Unilateral balance training has been suggested to promote a cross-education effect, which consists of skills transfer from the trained to untrained leg thanks to spinal and supraspinal adaptations. This systematic review and meta-analysis aimed to investigate the effect of unilateral balance training on balance abilities of the untrained leg in healthy people and patients with motor impairments. A systematic search was carried out on MEDLINE, CENTRAL, EMBASE, Scopus, Web of Science, CINAHL and PEDro databases. Randomized controlled trials investigating unilateral balance training effects on static, reactive and proactive balance of the untrained leg in healthy adults or patients with musculoskeletal or neurological conditions were included. Methodological quality was assessed using RoB-2 tool and pooled or un-pooled results were reported as standardized mean difference with 95% confidence interval. Evidence certainty was rated using the GRADE approach. Ten studies were included. Unilateral balance training improved proactive balance of the untrained leg in healthy people (moderate evidence). Unilateral balance training of the unaffected leg enhanced static and proactive balance of the affected leg in patients after anterior cruciate ligament reconstruction (low evidence) and reactive balance of the affected leg in patients with chronic ankle instability (very low evidence). These findings supported the occurrence of a cross-education effect in healthy people and patients with musculoskeletal conditions of the lower limb. Evidence certainty is limited and further studies are needed.

Background: Existing evidence suggests an association between temporomandibular disorders (TMDs) and alterations in body posture and balance; however, the mechanism underlying this relationship remains unknown. The present study aimed to investigate the associations between specific TMD subtypes, indices of bioelectrical activity of the masticatory muscles, and parameters of body posture and balance. Methods: The study followed a case-control study design. A total of 81 participants were enrolled, including 33 controls and 48 individuals with TMD, classified into myofascial (n = 14), articular (n = 17), and mixed (n = 17) subtypes. Diagnosis of temporomandibular disorders was carried out by prosthodontic specialists using the Polish adaptation of the Diagnostic Criteria for Temporomandibular Disorders. Masticatory muscle bioelectrical activity was assessed by surface electromyography. For statistical analysis, the Asymmetry Index and Functional Clenching Activity Indices were used. Static balance was evaluated with a pedobarographic platform. The sway area, velocity, and length of the Center of Pressure, as well as the foot contact area, were recorded and automatically calculated by the system. Measurements were performed under different mandibular conditions, with both eyes open and eyes closed. Correlation analyses were performed using Spearman Rank Order Correlation. Pearson's Chi-squared test was used for the analysis of categorical variables. Results: Weak to moderate negative correlations were primarily observed, indicating that higher indices of masticatory muscle bioelectrical activity were associated with better postural balance, with distinct correlation patterns identified across different TMD subtypes. Conclusions: This exploratory study identified multiple correlations between masticatory muscle activity and postural or balance parameters, suggesting possible subtype-specific patterns in TMDs. However, the evidence remains preliminary and should be interpreted with caution, warranting further confirmatory and longitudinal research.

Background Age-related changes in the neuromuscular and sensory systems compromise the control of balance and stability. Static balance assessments may overlook deficits that appear when coping with unexpected perturbations. This cross-sectional study aimed to compare static and dynamic balance performance in younger and older adults to assess age-related differences in postural control between the two age groups. Methods Sixty-nine younger adults (24.3 ± 0.4 years) and sixty-one older adults (72.1 ± 0.6 years) performed balance assessments under static and dynamic conditions on a force platform. Center of pressure (CoP) was calculated during quiet standing for static balance and during an unexpected perturbation of the base of support for dynamic balance. In the perturbation-based task, the following CoP-related parameters were analyzed within a 2.5-s window from perturbation onset: displacement (Area95D), Mean VelocityD, anterior–posterior first peak (FP), post-perturbation variability (PPV), and maximal oscillations (ΔCoPMax). Sample Entropy (SampEn X and Y) was computed to infer the automaticity of postural control. Results In the static test, balance performance did not differ between younger and older adults, although older adults exhibited reduced efficiency ( p < 0.05). Dynamic balance showed age-related differences, with older adults highlighting larger Area95D ( p < 0.001), higher Mean VelocityD ( p < 0.001), and greater FP ( p < 0.05). SampEn X did not differ between groups, whereas SampEn Y was lower in older adults ( p < 0.001). Conclusion Age-related changes in balance control are task dependent. Older adults preserved static balance performance but demonstrated impaired reactive balance responses in dynamic tasks. Furthermore, static and dynamic balance rely on distinct control mechanisms, highlighting the need for separate assessments.

