Balance Training Group Research Articles

Eyes-Open Versus Eyes-Closed Somatosensory Motor Balance in Professional Soccer Players With Chronic Ankle Instability: A Case-Control Study.

Background:Chronic ankle instability (CAI) is a condition defined by certain structural and functional deficits in the ankle joint complex after acute ankle injury. These deficits include pathological joint laxity, impaired postural control, and decreased strength and neuromuscular control.Purpose:To compare an eyes-open versus an eyes-closed balance training protocol in professional soccer players with CAI.Study Design:Cohort study; Level of evidence, 2.Methods:For this study, we evaluated 19 players from 2 professional soccer teams in Madrid, Spain, all of whom had CAI. Participants from both teams were randomly assigned to an eyes-open group (n = 9) or eyes-closed group (n = 10). All participants completed 4 weeks of a supervised exercise protocol consisting of 3 sessions per week. Members of both the eyes-open and eyes-closed groups performed the same exercise protocol in the same order of execution. At the end of the protocol, the participants were assessed for pain (visual analog scale), ankle dorsiflexion range of motion (weightbearing lunge test), dynamic stability (Star Excursion Balance Test), and fear of movement and reinjury (Tampa Scale for Kinesiophobia). We compared results both before and after balance training and between the eyes-open and eyes-closed balance training groups.Results:Statistically significant differences were found for all of the assessed variables before and after balance training. No statistically significant differences were found between the eyes-closed and eyes-open groups on any variable.Conclusion:In the current study, eyes-closed balance training was not more effective than eyes-open balance training for CAI in professional soccer players.

골반 불균형을 동반한 특발성 척추 측만증 청소년의 외발서기 동적 균형훈련의 효과 검증

This study examined the effects of single leg dynamic balance training on cobb"s angle, asymmetrical pelvic angle and gait in adolescent idiopathic scoliosis with pelvic disproportion. We selected 12 subjects who have Cobb"s angle of greater than 10°with pelvic disproportion. Subjects were randomly assigned to spinal stability exercise group(SSEG) 6 or spinal stability exercise and single leg dynamic balance training group(SLDBTG) 6. SSEG was performed spinal stabilization exercise and SLDBTG was performed spinal stabilization exercise and single leg dynamic balance training. We measured pre and post effect of cobb"s angle, asymmetrical pelvic angle and gait. The results showed that the single leg dynamic balance training improved significantly the difference in Cobb"s angle, asymmetric pelvic angle and gait compared to the spinal stability exercise. According to theses results, we verified that single leg dynamic balance training had a considerable effect on asymmetrical weight bearing in adolescent scoliosis. Therefore, this study suggested about how the single leg dynamic balance training will effect asymmetrical pelvic angle and gait in adolescent idiopatic scoliosis.

Effects of 8 Weeks of Balance Training, Virtual Reality Training, and Combined Exercise on Lower Limb Muscle Strength, Balance, and Functional Mobility Among Older Men: A Randomized Controlled Trial.

Poor muscle strength, balance, and functional mobility have predicted falls in older adults. Fall prevention guidelines recommend highly challenging balance training modes to decrease falls; however, it is unclear whether certain modes are more effective. The purpose of this study was to determine whether traditional balance training (BT), virtual reality balance training (VR), or combined exercise (MIX) relative to a waitlist control group (CON) would provoke greater improvements in strength, balance, and functional mobility as falls risk factor proxies for falls in older men. We hypothesized that 8 weeks of MIX will provoke the greatest improvements in falls risk factors, followed by similar improvements after BT and VR, relative to the CON. Single-blinded randomized controlled trial NCT02778841 (ClinicalTrials.gov identifier). Level 2. In total, 64 community-dwelling older men (age 71.8 ± 6.09 years) were randomly assigned into BT, VR, MIX, and CON groups and tested at baseline and at the 8-week follow-up. The training groups exercised for 40 minutes, 3 times per week, for 8 weeks. Isokinetic quadriceps and hamstrings strength on the dominant and nondominant legs were primary outcomes measured by the Biodex Isokinetic Dynamometer. Secondary outcomes included 1-legged stance on firm and foam surfaces, tandem stance, the timed-up-and-go, and gait speed. Separate one-way analyses of covariance between groups were conducted for each outcome using baseline scores as covariates. (1) MIX elicited greater improvements in strength, balance, and functional mobility relative to BT, VR, and CON; (2) VR exhibited better balance and functional mobility relative to BT and CON; and (3) BT demonstrated better balance and functional mobility relative to CON. The moderate to large effect sizes in strength and large effect sizes for balance and functional mobility underline that MIX is an effective method to improve falls risk among older adults. This study forms the basis for a larger trial powered for falls.

