Author(s): THEODOSIADOU, A., FABRE, M., SAHINIS, C., PAPAVASILEIOU, A., PATIKAS, D.A., AMIRIDIS, I.G., LAPOLE, T., BAUDRY, S., Institution: UNIVERSITÉ LIBRE DE BRUXELLES, Country: BELGIUM, Abstract-ID: 1613

INTRODUCTION:
Aging results in a progressive decline of motor control, affecting static and dynamic balance (1). Balance training programs for elderly individuals typically involve exercises targeting various factors, such as visual input, surface type, or foot positioning (2), but rarely incorporate specific stimulation of the neuromuscular system to enhance the training effects. While previous studies have focused on techniques like vibration or electrical stimulation (3,4), the combination of both remains largely unexplored. This study aims to investigate the effects of four balance training interventions that integrate balance exercises and neuromuscular stimulation.
METHODS:
Seventy-four healthy older adults (75-87 years old) completed a 6-month protocol that included 8 weeks of tailored balance training consisting of either 40-min session of balance exercises alone (CON group) or combined with concurrent application of electrical stimulation (TENS group), vibration (LV group) or both (LV+TENS group). Four evaluations were conducted: 8 weeks before the training (T1), 1-7 days before the training (T2), 1-7 days after the training period (T3), and after an 8-week retention period with no training (T4). The assessment included the 10-Meter Walking Test (10MWT), 6-Minute Walking Test (6MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), and Short Physical Performance Battery (SPPB). Linear mixed model (fixed effect: evaluation and group, random effect: participants) were used for analysis.
RESULTS:
No significant differences were found between T1 and T2 for any test (p>0.05), without group differences either. No significant effects of training (p=0.138) or group (p=0.525) were observed for the 6mWT. However, an improvement in 10mWT (p=0.004), TUG (p<0.001), SPPB (p<0.001) and BBS (p<0.001) was observed from T2 to T3, without differences between groups. After the retention period, the scores returned to their initial values (as in T2) for the TUG, SPPB and BBS (p=0.002; p=0.049; p<0.001, respectively) without differences between groups (p>0.05).
CONCLUSION:
These findings suggest that tailored balance training significantly enhances clinical balance performance, underscoring its importance as a non-pharmacological intervention to combat age-related decline in balance capacity. However, the addition of LV and TENS did not give additional benefits compared to exercises alone. This suggests that while these modalities are often posited to enhance neuromuscular activation and proprioceptive feedback, their contribution to balance improvement may be limited, at least in the context of this study. One possible explanation could be that the balance exercises provided sufficient stimulus for adaptation, leaving little range for additional gains from LV or TENS.

References
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2.Martínez-Amat et al. (2013). J Strength Cond Res 27, 2180–2188.
3.Filippi et al. (2009). Arch Phys Med Rehabil 90, 2019–2025.
4.Park et al. (2014). Med Sci Monit 20, 1890–1896.