Background: Liver cirrhosis is a chronic and progressive disease, and it affects liver parenchymal cells. Although it is known that during the course of this disease, cognitive function, balance, and physical activity levels decrease, and fatigue severity increases, the relationship between these variables remains unclear. This study is the first to examine the relationship between cognitive function level and balance, fatigue, and physical activity levels in patients with liver cirrhosis and was conducted to provide a new perspective on treatment. Aim: This study aims to investigate the relationship between cognitive function and balance, physical activity, and fatigue in patients with liver cirrhosis. Method: A total of 132 patients were included in the study. Cognitive function levels of the patients were measured with the Montreal Cognitive Assessment Scale, balance performance using the One-Legged Stance Test and timed up and go tests, physical activity levels with the International Physical Activity Scale-Short Form, and fatigue levels with the Fatigue Severity Scale. Results: Correlation analyses showed that cognitive function (MoCA) was significantly associated with static balance (r = 0.232, p = 0.007) and fatigue severity (r = -0.297, p = 0.001), whereas no statistically significant relationships were observed with dynamic balance (r = -0.068, p = 0.441) or physical activity (r = -0.011, p = 0.903). Multivariable regression analyses indicated that disease duration (β = 0.02, p = 0.009) and exercise habits (β = 0.65, p = 0.031) were independently associated with cognitive function (MoCA), while disease duration was also independently associated with static balance performance (β = 0.08, p = 0.002). Conclusions: These findings indicate statistically significant associations between cognitive function, static balance, and fatigue severity, whereas no significant associations were observed with dynamic balance or physical activity. These relationships should be interpreted as associative rather than causal and suggest that cognitive status may be clinically relevant when evaluating balance performance and fatigue burden in patients with cirrhosis.

Background: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that involves various biomechanical factors, including the altered positioning of the patella, weakness of the lower extremity muscles, delayed activation of the vastus medialis muscle, and excessive pronation of the foot. Although the short- and long-term effects of external support among the recommended conservative treatment methods for PFPS have been examined, there remains a lack of consensus regarding their impacts. This study was conducted to investigate the immediate effects of braces and rigid taping applied to control pain on proprioception, functional status, and balance in patients with PFPS, and to compare these outcomes with normative values obtained from healthy individuals. Methods: The study included 18 patients with PFPS and 18 healthy individuals who met the inclusion criteria. Through randomization of the intervention sequence, patients were evaluated under conditions of rigid taping, support, or without any support. Their pain levels before and after the application were assessed using the Visual Analog Scale; their functional status was evaluated with the Kujala Patellofemoral Scoring, the 10-Step Up Test, and the Squat; their balance performance was measured using the Y-Balance Test and the Single Leg Stance Test; and their proprioception was assessed with the Joint Position Sense Test. Results: It has been determined that rigid taping and bracing have similar effects in the immediate management of pain, proprioception, functional status, and balance issues in patients with PFPS. The interventions were observed to bring patients' static balance and proprioception parameters closer to the values seen in healthy individuals. Conclusions: Rigid taping and bracing are both effective interventions in the management of PFPS, offering benefits such as pain relief, prevention of proprioceptive deficits, mitigation of balance impairments, and enhancement of functional outcomes. The selection of the most appropriate modality should be based on the individual patient's characteristics and tolerance levels.