청각정보 중심의 외재성피드백 기반 Wii Fit 과제훈련이 만성 뇌졸중 환자의 균형 및 보행에 미치는 영향

The purpose of this study was to investigate the effects of Wii fit static balance training, which focused on auditory feedback and neurodevelopmental therapy, on static balance and gait in chronic stroke patients. In this study, a total of 30 chronic stroke patients were randomly assigned to either the auditory feedback balance training group, the visual feedback balance training group, or the control group. Berg balance scale (BBS) and functional reach test (FRT) were used to evaluate the subjects' ability to maintain balance. In order to evaluate the subject’s walking ability, a walking analysis was conducted via the 10MWT, the TUG test, and the GAITRite system. The intervention was performed 3 times a week for 8 weeks. Each session lasted 30 minutes. Static balance training using the Wii Fit board was provided with the auditory feedback group, to which auditory feedback was provided after vision was blocked. The visual feedback balance training group underwent static balance training on the Wii Fit board with visual feedback. The control group underwent general neurodevelopmental treatment. The results of this study confirmed that auditory feedback training was effective in improving balance and gait in chronic stroke patients. Therefore, auditory feedback training can be beneficially used as an therapeutic intervention to improve balance and gait of patients with chronic stroke.

Efficacy of Electrical Stimulation-Augmented Virtual Reality Training in Improving Balance in Individuals with Incomplete Spinal Cord Injury: Study Protocol of a Randomized Controlled Trial.

Study DesignThis study is a single-blind, parallel, three-group, and randomized controlled trial.PurposeThis study aimed to investigate the effectiveness of electrical stimulation-augmented virtual reality training in improving balance in individuals with incomplete spinal cord injury (iSCI).Overview of LiteratureIndividuals with iSCI often face significant balance and mobility impairments affecting their quality of life. Scientific studies focusing on standing balance training in the iSCI population are limited. Virtual reality-based balance training has shown positive results in several neurological populations. Electrical stimulation has also proved to be effective in improving voluntary muscle strength in partially paralyzed muscles after iSCI as well as promoting neuroplasticity.MethodsForty-eight iSCI participants will be recruited based on the inclusion criteria. The participants will be randomly assigned to any of the three groups: virtual reality-based balance training along with the electrical stimulation group, virtual reality-based balance training along with sham stimulation group, or virtual reality-based balance training group. The intervention will be delivered as 60-minute sessions, thrice a week for 4 weeks.ResultsThe performance of the participants will be assessed using the lower extremity motor score, static and dynamic balance assessment using TechnoBody ProKin tilting platform and Berg Balance Scale, Walking Index for Spinal Cord Injury, and World Health Organization Quality of Life-BREF at pre-intervention, after 4 weeks post-intervention, and at 1-month follow-up.ConclusionsThe trial will provide new knowledge about the effectiveness of electrical stimulation-augmented virtual reality training in improving balance in individuals with iSCI. The study results will contribute to the design of better rehabilitation programs for individuals with iSCI.

Effects of an 8-week basketball-specific proprioceptive training with a single-plane instability balance platform.

