Can the control of bodily orientation be significantly improved in a group of older adults with a history of falls? Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training. Wearable Sensor-Based Biofeedback Training for Balance and Gait in Parkinson Disease: A Pilot Randomized Controlled Trial. [Interest of visual biofeedback training in rehabilitation of balance after stroke]. Physical training in institutionalized elderly people with multiple diagnoses--a controlled pilot study. Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. Effect of a physical therapeutic intervention for balance problems in the elderly: A single-blind, randomized, controlled multicentre trial Real-time feedback of body center of gravity for postural training of elderly patients with peripheral neuropathy. A randomised controlled trial investigating motor skill training as a function of attentional focus in old age A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial A novel conceptual framework for balance training in Parkinson’s disease-study protocol for a randomised controlled trial Training of balance under single- and dual-task conditions in older adults with balance impairment. Sit-to-stand as home exercise for mobility-limited adults over 80 years of age--GrandStand System may keep you standing? Improving balance control and self-reported lower extremity function in community-dwelling older adults: a randomized control trial A community-based fitness and mobility exercise program for older adults with chronic stroke: a randomized, controlled trial. The effect of cognitive-motor dual task training with the biorescue force platform on cognition, balance and dual task performance in institutionalized older adults: a randomized controlled trial The efficacy of a specific balance-strategy training programme for preventing falls among older people: a pilot randomised controlled trial.
OBJECTIVE To determine the short-term effectiveness of a biofeedback-based , computerized intervention that applied the principles of the ecological theory of perception and control of bodily orientation to the rehabilitation of older adults with a history of falling . PARTICIPANTS Forty-five older adults ( X = 78.5 years ) with a history of falls were assigned to either a control ( n = 21 ) or intervention group ( n = 24 ) . DESIGN A 2 x 2 ( Group x Time ) mixed factorial design with repeated measures on the second factor . SETTING A motor control research laboratory in a university setting . MEASUREMENT Impairments in multiple dimensions of balance ( i.e. , dynamic postural control and sensory organization ) were measured before and after an 8-week balance intervention using the 100 % Limits of Stability Test and Sensory Organization Test . More functional limitations in balance and /or mobility were measured using two clinical tests : Berg Balance Scale and Timed Up and Go test . MAIN RESULTS Repeated measures multivariate analyses and follow-up testing indicated significant improvements in the dynamic balance and sensory integration capabilities in the case of the intervention group only ( P < .03 ) . Significant improvements were also observed in the two clinical measures of balance and mobility evaluated before and after the intervention for the intervention group only . CONCLUSIONS Theory-driven rehabilitation programs that focus on manipulating individual , task , and environmental constraints concurrently can significantly improve the control of bodily orientation of older adults with a previous history of falls in both static and dynamic action environments . Moreover , the significant improvements in functional performance observed for the intervention group suggest that interventions emphasizing task-specific practice are not the only means by which an older adult 's ability to perform daily activities requiring postural control can be improved BACKGROUND AND PURPOSE Visual biofeedback/forceplate systems are often used for treatment of balance disorders . In this study , the research ers investigated whether the addition of visual biofeedback/forceplate training could enhance the effects of other physical therapy interventions on balance and mobility following stroke . SUBJECTS The study included a sample of convenience of 13 out patients with hemiplegia who ranged in age from 30 to 77 years ( mean=60.4 , SD=15.4 ) and were 15 to 538 days poststroke . METHODS Subjects were assigned r and omly to either an experimental group or a control group when the study began , and their cognitive and visual-perceptual skills were tested by a psychologist . Subjects were also assessed using the Berg Balance Scale and the Timed " Up & Go " Test before and after 4 weeks of physical therapy . Both groups received physical therapy interventions design ed to improve balance and mobility 2 to 3 times per week . The experimental group trained on the NeuroCom Balance Master for 15 minutes of each 50-minute treatment session . The control group received other physical therapy for 50 minutes . RESULTS Following intervention , both groups scored higher on the Berg Balance Scale and required less time to perform the Timed " Up & Go " Test . These improvements corresponded to increased independence of balance and mobility in the study population . However , a comparison of mean changes revealed no differences between groups . DISCUSSION AND CONCLUSION Although both groups demonstrated improvement following 4 weeks of physical therapy interventions , no additional effects were found in the group that received visual biofeedback/forceplate training combined