Background: Chronic ankle instability (CAI) is a common functional disorder in older adults, affecting their balance and quality of life. Therefore, finding effective ways to enhance ankle stability and function under safe conditions remains a key issue for healthy aging. Objective: This study aims to explore the effects of the Otago Exercise Program (OEP) combined with Neuromuscular Electrical Stimulation (NMES) on ankle stability, the pain index, and balance ability in older adults aged 60 and above with CAI. Methods: This study is a single-blind pilot randomized controlled trial, including 36 eligible older adults with CAI, with 34 completing the trial. Participants were randomly assigned to the OEP group, the combined group (OEP + NMES), and the control group. The intervention period lasted 8 weeks. Evaluation measures included the Cumberland Ankle Instability Tool (CAIT), Visual Analog Scale (VAS), Eyes-closed Single-Leg Stance Test (UST), and the Modified Star Excursion Balance Test (mSEBT), with assessments conducted before the intervention, at week 4, and at week 8. Result: After the intervention, all three groups showed significant improvements in CAIT, VAS, UST, and mSEBT scores (p < 0.05), with a large group × time effect observed for the primary outcome CAIT (partial η2 = 0.414). The combined group (OEP + NMES) demonstrated the most significant improvement in CAIT and UST scores (p < 0.05) and outperformed the other two groups in dynamic balance in the posteromedial and posterolateral directions. Conclusions: The combined intervention of OEP and NMES significantly improves ankle stability, both static and dynamic balance abilities, and alleviates pain in older adults with CAI. This combined approach offers a safe and effective rehabilitation strategy for the older adults, with promising clinical application prospects.

This randomized controlled trial investigated the acute effects of floss band (FB) application at different pressures on multidimensional ankle stability in patients with chronic ankle instability (CAI). Forty-two male participants with CAI were randomly assigned to a medium-pressure (MP, 150 mmHg), high-pressure (HP, 200 mmHg), or control group (CG, non-compressive bandage). Outcomes included the Y-Balance Test (YBT), single-leg landing stability (assessed via surface electromyography), ankle proprioception, and static balance, measured at baseline (T0), 5 min (T1), 25 min (T2), and 45 min (T3) post-intervention. The results showed that both MP and HP groups exhibited significant improvements in YBT composite scores, lower limb muscle activation during landing, and joint position sense accuracy at T1 and T2 compared to T0 (all p < 0.05), with the MP group demonstrating longer-lasting benefits up to T3. The MP group also significantly outperformed the CG across multiple dynamic stability and neuromuscular metrics at early time points (p < 0.05). Improvements in static balance were limited and transient. These findings indicate that a single application of FB, particularly at 150 mmHg, can acutely enhance dynamic stability, neuromuscular control, and proprioception in CAI patients, with effects sustained for up to 45 minutes, supporting its use as an effective pre-activity or pre-rehabilitation intervention.

Effect of yogic pranayama on static balance and hand-eye coordination in intellectually disabled persons

Physical fitness and executive functions in early childhood: A systematic review of recent evidence.

Impact of multiple levels of visual occlusion on static postural control.

To systematically evaluate, using the GRADE framework, the effects of exercise training on static and dynamic balance function in middle-aged and older adults with DPN. We systematically searched the Cochrane Library, EMBASE, PubMed, Web of Science, CNKI, and Scopus from inception to March 21, 2025, for randomized controlled trials (RCTs) investigating exercise interventions targeting balance in adults with DPN. Eligible studies enrolled middle-aged and older adults with DPN and reported at least one validated balance-related outcome. Risk of bias was assessed, and the certainty of evidence was rated using the GRADE approach. Meta-analyses were performed using R software and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Sixteen RCTs involving 759 middle-aged and older adults with DPN were included. Low to very low certainty evidence indicated that exercise training significantly improved Berg Balance Scale scores [MD = 2.14, 95% CI (1.57-2.73)], Functional Reach Test distance [MD = 3.23, 95% CI (1.82-4.64)], and Timed Up and Go test performance [MD = -1.65, 95% CI (-1.98-1.32)]. Exercise also increased One-Leg Stand Test duration with eyes open [MD = 2.93, 95% CI (2.10-3.76)] and eyes closed [MD = 1.37, 95% CI (0.55-2.19)]. After exclusion of a study contributing substantial heterogeneity, the Five-Times Sit-to-Stand Test showed significant improvement [MD = -3.07, 95% CI (-4.87-1.28)]. No significant effect was observed for the Six-min Walk Test [MD = 27.36, 95% CI (-18.43-73.14)]. Exercise training may confer beneficial effects on both static and dynamic balance function in middle-aged and older adults with DPN, although the certainty of evidence is generally low to very low. No significant effect was found on six-min walking capacity. Larger, pragmatic trials are needed to confirm effects and to guide implementation in community and outpatient services, including monitoring of fall-related and longer-term functional outcomes. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261305039.

