Fall Risk Index Research Articles

Determining the Relationship Between Frailty and Fall Risk in Elderly People Living in Nursing Homes

Objective: The study aimed to determine the relationship between the level of frailty and the risk of falls in the elderly living in nursing homes and to draw attention to this issue. Method: The cross-sectional and descriptive study was conducted in two state-owned nursing homes in Adana between January 2, 2023, and January 15, 2023. The study was conducted by face-to-face interviews with a total of 220 elderly people who met the research criteria and agreed to participate in the study. Data were collected using the Personal Information Form, Itaki Fall Risk Index, and Edmonton Frailty Scale. Results: 63,6% of the participants were women, and the average age was 76±8 (min=60, max=98). Female gender (58,3%), normal BMI (54,9%), lack of regular exercise (85,4%), presence of chronic disease (55,6%), use of assistive devices (85,6%), history of falling A statistically significant relationship was found between (63,9%) and hospitalization history (61,1%) and fall risk level (p<0.05). Normal BMI (60%), lack of regular exercise (70%), presence of chronic disease (70%), number of medications used 1-3 (55%), use of assistive devices (97,5%), history of falling (100%), a statistically significant relationship was found between the history of hospitalization (72,5%) and the risk level of severe frailty (p<0,05). A statistically significant relationship was found between frailty level and fall risk (p = 0,00). Conclusion: Elderly people with moderate and severe frailty were found to be at high risk of falls.

Evaluation of Fall Risk in Hemodialysis Patients within the Scope of Quality Improvements: A Comparison of Two Assessment Scales

Introduction: Patient falls are one of the most important quality indicators in healthcare. Aim: It was aimed to compare two tools used to evaluate fall risk in hemodialysis patients. Method: The mean age of the patients was 58.72 ± 14.49 years and 62% were male. The mean duration of treatment was 4.98 ± 4.71 years. Within the last year, 33% of the patients had a history of falling. The patients' fall risk was assessed using the Itaki Fall Risk Scale and Dialysis Fall Risk Index. The relationship between patients' age, gender, duration of hemodialysis treatment, and the status of having a chronic disease and falls were examined. Results: According to the Itaki Scale, 57% were in the ''high-risk'' group. According to the Dialysis Fall Risk Index, 64% were in the "very high risk" group. The mean Itaki Fall Risk Scale score was 4.75 ± 3.92, and the mean of the Dialysis Fall Risk Index was 7.59 ± 1.92. According to the cut-of score, the sensitivity and specifiity of the Itaki Fall Risk Scale were 97% and 99.6%, and the Dialysis Fall Risk Index was 93.9% and 99.6%. The positive and negative predictive value were 56.1% and 97.7%, respectively for the Itaki Fall Risk Scale. These points were 51.6% and 100% for the Dialysis Fall Risk Index. Conclusion: Both scales were effctive in improving care quality in hemodialysis centers. Itaki Scale may be preferred due to its ease of use and patient compliance.

The Effect of Cochlear Implant Stimulation on Postural Control.

There are contradictory reports on the effect of cochlear implantation on postural control. Associated vestibular loss, electrode insertion trauma, and electrical stimulus of a cochlear implant can influence postural control. This study focused on the electrical stimulation of the cochlea. We aimed to examine whether a cochlear implant's electrical stimulation affects postural control measured by posturography. Thirty-three patients with unilateral cochlear implants were included. We used three preprogrammed main tests and their nine subtests in posturography. Postural stability [general stability index (GSI)], fall risk index (FRI), and sensory integration [modified clinical test of sensory integration of balance (m-CTSIB)] were calculated. All tests were performed under three conditions: implant off (1), implant on (2), and implant on music (3). The mean age was 46.29±16.09 years. GSI was above normal limits in 78% of adult cochlear implant users. We found that FRI was high in 30% of patients, and m-CTSIB was defective in 42%. There were no statistically significant differences in GSI, FRI, and m-CTSIB. Cochlear implant stimulation was found to have positively affected postural control when the subject's data were visualized individually. GSI, FRI, and m-CTSIB dropped to 39%, 24%, and 24%, respectively, when music was on. There was a significant correlation between age and fall index. But this correlation disappeared when music was playing. Cochlear implant stimulation affected the vestibular system in almost all patients. The effect was positive in most patients.

Effect of adding systematic desensitization to goal-directed paradigm on risk of falling in patients with stroke: a randomized controlled trial.