with other physical therapy OBJECTIVES To analyze the feasibility and efficacy of a novel system ( Gamepad [ GAMing Experience in PArkinson 's Disease ] ) for biofeedback rehabilitation of balance and gait in Parkinson disease ( PD ) . DESIGN R and omized controlled trial . SETTING Clinical rehabilitation gym . PARTICIPANTS Subjects with PD ( N=42 ) were r and omized into experimental and physiotherapy without biofeedback groups . INTERVENTIONS Both groups underwent 20 sessions of training for balance and gait . The experimental group performed tailored functional tasks using Gamepad . The system , based on wearable inertial sensors , provided users with real-time visual and acoustic feedback about their movement during the exercises . The physiotherapy group underwent individually structured physiotherapy without feedback . MAIN OUTCOME MEASURES Assessment s were performed by a blinded examiner preintervention , postintervention , and at 1-month follow-up . Primary outcomes were the Berg Balance Scale ( BBS ) and 10-m walk test ( 10MWT ) . Secondary outcomes included instrumental stabilometric indexes and the Tele-healthcare Satisfaction Question naire . RESULTS Gamepad was well accepted by participants . Statistically significant between-group differences in BBS scores suggested better balance performances of the experimental group compared with the physiotherapy without biofeedback group both posttraining ( experimental group-physiotherapy without biofeedback group : mean , 2.3±3.4 points ; P=.047 ) and at follow-up ( experimental group-physiotherapy without biofeedback group : mean , 2.7±3.3 points ; P=.018 ) . Posttraining stabilometric indexes showed that mediolateral body sway during upright stance was significantly reduced in the experimental group compared with the physiotherapy without biofeedback group ( experimental group-physiotherapy without biofeedback group : -1.6±1.5 mm ; P=.003 ) . No significant between-group differences were found in the other outcomes . CONCLUSIONS Gamepad-based training was feasible and superior to physiotherapy without feedback in improving BBS performance and retaining it for 1 month . After training , 10MWT data were comparable between groups . Further development of the system is warranted to allow the autonomous use of Gamepad outside clinical setting s , to enhance gait improvements , and to increase transfer of training effects to real-life context OBJECTIVE The aim of this study was the assessment of visual biofeedback  in the management of  balance disorders after stroke . MATERIAL AND METHODS This is a prospect i ve r and omised trial , which compares visual biofeedback training and traditional balance training .  Twenty-seven patients took part in this study : 13 in the first group and 14 in the second group . The rehabilitation program in the first group consists in an association of visual biofeedback and traditional training during 3 weeks . For the second group traditional training was used alone . Clinical , functional and forceplate assessment s were performed before and after the program of rehabilitation . RESULTS All the patients had a clinical and functional improvement . However , patients who have benefited from biofeedback training had a significant improvement of the forceplate parameters with closed eyes . DISCUSSION AND CONCLUSION Those results confirm the interest of rehabilitation in balance disorders after stroke . The use of biofeedback training incorporated into functional physiotherapy affords added benefits probably by a best integration of proprioceptive informations Reduction in muscle mass and physical function depends on a variety of interacting factors : age , physical activity level , nutritional state and the type and impact of disease . The aim of this study was to investigate the effect of an individualized moderate intensity physical training program on muscle strength , balance , mobility , ambulation and activities of daily living ( ADL ) in institutionalized elderly people aged 65 and over with multiple diagnoses . Baseline assessment s consisted of strength , balance , mobility/ambulation , and ADL .  Twenty-one subjects were included in the intervention program . A control group ( 21 subjects ) was first matched in pairs according to gender , age , ADL and mobility , and then by balance , ambulation and strength . The intervention program was individualized and included strength , mobility , balance and endurance training . Follow-up measures were conducted directly after the intervention and 10 weeks later . After drop-out , 20 subjects in the intervention group and 15 subjects in the control group remained for analyses . Balance and mobility improved significantly in the intervention group while declining in the control group . This pilot study indicates that a physical training program may improve functional capacity for institutionalized elderly persons with multiple diagnoses OBJECTIVES To primarily ascertain the effect of the Otago Exercise Program ( OEP ) on physiological falls risk , functional mobility , and executive functioning after 6 months in older adults with a recent history of falls and to ascertain the effect of the OEP on falls during a 1-year follow-up period . DESIGN R and omized controlled trial . SETTING Dedicated falls clinics . PARTICIPANTS Seventy-four adults aged 70 and older who presented to a healthcare professional after a fall . INTERVENTION The OEP , a home-based program that consists of resistance training and balance training exercises . MEASUREMENTS Physiological falls risk was assessed