Trunk motion visual feedback during walking improves dynamic balance in older adults: Assessor blinded randomized controlled trial.

Only 40 older adults were analysed, and they were recruited using self-reported balance problems, so the results may not apply to more impaired clinical populations. Fourteen of the 40 participants were classified as fallers, and many scored above the cut-off thresholds for identifying increased fall risk, so the sample was not uniformly high-risk. Participants had to pass a brief cognitive screen and walk safely on a treadmill for at least 2 minutes, which excludes some older adults who might need balance training. Only the assessors were blinded; participants were not explicitly told their group but were not blinded, so performance or reporting could be affected. The study had no follow-up after week 8, so it is unknown how long any benefit lasted. The average improvement on the primary tests was below the minimum detectable change reported for those tests, and only three individuals exceeded it on the BESTest and another three exceeded it on the mini-BESTest. The sensory subgroup findings were exploratory and involved small numbers, with 4 or 5 participants in each sensory category, so they cannot determine who will benefit. The Berg Balance Scale, Activities-specific Balance Confidence scale, and 6-minute walk test may not have been sensitive enough to capture change: the Berg Balance Scale had a possible ceiling effect, confidence scores were above the fall-risk threshold, and the walking speed task was designed not to change walking ability. It is unknown whether sensory function or sensitivity changed after training, which could have contributed to the results. Two authors are listed as inventors of the sensory treadmill used in the study.

J Jeka and E Anson are listed as inventors of the sensory treadmill described in the experiment; all other authors declared no conflict of interest.

Do not conclude that this feedback prevents falls or produces clinically meaningful improvement for most participants. The trial measured balance test scores, not fall outcomes, and the average improvement was below the change usually needed to be sure an individual improved.