Balance

The goal of this clinical trial is to compare the effect of the Otago exercise and Multisensory integration training on balance and gait in the elderly with type 2 diabetes mellitus. The main question it aims to answer is: • Is there a significant difference between the effect of Otago exercise and Multisensory integration training on balance and gait in the elderly with type 2 diabetes mellitus? Researchers will compare Otago exercise to Multisensory integration training to know which one has the greatest benefit on balance \&gait in the elderly with type2 diabetes. Participants will be divided into 3 groups; each group takes a certain training program for 8 weeks: * First group: Otago exercise group plus conventional treatment for neuropathy. * Second group: Multisensory integration training group plus conventional treatment for neuropathy. * Third group: control group takes only conventional treatment for neuropathy.

The primary purpose of this study overall is to validate a modified version of a commercially available ankle brace. Inertial measurement unit sensors will be incorporated into an existing ankle brace ("sXAB") by TayCo Brace, Inc. In two consecutive studies, gait metrics data collected from the sensor enabled ankle brace will be compared to data collected by the gold-standard equipment that is used in research and clinical settings to determine whether the sXAB performs adequately in terms of measurement or technical feasibility prior to further clinical evaluation. In the Phase 2 protocol, the sXAB will be validated on healthy subjects wearing combat boots performing walking, running, jumping, and stair climbing activities. These movements were selected because they simulate key movements performed during operational activities. All participants experience both conditions: with an ankle brace and without an ankle brace. Comparisons are made within-subject between brace and no-brace conditions. It is hypothesized that the sensor-enabled ankle brace will measure gait metrics with a high degree of accuracy (within 5%) when compared against the gold-standard lab equipment (i.e., motion capture and research-grade inertial measurement units).

To examine the effects of Dynamic Neuromuscular Stability exercises with and without Rhythmic Auditory Stimulation on balance, proprioception, and functional performance in badminton players with lateral ankle sprain.

Mobility is a fundamental element of healthy aging. Balance is a necessary function during mobility for all movements throughout life in elderly individuals. Falls due to balance disorders in elderly individuals cause a decrease in the quality of life. Studies in the literature indicate that 13% of individuals aged 65-69 experience falls, and this rate rises to 46% in individuals over 85. Lower extremity muscle volume and strength gradually decrease with aging. This decreased muscle strength directly impacts individuals' activities of daily living.Normal walking speed for elderly individuals is related to balance and overall health performance. However, walking assessments generally focus on walking activities in a forward direction and in a straight line. However, in daily life, we may need to sit on a chair, walk backward to navigate a narrow space, or change direction suddenly due to obstacles or environmental cues. Walking backward requires more complex motor control, and these gait training programs are known to be effective in improving balance and walking skills.Clinically, balance assessments in the elderly persons are commonly measured by using the TUG, 10-meter walk test, functional reach test, 4-square step test, and Berg balance scale. The methods used to assess balance are still not fully standardized. The best test for assessing dynamic balance and fall risk is still up for debate, especially when it comes to elderly individuals who live freely in the community. Further research is needed to determine whether lateral walking tests can identify those at high risk of falling in elderly adults. The purpose of this study was to determine the reliability, validity, and minimal detectable change (MDC) of the Figure-of-8 backward walking test in healthy elderly adults.

