required over and over again in a mindless manner. Especially for the optimization of the nerve-muscle interaction, it is important to repeatedly incorporate new requirements and stimuli for the various sensory systems into the training and to create variations that improve cognitive performance and pave the way for neuronal readiness for action.

Diseases and ailments

All diseases that affect either the motor properties or the capacities of the sensory systems involved and the control center in the cerebellum can affect the ability to balance. In the orthopedic-surgical field, these include all degenerative diseases and conditions that are associated with a long-lasting pain problem. In these cases, the gentle posture and behavior lead to a loss of strength and movement experience. Initially, such deficits become noticeable with high demands on the ability to balance, but as time goes on, they also become noticeable with simple demands such as walking or standing. Standing on one leg or hopping with one leg are typical stress foments where this loss of function becomes apparent. All types of vertigo have a direct impact on the ability to balance. The sensory information provides the affected person with an altered picture of the perception of the environment, and the control of balance reactions is often no longer possible. A common form of vertigo is paroxysmal positional vertigo, in which deposits in the endolymph of the vestibular organ in the ear cause irritation when position changes. Neurological disorders may affect the motor system or the control system, or both, and result in significant impairment of the ability to balance. Polyneuropathies cause flaccid paralysis of the foot muscles, often associated with a disturbance of sensitivity. Compensatory movements in walking and standing can then not or only insufficiently take place, balance reactions via the control of the foot musculature fail. The gait becomes increasingly unsteady and at some point is only possible with aids. Diseases of the cerebellum such as ataxia or a brain tumor significantly affect the control of the muscles responsible for maintaining balance. The consequences are similar to those of polyneuropathy, but much more serious. The same applies to multiple sclerosis and other neurological diseases. The ability to balance basically decreases with age, since on the one hand muscular abilities decrease and on the other hand brain performance and impulse rates of the nerve-muscle system decrease. However, this statement can be put into perspective, since the performance capacity is directly related to the training condition. Even in old age, motor characteristics can be trained, especially strength. The earlier systematic training is started, the lower the risk of losing performance and quality of life in old age.