Studiendatenbank

BACKGROUND: Falls are a leading cause of injuries in older adults, often resulting from slipping and tripping. Perturbation-based balance training (PBT) applied on treadmills is an emerging task-specific approach to falls prevention but standardized training protocols are lacking. This review presents an overview of PBT protocols on treadmills, their theoretical justification and proposes recommendations for standardized reporting. METHODS: A systematic search was conducted in PubMed, Embase, Web of Science, CINAHL, CENTRAL and Clinical Trials Registration on May 9, 2025 to identify RCTs, pilot studies, study protocols and trial registrations on treadmill-based PBT for falls prevention in healthy older adults or those diagnosed with stroke, Parkinson’s disease or multiple sclerosis. Studies were screened by two independent researchers. Data on general and PBT specific training parameters as well as the justification for those parameters were narratively synthesized. RESULTS: 1253 studies were identified. The eligibility criteria were met by 69 publications referring to 36 research projects. In total, 1928 participants were included, with 950 participants in the PBT groups. The training periods lasted from a single session to 12 weeks, including one to three sessions per week, each from 20 to 60 min. During standing and walking, from 24 up to 160 unannounced perturbations were induced, consisting of treadmill belt acceleration and deceleration as well as lateral displacements.

<h4>Objective</h4>This study aimed to evaluate the effects of Tai Chi on balance and fall risk in healthy older adults through a systematic review and meta-analysis of randomized controlled trials (RCTs).<h4>Methods</h4>A comprehensive literature search was conducted across international and Chinese databases to identify relevant studies published between 2004 and 2024. A total of 21 RCTs were included in the analysis, comparing Tai Chi with non-exercise control groups. Various balance measures, such as balance performance and fall risk, were assessed.<h4>Results</h4>The meta-analysis revealed that Tai Chi significantly improved balance and reduced fall risk among older adults. Specifically, improvements were observed in several key measures, including balance ability, walking speed, and confidence in preventing falls.<h4>Conclusion</h4>These findings suggest that Tai Chi is an effective intervention for enhancing balance and reducing fall risk in healthy older adults, highlighting its potential as a valuable preventive strategy for falls in the aging population.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/prospero/, identifier CRD420251004905.

<h4>Background</h4>Falls are prevalent and serious health problems among older adults. Concerns about falling and reduced falls efficacy are common fall-related psychological impairments, representing 2 distinct emotional and cognitive constructs, respectively. The impact of digital-based exercise interventions on these specific constructs remains unclear.<h4>Objective</h4>This systematic review and meta-analysis aimed to synthesize current evidence on digital-based exercise interventions for concerns about falling and falls efficacy among older adults, with a specific focus on determining their differential effects on emotional and cognitive constructs and evaluating their impact on physical performance.<h4>Methods</h4>The PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CINAHL, CNKI, SinoMed, VIP, and Wanfang databases were systematically searched from their inception dates to May 2025. We searched for published randomized controlled trials on the effects of digital-based interventions on the fear of falling, concerns about falling, and falls efficacy among older adults. The study followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was performed using Stata 17.0 software (StataCorp LLC).<h4>Results</h4>Eighteen studies involving 2435 participants were included. Meta-analyses revealed significant effects of digital-based exercise interventions on falls efficacy (standardized mean difference 0.70, 95% CI 0.51-0.90; P<

<h4>Background</h4>Hospitalized older adults are at high risk of falls. Although fall prevention education is recommended in hospital settings, the efficacy of different education programs remains inconsistent. This study aimed to systematically review the effectiveness of fall prevention education interventions among older inpatients.<h4>Methods</h4>We conducted a systematic review of randomized or trial-linked evaluations of fall prevention education programs for inpatients aged ≥60 years. A comprehensive search was performed across PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases from inception to January 7, 2026. Risk of bias was assessed for all included evaluations. Intervention characteristics, including format, content, duration, providers, and theoretical frameworks, were extracted and analyzed.<h4>Results</h4>Twelve reports describing 11 trial-based evaluations were included, with risk of bias ranging from low to high. Most reports described session-level or initial education contact of ≤1 h, whereas six reports incorporated protocol-specified repeated education, reinforcement, or post-education contact. Interventions varied considerably in format, content, duration, and providers, including physiotherapists, an occupational therapist, nurses or nurse investigators, a trained MSc sport science student, allied health assistants, and investigators with unspecified professional background. Five evaluations reported reductions in at least one fall-

