A Novel Multisegmental Individual-Based Exercise Approach for Postural Dysfunction and Balance Impairment in Older Adults: Randomized Controlled Trial

Background Age-related decline in mobility and balance substantially increases the risk of falls in older adults. Evidence-based exercise programs are recommended, but their effectiveness requires further evaluation. Objective The study aimed to find out the effectiveness of multisegmental individual-based exercise program (MIBEX) approach for postural dysfunction and balance impairment in older adults. Methods A 2-arm, single-blinded randomized controlled trial was conducted with 113 community-dwelling adults aged 65 years or older (exercise group, n=56; control group, n=57). Participants in the intervention arm received MIBEX, while the control group received postural education via video. Outcomes included the Timed Up and Go test, tragus-to-wall test, Mini-Balance Evaluation Systems Test, and postural sway, measured at baseline and 3 postintervention time points. Between-group comparisons were analyzed using the Mann-Whitney U test with effect sizes ( r ) and 95% CIs. Results Significant between-group differences were observed across all outcomes ( P <.01). The exercise group showed improvements in the Timed Up and Go test (median reduction from 15, IQR 13‐19 to 10, IQR 8‐12 s) compared with controls (15, IQR 13-18 to 12, IQR 10-14 s), with a large effect size ( r =0.65, 95% CI 0.45‐0.80). Tragus-to-wall test performance improved markedly in the intervention group (median increase from 41, IQR 36-47 to 49, IQR 44-54 cm) versus controls (40, IQR 35-46 to 37, IQR 31-43 cm; r =0.52, 95% CI 0.30‐0.70). Mini-Balance Evaluation Systems Test scores declined in controls but improved in the intervention group ( r =0.48, 95% CI 0.25‐0.66). Postural sway demonstrated moderate improvement ( r =0.40, 95% CI 0.18‐0.58). Conclusions These findings indicate that the MIBEX produced significantly greater improvements in mobility, balance, and postural stability compared with usual care, highlighting its potential as an effective intervention for older adults.