March: Single Leg Balance

The importance of keeping your balance on one foot

Ignite Neuro Fitness
March 26, 2025

March is flying by and I am very happy that spring is here. As the weather warms and the flowers bloom, so does our desire to get outside and try new things. These new outdoor adventures can sometimes feel intimidating if you are worried about loosing your footing, but do not let that stop you from figuring out how to safely participate.

This month at Ignite we have been focusing on Single leg balance within our exercise classes. Such a simple, but important task. We use this skill many times every day without thinking about it. In fact for most of us, every step we take is a momentary balance on one leg. This is also critical for putting on our pants on in the morning, stepping up a curb, or safely maneuvering over an unexpected obstacle.

So let’s start by defining what is “normal” single leg balance. The One legged stance test has been studied across all ages with norms created (see chart below). There has been further testing specific to people with Parkinson’s looking at fall risk cut offs with this test. A single leg balance ability of less than 10 seconds has been shown to correlate with a greater likelihood of falling.

One Legged Stance Test Norms by Age and Sex

*Note that the above chart includes eyes closed single leg balance testing. This is an excellent way to see how reliant you are on vision for balance. Give it a try!

One Study looked at something they are calling The ‘Pant’s- Sign’ as a possible predictor of falling. They studied the correlation between needing to sit down to put on pants due to a feeling of imbalance and likelihood of falling. They did in fact find that loss of the ability to put your pants on in standing is actually correlated with a higher likelihood of falling. If you consistently sit to put on your pants because it feels safer, maybe it is worth it to practice this skill in standing (in a safe set up) to make sure you maintain this skill.

Now it is time to test yourself. Watch the video below for accurate test performance of the one legged stance test. Set yourself up somewhere safe, lift one leg off the ground, give yourself a few trials, and see what you get! Keep in mind that this test is looking at only one specific type of balance control and is not the strongest predictor of falls by itself. That being said it is a very simple skill that you can easily monitor at home.

So you tested yourself and now you want to know how to improve your score. The good news is there is plenty of evidence studying the effects of different types of balance training for people with Parkinson’s.

This meta analysis looked at the effects of exercise on falls and balance control. They found that:

“Our meta-analysis is the first to report that exercise training could decrease the fall rates of PD participants by about 60% over both the short- and long-terms.” Another interesting finding was that people were more successful at improving their balance when performed at facilities with physical therapists rather than at home or at a general community exercise class. This is because as PT’s we are experts in how to augment and cue skilled training to improve success as well as progress you as you improve.

There are studies that have looked at the long term effects of completing a balance program and shown that the benefits deteriorate after stopping the training when re-tested 4 weeks to 1 year later. To this I have to say, of course they do! Let this be motivation to keep balance exercise as a regular part of your weekly exercise routine indefinitely. This is also the official recommendation of the Parkinson’s Foundation.

Time and time again the evidence has shown in Parkinson’s that the best way to improve any particular activity that is giving you trouble is to practice that exact activity over and over again in a set up that makes you most successful. As you get more successful, then you increase the challenge. Let’s apply that to standing on one leg. If this task is too challenging, then modify it to start. Below are pictures of two simple ways to perform modified single leg balance control. If possible, try to not hold onto anything for support during the exercise and try to hold for longer periods (ie 30 seconds).

Once you improve at these modifications then you can progress into single leg balance training and dynamic single leg tasks (meaning tasks that have you moving while balancing on one leg). Below are some examples of these exercises:

Many of my patients ask me if there are any other types of community exercise classes that additionally help to improve their balance control. Evidence shows significant support for participating in yoga and tai chi to improve balance and reduce fall risk for people with Parkinson’s. Interestingly, strength/power training (weight lifting) has not been shown to have any significant correlation with improving balance ability. Although it can help many other issues, but that is for another newsletter!

I hope you all feel motivated now to practice putting your pants on in standing, or more simply practice your single leg balance ability. Every evening after you brush your teeth in front of your bathroom counter take a few minutes to practice this skill (or the modified version of it!). Integrate balance training into your weekly exercise routine now, even if you are not noting any balance impairments. Think about finding a community tai chai or yoga class. Reach out to physical therapy now if you are starting to feel some changes in this ability for balance training.

Here at Ignite, we have just started offer our Ignite Yoga class. We will be focusing on balance control as well as improving flexibility and reducing rigidity in these classes. They are offered in person every Sunday and virtually on Tuesdays and Fridays.

To intro the class we will be offering a free class opportunity on Sunday April 27th. If you are interested in getting a spot in that class please contact us! You can also sign up for the class with the link below. We hope to see you there!

IGN!TE

Schedule your Free Yoga Class: April 27 at 11:30 am

ignte.as.me/?appointmentType=75634798