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Table 2 Balance board training (Standing exercises with feet in place during most exercises, high challenge balance)

From: The effect of interactive cognitive-motor training in reducing fall risk in older people: a systematic review

Study, sample size Intervention vs control (content, dose) Sample characteristics Main findings
  Within-group Between-group
Cognitive-motor only
Orsega-Smith 2012 [52] N = 34 IG1: WBB balance + strength 4 wk, 2/wk, 30 min Community-dwelling; age 72.1 (7.8), 55–86; independent, 88% self-reported health good or very good, 0% poor; overweight (mean BMI 27.19 (4.99); high-functioning (ceiling effect in several measures + +
IG1 IG1 vs CG:
  BBS pre 51.69 (10.05) post 53.13 (8.48), p < .05   BBS mean difference 2.33 (0.77), p = .004
IG2: WBB balance + strength 8 wk, 2/wk, 30 min
  STS pre 11.81 (3.62) post 13.69 (3.89), p < .01,   STS mean difference 2.54 (0.69), p = .002
  ADL pre 126.14 (19.53) post 130.36 (12.70), p < .05 IG2 vs CG:
  IG2   BBS p = .05
  BBS pre 54.22 (1.79) post 55.44 (0.89 3), p < .05   STS p = .10
TUG pre 7.14 (1.08) post 6.74 (0.76), p = .06  
CG: Passive     ADL pre 130.22 (8.00) post 135.00 (3.50), p < .05 No
  ABC pre 87.85 (11.19) post 93.93 (5.52), p < .05 IG1 vs IG2: no sig differences in any measure
IG1 vs CG: TUG
No IG2: vs CG:TUG
IG1: TUG, ABC, FES  
IG2: STS, FES
Bieryla 2013 [64] N = 9 IG: WBB balance + strength 3 wk, 3/wk, 30 min Community-dwelling; age 70+; 70–92; 81.5 (5.5); healthy; able to stand unassisted for 30 minutes; walk a minimum of 6 meters without aid + follow-up (1mo)  
  BBS pre 50 (47.5-51.5) follow-up 53 (52–54), p = .046
CG: N/A (reported as RCT but only within group analysis)
No
Post: BBS, FAB, FR , TUG follow-up: FAB, FR, TUG
Young 2010 [56] N = 6 IG: WBB balance (custom-made) 4 wk, 10 sessions, 20 min Community-dwelling; age 84.1 (5.1); healthy; no falls past year + sway variability decreased in EC A-P t(5) = 3.042; p = .03,  
No
CG: N/A Sway variability EO and EC M-L
Kim 2013 [48] N = 32 IG: slow static balance and strength 8 wk, 3/wk, 60 min Community-dwelling; age IG 68.3 (3.7), CG 66.2 (3.9); 65–75; independently ambulatory; able to stand on 1 leg for 15 seconds without any assistance; no history of orthopedic or neurologic surgery; MMSE ≥ 24; no dementia, cardiovascular disease, headache or dizziness + +
Hip extension 55%, flexion 29.9%, adduction 48.6%, abduction 41.9%, all p < .001 All hip muscles (p < .001
CG: passive
GRF backward stepping EO 15.4% p = .004, EC 11.5% p = .044 GRF backward stepping test EC p = .028
GRF cross-over stepping EO 28.7% p < .001, EC 26.6% p < .001 GRF cross-over stepping test EC p = .013
  No GRF EO backward and cross-over stepping
Lamoth 2011 [66], Kosse 2011 [49] N = 9 IG: Static balance 6 wk, 3/wk, 20 min Community-dwelling; age 77 (5), 65+; healthy; highly motivated to exercise; able to walk without aids; no orthopedic or neurological disorders which prevent them from walking without aids or pressing the buttons on the interface; adequate vision; no cognitive impairments   + BBS p < .01 Figure-of-eight p < .01
CG: passive (cross-over)
No Tandem, OLS with EO/EC
Bisson 2007 [46] N = 24 IG: IREX, static standing 10 wk, 2/wk, 30 min Community-dwelling; age 74.4 (4.3), 65+; no walking aids; no major cognitive impairment (MMSE > 19); no unexplained falls last year; no peripheral neuropathy, an uncontrolled heart problem, severe arthritis, severe back pain, a recent leg injury (last 6 mo), tunnel vision, or any vestibular problem + CB&M pre 58.6, post 64.2, follow-up 64.7 F(2,46) = 14.5, p < 0.01 No CB&M, RT , Sway no differences between groups and no training effect
RT main effect of time F(2,44) = 10.30, p < 0.01, no change between post and follow-up
No Sway
CG: Biofeedback training on force plate 10 wk, 2/wk, 30 min    
