The Balance System

Literature demonstrates a clear, positive relationship between balance and the ability to successfully participate in functional activities. The purpose of this paper is to review the current knowledge about balance and to discuss the integration of this information into occupational therapy intervention. The reflex-hierarchy model of postural control proposes that balance develops over time through the integration of reflexes, whereas the systems model describes the interaction of the motor and sensory strategies for balance and the environment. Changes in musculoskeletal abilities with ageing may result in postural control deficits and concomitant difficulty managing daily activities safely. Common intervention strategies related to balance include environmental modifications and education of the client and the family. Occupational therapists need increased knowledge about the function of the balance system under various environmental conditions and during an array of occupations in order to appropriately challenge the balance system during occupational therapy treatment.