***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study evaluated the effects of a water exercise training program that includes perturbation exercises ( WEP ) to improve the speed of voluntary stepping reaction in older adults .  Speed of voluntary stepping considered as an important skill to prevent a fall when balance is lost . In a single-blinded r and omized controlled trial with a crossover design thirty-six independent old adults ( 64 - 88 years old ) were divided into two groups . Group A received WEP for the first 12 weeks , followed by no intervention for the second 12 weeks . Group B did not receive intervention for the first 12 weeks and received WEP for the second 12 weeks . Voluntary Step Execution Test and postural stability in upright st and ing ( eyes open and closed conditions ) were measured at baseline , 12 weeks , and 24 weeks . A significant interaction effect between group and time was found for the step execution , due to improvement in initiation phase and swing phase duration s in the WEP group . Also significant improvement in postural stability parameters in eyes open and closed conditions is noted . The present results indicate that the primary benefit of WEP that include perturbations to induce stepping , was a reduction in voluntary stepping times . The WEP generalized to a better control of balance in up-right st and ing This study compared the effects of 2 types of water exercise programs on balance ability in the elderly . Thirty healthy elderly persons ( 60.7 + /- 4.1 yr ) were r and omly assigned to a deep-water-running exercise ( DWRE , n = 15 ) group or a normal water exercise ( NWE , n = 15 ) group . The participants completed a twice-weekly water exercise intervention for 12 wk . Exercise sessions comprised a 10-min warm-up on l and , 20 min of water-walking exercise , 30 min of water exercise while separated into NWE and DWRE , a 10-min rest on l and , and 10 min of recreation and relaxation in water .  Postural-sway distance and t and em-walking time were decreased significantly in DWRE . Postural-sway area was decreased significantly in NWE . In both groups , simple reaction times were significantly decreased . The findings of this study show that a water exercise program including deep-water running is much better than normal water exercise for improving dynamic balance ability in the elderly BACKGROUND Recently , several studies have reported age-associated increases in muscle coactivation during postural control . A rigid posture induced by strong muscle coactivation reduces the degree of freedom to be organized by the postural control system . The purpose of this study was to clarify the effect of balance training on muscle coactivation during postural control in older adults . METHODS Forty-eight subjects were r and omized into an intervention ( mean age : 81.0 ± 6.9 years ) and a control group ( mean age : 81.6 ± 6.4 years ) . The control group did not receive any intervention . Postural control ability ( postural sway during quiet st and ing , functional reach , and functional stability boundary ) was assessed before and after the intervention . A cocontraction index was measured during the postural control tasks to assess muscle coactivation . RESULTS Cocontraction index values in the intervention group significantly decreased following the intervention phase for functional reach ( p < .0125 ) . Cocontraction index values had a tendency to decrease during functional stability boundary for forward and quiet st and ing tasks . Functional improvements were observed in some of the tasks after the intervention , that is , functional reach , functional stability boundary for forward , one-leg stance , and timed up and go ( p < .05 ) . CONCLUSIONS Our study raised the possibility that balance training for older adults was associated with decreases in muscle coactivation during postural control . Postural control exercise could potentially lead older adults to develop more efficient postural control strategies without increasing muscle coactivation . Further research is needed to clarify in greater detail the effects of changes in muscle coactivation The changes in postural control in elderly people after an 8-week training course  were characterized . Static postural stability was measured during st and ing on a single force platform first with the eyes open and then with the eyes closed . Body sway was analysed on a force plate in groups of elderly and of young subjects . Half of the elderly subjects then took part in the training course . The posturographic measurements were repeated after the course . The sway in anteroposterior ( AP ) and mediolateral ( ML ) directions was subjected to spectral analysis . The frequency spectrum of the platform oscillations was calculated by fast Fourier transformation in the intervals 0.1–0.3 , 0.3–1 and 1–3 Hz . It was found that the sway path was longer and the frequency power was higher in the elderly group . The