Pluchino 2012 [53] N = 27 IG: WBB balance + strength 8 wk, 2/wk, 60 min Community-dwelling; age 72.5 (8.4) of n = 40; independent; no neurologic disorders affecting balance; no severe cognitive impairment; no major depression; no unstable disease; no severe vestibular problems; no assistance in ADL + DMA score pre 808.75 (98.17) post 761.13 (131.75), p = .036 No FROP-COM, TUG, OLS, POMA gait, POMA balance, FR, FES - Sway area pre −0.39 (0.23) post 1.65 (1.47), p < .001 (!) No FROP-COM, TUG, OLS, POMA, FR, Sway, dynamic posturography, FES
CG1: balance
Sway velocity pre 1.67 (0.57) post 1.90 (0.71), p = .013
CG2: Tai Chi Both 8 wk, 2/wk, 60 min    
Chen 2012 [47] N = 40 IG: Static balance and strength (power) 6 wk, 2/wk, 30 min Community-dwelling; age 75.9 (7.9), 65+; no dizziness/vertigo, degenerative neurological diseases, stroke, lower limbs fractures, cardio-pulmonary distress and any sensory, visual, auditory or cognitive impairment that would hinder testing procedures; no medication known to affect balance + POMA pre 15.68 (1.38) post 23.33 (2.29), p < .001, +50% + POMA p < .05
TUG p < .05
CG: Strength and balance 6 wk, 2/wk, 30 min STS p < .05
Power p < .05
mFES p < .05
FR pre 16.49 (3.37) post 22.26 (4.21), p < .001, +35% No FR
TUG pre 17.15 (4.49) post 12.90 (3.07), p = .026, −25%
STS pre 17.20 (3.51) post 12.46 (2.99), p = .004, −28%
Muscle power pre 4.56 (1.43) post 7.47(2.81), p < .001, +64% mFES pre 5.52 (1.28) post 8.14 (0.94), p = .002, +47%
Suarez 2006 [41] N = 26 IG: Static balance under changing sensory conditions 6 wk, daily, 40 min Outpatient clinic; age 73–82; balance disorder; >2 falls in last year; no musculoskeletal disorders, no dementia; no PD or neuropathy + Sway area normal standing pre 10.4 (2.3) post 3.5 (1.4), p < .001  
CG: N/A
Sway area optokinetic stimulation pre 22.4 (4.3) post 10.4 (4.2), p < .001
Sway velocity normal standing pre 3.2 (0.5) post 2.4 (0.4), p < .001
Sway velocity optokinetic stimulation pre 4.9 (1.4) post 2.9 (0.3), p < .001
Duque 2013 [40] N = 28 (within) N = 58 (between) IG: Static balance under changing sensory conditions plus ususal care (sham) 6 wk, 2/wk, 30 min Community-dwelling; age 65+; IG 79.3 (10); CG 75 (8); falls and fracture clinic; at least 1 fall past 6 mo; poor balance; ambulate independently with a cane or walker; able to stand unaided for 60secs; MMSE ≥ 22; no PD, or neuromuscular condition; GDS ≤ 7; no severe visual impairment + 6 wk + 9mo falls 1.1 (0.7) vs CG 2 (0.2), p < .01
LOS 31%, p < .01 Sway area EC hard surface −33%; EC foam −52%, optokinetic stimulation 25%, Sway velocity vertical 50%, horizontal 33%, all p < .01 LOS, p < .01 Sway area optokinetic stimulation, p < .01
CG: Usual care (Sham)
Sway velocity horizontal and vertical optokinetic stimulation, p < .01
SAFFE , p < .01
No Sway area standing hard surface/foam
Padala 2012 [36] N = 22 IG: WBB balance + strength 8 wk, 5/wk, 30 min Assisted living facility; age 80.5 (7.5), 60+; mild AD; MMSE ≥ 18; excluded: myocardial infarction, transient ischemic attack or stroke in the previous 6 mo, serious mental illness which impacted memory, active cancer diagnosis with the exception of skin cancer, poor prognosis for survival (e.g., severe congestive heart failure), severe sensory (visual or auditory) or musculoskeletal impairments, or a required use of a wheel-chair for ambulation; 44% walking aid; mean 3.2 comorbidities + BBS change 6.27 (5.27), p003 No BBS, POMA, TUG, ADL, IADLs, MMSE
CG: Walking 8 wk, 5/wk, 30 min
POMA change 1.82 (2.04), p = .013
No TUG, ADL, IADL, MMSE
Szturm 2011 [63] N = 27 IG: static balance on firm or compliant surface 8 wk, 2/wk, 45 min Geriatric day hospital; age 80.7 (6.5), 65–85; no cognitive impairment (MMSE > 24); independent ambulant; no condition or disability that prevents participation; 89% walking aids; mean gait speed <0.7 m/s + BBS p < .001 TUG p = .07 LOB p = .03 ABC p < .05 + BBS t = 5.9, df = 24, p < .001
TUG t = 1.87, df = 25, p = .08
No Gait speed
LOB U = 37.2, p = .007
ABC U = 44.5, p = .02
