Perturbation-based balance training (PBT)

Perturbation-based balance training (PBT) is balance training that knocks you off balance on purpose. The disturbance, called a perturbation, makes you correct yourself. If a balance exercise never does that, the nervous system isn’t asked to react and adapt.^{1Hoffman, NSCA’s Guide to Program Design, p. 216.}

Perturbations you see coming train the body to brace ahead of time. Surprise perturbations train fast, automatic reactions, which may help prevent injury from unexpected hits.^{2Hoffman, NSCA’s Guide to Program Design, p. 217.}

The push can come through the feet, by standing on an unstable platform.^{2Hoffman, NSCA’s Guide to Program Design, p. 217.} It can also come through the arms, held almost straight.^{3Hoffman, NSCA’s Guide to Program Design, p. 218.} The two can be combined later.^{3Hoffman, NSCA’s Guide to Program Design, p. 218.}

It is used in rehab. One research group reported that perturbation work on tilt boards, roller boards and other balance devices made injured athletes five times more likely to return to their sport.^{4Haff and Triplett (eds.), Essentials of Strength Training and Conditioning, 4th ed., pp. 428–429.} For older adults, ACSM includes moves that shift the center of gravity, such as stepping over obstacles, in fall-prevention training.^{5Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 442.}

In practice

• Start small. Move slowly toward the edges of a position, and add pushes there gradually.^{6Hoffman, NSCA’s Guide to Program Design, p. 215.}
• Match the push to the person. If it is too big, other body parts take over and the drill loses its point.^{3Hoffman, NSCA’s Guide to Program Design, p. 218.}
• For athletes, make the pushes look like the sport: the direction, the size and how often they come.^{7Hoffman, NSCA’s Guide to Program Design, p. 234.}