training caused a significant improvement in functional performance , but a significantly longer sway path was observed after the training in the ML direction . The frequency analysis revealed a significantly higher power after 8 weeks without visual control in the ML direction in the training group in the low and the middle frequency b and s. The results suggest that the participants ’ balance confidence and the control of ML balance improved in response to the training . The higher ML frequency power exhibited after the training may be indicative of a better balance performance . Thus , the increase in the sway path in this age group did not mean a further impairment of the postural control OBJECTIVE To compare the effect of a custom- design ed yoga program with 2 other balance training programs . DESIGN R and omized controlled trial . SETTING Research laboratory . PARTICIPANTS A group of older adults ( N=39 ; mean age , 74.15 ± 6.99 y ) with a history of falling . INTERVENTIONS Three different exercise interventions ( Tai Chi , st and ard balance training , yoga ) were given for 12 weeks . MAIN OUTCOME MEASURES Balance performance was examined during pre- and posttest using field tests , including the 8-foot up- and -go test , 1-leg stance , functional reach , and usual and maximal walking speed . The static and dynamic balances were also assessed by postural sway and dynamic posturography , respectively . RESULTS Training produced significant improvements in all field tests ( P<.005 ) , but group difference and time × group interaction were not detected . For postural sway , significant decreases in the area of the center of pressure with eyes open ( P=.001 ) and eyes closed ( P=.002 ) were detected after training . For eyes open , maximum medial-lateral velocity significantly decreased for the sample ( P=.013 ) . For eyes closed , medial-lateral displacement decreased for Tai Chi ( P<.01 ) . For dynamic posturography , significant improvements in overall score ( P=.001 ) , time on the test ( P=.006 ) , and 2 linear measures in lateral ( P=.001 ) and anterior-posterior ( P<.001 ) directions were seen for the sample . CONCLUSIONS Yoga was as effective as Tai Chi and st and ard balance training for improving postural stability and may offer an alternative to more traditional programs BACKGROUND Diabetes is the most common cause of peripheral neuropathies . No definitive treatment for diabetic neuropathies has been reported , and very few studies have been published on the role of exercise in reducing either the symptoms or incidence of diabetic neuropathies . METHODS This study assessed the effects of an exercise program on balance and trunk proprioception in older adults with diabetic neuropathies . Thirty-eight patients with diabetes having peripheral neuropathies were enrolled , r and omized , and subdivided in two groups : an experimental group of 19 participants with diabetes ( 72.9 ± 5.6 years old ) and a control group of 19 participants with diabetes ( 73.2 ± 5.4 years old ) . Both groups received health education on diabetes for 50 min/week for 8 weeks . The experimental group practice d an additional balance exercise program for 60 min , two times a week . The exercise training was performed two times per week for 8 weeks . Results were evaluated by both static and dynamic balance and trunk proprioception . RESULTS Postural sway significantly decreased ( P < 0.05 ) , the one-leg stance test significantly increased ( P < 0.05 ) , and dynamic balance from the Berg Balance Scale , Functional Reach Test , Timed Up and Go test , and 10-m walking time improved significantly after balance exercise ( P < 0.05 ) . Trunk repositioning errors also decreased with training ( P < 0.05 ) . CONCLUSION The balance exercise program improved balance and trunk proprioception . These results suggested that a balance exercise is suitable for individuals with diabetic neuropathy OBJECTIVE To determine whether a 12-week whole-body vibration ( WBV ) training program improved balance in participants with type 2 diabetes mellitus ( T2DM ) . DESIGN R and omized controlled trial . SETTING Primary health care setting . PARTICIPANTS Participants with T2DM ( N=50 ) . INTERVENTIONS Participants were r and omly allocated to either a WBV group ( n=25 ) , which performed a 12-week WBV-based exercise program on an oscillating platform ( 12 - 16Hz-4 mm ; 3 sessions/wk ) , or a usual-care control group ( n=25 ) . MAIN OUTCOME MEASURES Clinical and sociodemographic variables were recorded at baseline . Static balance and dynamic balance were also assessed at baseline by measuring postural sway ( measurement of center of pressure [ COP ] excursions in the anteroposterior and mediolateral directions ) using a Wii Balance Board and the Timed Up and Go test . RESULTS Significant between-group differences in COP excursions with participants ' eyes closed were found with their feet apart and feet together . In addition , participants in the WBV