The comparison of the effects of physical activity and neurofeedback training on postural stability and risk of fall in elderly women: A single-blind randomized controlled trial

Abstract

Study Design: This was a single-blind randomized controlled trial. Background: Fall and postural instability are common undesirable consequences of the elderly. Although the benefits of exercise for fall prevention have been demonstrated, the majority of the elderly are physically inactive due to several physical and mental limitations they may face. Another alternative treatment such as neurofeedback with providing additional sensory information may enhance movement performance and so decrease the risk of fall. Objectives: To compare the effects of physical activity and neurofeedback training on postural stability and risk of fall in elderly women. Methods: Forty-five physically independent women who were older than 65 years old, living in the Fereshtegan Elderly Care Center in Shiraz, were recruited and randomly divided into three groups including control, physical activity, and neurofeedback training (15 people in each group). Participants in experimental groups trained for 12 weeks (3 days per week/30 minutes per session). Fall risk and postural stability of participants in all three groups were evaluated before and after intervention using the Biodex Balance System. Results: A mixed model design ANOVA comparing neurofeedback training and physical activity exhibited a significantly greater improvement in both risk of fall and postural stability compared to control (P < .05). Results of post-hoc analysis further indicated that neurofeedback training compared to physical activity can be superior beneficial in reducing risk of fall (P = .005) and improving postural stability (P = .005). There were also significant interactions between group and time of fall risk (P = .0005, ηp² = 0.97) and postural stability (P = .001, ηp² = 0.79). Conclusion: Both neurofeedback and physical activity could be considered as useful alternative for postural stability and balance improvement in elderly women; however, neurofeedback training was more effective than physical activity.

Keywords: Elderly women; double-blind randomized controlled trial; neurofeedback; physical activity; postural stability; risk of fall.