The Effects of Light-Targeted Balance Training on Balance, Functional Performance, and Fear of Falling in Individuals With a History of Falls

Inclusion Criteria

1. Having experienced at least one fall within the previous 12 months.
2. Being 18 years of age or older.
3. Being able to walk independently or with the assistance of a walking aid.
4. Being able to understand and follow verbal and visual instructions.
5. Providing voluntary consent to participate in the study and signing the informed consent form.

Exclusion Criteria

1. Presence of an acute orthopedic injury or an active musculoskeletal condition causing pain.
2. Having undergone lower extremity surgery within the previous 6 months.
3. Having advanced neurological disorders (e.g., advanced Parkinson's disease, advanced dementia).
4. Having severe vestibular dysfunction or significant visual impairment.
5. Having a cardiovascular condition that contraindicates exercise.
6. Having advanced systemic diseases that significantly impair balance.

• Light- Targeted Balance Training (Behavioral): Exercises aimed at improving coordination, balance, and functional performance using visual and auditory cues.
• Standard Balance Training (Behavioral): Conventional balance training exercises.

Primary outcomes

• Change in Balance Performance (Berg Balance Scale) [Baseline and after 8 weeks of intervention]: Balance performance is assessed using the Berg Balance Scale (BBS). The scale consists of 14 functional tasks scored from 0 to 4. The total score ranges from 0 to 56, where higher scores indicate better balance and lower fall risk.

Secondary outcomes

• Change in Functional Mobility (Timed Up and Go Test - TUG) [Baseline and after 8 weeks of intervention]: Dynamic balance and mobility are assessed using the Timed Up and Go (TUG) test. The time (in seconds) taken to stand up from a chair, walk 3 meters, turn around, walk back, and sit down is recorded. Shorter completion times indicate better mobility.
• Change in Dynamic Balance (Y-Balance Test) [Baseline and after 8 weeks of intervention]: Dynamic postural control is evaluated using the Y-Balance Test (YBT) in anterior, posteromedial, and posterolateral reach directions for both lower extremities. Reach distance is normalized to limb length ((reach distance / limb length) x 100) and composite scores are calculated.
• Change in Lower Body Strength (30-Second Chair Stand Test) [Baseline and after 8 weeks of intervention]: Lower extremity functional muscle strength is measured using the 30-Second Chair Stand Test. The total number of full stands completed from a seated position in 30 seconds is recorded. A higher number of repetitions indicates greater lower body strength.
• Change in Gait Speed (10-Meter Walk Test - 10MWT) [Baseline and after 8 weeks of intervention]: Walking speed is assessed using the 10-Meter Walk Test (10MWT). Participants walk a 10-meter course at their comfortable and/or fast walking pace, and the time taken (in seconds) to traverse the intermediate 6 meters is recorded to calculate gait speed (m/s).
• Change in Fear of Falling (Falls Efficacy Scale-International - FES-I) [Baseline and after 8 weeks of intervention]: Fear of falling is evaluated using the 16-item Falls Efficacy Scale-International (FES-I). Each item is scored on a 4-point Likert scale from 1 (not at all concerned) to 4 (very concerned). Total score ranges from 16 to 64, with higher scores reflecting greater fear of falling.
• Change in Balance Confidence (Activities-specific Balance Confidence Scale - ABC) [Baseline and after 8 weeks of intervention]: Balance confidence is measured using the 16-item Activities-specific Balance Confidence (ABC) Scale. Participants rate their confidence in performing specific activities without losing balance on a scale from 0% to 100%. The overall score is the mean percentage across all items.

Sex: All, ages: 18 Years to 95 Years

Inclusion Criteria:

* History of at least one fall within the past 12 months
* Age 18 years or older
* Ability to walk independently or with an assistive device
* Ability to understand and follow verbal and visual instructions
* Voluntary participation in the study and provision of written informed consent by signing the informed consent form

Exclusion Criteria:

* Acute orthopedic injury or an active musculoskeletal condition causing pain
* History of lower extremity surgery within the past 6 months
* Advanced neurological disorders (e.g., advanced Parkinson's disease, advanced dementia)
* Severe vestibular dysfunction or significant visual impairment
* Medical conditions that contraindicate exercise due to severe cardiovascular disease
* Advanced systemic diseases that severely affect balance