Balance  Board 平衡板

在美國休斯敦大學 (University of Houston) 視覺感知實驗室中，Dr. Belgau 使用平衡板來提高視力和閱讀能力（1969）。他注意到進行視力治療的孩子中，出現平衡問題和尷尬的行走方式可能性很高。意識到平衡感（內耳的前庭系統）與閱讀所需的眼球運動（前庭眼反射）緊密相關，Dr. Belgau創建了一系列平衡板練習以改善視力。作為視覺專家，他對這個發明進行廣泛的前測試和後測試，並且發現因此而視覺技能和閱讀能力有了顯著提升。

1. 平衡作為核心的成分
 

為什麼要如此專注於平衡刺激活動，我們必須先了解平衡感或前庭系統 （Vestibular System）所起的核心作用。隨著孩子在子宮中的成長，前庭系統是發展的第一個感官，因此它成為其他大腦過程的組織工具。前庭系統是透過前庭器官取得原始信息，前庭器官由三個半圓形的管和耳石器官組成。

所以它是我們對世界慣性重力模型的基礎，即是我們對世界三維空間的體驗，並具有清晰的上下感。隨著孩子繼續在子宮內發育，其他主要的大腦系統：運動，觸覺，聽覺和視覺-也都在發育，但它們的發展是與前庭系統或平衡有關聯。

2. 前庭系統影響對世界的了解及學習能力

兒童的重心在其前庭系統中起著重要作用。這種感官系統向我們提供有關其他感官的接收的信息，影響您的孩子對世界的了解及其學習能力，發揮著重要作用。當嬰兒大約五個月大時，前庭系統是第一個完全發育的感官系統。這個系統控制著我們的平衡感和活動。我們的平衡是建基於身體的重心源自於底部的支持。隨著孩子的成長和發展，他/她的身體和重心也會改變。每個孩子的重心變化很大，因為頭部，軀乾和腿部不成比例地增長，並且男性和女性之間存在差異。由於前庭系統在感知基礎中起著關鍵作用，因此平衡問題可能會導致其他看似無關的大腦功能問題。美國國家航空航天局（NASA）還支持並資助了基本科研計劃，從而了解前庭或平衡感如何運作以及如何影響大腦流程。

 

3. 改善平衡技能提高孩子的注意力和學習技能 

 

儘管一個人的平衡力直到12歲時才能完全發展成熟，研究顯示改善兒童的協調和平衡技能，可以顯著地提高孩子的注意力和學習技能 （無論孩子的前庭系統的或肌肉和關節的本體感受是否健康）（Wiener-Vacher, Hamilton &Wiener, 2013，2013）。

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運動技能是兒童未來學習的基礎。他們參與體育活動有助於在他們參與課室所预備的各方位的教育地圖。例如，如果孩子無法保持平衡來完成跨過身體中線的運動，那麼孩子的大腦左右半球之間可能會不連接，因而令創造力、藝術性與組織性、保留性不能聯繫起來。這些類型的不連接會影響孩子閱讀、書寫、追踪、保留信息，在紙上表達想法的能力，並且可能會阻礙他們集中注意力和理解的能力。如果這些技能在童年時期還未成熟，那麼會減弱他們參與體育運動、遊樂場遊戲以及上課的注意力等活動的能力。當平衡得到發展並最終達致成熟時，可以提高孩子的學習自信心，並使他們在學校中可以接受更大的挑戰。

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​兒童直到12歲左右才表現出類似成年人使用感官資訉的能力（Peterson，2006），這意味著前庭發育的過程幾乎延伸到青春期。因此，在一段很長時間內，有足夠的機會來幫助兒童，甚至沒有閱讀障礙，專注力失調及過度活躍症 （ADD，ADHD）和學習障礙的兒童，提高他們的發展技能。通過致力於改善平衡和感官處理的能力，具有健康前庭系統的兒童可以努力成長，而對前庭系統有困難的兒童則可以有顯著的改善。

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4. 感官統合方法進行的治療​

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「使用感官統合方法進行的治療是（對有感官統合問題的孩子）最常見的治療方法，並且在80多項研究中已經證明是有效的。」這種類型的治療為兒童或成人提供了刺激前庭，本體感受和觸覺的運動。這種治療方法根源於平衡和感覺統合：「已被證明可以改善患有感覺統合和閱讀障礙的兒童對於追求眼球（saccades），融合（convergence），融合儲備（fusional reserves），住宿設施（accommodative facility）視覺感知（visual perception） 和閱讀的技巧。」（Allison，2007）對於沒有學習障礙或與感官統合和平衡問題的孩子，這種類型的治療（本質上類似 Dr. Belgau “Learning Breakthrough” 的治療）可以增強現有技能並以避免補償感官行為的形成。

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Dr. Belgau 認為，大多數的學習障礙是由感官統合障礙引起的，每一件任務的複雜性決定了所需的神經介入水平。Belgau平衡板上平衡活動在的難度越來越高，具有不斷地建立和創建更廣泛的神經網絡作用。因為在此過程中創建的神經網絡與負責大腦的視覺，聽覺，運動和感官過程的神經網絡相同，所以平衡活動可提高大腦的效率。

