about Balance, Falls and Nymbl Science
Balance is defined as "an even distribution of weight enabling someone or something to remain upright and steady." We all learned balance in our first years, as we learned to walk. We don't think about balance much once we've mastered it, until we get older and find that we feel a bit unstable.
Instability can lead to falls. The good news is that balance can be improved with proper exercise. That's why Nymbl was created.
Almost unbelievably, 1/3 of people over 65 fall EVERY year. Falls, in fact, are the leading cause of death among seniors, and cost the health care system $60 Billion per year. And as the Baby Boomer generation ages, these costs will double by 2030 unless we do something about it.
The CDC reports that falling once doubles a senior’s chance of falling again. Falls are responsible for 40% of accidental deaths, and are projected to double by 2030 as the population ages, with senior hip fractures alone topping 850,000! The World Health Organization (WHO) calls this issue "alarming" in their “Global Report on Falls Prevention in Older Age”. Unless we address this unnecessary crisis of balance, both with the aging and our middle-aged population now, the estimated $150B price tag could climb much higher.
Generally speaking, balance peaks in one's 20's and declines slowly thereafter.
However, with proper exercise and training, the decline can be significantly delayed, with the goal of always staying above the "disability threshold" when one is in danger of injuring themselves from a fall.
A large body of research shows that a person’s balance can be improved significantly, and that improved balance can reduce falls. Okubo et al (2016) in their meta study showed that balance improvement through step interventions reduces falls by “up to 50%”. Laia et al (2013) demonstrated that cognitive exercises (in this case video games) significantly improved balance.
Nymbl Science’s mission is to help millions of people improve their balance at very low cost, and with a minimal time commitment. The Nymbl balance improvement system is essentially a personalized balance coach on a smartphone. The app, with the help of the motion sensors already in a smartphone, evaluates a user’s balance, provides them a score, recommends a personalized exercise routine, tracks progress over time, and finally adjusts their exercises based on improvement or decrease in the balance score. For stride improvement (important as people age), we will offer ankle sensors that provide a precise measurement of gait.
Our system is based on 35 years of clinical research by Dr. JP Farcy, who practiced at NYU and Columbia Medical Centers. He also founded the Balance Research Foundation, the first to explore this human condition in-depth. His work clearly demonstrates that it is the interaction of physical and cognitive exercises (dual tasking) that will significantly improve balance when practiced as little as 5 minutes per day, over 2-4 weeks. Dr Farcy was the first to identify this balance dual tasking approach, as the critical foundation of brain plasticity, an anti-aging function. This is one of the key innovations of the Nymbl system: our balance regimen, coached via the smartphone app, combines both physical balance exercises and cognitive problem solving in order to integrate ongoing brain function while maximizing the improvement for the participants balance. See this in Dr Farcy’s words on our Vimeo Page.
Other existing balance measurement systems rely on large clinical devices, whose test methodology cost thousands of dollars, and require multiple participation hours of the patient. Typically, balance training is only available from certified clinicians, or in specialty designed balance/gait movement classes. Incorporating both methodologies into a uniform smartphone-based system is a radical approach. Yet Nymbl has effectively reduced almost the entire previous clinical costs, by making a personalized system widely available to the general population.
This non-clinical setting, customized balance evaluation, very low cost system that makes a rich, data training tool available to millions of consumers, is both disruptive and an innovation that the aging and broader patient health care markets desperately need.
We have filed provisional patents on the dual tasking balance improvement system.
Our Founder and Chief Scientist is a leading balance specialist and orthopedic surgeon who has spent his entire career studying people's balance. His extensive research shows that balance is all about a healthy mind interacting with the body, and that combining cognitive problem solving with physical exercises can significantly improve balance in a short period of time (normally around 2 weeks).
There are three types of balance - Static (stability while not moving), Dynamic (stability while moving, such as walking) and Cognitive (stability while moving and also problem solving). Cognitive Balance requires the most brain processing, and it is not uncommon that someone with good static balance has problems when trying to talk and walk, for instance.
Cognitive Balance can be improved by doing physical exercises and problem solving simultaneously - which increases brain plasticity. That is, the brain essentially grows new neurons and makes new connections between them. This is why our app combines physical exercise with problem solving - for instance we may ask you to stand on one foot while answering math or geography questions on your smartphone.
No! Falls are largely preventable.
The National Council on Aging (NCOA) has written an excellent article about preventing falls for seniors. NCOA debunking myths about falls. The article shows that falls are not a necessary part of getting older, and there are plenty of things one can do to avoid falls.
Given the importance of balance to one's life, its surprising that almost no one has a true measure of how good their balance is. Nymbl was founded to change this. We have constructed a single balance score, based on standard tests that are commonly used by physicians in their clinics to measure balance. The index is comprised of tests that measure Stability, Movement and Strength.
- The Stability score is measured by how you perform on a standing test, normally with one foot off the ground.
- The Movement score measures how fast you can get up, walk turn around, walk back and sit down.
- The Strength score measures how many times you can stand up and sit down in 20 seconds.
When a brain loses neurons or synapse connections, it has the ability to replace them. This is called brain plasticity. In order for these neurons to be replaced, you need to actively work at it. The harder the brain is pushed the more it will improve - similar to lifting weights or long distance run training.
Knowing that, our Chief Scientist, Dr J.P. Farcy, created a system where we ask the brain to do two exercises, one physical (such as standing on a one foot) and one cognitive, such as answering multiple choice questions. This approach aggressively pushes the area of the brain responsible for balance and we quickly see brain plasticity increase (again similar to how you can lift more weight after a few days of weight training). This is the foundation for "double task" balance improvement - for which we have applied for provisional patents.