To avoid injuries in basketball players, they are recommended to pay more attention to improve their body balance. Therefore new training methods and equipment need to be devised. This study examined the effects of an 8-week basketball-specific proprioception training program while using a new developed one plane instability balance board during warm-up for improving balance ability in basketball players. Players who obtained basketball-specific balance training were compared to a control group. Thirty-one male university basketball players (age: 21.35, SD = 0.605years; height: 190.97, SD = 1.88; body mass: 86.95, SD = 2.61) participated in this study. Seventeen participants were assigned to the basketball-specific 8-week balance training group (BTG) while 14 participants served as a control group (CG). Both groups were tested with the Y balance test (YBT) and postural stability test (PST) at baseline and 8 weeks later. The results indicate significant improvements in the overall YBT for both legs in BTG, but not in CG. However, no group differences were found for dynamic balance performance, but static balance (i.e., postural stability) differed between groups after 8weeks. A statistically significant moderate inverse correlation was computed between the total score of YBT and the total score of the overall stability index (r=-0.404; p= 0.041). An 8-week basketball-specific proprioception training program with a single-plane instability balance platform improved balance ability (Y balance test and postural stability test) of basketball players.

Investigation of the Effects of Dual-Task Balance Training on Gait and Balance in Transfemoral Amputees: A Randomized Controlled Trial

ObjectivesTo investigate the effects of dual-task balance training on static and dynamic balance, functional mobility, cognitive level, and sleep quality in individuals with transfemoral amputation. DesignRandomized controlled clinical trial. ParticipantsTransfemoral amputees (N=20). InterventionsParticipants were randomly assigned to the single-task gait and balance training group (n=10) or the dual-task gait and balance training group (n=10). Training was given in sessions of 60 min/d, 3 d/wk for 4 weeks. The single-task training group performed traditional gait and balance exercises, and the dual-task training group practiced cognitive and motor tasks while performing gait and balance exercises. Main Outcome MeasuresThe 1-leg stance test and the Four Square Step Test were used for balance assessment. The timed Up and Go test and 10-m walk test were used for gait assessment. Three test conditions to evaluate the training effects were single walking, walking while performing a cognitive task (serial subtraction), and walking while performing a motor task (tray carrying). The Montreal Cognitive Assessment scale was used for cognitive assessment and the Pittsburgh Sleep Quality Index for sleep quality assessment. ResultsBalance and mobility improved in both groups. Dual-task balance performance, functional mobility, and gait speed improved more in the dual-task training group after training (P<.05). Cognitive status and sleep quality improved significantly in the dual-task group (P<.05). ConclusionsDual-task training was more effective than single-task training in the improvement of dual-task performance and cognitive status. The inclusion of dual-task exercises in the rehabilitation program of transfemoral amputees will provide a different perspective because of increased task automation.

Effectiveness of early high-intensity balance training for early home life independence after total knee arthroplasty: a pseudo-randomized controlled trial.

In Japan, the number of elderly individuals living alone is increasing, leading to an increase in hospital medical expenses attributed to total knee arthroplasty (TKA). Improvement in balance and functional performance is a priority in the early postoperative stages after TKA. However, there are no reports on the effectiveness of balance training (BT) for inpatients in the early postoperative period. Thus, we aimed to evaluate the effectiveness of early high-intensity BT for early home-life independence after TKA. This pseudo-randomized controlled trial included 49 inpatients who underwent TKA and had osteoarthritis. Inpatients were categorized into the BT or typical training (TT) group. The BT program began on post-TKA day 4, with 12-14 sessions between day 7 and 10 (i.e., 1-2 sessions per day). The effect of the intervention was assessed using balance ability as the main outcome. Sub-outcomes included evaluation of motion function. The differences in each variable before and after intervention were compared, including covariance analysis adjusted for age and sex. The mean (standard deviation) balance ability indexes in the left and right directions were BT, pre 4.5 (0.8) and post 4.4 (0.8); TT, pre 4.8 (0.9) and post 4.4 (0.8), and those in the forward and backward directions were BT, pre 4.7 (1.7) and post 5.1 (2.1); TT, pre 6.3 (2.6) and post 5.9 (2.0). No significant differences were found between the preoperative and postintervention scores in the two groups for any measured outcome. BT did not appear to improve balance ability or functional performance.

Balance training can enhance hip fracture patients' independence in activities of daily living: A meta-analysis of randomized controlled trials.

