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Table 1 Characteristics of studies exploring the association between Physical Activity and Balance in community dwelling healthy older adults (50 years and over)

From: The association between balance and free-living physical activity in an older community-dwelling adult population: a systematic review and meta-analysis

Study Author

Study Design

Study Population

Physical Activity measure (type, level)

Outcome measures of balance

Main Finding

N, Age (mean & range) % female, race, ethnicity, height (m), weight (kg), BMI, education, country, setting, consent

More active (MA)

V less active (LA)

Measure, Duration, Intensity

Neuromuscular

(Gait (G); Strength (S); Functionality (FU); Flexibility (FL)

Cognitive

Sensory

Other

Observational Studies:

Aoyagi et al., 2009 [47]

Prospective cohort

1 year

Recruitment: Nakanojo study

Conflict of Interest:

N/k

Source of funding: declared

N: 170

Age: 72.6 ± 4.6 yrs

(65-84 yrs)

55% women

Height(m): 1.53 ± 0.08

Weight(kg): 54.3 ± 8.6

BMI: 23.3 ± 3.3

Japan

Community setting

Written informed consent

MA group: 65-74 yr group

LA group: 75-84 yr group

Accelerometer

MA group: 7190 ± 2491

steps per day

LA group: 5482 ± 2829

steps per day

Indirect measure

- (G) Walking speed (preferred &

maximal) (5 m) (velocity - m/s)

- (S) Handgrip test (dynamometer)

(force - n)

- (S) Isometric knee extension

(dynamometer) (torque –

N*m/kg)

- (FL) Functional reach test

(distance - m)

Direct measure

Static balance test:

Total body stability (eyes open/closed) (sway distance - m)

n/a

n/a

n/a

Measures of physical fitness except handgrip and total body sway were greater for MA group (65-74 yr).

Brooke-Wavell & Cooling, 2008 [50]

Cross sectional

1 time point

Recruitment: local bowls clubs; media & friends & family)

Conflict of Interest:

N/k

Source of funding: N/k

N: 74

Age: 68.3 ± 4.65 yrs

(60-75 yrs)

100% women

Weight(kg): 69.2 ± 10.1

BMI(kg/m2): 26.95 ± 3.9

Community setting

Written informed consent

MA group: Bowlers

LA group: non-bowlers

MA group:

2–3+ hours of PA per week

LA group: less than 3 h PA per week

Indirect measure

(S) Isometric knee & hip extension (scat & force meter) (force - n)

(S) BUA of the calcaneus (Osteometer) (dB/MHz)

(FL) TUG (3 m) (time - s)

(FL) Range of Motion: shoulder & ankle (goniometer) (degrees°)

Direct measure

Static balance test

Total body stability (eyes open/closed (distance - mm)

Reaction time (s)

n/a

Falls

MA group had significantly better postural stability, muscle strength, and flexibility.

Buatois et al., 2007 [51]

Cross sectional

1 time point

Recruitment: cohort from a larger study on fall prevention

Conflict of Interest:

N/k

Source of funding: declared

N: 130

Age: 70.3 ± 4.3 yrs

41% women

BMI(kg/m2): 26.28 ± 3.75

Community setting

Written informed consent

MA group: PA -walking, cycling, swimming, gymnastics;

PA experience: 28 ± 9.5 yrs

LA group: no PA

MA group: 1–2 h per week

LA group: no PA

Direct measure

Sensory Organisation Test (equilibrium scores and composite score)

n/a

n/a

n/a

Sensory conflicting conditions were more challenging for LA group who swayed more and frequently lost balance than MA group.

