Mapping the Effectiveness of Compensatory Stepping Training for Balance and Fall Prevention in Community-Dwelling Older Adults: A Scoping Review
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Among older adults, falls are a leading cause of injury, mortality, and hospitalization globally. For fall prevention, perturbation-based protocols targeting reactive responses are used in compensatory stepping training (CST). However, compared with conventional interventions, evidence on the efficacy of CST remains underexplored. Hence, this scoping review maps the current evidence on the effectiveness and outcomes of CST in older adults for reducing falls and enhancing balance confidence compared with conventional interventions, thereby identifying gaps and providing recommendations. A comprehensive literature search was conducted in the PubMed and ScienceDirect databases regarding CST versus conventional therapy from January 2000 to December 2025. Seven studies (n = 12-102; 2008-2021) were included based on the eligibility criteria. Conventional therapies showed comparable functional gains but limited perturbation transfer. CST improved reactive balance, with 31% fewer recovery steps, 15-17% faster step initiation, and improved kinematic adaptability, along with 56-74% prospective fall reductions and high feasibility, reflected by 75-100% adherence and no adverse events. Frail subgroup exclusion, small sample sizes, and short follow-up periods were identified as gaps. For fall prevention and reactive balance, CST offers task-specific promise in terms of kinematic efficiency and scalability. To address psychological outcomes and optimize clinical integration, future trials should focus on multidirectional protocols with larger samples, including high-risk populations, along with assessment of long-term effects.
Source: Cureus
Authors: Radha R Bhattad, Sudhir L Tungikar
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7160934347