using the Physiological Profile Assessment . Functional mobility was assessed using the Timed Up and Go Test . Three central executive functions were assessed : set shifting , using the Trail Making Test Part B ; updating , using the verbal digits backward test ; and response inhibition , using the Stroop Color-Word Test . Falls were prospect ively monitored using daily calendars . RESULTS At 6 months , there was no significant between-group difference in physiological falls risk or functional mobility ( P > or= .33 ) . There was a significant between-group difference in response inhibition ( P=.05 ) . A falls histogram revealed two outliers . With these cases removed , using negative binomial regression , the unadjusted incidence rate ratio of falls in the OEP group compared with the control group was 0.56 . The adjusted incidence rate ratio was 0.47 . CONCLUSION The OEP may reduce falls by improving cognitive performance Objective : To establish the effect of a short , individualized exercise programme on  balance dysfunction in the elderly . Design : A single-blind , r and omized , controlled , multicentre trial . Setting : Physical and recreational therapy departments from two rehabilitation centres . Participants : Ninety-four subjects of ≥75 years with functional balance problems living independently or in a residential care facility . Seventy-seven subjects completed the intervention period and four-week follow-up . At a one-year follow-up 49 subjects were evaluated on balance functioning . Interventions : Twelve sessions of an individualized balance training programme ( experimental group ) or 12 sessions of an individualized extra attention programme ( control group ) given in 4–6 weeks . Main outcome measures : Berg Balance Scale and the Dynamic Gait Index to establish balance functioning , a visual analogue scale to establish fear of falling in daily life and the Hospital Anxiety Depression Scale to verify feelings of anxiety and depression . Results : Subjects in the experimental group improved significantly more on the Berg Balance Scale and the Dynamic Gait Index than those in the control group ( p ≤ 0.001 , p ≤ 0.001 , respectively ) . However the effect disappeared at a one-year follow-up on the Berg Balance Scale . No prognostic factors could be identified to determine who would benefit most from the individualized exercise programme . Results on the other response variables revealed no effect of the intervention . Conclusion : A short individualized exercise programme can improve functional balance in people aged 75 years and older . This improvement was maintained at least for one month but had worn off by one year A system that estimates and displays , in real-time , the location of the center of gravity of the human body relative to the feet was developed and then used in a biofeedback training program for improving the postural instability caused by deterioration of the proprioceptive system in elderly patients with significant diabetic sensory neuropathy during perturbations of a support platform . Training sessions were scheduled three times a week for four weeks and consisted of continuous perturbations of the support platform for the st and ing subject  . Postural stability of each subject was evaluated before , during and after training on a weekly basis . After twelve sessions of training , subjects who received visual feedback showed greater reduction in total number of falls and in fall magnitude defined by force in the body suspension cord , and longer delay in time between perturbation and fall than NFB group Background Motor learning research has had little impact on clinical applications and rarely extended to research about how older adults learn motor skills . There is consistent evidence that motor skill performance and learning can be enhanced by giving learners instructions that direct their attention . The aim of this study was to test whether elderly individuals that receive an external focus instruction during training of dynamic balance skills would learn in a different manner compared to individuals that received an internal focus instruction . Methods This r and omised trial included 26 older persons ( 81 ± 6 years ) that were training functional balance twice a week for the duration of 5 weeks .  Learning outcomes were recorded after every training session . Weight shifting score and dynamic balance parameters ( Biodex Balance System ) , components of the Extended Timed-Get-Up- and -Go test , five chair rises , and falls efficacy ( FES-I )  was assessed at baseline and post-intervention . Results Participation for training sessions was 94 % . No differences between groups were found following 5 weeks of training for weight shifting score , dynamic balance index and dynamic balance time ( p < 0.95 , p = 0.16 , p < 0.50 ) , implying no learning differences between training groups . Extended Timed-Get-Up- and -Go components Sit-to-st and , p = .036 ; Gait initiation , p = .039 ; Slow down , stop , turnaround , and sit down , p = 0.011 and the Fes-I ( p = 0.014 ) showed improvements for the total group , indicating that function improved compared to baseline . Conclusion A 5-week balance training improved weight shifting scores and dynamic balance parameters as well as functional abilities . The observed improvements were independent from the type of attentional focus instructions . The findings provide support for the proposition of different motor learning principles in older adults compared to younger adults . Trial Registration IS RCT Background With increasing age neuromuscular deficits ( e.g. , sarcopenia ) may result in impaired physical performance and an increased risk for falls . Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline . Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice . Thus , the objective of the present trial is to assess the effects of a  fall prevention program that was developed by an interdisciplinary expert panel on measures of balance , strength / power , body composition , cognition , psychosocial well-being , and falls self-efficacy in healthy older adults . Additionally , the time-related effects of detraining are tested . Methods / Design Healthy old people ( n = 54 ) between the age of 65 to 80 years will participate in this trial . The testing protocol comprises tests for the assessment of static / dynamic steady-state balance ( i.e. , Sharpened Romberg Test , instrumented gait analysis ) , proactive balance ( i.e. , Functional Reach Test ; Timed Up and Go Test ) , reactive balance ( i.e. , perturbation test during bipedal stance ; Push and Release Test ) , strength ( i.e. , h and grip strength test ; Chair St and Test ) , and power ( i.e. , Stair Climb Power Test ; countermovement jump ) . Further , body composition will be analysed using a bioelectrical impedance analysis system . In addition , question naires for the assessment of psychosocial ( i.e. , World Health Organisation Quality of Life Assessment -Bref ) , cognitive ( i.e. , Mini Mental State Examination ) , and fall risk determinants ( i.e. , Fall Efficacy Scale – International ) will be included in the study protocol . Participants will be r and omized into two intervention groups or the control / waiting group . After baseline measures , participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week , with each training session lasting 30 min . ( actual training time ) . One intervention group will complete an extensive supervised training program , while the other intervention group will complete a short version ( ' 3 times 3 ’ ) that is home-based and controlled by weekly phone calls . Post-tests will be conducted right after the intervention period . Additionally , detraining effects will be measured 12 weeks after program cessation . The control group / waiting group will not participate in any specific intervention during the experimental period , but will receive the extensive supervised program after the experimental period . Discussion It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance , strength / power , body composition , cognitive function , psychosocial well-being , and falls self-efficacy of older adults . In addition , information regarding fall risk assessment , dose – response-relations , detraining effects , and supervision of training will be provided . Further , training-induced health-relevant changes , such as improved performance in activities of daily living , cognitive function , and quality of life , as well as a reduced risk for falls may help to lower costs in the health care system . Finally , practitioners , therapists , and instructors will be provided with a scientifically evaluated feasible , safe , and easy-to-administer exercise program for fall prevention . Trial registration Clinical Trials.gov Identifier : Background There is increasing scientific knowledge about the interaction between physiological ( musculoskeletal , neuromuscular , cognitive and sensory ) systems and their influence on balance and walking impairments in Parkinson ’s disease . We have developed a new conceptual framework for balance training , emphasising specific components of balance control related to Parkinson ’s disease symptoms by using highly challenging , progressive and varying training conditions . The primary aim of this proposed r and omised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson ’s disease . Methods / Design Eighty participants with mild to moderate idiopathic Parkinson ’s disease will be recruited and r and omly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care . The intervention will consist of a 10-week group training regime ( 1-hour training , three times per week ) , which will be led by two physiotherapists to ensure training progression and safety . The conceptual framework will be applied by addressing specific balance components ( sensory integration , anticipatory postural adjustments , motor agility , stability limits ) through varying training conditions and structured progression . Assessment will be conducted through a multi-dimensional battery of outcomes , prior to and immediately after the 10-week intervention , and at 9 and 15 months ’ follow-up after entering the study . Primary outcome measures will be balance performance ( assessed using the Mini Balance Evaluation Systems Test ) , change in gait velocity ( m/s ) between single and dual task walking , and fear of falling ( evaluated using the Fall Efficacy Scale International ) . Discussion This study has the potential to provide new insight and knowledge of the effects of specific , varied and challenging balance training on a wide health spectrum in elderly with PD . If found to be effective , this pragmatic approach with translation of theory into practice , can be implemented in existing outpatient care . Trial registration BACKGROUND AND PURPOSE Traditionally , rehabilitation programs emphasize training balance under single-task conditions to improve balance and reduce risk for falls . The purpose of this case report is to describe 3 balance training approaches in older adults with impaired balance . CASE DESCRIPTIONS Three patients were