Balance Training Research Articles

Effects of task-oriented balance training with sensory integration in post stroke patients

Background: Balance and functional mobility is greatly affected in stroke patients. Balance training integrated with sensory input is more beneficial for improving balance and mobility in stroke patients. Objective: To determine the effects of task-oriented balance training with and without sensory integration on balance, postural stability, and mobility in post-stroke patients. Methods: A randomized control trial was conducted at RHS Rehabilitation Centre, Islamabad. A total of n=60 post-stroke patients were included in the study through a non-probability purposive sampling technique. Male and female stroke patients above 40 years of age, having the ability to maintain a standing position without aid for at least 5 minutes, and patients on Grades II, III, IV on the Functional Mobility Scale were included in this study. They were randomly allocated into Group A (n=30) and Group B (n=30). Both groups received Task oriented balance training while group B was treated with additional sensory integration. The Berg Balance Scale, Dynamic Gait Index, Activities Specific Balance Confidence Scale, and Balance Error Scoring system were used for balance assessment. The assessment was done at baseline and after 6th week. Results: The mean age of the participants was 54.47 years. After 6 weeks of intervention, a significant difference was found in group A as compared to group B for Dynamic mobility measured by Dynamic gait index with p-value (p=0.06) and for balance measured by BBS with p-value (p=0.05). Conclusion: The task-oriented balance training with sensory integration is effective in improving dynamic balance and mobility in stroke patients. Keywords: balance training; Sensory Integration; stroke rehabilitation; task-oriented balance exercises.

To Compare the Effect of Land and Water Based Balance Training in Functional Ankle Instability

Background: With increasing amount of leisure time and the current emphasis on the physical fitness, the incidence of sports injuries has increased dramatically. Ankle is one of the most common parts of the body to get injured during sports activities. Functional ankle instability is defined as recurrent or subjective feeling of giving way. The studies have shown that Functional Ankle Instability results in decreased ability to maintain balance & a decrease in joint position sense. Aims & Objective: The primary aim of the study is to determine the effect of water & land-based balance training in Functional Ankle Instability.

Penyuluhan Resiko Jatuh Pada Lansia Di Masyarakat Pudak Payung

The elderly are an age group that is prone to falls. The purpose of this service is to detect the risk of falls in the elderly and provide assistance in balance training as an effort to prevent the risk of falls in the elderly. Falls occur due to unintentional loss of balance resulting in failure of postural stability, or unexpected and sudden changes resulting in a position landing on the floor. Associated risk factors include current health status (living in the community, nursing home, hospital, frail or active state), diseases suffered (diabetes, hip fracture, stroke) and general changes related to aging (decreased balance, coordination, muscle strength, visual impairment, etc.). The output targets to be achieved are in the form of publications in accredited national journals and copyright for videos of community service activities. The method used is a fall risk detection examination using the Time Up and Go Test and continued with the provision of balance training, so that the elderly who have a risk of falling can be recognized as early as possible so that the provision of balance training can maintain and improve the balance of the elderly body.

Effect of Balance Exercises with Smart Phone Based Virtual Reality Programme on Balance in Stroke Patients

Background and objectives: A stroke is a neurological deficit, caused due to vascular changes. Impaired postural control and balance impairments in post-stroke patients are associated with a high risk of falls among stroke patients. The perturbation-based balance training is mainly used in older adults and balance impairment. Virtual reality (VR) as a novel technology is rapidly becoming a popular intervention for improving balance. VR can visualize computer-generated environments with a full field of view through Head-mounted displays (HMD-VR). This study was conducted to assess and investigate the effect of balance exercises with smartphone-based virtual reality programs on balance in stroke patients. Methods: This was a randomized single-group pre and post-test study design. 30 subjects met the inclusion criteria and were enrolled, assigned, and received intervention. Subjects were given perturbation-based balance exercises and smartphone-based virtual reality along with conventional physiotherapy. The intervention protocol was for 6 days/week for 4 weeks period. Results: Following 4 weeks of intervention showed improvement in postural control and balance which was assessed using BBS, TUG, VR BESS, BESTest, and SIS 3.0. Paired t-test was used to differentiate the mean significance. The mean pre to post-intervention difference is 12.6 with a p - value < 0.05. TUG score improved from pre to post-intervention difference is 1.443 with a p - value < 0.05. VR BESS score improved from pre to post-intervention difference is 10.266 with a p value < 0.05. The mean BESTest pre to post-intervention difference is 11.467 with a p - value < 0.05. SIS 3.0 score improved from a pre to post-intervention difference is 20.33 with p - value < 0.05. The result of this study showed a highly significant difference in pre and post-treatment. Conclusion: The study concludes that perturbation-based balance exercises with smartphone-based virtual reality programs are a useful adjunct to improving balance in stroke patients along with conventional physiotherapy.

