STEADY — Clinical Overview

Program Structure

• Duration: 8 weeks
• Frequency: Two 60-minute one-on-one sessions per week (16 sessions total)
• Setting: Private, quiet studio; supplemented by one in-home safety visit
• Homework: Structured daily home program, progressed weekly
• Re-assessment: Mid-program and graduation, standardized measures

Training Domains

• Strength: functional lower-extremity strength emphasizing sit-to-stand mechanics, hip abductor strength, and posterior chain
• Balance: static and dynamic, progressing to compliant surfaces, eyes closed, and head-turn variations
• Gait: cadence, step length, and turning under load and dual-task
• Dual-task: concurrent cognitive challenge to train executive-function integration with motor control
• Proprioception: barefoot and uneven-surface work as tolerated
• Environmental & lifestyle: home safety, hydration, vitamin D, footwear, sleep

Evidence Base — Selected

• Single-leg training has been associated with substantial reductions in fall risk in adults 75+.
• Dual-task balance training outperforms single-modality balance training for gait and fall outcomes.
• The ability to complete a 10-second single-leg stand is inversely correlated with all-cause mortality risk (British Journal of Sports Medicine).
• Sit-to-stand ability is a strong independent predictor of longevity (European Journal of Preventive Cardiology).
• Environmental modification of the home reduces fall incidence in older adults with prior falls (Cochrane review–consistent findings).

Not Physical Therapy

STEADY is a preventive, comprehensive program — not episodic PT. There is overlap in some techniques, but the intent, duration, and scope are different. STEADY is well suited to patients who have completed PT and need continued, structured progression, and to patients who have not been injured but are at rising fall risk.

Skill Maintenance — after STEADY

Balance naturally declines with aging. Strength, reaction time, proprioception, and vision continue to change year over year, and the gains made during the STEADY arc require ongoing reinforcement to hold. We offer structured Skill Maintenance after graduation — typically one session per week — to preserve gains, progress the challenge as the patient changes, and catch new risk factors early. It is the evidence-based maintenance phase following the initial training phase.