The Effect of Perturbation-Based Balance Training on Fall Incidence, Mobility, Postural Control, and Fear of Falling of the Older Adults: A Systematic Review and Meta-Analysis

Perturbation-based training (PBT) is a balance training method that uses externally applied mechanical perturbations to trigger rapid reactions for regaining postural stability in a controlled environment. However, there is a lack of comprehensive reviews on PBT's efficacy in older adults. Therefore, this study investigated the impact of PBT on older adults. Primary sources were gathered from SCOPUS, PubMed, CENTRAL, and Web of Science, covering data up to January 23, 2025. The analysis included 17 studies with 1,006 participants. Results indicated that PBT significantly reduced fall incidence (SMD: 4.82, 95% CI: 3.10-6.55, p = 0.001) and improved balance control (SMD: 0.47, p = 0.001), Timed Up and Go (SMD: 0.64, p = 0.02), fear of falling (SMD: 0.62, p = 0.004), reactive balance control (SMD: 0.72, p = 0.002), gait speed (SMD: 0.50, p = 0.01), and postural stability (SMD: 0.38, p = 0.001). The findings revealed that PBT improved mobility, postural control, and fear of falling while decreasing the fall incidence of older adults.