A Systematic Review of the Long-Term Effects of Using Smartphone- and Tablet-Based Rehabilitation Technology for Balance and Gait Training and Exercise Programs.

Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or more), this systematic review summarizes the effects of smartphone- or tablet-based rehabilitation technology on balance and gait exercise and training in balance and gait disorders. The review examined studies written in English published from 2013 to 2023 in Web of Science, Pubmed, Scopus, and Google Scholar. Of the 806 studies identified, 14 were selected, and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was applied to evaluate methodological quality. The systematic review concluded that all 14 studies found balance and gait performance improvement after four weeks or more of balance and gait telerehabilitation. Ten of the 14 studies found that carry-over effects (improved functional movements, muscle strength, motor capacity, cognition, and reduced fear of falling and anxiety levels) were maintained for weeks to months. The results of the systematic review have positive technical and clinical implications for the next-generation design of rehabilitation technology in balance and gait training and exercise programs.

Development of an Elliptical Perturbation System that provides unexpected perturbations during elliptical walking (the EPES system)

Background‘Perturbation-based balance training’ (PBBT) is a training method that was developed to improve balance reactive responses to unexpected balance loss. This training method is more effective in reducing fall rates than traditional balance training methods. Many PBBTs are performed during standing or treadmill walking which targeted specifically step reactive responses, we however, aimed to develop and build a mechatronic system that can provide unexpected perturbation during elliptical walking the Elliptical Perturbation System (the EPES system), with the aim of improving specifically the trunk and upper limbs balance reactive control.MethodsThis paper describes the development, and building of the EPES system, using a stationary Elliptical Exercise device, which allows training of trunk and upper limbs balance reactive responses in older adults.ResultsThe EPES system provides 3-dimensional small, controlled, and unpredictable sudden perturbations during stationary elliptical walking. We developed software that can identify a trainee’s trunk and arms reactive balance responses using a stereo camera. After identifying an effective trunk and arms reactive balance response, the software controls the EPES system motors to return the system to its horizontal baseline position after the perturbation. The system thus provides closed-loop feedback for a person’s counterbalancing trunk and arm responses, helping to implement implicit motor learning for the trainee. The pilot results show that the EPES software can successfully identify balance reactive responses among participants who are exposed to a sudden unexpected perturbation during elliptical walking on the EPES system.ConclusionsEPES trigger reactive balance responses involving counter-rotation action of body segments and simultaneously evoke arms, and trunk reactive response, thus reactive training effects should be expected.

Dual-Branch Fourier-Mixing Transformer Network for Hyperspectral Target Detection

In recent years, transformers have shown great potential in hyperspectral image processing and have also been gradually applied in hyperspectral target detection (HTD). Nonetheless, applying a typical transformer to HTD remains challenging. The heavy computation burden of the multi-head self-attention (MSA) in transformers limits its efficient HTD, while the limited ability to extract local spectral features can reduce the discrimination of the learned spectral features. To further explore the potential of transformers for HTD, for balance of representation ability and computational efficiency, we propose a dual-branch Fourier-mixing transformer network for hyperspectral target detection (DBFTTD). First, this work explores a dual-branch Fourier-mixing transformer network. The transformer-style network replaces the MSA sublayer in the transformer with a Fourier-mixing sublayer, which shows advantages in improving computational efficiency and learning valuable spectral information effectively for HTD. Second, this work proposes learnable filter ensembles in the Fourier domain that are inspired by ensemble learning to improve detection performance. Third, a simple but efficient dropout strategy is proposed for data augmentation. Sufficient and balanced training samples are constructed for training the dual-branch network, and training samples for balanced learning can further improve detection performance. Experiments on four data sets indicate that our proposed detector is superior to the state-of-the-art detectors.

