Do you know why I think of what I do as balance retraining? Pretty much every patient I work with tends to feel unsteady. Now, they didn't feel unsteady their whole life. I assume when they were younger they felt steady and had decent balance. So now, as they are generally healthy older adults, they are noticing that they aren't quite as steady on their feet.
More often than not, most patients lack confidence in their balance and are in a high risk of falling category (based on a self assessment called Activity-Specific Balance Confidence Scale). My impression is that at some point in life, older adults begin to limit themselves with the types of physical activities they perform. Maybe because they don't think they should be doing them... maybe because they think they are risky. I really don't know that part of the story. I do know that what we were all told, "If you don't use it, you'll lose it," seems to apply. As they do less self-perceived risky activities, it's almost like their brains change and forget how to maintain balance in situations that challenge one's balance.
What is really amazing is seeing brains change. The generally healthy older adults I see will demonstrate definite changes in their response to challenging activities. The reason I think they are able to retrain their balance is because they know they are completely safe in the clinic. The activities they perform are difficult for them and scary. They don't have to trust a physical therapist holding onto a gait belt. They trust the rope tackle system and harness to keep them safe as they try scary activities. When they "fall," they never hit the ground. The reason I think brain changes happen so quickly is because the brain learns from "failed" responses. The brain adapts and learns. It is truly amazing to see changes.
The rope tackle and harness allow me to truly assess and retrain balance. In the below video you will see how balance retraining is very different in an environment that has equipment in place to safely challenge patients who are unsteady on their feet.