Systematic review and meta-analysis of multisensory integration training in healthy older adults shows improved balance and reduced fall risk

BACKGROUND: The risk of falls escalates with advancing age, a consequence of the concomitant degeneration of multiple physiological systems, altered sensory processing capabilities, and reduced postural control. Multisensory integration (MSI) training has been demonstrated to enhance the brain's processing of multisensory information. However, existing studies show considerable variability in intervention duration and training modalities, limiting comparability across studies and contributing to inconsistent findings. OBJECTIVE: This study aimed to systematically evaluate the effectiveness of MSI training on postural stability and fall risk in healthy older adults and provide an evidence base for clinical practice. METHODS: Databases including PubMed, Embase, and Cochrane Library were searched by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The methodological quality of the included randomized controlled trials was assessed using the Cochrane risk of bias tool, and publication bias was evaluated through funnel plots. Meta-analyses using R packages quantified effects via standardized mean differences (SMDs) and 95% CIs, with fixed or random effects models selected based on heterogeneity (I²). Subgroup analyses explored age, intervention duration, and type. RESULTS: A total of 14 randomized controlled trials were included in the meta-analysis. Results showed that MSI training significantly reduced center of pressure displacement in the anterior-to-posterior displacement (SMD -1.64, 95% CI -2.78 to -0.49, P<.001) and center of pressure displacement in the medio-to-lateral displacement (SMD -1.37, 95% CI -2.68 to -0.07, P<.001). In terms of postural stability, MSI training significantly improved Berg Balance Scale scores (SMD 3.42, 95% CI 2.41 to 4.44, P=.006). In terms of fall risk, MSI training significantly reduced the time to complete the timed up and go test, and intervention type significantly moderated this effect (SMD -1.43, 95% CI -2.36 to -0.50, P<.001). Additionally, MSI training reduced the risk of falls (SMD -1.27, 95% CI -2.03 to -0.52, P<.001). CONCLUSIONS: In conclusion, MSI training is an effective intervention for enhancing static and dynamic postural control and reducing fall risk in healthy older adults, suggesting a beneficial effect on postural stability and fall-related outcomes.