Improved Balance and Walking Capacities after Tailored Balance Training with and without Superimposed Sensory Stimulation in Older Adults

Purpose: We investigated the impact of an 8-week tailored balance program, with or without superimposed sensory stimulation (local vibration, LV, and/or transcutaneous electrical nerve stimulation, TENS), on balance and walking performance in older adults. Methods: Seventy-five healthy elderly participants (age 79.9 ± 3.9 years) were randomly assigned to one of four groups: postural exercises only (n=17), exercises with LV (n=19), exercises with TENS (n=19), and exercises with LV+TENS (n=20). For LV, TENS and LV+TENS groups, proprioceptive stimulation targeted the triceps surae and tibialis anterior. Participants completed a baseline assessment including the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), 6-minute walk test (6minWT), 10-meter walk test (10MWT), and Timed Up and Go test (TUG). A similar assessment was performed 8 weeks later, and after the 8-week tailored intervention which consisted of two 1-hour sessions per week. Balance and walking capacities were finally reassessed 8 weeks after training. Results: In all groups, reliability of the outcomes measures was moderate to high between baseline and pre-intervention values (ICC>0.63). Post-intervention, linear mixed-effects models revealed significant improvements in BBS and SPPB scores (53.1±2.4 and 10.9±0.9 vs. 54.9±2.4 and 11.5±0.9, p<0.001), and reduced times for TUG (7.3±1.7sec vs. 6.6±1.7sec, p<0.001) and increased 10MWT velocity (3.6±0.7m/sec vs. 3.4±0.7m/sec, p=0.004), with no group differences nor interactions. Benefits were partially maintained 8 weeks after training. The interventions did not affect 6minWT performance (525.5±75.1m vss 527.8±74.1m, p=0.143). Conclusions: Tailored balance exercises alone significantly enhanced postural control and walking capacity in healthy older adults. Additional sensory stimulation provided no extra benefit, suggesting that for healthy older adults without major balance impairments, exercises alone may suffice to achieve meaningful functional improvements.