Dewhurst et al., 2014 [69]

Cross sectional

1 time point

Recruitment: n/k

Conflict of Interest:

N/k

Source of funding: N/k

N: 60

Mean age: 69.36 ± 2.9 yrs

(60-80 yrs)

100% women

Height(m): 1.58 ± 0.07

Weight(kg): 64.05 ± 8.15

BMI(kg/m2): 25.95 ± 3.9

Waist(cm):82.45 ± 9.08

Hip (cm): 102.6 ± 7.62

Waist/hip ratio: 0.80 ± 0.2

Scotland

Community setting

Written informed consent

MA group: Dancers

LA group: Non-dancers

RAPA

MA group: 2.5 h hours of PA per week

10 yrs Scottish dance experience

LA group:

2.5 h PA per week (no dancing)

Indirect measure

(G) Walking speed (preferred/maximum) (6 m) (speed - s)

(FL) Timed Up & Go (2.44 m) (time to complete - s)

(FL) Range of motion: Chair sit & reach test (distance - cm)

(FL) Range of motion: Back scratch test (left/right shoulder) (distance - cm)

Direct measure

Static balance test

Total body stability (sway area -cm2)

n/a

n/a

n/a

No differences in measures of flexibility between groups. Better results for MA group on measures of TUG, walking and sway.

Fong & Ng, 2006 [52]

Cross sectional

1 time point

Recruitment: n/k

Conflict of Interest:

N/k

Source of funding: N/k

N: 48

Age: 55.4 ± 11.5 yrs

50% women

Community setting

Written informed consent

MA group: tai chi

LA group: no tai chi

MA group: 3-6 h per week

1-3 yrs tai chi experience

LA group: no tai chi

Indirect measure

(FL) Knee repositioning (electrogoniometer) (°degrees; absolute error)

Direct measure

Tilt board (balance time - s)

Reaction time (electromyography) (ms)

Knee angle repositioning

n/a

MA group had better reaction times, knee joint positioning, and dynamic standing balance measures than LA group.

Fong et al., 2014 [53]

Cross sectional

1 time point

Recruitment: martial arts and elderly centres

Conflict of Interest:

N/k

Source of funding: N/k

N: 84

Age: 64.39 ± 11.9 yrs

44% women

Weight(Kg): 63.2 ± 11.8

Height(m): 1.60 ± 0.09

BMI(kg/m2): 49.3 ± 3.65

Falls: 0.1 ± 0.35

Community setting

Written informed consent

MA group: martial arts

LA group: no martial arts

MA group: 2 h per week of martial arts

Experience: 8 ± 9.9 yrs

LA group: no martial arts

Direct measure

(S) Bone ultrasound: arm (SOS T & Z scores)

Indirect measure

(FU) Five times sit to stand (time to complete s)

(FU) Berg Balance Scale (14 items) (max score 56)

ABC (16 items)

n/a

n/a

MA had better bone strength, lower limb muscular strength and better functional balance than LA group.

Gao et al., 2011 [48]

Cross sectional

1 time point

Recruitment: local golf clubs, community centres

Authors declare no conflict of interest

Source of funding: declared

N: 23

Age: 68.75 ± 6.7 yrs

(60-80 yrs)

0% women

Height(m): 1.6 ± 0.06

China

Community setting

Written informed consent

MA group: Golfers

LA group: Non-golfers

MLTPAQ

MA group:

Light =6

Mod. =4

Heavy =1

LA group:

Light =10

Mod. = 2

Heavy =0

Indirect measure

(FL) Functional reach test (forward) (functional reach normalised with body height - %)

Direct measure

Sensory Organisation Test (somatosensory, visual and vestibular ratios)

MMSE (30 items)

ABC (mod.)(16 items)

n/a

n/a

MA group had better balance control, reach, postural control, visual & vestibular inputs. No significant difference between somatosensory ratios between groups.

Gauchard et al., 1999 [54]

Cross sectional

1 time point

Recruitment: cohort involved in a study of ageing

Conflict of Interest:

N/k

Source of funding: N/k

N: 40

Age: 72.7 ± 6.5 yrs

70% women

Community setting

Informed consent

MA group: yoga & soft gymnastics

LA group: walking

MA group: 90mins per week

LA group: 5 km per week

Indirect measure

(S) Knee & ankle extension/flexion, dynamometer (power - Nm/s; strength - Nm)

Direct measure

Dynamic balance test

AP stability (eyes open/closed) (foot displacement - FFT; strategy type - Type 1, 2, & 3)

n/a

n/a

n/a

Regular PA improves measures of strength and postural control.

