***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background About one-third of people older than 65 years fall at least once a year . Physical exercise has been previously demonstrated to improve gait , enhance physical fitness , and prevent falls . Nonetheless , the addition of cognitive training components may potentially increase these effects , since cognitive impairment is related to gait irregularities and fall risk . We hypothesized that simultaneous cognitive – physical training would lead to greater improvements in dual-task ( DT ) gait compared to exclusive physical training . Methods Elderly persons older than 70 years and without cognitive impairment were r and omly assigned to the following groups : 1 ) virtual reality video game dancing ( DANCE ) , 2 ) treadmill walking with simultaneous verbal memory training ( MEMORY ) , or 3 ) treadmill walking ( PHYS ) . Each program was complemented with strength and balance exercises . Two 1-hour training sessions per week over 6 months were applied . Gait variables , functional fitness ( Short Physical Performance Battery , 6-minute walk ) , and fall frequencies were assessed at baseline , after 3 months and 6 months , and at 1-year follow-up . Multiple regression analyses with planned comparisons were carried out . Results Eighty-nine participants were r and omized to three groups initially ; 71 completed the training and 47 were available at 1-year follow-up . DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking ( P=0.044 ) . Training-specific gait adaptations were found on comparing DANCE and MEMORY : DANCE reduced step time at fast walking ( P=0.007 ) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed ( both trend P=0.062 ) . Global linear time effects showed improved gait ( P<0.05 ) , functional fitness ( P<0.05 ) , and reduced fall frequency ( −77 % , P<0.001 ) . Only single-task fast walking , gait variability at preferred walking speed , and Short Physical Performance Battery were reduced at follow-up ( all P<0.05 or trend ) . Conclusion Long-term multicomponent cognitive – physical and exclusive physical training programs demonstrated similar potential to counteract age-related decline in physical functioning This study aim ed to evaluate the effectiveness of an innovative exercise program on muscle strength , balance , and gait kinematics in elderly community-dwellers . The exercise program included strength and balance training and the 8-form Tai Chi Chuan . The measurements were carried out at baseline and 12 weeks , and consisted of four physical performance tests , joint isokinetic strength tests , and three-dimensional gait analysis . Fifty-six community-dwelling older adults aged 60–80 years old were r and omly assigned to an intervention or control group . After 12 weeks , the intervention group showed a 17.6 % improvement in the timed up and go test , accompanied by a 54.7 % increase in the 30-second chair st and test score . Significant increases in the score of star excursion balance tests , and the strength of the extensor and flexor muscles at knee and ankle joints were also observed . In addition , the intervention group walked at a faster speed with a longer step length , shorter support phase , and a greater sagittal plane range of motion at the hip and ankle joints . No statistical improvements were seen in the control group . This study provided an effective , evidence -based falls prevention program that can be implemented in community setting s to improve physical fitness and reduce fall risks among community-dwelling older adults .  The star excursion balance test could be a sensitive measure of physical performance for fall risk assessment in older people Background Fatigue , lack of motivation and low compliance can be observed in nursing home residents during the practice of physical activity . Because exercises should not be too vigorous , whole body vibration could potentially be an effective alternative . The objective of this r and omized controlled trial was to assess the impact of 3-month training by whole body vibration on the risk of falls among nursing home residents . Methods Patients were r and omized into two groups : the whole body vibration group which received 3 training sessions every week composed of 5 series of only 15 seconds of vibrations at 30 Hz frequency and a control group with normal daily life for the whole study period . The impact of this training on the risk of falls was assessed blindly by three tests : the Tinetti Test , the Timed Up and Go test and a quantitative evaluation of a 10-second walk performed with a tri-axial accelerometer . Results 62 subjects ( 47 women and 15 men ; mean age 83.2 ± 7.99 years ) were recruited for the study . No significant change in the studied parameters was observed between the treated ( n=31 ) and the control group ( n=31 ) after 3 months of training by controlled whole-body-vibrations . Actually , the Tinetti test increased of + 0.93 ± 3.14 points in the treated group against + 0.88 ± 2.33 points in the control group ( p = 0.89 when adjusted ) . The Timed Up and Go test showed a median evolution of - 1.14 ( − 4.75 - 3.73 ) seconds in the treated group against + 0.41 ( − 3.57- 2.41 ) seconds in the control group ( p = 0.06 ) . For the quantitative evaluation of the walk , no significant change was observed between the treated and the control group in single task as well as in dual task conditions . Conclusions The whole body vibration training performed with the exposition setting s such as those used in this research was feasible but seems to have no impact on the risk of falls among nursing home residents . Further investigations , in which , for example , the exposure parameters would be changed , seem necessary . Trial registration Trial registration number : Objective : To compare the effectiveness of unsupervised home and supervised group exercise on parameters related to risk of falling among older adults . Design : Prospect i ve , single-blind , r and omized and controlled trial . Setting : Nursing home . Subjects : The subjects were selected from 535 independent individuals who resided in a nursing home . Forty-two older adults , aged > 65 years , with risk of falling were recruited , and 32 of them completed the study . Intervention : The 42 subjects were divided into two groups ( unsupervised home exercise and supervised exercise group ) r and omly . Exercise sessions were performed three times a week for a period of eight weeks . Main measures : Measurements were taken at baseline and after the completion of the exercise programme . The fear of falling was evaluated using a visual analogue scale , quadriceps muscle strength was measured with a dynamometer , flexibility was assessed with the sit and reach test , functional mobility was determined using the Timed Up and Go Test , balance was evaluated using one-leg and t and em st and ing , and Berg Balance Scale and proprioception was assessed with knee position sense . Results : Thirty-two subjects ( unsupervised home exercise n = 15 , supervised group exercise n = 17 ) completed the exercise programme and all of the measurements . The unsupervised home exercise group showed significant improvement in balance , functional mobility and flexibility ( P > 0.05 ) . In addition to balance , functional mobility and flexibility , the supervised exercise group also showed significant improvements in both strength and proprioception ( P > 0.05 ) . Conclusions : Supervised group exercise is more effective at reducing the risk factors related to falling among older adults living in a nursing home than is unsupervised home exercise Objectives : Although the fear of falling is common among elderly residents in long-term care facilities , interventions developed for fear of falling management is very rare . Of these limited interventions , most were exercise interventions with only limited testing . The cognitive-behavioural intervention can decrease the fear of falling ; however no intervention of the kind was developed and assessed to decrease fear of falling among the elderly in long-term care facilities . The purpose of this study was to examine the effectiveness of cognitive-behavioural strategies either with or without exercise in reducing fear of falling among elderly residents in nursing homes . Method : A prospect i ve r and omized control trial was conducted in six nursing homes in northern Taiwan . Seventy-five elderly participants were r and omly assigned to one of the three groups : the comparison group , the cognitive-behavioural strategies with or without exercise group . The fear of falling , falls , depressive inclination , mobility , and muscle strength of extremities were collected at the two-month and five-month follow-up sessions , in which the progress of the patients were assessed . Results : The mixed model analysis revealed that elderly adults in the combination experimental group had significant improvements compared with the other two groups on fear of falling , depressive inclination , mobility , and muscle strength at five months . The incidences of falls , post intervention , in both experimental groups were significantly lower than those in the comparison group . Conclusions : The results suggest that the combination intervention helped elderly residents manage their fear of falling and falls , decrease their depressive inclination , and enhance their mobility and muscle strength QUESTION What is the effect of a balance training protocol with the Biodex Balance System in institutionalised older people with fear of falling ? DESIGN R and omised controlled trial with concealed allocation and assessor blinding . PARTICIPANTS Forty older people who lived in a nursing home and had fear of falling . INTERVENTION The experimental group completed a 12-week balance