We lose balance most often not when standing still, but during transitions – those quick shifts from one posture or movement to another. In movement science, these are the moments the body must rapidly reorganise while the centre of mass travels.
Common transitions where falls frequently occur include:
- Rising from sitting to standing
- Starting to walk from standing
- Turning while walking
- Stepping over curbs or obstacles
- Stopping abruptly
- Reaching for something while standing
- Changing direction suddenly
What Makes Transitions So Demanding?
In a split second, multiple systems must coordinate perfectly:
- The centre of mass shifts forward, backward or sideways.
- The base of support narrows or changes shape.
- Muscles fire in precise sequences.
- The brain anticipates and fine-tunes the movement.
These are called anticipatory postural adjustments (APAs), where the body prepares before the movement starts to keep you stable.
APAs are small, automatic muscle activations that stabilize you in advance of voluntary movement. Think of them as the body’s built-in safety net.
Examples in action:
- Engaging core and hip muscles just before lifting a foot to step
- Shifting weight laterally before turning
- Leaning slightly forward before rising from a seat
Transitions rely heavily on feedforward motor control, where the brain predicts the movement demands and prepares the body in advance.
In conditions like Parkinson’s, stroke and dementia, APAs are often delayed, reduced or absent, which explains why transitions become especially hazardous.
Transition-Focused Training
So, we want to work on dynamic moments to rebuild nervous system timing, coordination and adaptability, with exercises like:
- Repeated sit-to-stand (progressing toward minimal arm support)
- 180° or 360° turning drills
- Start-and-stop walking
- Quick direction changes or figure-8 patterns
- Reaching beyond arm’s length while standing
- Dual-task challenges e.g., counting backward or carrying an object during transitions
The Bottom Line
True balance is about moving confidently and safely from one position to the next. By training transitions deliberately, we can build the anticipatory control needed to stay steady in daily life, preserve independence, and cut fall risk.