Gauchard et al., 2001 [55]

Cross sectional

1 time point

Recruitment: cohort involved in a study of ageing

Conflict of Interest:

N/k

Source of funding: N/k

N: 36

Age: 72.9 ± 6.5 yrs

72% women

Community setting

Informed consent

MA group: yoga & soft gymnastics

LA group: walking

MA group: 90mins per week and 5 km walking per week

LA group: 5 km per week

Direct measure

Static balance test

AP (eyes open/closed) (EC/EO ratio)

Dynamic balance test

AP stability (eyes open/closed) (component velocities of nystagmus -left, right, total R-MSCV; L-MSCV; T-MSCV; strategy type Type 1, 2, 3)

n/a

Vestibular tests (caloric/rotational-vestibular reflectivity)

n/a

Inactivity causes poor balance, vestibular hypo excitability and dependency on visual afferent. PA such as yoga improves dynamic postural control.

Gauchard et al., 2003 [56]

Cross sectional

1 time point

Recruitment: cohort study of age-related physiology

Conflict of Interest:

N/k

Source of funding: N/k

N: 44

Median age: 73.33 yrs

(63-85 yrs)

100% women

Community setting

Written informed consent

MA group: yoga & soft gymnastics

LA group: no PA: walking

MA group: 90 mins per week

LA group: n/k

Direct measures

Static balance test

Total body stability (sway distance - m; sway area -cm2)

AP & ML stability (eyes open/closed) (sway distance - m; sway area - cm°; ratio - EO/EC)

n/a

n/a

n/a

Regular PA increases postural control in older adults. Proprioceptive PA like yoga is more successful in improving static balance.

Gaudagnin et al., 2015 [71]

Cross sectional

1 time point

Recruitment: n/k

Authors declare no conflict of interest

Source of funding declared

N: 24

Age: 67.5 ± 5.5 yrs

100% women

Height(m): 1.54 ± 0.06

Weight(Kg): 65.5 ± 10.5

Brazil

Community setting

Written informed consent

MA group: PA

LA group: no regular PA

MA group: at least 150mins per week

LA group: no PA

Indirect measure

(G) Walking speed (preferred) (8 m) (velocity - m/s)

n/a

n/a

n/a

Active lifestyle improves gait speed.

Gyllensten et al., 2010 [64]

Cross sectional

1 timepoint

Recruitment: community centres

Authors declare no conflict of interest

Source of funding: N/k

N: 44

Age: 69.9 ± 6.85 yrs

82% women

Weight(k) 154.8 ± 6.95

Height(m): 1.55 ± 6.95

Hong Kong, China

Community setting

Written informed consent

MA group: Tai chi

LA group: Non-tai chi

MLTPAQ

MA group:

Light =4

Mod. =17

Heavy =3

LA group:

Light =7

Mod. =12

Heavy =1

Indirect measure

(FU) Body Awareness Scale- Healthy (BAS-H) (25 items)

(FU) Single Leg Jump Test (yes/no; s)

Direct measure

Dynamic balance test

Limits of Stability (movement velocity - °/sec; endpoint excursion - %; maximum excursion - %; directional control - %)

MMSE (mod.) (30 items)

n/a

n/a

MA group had better stability limits, increased ability to perform a single leg stance, more stability on landing on one leg, and better body awareness.