training protocol based on balancing/rebalancing training with the Biodex Balance System , with two sessions per week . During the training period , participants in both groups received the same multidisciplinary care ( such as physiotherapy , occupational therapy and nursing ) that they usually received in the nursing home . OUTCOME MEASURES The primary outcome was fear of falling ( Falls Efficacy Scale International question naire ) . Secondary outcomes were dynamic balance ( Fall Risk Test ) and isometric strength ( torque of knee flexor and extensor isometric strength measured with an isokinetic dynamometer ) . Outcome measures were taken before and after the training program protocol . RESULTS Compared to the control group , the exercise group had significantly greater improvements at 12 weeks in fear of falling ( by 8 points , 95 % CI 4 to 12 ) , in dynamic balance ( by 2 degrees , 95 % CI 1 to 3 ) , and in isometric strength of the knee flexors ( by 7Nm , 95 % CI 3 to 11 ) and knee extensors ( by 7Nm , 95 % CI 1 to 13 ) . CONCLUSION The training program was feasible and effective in reducing fear of falling and improving dynamic balance and isometric strength in institutionalised older people with fear of falling . TRIAL REGISTRATION IS RCT N21695765 Background We have previously shown that short sessions of whole body vibration ( WBV ) were not able to significantly improve fall risk among nursing home residents but some trends towards an improvement of motor capacity were observed . Objective The objective of the present study was to evaluate the impact of 6-month training by WBV on functional and motor abilities among nursing home residents observed over a 12-month period . Methods Patients were r and omized into two groups : the WBV group which received three training sessions every week composed of five series of 15 s of vibration at 30 Hz intensity for a period of 6 months and a control group with normal daily life . The impact of this training on the risk of falls was assessed blindly after 6 and 12 months by the Tinetti Test , the “ Timed Up and Go ” test and a quantitative evaluation of a 10-s walk performed with a tri-axial accelerometer . The occurrence of falls was also observed . Results 62 elderly healthy volunteers , ( 47 women and 15 men , mean age 83.2 ± 7.9 years ) were included in this study . There was no significant difference between the two groups regarding the Tinetti test ( p = 0.75 ) , the “ Timed Up and Go ” test ( p = 0.19 ) and the Locométrix ® test , except for the step length , measured by dual task ( p < 0.01 ) . No significant inter-group difference in the frequency of falls was observed during the 12 months of research . A total of 42 falls were recorded during the first 6 months of experimentation : 24 falls in the treated group and 18 in the control group ( p = 0.60 ) . During the next 6 months , 19 falls occurred : 8 falls in the treated group and 11 in the control group ( p = 0.52 ) . Conclusion This study failed to establish the effectiveness of low doses of WBV , under the conditions used in our study , on functional and motor abilities of institutionalized elderly patients . However , given the positive results of other studies , further investigations , with modified therapeutic protocol s , seem necessary to clarify the effects of WBV in the elderly OBJECTIVES To assess the efficacy of an exercise program on a whole-body vibration platform ( WBV ) in improving body balance and muscle performance and preventing falls in institutionalized elderly people . DESIGN / SETTING / PARTICIPANTS A multicentre r and omized parallel assessor-blinded clinical trial was conducted in elderly persons living in nursing homes . INTERVENTIONS Participants were r and omized to an exercise program performed either on a whole body vibratory platform ( WBV plus exercise group ) or on a stationary surface ( exercise group ) . The exercise program for both groups consisted of static and dynamic exercises ( balance and strength training over a 6-week training period of 3 sessions per week ) . The frequency applied on the vibratory platform was 30 to 35 Hz and amplitude was 2 to 4 mm . MEASUREMENTS The primary outcome measurement was static/dynamic body balance . Secondary outcomes were muscle strength and number of falls . Efficacy was analyzed on an intention-to-treat basis and per protocol . The effects of the intervention were evaluated using the t test , Mann-Whitney test , or chi-square test , depending on the type of outcome . Follow-up measurements were collected 6 weeks and 6 months after r and omization . RESULTS A total of 159 participants from 10 centers were included : 81 in the  WBV plus exercise group and 78 in the control group . Mean age was 82 years , and 67.29 % 
    Output:
    
CONCLUSIONS A multi-component exercise programme was found to be useful for reducing elderly adults ' risk of falling in nursing homes