Interventions for addressing low balance confidence in older adults: A systematic review and meta-analysis

Background: Low balance confidence is a major health problem among older adults restricting their participation in daily life. Objectives: To determine what interventions are most effective in increasing balance confidence in older adults. Design: Systematic review with meta-analysis of randomised controlled trials including at least one continuous end point of balance confidence. Studies, including adults 60 years or older without a neurological condition, were included in our study. Methods: The standardised mean difference (SMD) of continuous end points of balance confidence was calculated to estimate the pooled effect size with random-effect models. Methodological quality of trials was assessed using the Physical Therapy Evidence Database (PEDro) Scale. Results: Thirty studies were included in this review and a meta-analysis was conducted for 24 studies. Interventions were pooled into exercise (n = 9 trials, 453 subjects), Tai Chi (n = 5 trials, 468 subjects), multifactorial intervention (n = 10 trials, 1,233 subjects). Low significant effects were found for exercise and multifactorial interventions (SMD 0.22-0.31) and medium (SMD 0.48) significant effects were found for Tai Chi. Conclusion: Tai chi interventions are the most beneficial in increasing the balance confidence of older adults.