External mechanical perturbations challenge postural stability in dogs.

This study aimed to explore the effect of external mechanical perturbations on postural stability (PS) in dogs using the body center of pressure (COP). Thirteen sound adult dogs were included in this study. PS was tested during quiet standing on a pressure measurement plate. The conditions included a standard standing measurement and external mechanical perturbations conducted using six settings on a motorized training platform with different intensities of speed and amplitude. Measurement conditions were compared using linear mixed-effects models, followed by multiple comparisons using Sidak's alpha correction procedure. Compared with the standing measurement, external mechanical perturbations resulted in a significant increase in almost all COP parameters, indicating a challenge for the PS. Furthermore, an increase in amplitude had a greater effect than an increase in speed, whereas the combination of the highest intensities of amplitude and speed was not well tolerated by the dogs. The mediolateral COP displacement was significantly greater than the craniocaudal COP displacement during standing measurement and conditions with a small amplitude, whereas no significant difference was observed during settings with an increased amplitude. To the best of our knowledge, this is the first study to demonstrate the effects of a balance training device in dogs. Therefore, the intensity of the training programs on motorized platforms or similar devices can be controlled by the wobbling amplitude of the platform.

The Effects of Fatigue on the Lower Limb Biomechanics of Amateur Athletes during a Y-Balance Test.

The Y-Balance Test (YBT) is a reliable tool for assessing the dynamic balance of athletes' lower limbs. This study aimed to compare the effects of the YBT on lower limb biomechanics before and after fatigue. Sixteen adult male recreational athletes were recruited for the study, and motion capture in combination with a force plate was used to collect kinematic, dynamics, and center of pressure (COP) data of the dominant leg during YBT testing before and after fatigue. Based on the research findings, there were significant statistical differences in the distances reached during the YBT in three directions before and after fatigue. After fatigue, there is a significant decrease in the ROM of the hip and knee joints in all three directions. Also, there is a significant increase in hip joint torque in the anterior- and posterior-lateral directions, while a significant decrease in hip and ankle joint torque is observed in the posterior-medial direction. Moreover, there is an increasing trend in positive and negative joint work for the hip, knee, and ankle joints in all three directions after fatigue. The range of COP displacement also increases following fatigue. The decline in YBT scores demonstrates the detrimental impact of fatigue on the dynamic balance of the lower limbs of adult male amateur athletes. We hope that these results can provide information for athletes and coaches to better understand the effects of fatigue on the dynamic balance of lower limbs, so as to carry out targeted lower limb balance training and prevent sports injuries.

Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty

BackgroundTo investigate the effect of preoperative high-intensity strength training combined with balance training on the knee function of end-stage knee osteoarthritis (KOA) patients after total knee arthroplasty (TKA).MethodsA prospective study was conducted on end-stage KOA patients awaiting TKA. The patients were divided into an experimental group and a control group according to whether they received a preoperative training intervention. The differences in knee flexor–extensor strength, knee range of motion (ROM), timed up and go (TUG) test result, stair ascend/descend test result, Knee Society score (KSS) and Berg balance scale (BBS) score were assessed in both groups at baseline (T1), before operation (T2), 3 months after operation (T3), and 1 year after operation (T4).ResultsAfter high-intensity strength training and balance training, the knee flexor–extensor strength, TUG test result, stair ascend/descend test result, and KSS were all significantly improved at T2 in the experimental group over the control group. At T3, the knee ROM, knee flexor–extensor strength, TUG test result, BBS score, and KSS clinical and functional scores were all significantly superior in the experimental group. The experimental group enjoyed a superiority in KSS clinical and functional scores until T4. Group × time and between-group interactions were found in all assessment indicators in both groups (p < 0.01).ConclusionPreoperative high-intensity strength training combined with balance training can enhance the knee flexor–extensor strength and balance of patients with end-stage KOA in the short term and help improve early outcomes after KOA.Trial registration ChiCTR2000032857, 2020-05-13.