r and omly assigned to 1 of 3 interventions : ( 1 ) single-task balance training , ( 2 ) dual-task training under a fixed-priority instructional set , and ( 3 ) dual-task training under a variable-priority instructional set . OUTCOMES The patients who received balance training under dual-task conditions showed dual-task training benefits ; these training benefits were maintained for 3 months . The patient who received variable-priority training showed improvement on novel dual tasks . DISCUSSION Older adults may be able to improve their balance under dual-task conditions only following specific types of balance training . This case report gives insight on how this intervention might be combined with more traditional physical therapy intervention PURPOSE To compare the effects of functional home exercise of repeated sit-to-st and s with low-intensity progressive resistance training , on performance measures in mobility-limited adults over 80 years of age . SETTING Participants ' homes . DESIGN Community-dwelling older adults > or = 80 years of age were invited to participate in a r and omised controlled clinical trial . Baseline and outcome measures were : comfortable gait velocity , 30-s chair-st and test , 15-s step test , Berg Balance Scale , Modified Falls Efficacy Scale and the Late-Life Function and Disability Instrument-function component . Participants r and omised to the intervention group performed repeated sit-to-st and s using a Gr and St and System ; a biofeedback device that recorded and displayed the number of repetitions performed . Participants r and omised to the control group performed knee extensions using ankle cuff weights . Both groups performed the exercises daily for 6 weeks . RESULTS Sixty-six older adults took part . The intervention group had a statistically significant improvement in Berg Balance Scale mean score , 1.67 + /- 2.64 points , P = 0.001 ( control group 0.73 + /- 3.63 points , P = 0.258 ) , indicating an improvement in balance over the 6-week exercise period . There was no statistically significant effect of either intervention on the other outcome measures . CONCLUSIONS In a highly variable population of older adults with mobility limitations , low-intensity functional home exercise of repeated sit-to-st and s using the Gr and St and System improved Berg Balance Scale score while low-intensity progressive resistance training did not . While statistically significant , the improvement in Berg Balance Scale score was modest raising the issue of what extent of change in score is clinical ly significant in this population Objectives : To evaluate the effect of a group-based functional and specific balance training programme that included dual-task exercises on balance function  in healthy older adults . Design : A single-blind r and omized controlled trial . Setting : General community . Participants : Sixty-six community-dwelling older adults ( age 77.0 ± 6.5 years ) , without functional balance impairment were recruited and allocated at r and om to an intervention group ( n = 33 ) or a reference group ( n = 33 ) . Intervention : The intervention group received 24 training sessions over three months that included perturbation as well as dual-task exercises . The reference group received no intervention . Outcome measures : The voluntary step execution times during single- and dual-task conditions , stabilogram-diffusion analysis in upright st and ing , and self-reported physical function ; all were measured assessed at baseline and at the end of intervention . The intervention group was retested after six months . Results : Compared with the reference group , participation in group-based functional and specific balance training led to faster voluntary step execution times under single-task ( P = 0.02 ; effect size ( ES ) = 0.34 ) and dual-task ( P = 0.036 ; ES = 0.55 ) conditions ; lower transition displacement and shorter transition time of the stabilogram-diffusion analysis under eyes-closed conditions ( P = 0.007 , ES = 0.30 and P = 0.08 , ES = 0.44 , respectively ) ; and improved self-reported lower extremity function ( P = 0.006 , ES = 0.37 ) . Effects were lost at six-month follow-up . Conclusions : Functional and specific balance training can improve voluntary stepping and balance control in healthy older non-fallers , parameters previously found to be related to increased risk of falls and injury in older adults OBJECTIVES To examine the effects of a community-based group exercise program for older individuals with chronic stroke . DESIGN Prospect i ve , single-blind , r and omized , controlled intervention trial . SETTING Intervention was community-based . Data collection was performed in a research laboratory located in a rehabilitation hospital . PARTICIPANTS Sixty-three older individuals ( aged > or = 50 ) with chronic stroke ( poststroke duration > or = 1 year ) who were living in the community . INTERVENTION Participants were r and omized into intervention group ( n=32 ) or control group ( n=31 ) . The intervention group underwent a fitness and mobility exercise ( FAME ) program design ed to improve cardiorespiratory fitness , mobility , leg muscle strength , balance , and hip bone mineral density ( BMD ) ( 1-hour sessions , three sessions/week , for 19 weeks ) . The control group underwent a seated upper extremity program . MEASUREMENTS Cardiorespiratory fitness ( maximal oxygen consumption ) , mobility ( 6-minute walk test ) , leg muscle strength ( isometric knee extension ) , balance ( Berg Balance Scale ) , activity and participation ( Physical Activity