Hakim et al., 2004 [70]

Cross sectional

1 time point

Recruitment: local tai chi clubs/senior centres

Conflict of Interest:

N/k

Source of funding: N/k

N: 94

Age: 75.2 ± 7.5 yrs

(60-96 yrs)

84% women

87% 1 or more chronic conditions

88% independent ambulation

Pennsylvania; US

Community setting

Written informed consent

MA group: Tai chi

LA group:

No exercise

MA group: 62.5% walk regularly and 100% take a tai chi class 1 or more times per week

tai chi experience: mean 5.6 yrs

LA group: no tai chi and no walking

Indirect measure

(FU) Timed Up & Go (3 m) (time to complete - s)

(FU) Chair stand test (30s) (number of full stands)

(FL): Multidirectional reach test (distance - inches)

ABC (16 items)

n/a

n/a

MA group have better balance performance, confidence, and multidirectional reach results

Hakim et al., 2010 [57]

Cross sectional

1 time point

Recruitment: local tai chi/senior centres

Authors declare no conflict of interest

Source of funding: N/k

N: 52

Age: 74.46 ± 5.09 yrs

87% women

Marital status:

Single = 17%; Married = 30%; Divorced = 11%

Widowed = 42%

17% comorbidities

37% fall history

Community setting

Informed consent

MA group: Tai chi

LA group: No exercise

MA: 11.66 ± 5.15 (days/month)

LA group: 10.73 ± 9.52 (days/month)

Indirect measure

(FU) Fullerton Advanced Balance Scale (FAB) (10 items)

(FU) Time Floor Transfer test (time to complete - s)

(FU) Single leg stance (30s) (balance time - s)

(FL) Multidirectional reach test (distance - inches)

ABC (16 items)

n/a

n/a

MA group have better balance performance scores on FAB and multidirectional reach test. No significant differences found on ABC, single leg stance, and Timed floor transfer test between groups

Lu et al., 2013 [65]

Cross sectional

1 timepoint

Recruitment: local tai chi clubs/ elderly centres

Authors declare no conflict of interest

Source of funding declared

N: 58

Age: 73.5 ± 5.15 yrs

72% women

Height(m): 1.54 ± 0.80

Weight(kg): 56.95 ± 9.1

Hong Kong, China

Community setting

Written informed consent

MA group: Tai chi

LA group: Non-tai chi

MA group: Light = 4

Mod. =23

Heavy = 1

Minimum of 1.5 h per week tai chi

Tai chi experience: 6.7 ± 4.6 yrs

LA group: No tai chi:

Light = 5

Mod. =25

Heavy = 0

Direct measures

Static balance test

Total body sway (dual and single task) (sway distance - mm; sway area - cm2)

MMSE(30 items)

Auditory Stroop test (reaction time (s); error rate (%)

 

n/a

MA group performed better in both stepping down and Stroop tests and so have better postural control and cognitive performance whether there is a single or dual task situation.

Perrin et al., 1999 [72]

Cross sectional

1 time point

Recruitment: cohort study of ageing

Authors declare no conflict of interest

Source of funding: N/k

N: 65

Age: 71.8 s ± 0.8 yrs

66% women

France

Community setting

MA group: either walking, swimming, cycling, tennis

LA group: no PA

MA group: n/k

LA group: no PA

Direct measure

Static balance test:

Total body stability (eyes open/closed) (sway velocity - cm/s; sway area - cm2)

AP/ML stability (eyes open/closed) (sway velocity -cm/s; sway area - cm2)

Dynamic balance test:

Tilt board (Short, medium, and long latency responses)

n/a

n/a

n/a

Balance in EO or EC conditions is significantly improved in MA group.

Rahal et al., 2015 [58]

Cross sectional

1 time point

Recruitment: geriatrician by anamnesis

Conflict of Interest:

N/k

Source of funding: N/k

N: 76

Age: 73.55 yrs

(60-80 yrs)

74% women

Community setting

Written informed consent

MA group: Tai chi group

LA group: Dance group

Measure: n/k

MA group: up to 3 h tai chi per week

LA group: up to 3 h dance per week

Direct measure

Static balance test:

Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) (sway velocity - °/s)

Unilateral stance (sway velocity - °/s)

Dynamic balance test:

Walk across test: (sway speed - cm/s; step width - cm; sway velocity - °/s)

Sit to stand test: (sway velocity - - °/s; weight transfer - s)

n/a

n/a

n/a

MA group had reduced postural sway and thus improved static and dynamic balance.

