Does wobble board training improve balance in older adults? A systematic review

Figures & data

Table 1. Search terms using Boolean logic.

Key concept	Search terms
Older adult	Elderly OR Aged OR Older OR Elder OR Geriatric OR Elderly people OR Old people OR Senior
	AND
Wobble board	Wobble board OR Wobbleboard OR Wobble platform OR Balance board OR Balance platform OR Balance disc OR Biomechanical ankle platform OR Ankle disc platform OR Unstable surface OR Unstable platform OR Electronic balance board OR Tiltboard OR Dynadisc
	AND
Balance	Balance OR Postural balance OR Standing balance OR Postural sway OR Standing sway OR Postural stability OR
	Postural control OR Static balance OR Dynamic balance OR Perturbation OR Sensorimotor OR Somatosensory OR Proprioceptive* OR Neuromuscular
	AND
	Exercise OR Exercises OR Training OR Intervention OR Activity
Exercise

Figure 1. PRISMA flow-diagram of search strategy.

Table 2. Methodological quality assessment results using a modified version of the Downs and Black appraisal tool [15].

Author and date	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22	23	24	25	26	27	Total
(Hande et al. [18]	y	y	n	y	n	y	y	y	y	y	n	n	y	n	n	y	y	y	y	y	u	y	n	n	n	y	y	16
Ogaya et al. [19]	y	y	y	y	y	y	y	y	y	n	y	y	y	n	n	y	y	y	y	y	y	y	n	n	y	u	y	22
Schilling et al. [20]	y	y	y	y	y	y	y	y	y	y	y	y	y	n	n	y	y	y	y	y	y	y	y	n	n	y	y	23
Smee et al. [21]	y	y	y	y	y	y	y	n	y	y	y	y	y	n	n	y	y	y	y	y	y	y	n	n	y	y	y	22
(Dougherty et al. [22]	y	y	y	y	y	y	y	n	y	y	y	y	y	n	n	n	y	y	u	y	y	y	n	n	y	y	y	19
Kosse et al. [23]	n	y	y	y	y	y	n	n	n	n	y	y	y	n	n	n	y	y	u	y	y	y	n	n	u	u	y	15

(1 = Yes, 0 = No, question 5, 2 = Yes, 1= partially 0 = No).

Table 3. Data extraction.

