An accelerometer-based device (postural sway-meter) is increasingly used for balance assessment, training, and fall prevention. However, limited information exists regarding its immediate effect on physical and cognitive performance, especially among middle-aged and older adults. This study aims to investigate the immediate effects of a balance training program using a postural sway-meter on balance, functional, and cognitive performance in adults over 50 years. This experimental study involved 72 participants aged 50 years and over, randomly assigned to either the intervention or control group. The intervention group underwent a 30-minute balance training session using the sway-meter with sound feedback (set at 75% of the stability limits at baseline). The control group participated in a 30-minute fall prevention knowledge session. The sway-meter measured balance during quiet stance and leaning. Functional performance was assessed using the multi-dimensional reach test (MDRT). Cognitive performance was evaluated through Trail Making Tests (TMT) A & B, as well as hand/foot reaction time assessments. Between-group comparisons at post-intervention showed no significant differences in balance, functional, and cognitive performance outcomes. Within-group analysis revealed a significant decrease in maximum reaching distance in the forward direction (MDRT) (p = 0.032, d = 0.31, 95% CI [-0.15, 0.78]) and the time to complete TMT-B (p = 0.036, d = 0.24, 95% CI [-0.22, 0.71]) in the intervention group. The control group showed a significant increase in COM angle sway excursion (lateral direction) (p = 0.011, d = 0.27, 95% CI [-0.19, 0.74]) and a decrease in TMT-A time (p = 0.031, d = 0.38, 95% CI [-0.09, 0.85]). Both groups significantly reduced hand reaction time (intervention: p = 0.036, d = 0.24, 95% CI [-0.22, 0.70]; control: p = 0.034, d = 0.20, 95% CI [-0.26, 0.66]) at post-intervention assessment. The findings of this study suggest that a single 30-minute balance training session using a postural sway-meter, delivered by a physiotherapist, is not only feasible and safe for community-dwelling older adults but also has the potential to significantly improve balance and cognitive outcomes. Enhancing the training program by increasing the amount of leaning and duration could further amplify these benefits, underscoring the need for a more robust training regimen.
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