Discussion
BBS
SECONDARY, ADVERSE EVENT
This study evaluated the effects of a PBT protocol in addition to usual care on balance control and fear of falling in older adults with a recent history of falls. We hypothesised that the PBT group would show greater improvements compared to the control group. While median Mini-BESTest scores increased slightly in both groups, these changes were below the threshold for minimal detectable change and were not significantly different between groups. Median falls efficacy scores decreased by one point in the PBT group but not in the control group, and no significant between-group differences were found. Explorative secondary analysis revealed interactive effects of age and receiving physiotherapy on the association between group and ΔMini-BESTest, while age acted as a confounding variable on the association between group and ΔFES-I. Correction for confounding variables strengthened both associations but did not lead to a significant association with group in either.The findings of this study do not support our hypothesis that balance control measured with the Mini-BESTest would improve significantly in the PBT group compared to the control group. Similar conclusions were drawn by recent studies comparing the effects of PBT to general balance training or multimodal physiotherapy on clinical measures of balance control (BBS, Timed Up and Go, and Dynamic Gait Index) in healthy community-dwelling older adults [Transfer of training adaptations to other tasks or contexts is an important challenge of PBT. Studies have shown that transfer of training adaptations can be achieved, but so far only to different conditions for a similar task. For example, studies have found transfer of PBT training adaptations after slip-perturbations on a low-friction moveable platform to a slippery floor [Additionally, while studies have shown promising beneficial effects of PBT with a single or few training sessions [No significant between-group differences were found in change of fear of falling measured with the FES-I. Median values at baseline were classified as ‘low concern’ based on previously determined cut-off values, and stayed the same for the control group and decreased by one point for the PBT group [The results of this study show high training adherence rates, one training-related adverse event, and that increasing training difficulty was possible for each participant, confirming the feasibility of this PBT protocol for participants. However, including participants in the study proved challenging. Figure 