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Assessment Phase:
- Baseline Evaluation:
- Functional mobility tests: Timed Up & Go (TUG), Berg Balance Scale.
- Strength assessment (sit-to-stand test).
- Gait analysis (stride length, step symmetry).
- Identify Risks: Fall history, sensory deficits, medications affecting coordination.
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Warm-Up (5–10 minutes):
- Gentle mobility exercises (marching in place, shoulder circles, ankle rolls).
- Breathing exercises to enhance oxygen delivery.
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Core Neuromuscular Coordination Training:
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Balance & Proprioception:
- Static Balance: Standing with feet together, semi-tandem, tandem stance → progress to single-leg stance.
- Dynamic Balance: Heel-to-toe walking, stepping over obstacles, lateral walking.
- Unstable Surfaces: Foam pad or balance board (with support if needed).
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Strength with Coordination:
- Sit-to-stand with controlled pace.
- Step-ups with alternating legs.
- Resistance band exercises focusing on major muscle groups while maintaining posture control.
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Dual-Task Training:
- Walking while counting backwards or carrying a light object.
- Ball toss while standing on one leg.
(This simulates real-life multitasking and improves cognitive-motor integration.)
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Fine Motor & Hand-Eye Coordination:
- Picking up small objects (beans, coins) and sorting.
- Throwing and catching a lightweight ball.
- Finger-to-nose with eyes open/closed.
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Flexibility & Mobility:
- Stretching of hamstrings, calves, hip flexors, shoulders.
- Gentle yoga or tai chi movements (evidence-based for balance and coordination).
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Gait Training:
- Practice with walking aids if required.
- Varying speed and direction while walking.
- Walking drills: sideways, backward, figure-8 patterns.
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Cool-Down (5–10 minutes):
- Gentle stretches.
- Deep breathing and relaxation.
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Frequency & Progression:
- Frequency: 3–5 sessions per week.
- Duration: 30–60 minutes/session.
- Progression: Increase complexity (unstable surfaces, dual-task, reduced support) as safety allows.
- Safety: Always supervised initially; ensure fall-prevention strategies (parallel bars, railings, caregiver support).
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Adjunct Therapies:
- NLP cues or motor imagery: Older adults benefit from imagining movements before performing them.
- Music/rhythm training: Improves gait synchronization.
- Aquatic therapy: Reduces joint stress while challenging coordination.
8-weeks neuromuscular coordination rehab program:
| Weeks | Goals | Exercises (per session, 30–45 min, 3–5x/week) | |
| 1–2
Foundation & Safety |
• Establish safety & routine
• Improve mobility & body awareness |
🔹 Warm-up: March in place (2–3 min), ankle circles
🔹 Balance: Feet together → semi-tandem stance (30s ×3) 🔹 Strength: Sit-to-stand with support (2×10) 🔹 Coordination: Ball pass hand-to-hand or wall toss (2 min) 🔹 Gait: Walk 10 m, repeat ×3 🔹 Cool-down: Seated hamstring/calf stretch |
 |
| 3–4
Core Balance & Motor Control |
• Improve static & dynamic balance
• Start dual-task training |
🔹 Warm-up: Side steps + arm swings (3 min)
🔹 Balance: Tandem → single-leg stance (10–20s ×3) 🔹 Strength: Step-ups (2×8/leg) 🔹 Coordination: Balloon toss or light ball catch (2 min) 🔹 Dual-task: Walk while counting backwards/naming fruits (10 m ×3) 🔹 Gait: Heel-to-toe walk (5 m ×3) 🔹 Cool-down: Deep breathing + seated spinal twist
|
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| 5–6
Dynamic Challenge & Proprioception |
• Train on unstable surfaces
• Strength + coordination focus • Multi-directional gait |
🔹 Warm-up: March with high knees (2 min)
🔹 Balance: Stand on cushion/foam (20–30s ×3) 🔹 Strength: Sit-to-stand without hands (3×10) 🔹 Coordination: Ball toss with partner on 1 leg (2 min) 🔹 Dual-task: Side steps with rhythmic clapping (10 steps ×3) 🔹 Gait: Figure-8 walk around cones (5 rounds) 🔹 Cool-down: Hip flexor & hamstring stretch |
 |
| 7–8
Advanced Functional Integration |
• Stimulate daily-life tasks
• Improve reaction & agility • Boost confidence & independence |
🔹 Warm-up: March with turns + arm swings (3 min)
🔹 Balance: Single-leg stance eyes closed (10s ×3, with safety) 🔹 Strength: Step-ups with knee lift (2×10/leg) 🔹 Coordination: Catch/throw small ball while walking (2 min) 🔹 Dual-task: Walk while carrying light object & naming months backward (10 m ×3) 🔹 Gait: Backward & sideways walking (5 m ×3 each) 🔹 Cool-down: Relaxation breathing + gentle stretches |
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