Tsang & Hui-Chan, 2004 [59]

Cross sectional

1 time point

Recruitment: tai chi clubs

Authors declare no conflict of interest

Source of funding declared

N: 47

Age:

69.03 ± 6.37 yrs

0% women

Height(m): 1.61 ± 6.45

Weight(kg): 62.65 ± 7.75

Community setting

Written informed consent

MA group: Tai chi group

Tai chi experience: 8.4 yrs

LA group: No exercise group

MLTPAQ

MA group:

Light =7

Mod. =4

Heavy = 1

PA - Up to 1.5 h p/w

LA group: Light = 10

Mod. =2

Heavy =0

Walked/ stretching exercise daily

Direct measure

Dynamic balance test

Limits of stability test (reaction time (s); maximum excursion (%); directional control (%))

MMSE (30 items)

Passive knee joint repositioning test (dynamometer); (absolute angle error - °)

n/a

MA group had better knee joint proprioception and greater limits of stability (dynamic balance).

Tsang & Hui-Chan, 2005 [60]

Cross sectional

1 timepoint

Convenience sampling: tai chi clubs and community centres

Authors declare no conflict of interest

Source of funding declared

N: 48

Age: 70.45 ± 5.55 yrs

50% women

Height(m): 1.55 ± 0.07

Weight(kg): 58.1 ± 9.05

Community setting

Written informed consent

MA group:

Tai chi

LA group: No tai chi

MLTPAQ

MA group:

Light =17

Mod. =5

Heavy = 2

PA Up to 1.5 h per week

LA group:

Light =21

Mod. =3

Heavy =0

Walked/ stretching exercise daily

Indirect measure

(S) Isokinetic knee strength test (dynamometer) (peak torque to body weight ratio)

Direct measure

Static balance test

AP & ML body stability (body sway angle °)

Dynamic balance test

AP & ML body stability (body sway angle °)

ABC (16 items)

n/a

n/a

MA group showed better knee muscle strength, less body sway in static standing and perturbed single leg stance and greater balance confidence.

Tsang & Hui-Chan, 2006 [61]

Cross sectional

1 timepoint

Recruitment: tai chi clubs/ community centres

Conflict of interest: N/k

Source of funding: N/k

N: 48

Age: 70.45 ± 5.55 yrs

50% women

Height(m): 1.55 ± 0.09

Weight(kg): 58.1 ± 17.5

Community setting

Written informed consent

MA group: tai chi group

Tai chi experience: mean 8.5 yrs

LA group: No tai chi group

MLTPAQ

MA group:

Light =17

Mod. =5

Heavy =2

PA Up to 1.5 h per week

LA group:

Light =21

Mod. =3

Heavy =0

Walked/ stretching exercise daily

Direct measure

Static balance test

Total body stability pre-& post vestibular stimulation (eyes open/closed) (sway distance - cm)

AP & ML stability pre-& post vestibular stimulation (eyes open/closed) (velocity -cm/s; amplitude°)

n/a

n/a

n/a

MA group have better control of body sway along AP direction.

Tsang & Hui-Chan, 2010 [62]

Cross sectional

1 time point

Recruitment: golf clubs/community centres

Authors declare no conflict of interest

Source of funding declared

N: 23

Age: 68.75 ± 6.7 yrs

0% women

Height(m): 1.62 ± 6.95

Weight(kg): 64.05 ± 8.15

Community setting

Written informed consent

Ma group:

Golfers

Golf experience: 15.2 yrs

LA group: Non-golfers

MLTPAQ

MA group:

Light =6

Mod. =4

Heavy =1

PA Up to 1.5 h per week

LA group:

Light =10

Mod. =2

Heavy =0

Walked/ stretching exercise daily

Indirect measure

(FU) Single leg stance (balance time -s)

(FL) forward lunge test (average distance of lunge as % of height)

Direct measure

Dynamic balance test

AP body stability (body sway angle °)

N/a

n/a

n/a

MA group achieved significantly longer stance duration during single-leg stance, better results on perturbed single leg stance, smaller sway, larger lunge distance onto both legs.