Diabetes Mellitus (DM) is a chronic metabolic disease characterized by hyperglycemia, which occurs in insulin deficiency or when the body cannot effectively use the insulin produced. Moreover, according to the "Global Report on Diabetes" data published by the World Health Organization (WHO) in 2016, it is an important public health problem, one of the four priority non-communicable diseases (1, 2). In addition to the high mortality rates caused by complications due to DM, it is also known that it can cause low quality of life and many other additional problems in individuals. Possible complications are chronic and serious problems such as heart attack, risk of stroke, kidney failure, vision loss and nerve damage. One of the most common and most disabling complications is neuropathy. It should also be noted that approximately half of diabetic neuropathy is asymptomatic and patients diagnosed with DM may have neuropathy due to causes other than diabetes (2). These complications and damage that DM can cause can lead to decreased blood flow combined with neuropathy; As a result, foot ulcers and infections may occur; Amputation rates may increase. In addition to such additional complications that diabetic neuropathy may cause, due to all these; Loss of protective plantar sensation may also occur (3). This loss of protective sensation may lead to cutaneous deficits in the lower extremities, loss of muscle strength and reflexes, and gait and balance disorders (4). The mechanism that makes an important contribution to functional joint stability and the continuity of this stability, along with the feedback mechanisms required to ensure neuromuscular control, is proprioception, which includes joint movement (kinesthesia) and joint position sense (EPH) and is a subunit of the somatosensory system (5-7). . Rehabilitation with various injuries and other clinical conditions; Clinical studies to determine its effects on joint proprioception, neuromuscular control and balance have mostly focused on knee and ankle joints (5). The main reason for this can be attributed to the great importance of the knee and ankle joints in the lower extremities in maintaining general body kinematics and balance (8). Additionally, it has been reported in the literature that EPH and plantar sensory loss are observed in individuals diagnosed with DM, and these complications may cause additional problems (10, 12, 18-22). Additionally, many studies in the literature on this subject have been conducted in individuals with diabetic neuropathy, and changes in functional parameters such as plantar sensation, proprioception, muscle strength and balance have been examined (10, 19, 20, 22, 23). However, it has been found that not only individuals with neuropathy but also individuals diagnosed with DM without neuropathy have balance disorders (24). There are many studies in the literature about the effects of different exercise training on proprioception. In general, studies have reported that exercise training without weight bearing on the extremity has no effect on proprioception, but as a result of exercises performed with weight bearing on the extremity, a significant improvement was noted in both proprioceptive performance and muscle strength (25). In one of the most recent studies on this subject, it was stated that proprioceptive sensitivity increased in individuals with knee osteoarthritis with 8-week squat strengthening training performed by transferring weight to the extremity (26). Additionally, there are studies in the literature reporting different results regarding the effects of stretching exercises on proprioceptive performance. Some studies have reported that static stretching has no effect on proprioception, while others have reported that it has a positive effect on proprioception (27,28). The Otago Exercise Program is an evidence-based, home-based, individually tailored strength and balance retraining program. Research shows that the Otago Exercise Program is effective in reducing the risk of death and the incidence of falls in older adults over a one-year period. In one study, falls were reduced by 35% in older adults has been reported(29) This study was planned to examine the effectiveness of balance exercises given as a home program to individuals diagnosed with Type 2 DM.

The goal of this clinical trial is to investigate whether sensory stimulations from a neuroprosthesis device (Walkasins®) can increase physical activity and improve gait quality in persons with peripheral neuropathy (PN). The main question it aims to answer is whether Walkasins enhances habitual activity patterns in adults with peripheral neuropathy. Participants will do the following as part of the study: * Complete a sensation and balance assessment to determine eligibility for the study. * Answer questions about their medical history, physical function, balance confidence, and sleep. * Perform various balance and walking tasks on three separate occasions. One of the tests involves walking for six minutes without a cane or walker. * Wear an activPAL activity monitor for ten days on three separate occasions and return it to the researcher as directed. * Wear Walkasins for ten weeks as part of their daily routine. Walkasins consists of two parts: 1) an insole that fits inside the shoe and 2) a strap that secures around the ankle.

Studies comparing aerobic exercise with virtual reality or video game technologies to traditional games and classical exercise have been conducted in healthy adolescents, but no studies comparing virtual reality and video game technologies have been found. Based on all this, we aimed to investigate the effect of virtual reality and video game-based exercise programs on physical fitness and attention levels in healthy adolescents. The study was planned as a quantitative experimental randomized controlled trial. Healthy individuals aged 10-18 years who meet the inclusion criteria will be evaluated during the dates of the study. Individuals will be divided into 3 groups: a classical physical activity group, a virtual reality group, and a video-based game group. Each program will be implemented for 20-30 minutes, three days a week for eight weeks. The Physical Activity Scale for Adolescents was used to evaluate the physical activity of the individuals, the Multidimensional Body-Self Relationship Scale was used to measure body image, and the Exercise Benefit/Barrier Scale was used to measure exercise perception. To measure attention, balance, and reaction time, the D2 Attention Test, Y-Balance Test, and Nelson's Hand Reaction Test will be administered, respectively. In the virtual reality and video-based game group, the games played by participants will be similar to the physical activities performed in the classic exercise group. One or more games incorporating these physical activities will be selected.

