Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Balance-recovery training may lower risk of falls for older adults and people with Parkinson’s disease

Mansfield A, Wong JS, Bryce J, et al. Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials Physical Therapy. 2015;95:700-709.

Review question

Does perturbation-based (balance recovery) balance training lower risk of falls for older adults and individuals with Parkinson’s disease?


Age-related body changes along with nerve conditions can contribute to poor balance and increased fall risk. Past research has shown that exercise with a focus on balance training can prevent falls, but studies of specific exercises or among people with specific conditions are limited. ‘Perturbation-based balance training’ (PBT) uses a balance-recovery approach to help improve a person’s reaction to losing their balance (eg. using a moving platform or nudges from a therapist) and has the potential to improve balance control better than other training methods.

How the review was done

This is a systematic review and meta-analysis of 8 randomized controlled trials published between 2004 and 2014. All study participants (404 total) were between the ages of 50 and 98. The studies focused on different populations including healthy older adults, frail older adults or individuals with neurological conditions (such as Parkinson’s disease). In all studies, some older adults participated in PBT while the control group participated in other forms of balance training or other types of exercise. Researchers measured number of people who experienced a fall and total number of falls among all participants.

What the researchers found

Six studies found that participants who completed PBT were less likely to fall and reported fewer falls than those in the control groups. Overall, participants who completed PBT reported fewer falls in daily life than those in the control group.


Perturbation-based (balance recovery) balance training can lower risk of falls for older adults and individuals with Parkinson’s disease.


Control group
A group that receives either no treatment or a standard treatment.
Advanced statistical methods contrasting and combining results from different studies.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

  • Too fit to fracture: Managing osteoporosis through exercise

    Osteoporosis Canada
    If you have osteoporosis, it is recommended to exercise regularly. A physical therapist or kinesiologist can give you advice on what type of exercise is best for you. You should do a combination of strength, posture, balance, and aerobic exercise.
  • Improving housing to improve health - warmth and space are key

    Evidently Cochrane
    Poor housing is associated with poor health. Research shows cold, damp and overcrowded homes can have a negative impact on your respiratory health.
  • Foot pain: When to see a doctor

    Mayo Clinic
    If you have foot pain due to an injury, it might respond well to rest and cold. Put ice on your foot for 15 to 20 minutes several times a day. You can also try anti-inflammatory medication. See a doctor right away if it is serious.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (

Register for free access to all Professional content