Zhong Yuanji, Chen Pengwei, Guo Wenhao, Wang Yongshun, Xue Yang, Chen Penghong, Liu Jingjin
School of Physical Education and Arts, Jiangxi University of Science and Technology, Ganzhou, China.
School of Recreational Sports and Tourism, Beijing Sport University, Beijing, China.
Front Physiol. 2025 Aug 8;16:1623908. doi: 10.3389/fphys.2025.1623908. eCollection 2025.
BACKGROUND: Neuromuscular training (NMT) is widely utilized to enhance balance and reduce fall risk in older adults, yet comparative effectiveness across various modalities remains unclear. This study aimed to systematically assess and rank the effects of sensorimotor training (ST), whole-body vibration training (WBVT), neurofunctional training (NT), and balance training (BT) on balance performance in older adults. METHODS: A systematic review and network meta-analysis was conducted following PRISMA guidelines, including 49 randomized controlled trials with a total of 3,028 older adults. Intervention efficacy was assessed through dynamic balance (Timed Up and Go Test [TUGT], Walk Test [WT]) and static balance (Berg Balance Scale [BBS]) outcomes. RESULTS: Significant improvements in dynamic balance (TUGT) were observed with ST (SMD = -0.92; 95% CI: -1.66, -0.18) and NT (SMD = -0.92; 95% CI: -1.44, -0.40), which ranked highest in efficacy (NT: 85.9%, ST: 83.4%). WBVT (SMD = -0.35; 95% CI: -0.69, -0.02) and BT (SMD = -0.33; 95% CI: -0.64, -0.01) also showed statistically significant, but modest effects on dynamic balance. In contrast, the effects of all interventions on static balance, as measured by the BBS, were not statistically significant, suggesting limited and inconclusive evidence regarding their impact on postural stability. Although ST ranked highest in WT (73.7%) and BT showed a favorable SUCRA value in BBS (60.2%), these rankings should be interpreted with caution. CONCLUSION: The corresponding effect sizes were small and not statistically significant, indicating that SUCRA reflects relative ranking probability rather than actual clinical efficacy. Therefore, the potential benefits for improving static balance and walking speed remain limited and inconclusive. ST and NT were identified as the most effective NMT modalities for significantly enhancing dynamic balance in older adults, indicating their suitability for targeted interventions in fall prevention strategies. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2025-4-0015/, identifier INPLASY202540015.
背景：神经肌肉训练（NMT）被广泛用于提高老年人的平衡能力和降低跌倒风险，但不同训练方式的相对有效性仍不明确。本研究旨在系统评估并排序感觉运动训练（ST）、全身振动训练（WBVT）、神经功能训练（NT）和平衡训练（BT）对老年人平衡能力的影响。 方法：按照PRISMA指南进行系统评价和网状Meta分析，纳入49项随机对照试验，共3028名老年人。通过动态平衡（定时起立行走测试[TUGT]、步行测试[WT]）和静态平衡（伯格平衡量表[BBS]）结果评估干预效果。 结果：ST（标准化均值差[SMD]=-0.92；95%置信区间：-1.66，-0.18）和NT（SMD=-0.92；95%置信区间：-1.44，-0.40）对动态平衡（TUGT）有显著改善，在疗效方面排名最高（NT：85.9%，ST：83.4%）。WBVT（SMD=-0.35；95%置信区间：-0.69，-0.02）和BT（SMD=-0.33；95%置信区间：-0.64，-0.01）对动态平衡也有统计学意义上的显著但适度的影响。相比之下，所有干预措施对静态平衡（通过BBS测量）的影响均无统计学意义，表明关于它们对姿势稳定性影响的证据有限且不确定。尽管ST在WT中排名最高（73.7%），BT在BBS中显示出良好的累积排序曲线下面积（SUCRA）值（60.2%），但这些排名应谨慎解读。 结论：相应的效应量较小且无统计学意义，表明SUCRA反映的是相对排序概率而非实际临床疗效。因此，改善静态平衡和步行速度的潜在益处仍然有限且不确定。ST和NT被确定为显著增强老年人动态平衡最有效的NMT方式，表明它们适用于跌倒预防策略中的针对性干预。 系统评价注册：https://inplasy.com/inplasy-2025-4-0015/，标识符INPLASY202540015。
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