ABSTRACT Understanding the relationship between fitness, anthropometric characteristics, and internal load is essential for optimising training and reducing injury risk in youth athletes. This study classified senior youth badminton players into exertion groups using decision tree (DT) models, guided by rate of perceived exertion (RPE). Seventy-three players (mean experience = 6 years) completed physical assessments, and RPE was recorded during match play. K-means clustering identified two exertion groups: Low Exertion Group (LEG, n = 36) and Moderate Exertion Group (MEG, n = 37). A DT regression model predicted RPE with high accuracy (R2 = 0.87 training, 0.95 test; MAE = 0.25 training, 0.07 test). Push-up performance was the most significant split variable (>25 reps for MEG), with additional predictors including standing broad jump, single-leg wall-sit, vertical jump, and stork balance test. SHAP analysis highlighted stork balance, single-leg wall sit, push-ups, height and hand grip strength as key contributors across groups. For LEG, static balance and muscular endurance emerged as dominant positive predictors. These findings accentuate the importance of neuromuscular coordination and strength in modulating exertion. Interpretable machine learning models offer practical tools for developing individualised, data-informed training strategies that enhance performance while accounting for athletes’ unique physical profiles.

Neuromuscular performance – including strength, power, balance, and motor control – develops dynamically across childhood and adolescence. Its trajectory reflects the interaction of biological maturation, neural plasticity, and musculoskeletal development, making this period a key window for enhancing performance, preventing injuries, and supporting lifelong physical competence. During childhood, strength and power increase gradually and, particularly in boys, accelerate around puberty due to androgen-driven gains in muscle size, tendon stiffness, and lean body mass. In girls, improvements are smaller and primarily related to neural and coordinative adaptations. Compared with adults, children typically display lower maximal and explosive force, reduced activation of high-threshold motor units, lower fatigability, and faster recovery, indicating efficient submaximal performance and high adaptive potential. These differences were summarized by the differential motor-unit activation hypothesis, which attributes them to a reduced recruitment of large motor units that predominantly innervate type II muscle fibers (Dotan et al., 2012). This aligns with our understanding that early strength gains from resistance training are primarily neural, while structural adaptations such as greater muscle cross-sectional area develop progressively with maturation and endocrine development. Systematic analyses show that structured resistance and integrative neuromuscular training effectively enhance strength, power, and coordination in youth. A recent meta-analysis reported significant improvements in jump performance, maximal strength, dynamic and static balance, compared with traditional training, with the strongest effects in programs related to higher overall training loads (Wan et al., 2025). Strength training builds the foundation for force production, while subsequent power training further improves high-velocity actions such as jumping and sprinting. In line with this, strength-based programs yield larger gains in lower-body force, whereas power training enhances explosive output once adequate strength is established (Behm et al., 2017). This sequential model - developing strength before power - appears optimal for promoting neural efficiency, coordination, and joint stability. Beyond performance enhancement, neuromuscular training supports musculoskeletal strength, joint stability, and movement mechanics. These adaptations benefit athletic development and daily function, improving health, motor proficiency, and well-being. Current knowledge on developmental pathways relies largely on cross-sectional data and reviews, while longitudinal studies covering key stages from prepuberty to late adolescence remain scarce. Addressing this gap, our own ongoing decade-study investigates neuromuscular and morphological adaptations over ten years to distinguish developmental from training-related changes. Preliminary data will be presented.

