JMIR Publications

ABSTRACT

Background:

Postural control is the act of maintaining, achieving, or restoring balance. It is a complex skill based on interactions of multiple, dynamic sensorimotor processes utilizing sensory information from vision, vestibular, and proprioception. Postural sway is the result of the movements of the body’s centre of mass and bodily responses produced to maintain balance. Multiple age-related changes in postural control systems cause decline in balance resources. Digital systems use to provide additional sensory information have been as promising means to compensate for this decline. However, firm results on the systems’ effectiveness, user experience and feasibility are limited.

Objective:

The aim of this study was to make an updated systematic review of digital systems and interactive interfaces to provide older adults with real time feedback on postural sway including evaluations of effects on postural sway (or similar balance-related variables) as well as user experience- and acceptability.

Methods:

This systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies reported in original, peer-reviewed journal articles or conference papers published and indexed during Jan 2015–June 2025 in English language were identified via searches in 5 databases. Included articles had samples of at least 5 individuals aged 60 years and older, used digital systems to monitor parameters related to postural sway (or similar balance related variables) as well as to give real-time feedback to the user, and presented study results related to effect on user’s postural sway (or similar balance-related variables) and/or user experience and acceptability.

Results:

1.2 % (11/ 927) of the screen records were included. The review identified indications of positive effects of auditory-visual, vibrotactile and visual- feedback on sway and related balance outcomes. Indications of short –term and immediate effects on sway due to vibrotactile-visual and auditory feedback were also identified. Feasibility and user experience were studies in some of the included studies, some of the evaluated systems demonstrated satisfactory feasibility and positive user experience.

Conclusions:

Although new types of systems and user interfaces continuously become available for delivering feedback on sway and balance, applications for home-setting and activities of daily life activities are still scarce. While indications of positive effects of biofeedback on sway exist and results on user experience as well as feasibility are reported, evidence of the systems’ long-term effects are still lacking.