<h4>Background</h4>Exergames, which combine physical exercise with interactive gameplay, are increasingly being incorporated into fall prevention programs for older adults. Gamified elements, such as real-time feedback and progress tracking, may enhance motivation, engagement, and adherence. Although several systematic reviews have examined the effects of exergaming on balance and physical function, fewer have focused specifically on clinically meaningful outcomes, such as falls and injurious falls, or on indicators that may influence real-world adoption of exergames.<h4>Objective</h4>This study aimed to evaluate the effectiveness of exergaming interventions for preventing falls and injurious falls in people aged ≥60 years and to synthesize evidence on implementation-related outcomes, including adherence, acceptability, concerns about falling, quality of life, adverse events, and cost-effectiveness.<h4>Methods</h4>MEDLINE, Embase, CINAHL Plus, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to February 2025 for randomized controlled trials evaluating exergaming interventions in older adult populations across all settings. Outcomes included fall rate, number of fallers and injurious falls, and implementation-related secondary outcomes. Risk of bias was assessed using RoB 2.0, and certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were synthesized narra

Falls are a leading cause of injury-related hospitalization, morbidity, and mortality in older adults, with impaired postural control serving as a key predictor of fall risk. The triceps surae, and particularly the soleus, plays a central role in maintaining upright stance by generating continuous plantarflexion moments that stabilize the body's center of mass. This mini-review summarizes evidence for the neuromechanical contributions of the soleus to postural stability and how these functions decline with age. Mechanically, the soleus acts as a brace for balance, providing sustained torque through fatigue-resistant type I fibers and a compliant Achilles tendon that buffers perturbations and contributes to ankle stiffness. Age-related reductions in tendon stiffness and rate of torque development compromise these stabilizing properties, increasing fall susceptibility. When passive stiffness is insufficient, the soleus compensates through active contraction, trading energy cost of activation for joint stability. Reflexively, the soleus serves as a stabilizer of balance through strong coupling to spinal, cutaneous, vestibular, and transcortical pathways that rapidly adjust muscle activation in response to perturbations. These reflex mechanisms also degrade with aging, leading to delayed, less adaptable responses. Together, age-related mechanical and neural deterioration reduce the soleus' ability to sustain balance and contribute to fall recovery. Preserving soleus strength, ten

<h4>Introduction</h4>Given the accelerated aging processes and elevated fall risk associated with functional decline in correctional settings, developing effective exercise programs for older inmates is increasingly important.<h4>Methods</h4>This study examined the potential effects of a six‑week balance‑training program on static and dynamic balance performance, well‑being, and enjoyment of physical activity among older inmates in an open German prison. Ten male inmates (mean age = 62.1 ± 4.4 years) participated, with five assigned to an intervention group and five to a control group. The intervention comprised three 60‑minute sessions per week. based on a standardized balance‑training protocol for older adults. A repeated‑measures design assessed pre‑ and post‑intervention changes in anthropometric data, static balance, static balance on unstable surfaces, dynamic balance, well‑being, and physical activity enjoyment.<h4>Results</h4>The training group showed significant improvements in static balance and static balance on unstable surfaces, corresponding to functional gains of approximately 26% and 33%, respectively. Dynamic balance, well‑being, and enjoyment of physical activity did not change significantly.<h4>Discussion</h4>The observed improvements in static balance suggest that even limited interventions may yield meaningful physical benefits in older inmates. However, the absence of effects on dynamic balance and psychosocial outcomes may reflect the short intervention

With growing global life expectancy, age-related physical problems, including balance impairments, are becoming more prevalent, increasing the risk of falls, mobility limitations, and loss of independence. This review summarizes current evidence on how balance may be influenced and improved by training modalities including reactive, strength-based, and functional exercises, through neuromuscular adaptations relevant to postural control and functional stability in older adults. Emerging evidence suggests that gut microbiota may influence neuromuscular health via neuroimmune, metabolic, and mitochondrial pathways across the gut-muscle-brain axis. However, most studies focus on muscle metabolism, inflammation, and systemic physiological processes rather than direct assessments of balance or postural control. Gut dysbiosis has been associated with sarcopenia and impaired physical function, although evidence linking microbiota alterations to balance outcomes remains limited and mainly observational. Exercise has beneficial effects on neuromuscular function and gut microbial composition, including increased diversity and metabolite production. While exercise-induced neuromuscular adaptations are well supported experimentally, little direct evidence shows the contribution of gut-related mechanisms to balance regulation. Overall, neuromuscular and gut-related processes seem to be associated with balance capacity in older adults; however, further mechanistic and interventional studies

