Effects of different neuromuscular training modalities on balance performance in older adults: a systematic review and network meta-analysis
Neuromuscular training (NMT) is widely utilized to enhance balance and reduce fall risk in older adults, yet comparative effectiveness across various modalities remains unclear. This study aimed to systematically assess and rank the effects of sensorimotor training (ST), whole-body vibration trainin...
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| Published in | Frontiers in physiology Vol. 16; p. 1623908 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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Frontiers Media S.A
08.08.2025
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| Online Access | Get full text |
| ISSN | 1664-042X 1664-042X |
| DOI | 10.3389/fphys.2025.1623908 |
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| Abstract | Neuromuscular training (NMT) is widely utilized to enhance balance and reduce fall risk in older adults, yet comparative effectiveness across various modalities remains unclear. This study aimed to systematically assess and rank the effects of sensorimotor training (ST), whole-body vibration training (WBVT), neurofunctional training (NT), and balance training (BT) on balance performance in older adults.
A systematic review and network meta-analysis was conducted following PRISMA guidelines, including 49 randomized controlled trials with a total of 3,028 older adults. Intervention efficacy was assessed through dynamic balance (Timed Up and Go Test [TUGT], Walk Test [WT]) and static balance (Berg Balance Scale [BBS]) outcomes.
Significant improvements in dynamic balance (TUGT) were observed with ST (SMD = -0.92; 95% CI: -1.66, -0.18) and NT (SMD = -0.92; 95% CI: -1.44, -0.40), which ranked highest in efficacy (NT: 85.9%, ST: 83.4%). WBVT (SMD = -0.35; 95% CI: -0.69, -0.02) and BT (SMD = -0.33; 95% CI: -0.64, -0.01) also showed statistically significant, but modest effects on dynamic balance. In contrast, the effects of all interventions on static balance, as measured by the BBS, were not statistically significant, suggesting limited and inconclusive evidence regarding their impact on postural stability. Although ST ranked highest in WT (73.7%) and BT showed a favorable SUCRA value in BBS (60.2%), these rankings should be interpreted with caution.
The corresponding effect sizes were small and not statistically significant, indicating that SUCRA reflects relative ranking probability rather than actual clinical efficacy. Therefore, the potential benefits for improving static balance and walking speed remain limited and inconclusive. ST and NT were identified as the most effective NMT modalities for significantly enhancing dynamic balance in older adults, indicating their suitability for targeted interventions in fall prevention strategies.
https://inplasy.com/inplasy-2025-4-0015/, identifier INPLASY202540015. |
|---|---|
| AbstractList | Neuromuscular training (NMT) is widely utilized to enhance balance and reduce fall risk in older adults, yet comparative effectiveness across various modalities remains unclear. This study aimed to systematically assess and rank the effects of sensorimotor training (ST), whole-body vibration training (WBVT), neurofunctional training (NT), and balance training (BT) on balance performance in older adults.BackgroundNeuromuscular training (NMT) is widely utilized to enhance balance and reduce fall risk in older adults, yet comparative effectiveness across various modalities remains unclear. This study aimed to systematically assess and rank the effects of sensorimotor training (ST), whole-body vibration training (WBVT), neurofunctional training (NT), and balance training (BT) on balance performance in older adults.A systematic review and network meta-analysis was conducted following PRISMA guidelines, including 49 randomized controlled trials with a total of 3,028 older adults. Intervention efficacy was assessed through dynamic balance (Timed Up and Go Test [TUGT], Walk Test [WT]) and static balance (Berg Balance Scale [BBS]) outcomes.MethodsA systematic review and network meta-analysis was conducted following PRISMA guidelines, including 49 randomized controlled trials with a total of 3,028 older adults. Intervention efficacy was assessed through dynamic balance (Timed Up and Go Test [TUGT], Walk Test [WT]) and static balance (Berg Balance Scale [BBS]) outcomes.Significant improvements in dynamic balance (TUGT) were observed with ST (SMD = -0.92; 95% CI: -1.66, -0.18) and NT (SMD = -0.92; 95% CI: -1.44, -0.40), which ranked highest in efficacy (NT: 85.9%, ST: 83.4%). WBVT (SMD = -0.35; 95% CI: -0.69, -0.02) and BT (SMD = -0.33; 95% CI: -0.64, -0.01) also showed statistically significant, but modest effects on dynamic balance. In contrast, the effects of all interventions on static balance, as measured by the BBS, were not statistically significant, suggesting limited and inconclusive evidence regarding their impact on postural stability. Although ST ranked highest in WT (73.7%) and BT showed a favorable SUCRA value in BBS (60.2%), these rankings should be interpreted with caution.ResultsSignificant improvements in dynamic balance (TUGT) were observed with ST (SMD = -0.92; 95% CI: -1.66, -0.18) and NT (SMD = -0.92; 95% CI: -1.44, -0.40), which ranked highest in efficacy (NT: 85.9%, ST: 83.4%). WBVT (SMD = -0.35; 95% CI: -0.69, -0.02) and BT (SMD = -0.33; 95% CI: -0.64, -0.01) also showed statistically significant, but modest effects on dynamic balance. In contrast, the effects of all interventions on static balance, as measured by the BBS, were not statistically significant, suggesting limited and inconclusive evidence regarding their impact on postural stability. Although ST ranked highest in WT (73.7%) and BT showed a favorable SUCRA value in BBS (60.2%), these rankings should be interpreted with caution.The corresponding effect sizes were small and not statistically significant, indicating that SUCRA reflects relative ranking probability rather than actual clinical efficacy. Therefore, the potential benefits for improving static balance and walking speed remain limited and inconclusive. ST and NT were identified as the most effective NMT modalities for significantly enhancing dynamic balance in older adults, indicating their suitability for targeted interventions in fall prevention strategies.ConclusionThe corresponding effect sizes were small and not statistically significant, indicating that SUCRA reflects relative ranking probability rather than actual clinical efficacy. Therefore, the potential benefits for improving static balance and walking speed remain limited and inconclusive. ST and NT were identified as the most effective NMT modalities for significantly enhancing dynamic balance in older adults, indicating their suitability for targeted interventions in fall prevention strategies.https://inplasy.com/inplasy-2025-4-0015/, identifier INPLASY202540015.Systematic Review Registrationhttps://inplasy.com/inplasy-2025-4-0015/, identifier INPLASY202540015. BackgroundNeuromuscular training (NMT) is widely utilized to enhance balance and reduce fall risk in older adults, yet comparative effectiveness across various modalities remains unclear. This study aimed to systematically assess and rank the effects of sensorimotor training (ST), whole-body vibration training (WBVT), neurofunctional training (NT), and balance training (BT) on balance performance in older adults.MethodsA systematic review and network meta-analysis was conducted following PRISMA guidelines, including 49 randomized controlled trials with a total of 3,028 older adults. Intervention efficacy was assessed through dynamic balance (Timed Up and Go Test [TUGT], Walk Test [WT]) and static balance (Berg Balance Scale [BBS]) outcomes.ResultsSignificant improvements in dynamic balance (TUGT) were observed with ST (SMD = −0.92; 95% CI: −1.66, −0.18) and NT (SMD = −0.92; 95% CI: −1.44, −0.40), which ranked highest in efficacy (NT: 85.9%, ST: 83.4%). WBVT (SMD = −0.35; 95% CI: −0.69, −0.02) and BT (SMD = −0.33; 95% CI: −0.64, −0.01) also showed statistically significant, but modest effects on dynamic balance. In contrast, the effects of all interventions on static balance, as measured by the BBS, were not statistically significant, suggesting limited and inconclusive evidence regarding their impact on postural stability. Although ST ranked highest in WT (73.7%) and BT showed a favorable SUCRA value in BBS (60.2%), these rankings should be interpreted with caution.ConclusionThe corresponding effect sizes were small and not statistically significant, indicating that SUCRA reflects relative ranking probability rather than actual clinical efficacy. Therefore, the potential benefits for improving static balance and walking speed remain limited and inconclusive. ST and NT were identified as the most effective NMT modalities for significantly enhancing dynamic balance in older adults, indicating their suitability for targeted interventions