The aim of the protocol is to investigate the feasibility and effectiveness of combining conventional rehabilitation with visual-feedback balance platform training in elderly patients undergoing primary unilateral Total Knee Arthroplasty (TKA). The method shows a single-blind, randomized controlled trial that enrolled 60 patients undergoing primary unilateral TKA (23 males, 37 females). Participants were randomly assigned to a control group (n=30; mean age 69.60 ± 2.98 years) or an observation group (n=30; mean age 70.87 ± 4.26 years). The control group received conventional rehabilitation, while the observation group received conventional rehabilitation plus visual-feedback balance platform training. The visual feedback intervention commenced in the second postoperative week, conducted 5 times per week for 20-30 min per session, over a 5-week period. Balance function was evaluated using platform-specific metrics: Length of Movement Trajectory (LMT) and Area of Movement Ellipse (AME). Functional mobility was assessed via the Timed Up and Go Test (TUGT), Single-Leg Stance (SLS), Timed Sit-to-Stand (STS), and Timed Stair Test (TST). Data were analyzed using independent and paired t-tests with a significance level of p < 0.05. After the 6-week program, both groups showed significant improvements across all parameters compared to baseline (p < 0.05). However, the observation group exhibited significantly superior outcomes compared to the control group. Specifically, static stability metrics (LMT, AME) and TUGT performance were significantly better in the observation group (p < 0.01). Similarly, the observation group demonstrated significant improvement in SLS, STS, and TST (p < 0.05) compared to controls. Integrating visual-feedback balance platform training with conventional rehabilitation significantly enhanced static and dynamic balance function in elderly TKA patients, offering superior efficacy to conventional rehabilitation alone.

Introduction: As exercise is recognised as a health management occupation that supports daily life, enabling exercise participation falls within the scope of occupational therapy in promoting health and well-being through meaningful activities. This study examined the outcomes of an exercise programme designed to enhance participation of people with visual impairment (VI) to improve their health and occupational participation. Methods: A 10-week designed group-based mat exercise programme was conducted for 12 participants with severe VI, using a pretest–posttest design. Outcome measures included physical fitness (dynamic and static balance, flexibility and muscle strength), health-related quality of life (HRQoL), physical activity (PA) participation and occupational performance and satisfaction were also measured. Results: Significant improvements were observed in static balance, flexibility and muscle strength, as well as in HRQoL domains of bodily pain, vitality and social functioning. PA participation increased, particularly in moderate PA and walking, with a significant reduction in sedentary time. Ten reported improved occupational performance and nine reported improved satisfaction. Conclusion: A structured, adapted exercise programme that facilitates participation can support both health and occupational performance for people with VI, highlighting the role of occupational therapy in exercise-based health promotion and the need to consider occupational performance as an outcome.

Effectiveness of balance training in people with chronic ankle instability: An Umbrella review with meta-meta-analysis.

Knee osteoarthritis (OA) is associated with pain and reduced functional performance, increasing fall risk in older adults. While conventional physiotherapy is widely used, limited evidence exists regarding the added value of exercise programs on proprioception and balance outcomes. This study aimed to evaluate the effects of a structured four-week exercise program, in combination with conventional physiotherapy, on function, pain, proprioception, and balance in adults with knee OA. Thirty participants (aged 50-65years) with clinically diagnosed knee OA were randomly assigned to either an experimental group (n = 15), which received conventional physiotherapy (including electrotherapy, manual therapy, and therapeutic modalities) combined with structured exercise, or a control group (n = 15), which received conventional physiotherapy alone. Outcome measures included knee function, pain, proprioception, and static balance. Data were analyzed using repeated measures ANOVA. Both groups showed significant pre-to post-test improvements across all outcomes (p < .05). However, the experimental group achieved markedly greater gains in proprioception (-33.85% and -36.04% at 30° and 60°, respectively), static balance (+25.13% eyes-open, +42.25% eyes-closed), and functional reach (+10.87%) compared with the control group. Pain reduction was also greater in the experimental group (-28.02% vs. -19.37%). Improvements in knee function were observed in both groups, with no significant group-by-time interaction. Integrating a targeted exercise program with physiotherapy leads to superior improvements in sensorimotor and functional outcomes in individuals with knee OA. These findings support non-pharmacological strategies to enhance mobility and reduce fall risk in this population.