This study aims to evaluate balance ability, core stability, functional capacity, lower extremity muscle strength, and fatigue levels in children diagnosed with central nervous system demyelinating diseases, in order to contribute to the development of evidence-based and individualized rehabilitation strategies.

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system characterized by demyelination and axonal degeneration. Neuromuscular impairments associated with MS, including muscle weakness, spasticity, fatigue, and proprioceptive deficits, may lead to alterations in spinal posture and reduced spinal mobility. These changes can negatively affect trunk control, balance, respiratory function, and functional independence. Although postural abnormalities and mobility limitations have been reported in individuals with MS, the relationship between spinal posture, spinal mobility, and balance remains insufficiently investigated. Therefore, this study aims to examine the associations between spinal posture, spinal mobility, and balance performance in individuals with multiple sclerosis. Improved understanding of these relationships may contribute to the development of targeted rehabilitation interventions aimed at enhancing postural control and functional outcomes in this population. This study further hypothesises that alterations in spinal posture and spinal mobility are associated with impaired balance performance in individuals with multiple sclerosis.

Total knee arthroplasty (TKA) is a commonly performed surgical procedure aimed at reducing pain, restoring joint function, and improving quality of life, particularly among older women. Despite improvements in pain and functional outcomes following TKA, findings regarding balance, fall risk, and gait performance remain inconsistent. Impairments in these parameters may adversely affect daily activities, independence, and overall quality of life. Unlike previous studies that have primarily focused on one or two outcomes, this study will comprehensively evaluate balance, fall risk, gait performance, and quality of life in postmenopausal women who have undergone TKA. The findings are expected to provide a more holistic understanding of long-term functional outcomes following TKA and contribute to the planning of rehabilitation programs. Therefore, the aim of this study is to compare balance, fall risk, gait performance, and quality of life between postmenopausal women who have undergone TKA and healthy postmenopausal women.

Cerebral Palsy (CP) is the most common cause of childhood disability, with an estimated prevalence of 17 million individuals worldwide. Children and adolescents with CP present impaired postural control and balance, negatively affecting their mobility and functional performance. The use of dynamic orthotic garments may contribute to the improvement of postural control, balance, and functional mobility in children and adolescents with CP. The aim of the present study is to investigate the immediate effect of the dynamic orthotic garment TheraTogs on balance and functional mobility in children and adolescents with CP. In this cross-sectional pilot study, children and adolescents with CP classified as levels I and II according to the Gross Motor Function Classification System (GMFCS), and with spasticity levels lower than +1 according to the Modified Ashworth Scale, will participate. Balance will be assessed using the Pediatric Balance Scale (PBS), while functional mobility will be evaluated with the Timed Up and Go (TUG) test and the 10 Meter Walk Test (10MWT). Each assessment will be performed twice by each participant, with and without the TheraTogs dynamic orthotic garment, in random order. Statistical analysis will be conducted using SPSS Statistics V29 software, with the level of significance set at p \< 0.05.

This study aims to comparatively investigate the effects of low-volume High-Intensity Interval Training (HIIT) versus Moderate-Intensity Continuous Training (MICT) on gait, balance, cognitive functions, and neurovascular biomarkers (BDNF, VEGF) in individuals with Multiple Sclerosis (MS). This randomized controlled trial will be conducted at Hacettepe University, Faculty of Physical Therapy and Rehabilitation.

Chronic post-stroke hemiplegia frequently results in persistent motor deficits, impaired balance, and reduced quality of life. Conventional physical therapy is fundamental for functional recovery; however, motor improvement often plateaus during the chronic phase. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that has shown potential to enhance motor recovery by modulating cortical excitability and promoting neuroplasticity. This case series aims to investigate the effects of a combined protocol of repetitive transcranial magnetic stimulation and conventional physical therapy on motor function, balance, and quality of life in individuals with chronic post-stroke hemiplegia. Participants will undergo rTMS applied to the motor cortex in conjunction with a structured physical therapy program. Clinical outcomes will be assessed before and after the intervention to explore feasibility, safety, and potential functional benefits of the combined approach.