in fall prevention strategies.Systematic Review Registrationhttps://inplasy.com/inplasy-2025-4-0015/, identifier INPLASY202540015 Neuromuscular training (NMT) is widely utilized to enhance balance and reduce fall risk in older adults, yet comparative effectiveness across various modalities remains unclear. This study aimed to systematically assess and rank the effects of sensorimotor training (ST), whole-body vibration training (WBVT), neurofunctional training (NT), and balance training (BT) on balance performance in older adults. A systematic review and network meta-analysis was conducted following PRISMA guidelines, including 49 randomized controlled trials with a total of 3,028 older adults. Intervention efficacy was assessed through dynamic balance (Timed Up and Go Test [TUGT], Walk Test [WT]) and static balance (Berg Balance Scale [BBS]) outcomes. Significant improvements in dynamic balance (TUGT) were observed with ST (SMD = -0.92; 95% CI: -1.66, -0.18) and NT (SMD = -0.92; 95% CI: -1.44, -0.40), which ranked highest in efficacy (NT: 85.9%, ST: 83.4%). WBVT (SMD = -0.35; 95% CI: -0.69, -0.02) and BT (SMD = -0.33; 95% CI: -0.64, -0.01) also showed statistically significant, but modest effects on dynamic balance. In contrast, the effects of all interventions on static balance, as measured by the BBS, were not statistically significant, suggesting limited and inconclusive evidence regarding their impact on postural stability. Although ST ranked highest in WT (73.7%) and BT showed a favorable SUCRA value in BBS (60.2%), these rankings should be interpreted with caution. The corresponding effect sizes were small and not statistically significant, indicating that SUCRA reflects relative ranking probability rather than actual clinical efficacy. Therefore, the potential benefits for improving static balance and walking speed remain limited and inconclusive. ST and NT were identified as the most effective NMT modalities for significantly enhancing dynamic balance in older adults, indicating their suitability for targeted interventions in fall prevention strategies. https://inplasy.com/inplasy-2025-4-0015/, identifier INPLASY202540015. |
| Author | Zhong, Yuanji Chen, Penghong Guo, Wenhao Liu, Jingjin Chen, Pengwei Wang, Yongshun Xue, Yang |
| AuthorAffiliation | 1 School of Physical Education and Arts , Jiangxi University of Science and Technology , Ganzhou , China 5 Department of Cardiology , Shenzhen People’s Hospital , The First Affiliated Hospital of Southern University of Science and Technology , The Second Clinical Medical College , Jinan University , Shenzhen , Guangdong , China 3 College of Physical Education , Huaqiao University , Quanzhou , China 2 School of Recreational Sports and Tourism , Beijing Sport University , Beijing , China 4 School of Physical Education , Zhengzhou Normal University , Zhengzhou , China |
| AuthorAffiliation_xml | – name: 2 School of Recreational Sports and Tourism , Beijing Sport University , Beijing , China – name: 1 School of Physical Education and Arts , Jiangxi University of Science and Technology , Ganzhou , China – name: 3 College of Physical Education , Huaqiao University , Quanzhou , China – name: 5 Department of Cardiology , Shenzhen People’s Hospital , The First Affiliated Hospital of Southern University of Science and Technology , The Second Clinical Medical College , Jinan University , Shenzhen , Guangdong , China – name: 4 School of Physical Education , Zhengzhou Normal University , Zhengzhou , China |
| Author_xml | – sequence: 1 givenname: Yuanji surname: Zhong fullname: Zhong, Yuanji – sequence: 2 givenname: Pengwei surname: Chen fullname: Chen, Pengwei – sequence: 3 givenname: Wenhao surname: Guo fullname: Guo, Wenhao – sequence: 4 givenname: Yongshun surname: Wang fullname: Wang, Yongshun – sequence: 5 givenname: Yang surname: Xue fullname: Xue, Yang – sequence: 6 givenname: Penghong surname: Chen fullname: Chen, Penghong – sequence: 7 givenname: Jingjin surname: Liu fullname: Liu, Jingjin |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40861893$$D View this record in MEDLINE/PubMed |
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| Keywords | balance performance neuromuscular training older adults network meta-analysis fall prevention |
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| Title | Effects of different neuromuscular training modalities on balance performance in older adults: a systematic review and network meta-analysis |
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