The goal of this study was to determine if a robot-assisted exercise system could lead individuals with Parkinson's disease (PD) through different joint ranges of motion in a fun and effective manner. Eleven individuals with PD participated. A novel robotic system placed a target at different places in space for participants to tap with their hand, foot or knee. The range of motion (ROM) was collected by inertial measurement units (APDM), and was extracted using a custom code (Matlab). ROM was dependent upon the exercise and joint of interest. Participants illustrated acceptable levels of fatigue during each session, based on an average ending heart rate of 107.0 ± 11.9 bpm (~70% of maxHR) and an ending RPE of 6.5 ± 1.8 on a 10-point scale, indicating that the sessions were appropriately challenging. Standing forward reach, used to assess static balance and flexibility, improved by an average of 1.7 inches (p < 0.01), demonstrating immediate improvements from exercising with the robot. The results demonstrate the potential benefits of exercising with a robotic exercise system. The number of sessions spent with a PT can be limited by availability, so this system could be a fun way to encourage individuals with PD to complete their PT exercises at home.

Background: The Balance Error Scoring System (BESS) is the most practiced static postural balance assessment tool, which relies on visual observation, and has been adopted as the gold standard in the clinic and field. However, the BESS can lead to missed and inaccurate diagnoses—because of its low inter-rater reliability and limited sensitivity—by missing subtle balance deficits, particularly in the athletic population. Smartphone technology using motion sensors may act as an alternative option for providing quantitative feedback to healthcare clinicians when performing balance assessments. The primary aim of this study was to explore the discriminative validity of an alternative novel smartphone-based cloud system to measure balance remotely in soccer athletes with and without hip pain. Methods: This is an exploratory cross-sectional study. A total of 64 Australian soccer athletes (128 hips, 28% females) between 18 and 40 years completed single and tandem stance balance tests that were scored using the modified BESS test and quantified using the smartphone device attached to their lower back. An Exploratory Factor Analysis (EFA) and a Clustered Receiver Operating Characteristic (ROC) using an Area Under the Curve (AUC) were used to explore the discriminative validity between the smartphone sensor system and the modified BESS test. A Linear Mixed-Effects Analysis of Covariance (ANCOVA) was used to determine any statistical differences in static balance measures between individuals with and without hip-related pain. Results: EFA revealed that the first factor primarily captured variance related to smartphone measurements, while the second factor was associated with modified BESS test scores. The ROC and the AUC showed that the smartphone sway measurements in the anterior–posterior and mediolateral directions during single-leg stance had an acceptable to excellent level of accuracy in distinguishing between individuals with and without hip-related pain (AUC = 0.72–0.80). Linear Mixed-Effects ANCOVA analysis found that individuals with hip-related pain had significantly less single-leg balance variability and magnitude in the anteroposterior and mediolateral directions compared to individuals without hip-related pain (p < 0.05). Conclusion: Due to the ability of smartphone technology to discriminate between individuals with and without hip-related pain during single-leg static balance tasks, it is recommended to use the technology in addition to the modified BESS test to optimise a clinician-led assessment and to further guide clinical balance decision-making. While the study supports smartphone technology as a method to assess static balance, its use in measuring balance during dynamic movements needs further research.

Background: Balance is an essential motor skill that enables individuals to maintain a stable posture and perform daily activities safely. Dual-task assessments are widely used to evaluate the integration of motor and cognitive functions in paediatric populations, but their effects on postural control in children with haemophilia (CwH) remain poorly understood. The objective was to analyse and compare static balance performance under single-task and cognitive dual-task conditions between CwH and age-matched healthy controls (HC). Methods: This comparative cross-sectional study included 34 CwH and 32 HC aged 8-12 years. Balance was assessed using the Wii Balance Board® under six conditions: bipedal, bipedal with cognitive task, and dominant and non-dominant unipedal (with and without cognitive task). Primary outcome variables included overall stability index, total velocity, and sway area. Physical activity habits were also recorded in both groups with an ad hoc questionnaire. Among CwH, joint health was measured with the Haemophilia Joint Health Score (v2.0), and joint effusion/synovial hypertrophy was evaluated by ultrasound. Results: CwH showed significantly poorer performance in all variables, primarily under unipedal dominant/non-dominant dual-task conditions (p < 0.05) with percentage differences ranging from approximately 15% to over 60%. CwH reported lower-intensity and shorter-duration physical activity than HC. Conclusions: CwH demonstrates impaired balance, especially under unipedal and cognitive demands. Assessment of balance alongside dual-task performance may help detect subtle deficits not captured by only static balance assessment. These findings may suggest the incorporation of dual-task training into balance training programmes for this population.