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 增加平衡活動的難度會刺激並增加腦神經元的數量，Dr. Belgau 因個人經驗發現了直走的身體能力與閱讀的認知能力有聯繫，他通過運動和組織自己的身體平衡，Dr. Belgau 組織了他的大腦。因此，他在著作的背面概述了「太空漫步」一系列的練習，這些練習可以明顯地改善閱讀。太空漫步會幫助形成平穩的行走的模式：用腳趾行，腳跟到腳趾、側行、步操、傾左、向後步操、向前按時針轉、向前逆時針轉、選擇目標、閉上眼睛走到目標、閉上眼睛、腳跟到腳尖在直線上、曲折行走。平衡板和運動可以幫助改善腦功能的基本組合如下​

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參考：

• Wiener-Vacher,Hamilton &Wiener (2013). Vestibular activity and cognitive development in children: perspectives. Front Integr Neurosci. 2013; 7: 92.

•  Peterson ML. (2006). Children achieve adult-like sensory integration during stance at 12-years-old. Gait & Posture, 23(4), 455-6    

• Allison CL. (2007). An optometric approach to patients with sensory integration dysfunction. Optometry- The Journal of the American Optometric Association (St. Louis, Mo.), 78(12), 644-51.

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Balance Board Research  平衡板研究結果

For more detailed research, case studies and articles on Balance Board Exercises, please refer to the following information 有關更詳細的研究，案例研究和有關平衡板的文章，請參考以下信息：

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 1. Reynolds, D., Nicolson, R. I., & Hambly, H. (2003). Evaluation of an exercise‐based treatment for children with reading difficulties. Dyslexia, 9(1), 48-71.

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2. Reynolds, D., & Nicolson, R. I. (2007). Follow‐up of an exercise‐based treatment for children with reading difficulties. Dyslexia, 13(2), 78-96.

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3. Moghadam, Haghgoo, Pishyareh, Bakhshi, Rezazadeh,  Rostami ,Sadeghi (2018). Vestibular therapy improved motor planning, attention, and balance in children with attention deficit hyperactivity disorders: a randomized controlled trial. Open-access,April 30, 2018.

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4. Wiener-Vacher, S. R., Hamilton, D. A., & Wiener, S. I. (2013). Vestibular activity and cognitive development in children: perspectives. Frontiers in integrative neuroscience, 7, 92.

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5. Wiesmeier, I. K., Dalin, D., Wehrle, A., Granacher, U., Muehlbauer, T., Dietterle, J., ... & Maurer, C. (2017). Balance training enhances vestibular function and reduces overactive proprioceptive feedback in elderly. Frontiers in aging neuroscience, 9, 273.

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6. Rogge, Röder,  Zech,  Nagel,  Hollander,  Braumann & Hötting (2017). Balance training improves memory and spatial cognition in healthy adults. Scientific Reports volume 7, Article number: 566118 July 2017

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7. Rine,  Schubert,  Balkany (1999). Visual-Vestibular Habituation and Balance Training for Motion Sickness. Physical Therapy, Volume 79, Issue 10, 1 October 1999, Pages 949–957

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8. Bao, Carender, Kinnaird,  Barone,  Peethambaran,  Whitney,  Kabeto, Seidler &  Sienko (2018). Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults: a randomized preliminary study. Journal of NeuroEngineering and Rehabilitation volume 15, Article number: 5 (2018)

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9. Wiszomirska , Kaczmarczyk, Błażkiewicz, &  Wit. (2015). The Impact of a Vestibular-Stimulating Exercise Regime on Postural Stability in People with Visual Impairment. Clinical Study, Volume 2015

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Research regarding the benefit of Exercise 研究有關運動的人效益：

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1. Heyn P.; Abreu B. C.; Ottenbacher K. J. (2004). The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Archives of physical medicine and rehabilitation, 85(10), 1694-704.

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2."Attentional Networks" Posner, Michael and Dehaene, Stanislas. Trends In Neurosciences 17 75-79 1994

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3. Neuroplasticity and Brain Imaging Research: Implications for Rehabilitation, Archives of Physical Medicine and Rehabilitation, Volume 87, Issue 12, Page 1. H. Levin

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4. Schaie, K. Warner. 1966. Intellectual development in Adulthood: The Seattle Longditudinal Study. Cambridge: Cambridge University Press. The findings demonstrate how significantly specialized neurocognitive brain training effectively boosts intellectual power, maintains intellectual function, and reverses memory decline and the loss of other intellectual abilities.

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5. Mahncke, Henry W.and Michael M. Merzenich. "Memory Enhancement in Healthy Older Adults Using a Brain Plasticity-Based Training Program: A Randomized, Controlled Study." Proceedings of the National Academy of Sciences of the United States of America 103 (2006): 12523–2528.

