Table 3 Characteristics of included studies for evaluating effectiveness of biofeedback-based interventions.

Hatzitaki et al[38] 2009 Greece

RCT

Community-dwelling, older women

E1 = 71, E2 = 71^b C = 71

E1 = 19, E2 = 15^b C = 14

ERBE Balance System: force plate system with display

Continuous visual feedback of force vector under each foot vs no intervention

3× wk, 4 wks 25 minutes

Total: 300 min

COP asymmetry during standing, sway during normal and tandem standing.

Heiden & Lajoie[39] 2009 Canada

CT

Community-dwelling, older adults recruited from a chair exercise program 77

E = 9, C = 7

NeuroGym Trainer: games- based system with 2 pressure sensors & display

Visual feedback of the difference in signal between the 2 sensors in controlling a virtual tennis game vs no intervention, both in addition to a chair exercise program

2× wk, 8 wks 30 minutes

Total: 480 min

Sway and RT during standing with feet together. CB&M scale, 6-minute walk distance

Lajoie[42] 2004 Canada

CT

Older adults from residential care facilities or living in the community

E = 70, C = 71

E = 12, C = 12

Force plate system with display

Continuous visual feedback of COP (feedback-fading protocol) vs no intervention

2× wk, 8 wks 60 minutes

Total: 960 min

Sway and RT during standing with feet together. BBS

Rose & Clark[46] 2000 USA

CT

Older adults with a history of falls 79

E = 24, C = 21

Pro Balance Master system: force plate system with display

Continuous visual feedback of COG (feedback-fading protocol) vs no intervention

2× wk, 8 wks 45 minutes

Total: 720 min

Sway (SOT) and weight-shifting (100%LOS) during standing. BBS, TUG

Sihvonen et al[48, 49] 2004 Finland

RCT

Frail older women living in residential care homes E = 81, C = 83

E = 20, C = 8

1 C

Good Balance system: force plate system with display

Continuous visual feedback of COP vs no intervention

3× wk, 4 wks 20-30 minutes

Total: 240-360 min

Sway during standing, varying vision and base of support & weight-shifting during standing.

BBS, activity level

Wolf et al[52] 1997 USA

RCT

Physically inactive older adults from independent-living center

E = 78, C1 = 78, C2 = 75

E = 24, C1 = 24 C2 = 24

Chattecx Balance System: force plate system with display

Continuous visual feedback of COP vs Tai Chi chuan training vs Educational sessions

1× wk, 15 wks 60 minutes

Total: 900 min

Sway during standing, varying vision and base of support.

Reference Location

Design

Population

Mean age (years)

Group size Drop-outs

Equipment

Biofeedback type,

comparison group(s)

Frequency Duration ^a

Short-term outcomes

Cheng et al[30] 2004 Taiwan

CT

Patients post-stroke

E = 61, C = 61

E = 30, C = 25

2 E, 1 C

Balance Master: force plate system with display

Continuous visual feedback of COG & conv. therapy vs conv. therapy

5× wk, 3 wks 20 minutes

Total: 300 min

Sway during standing, varying vision and surface movement & weight-shifting during standing

Grant et al[35] 1997 Canada

RCT

Patients post-stroke 65

E = 8, C = 8

1

Balance Master: force plate system with display

Continuous visual feedback of COG vs conv. balance training, both in in addition to conv. therapy

2 to 5× wk, max. 8 wks 30 minutes

Total: 570 min (average)

Weight-distribution during standing

Sackley & Lincoln[47] 1997 UK

RCT

Patients post-stroke

E = 61, C = 68

E = 13, C = 13

1 E

Nottingham Balance

Platform: force plate system with display

Continuous visual feedback of weight on the legs vs same training without feedback, both as part of functional therapy and in addition to conv. therapy

3× wk, 4 wks 20 minutes

Total: 240 min

Sway and weight-distribution during standing. RMA, Nottingham ADL scale

Shumway et al[57] 1988 USA

RCT

Patients post-stroke

E = 66, C = 64

E = 8, C = 8

Force plate system with display

Continuous visual feedback of COP vs conv. balance training, both as part of conv. therapy

2× day, 2 wks 15 minutes

Total: 300 min

Sway and weight-distribution during standing

Walker et al[51] 2000 Canada

RCT

Patients post-stroke

E = 65, C1 = 62, C2 = 66

E = 18, C1 = 18 C2 = 18

2 E, 2 C1, 4 C2

Balance Master: force plate system with display

Continuous visual feedback of COG and weight on the legs vs conv. balance training, both in addition to conv. therapy vs conv. therapy

