Comparative Effectiveness of Balance Training on Dynamic Balance in Older Adults: A Systematic Review

Abstrak

Background: Impairment in dynamic balance is a major contributor to falls among older adults and represents a critical target for rehabilitation. Although various balance training approaches have been developed, their comparative effectiveness remains unclear.
Objective: To evaluate and compare the effectiveness of multicomponent, technology-based, and dual-task balance training in improving dynamic balance in older adults.
Methods: A systematic review was conducted in accordance with PRISMA guidelines. Four electronic databases (Scopus, PubMed, Google Scholar, and Semantic Scholar) were searched for randomized controlled trials published between 2018 and 2025. Studies involving participants aged ≥60 years and reporting dynamic balance outcomes were included. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Due to heterogeneity in interventions and outcome measures, findings were synthesized narratively.
Results: Nine studies involving approximately 553 participants were included. All studies reported improvements in dynamic balance, with most demonstrating statistically significant effects (p < 0.05). Technology-based and dual-task interventions tended to produce greater improvements compared with multicomponent training; however, results were not consistent across all studies. Reported effect sizes ranged from moderate to large (Cohen’s d up to 1.12; η² up to 0.395), while reporting of confidence intervals was inconsistent.
Conclusion: Balance training is effective in improving dynamic balance in older adults. Technology-based and dual-task approaches may provide additional benefits; however, these findings should be interpreted with caution due to methodological variability. Clinical implementation should consider individual patient characteristics.