By Ram Rao, Ph.D., Principal Research Scientist for Apollo Health

Before Reading this Article, please attempt this exercise:

  1. Start with bare feet.
  2. Grab a pair of socks.
  3. From standing, bend one knee and raise the leg in front. From here, try to put a sock on your raised foot while maintaining your balance.
  4. Repeat the same procedure on the other leg.

If you successfully put on both socks without losing your balance, congratulate yourself and do this exercise daily. However, if you struggled with your balance, you need to think about strategies to strengthen your balance centers in the brain, as poor balance may affect brain health and your quality of life.

Unless you have a physical/pathological condition affecting one or both legs, people who cannot stay balanced on one leg for longer than 20 seconds need to consult with their doctor as this may strongly correlate with the presence of tiny microbleeds (small blood vessel tear) in the brain that may be a harbinger for an impending stroke. Microbleeds can happen even when you’re otherwise feeling healthy, and if this is not stopped or controlled, it can trigger a severe stroke in the future. To understand this concept better, let us take a closer look at the anatomy of the brain and the balance centers. There are three main components of the brain: the cerebrum, cerebellum, and the brain stem. While each component has a distinct function, all three areas are involved in some aspect of postural stability. The cerebrum is composed of two layers. The thick outermost layer is the cortex, aka gray matter, which contains the centers of cognition and personality, and coordinates complicated movements. The inner area called the white matter is a rich network of neuronal fibers that help the brain regions to communicate with each other. The entire cerebrum is divided into right and left hemispheres, with the left hemisphere controlling the majority of functions on the right side of the body and the right hemisphere controlling most of functions on the left side of the body. Any injury to the left hemisphere produces motor deficits on the right side and vice versa. A stroke in the left or right hemisphere of the cerebrum can impair orientation, resulting in improper balance.

The brain stem is a region of the brain that connects the cerebral structures to the spinal cord. Some common effects of a stroke in the brain stem include problems with balance, coordination, weakness, or paralysis. The cerebellum receives sensory information from the body through the spinal cord and helps to coordinate muscle action, fine movement, coordination, and balance. The effects of strokes in the cerebellar area result in difficulty maintaining balance, inability to walk smoothly, and problems with coordination and movement.

A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain is either blocked by a clot or if it ruptures. In either situation, certain areas of the brain do not receive the much-needed blood and oxygen, triggering the brain cells to die. If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that this area of the brain controls. A stroke can cause severe brain damage, long-term disability, or even death. A class of strokes called “whispering strokes,” aka “silent” strokes, do not result in any gross symptoms to raise concerns among victims. Instead, these strokes are often associated with tiny microbleeds. Whispering/silent strokes that occur very frequently can serve as a great risk factor for future severe strokes and ultimately diminish patients’ physical and mental functioning. But how does one recognize silent strokes if it does not trigger visible symptoms?

In addition to brain imaging, there appears to be a simple, inexpensive, and indirect technique to detect the presence of microbleeds. In a study entitled “Association of postural instability with asymptomatic cerebrovascular damage and cognitive decline,” a team of Japanese researchers noted that the inability to balance on one leg for 20 seconds or longer could be linked to silent strokes and microbleeds. The researchers recruited 841 women and 546 men who had an average age of 67. The participants were required to stand on one leg for up to one minute with both eyes open. They were asked to do this twice, and the better of the two was recorded. The researchers then examined the brain of each participant by magnetic resonance imaging for any microbleeds. The participants were also asked to fill out a computer-based questionnaire to assess any cognitive impairment. The researchers found using the brain MRI scans that nearly 35% of the participants who had microbleeds in their brains were unable to balance on one leg for longer than 20 seconds. In addition, these subjects also performed poorly on the computer-based questionnaire suggesting some degree of cognitive impairment.

According to the authors of the study, small blood vessel damages due to silent strokes coupled with reduced cognitive function in otherwise healthy people with no clinical symptoms can be observed by their ability to balance. Therefore, individuals who show poor balance and postural instability will need serious attention. This may indicate that small strokes or tiny bleeds have already occurred, putting the individual at a greater risk for more serious strokes and cognitive impairment.

So how does one improve postural stability and prevent small strokes and microbleeds? The answer is the B7 strategies. Every component of the B7 protocol provides optimal conditions for the brain to thrive. These components address all of the contributors to cognitive decline (including silent strokes and microbleeds) while concurrently optimizing cognitive and overall health. Furthermore, we need to be mindful of our postural stability as we incorporate the B7 protocol and look for ways to build, improve and maintain our balance. One way of doing this is to add balance poses to our daily physical exercise. The more complicated the balance pose, the greater is the effort on the brain to fire up the neural circuitry to maintain postural stability, which further strengthens the brain areas.

And if you are into yoga, the good news is that yoga balance poses will also help strengthen brain areas, thereby improving postural stability. While a regular well-rounded yoga practice helps improve your overall strength and stability, several poses are specifically aimed at improving postural stability. In addition, yoga also incorporates safe and alternate methods for balance poses, thereby minimizing the chance of falls or accidents. So for the Apollo Health subscribers who wish to add ‘balance poses and yoga’ to your ‘to-do’ list to strengthen your brain, do attend the classes on Friday via Zoom. Check out the details here. 

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