Before reading this article, please attempt this exercise:

Try balancing on one leg for 20 seconds. (Wikimedia)

Try balancing on one leg for 20 seconds. (Wikimedia)

Grab a pair of socks. From a standing position, bend one knee and raise that leg out in front of you, keeping your knee bent. From here, try to put a sock on your raised foot while maintaining your balance. Repeat the same procedure on the other leg. If you successfully managed to put on both socks without losing your balance, congratulate yourself and do this exercise daily. However, if you struggled with your balance, you need to think about strategies to strengthen your balance centers in the brain as this may affect your quality of life and lifespan.

According to a recent study, people who cannot stay balanced on one leg for longer than 20 seconds need to consult with their doctor as this may strongly correlate with the presence of tiny microbleeds in the brain that may be a harbinger for an impending stroke. The microbleeds can happen even when you’re otherwise feeling healthy, and if they are not stopped or controlled, they will be the greatest risk factor for future severe strokes. The risk of having a stroke increases with age, so identifying the presence of microbleeds in healthy elderly people is especially important.

Some of the balance centers in the brain include the cerebrum, brain stem and cerebellum. The entire cerebrum is divided into a right and a left hemisphere-any injury to the left hemisphere produces motor deficits on the right side, and vice versa. A stroke in the left or right hemisphere of the cerebrum can lead to impairment of perception and orientation resulting in improper balance. The brain stem is a region of the brain that connects the cerebral structures to the spinal cord. The brain stem is responsible for a variety of autonomic functions including respiration, heart rate, blood pressure, wakefulness and arousal, among others. Some common effects of a stroke in the brain stem include problems with balance, coordination, weakness or paralysis. The cerebellum, the second largest area of the brain, receives sensory information from the body through the spinal cord and helps to coordinate muscle action, fine movement, coordination and balance. The effects of strokes in the cerebellar area result in improper balance, difficulty maintaining balance, inability to walk and problems with coordination and movement.

A stroke can be caused by a clotted blood vessel or a ruptured blood vessel in the brain or brain stem.

A stroke can be caused by a clotted blood vessel or a ruptured blood vessel in the brain or brain stem. (Wikimedia)

Unlike other regions of the body, the brain cannot function if it’s deprived of oxygen even for a very short time. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is blocked by a clot or ruptures. In either situation, portions of the brain do not receive the much needed blood and oxygen, and as a result, brain cells die. If brain cells die or are damaged because of stroke, symptoms occur in the parts of the body that this region of the brain controls. A stroke can cause severe brain damage, long-term disability, or even death. A class of strokes called “whispering strokes” aka “silent” strokes do not result in any gross symptoms to raise concerns among victims. These strokes are often associated with tiny microbleeds (small blood vessel tear). Whispering/silent strokes that occur very frequently can serve as a greatest risk factor for future severe strokes and ultimately diminish patients’ physical and mental functioning. But how does one recognize the presence of microbleeds if it does not trigger visible symptoms?

In a recent study published in the journal STROKE, a team of Japanese researchers noted that the inability to balance on one leg for 20 seconds or longer could be linked to whispering strokes due to microbleeds. The researchers recruited 841 women and 546 men who had an average age of 67. The participants were required to stand on one leg for up to one minute with both eyes open. They were asked to do this twice and the longest of the two timings was recorded. Then, the brain of each participant was examined using magnetic resonance imaging (MRI) to check for the presence of microbleeds. The participants were also asked to fill out computer-based questionnaires to assess any cognitive impairment. Using the brain MRI scans, the researchers found that all subjects who had microbleeds in their brains were those that were unable to balance on one leg for longer than 20 seconds. Nearly 35% of those with a couple or more microbleed lesions had trouble balancing though they did not manifest any other gross symptoms. Moreover, balance problems were also associated with reduced thinking and memory skills.

An MRI scan of an Alzheimer's patient brain reveals the presence of microbleeds (white arrows).

A MRI brain scan of an elderly patient with Alzheimer’s disease reveals the presence of microbleeds (white arrows).

According to the authors, small blood vessel damages in the brain coupled with reduced cognitive function in otherwise healthy people with no clinical symptoms can simply be observed by their ability to balance on one leg. Individuals who show poor balance on one leg will need serious attention, since this may indicate that small strokes or tiny bleeds have already occurred, which further implies that the risk for more serious strokes is high. One-leg standing time may thus serve as a simple, inexpensive, low-tech but powerful method to screen people for small cerebral vessel damage who are at risk for further strokes and thereby provide indication of their overall brain health.

So how about taking preventative measures instead of waiting for a stroke (whether a silent/whispering or a major) to happen? How about strengthening the brain, the nerves, the cognitive skills and furthermore the balance centers of the brain? One way to do this is to look for ways to build, improve, strengthen and sustain your ability to balance. Start practicing one-leg balance poses, the more complicated the poses, the more work the brain needs to do to fire up the neural circuitry, which further strengthens the brain areas. If you cannot think of a balance pose, attempt the sock exercise daily.