Balance, a critical motor skill combining strength, agility and flexibility, is a strong indicator of longevity and how well you're aging.
Simple 10-Minute Exercises Could Slash Fall Risk, Study Finds
What if you could improve your balance while lying down?
Researchers at the Tokyo University of Agriculture and Technology found that a daily series of toe scrunches and core exercises performed lying on your back - called the supine position - helped with balance and agility. The findings were published Wednesday in the journal PLOS One.
Rock, paper, scissors for your toes
In two experiments, 36 men and three women, in their early 20s on average, completed a series of four supine exercises for about 10 minutes daily for two weeks.
For the first two exercises, people placed both feet flat on the floor, with the knees raised. One exercise involved lightly pressing down on the abdomen in specified areas surrounding the belly button, while the other required contracting the hips in a bridge motion.
In the third exercise, people put one foot flat on the floor with the knee raised, leaving the other leg extended. Next, they slid both heels forward, slowly moving the bent leg back down.
The fourth exercise imitated a game of "rock, paper, scissors" with the toes.
Participants alternately clenched their toes (rock), spread them apart (paper) and crossed the big toe over the others (scissors).
How balance changes were measured
The first experiment looked at fitness and balance.
Seventeen participants completed physical fitness assessments, including side-stepping, a 50-meter run and sitting trunk flexion, where they sat with their legs out in front of them and reached forward without bending their knees. Researchers also used a tool to measure how much participants swayed when standing naturally, as well as with their feet together.
Participants were part of both the control and exercise groups, meaning a person assigned to the exercise group would complete the supine exercises, wait a two-week washout period and then complete the experiment again in the control group, and vice versa.
At the end of the trial, the exercise group showed greater improvements in the side-step and sitting trunk flexion tests than the control group. They also had greater reductions in how much they swayed while standing.
In the second experiment, 22 participants completed a version of the side-stepping test designed to capture the acceleration of different body segments.
After completing the supine exercises for two weeks, they showed improved stability of the head and chest.
Study co-author Yoriko Atomi, 81, who recently moved her lab to the Center for Neuroscience and Biomedical Engineering at the University of Electro-Communications in Tokyo, said in an email that performing these exercises while lying down allows people to focus on the movements without the gravitational pressure of maintaining postural control.
From an evolutionary standpoint, humans are at a disadvantage, Atomi said. They have the unique challenge of balancing about half their body weight in the torso, even though their feet take up a relatively small surface area.
"Since we evolved to move in a bipedal stance despite having a four-limbed body design, it is better to assume that neither our standing posture nor our movements are performed correctly," she said.
Atomi noted that while supine movements are common in physical therapy and exercise programs such as Pilates, there's been little scientific evidence of their efficacy. She said the study results, along with her own rehabilitation experience, highlight the interplay between targeted musculoskeletal training and overall balance.
"Although each exercise is performed separately, since the body is interconnected, the four exercises gradually coordinate to form a circuit involving the entire body," she said.
Atomi said completing similar exercises "saved" her in her 70s, when she was experiencing lower back pain and knee osteoarthritis that made walking difficult.
She turned to her son and colleague Tomoaki Atomi, a physical therapist who studies posture and motor control. He prescribed her a set of supine rehabilitative exercises to be done for about 10 minutes daily. Two months later, she couldn't believe the results.
"I have been able to move more energetically and comfortably than ever before over the past 10 years," Atomi said. "I've even been able to jog again."
Atomi was inspired to not only continue the routine every morning but also use her background in biomechanics to learn more about the benefits of these simple movements.
The result was a family affair; she conducted this latest research with Tomoaki as well as his wife, Aya Atomi, also a physical therapist.
"Although I am an expert in exercise adaptation science, this was the first time I had ever considered the supine position from a scientific perspective," Yoriko Atomi said.
Why is balance important for healthy aging?
Carmen Swain, the director of the health and exercise science program at the Ohio State University, said that as people age, they naturally lose muscle mass, particularly if they're not doing any strength training.
With age also come changes in vision, neuromuscular response and proprioception, or spatial awareness of the body, all of which impact balance. In addition, research has shown that balance training may improve memory.
Strength training is the best way to improve balance for people of all ages, Swain said. However, she sees value in the supine exercises for people who may be unable to complete more complex balance training, such as standing on one leg while lifting weights.
"I don't think you could say that this is going to be the end-all, be-all in improving balance," said Swain, who wasn't involved in the study. "It might be a small piece, and sometimes that's where you need to start."
The study's biggest limitation is its focus on healthy young adults, said Glenn Gaesser, a professor of exercise physiology at Arizona State University who wasn't involved in the research.
"These individuals don't have balance issues, generally," he said. "It is a very important issue for older individuals, because poor balance can increase risk of falls, and falls increase risk of bone fractures, and bone fractures increase the risk of hospitalization and the mortality rate for older individuals."
Annually, more than 14 million U.S. adults 65 and older report falling, according to the Centers for Disease Control and Prevention. About 9 million of those falls result in injury.
As an octogenarian herself, Atomi acknowledged the need to replicate the research among an older, larger population. She said her team has already completed a small pilot study with people 75 and older that they hope to publish.
In the meantime, Atomi encourages people to try the supine core and toe-scrunching exercises at home.
"Skeletal muscle is the one tissue in the body we can voluntarily change, and our cells never lose their capacity to adapt," she said. "This means it is never too late to start."