This observational study aims to investigate the validity and reliability of the Figure-of-8 Walk Test (8FWT) in individuals with Motoric Cognitive Risk Syndrome (MCRS). The study will evaluate test-retest reliability, measurement error (SEM, MDC), and construct validity by examining the relationship between 8FWT performance and functional mobility measures. The findings are expected to provide evidence for the clinical applicability of 8FWT in assessing dynamic balance, gait performance, and cognitive-motor interaction in older adults.

Hemiparesis following a stroke is associated with persistent deficits in postural control, balance, and social participation, especially in the chronic phase. Dance therapy, as a multisensory intervention based on movement, music, and body expression, could promote sensorimotor integration and improve postural stability, complementing conventional physiotherapy. The primary objective of this pilot study is to evaluate the effect of a therapeutic dance program on postural control in individuals with chronic hemiparesis. A secondary objective is to analyze changes in functional balance and gait, as well as subjective satisfaction with the therapy. A controlled study with two parallel groups will be conducted. Sixteen participants with chronic hemiparesis will be recruited (n=8 experimental group; n=8 control group). Both groups will receive standard physiotherapy, but the experimental group will also receive an 8-week therapeutic dance program, with one 30-minute session per week to complement their usual therapy. Pre- and post-intervention assessments will be performed. ThThe experimental group is expected to show a significantly greater improvement in posturographic and clinical parameters compared to the control group. The results could support the implementation of dance therapy as a complementary intervention in community neurorehabilitation programs.

This study aims to investigate the effects of cognitive load on gait and balance performance in individuals with Motoric Cognitive Risk Syndrome (MCRS). Participants will perform Timed Up and Go (TUG) and tandem walking tests under single-task and dual-task conditions. The study evaluates cognitive-motor interference and dual-task cost to better understand early markers of cognitive decline and fall risk.

The aim of this study is to compare the effects of body weight-supported gait training that includes virtual reality-assisted dual-task applications with body weight-supported forward and backward gait training on functional capacity, gait parameters (such as step length, gait speed, and balance), cognitive functions and psychological status in patients with stroke. The findings of this study are expected to contribute to the development of more effective rehabilitation strategies for improving mobility in patients with stroke

The goal of this clinical trial is to determine whether virtual reality (VR) training using the Nintendo Wii Fit can improve balance, gross motor function, and agility in children aged 7-14 years with spastic cerebral palsy (GMFCS Levels I-II). The main questions it aims to answer are: Does Wii Fit-based VR training improve balance more than conventional physiotherapy? Does VR training enhance gross motor skills such as standing, walking, running, and jumping? Does VR training improve agility in children with cerebral palsy? Does VR training increase enjoyment and engagement during therapy? Researchers will compare Wii Fit-based VR training with conventional physiotherapy to determine which approach leads to greater improvements in motor function. Participants will: Attend 18 sessions over 6 weeks (3 sessions per week). Perform either VR-based exercises using the Wii Fit Balance Board or traditional physiotherapy exercises. Complete pre- and post-intervention assessments using the Pediatric Balance Scale, GMFM-88 (domains D and E), BOT-2 agility subtest, and the PACES enjoyment scale. This study aims to explore a fun, cost-effective, and engaging rehabilitation strategy that may improve functional independence and overall quality of life for children with cerebral palsy.

This study will investigate the balance performance and balance-related activities of daily living in 35 industrial workers with hearing problems exposed to occupational noise, using the Berg Balance Scale and the Vestibular Disorders Activities of Daily Living Scale. The research aims to determine whether there is a statistically significant association between hearing problems, balance performance, and daily noise exposure duration. It is hypothesized that while hearing problems related to occupational noise exposure may exist, they may not be directly associated with clinically significant balance impairment, potentially remaining at a tolerable level in daily life. Furthermore, the correlation between Berg Balance Scale and daily living activity scores will be evaluated to understand the functional impact of balance on these workers.

