Machines that go ”ping” may improve balance but may not improve mobility or reduce risk of falls: A systematic review

OBJECTIVE: To determine the effectiveness of computer-based electronic devices that provide feedback in improving mobility and balance and reducing falls. DATA SOURCES: Randomized controlled trials were searched from the earliest available date to August 2013. DATA EXTRACTION: Standardized mean differences were used to complete meta-analyses, with statistical heterogeneity being described with the I-squared statistic. The GRADE approach was used to summarize the level of evidence for each completed meta-analysis. Risk of bias for individual trials was assessed with the (Physiotherapy Evidence Database) PEDro scale. DATA SYNTHESIS: Thirty trials were included. There was high-quality evidence that computerized devices can improve dynamic balance in people with a neurological condition compared with no therapy. There was low-to-moderate-quality evidence that computerized devices have no significant effect on mobility, falls efficacy and falls risk in community-dwelling older adults, and people with a neurological condition compared with physiotherapy. CONCLUSION: There is high-quality evidence that computerized devices that provide feedback may be useful in improving balance in people with neurological conditions compared with no therapy, but there is a lack of evidence supporting more meaningful changes in mobility and falls risk.