Margins of postural stability in Parkinson's disease: an application of control theory.

Introduction: Postural instability is a restrictive feature in Parkinson's disease (PD), usually assessed by clinical or laboratory tests. However, the exact quantification of postural stability, using stability theorems that take into account human dynamics, is still lacking. We investigated the feasibility of control theory and the Nyquist stability criterion-gain margin (GM) and phase margin (PM)-in discriminating postural instability in PD, as well as the effects of a balance-training program. Methods: Center-of-pressure (COP) data of 40 PD patients before and after a 4-week balance-training program, and 20 healthy control subjects (HCs) (Study1) as well as COP data of 20 other PD patients at four time points during a 6-week balance-training program (Study2), collected in two earlier studies, were used. COP was recorded in four tasks, two on a rigid surface and two on foam, both with eyes open and eyes closed. A postural control model (an inverted pendulum with a Proportional-integral-derivative (PID) controller and time delay) was fitted to the COP data to subject-specifically identify the model parameters thereby calculating |GM| and PM for each subject in each task. Results: PD patients had a smaller margin of stability (|GM| and PM) compared with HCs. Particularly, patients, unlike HCs, showed a drastic drop in PM on foam. Clinical outcomes and margins of stability improved in patients after balance training. |GM| improved early in week 4, followed by a plateau during the rest of the training. In contrast, PM improved late (week 6) in a relatively continuous-progression form. Conclusion: Using fundamental stability theorems is a promising technique for the standardized quantification of postural stability in various tasks.

S9-3 Keep up -groups support fall prevention

Abstract Purpose In Finland one third of home dwelling older adults 70+ fall at least once a year. Falling causes injuries and suffering. The cost of one hip fracture is about 30 000 € on the first treatment year. Balance and functional training is effective in preventing falls. Half of hip fractures can be prevented by exercising. Project or policy description Development: Age Institute is a partner in Age-friendly South Karelia project coordinated by Wellbeing Services County of South Karelia. The project acts through a network with municipalities, NGO’s, congregations, and older people councils. Preventing falls became an important goal of project since the number of hip fractures was increasing and higher than the average in Finland. Several actions were developed: educating professionals, giving information to older people, and improving exercise groups. Implementation ‘Keep up’ exercise group for older adults with increased risk of falling was implemented in every municipality (9) of the county. The risk of falling was assessed using a screening questionnaire in health care centers or in events, where participants with high scores were guided to the groups. Municipal sport sector organized the strength and balance training group once a week. The participants were encouraged to do home exercise weekly. The groups also included discussion and tasks about falls prevention. Themes were e.g. nutrition, fear of falling, medication and safe environment. Age Institute made the material for the group. Evaluation SPPB test was made in the beginning and in the end of the 10 weeks training period. Majority of participants improved their physical performance. According to a questionnaire the participants perceived mostly good or strong benefits. Especially mood, strength, and knowledge of preventing falls improved. After the training period the participants were guided to continue exercising. Dissemination The municipalities continue to organize Keep up groups. The good practice will be disseminated to other municipalities and counties involved in Strength in Old Age Programme. Conclusions With multisectoral co-operation you can find older adults with increased risk of falling and guide them to exercise group. Strength and balance training combined with getting more knowledge is a feasible good practice.

Exercise as an add-on treatment in individuals with schizophrenia: Results from a large multicenter randomized controlled trial

Current treatment methods do not achieve recovery for most individuals with schizophrenia, and symptoms such as negative symptoms and cognitive deficits often persist. Aerobic endurance training has been suggested as a potential add-on treatment targeting both physical and mental health. We performed a large-scale multicenter, rater-blind, parallel-group randomized controlled clinical trial in individuals with stable schizophrenia. Participants underwent a professionally supervised six-month training comprising either aerobic endurance training (AET) or flexibility, strengthening, and balance training (FSBT, control group), follow-up was another six months. The primary endpoint was all-cause discontinuation (ACD); secondary endpoints included effects on psychopathology, cognition, functioning, and cardiovascular risk.In total, 180 participants were randomized. AET was not superior to FSBT in ACD and most secondary outcomes, with dropout rates of 59.55% and 57.14% in the six-month active phase, respectively. However, both groups showed significant improvements in positive, general, and total symptoms, levels of functioning and in cognitive performance. A higher training frequency additionally promoted further memory domains. Participants with higher baseline cognitive abilities were more likely to respond to the interventions.Our results support integrating exercise into schizophrenia treatment, while future studies should aim to develop personalized training recommendations to maximize exercise-induced benefits.