The goal of this clinical trial is to evaluate the efficacy of Whole-body vibration in improving postural control, risk of falling, and quality of life in patients with chemotherapy-induced peripheral neuropathy. The main questions it aims to answer are: Does Whole-body vibration have a significant effect on postural control, risk of falling, and quality of life in patients with chemotherapy-induced peripheral neuropathy? Researchers will compare whole body vibration in addition to traditional exercise to traditional exercise alone to see if Whole-body vibration have a significant effect on postural control, risk of falling, and quality of life in patients with chemotherapy-induced peripheral neuropathy. Participants will: * age between 30-60 years old. * be on chemotherapy for at least one cycle as a treatment of malignant tumors with peripheral neuropathy. * have mild to moderate neuropathy according to mTNS. * be assigned randomly into two equal groups (control group (A) and study group (B)). * Take three sessions per week for eight weeks. * The control group (A) will be treated by selected physical therapy treatment (Strength resistive training, Stretching \& flexibility, Balance training) * The study group (B) will be treated with selected physical therapy treatment in addition to whole-body vibration therapy.

Objectives Objective 1: To determine the effects of a 16-week remotely delivered Pilates intervention on walking endurance, walking speed, balance, fatigue, and pain compared to a waitlist control group in individuals with MS. Objective 2: To examine the impact of a 16-week remotely delivered Pilates intervention on depression \& anxiety, cognitive function, and QOL compared to a waitlist control group in individuals with MS. Aim Aim 1: To assess whether the 16-week remotely delivered Pilates intervention significantly improves walking endurance, walking speed, balance, fatigue, and pain compared to a waitlist control group in individuals with MS Aim 2: To investigate whether the 16-week remotely delivered Pilates intervention significantly improves depression \& anxiety, cognitive function, and QOL compared to a waitlist control group in individuals with MS. Hypothesis Hypothesis 1: The 16-week remotely delivered Pilates intervention will significantly improve walking endurance, walking speed, balance, fatigue, and pain compared to a waitlist control group in individuals with MS. Hypothesis 2: Participants receiving the 16-week remotely delivered Pilates intervention will demonstrate significantly greater improvements in depression \& anxiety, cognitive function, and QOL compared to a waitlist control group in individuals with MS.

The purpose of this clinical trial is to investigate the effects of a rehabilitative game-based intervention on self-efficacy, balance, and visual-motor integration in individuals aged 60 years and older. The primary research questions are: Does the rehabilitative game-based intervention improve balance and visual-motor integration? Does the rehabilitative game-based intervention improve self-efficacy levels? Researchers will compare a rehabilitative game intervention group with a control group. Participants will complete baseline and post-intervention assessments. Individuals in the intervention group will participate in rehabilitative game sessions twice per week for 6 weeks, while the control group will not receive any intervention.

The purpose of this research study is to determine if intermittent visual perturbations can improve balance training. The investigators will quantify differences in body movement, muscle activity, and beam walking performance during and after practice walking on a balance beam that is 1" high. The investigators will ask the participants to come to the laboratory twice (2 sessions). The first session will not last more than 3 hours. The second session will not last more than 1 hour and will be two weeks after the first session. In total, the maximum amount of time the participant would be asked to participate is 4 hours.

This randomized controlled study aims to investigate the acute effects of a single session of core stabilization exercises on balance and upper extremity functional performance in competitive archers. Core stability is essential for postural control, neuromuscular coordination, and efficient force transfer during archery shooting. Understanding the immediate effects of core stabilization exercises may support their use as an effective warm-up and performance-enhancing strategy in archery athletes.

The goal of this randomised clinical trial is to investigate the effectiveness of an innovative therapeutic exercise program emphasizing in dual-task exercises in people with amnestic Mild Cognitive Impairment. The main questions it aims to answer are: Does the innovative therapeutic exercise program improve gait and balance? Does the innovative therapeutic exercise program improve cognition? Researchers will compare the innovative therapeutic exercise program emphasizing in dual-task exercises to a therapeutic exercise program without emphasizing in dual-task exercises and to a control group (given instruction about the benefits of exercise). Participants will: * Perform the exercise program twice a week for three months. * Will be assessed before and after the intervention. * Will record The Borg Scale of Perceived Exertion every second week to monitor and assess the progression of exercise intensity.