No
Gait speed
CG: Strength, aerobics, balance
Yen 2011 [34] N = 42 IG: Static balance with tilt 6 wk, 2/wk, 30 min CG1: balance (incl. tilt board) 6 wk, 2/wk, 30 min Outpatient clinic; age 70.7 (6.4); idiopathic PD (Hoehn and Yahr stages II and III); no cognitive impairment (MMSE > 24); no uncontrolled chronic diseases; no other neurological, cardiovascular or orthopaedic disorders affecting postural stability; no on-off motor fluctuation; no dyskinesia > grade 3 (UPDRS) + SOT-6 pre 37.4 (25.3-49.4) post 54.3 (44.1-64.5) follow-up 48.6 (36.8-60.4), p < .05/3 + Vs CG 2: DT SOT-6, p < .05/3
DT SOT-6 pre 39.9 (27.9-52.0) post 55.3 (43.7-66.9) follow-up 52.6 (41.3-66.9), p < .05/3 No Vs CG 1: no in any measures Vs CG 2: ST SOT-6
CG2: none
ST SOT 1–5 DT SOT 1–5 Verbal RT
No SOT 1–5 Verbal RT DT SOT 1-5
Cognitive-motor plus other components
Franco 2012 [57] N = 32 IG: WBB plus strength and balance 3 wk, 2/wk, 10-15 min + daily 15 min Independent-living facility; age 78.3 (6); able to walk independently; adequate vision; able to stand for at least 2 min; no reduced weight-bearing capability; cognitively able to understand instructions + BBS F(1,29) = 17.034, p < .001, change 3.55 (5.03) No BBS, POMA
POMA F(1,29) = 9.715, p < .004, change 0.91 (2.39)
CG1: strength and balance 3 wk, 2/wk, 30-45 min
CG2: none
Fung 2012 [35] N = 50 IG: WBB plus strength and balance (TKR) Outpatient clinic; age 68 (11); following knee replacement; full lower extremity weight bearing; no active painful OA in lower limb; no visual impairment   No knee extension, knee flexion and ABC
LOS, 2/wk, 15 min + 2/wk, 60 min?
CG: Balance + strength
LOS, 2/wk, 60 min
Griffin 2012 [44] N = 65 IG: WBB plus strength and balance 7 wk? CG: strength and balance 7 wk? Age 83.2 (5.5), 67–90; met the existing criteria to join the falls prevention training group (poor performance TUG, FR, 180 degree turn, flexibility); +TUG −17% FR + TUG FR
No OLS No OLS
Kubicki 2014 [45] N = 32 IG: Fovea, static standing (position/foam/unstable plate according to individual’s ability) + strength and balance; 3 wk, 2/wk, 10 sequences + 3 wk, 3/wk, 30 min Short-term rehabilitation service; age 71–94; IG 82.2 (6.9), CG 81.5 (5.0); frail (Fried criteria); balance disorder; able to stand unassisted; multiple causes for hospitalisation; no pyramidal or extra-pyramidal syndrome or neuropathy; MMSE ≥24; gait speed = 0.65 (0.23) + Hand RT (ms) pre 605 (244) post 446 (110), p < .05 + Hand RT F1,29 = 5.057, p = 0.032
No Sway (mean velocity) TUG ST gait DT gait
-Sway velocity (APA) F(1,29) = 8.031, p < 0.01 (!)
CG: strength and balance; 3 wk, 3/wk, 30 min
Sway velocity (acc) p = .075
  1. (!) there exists inconsistency in the literature regarding the interpretation of postural sway score changes. Here we assume that an increase in sway is a negative finding.
  2. IG intervention group, CG control group, wk week, WBB wii balance board, MMSE Minimental State Examination, GDS Geriatric Depression Scale, ADL Activities of daily living, AD Alzheimer’s Disease, PD Parkinson’s Disease, UPDRS Unified Parkinson’s Disease Rating Scale, TUG Timed up and go test, FR functional reach test, BBS Berg Balance Scale, STS Sit-to-stand test, ABC Activities-specific Balance Confidence Scale, FES Falls-efficacy Scale, FAB Fullerton Advanced Balance Scale, A-P anterio-posterior, M-L medio-lateral, EO eyes open, EC eyes closed, GRF ground reaction force, CB&M Community Balance and Mobility Scale, RT reaction time, DMA dynamic motion analysis, FROP-Com Falls Risk for Older People–Community Setting, OLS One leg stance test, POMA Performance Oriented Mobility Assessment, MFES modified falls efficacy scale, LOS limits of stability, SAFFE Survey of Activities and Fear of Falling in the Elderly, IADL Instrumental activities of daily living, LOB loss of balance, SOT Sensory Organization Test, DT dual task, ST single task, APA anticipatory postural adjustment, acc acceleration phase.