Improvement in rehabilitation outcomes for patients suffering from chronic stroke can be attained through systematic desensitization of their fear of falling, which in turn reduces the risk of falling. This study aimed to examine the effect of adding systematic desensitization to a goal-directed paradigm on functional performance, balance, risk of falling, and fear of falling among chronic ischemic stroke patients. Two equally sized groups, each comprising 40 stroke patients of both sexes, were randomly divided. For 8 weeks, Group A received three sessions per week of combined treatment consisting of systematic desensitization and a goal-directed paradigm, while Group B received only the goal-directed paradigm. The Timed Up and Go (TUG) test and Dynamic Gait Index (DGI) were used to assess function performance; the Berg Balance Scale (BBS) and the Biodex Fall Risk Index (FRI) were used to evaluate balance; and the 16-item Fall Efficacy Scale-International (FES-I) was used to evaluate fear of falling. At baseline and after the treatment, all measurements were obtained. Both groups (A and B) revealed a substantial increase in functional performance through a decrease in TUG scores and an increase in DGI. Additionally, there was a decrease in the risk of falling through an increase in the BBS scores and a decrease in the FRI. Furthermore, there was a decrease in the fear of falling, as measured using the FES-I, after treatment, with superior improvement in Group A with a p-value of <0.001. Systematic desensitization combined with a goal-directed paradigm has a superior effect on improving functional performance and reducing the risk of falling and the fear of falling in patients with stroke compared to a goal-directed paradigm alone.

The Impact of Resistance Training on Equilibrium Abilities and Quality of Life in Older Adults after SARS-CoV-2 Survival.

Background: The scientific literature on COVID-19 and its long-term impacts on all-body systems and their treatments is still limited. The aim of the study was to create a safe protocol-based intervention to improve functional and equilibrium abilities in older adults impacted by COVID-19. Methods: This study used a sample of 46 people (intervention group: n = 26; control group: n = 20). Resistance training (RT) was held twice a week, with 60 min per session for 8 weeks. The postural stability and quality of life questionnaire (WHQOOL) was completed during pre- and post-testing. Results: The results indicated significant differences in overall stability index (OSI) with eyes open (EO), anterior-posterior stability index (APSI) EO, fall-risk index 6-2 (FRI6-2) values in males (p < 0.05), and APSI EO (p < 0.05) values in females compared to control groups, respectively. In the training, a significant improvement was reported in OSI EO and APSI EO (p < 0.05) female groups compared to baseline results and in FRI6-2 values in both gender groups (p < 0.01-men, p < 0.05-women). The effect of the intervention was recorded in the intervention group in the OSI EO (Z = -3.12, p < 0.01, R = 0.533) and FRI6-2 (Z = -2.06, p < 0.05, R = 0.354). Additionally, significantly different reactions between the groups were observed in the psychological domain (DOM2) (Z = 2.194, p < 0.028, R = 0.389), social relationship domain (DOM3) (Z = 2.051, p < 0.0403, R = 0.361), and in question 2 concerning general health (Z = 3.309, p < 0.0009, R = 0.535). Conclusions: The findings indicate that RT had a positive effect on older adults affected by COVID-19, led to a significant improvement in their postural stability, and had a significant impact on elements of psychological well-being and quality of life.

Association between advanced glycation end-products and fall risk in older adults: The Yakumo Study.

Advanced glycation end-products (AGEs) are irreversibly and heterogeneously formed compounds during the non-enzymatic modification of macromolecules, such as proteins. Aging and lifestyle habits, such as high-fat and high-protein diets, and smoking, promote AGEs accumulation. This study aimed to investigate the relationship between fall risk and AGEs in community-dwelling older adults. This cross-sectional study included patients from the 2022 Yakumo Study who were evaluated for fall risk index 5-items version, locomotive syndrome stage and AGEs. AGEs were evaluated using Skin autofluorescence (SAF) measured by the AGE reader (DiagnOptics Technologies BV, Groningen, the Netherlands). We divided the participants into two groups according to the presence or absence of fall risk (fall risk index 5-items version ≥6 or not), and investigated the factors associated with fall risk. The fall risk group had a higher age and SAF, and a higher proportion of locomotive syndrome stage >2 than the without fall risk group in patients aged ≥65 years (P < 0.01). The multivariate logistic regression analysis after adjustment of age, sex and body mass index showed that locomotive syndrome stage ≥2 and SAF were independent associators of fall risk in older adults (odds ratio 3.26, P < 0.01, odds ratio 2.96, P < 0.05, respectively). The optimal cutoff value of the SAF for fall risk was 2.4 (area under the curve 0.631; 95% CI 0.53-0.733; sensitivity 0.415; specificity 0.814; P < 0.05). The accumulation of AGEs in skin tissues can be used to screen for fall risk comprehensively. Geriatr Gerontol Int 2024; 24: 517-522.