CA-discharge: Geo-Located Discharge Time Series for Mountainous Rivers in Central Asia

We present a collection of 295 gauge locations in mountainous Central Asia with norm discharge as well as time series of river discharge from 135 of these locations collected from hydrological yearbooks in Central Asia. Time series have monthly, 10-day and daily temporal resolution and are available for different duration. A collection of third-party data allows basin characterization for all gauges. The time series data is validated using standard quality checks. Norm discharge is validated against literature values and by using a water balance approach. The novelty of the data consists in the combination of discharge time series and gauge locations for mountainous rivers in Central Asia which is not available anywhere else. The geo-located discharge time series can be used for water balance modelling and training of forecast models for river runoff in mountainous Central Asia.

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps.

People living with Parkinson's disease (PD) have a high risk for falls. To examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults. A Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention. A recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi-domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels. Effective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.

Occupational Therapy Practice Guidelines for Adults With Stroke.

Stroke is a leading cause of disability. Occupational therapy practitioners ensure maximum participation and performance in valued occupations for stroke survivors and their caregivers. These Practice Guidelines are meant to support occupational therapy practitioners' clinical decision making when working with people after stroke and their caregivers. Clinical recommendations were reviewed from three systematic review questions on interventions to improve performance and participation in daily activities and occupations and from one question on maintaining the caregiving role for caregivers of people after stroke. The systematic reviews included 168 studies, 24 Level 1a, 90 Level 1b, and 54 Level 2b. These studies were used as the basis for the clinical recommendations in these Practice Guidelines and have strong or moderate supporting evidence. Interventions with strong strength of evidence for improving performance in activities of daily living and functional mobility include mirror therapy, task-oriented training, mental imagery, balance training, self-management strategies, and a multidisciplinary three-stages-of-care rehabilitation program. Constraint-induced therapy has strong strength of evidence for improving performance of instrumental activities of daily living. Moderate strength of evidence supported cognitive-behavioral therapy (CBT) to address balance self-efficacy, long-term group intervention to improve mobility in the community, and a wearable upper extremity sensory device paired with training games in inpatient rehabilitation to improve social participation. Practitioners should incorporate problem-solving therapy in combination with CBT or with education and a family support organizer program. What This Article Adds: These Practice Guidelines provide a summary of strong and moderate evidence for effective interventions for people with stroke and for their caregivers.

The comparative effect of exercise interventions on balance in perimenopausal and early postmenopausal women: A systematic review and network meta-analysis of randomised, controlled trials.

In addition to a range of physiological and psychological symptoms, menopause causes a decrement to balance performance and risk of falls. This review aimed to determine the effects of exercise interventions on balance in perimenopausal and early postmenopausal women. Web of Science, PubMed, CINAHL, SPORTDiscus and Cochrane Central Register of Controlled Trials databases were searched. Randomised, controlled trials of exercise interventions in perimenopausal or early postmenopausal populations with an average age of 65years or younger reporting balance measures were included. Risk of bias was assessed using Cochrane RoB 2. A random effects model network meta-analysis was performed to assess the effect of exercise on balance. Standardised mean differences with 95% confidence intervals were used as the measure of effect. Twenty-six studies were included after screening. Network meta-analyses were conducted for 5 balance variables. Whole-body vibration (standardised mean difference: 2.25, confidence interval: 0.08; 4.43), balance (standardised mean difference: 1.84, confidence interval: 0.15; 3.53), balance + nutrition (standardised mean difference: 3.81, confidence interval: 1.57; 6.05) and resistance (standardised mean difference: 1.43, confidence interval: 0.41; 2.46) exercise improved Berg balance scale performance. Resistance + aerobic + balance exercise improved one-leg stance (standardised mean difference: 0.80, confidence interval: 0.39; 1.22) and whole-body vibration improved anterior-posterior (standardised mean difference: -0.89, confidence interval: -1.48; -0.31), medio-lateral (standardised mean difference: -0.58, confidence interval: -1.15; -0.01) postural sway and falls indices (standardised mean difference: -0.75, confidence interval: -1.45; -0.04). Exercise improved all balance measures and should be considered as an adjunct therapy in perimenopausal and postmenopausal women. Whole-body vibration was most frequently the highest ranked intervention; resistance and balance training also improved balance.