Background:We conducted this meta-analysis to analyze the effectiveness of balance training in improving postoperative rehabilitation outcomes in hip fracture surgery patients.Methods:The Cochrane Library, Web of Science, Embase, and PubMed electronic databases were searched from their inception to December 2018. We selected prospective clinical control analyses and high-quality randomized controlled trials (RCTs) following the inclusion standards. We used Stata 12.0 to perform the meta-analysis. Where possible, the standard mean difference (SMD) with the 95% confidence interval (CI) was determined using a random effects model.Results:Ten RCTs involving 955 hips (balance training = 487, control = 468) published between 2002 and 2019 were assessed for eligibility of inclusion in the meta-analysis. Balance training was shown to remarkably improve the aspects of quality of life associated with physical health (standard mean difference [SMD], 2.20; 95% CI, 1.63–2.78, P = .000), a fast gait speed (SMD, 1.01; 95% CI, 0.25–1.77, P = .009), and balance (SMD = 0.26, 95% CI: [0.12, 0.41], P = .000). Moreover, the balance training group showed increases in independence in activities of daily living (ADLs), performance task scores, and health-related quality of life (HRQoL) scores compared with the control group (P < .05).Conclusion:According to the present meta-analysis, balance training improves one's independence in activities of daily living, performance tasks, lower limb strength, gait, and total physical function compared with no balance training. More high-quality RCTs with large sample sizes are required for the identification of the best balance training program after hip fracture.

Effects of Motor Imagery Training and Balance Training on Static Balance: A Quasi-Experimental Study

Background: Although studies on physical motor learning through motor imagery training have been conducted in various fields, studies on its effectiveness are still considered insufficient. Objective: To investigate the effect of motor imagery training and balance training on static balance of asymptomatic adults in their 20s. Design: A quasi-experimental study. Methods: Thirty-six adults in their 20s who passed the tandem stance test were randomized to the motor imagery training group (MIG, n=12), motor imagery with balance training group (MIBG, n=12), and balance training group (BG, n=12). Each group underwent their respective interventions three times a week for four weeks, and changes in static balance were analyzed using multivariate analysis of variance. Results: Trace length was significantly lower in the MIBG than in the MIG and BG (P<.05), and a significant reduction in trace length in the MIBG was observed after the intervention as compared to the baseline (P<.05). Furthermore, a significantly lower velocity was observed in the MIBG than in the MIG and BG (P<.05), and a significant reduction of velocity in the MIBG was more observed after the intervention compared to the baseline (P<.05). Conclusion: These results suggest that motor imagery training enhance static balance in healthy college students.

Effects of Single-Task Versus Dual-Task Training on Balance Performance in Elderly Patients With Knee Osteoarthritis.

This study aims to compare the effects of single-task and dual-task training on balance performance in elderly patients with knee osteoarthritis (OA). Fifty elderly osteoarthritic patients with balance impairment (16 males, 34 females; mean age 72.9±5.5 years; range 65 to 84 years) were included in this study. Patients were randomly assigned to single-task balance training (group 1) or dual-task balance training (group 2) groups. Balance activities were given to both groups for three times a week for four weeks. Patients in group 2 also performed cognitive tasks simultaneously with these exercises. Patients were evaluated with Berg balance scale (BBS), kinesthetic ability trainer static and dynamic scores, timed up and go (TUG) test and walking speed (WS) for single and dual tasks, number of stopping and activities-specific balance confidence (ABC) scale at baseline and at the end of four weeks. At the end of the therapy, there were statistically significant improvements in BBS, KAT 2000 static and dynamic scores, TUG test and WS for single and dual tasks, number of stopping and ABC scale in both groups (p<0.05). But there was no statistical difference in any parameter between the groups (p>0.05). Both single- and dual-task trainings are effective in improving balance performance under single- and dual-task conditions in elderly patients with knee OA. Dual-task training is not superior to single-task training for balance improvement in elderly osteoarthritic patients.