Correlation between postural stability and fall risk in trans-femoral amputees due to muscle fatigue.

[Purpose] This study aimed to establish a connection between postural stability and falling in individuals with transfemoral amputation (TFA), particularly with muscle fatigue. [Participants and Methods] Fourteen participants were recruited. Muscle fatigue was induced using a sit-to-stand (STS) fatigue protocol. Pre-fatigue and post-fatigue assessments were conducted using the Biodex Balance System (BBS). [Result] The findings of the study revealed significant increases in the postural stability index between the pre-fatigue and post-fatigue conditions for the TFA group, particularly in the overall stability index (OSI) and anterior-posterior stability index (APSI) components. The mean postural stability index scores for the TFA group exhibited a percentage increase of 65.2% for OSI, 52.7% for APSI, and 50% for medial-lateral stability index (MLSI). Furthermore, the TFA fall risk index surged by 61.4%. Regarding the relationships observed, a significant correlation emerged between fall risk and both OSI and APSI. [Conclusion] These findings underscore the impact of muscle fatigue on postural stability and an increase in fall risk among TFA. By mitigating the effects of muscle fatigue, therapists can play an important role in reducing the risk of falls and promoting better postural stability in this population.

Evaluation of Balance and Muscle Strength of Upper and Lower Limbs in Rock Climbers

Abstract Introduction. The purpose of this study was to evaluate the effects of bouldering on upper and lower limb muscle strength and body balance. Material and Methods. The study group consisted of 22 climbers (aged 27.23 ± 4.81) with at least 2 years of bouldering experience, while the control group consisted of 20 men (aged 23.10 ± 5.28) not practicing rock climbing. The study received approval from the local bioethical commission in Poland. Static and dynamic stabilographic parameters were measured with eyes open (EO) and closed (EC) on the Biodex Balance System SD USA (BBS) platform. Subsequently, the maximum muscle torques of the elbow, hip, knee and ankle joints were measured in isometric conditions. Hand-grip strength (HGS) with and without the thumb was assessed using a handheld dynamometer. Results. Climbers achieved significantly higher values of HGS with the thumb of both hands (p &lt; 0.005), foot extensors strength (FES) in both limbs (p &lt; 0.05) and left hip extensors (HES L) (p &lt; 0.05). They also achieved significantly lower values of all stabilographic parameters, indicating better balance compared to the control group (p &lt; 0.05). An interaction of HES x SIDE across the groups was observed (F(1,40) = 13.588, p &lt; 0.001 η2 = 0.254). Moreover, there was a statistically significant negative correlation of ankle extensors strength with medial-lateral stability index (MLSI EC) (right: r = -0.418; left: r = -0.331) and fall risk index (FRI6-2) (right: r = -0.520; left: r = -0.435). Conclusions. Regular climbing training develops muscle strength, especially FES, HES, HGS, and improves balance. Climbing can be used for prevention of muscle weakness and equilibrium disorders.

Correlation Of Medial Longitudinal Arch Height With Postural Stability, Sensory Integration, Balance And Fall Risk Among Healthy Young Adults.

A cross-sectional analytical study was conducted on 165 healthy young adults. With pes rectus and pes planus to correlate the medial longitudinal arch height with postural stability, sensory integration of balance and fall risk. Persons with pes cavus, congenital foot anomalies other than pes planus, leg length discrepancies, recent history of trauma, lower limb amputations, history of serious foot injury, ligamentous laxity, or an active inflammatory disorder were excluded. Outcome measurements included normalised truncated navicular height (NTNH), Chippaux Smirak index (CSI), athletic single leg stability (ASLS) index, fall risk (FR) index, postural stability (PS), clinical test of sensory integration of balance (CTSIB), and balance error scoring system (BESS). Spearman correlation and Mann Whitney U test were used for data analysis. CSI and NTNH were noted to have no significant correlation (p<0.05) with PS, FR, CTSIB, ASLS and BESS among healthy young adults. Males were observed to have poorer balance and fall risk as compared to females.