<h4>Objectives</h4>Falls among older people are a significant health issue. Exercise reduces falls, yet many older people do not meet physical activity guidelines. Digital health platforms may improve access to fall prevention programs, but limited research has explored how these platforms meet older people's needs. This study aimed to use co-design principles to develop a website supporting delivery of the TOP UP program in aged care. A secondary aim explored older people's experiences of participating in the co-design process.<h4>Methods</h4>A three-phase co-design study was conducted. Phase 1 used interviews, focus groups and heuristic evaluation to inform development of a prototype website. Participants included 14 older people receiving aged care services (median age 84 years), 10 care staff and six physiotherapists. Phase 2 used think-aloud usability interviews with 11 older people, including Likert scale ratings, to assess navigation, clarity and functionality and refine the prototype. Phase 3 explored participants' experiences of the co-design process.<h4>Results</h4>Thematic analysis identified eight design themes highlighting priorities related to simplicity, accessibility, relatability, safety, customisation and engaging features that supported motivation while minimising staff burden. Feedback on the website was positive and informed improvements in readability, navigation and credibility. Participants reported positive co-design experiences and valued contributin

Falls among older people remain one of the most pressing and persistent public health challenges worldwide [...].

<h4>Introduction</h4>Older adults with mild cognitive impairment (MCI) or dementia have a substantially elevated risk of falls compared with cognitively intact peers, and the consequences of falls in this population are more severe. Multiple exercise modalities, including aerobic exercise, resistance training, balance training, mind-body exercise, multicomponent programs, dual-task training, and exergaming, have been investigated for fall prevention, yet the comparative efficacy of these interventions in cognitively impaired populations remains unclear. Existing evidence relies on pairwise meta-analyses that compare only two interventions at a time, limiting the ability to determine which exercise type is most effective. We will conduct a systematic review and network meta-analysis (NMA) to compare the efficacy of different exercise interventions for fall prevention in older adults with MCI or dementia.<h4>Methods</h4>We will include randomized controlled trials (RCTs) comparing any structured exercise intervention (aerobic exercise, resistance training, balance training, mind-body exercise, multicomponent exercise, dual-task training, or exergaming) with each other or with control conditions in adults aged 60 years or older with MCI or dementia. The co-primary outcomes will be the number of fallers (odds ratio) and the rate of falls (incidence rate ratio). Secondary outcomes will include balance, mobility, cognitive function, fear of falling, and exercise-related adverse eve

Falls are one of the most frequently reported postoperative complications among geriatric patients after total hip replacement (THR) surgery and may lead to fractures, extended hospital stays, delayed rehabilitation, loss of functional independence, and decreased quality of life. Various physiological changes associated with age, muscle weakness from surgery, altered gait patterns, polypharmacy, and environmental hazards all contribute to fall risk during recovery. The What's Important Now (WIN) Fall Prevention Protocol (FPP) is a multidisciplinary, evidence-based rehabilitation program designed to reduce fall risk and maximize postoperative outcomes for older adults who are undergoing THR. The protocol incorporates progressive strength and balance exercises, gait re-education, patient and caregiver education, environmental modifications, medication review, and psychological support into a structured six-week rehabilitation program. A progression of exercises (range of motion, Theraband resistance training, functional strengthening, balance exercises, and task-oriented gait exercises) is outlined to support mobility and confidence while ensuring safe recovery. The protocol also focuses on personalized evaluation and customized treatment, which helps ensure that patients receive the most appropriate care for their needs and that they are more likely to stick to their rehabilitation program. The current evidence for each component of the protocol is summarized, emphasizing the

