The Effectiveness of Neurofeedback Training and Exercise Environmental Affordances on Static and ‎Dynamic Balance and The Fear of Falling in The Elderly

Balance ability is a critical component of independent daily activities among the elderly. Balance disorder is one of the major risk factors for falls and related complications. Therefore, this study was conducted with the aim of the the comparision of the effectiveness of neurofeedback training (NT) and exercise environmental affordances (EEA) on static and dynamic balance and the fear of falling in the elderly. This was a quasi-experimental study with pretest-posttest design with a control group. The statistical population of the current study included elderly men aged 60 to 80 years living in Ilam, Iran, among whom 36 people were selected based on inclusion and exclusion criteria, and randomly assigned into three 12-member groups of NT, EEA and control. In the pretest and posttest stages, the participants completed the Yardley et al.’s fall self-efficacy questionnaire-international form, and having completed the questionnaire, they performed the static (Carlsen et al.) and dynamic (Tsang et al.) balance task in 3 attempts. In the intervention phase (exercise), carried out in form of three 30-minute sessions per week for eight weeks, NT and EEA groups performed the relevant exercises, and control group carried out their usual and daily activities in this time. The data were analyzed using univariate analysis of covariance (ANCOVA) using SPSS-22 software. The results indicated that EEA and NT have a significant effect on posterior and central-lateral displacement of the center of pressure as well as the time to reach anterior-posterior, lateral stability and the time to reach total stability of elderly men. EEA had a significant effect on the risk of fear of falling, but NT did not have the same effect. Besides, the results revealed that EEA, compared to NT, had more effect on static balance (anterior-posterior displacement and central-lateral displacement of the center of pressure) and dynamic balance (the time to reach anterior-posterior stability, the time to reach lateral stability, and the time to reach total stability) in elderly men. According to the results of the present study, it is suggested to geriatric trainers and specialists to pay attention to the enrichment of the environment to improve the static and dynamic balance of the elderly and the risk of falling.