Hubungan Indeks Massa Tubuh (IMT) Dengan Resiko Jatuh Pada Lansia Di Desa Tegalsiwalan Kecamatan Tegalsiwalan Kabupaten Probolinggo

&#x0D; &#x0D; &#x0D; &#x0D; Elderly is someone who is experiencing the final stage in the development of human life. The risk of falling is one of the problems caused by intrinsic and extrinsic factors. This study aims to analyze the factors that cause the risk of falls in the elderly. This study uses a correlational analytic study design with a cross sectional approach. The population 130 and the sample 98 elderly respondents at risk of falling in Tegalsiwalan Village, Tegalsiwalan who met the inclusion and exclusion criteria, they were taken by purposive sampling. The instruments used were BB and TB observation sheets, Bivariate test data using spearman rank. The results showed that the risk of falling low category was 41 ederly (41,8%), the risk of falling in the medium category was 8 ederly (9,2%), the risk of falling in the high category was 48 ederly (49,0%). Ederly with thin BMI are 32 ederly (32,7%), ederly with normal BMI are 11 ederly (11,2%) and ederly with fat BMI are 48 ederly (49,0%). The results of the relationship between fall risk and Body mass Index (BMI) OR = 0.389 with a significant value of &lt;0.05 BMI, so it can be stated that H1 is accepted, meaning that there is a relationship between the risk of falling and BMI. The higher the BMI, there will be a buildup of changes in the center of mass of the body, therefore it will have an impact on the risk of falling. It is hoped that the elderly will pay more attention to the impact of the risk of falling.&#x0D; &#x0D; &#x0D; &#x0D;

Fall risk in patient with dysplastic hip osteoarthritis.

Patients with dysplastic hip osteo arthritis (DHOA) often have a spinopelvic imbalance, and they are more likely to experience falls. This study aimed to evaluate the risk factors for falls in patients with DHOA, including spinopelvic parameters. In this cross-sectional study, a total of 103 patients with DHOA were included from 2019 to 2021. Fall risk was evaluated using the Fall Risk Index 5 items version (FRI-5). Demographics, functional outcomes, and spinopelvic parameters were compared between the high-risk group (FRI-5 ≥ 6) and the low-risk group (FRI-5 < 6). Multivariate analysis was performed using factors with significant differences in univariate analysis. High-risk and low-risk groups comprised 54 and 49 patients, respectively. Females were significantly more common in the high-risk group than in the low-risk group. The Harris Hip Score was significantly lower in the high-risk group than in the low-risk group (p = 0.02). Pelvic incidence, tilt, and obliquity were significantly higher in the high-risk group than in the low-risk group (p < 0.01). In multivariate analysis, female sex (odds ratio [OR]: 3.76, 95% confidence interval [CI]: 1.11-12.64, p = 0.03), pelvic obliquity (OR: 1.36, 95% CI: 1.09-1.71, p < 0.01), and Harris hip score (OR: 0.96, 95% CI: 0.93-0.99, p = 0.02) were identified as risk factors. Female sex, pelvic obliquity, and low Harris hip score were associated with an increased risk of falls among patients with DHOA.

Falls during oxaliplatin-based chemotherapy for gastrointestinal malignancies - (lessons learned from) a prospective study.

This prospective cohort study aimed to characterise the impact of oxaliplatin-based chemotherapy and its neurotoxic side effects (i.e., chemotherapy-induced neuropathy) on functional fall-risk and falls. Twenty chemotherapy-naïve participants (mean age, 59 years; 16 males) were consecutively included. A multimodal fall risk assessment was performed at four time points within 6 months. Polyneuropathy was assessed using the Neurologic Disability Scale; the fall risk was assessed by functional tests (Tinetti Test, Chair-Rising Test, and Timed up and Go Test). Patient-reported outcomes comprised the Hospitality Anxiety and Depression Scale (HADS), the Falls Efficacy Scale - International (FES-I) to assess the fear of falling, and the Physical Activity for the Elderly (PASE) questionnaire. Three falls occurred during the study. All fallen participants had a high fall risk-index (≥4 more risk factors) compared to only 30% of the non-fallen participants (p = 0.03) and suffered more frequently from pre-existing mild polyneuropathy (p = 0.049). Study discontinuation (n = 12) was associated with a higher rate of polypharmacy (p = 0.045), anxiety (HADS-A, p = 0.03), and specific fear of falling (FES-I, p = 0.025). In contrast, study completers (n = 8) reported an improvement in physical activity (PASE) (p = 0.018). In summary, pre-existing fall-risk factors impacted more falls than chemotherapy. A fall risk index offers a time-efficient screening option in an outpatient oncological setting.

