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Balance training moves to high-end gyms

Athletes of all ages are working on their stability to improve stamina and minimize injuries

Nawal Ilyas, 27, works on core and balance in an exercise class at Equinox health club in the Back Bay.Joanne Rathe/Globe Staff

Josie Gardiner was showing her class no mercy.

“Down, up, exhale, lift, again, lift, two more times,” she ordered as she patrolled an airy studio at Equinox in Back Bay on a recent Friday. “How can I make this harder?” she mused a few minutes later. It was less a question than a threat. The 11 students — average Body Mass Index a lean 20 — including the pregnant woman — held their positions on wobbly exercise balls, their muscles shaking with fatigue.

Instructor Josie Gardiner leading exercise class at Equinox health club in the Back Bay.Joanne Rathe/Globe Staff/Globe Staff

The class is called “core synergy,” but “balance boot camp” would be more accurate.

Exercise trends usually flow from the young and toned down to the rest of us. But in 2014, the quest for better physical balance is going the other way: from assisted living facilities to fancy gyms.

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Indeed, when the Mobility and Falls Program at Hebrew SeniorLife’s Institute for Aging Research recently participated in a project to assess the balance-enhancing benefits of tai chi, people as young as 50 signed up to participate, said Brad Manor, a co-investigator on the project and an instructor at Harvard Medical School.

“And they were very healthy,” he added. “It suggests that people are realizing at an earlier age that balance is something that will decline with age and there are things we can do to prevent and delay that decline.”

The interest in balance is being fueled by several factors: the baby boomers’ fierce determination not to get old; an increased understanding that good balance enhances athletic performance at any age; and the growing recognition of the health and financial costs of falls.

In 2010, the direct medical cost of falls, adjusted for inflation, was $30 billion, according to the most recent statistics from the Centers for Disease Control and Prevention .

Shirlene Chi of the Back Bay doing core work on a balance ball in an exercise class at Equinox health club.Joanne Rathe/Globe Staff/Globe Staff

The CDC also reports that one in three older adults (age 65 or older) falls each year, and that among older adults, falls are the leading cause of both fatal and nonfatal injuries. In 2011, emergency departments treated 2.4 million nonfatal fall injuries among older adults, and more than 689,000 of these patients were hospitalized.

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With a growing market, researchers are creating balance-related products for a target market that includes those who don’t even have balance problems.

At Boston University and Harvard’s Wyss Institute for Biologically Inspired Engineering, BU professor James Collins is working on balance-enhancing shoe insoles, and knee and shin wraps that vibrate.

When Collins started working on the vibrating shoe soles 20 years ago, he had the elderly in mind. “But now we are looking at possible markets that would include performance enhancement for people in their 30s, 40s, and 50s,” he said. “These [shin and knee wraps] could play a role for athletes or people looking to have an enhanced yoga experience.”

In a scholarly paper on the subject, he explained why vibration works. “The human balance control system relies, in part, on somatosensory feedback, and in adults 65 years or older, diminished somatosensation is associated with an increased likelihood of falling. Input noise [such as vibration] can enhance sensory and motor function.”

Once “largely overlooked,” in the words of Thomas Moore, associate provost and director of the Office of Clinical Research at Boston University Medical Center, these days balance-related classes and training seem to be everywhere.

As the author of “The Dash Diet for Hypertension,” he recently sent an e-mail blast that emphasized its importance and provided balance-enhancing exercises. “We realized that balance was not the kind of training that was included in standard cardiovascular or weight-training exercises,” he said.

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The jaunty April 1 e-mail read in part: “We all know that keeping our exercise routines varied is a great way to ensure all-around fitness. Until recently the focus has been on balancing three established components of fitness — heart/lung (cardiovascular) endurance, strength, and flexibility. . . . But there’s a fourth pillar of fitness that is important, too. And it has to do with balance — yes, actual balance!”

Meanwhile, with newfound respect has come the potential for shame.

“If you’re in class and you’re falling off [the balance ball] it’s embarrassing,” Nawal Ilyas, 27, a pharmacist from Back Bay, said after finishing a balance class at Equinox recently.

She’d never thought about her balance until a personal trainer told her she was balance-challenged. “I want to improve,” she said, with the utmost seriousness.

In Sudbury, high school senior and varsity lacrosse player Elizabeth Krumsiek spent eight months training with a gym, Impact Functional and Sports Training , that takes balance so seriously it puts new clients through a balance assessment.

Now Krumsiek sounds more like a physical therapist than a teenager when discussing the subject.

“Balance makes it so you don’t hurt any muscles. I’ve come face to face with some athletes who don’t have strong balance and it throws them off,” she added, practically shuddering at the thought.

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Although many people in their 50s feel closer to age 30 than the CDC’s “older adult” category, dark thoughts about aging do sneak in. The actress and author Annabelle Gurwitch , who recently injured her ankle playing tennis, says wearing a cast-like boot is the “official must-have” accessory for middle-age people. “It shows you are still trying,” she said.

At 52, she’s started worrying about her mother’s balance — but for her own reasons. “I’ve noticed that she veers when she walks,” said Gurwitch, author of the new “I See You Made an Effort.” “Your mother is an indicator of what your future will look like. I have to get her to walk better.”

In Newton, Ronna Benjamin, a 55-year-old with no balance problems, has started folding laundry while balancing on one foot.

“We used to have a fear of failing,” she said, “now we have a fear of falling.”

As balance’s buzz grows, Benjamin and others are realizing that working on it is worth their time.

“Do I want to go to the gym and work on balance?” asked Benjamin, a partner in BetterAfter50.com , an online magazine and newsletter. “No, I’d much rather focus on my rear end and my thighs. But balance is like the roof. If you don’t take care of it, everything else caves in.”

Beth Teitell can be reached at bteitell@globe.com. Follow her on Twitter @BethTeitell.