Tsang et al., 2004 [66]

Cross sectional

1 timepoint

Recruitment: centres for elderly

Conflict of interest: N/k

Source of funding: N/k

N: 60

Age: 53.33 ± 3.73 yrs

50% women

Height(m): 1.57 ± 0.09

Weight(kg): 58.7 ± 9.7

Hong Kong, China

Community setting

Informed consent

MA group:

Tai chi group

Tai chi experience: 7.2 yrs

LA group: No tai chi group

MLTPAQ

MA group:

Light =1

Mod. =15

Heavy =4

PA Up to 3 h per week

LA group:

Light =0

Mod. =15

Heavy = 5

Walked/or stretching exercise daily

Indirect measure

(S) Handgrip test (dynamometer) (strength (Kg))

Direct measure

Sensory Organisation Test (somatosensory, visual, vestibular ratios)

MMSE(mod.)(30 items)

n/a

n/a

MA group had better postural control under reduced or conflicting sensory conditions (increased reliance on vestibular and visual systems).

Wayne et al., 2014 [49]

Cross sectional

1 time point

Recruitment: N/k

Conflict of interest: N/k

Source of funding: N/k

N: 87

Age: 63.48 ± 7.63 yrs

(50-79 yrs)

66% women

White: 86%

Non-Hispanic: 98%

Education: 18 ± 3.3 yrs

BMI(kg/m2) 25 ± 3.9

Boston, US

Community setting

MA group: Tai chi expert

LA group: Tai chi naïve

PASS

MA group:

6.0 ± 2.0 (intensity/mins per week)

LA group: 4.4 ± 2.2

(intensity/mins per week

Indirect measure

(FU) Timed Up & Go (time to complete - s)

(FU) Single leg stance (balance time - s)

Direct measure

Static balance test

Total body stability (eyes open/close) (sway velocity (mm/s); sway area (mm2))

Dynamic balance test

AP & ML stability (eyes open/closed) (sway velocity (mm/s)

MMSE (30 items)

n/a

n/a

Complexity based measures of sway, single leg stance and TUG are better for MA group.

Wong et al., 2001 [67]

Cross sectional

1 time point

Recruitment: tai chi clubs; volunteer group

Conflict of interest: N/k

Source of funding declared

N: 39

Age: 68.47 ± 5.53 yrs

69% women

Weight(kg): 64.73 ± 8.03

Height(m): 1.57 ± 0.08

Taiwan

Community setting

Informed consent

MA group: tai chi

LA group: no tai chi

MA group: tai chi

Experience: 15.6 ± 10.5 yrs

LA group: no tai chi

Direct measure

Static balance test

Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s)

Dynamic balance test

Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s)

n/a

n/a

n/a

MA group had better postural control than LA group.

Wong et al., 2011 [68]

Cross sectional

1 time point

Recruitment: local tai chi clubs

Authors declare no conflict of interest

Source of funding declared

N: 86

Age: 66.93 ± 5.63 yrs

62% women

Weight(Kg): 58.65 ± 8

Height(m): 1.57 ± 0.07

Taiwan

Community setting

Written informed consent

MA group: tai chi

LA group: no PA

MA group: 162mins per week

LA group: no PA

Direct measure

Static balance test

Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s; ankle strategy - %)

Dynamic balance test

Total body stability (eyes open/closed) (max stability - %; sway velocity - °/s; ankle strategy - %)

Reaction time (eye/hand) speed - ms)

 

n/a

MA group showed significantly greater maximal stability, smaller COP velocity, and greater use of ankle strategy, therefore overall better postural control.

Zhang et al., 2011 [63]

Cross sectional

1 timepoint

Recruitment: local tai chi/ walking groups

Authors declare no conflict of interest

Source of funding declared

N: 30

Age: 65.7 ± 4.9 yrs

100% women

Community setting

Written informed consent

MA group: Tai chi group

LA group: Walking group

MA group: 7 h per week of tai chi

8.2 yrs tai chi experience

LA group: 7 h per week of walking

8.8 yrs walking experience

Indirect measure

- (FU) Single leg stance (time spent on one leg during walking (s))

- (G) Walking speed (preferred) (velocity (m/s)

n/a

n/a

n/a

MA group have better movement control but LA group have better results on single leg stance measures.

