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.