Effects of virtual balance training and conservative rehabilitation on balance in chronic stroke patients

Objective: This study aimed to test the comparative efficacy of virtual balance training (VBT) and conservative rehabilitation (CR) relative to CR alone on balance in chronic stroke patients. Methods: Thirty patients with chronic stroke (&gt;6-months post-stroke) were allocated into 2 groups (n=15) as Group CR and Group VBT. CR was performed for 60 min, 4 times a week, for 8 weeks in both groups. VBT was applied for 20 min, 4 times a week, for 8 weeks along with the CR, in Group VBT. Brunnstrom motor recovery (BMR) stage, spasticity degrees, Functional Ambulation Scale (FAS), Short Form-36 (SF-36) scale, Berg Balance Scale (BBS) in both groups were assessed before and after treatment. Mann-Whitney U, Wilcoxon signed rank tests were used to evaluate BBS data (p&lt;0.05). Results: Although, no significant difference was observed between groups in terms of BBS scores, BMR stages, FAS scores, SF-36 scale scores, and spasticity degrees before and after treatment; significant improvements were observed in BBS scores, BMR stages, and FAS scores after treatment in both groups (p&lt;0.05). Comparing the SF-36 subscale scores before and after treatment, significant differences were noted in emotional role limitation scores for Group VBT (p=0.03) and in pain scores for Group CR (p=0.01). Conclusion: VBT along with the CR in chronic stroke patients was not superior to the CR alone, in terms of improving balance, motor recovery, ambulation level, and quality of life.

Post-Doc Competition (Knowledge Generation) ID 1985177

Background Heart Disease is the leading cause of death after spinal cord injury (SCI). Individuals with paraplegia develop hypertension and elevated arterial stiffness prior to their age matched peers. Overground exoskeleton training is becoming an increasingly prevalent form of exercise. In the general population, exercise training has been shown to reduce arterial stiffness. Recent RCT failed to show changes in arterial stiffness with arm ergometry or body weight supported treadmill training. Objectives The aim of this project is to determine the effect of Exoskeleton Exercise on changing arterial stiffness. Study Design The study setting will take place at a rehabilitation facility. The study will involve 34 sessions over the span of approximately 18-20 weeks. The key intervention utilized in the investigation will be an Overground EksoNR gait and balance training program. The primary outcome measure will be carotid-femoral pulse wave velocity (cfPWV) and secondary measures will include heart rate (HR), blood pressure (BP), waist circumference (WC), and oxygen saturation (SpO2). Statistical Analysis will involve mean changes at baseline, midway, and end of study. Methods The 34-session (2x/week for ∼18 weeks) rehabilitation protocol will focus on using the EksoNR for overground gait and balance activities. For measurement of cfPWV, two transcutaneous Doppler flowmeters will be used at the common carotid and femoral artery. To calculate cfPWV, the distance travelled by the pulse is divided by the average pulse transit time (PTT). Hypothesis The 18-week Exoskeleton Program would improve arterial stiffness (cfPWV) in individuals with chronic incomplete SCI/D.

Feasibility, effectiveness and acceptability of two perturbation-based treadmill training protocols to improve reactive balance in fall-prone older adults (FEATURE): protocol for a pilot randomised controlled trial

IntroductionPerturbation-based balance training (PBT) targets the mechanism of falls (eg, slipping, tripping) to specifically train the recovery actions needed to avoid a fall. This task-specific training has shown great promise...