Scale for Individuals with Physical Disabilities ) , and femoral neck BMD ( using dual-energy x-ray absorptiometry ) . RESULTS The intervention group had significantly more gains in cardiorespiratory fitness , mobility , and paretic leg muscle strength than controls . Femoral neck BMD of the paretic leg was maintained in the intervention group , whereas a significant decline of the same occurred in controls . There was no significant time-by-group interaction for balance , activity and participation , nonparetic leg muscle strength , or nonparetic femoral neck BMD . CONCLUSION The FAME program is feasible and beneficial for improving some of the secondary complications result ing from physical inactivity in older adults living with stroke . It may serve as a good model of a community-based fitness program for preventing secondary diseases in older adults living with chronic conditions [ Purpose ] This study investigates whether cognition , balance and dual task performance in institutionalized older adults improves by a virtual reality dual task training . [ Subjects and Methods ] R and omized controlled trial ; Twenty institutionalized older adults with mild cognitive impairment ( 13 female , 7 male ; average age , 87.2 ± 5.96 years ) were r and omized to the intervention ( i.e. Virtual reality dual-task training using the BioRescue ) or control group ( no additional training ) . The intervention group took part in a 6-week training program while the elderly in the control group maintained their daily activities . Balance was measured with the Instrumented Timed Up- and -Go Test with and without a cognitive task . The Observed Emotion Rating Scale and Intrinsic Motivation Inventory were administered to evaluate the emotions and motivation regarding the exergaming program . [ Results ] The intervention group improved significantly on the total Timed Up- and -Go duration and the turn-to-sit duration during single-task walking in comparison to the control group who received no additional training . Participants found the virtual reality dual task training  pleasant and useful for their concentration , memory and balance . Pleasure and alertness were the two emotions which were mostly seen during the intervention . [ Conclusion ] The BioRescue is a pleasant and interesting treatment method , well suited for institutionalized older adults in need of lifelong physical therapy BACKGROUND older people participate in exercise programmes to reduce the risk of falls but no study has investigated a specific balance strategy training intervention presented in a workstation format for small groups . OBJECTIVE to determine whether a specific balance strategy training programmeme delivered in a workstation format was superior to a community based exercise class programme for reducing falls . DESIGN a r and omised controlled trial model . SETTING Neurological Disorders , Ageing and Balance Clinic , Department of Physiotherapy , The University of Queensl and . SUBJECTS 73 males and females over 60 years , living independently in the community and who had fallen in the previous year were recruited . METHODS all subjects received a falls risk education booklet and completed an incident calendar for the duration of the study . Treatment sessions were once a week for 10 weeks . Subject assessment before and after intervention and at 3 months follow-up included number of falls , co-morbidities , medications , community services and activity level , functional motor ability , clinical and laboratory balance measures and fear of falling . RESULTS all participants significantly reduced the number of falls ( P < 0.000 ) . The specific balance strategy intervention group showed significantly more improvement in functional measures than the control group ( P = 0.034 ) . Separate group analyses indicated significantly improved performance in functional motor ability and most clinical balance measures for the balance group ( P < 0.04 ) . The control group only improved in TUG and TUGcog . CONCLUSIONS the results provide evidence that all participants achieved a significant reduction in falls .  Specific balance strategy training using workstations is superior to traditional exercise classes for improving function and balance
Results and Conclusions Although most available studies did not systematic ally evaluate feasibility aspects , reports of high participation rates , low drop-out rates , absence of adverse events and positive training experiences suggest that biofeedback methods can be applied in older adults .
An indication for effectiveness of visual feedback-based training of balance in ( frail ) older adults was identified for postural sway , weight-shifting and reaction time in st and ing , and for the Berg Balance Scale .
Indications for added effectiveness of applying biofeedback during training of balance , gait , or sit-to-st and transfers in older patients post-stroke were identified for training-specific aspects .
The same applies for auditory feedback-based training of gait in older patients with lower-limb surgery .
Implication sFurther appropriate studies are needed in different population s of older adults to be able to make definitive statements regarding the ( long-term ) added effectiveness , particularly on measures of functioning
Context An effective application of biofeedback for interventions in older adults with balance and mobility disorders may be compromised due to co-morbidity .
Objective To evaluate the feasibility and the effectiveness of biofeedback-based training of balance and /or mobility in older adults .