5× wk, 3-8 wks 30 minutes Total: 450-1200

min

Sway during standing, varying vision. BBS, TUG, max. gait velocity test

Yavuzer et al[55] 2006 Turkey

RCT

Patients post-stroke

E = 60, C = 62

E = 25, C = 25

3 E, 6 C

Nor-Am Target Balance

Training System: portable force plate system with display

Continuous visual feedback of COG & conv. therapy vs conv. therapy

5× wk, 3 wks 15 minutes

Total: 225 min

Gait: time-distance, kinematic and kinetic parameters

Reference Location

Design

Population

Mean age (years)

Group size

Drop-outs

Equipment

Biofeedback type,

comparison group(s)

Frequency Duration ^a

Short-term outcomes

Aruin et al[26] 2003 USA

RCT

Patients post-stroke and narrow base of support during walking 65

E = 8, C = 8

2 sensors placed below knees and next to tibial tuberosity & wearable unit providing signals

Auditory feedback of distance between knees during conv. therapy vs conv. therapy

2× day, 10 days 25 minutes

Total: 500 min

Step width during walking

Bradley et al[28] 1998 UK

RCT

Patients post-stroke

E1 = 67, E2 = 72, C1 = 77, C2 = 68^c

E1 = 5, E2 = 7 C1 = 5, C2 = 6^c

2 C1

Portable EMG device

Auditory & visual feedback of muscle tone during conv. therapy

vs conv. therapy

18×, 6 wks ? minutes

Step length, stride width, foot angle during walking & RMI & Nottingham Extended ADL Index

Montoya et al[44] 1994 France

RCT

Patients post-stroke

E = 64, C = 60

E = 9, C = 5

Walkway with lighted targets & locometer

Auditory feedback of step length vs same training without feedback, both in addition to conv. therapy

2× wk, 4 wks 45 minutes

Total: 360 min

Step length of paretic side during walking

Morris et al[45] 1992 Australia

RCT

Patients post-stroke and knee hyperextension

E = 64, C = 64

E = 13, C = 13

Electrogoniometric monitor

Auditory feedback of knee angle during conv. therapy (phase 1) vs conv. therapy (phase 1), both followed by conv. therapy (phase 2)

1× wk, 4 wks 30 minutes

Total: 600 min

Velocity, asymmetry and peak knee extension during walking & MAS (gait)

Reference Location

Design

Population

Mean age (years)

Group size Drop-outs

Equipment

Biofeedback type,

comparison group(s)

Frequency Duration ^a

Short-term outcomes

Cheng et al[29] 2001 Taiwan

RCT

Patients post-stroke

E = 62, C = 63

E = 30, C = 24

Force plate system with voice instruction system, numerical LED and mirror

Visual feedback of weight-bearing symmetry, as part of conv. therapy vs conv. therapy

5× wk, 3 wks 50 minutes

Total: 750 min

-, only long-term outcomes are reported

Engardt et al[32] 1993 Sweden

RCT

Patients post-stroke

E = 65, C = 65

E = 21, C = 21

1 E, 1 C

Portable force-plate feedback system

Auditory feedback of weight on paretic leg vs same training without feedback, both in addition to conv. therapy

3× day, 6 wks 15 minutes

Total: 1350 min

Weight-distribution during rising and siting down.

BI (self-care & mobility), MAS (sit-stand)

Reference Location

Design

Population

Mean age (years)

Group size Drop-outs

Equipment

Biofeedback type,

comparison group(s)

Frequency Duration ^a

Short-term outcomes

Gauthier et al[56] 1986 Canada

RCT

Unilateral below-knee amputees

E = 60, C = 65

E = 5, C = 6

Limb Load Monitor: Pressure sensitive sole

Auditory feedback of weight on prosthesis during conv. therapy vs conv. therapy

1× day, 8 days 10 minutes

Total: 80 min

Sway and weight-distribution during standing, varying vision

Hershko et al[40] 2008 Israel

RCT

Patients with unilateral hip, tibial plateau or acetabular surgery 68

E1 = 9, E2 = 6 C1 = 8, C2 = 10^d

SmartStep: in-shoe sole

Auditory feedback of weight on affected leg during PWB therapy vs PWB therapy, both followed by by conv. therapy

1× day, 5 days 35 minutes

Total: 175 min

PWB on injured leg during walking & TUG

Isakov[41] 2007 Israel

RCT

Patients with below- or above-knee amputation, hip or knee replacement or femoral-neck fracture

E = 62, C = 66

E = 24, C = 18

SmartStep: in-shoe sole

Auditory feedback of weight on affected leg during FWB therapy vs FWB therapy

2× wk, 2 wks 30 minutes

Total: 120 min

FWB on injured leg during walking