It has become almost routine practice to incorporate balance exercises into training programs for athletes from different sports. However, the type of training that is most efficient remains unclear, as well as the frequency, intensity and duration of the exercise that would be most beneficial have not yet been determined. The following review is based on papers that were found through computerized searches of PubMed and SportDiscus from 2000 to 2016. Articles related to balance training, testing, and injury prevention in young healthy athletes were considered. Based on a Boolean search strategy the independent researchers performed a literature review. A total of 2395 articles were evaluated, yet only 50 studies met the inclusion criteria. In most of the reviewed articles, balance training has proven to be an effective tool for the improvement of postural control. It is difficult to establish one model of training that would be appropriate for each sport discipline, including its characteristics and demands. The main aim of this review was to identify a training protocol based on most commonly used interventions that led to improvements in balance. Our choice was specifically established on the assessment of the effects of balance training on postural control and injury prevention as well as balance training methods. The analyses including papers in which training protocols demonstrated positive effects on balance performance suggest that an efficient training protocol should last for 8 weeks, with a frequency of two training sessions per week, and a single training session of 45 min. This standard was established based on 36 reviewed studies.

Evaluation of the Limits of Stability (LOS) Balance Test: The main objective of this study was the estimation of intrasession reliability of the limits of stability (LOS) test conducted on a force platform as an alternative measurement to standard posturography in quiet standing. Fifteen healthy adults took part in the experiment. The standardized measurement protocol of the LOS test was proposed. It consists of three phases - 1^st phase - 10s of quiet standing, 2^nd phase - the maximal forward leaning in a self paced manner, and 3^rd phase - maintenance of maximal forward leaning position. The analysis of variance Friedman's ANOVA and Repeated Measures ANOVA/MANOVA was used to diagnose the differences between 10 consecutive trials of the LOS test. In order to establish reliability of the test, the intraclass correlation (ICC) procedure was used. We presented different ways of maximal center of pressure (COP) excursion estimates. The results of this study show no significant differences between the chosen parameters of the LOS test. Moreover, the measurement of the range of COP excursion, which is most commonly analyzed in such tests, showed to be quite reliable with ICC_2,1 above .85. LOS test conducted along the standard procedure should be considered as a very useful method in clinical and research conditions. Still the specific parameters of the LOS test should be given more thorough insight, but it is a very good alternative to quiet standing posturography.

Postural instability is common in Parkinson’s disease (PD), often contributing to falls, injuries, and reduced mobility. In the clinical setting, balance disorder is commonly diagnosed using clinical tests and balance scales, but it is suggested that the most sensitive measurement is the force platform. The aim of this systematic review was to summarize the methods and various posturographic procedures used to assess the body balance and gait in PD. A systematic review was conducted of papers published from 2000 to 2017. Databases searched were PubMed and EBSCO. Studies must have involved patients with PD, used force platform or motion analysis system as a measurement tool, and described posturographic procedure. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. A total of 32 studies met the inclusion criteria. The PEDro scores ranged from 5 to 7 points. The analysis of the objective methods assessing balance disorders revealed a large discrepancy in the duration and procedures of measurements. The number of repetitions of each trial fluctuated between 1 and 8, and the duration of a single trial ranged from 10 to 60 seconds. Overall, there are many scales and tests used to assess the balance disorders and disabilities of people with PD. Although in many included studies the authors have used posturography as a method to evaluate the postural instability of PD patients, the results are contradictory. To solve this issue, it is indicated to establish a “gold standard” of procedures of measures of balance.

Objective: To determine the effect of virtual reality (VR) games on improving balance in different groups of neurological patients with a particular focus on the study quality and to determine the gold standard in VR training in these groups. Materials and Methods: A systematic review of controlled trials published between January 2009 and December 2017 was conducted. The PubMed, SCOPUS, SPORTDiscus, and Medline databases were searched. Studies involved patients with stroke or Parkinson's disease or children with cerebral palsy. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. Results: A total of 20 studies met the inclusion criteria. The PEDro scores ranged from 4 to 8 points. Analysis of the rehabilitation programs revealed a very large discrepancy in the planned volume of exercises in different subgroups of patients. Conclusions: Overall, the comparison of VR interventions between conventional rehabilitation and no intervention exhibited significantly better results. However, these results should be interpreted with great caution due to the large diversity of the systems, games, and training volume used in the VR therapy. In all included studies, only several articles included objective methods to assess the effect of VR. In addition, most of the articles showed a high risk of bias, such as a lack of randomization and blinding or a small sample size. That is why further well-designed randomized control trials are required to evaluate the influence of VR on balance in different groups of neurological patients.

Introduction: Little is known about the early stage balance changes in PD. Many clinicians assume that there are no postural issues in early PD because of failure to identify them on bedside and clinical testing. Here, we quantify balance changes in early and moderate stage PD and compared these values to healthy controls (HC) using clinical assessments of balance and posturography. Methods: We compared 15 HC with 15 early PD (PD-II; Hoehn and Yahr stage II) and 15 moderate PD (PD-III; H&Y stage III). Participants performed various clinical tests of balance and a standing postural task on a force platform. We quantified the spatiotemporal parameters of the center of pressure (COP), the sample entropy and power spectral density (PSD) of the COP. Results: The PSD of the COP differentiated PD-II from HC from 0–0.5 Hz and PD-II from PD-III from 0.5–1 Hz. Specifically, PD-II and PD-III manifested greater power than HC from 0–0.5 Hz, whereas PD-III exhibited greater power than PD-II and HC from 0.5–1.0 Hz (p0.05). Although the sample entropy was significantly lower in the PD groups (p<0.05), entropy failed to differentiate PD-II from PD-III. Conclusion: The low-frequency modulation of the COP in this small cohort differentiated early PD from HC and from moderate PD. Clinicians should be aware that there are early balance deficits in PD. A larger sample size is needed to confirm these findings.