RCT studies:

Paillard et al., 2004 [73]

RCT

Baseline & post 12 weeks

Randomised but not specified

Conflict of interest: N/k

Source of funding: N/k

N: 21

Age: 66.15 ± 2 yrs

(63-72 yrs)

0% women

Weight(kg): 74.8 ± 6.7

Height(m): 1.71 ± 0.05

Community setting

Written informed consent

Intervention group: 3 months walking programme

Control: no walking programme

Baseline measure: n/k

MA group: up to 5 h of walking per week for 3 months

LA group: up to 3 h per week no walking programme

Indirect measure

(G) Walking speed (preferred) (velocity - m/min)

Direct measure

Static balance test

Total body stability (eyes open/closed) (sway distance -- mm; sway area -mm2; speed variation; ratio - EO/EC*100)

AP & ML stability (eyes open/closed) (distance - mm; sway area - mm2)

Dynamic balance test

ML stability (eyes open/closed) (position°; amplitude°; spectral energy- %)

n/a

n/a

n/a

12 week walking programme can improve postural control whilst moving but not when static.

Santos Mendeset al., 2011 [74]

RCT

Baseline & post 4 months

stratified by sex & randomised

Conflict of interest: N/k

Source of funding: N/k

N: 30

Age 68.7 ± 3.5 yrs

60% women

Weight(kg): 66.9

Height(m): 1.69

Community setting

Intervention group: 4 months walking programme

Control: no PA

MA group: 1 h per week for 4 months

LA group: no PA

Direct measure

Static balance test

Total body stability (8 positions) (Static Balance Index)

Dynamic balance test

Total body stability (2 tests - hurdle obstacle; sit down and stand up from chair) (Dynamic Balance Index)

n/a

n/a

n/a

Walking is beneficial to both dynamic and static balance.

Wayne et al., 2014 [49]

RCT

3 time points: Baseline, 3 months, 6 months

Recruitment: N/k

Conflict of interest: N/k

Source of funding: N/k

N: 60

Age: 64.19 ± 7.72 yrs

(50-79 yrs)

67% women

White: 92%

Non-Hispanic: 98%

Education: 17 ± 3 yrs

BMI(kg/m2): 26.5 ± 5.5

Boston, US

Community setting

MA group;

Tai chi expert

6 months tai chi

LA group: Tai chi naïve

PASS

MA group: 4.0 ± 2.0 (intensity/mins per week)

LA group: 4.0 ± 2.0

(intensity/mins per week

Indirect measure

(FU) Timed Up & Go (time to complete -s)

(FU) Single leg stance (balance time - s)

Direct measure

Static balance test

Total body stability (eyes open/close) (sway velocity - mm/s; sway area - mm2)

Dynamic balance test

AP & ML stability (eyes open/closed) (sway velocity - mm/s)

MMSE (30 items)

n/a

n/a

MA group had no significant short term effects from being more active based on traditional COP measures, but some increases in body sway in complexity COP measures (AP and ML eyes closed) correlated to practice hours.

Yang et al., 2007 [75]

RCT

Baseline, 2 month, 6 month

Randomisation program for 4 locations

Conflict of interest: N/k

Source of funding: N/k

N: 49

Age: 80.55 ± 8.49 yrs

(60-97 yrs)

80% women

Retirement home (76%)

MA group: 2 months Tai chi

LA group: no tai chi

Measure: n/k

MA group: 3 h tai chi per week for 2 months

LA group: usual activity 3.67 ± 2.38 h per week

Indirect measure

(FU) Berg Balance (baseline only)

Direct measure

Sensory Organisation Test (somatosensory, visual & vestibular ratios)

Base of support (area - cm2; feet opening angle °)

n/a

n/a

n/a

MA group have better SOT vestibular results and greater Base of Support measures but no differences for SOT visual ratios or feet opening angle between groups.