<h4>Background</h4>Falls are a major public health concern due to their impact on individuals and the health system. StandingTall (Ylva Health Pty Ltd) is a digital balance exercise app that has demonstrated strong adherence and fall-reduction effects in Australia. Before considering implementation in Canada, its acceptability must be assessed.<h4>Objective</h4>This study aimed to explore the prospective acceptability of the StandingTall app among Canadian community-dwelling adults aged 50 years and older with varying levels of physical activity and technological skills.<h4>Methods</h4>A concurrent mixed methods design was guided by the Theoretical Framework of Acceptability (TFA). After viewing a demonstration video, participants completed an online survey in which they rated the 7 TFA constructs using a 5-point Likert scale. Participants also reported demographic and health characteristics. A subsample completed interviews that were also based on TFA constructs. Convergence between data sources was assessed through overall patterns.<h4>Results</h4>In total, 314 individuals completed the survey (mean age 61.8,  SD 8.0 y; n=279, 88.9% female participants) and 22 completed interviews. The mean acceptability score was 5.8  (SD 1.3; out of 7). Participants viewed the StandingTall app positively, valuing its convenience, flexibility, clear design, and alignment with their health and aging goals. Both data sources indicated strong acceptability, shaped by high affective attitude a

<b>Objectives</b>: This study aimed to evaluate the effects of a nurse-led Web-Based Fall Prevention Program (Web-FPP) on fall risk, fear of falling, fall-preventive behaviors, and the number of falls among community-dwelling older adults aged 65 years and older. <b>Methods</b>: A single-blind, stratified randomized controlled trial was conducted with 72 older adults (36 intervention, 36 control) in Türkiye. The Web-FPP was delivered over six weeks and included educational content, video-based exercises, and home safety strategies accessed through a web platform. Outcomes were assessed at baseline, immediately after the intervention, and at 3-month follow-up using the Timed Up and Go test (TUG), the Falls Efficacy Scale (FES), and the Falls Behavioural (FaB) Scale. <b>Results</b>: Compared with the control group, the intervention group showed significantly greater improvements in TUG performance, fear of falling, and fall-preventive behaviors, and these gains were maintained at three months (<i>p</i> < 0.05). No significant between-group difference was observed in the number of falls during the 3-month follow-up (<i>p</i> > 0.05). <b>Conclusions</b>: The findings suggest that nurse-led web-based fall prevention programs may represent an effective community-based strategy for reducing fall risk and fear of falling among older adults. Further studies with longer follow-up are needed to determine their effects on actual fall incidence.

<h4>Background</h4>Falls are a major contributor to injury, disability, and mortality among older adults worldwide. Digital health-based e-counseling has emerged as a scalable strategy to support fall prevention by addressing physical, behavioral, and cognitive risk factors.<h4>Objective</h4>This scoping review aimed to map the scope, characteristics, and outcomes of e-counseling interventions for fall prevention among adults aged 60 years or older.<h4>Methods</h4>Guided by Arksey and O'Malley's framework and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews), we searched PubMed, ScienceDirect, CINAHL, and ProQuest for studies published between January 2019 and May 2025. Eligible studies evaluated digital or telehealth-based counseling interventions for fall prevention. Data were synthesized descriptively, and methodological quality was appraised using the Mixed Methods Appraisal Tool.<h4>Results</h4>A total of 13 studies were included, comprising randomized controlled trials, feasibility studies, qualitative research, and retrospective cohorts conducted across Asia, Europe, and North America. e-Counseling modalities included virtual reality, mobile health application, teleconsultations, and wearable-triggered feedback systems. Reported outcomes included reductions in fall incidence ranging from 15% to 90.9%, improvements in balance and mobility, increased fall risk awareness, and enhanced

<h4>Background</h4>Falls are a major health concern among older adults, leading to injury, reduced independence, and increased healthcare cost. Reactive balance training can reduce fall risk, but barriers such as fear, joint discomfort, and harness burden limit its use - barriers that training in aquatic environment  may help overcome.<h4>Objective</h4>To design an aquatic reactive balance training (AquaReBal) program for older adults, integrating end-user perspectives to enhance safety, accessibility, and engagement.<h4>Methods</h4>Using a participatory design approach grounded in Participatory Action Research principles, we engaged three older adult partners, physiotherapists, and researchers in iterative phases including literature review, stakeholder consultations, practical pool sessions, and feedback meetings. Data collected through online meetings, surveys, field notes, and observations were reviewed using an inductive qualitative content analysis approach to inform iterative refinement of the intervention, following the Guidance for Reporting Involvement of Patients and the Public 2 framework.<h4>Results</h4>Three older adult partners and a multidisciplinary team co-designed the AquaReBal protocol through two participatory design sessions, one practical pool session, and two internal team sessions. Key recommendations from partners included using a vest instead of a hip belt for perturbations, addressing pool depth visibility, and creating an introductory package with