3.2.2.1 Berg Balance Scale

The Berg Balance Scale (BBS) consists of a battery of 14 tasks common to the activities of daily living, which quantitatively evaluate the risk of falls, through observations undertaken by the examiner [45]. The score on the test ranges from 0 to 56 and the performance on each task is measured on a five-point scale ranging from 0 to 4 (0 = unable to perform, 4 = independent). Scores of 48 or less indicate

inability to walk independently and safely in activities of daily living and, consequently, increased risk of falls [46].

4. Improvement of the postural balance

Postural Imbalance in the Elderly: Main Aspects DOI: http://dx.doi.org/10.5772/intechopen.79830

and, consequently, fall prevention.

4.1 Types of exercises

4.1.1 Video games

4.1.2 Treadmill exercise

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assessment.

Falls are a public health problem. The risk of falling increases with age for many

One type of treatment to improve balance is physical exercise. Figure 5 presents a summary of best practice recommendations to use for improving postural balance

Any physical exercise that overloads the balance systems without putting the patient at risk is recommended. It is possible, for example, to make a training circuit, with different stimuli for the elderly [51]. In the circuit, exercises such as one-legged support (both sides), gait on unstable surface, tandem gait, among

Another possibility is to join two modalities of exercises: video games and muscle strengthening, for example. In a study, Prata and Scheicher found improvement in fear of falling and in mobility after 12 weeks of video game and muscle strength

Postural balance training involving new technologies can promote more challenging situations for the elderly, increasing patient motivation and adherence to the program [53]. The use of video games provides immediate visual feedback, allowing users to make changes in motion according to the situations of the games and thus to develop strategies to restore and/or maintain postural balance, and may

Carvalho et al. showed an increase in gait speed and a decrease in the TUG time in elderly female fallers after 12 weeks of training (two sessions per week) with commercialized games of Wii Fit by Nintendo® in sync with the Wii Balance Board® [55]. Three different games were used for postural balance training: Penguin Slide, where the participants had to catch fish while balanced on a piece of ice by shifting their weight from side to side; Table Tilt, where participants move their bodies in various directions to put balls into holes; and Tightrope, where participants

others can be done, always increasing the level of difficulty.

training in older women with a history of falls [52].

therefore be effective for the prevention of falls [54].

walk on a tightrope with several vertical jumps to avoid obstacles.

In the last decade, the use of the treadmill in the rehabilitation of gait in Parkinson's disease patients, stroke patients, and cerebral palsy (CP) patients has been studied. Some studies explain the reasons for improving postural balance patterns with treadmill training. One of them explains that treadmill training has the capacity to promote motor re-learning and, consequently, improve locomotor capacity during walking [56]. It has also been suggested that training, through repetitive movements generated by the treadmill, activates locomotor patterns of functional movements, sensory inputs, and circuits of the central nervous system [57]. In addition, it has been hypothesized that repetitive movements associated

reasons, for example overall weakness and frailty, balance problems, cognitive problems, vision problems, some medications and polypharmacy, acute illness, and other environmental hazards. Because of this, multifactorial interventions should include an initial assessment of modifiable risk factors for falls and subsequent customized interventions for each patient based on issues identified in the initial