Author and date	Participants and study type	Type of wobble board and intervention	Balance Measurement	Findings
Hande et al. [18]	Age ≥60 years. 18 participants in the wobble board group. gender breakdown unavailable. No information about the source of recruitment. RCT.	Both groups: 4 sessions/week of 4 mins for 3 weeks. wobble board group assigned the following (15mins): Forward/backward rocking. Side-to-side rocking. Cursor matching task. Type of balance board: (My Fitness Trainer MFT®)	TUG BBS EBB	A significant increase in TUG: Pre-TUG 15.4 ± 1.7s and Post 13.7 ± 2.1s. A significant increase in BBS: Pre BBS 48.5 ± 3.1 and Post 50.8 ± 1.4. A significant increase in EBB.MFT mediolateral: Pre 3.8 ± 0.3 and Post 3.3 ± 0.5. A significant increase in wobble board performance for anteroposterior: Pre 3.8 ± 0.3 and Post 3.2 ± 0.3.
Ogaya et al. [19]	Age >70 years (mean 84.2 years). 12 participants in the wobble board group (11 female). Recruited from the same nursing home. Double-blinded and controlled trial.	Barefoot wobble board training: 2 sessions/week of 10mins for 9 weeks. Wobble board group assigned the following: Trying to maintain wobble board level. Cursor matching task. 3 levels of progression for each task. Restricted to forward/backward tilt. Type of balance board: DYJOC board plus SV-200, (Sakai Medical Co. Ltd., Tokyo, Japan).	Postural sway from foot pressure, measuring: Single leg stance standing time Unsupported standing time on balance mat Limit of stability Functional reach test. TUG. Wobble board stance time.	No significant difference apparent in the Root mean Square sway area: Pre 2.9 ± 2.4 cm² and Post 1.7 ± 0.9 cm². -No significant difference in SLS time: Pre 19.6 ± 30.0s and Post 27.0 ± 40.2s. Significant increase in limit of stability anteroposterior excursion: Pre 8.7 ± 1.9 cm and Post 10.3 ± 2.5 cm. No significant difference in the mean range of angular fluctuation: Pre 1.7 ± 1.2° and Post 0.9 ± 0.6° Significant increase on standing time on wobble board: Pre 41.6 ± 41.6s and Post 88.8 ± 38.8s. No significant difference in mediolateral excursion: Pre 16.1 ± 3.4 cm and Post 14.3 ± 5.3 cm. No significant difference in functional reach test: Pre 26.3 ± 8.6 cm and Post 22.9 ± 7.8 cm. No significant difference in TUG: Pre 14.7 ± 13.6s and Post 13.7 ± 6.8s.
Schilling et al. [20]	Age 60–68 years. 10 participants in the wobble board group (5 females) No information about the source of recruitment. RCT.	3 session/week of 15–30 mins for 5 weeks. Wobble board group assigned the following: A mix of open and closed kinetic chain wobble board exercises such as squat lunges and reaching tasks. Type of balance board: VersaDisc and Coredisc device.	Postural sway from force plate performing the following: Single leg stance Double leg stances (eyes open and closed) TUG ABC questionnaire	No significant difference in postural sway. No significant difference in TUG test: Pre TUG 5.6 ± 0.6s and Post TUG 5.5 ± 0.6s. Significant increase in ABC questionnaire: Pre ABC 92.8 ± 4.3% and Post 96.6 ± 3.6%.
Smee et al. [21]	Age 65–96 years (mean 77.7 years). 16 participants in the wobble board group (7 females) Participants described as community dwelling RCT.	3 sessions/week of 6 mins for 16 weeks. wobble board group assigned the following: Side to side rocking Forward/backward rocking Trying to maintain wobble board level. Type of balance board: ‘standard’ wobble board with 42cm diameter.	SCS-PEP10	Significant increase in SCS-PEP10 balance domain: Pre 51.0 ± 12.7 and Post 54.2 ± 11.8.
Dougherty et al. [22]	Age > 65 years (mean 74.8 years). 9 participant in the wobble board group (3 females) Participants recruited from a local community centre for older adults. Pilot study.	3 sessions/week of 10 mins for 5 weeks. Wobble board group assigned the following: Trying to maintain wobble board level. Type of balance board: Indo Board Balance Trainer utilised IndoFLO ® Balance.	BBS Wii-Fit balance age ABC questionnaire	Significant increase in BBS: Pre BBS 53.4 ± 2.2 and Post 54.3 ± 2.6. No significant difference in Wii-Fit age: Pre- 67.7 ± 11.0 years and 66.2 ± 15.6 years. Significant difference in ABC: No reporting of actual values.
Kosse et al. [22]	Age > 65 years (mean 77yrs). 10 participants in wobble board group (5 females) Recruited from ‘older adults’ apartments Repeated measure, single subject design.	3 sessions/week of 20 mins for 6 weeks. Wobble board group assigned the following: Side to side rocking Lateral rocking Progressed to: Cursor matching tasks Type of wobble board: SensBalance.	Time to complete figure-of-eight walking test BBS Postural sway during: Tandem stance Single leg stance eyes open Single leg stance eyes closed	No actual numbers reported. Fig 8 test improved significantly. BBS improved significantly. Tandem stance and SLS eyes open and closed no significant improvements.

Notes: RCT, Randomised Controlled Trail; TUG, Time Up and Go test; BBS, Berg Balance Scale Test; EBB MFT, Electronic Balance Board manufactured by Fitness Trainer; ABC, Activities Specific Balance Confidence scale; SCS-PEP10, Continuous Scale-Physical Functional Performance 10; mins, minutes.

Figure 2. Forest plot for the effect of wobble board training on balance.

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