group exhibited significantly lower COP excursions with their eyes closed after the intervention , while participants in the control group experienced a nonsignificant deterioration in COP excursions ( ie , greater excursion ) with their eyes open ( mediolateral axis ) . There was no significant difference in the Timed Up and Go test values postintervention . CONCLUSIONS WBV provides a safe and well-tolerated approach to improve balance in participants with T2DM . These findings may have important implication s for falls prevention in those with T2DM in the primary health care setting Purpose The purpose of the study was to evaluate the effect of BodyBalance ® training on balance , functional task performance , fear of falling , and health-related quality of life in adults aged over 55 years . Participants and methods A total of 28 healthy , active adults aged 66±5 years completed the r and omized controlled trial . Balance , functional task performance , fear of falling , and self-reported quality of life were assessed at baseline and after 12 weeks . Participants either undertook two sessions of BodyBalance per week for 12 weeks ( n=15 ) or continued with their normal activities ( n=13 ) . Results Significant group-by-time interactions were found for the timed up and go ( P=0.038 ) , 30-second chair st and ( P=0.037 ) , and mediolateral center-of-pressure range in narrow stance with eyes closed ( P=0.017 ) . There were no significant effects on fear of falling or self-reported quality of life . Conclusion Twelve weeks of BodyBalance training is effective at improving certain balance and functional based tasks in healthy older adults OBJECTIVE To compare the impacts of Tai Chi , a st and ard balance exercise program , and a video game balance board program on postural control and perceived falls risk . DESIGN R and omized controlled trial . SETTING Research laboratory . PARTICIPANTS Independent seniors ( N=40 ; 72.5±8.40 ) began the training , 27 completed . INTERVENTIONS Tai Chi , a st and ard balance exercise program , and a video game balance board program . MAIN OUTCOME MEASURES The following were used as measures : Timed Up & Go , One-Leg Stance , functional reach , Tinetti Performance Oriented Mobility Assessment , force plate center of pressure ( COP ) and time to boundary , dynamic posturography ( DP ) , Falls Risk for Older People-Community Setting , and Falls Efficacy Scale . RESULTS No significant differences were seen between groups for any outcome measures at baseline , nor were significant time or group × time differences for any field test or question naire . No group × time differences were seen for any COP measures ; however , significant time differences were seen for total COP , 3 of 4 anterior/posterior displacement and both velocity , and 1 displacement and 1 velocity medial/lateral measure across time for the entire sample . For DP , significant improvements in the overall score ( dynamic movement analysis score ) , and in 2 of the 3 linear and angular measures were seen for the sample . CONCLUSIONS The video game balance board program , which can be performed at home , was as effective as Tai Chi and the st and ard balance exercise program in improving postural control and balance dictated by the force plate postural sway and DP measures . This finding may have implication s for exercise adherence because the at-home nature of the intervention eliminates many obstacles to exercise training BACKGROUND AND PURPOSE Loss of lower-extremity strength increases the risk of falls in older persons . The purpose of this study was to test the hypothesis that a vigorous program of lower-extremity strengthening , walking , and postural control exercises would improve the single-stance balance of healthy older women and lower their risk of falls and fall-associated injuries . SUBJECTS From a total of 38 respondents , 21 women were r and omly assigned to either a treatment group ( combined training , n = 12 ) or a control group ( flexibility training , n = 9 ) . The subjects ranged in age from 62 to 75 years ( mean = 68 , SD = 3.5 ) . METHODS A r and omized control trial compared the effects of two exercise programs on static balance . The combined training group exercised three times per week on knee extension and sitting leg press machines , walked briskly for 20 minutes , and performed postural control exercises , which included simple tai chi movements . The flexibility training group performed postural control exercises weekly . Measurements of balance were obtained on a force platform in double and single stance , at baseline and following 6 months 
    Output:
    
In contrast , neither resistance nor multi-component exercise interventions affected any of the included COP measurements .
Conclusions Postural control is improved by balance exercise interventions .
In contrast , strength or multi-component exercise interventions did not influence postural control measurements in older adults .