Testing the reliability of the Downton Fall Risk Index for predicting incident falls in community-dwelling older adults. A prospective population-based study.

Antecedentes: Las caídas accidentales son una de las causas principales de discapacidad y muerte en adultos mayores. Sin embargo, la confiabilidad de los instrumentos diseñados para estimar el riesgo de futuras caídas no se ha establecido adecuadamente a nivel comunitario. Métodos: Partiendo de un estudio transversal previo realizado en adultos mayores residentes en zonas rurales de Ecuador que estimó el riesgo potencial de caídas futuras, realizamos un estudio longitudinal prospectivo para evaluar la confiabilidad del Índice Downton de Riesgo de Caídas de (IDRC) como predictor de caídas incidentes durante tres años de seguimiento. Resultados: De 254 individuos, 158 (62%) experimentaron caídas incidentes. La puntuación media del IDRC inicial fue de 1,6 ± 1,3 puntos. De éstos, 54 (21 %) presentaron mayor riesgo de caídas futuras (puntuación IDRC ≥3 puntos). Cuarenta y siete de los 54 individuos con IDRC positivo tuvieron caídas incidentes en comparación con 111/200 individuos con IDRC negativo (p&lt;0,001). Un modelo de regresión logística ajustado encontró que las personas con un IDRC positivo tenían un aumento cinco veces mayor de caídas incidentes en comparación con aquellos que tuvieron un IDRC negativo (OR: 4,91; 95% I.C.: 1,94 – 12,4). El análisis ROC mostró un área bajo la curva de 0,612 (95% C.I.: 0,568 – 0,657) para un IDRC positivo para predecir caídas incidentes. Sin embargo, el área bajo la curva para el valor predictivo de caídas incidentes dado un historial de caídas previas (como variable única) fue de 0,908 (95% I.C.: 0,875 – 0,942). Conclusiones: El IDRC tiene solamente un valor predictivo moderado para la ocurrencia de caídas futuras y es superado por el valor predictivo de caídas previas.

Evaluation of the implementation and effectiveness of a multifactorial intervention strategy for safe patient handling and movement in the healthcare sector: a study protocol of a cluster randomised controlled trial

IntroductionHealthcare workers with physically demanding work tasks, such as patient handling and movement (PHM), are at high risk of musculoskeletal disorders. To facilitate safe PHM and prevent musculoskeletal disorders, a...

Balance and Fall Risk Assessment in Community-Dwelling Older Adults after Recovery from COVID-19: A Cross-Sectional Study.

SARS-CoV-2 atypical symptoms in older persons include falls, confusion, dizziness, and unusual weariness. Falls and their consequences are among the most prevalent causes of disability among older adults, significantly lowering quality of life and resulting in the loss of independence as well as impaired psychosocial functioning. The study purpose was to examine the impact of the SARS-CoV-2 infectious disease on balance in community-dwelling older adults. Sixty-four older adults aged ≥ 60 years from both sexes, 31 treated for SARS-CoV-2 infection and 33 matched normal controls participated in the study. The Biodex Stability System (BSS) and Berg Balance Scale (BBS) were used for evaluation of balance and fall risk. The correlation between the Biodex overall stability index and the Berg Balance Scale score was investigated. When compared to controls, the SARS-CoV-2 group had significantly higher values of the Biodex overall stability index (OSI) (p = 0.011), anterior-posterior stability index (APSI) (p = 0.013), mediolateral stability index (MLSI) (p = 0.018), and fall risk index (FRI) (p = 0.008), as well as statistically lower scores on the Berg balance scale (p = 0.003). A moderate negative correlation was found between the two assessment tools in the SARS-CoV-2 group. Balance impairment and an increased risk of falling are among the outcomes of SARS-CoV-2 in community-dwelling older adults.

Falling of older adults with cognitive impairment: a new home environment evaluation chart and a preliminary examination in the Wakuya Project.