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6. Doidge, Norman. The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. New York: Penguin Group (USA) Incorporated, 2007

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7. Fawcett, A.J. & Nicolson, R.I. (1992). Automatisation Deficits in Balance for Dyslexic Children. Perpetual and Motor Skills, 75, 507-529

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8. Fawcett, A.J. and Nicolson, R.I. (1995c). Persistent deficits in motor skill for children with dyslexia. Journal of Motor Behaviour, 27, 235-241

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9. “Spark: The Revolutionary New Science of Exercise and the Brain.” - Ratey M.D., John, J., Hagerman, Eric; Little, Brown & Company. Ed 1, January 2008, According to Harvard Psychiatry Professor nothing beats exercise for promoting brain heath.

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10. Levinson, H.N. (1990). The diagnostic value of cerebellar-vestibular in detecting learning disabilities, dyslexia and attention deficit disorder. Perceptual and Motor Skills, 71, 67-82

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11. Nicolson, R.I. and Fawcett, A.J. (1990). Automaticity: A new framework for dyslexia research. Cognition, 35, 159-182

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12. Nicolson, R.I. and Fawcett, A.J. (1994b). Comparison on deficits in cognitive and motor skills among children with dyslexia. Annals of Dyslexia, 44, 147-164

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13. Berquin, PC et al (1998) Cerebellum in Attention Deficit Hyperactivity Disorder. Neurology 50, 1087-1093

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14. Natacha A et al ERP Evidence for a shifting Attention Deficit in Patients with Damage to the Cerebellum. Journal of Cognitive Neuroscience 6, 388-399

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15. Nicolson, R.I. and Fawcett, A.J. (1995). Dyslexia is more than a phonological disability. Dyslexia: An international journal of research and practice, 1, 19-37

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16. Desmond, J.E., Gabrieli, J.D.E., Ginier, B.I., Demb, J.B., Wagner, A.D., Enzmann, D.R., and Glover, G.H. (1995) A functional MRI (fMRI) study of cerebellum during motor and working memory tasks. Soc. Neurosci. Abst. 21 1210

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17.Thach, W. T. (1997). On the specific role of the cerebellum in motor learning and cognition: Clues from PET activation and lesion studies in man. Behav, Brain Sci., in press.

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18. Parsons, L.M. and Fox, P.T. (1997). Sensory and cognitive functions. International Review of Neurobiology, Vol. 41, 255-271

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19. Hallett, M. and Grafman, J. Executive function and motor skill learning. International Review of Neurobiology, Vol. 41, 297-323

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20. Akshoomoff, N.A., and Courchesne, E. (1994). ERP evidence for a shifting attention deficit in patients with damage to the cerebellum. J. Cogn. Neurosci. 6, 388-389

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21. Allen, G., Courchesne, E., Buxton, R.B., and Wong, E.C. (1996). Dissociation of attention and motor operations in the cerebellum. In “Proceedings of the Third Annual Meeting of the Cognitive Neuroscience Society” p.28

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22. Allen, G., Buxton, R.G., Wong, E.C., and Courchesne, E. (1997). Attentional activation of the cerebellum independent of motor involvement. Science 275, 1940-1943

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23. Anderson, B. (1994). The volume of the cerebellum molecular layer predicts attention to novelty in rats. Brain Res. 641, 160-162

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24. Courchesne, E., Townsend, J., Askhoomoff, N.A., Saitoh, O., Yeung-Courchesne, R., Lincoln, A., James, H., Haas, R.H., Schreibman, L., and Lau, L. (1994c). Impairment in shifting attention in autistic and cerebellar patients. Behav. Neurosci, 108, 848-865

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25. Courchesne, E., Townsend, J., Askhoomoff, N.A., Yeung-Courchesne, R., Press, G.A., Murakami, J.W., Lincoln, A.J., James, H.E., Saitoh, O., Egass, B., Haas, R.H., and Schreibman, L. (1994d). A new finding: Impairment in shifting attention in autistic and cerebellar patients. In “Atypical Cognitive Deficits in Developmental Disorders: Implications for Brian Function” (S.H. Broman and J. Grafman, eds.) pp.101-137, Lawrence Erlbaum, Hillsdale, NJ

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26. Helmuth, L.L., and Ivry, R.B. (1994). Cognitive deficits following cerebellar lesions in humans: Studies of attention and verbal fluency. Soc. Neurosci. Abstr. 20, 412.12

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27. Lee, T.H., and Hu, X. (1996). Involvement of the cerebellum in intramodality attention shifting. Neuroimage 3, 246

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28. Townsend, J., Courchesne, E., and Egaas, B. (1996a). Slowed orienting of covert visual spatial attention in autism: Specific deficits associated with cerebellar and parietal abnormalities (Dev. Pschopathol. 8, 563-584.

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29. Townsend, J., Singer-Harris, N.S., and Courchesne, E. (1996b). Visual attention abnormalities in autism: Delayed orienting to location. J. Int. Neuropsychol. Soc. 2, 541-550.

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30. Watson, P.J. (1978). Nonmotor functions of the cerebellum. Psychol. Bull. 85, 944-967

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31. McCredie,Scott. (2007). Balance: In Search of the Lost Sense. Little, Brown and Company, USA: New York.