A review of concurrent sonified biofeedback in balance and gait training.
Antonia Zaferiou, Zahava Hirsch, Tristan Bacani and 1 others
PMID 40011952WHAT IT FOUND
Most studies testing sound-based balance feedback reported improvements, but many were small and short-term.
Clinicians should view this as promising research rather than established practice, as evidence for long-term skill transfer is currently lacking.
Key findings
01Positive effects from experiments using sonified biofeedback were shared in 47 of 49 prior papers.
02Most feet-in-place balance studies did not assess if improvements transferred to other tasks, limiting knowledge of clinical impact.
03Gait training studies included more randomized controlled trials and longitudinal designs compared to balance studies.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review includes many small studies, with 12 feet-in-place studies having fewer than 20 participants. Most feet-in-place studies were cross-sectional and did not test if balance improvements transferred to real-world tasks. The quality of reporting varied, with many studies failing to describe the sound design details or system latency. The review excluded studies that combined sound with visual or haptic feedback, so the effect of multimodal systems is unknown.
Declared interests
The research was supported by the NIH and NSF. No specific commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that short-term improvements in lab-based sway or gait metrics translate to long-term clinical benefits or fall reduction. The review notes that most balance studies did not test skill transfer to other tasks, and many included studies were small pilots without control groups.