The purpose of this study was to develop an evaluation method specific to the home environment and examine the effects of environment and cognitive impairment on falls. This was a case-control study analyzing 95 older adults living in the community. A Visiting Checklist for the Home Environment (VICHe) was developed and examined for reliability and validity. Inter-rater reliability (IRR) was examined by determining Cohen's kappa and the intra-class correlation coefficient. Guttman's split-half method was used for internal consistency, and Cronbach's alpha coefficient was obtained. Criterion-related validity was confirmed by Spearman's rank correlation coefficient with the Fall Risk Index's (FRI) total score of the environmental factor items. As a preliminary study, trends in the number of falls by cognitive function and home environment were examined. The VICHe obtained validity, but the IRR was inadequate. In contrast, the version that focused on the on-floor environment (VICHe-OFI) showed IRR for all items and validity through correlations with the FRI. The number of fallers increased in the cognitive impairment group when the home environment was bad. Reliability and validity of the VICHe-OFI were obtained. Preliminary examination using this scale indicates that falls in the home of the elderly may be more affected by the home environment as cognitive function declines.

Machine Learning Techniques Applied to the Development of a Fall Risk Index for Older Adults

Machine Learning Techniques Applied to the Development of a Fall Risk Index for Older Adults

Association between locomotive syndrome and fall risk in the elderly individuals in Japan: The Yakumo study

BackgroundPatients with locomotive syndrome (LS) are poor ambulatory status and a high risk of requiring nursing care. The purpose of this study is to investigate the relationship between LS and fall risk among community-dwelling elderly individuals. MethodsThe subjects were Japanese elderly individuals aged 65 and over who participated in Yakumo study 2019 (N = 189). We defined the fall risk index 5 items version (FRI-5) ≥6 points as the fall risk group. LS was evaluated by stand-up test, two-step test, and 25-Geriatric Locomotive Function Scale (GLFS-25). We divided the subjects into two groups according to the presence or absence of fall risk, and investigated factors associated with fall risk. ResultsThe fall risk group (30 patients, 15.9%) had higher GLSF-25 (P = 0.001). The results of logistic regression analysis adjusted for age, sex, BMI, and knee osteoarthritis revealed that GLFS-25 (OR: 1.052; 95%CI: 1.009–1.097) was independent factor associated with fall risk. In the ROC analysis, the optimal cut-off value of the GLFS-25 to predict fall risk was 12, which is equivalent to LS stage 1 (AUC 0.688; 95% CI: 0.588–0.787; sensitivity: 0.467, specificity: 0.836). ConclusionsGLFS-25 was associated with fall risk among community-dwelling elderly individuals aged 65 and over.

Effects of Chinese fitness dancing on lower limb strength and fall risk in middle-aged and older women: A cross-sectional study.

This study sought to identify the effect of Chinese fitness dancing on lower limb strength and fall risk in middle-aged and older women. The MicroFET3 portable muscle strength tester, the FreeStep test system, and tests to evaluate fall risk were used to measure the maximum muscle strength, fall risk index, and static balance ability of extensor muscle groups in the lower limbs. Compared with the irregular exercise group, the maximum muscle strength of extensor muscle groups in the lower limb, five sit-to-stand test timings, fall risk index, static balance ability, and lower limb flexibility did not improve significantly in the 1-year regular exercise group (p > 0.01). However, these indicators were significantly improved in the 10-year regular exercise group compared with the 1-year regular exercise group (p < 0.01). Long-term regular participation in Chinese fitness dancing significantly increased muscle strength in the lower limbs and effectively lowered the fall risk index in middle-aged and older women. Thus, long-term regular participation in Chinese fitness dancing can be used as a preventive measure to increase muscle strength in the lower limbs and reduce the risk of falls in middle-aged and older women.

Game-like interactive exercise versus visual feedback in patients with chemotherapy induced peripheral neuropathy post mastectomy: A randomized comparative study

Background Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects of antineoplastic agents, with a prevalence of 19 to 85%. In terms of clinical manifestations, CIPN is primarily a sensory neuropathy with motor and autonomic alterations of varying intensity and duration. CIPN consider as major problem for both cancer patients and survivors, as well as for their healthcare providers, possibly increasing the risk of falling. Objective: To evaluate the efficacy of game-like interactive exercise versus visual feedback training on the risk of falling and sensory integration in patients with chemotherapy-induced peripheral neuropathy after mastectomy. Methods: In this randomized comparative study, 30 female patients diagnosed with chemotherapy-induced peripheral neuropathy after mastectomy were randomly allocated into two equal groups; group (A) underwent game-like interactive exercise using the Biodex Balance System (BBS), while group (B) underwent a visual feedback training program using BBS. The treatment was applied for three sessions per week for four consecutive weeks. All subjects in both groups were assessed using the fall risk index and sensory integration test (sway index) in four sensory conditions at baseline and at the end of the study for both groups.