Effect of immersive virtual reality on balance, mobility, and fatigue in patients with multiple sclerosis: A single-blinded randomized controlled trial

IntroductionImbalance, mobility impairment, and fatigue are common in Multiple Sclerosis (MS) patients. Virtual reality (VR) promises to be an effective and enjoyable tool for the rehabilitation of these symptoms. Immersive virtual reality (IVR) with a head-mounted display (HMD) enhances the perception of reality. The purpose of this study was to investigate the efficacy of IVR training on balance, mobility, and fatigue in patients with MS. MethodsThe patients were randomly divided into three groups; the immersive virtual reality group (IVRG, n:17), the balance training group (BTG, n:17) and the control group (CG, n:17). The IVRG and BTG received the training twice a week for 8 weeks. The CG performed only relaxation exercises at home. All patients were evaluated at baseline and after eight weeks by the Berg Balance Scale (BBS), posturography, Timed Up and Go (TUG), and Fatigue Severity Scale (FSS). ResultsThe balance assessed with BBS increased in only BTG (p < 0.05). The postural stability on eyes open-firm surface and eyes closed-foam surface improved in both training groups (p < 0.05) without any inter-group superiority (p > 0.05). However, the postural stability on eyes closed-firm surface in only IVRG and the single-leg stability on the right foot in only BTG improved (p < 0.05). In addition, overall limits of stability, fatigue, and mobility under both the single-task and cognitive dual-task conditions improved in both training groups (p < 0.05) without any inter-group superiority (p > 0.05). In the CG, the postural sways on both right and left single foot increased (p < 0.05) while overall limits of stability, mobility, and fatigue did not change significantly (p > 0.05). ConclusionsIVR training has beneficial effects similar to those of balance training on balance, mobility, and fatigue in patients with MS and could be used as an effective integrative method for balance training in patients with MS.

Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial

Background:Balance impairment in Parkinson’s disease (PD) improves only partially with dopaminergic medication. Therefore, non-pharmacological interventions such as physiotherapy are important elements in clinical management. External cues are often applied to improve gait, but their effects on balance control are unclear.Objective/Methods:We performed a prospective, single-blind, randomized clinical trial to study the effectiveness of balance training with and without rhythmical auditory cues. We screened 201 volunteers by telephone; 154 were assigned randomly into three groups: (1) multimodal balance training supported by rhythmical auditory stimuli (n = 56) (RAS-supported multimodal balance training); (2) regular multimodal balance training without rhythmical auditory stimuli (n = 50); and (3) control intervention involving a general education program (n = 48). Training was performed for 5 weeks, two times/week. Linear mixed models were used for all outcomes. Primary outcome was the Mini-BESTest (MBEST) score immediately after the training period. Assessments were performed by a single, blinded assessor at baseline, immediately post intervention, and after one and 6-months follow-up.Results:Immediately post intervention, RAS-supported multimodal balance training was more effective than regular multimodal balance training on MBEST (difference 3.5 (95% Confidence Interval (CI) 2.2; 4.8)), p < 0.001). Patients allocated to both active interventions improved compared to controls (MBEST estimated mean difference versus controls 6.6 (CI 5.2; 8.0), p < 0.001 for RAS-supported multimodal balance training; and 3.0 (CI 2.7; 5.3), p < 0.001 for regular multimodal balance training). Improvements were retained at one-month follow-up for both active interventions, but only the RAS-supported multimodal balance training group maintained its improvement at 6 months.Conclusion:Both RAS-supported multimodal balance training and regular multimodal balance training improve balance, but RAS-supported multimodal balance training–adding rhythmical auditory cues to regular multimodal balance training–has greater and more sustained effects.

Effects of balance and plyometric training on balance control among individuals with functional ankle instability

IntroductionThis study aimed to compare the effects of balance and plyometric training on balance control among individuals with functional ankle instability (FAI).MethodsOverall, 20 individuals with FAI, classified in balance (&lt;i&gt;n&lt;/i&gt; = 10) and plyometric (&lt;i&gt;n&lt;/i&gt; = 10) training groups, participated in the study. Testing variables included standard deviations and ranges of centre of pressure in mediolateral (ML-COPsd/ML-COPr) and anteroposterior (AP-COPsd/AP-COPr) directions during single-legged stance with eyes open and closed, times to stabilization of ground reaction force in mediolateral (ML-TTS) and anteroposterior (AP-TTS) directions during step-down, and reach distances in anterior, posteromedial, and posterolateral directions from the modified Star Excursion Balance Test.ResultsWhen comparing between the groups, the plyometric training group exhibited a significant reduction of ML-COPsd with eyes open after 6 weeks of training (&lt;i&gt;p&lt;/i&gt; = 0.004) and shorter ML-TTS and AP-TTS after 4 weeks (&lt;i&gt;p&lt;/i&gt; = 0.009 and &lt;i&gt;p&lt;/i&gt; = 0.007) and 6 weeks (&lt;i&gt;p&lt;/i&gt; = 0.011 and &lt;i&gt;p&lt;/i&gt; = 0.029) of training. For within-group comparison, the plyometric training group showed significant improvements (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) in all testing variables, whereas the balance training group presented improvement only in the reach distances.ConclusionsPlyometric training provided benefits in both static and dynamic balances for individuals with FAI.

