A Scoping Review of Principles of Multisensory Exercise Training Interventions in Older Adults Emphasizing Balance
Sahar Johari1, Joy MacDermid2,3, Laura J Graham2,4
1School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, Ontario, ON.
Background And Purpose:
Multisensory exercises target visual, vestibular, and somatosensory systems to improve balance and mobility, thus reducing fall risk in older adults. Unlike traditional exercise interventions focusing on physical strength or motor skills, multisensory exercises challenge sensory inputs to enhance adaptability and stability. Despite their potential benefits, the role of sensory training in balance improvement and fall prevention has not been extensively explored. This scoping review aimed to examine and summarize multisensory exercise interventions' content, delivery, and outcomes in older adults without specific health diagnoses.
Methods:
A scoping review was conducted following Arksey and O'Malley's framework, encompassing stages such as identifying the research question, identifying relevant studies, study selection, charting the data, and synthesizing, summarizing, and reporting the results. Cochrane Library, Medline, PEDro, EMBASE, ProQuest, and Google Scholar were systematically searched using key terms such as "older adults," "multisensory," "balance," "exercise," and "fall." Studies were included if they evaluated the impact of multisensory exercises on balance and fall incidence in older adults without specific health diagnoses. The TIDieR checklist guided data extraction to ensure comprehensive reporting and analysis of intervention protocols.
Results And Discussion:
A total of 21 articles met the inclusion criteria, including 15 randomized controlled trials and 6 pre-post design studies without control groups. The total number of enrolled older adults was 1,018, 65% of whom were women. The review identified 4 principal categories of sensory interventions targeting visual, vestibular, proprioceptive modalities, and their combinations. Walking with sensory stimulation was the most common exercise intervention, featured in almost 60% of the studies. The Berg Balance Scale was the most frequently employed outcome measure, used in 42% of studies. However, the studies demonstrated considerable diversity in objectives, reporting, and intervention designs, including variations in exercise duration, frequency, intensity, and the specific sensory challenges applied. Additionally, inconsistencies were observed in the selection of outcome measures, with limited standardization across studies, making comparisons challenging.
Conclusion:
Although multisensory interventions are widely used to improve balance, empirical evidence is limited by inconsistencies in study design, intervention delivery, and reporting. Greater theoretical clarity, operational definitions, intervention mapping, and codesign techniques are necessary to enhance the quality and impact of future research in clinical practice.