Study protocol for a single-blind randomised controlled trial to evaluate the clinical effects of an Integrated Qigong exercise intervention on freezing of gait in Parkinson’s disease

IntroductionQigong exercise offers a potentially safe, low-cost and effective mind–body rehabilitative intervention for mitigating the problem of gait interruption among patients with Parkinson’s disease (PD) who have frequent freezing of...

A Comparison of the Effects of Balance Training and Technological Games on Balance in Hearing-Impaired Individuals

It is aimed to compare the effects of the two different methods as balance training and wii fit balance games based on game technology on the balance functions of hearing-impaired individuals.36 male born deaf individuals between the ages of 18-22 and playing sports actively have participated in the study. The first group consisted of the ones having balance training, the second group consisted of those playing technological games, and the third group (control group) consisted of individuals having no balance training. The first group was given balance training 3 days a week for 8 weeks. The second group was made to play 30-minute wii fit three days a week for 8 weeks.Statistical difference was between the group playing technological games and control group, and between the group having balance training and control group (p&lt;0.01).A statistical difference was found in dynamic balance values after the study. In the after values, a statistical difference occurred between the control group and the group having balance training and the group playing technological games (p&lt;0.05).In dynamic balance values, a statistical difference occurred in before and after values of the group having balance training and the group playing technological games (p&lt;0.01).As a result of the study comparing the effects of the balance training and game technology based wii fit methods on hearing impaired individuals, it is considered that both practices will be efficient for hearing impaired individuals to improve movements and balance values and to increase daily life activities.

Can action observation modulate balance performance in healthy subjects?

BackgroundAction observation activates brain motor networks and, if followed by action imitation, it facilitates motor learning and functional recovery in patients with both neurological and musculoskeletal disorders. To date, few studies suggested that action observation plus imitation can improve balance skills; however, it is still unclear whether the simple repetitive observation of challenging balance tasks is enough to modify postural control. Thus, the primary aim of this study was to investigate whether repetitive action observation of balance exercises without imitation has the potential to improve balance performance; the secondary aim was to estimate the different training effects of action observation, action observation plus imitation and balance training relative to a control condition in healthy subjects.MethodsSeventy-nine healthy young adults were randomly assigned to 4 groups: action observation, action observation plus imitation, balance training and control. The first three groups were trained for about 30 minutes every day for three weeks, whereas the control group received no training. Center of pressure path length and sway area were evaluated on a force platform at baseline and after training using posturographic tests with eyes open and closed.ResultsAs expected, both action observation plus imitation and balance training groups compared to the control group showed balance improvements, with a medium to large effect size performing balance tasks with eyes open. Action observation without imitation group showed a balance improvement with eyes open, but without a significant difference relative to the control group.ConclusionsBoth action observation plus imitation and balance training have similar effects in improving postural control in healthy young subjects. Future studies on patients with postural instability are necessary to clarify whether AOT can induce longer lasting effects. Action observation alone showed a trend toward improving postural control in healthy subjects, suggesting the possibility to study its effects in temporarily immobilized diseased subjects.

Intracortical Inhibition Increases during Postural Task Execution in Response to Balance Training

Intracortical inhibitory modulation seems crucial for an intact motor control and motor learning. However, the influence of long(er) term training on short-interval intracortical inhibition (SICI) is scarcely investigated. With respect to balance, it was previously shown that with increasing postural task difficulty, SICI decreased but the effect of balance training (BT) is unknown. The present study tested whether improvements in postural control due to BT are accompanied by changes in SICI. SICI was measured in the tibialis anterior by applying paired-pulse magnetic stimuli to the motor cortex in a BT group (n = 13) training 2 weeks on an unstable platform and a control (CON) group (n = 13) while performing three progressively demanding postural tasks: stable stance (‘Stable’), standing on a movable platform partly secured with elastic straps (‘Straps’) or freely moving (‘Free’). The BT group improved postural control significantly more than the CON-group (‘Free’ condition: +80% vs. + 21%; p < 0.001). For SICI, there was a main effect of POSTURAL TASK (F2, 48 = 24.6; p < 0.001) with decreasing SICI when task difficulty increased and a TIME × GROUP interaction (F1, 24 = 5.9; p = 0.02) caused by significantly enhanced SICI in the BT group in all three postural tasks after the training. The increases in SICI were significantly correlated with improvements in balance performance (r = 0.56; p = 0.047). The present study confirms previous findings of task-specific modulation of SICI when balancing. More importantly, training was shown to increase SICI and this increase was correlated with changes in balance performance. Thus, changes in SICI seem to be involved not only for the control but also when adapting upright posture with training.

“Stay balanced” – effectiveness of evidence-based balance training for older adults transferred into a physical therapy primary care setting – a pilot study

Purpose: To evaluate the effects of the Stay Balanced program when this is transferred into a clinical setting regarding balance, gait speed, leg muscle strength, concerns about falling, and physical activity.Method: Implementation pilot study with a pre-post intervention design. Fifteen older adults, 75–91 years of age, participated in a progressive balance training program with a focus on divided attention. The balance training was performed in group sessions twice a week for 10 weeks at a primary care physical therapy clinic. Training efficacy was evaluated after completion of training as well as after 3 months using the Mini-Balance Evaluation Systems Test (Mini-BESTest), 10-meter walk test, 30-s chair stand test, Fall Efficacy Scale-International (FES-I), and steps/day.Results: Significant improvements were shown at the 10-week follow up for balance, gait speed, leg muscle strength, and concerns about falling (p < 0.008). At the 3-month follow-up balance, leg muscle strength and concerns about falling showed persistent improvement compared to baseline (p < 0.045). No significant differences were found for physical activity.Conclusions: This study confirms the results of our previous randomized controlled trials (RCTs), and suggests that the Stay Balanced program can be transferred to clinical physiotherapy practice. The program was appreciated by the participants and proved to be safe, effective, and feasible in primary care.Implication for rehabilitationThe Stay Balance program can easily be transferred to clinical practice without losing the effectiveness of the intervention in older adults with balance problems.The program was appreciated by the participants and proved to be safe, effective, and feasible when executed in primary care.Stay Balance program is an individually adjusted and progressive group balance training including exercises with divided attention that can easily be transferred to tasks in daily life.

Effect of Balance Training After Hip Fracture Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Studies.

Although balance impairment after hip fracture surgery (HFS) can constitute a long-term problem of limiting mobility and increasing the risk of falls in older adults, little is known about the effect of balance training (BT) on physical functioning after HFS. Thus, we performed a meta-analysis to evaluate whether BT improved the overall physical functioning of patients after HFS. We searched the PubMed-Medline, Embase, and Cochrane Library databases in January 2018 and included all randomized controlled trials comparing BT with usual care after HFS. We performed a pairwise meta-analysis using fixed- and random-effects models. Eight randomized controlled trials including a total of 752 participants were retrieved. The BT group showed significantly improved overall physical functioning after HFS compared with the usual care group (overall standardized mean difference [SMD] = 0.390; 95% confidence interval [CI] = 0.114-0.667; p = .006). Both, balance and gait improved (SMD = 0.570; 95% CI = 0.149-0.992; p = .008 and SMD = 0.195; 95% CI = 0.043-0.347; p = .012, respectively) in the BT group. Lower limb strength, performance task, activity of daily living, and health-related quality of life also improved significantly in the BT group. Our meta-analysis revealed that BT after HFS improved overall physical functioning. Positive effects on balance, gait, lower limb strength, performance task, activity of daily living, and health-related quality of life were evident. Therefore, BT should be specifically included in postoperative rehabilitation programs and balance must be thoroughly checked in elderly patients with hip fractures.