{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:15:49Z","timestamp":1771258549073,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["GARDE 1159635"],"award-info":[{"award-number":["GARDE 1159635"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["CAREER RAPD\/GARDE-0846471"],"award-info":[{"award-number":["CAREER RAPD\/GARDE-0846471"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5R21DC012410\u201302"],"award-info":[{"award-number":["5R21DC012410\u201302"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007270","name":"University of Michigan-Ann Arbor","doi-asserted-by":"publisher","award":["MiBrain Initiative Working Group grant, Multisensory Integration and Reweighting Dynamics"],"award-info":[{"award-number":["MiBrain Initiative Working Group grant, Multisensory Integration and Reweighting Dynamics"]}],"id":[{"id":"10.13039\/100007270","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Vibrotactile sensory augmentation (SA) decreases postural sway during real-time use; however, limited studies have investigated the long-term effects of training with SA. This study assessed the retention effects of long-term balance training with and without vibrotactile SA among community-dwelling healthy older adults, and explored brain-related changes due to training with SA. Sixteen participants were randomly assigned to the experimental group (EG) or control group (CG), and trained in their homes for eight weeks using smart-phone balance trainers. The EG received vibrotactile SA. Balance performance was assessed before, and one week, one month, and six months after training. Functional MRI (fMRI) was recorded before and one week after training for four participants who received vestibular stimulation. Both groups demonstrated significant improvement of SOT composite and MiniBESTest scores, and increased vestibular reliance. Only the EG maintained a minimal detectable change of 8 points in SOT scores six months post-training and greater improvements than the CG in MiniBESTest scores one month post-training. The fMRI results revealed a shift from activation in the vestibular cortex pre-training to increased activity in the brainstem and cerebellum post-training. These findings showed that additional balance improvements were maintained for up to six months post-training with vibrotactile SA for community-dwelling healthy older adults.<\/jats:p>","DOI":"10.3390\/s22083014","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T02:39:31Z","timestamp":1650335971000},"page":"3014","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Retention Effects of Long-Term Balance Training with Vibrotactile Sensory Augmentation in Healthy Older Adults"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7310-3436","authenticated-orcid":false,"given":"Tian","family":"Bao","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"given":"Fatemeh","family":"Noohi","sequence":"additional","affiliation":[{"name":"Department of Psychology, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"given":"Catherine","family":"Kinnaird","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"given":"Wendy J.","family":"Carender","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA"}]},{"given":"Vincent J.","family":"Barone","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"given":"Geeta","family":"Peethambaran","sequence":"additional","affiliation":[{"name":"Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4271-8718","authenticated-orcid":false,"given":"Susan L.","family":"Whitney","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Otolaryngology, School of Health and Rehabilitation Sciences, University of Pittsburgh, 100 Bridgeside Point, Pittsburgh, PA 15219, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2452-9024","authenticated-orcid":false,"given":"Rachael D.","family":"Seidler","sequence":"additional","affiliation":[{"name":"Department of Psychology, School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-6788","authenticated-orcid":false,"given":"Kathleen H.","family":"Sienko","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1111\/jgs.15304","article-title":"Medical costs of fatal and nonfatal falls in older adults","volume":"66","author":"Florence","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_2","first-page":"CD007146","article-title":"Interventions for preventing falls in older people living in the community","volume":"2012","author":"Gillespie","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_3","first-page":"240","article-title":"Preventing Falls in Older Persons","volume":"96","author":"Moncada","year":"2017","journal-title":"Am. Fam. Physician"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society (2011). Summary of the updated American Geriatrics Society\/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J. Am. Geriatr. Soc., 59, 148\u2013157.","DOI":"10.1111\/j.1532-5415.2010.03234.x"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"83","DOI":"10.21315\/mjms2016.23.6.9","article-title":"Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects","volume":"23","author":"Youssef","year":"2016","journal-title":"Malays. J. Med. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.archger.2009.11.014","article-title":"Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients","volume":"51","author":"Kao","year":"2010","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.2147\/CIA.S69673","article-title":"Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review","volume":"9","author":"Laufer","year":"2014","journal-title":"Clin. Interv. Aging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.gaitpost.2017.10.006","article-title":"Virtual reality balance training for elderly: Similar skiing games elicit different challenges in balance training","volume":"59","author":"Faber","year":"2018","journal-title":"Gait Posture"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.gaitpost.2016.03.017","article-title":"Benefits of multi-session balance and gait training with multi-modal biofeedback in healthy older adults","volume":"47","author":"Lim","year":"2016","journal-title":"Gait Posture"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1159\/000442253","article-title":"Interactive Sensor-Based Balance Training in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial","volume":"62","author":"Schwenk","year":"2016","journal-title":"Gerontology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"273","DOI":"10.3233\/VES-2008-185-604","article-title":"Effects of multi-directional vibrotactile feedback on vestibular-deficient postural performance during continuous multi-directional support surface perturbations","volume":"18","author":"Sienko","year":"2008","journal-title":"J. Vestib. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1097\/MAO.0b013e31823827ec","article-title":"Efficacy of a vibrotactile neurofeedback training in stance and gait conditions for the treatment of balance deficits: A double-blind, placebo-controlled multicenter study","volume":"32","author":"Basta","year":"2011","journal-title":"Otol. Neurotol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.bjorl.2015.08.013","article-title":"Effects of vibrotactile vestibular substitution on vestibular rehabilitation\u2014preliminary study","volume":"81","author":"Brugnera","year":"2015","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"944","DOI":"10.3389\/fneur.2018.00944","article-title":"Potential Mechanisms of Sensory Augmentation Systems on Human Balance Control","volume":"9","author":"Sienko","year":"2018","journal-title":"Front. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00415-018-9133-z","article-title":"Van De Vibrotactile feedback improves balance and mobility in patients with severe bilateral vestibular loss","volume":"266","author":"Kingma","year":"2019","journal-title":"J. Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.gaitpost.2014.03.189","article-title":"Quantified self and human movement: A review on the clinical impact of wearable sensing and feedback for gait analysis and intervention","volume":"40","author":"Shull","year":"2014","journal-title":"Gait Posture"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"862","DOI":"10.2522\/ptj.20100050","article-title":"Effects of Virtual Reality\u2014Augmented Balance Training on Sensory Organization and Attentional Demand for Postural Control in People With Parkinson Disease: A Randomized Controlled Trial","volume":"91","author":"Yen","year":"2011","journal-title":"Phys. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.gaitpost.2012.07.002","article-title":"Vibrotactile neurofeedback balance training in patients with Parkinson\u2019s disease: Reducing the number of falls","volume":"37","author":"Ernst","year":"2013","journal-title":"Gait Posture"},{"key":"ref_19","unstructured":"American College of Sports Medicin (2013). ACSM\u2019s Health-Related Physical Fitness Assessment Manual, Lippincott & Wilkins."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3233\/VES-190683","article-title":"Effects of long-term vestibular rehabilitation therapy with vibrotactile sensory augmentation for people with unilateral vestibular disorders\u2014A randomized preliminary study","volume":"29","author":"Bao","year":"2019","journal-title":"J. Vestib. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12984-017-0339-6","article-title":"Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults","volume":"15","author":"Bao","year":"2018","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3233\/VES-170606","article-title":"The role of sensory augmentation for people with vestibular deficits: Real-time balance aid and\/or rehabilitation device?","volume":"27","author":"Sienko","year":"2017","journal-title":"J. Vestib. Res."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Schumann, F., Keyser, J., Goeke, C., Ko, S.U., Krause, C., Wache, S., Lytochkin, A., Ebert, M., Brunsch, V., and Wahn, B. (2016). Learning New Sensorimotor Contingencies: Effects of Long-Term Use of Sensory Augmentation on the Brain and Conscious Perception. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0166647"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/S0030-6665(05)70225-5","article-title":"Outcome measures for assessment of treatment of the dizzy and balance disorder patient","volume":"33","author":"Clendaniel","year":"2000","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_25","unstructured":"(2017, October 09). Rehabilitation Measures Database. Available online: https:\/\/www.sralab.org\/statistical-terms-use."},{"key":"ref_26","unstructured":"Bao, T., Kinnaird, C., Carender, W.J., and Sienko, K.H. (July, January 30). Effects of sensory augmentation activation thresholds on balance performance in people with vestibular disorders. Proceedings of the ISPGR\u2014The International Society of Posture and Gait Research World Congress, Edinburgh, UK."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1743-0003-9-10","article-title":"Cell phone based balance trainer","volume":"9","author":"Lee","year":"2012","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_28","first-page":"1044","article-title":"A Conceptual Framework for the Progression of Balance Exercises in Persons with Balance and Vestibular Disorders","volume":"2","author":"Klatt","year":"2015","journal-title":"Phys. Med. Rehabil. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3389\/fnsys.2017.00011","article-title":"Functional Brain Activation in Response to a Clinical Vestibular Test Correlates with Balance","volume":"11","author":"Noohi","year":"2017","journal-title":"Front. Syst. Neurosci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1093\/cercor\/bhab239","article-title":"Brain and Behavioral Evidence for Reweighting of Vestibular Inputs with Long-Duration Spaceflight","volume":"32","author":"Hupfeld","year":"2022","journal-title":"Cereb. Cortex"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/hbm.460020402","article-title":"Statistical parametric maps in functional imaging: A general linear approach","volume":"2","author":"Friston","year":"1994","journal-title":"Hum. Brain Mapp."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1002\/1522-2594(200007)44:1<162::AID-MRM23>3.0.CO;2-E","article-title":"Image-Based Method for Retrospective Correction of Physiological Motion Effects in fMRI: RETROICOR","volume":"44","author":"Glover","year":"2000","journal-title":"Magn. Reson. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1002\/hbm.460030303","article-title":"Spatial Registration and Normalization of Images","volume":"3","author":"Friston","year":"1995","journal-title":"Hum. Brain Mapp."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.neuroimage.2009.01.045","article-title":"A probabilistic MR atlas of the human cerebellum","volume":"46","author":"Diedrichsen","year":"2009","journal-title":"Neuroimage"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1016\/j.neuroimage.2010.10.035","article-title":"NeuroImage Imaging the deep cerebellar nuclei: A probabilistic atlas and normalization procedure","volume":"54","author":"Diedrichsen","year":"2011","journal-title":"Neuroimage"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Diedrichsen, J., and Zotow, E. (2015). Surface-Based Display of Volume-Averaged Cerebellar Imaging Data. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0133402"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1006\/nimg.2001.0978","article-title":"Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain","volume":"15","author":"Landeau","year":"2002","journal-title":"Neuroimage"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1007\/s00429-014-0971-x","article-title":"Structural and functional connectivity mapping of the vestibular circuitry from human brainstem to cortex","volume":"221","author":"Kirsch","year":"2016","journal-title":"Brain Struct. Funct."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.apmr.2007.05.003","article-title":"Learning Effects of Repetitive Administrations of the Sensory Organization Test in Healthy Young Adults","volume":"88","author":"Wrisley","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/BF03325265","article-title":"The five-times-sit-to-stand test: Validity, reliability and detectable change in older females","volume":"24","author":"Goldberg","year":"2012","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1152\/jn.00889.2007","article-title":"Vestibular nuclei and cerebellum put visual gravitational motion in context","volume":"99","author":"Miller","year":"2008","journal-title":"J. Neurophysiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1152\/jn.2002.88.3.1097","article-title":"Sensorimotor Integration in Human Postural Control","volume":"88","author":"Peterka","year":"2002","journal-title":"J. Neurophysiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1093\/ageing\/afl077","article-title":"Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls?","volume":"35","author":"Horak","year":"2006","journal-title":"Age Ageing"},{"key":"ref_44","unstructured":"King, L., and Horak, F.B. (2014). The role of the vestibular system in postural control. Vestibular Rehabilitation, FA Davis. [4th ed.]."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1016\/j.neuroimage.2011.03.074","article-title":"High-resolution fMRI detects neuromodulation of individual brainstem nuclei by electrical tongue stimulation in balance-impaired individuals","volume":"56","author":"Wildenberg","year":"2011","journal-title":"Neuroimage"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s11682-010-9099-7","article-title":"Sustained cortical and subcortical neuromodulation induced by electrical tongue stimulation","volume":"4","author":"Wildenberg","year":"2010","journal-title":"Brain Imaging Behav."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1089\/brain.2011.0029","article-title":"Electrical tongue stimulation normalizes activity within the motion-sensitive brain network in balance-impaired subjects as revealed by group independent component analysis","volume":"1","author":"Wildenberg","year":"2011","journal-title":"Brain Connect."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s12311-014-0608-x","article-title":"Neural correlates of sensory prediction errors in monkeys: Evidence for internal models of voluntary self-motion in the cerebellum","volume":"14","author":"Cullen","year":"2015","journal-title":"Cerebellum"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1093\/brain\/awm130","article-title":"Evidence for cortical visual substitution of chronic bilateral vestibular failure (an fMRI study)","volume":"130","author":"Dieterich","year":"2007","journal-title":"Brain"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"227","DOI":"10.3389\/fnhum.2020.00227","article-title":"Effect of Vestibular Rehabilitation on Spontaneous Brain Activity in Patients With Vestibular Migraine: A Resting-State Functional Magnetic Resonance Imaging Study","volume":"14","author":"Liu","year":"2020","journal-title":"Front. Hum. Neurosci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"273","DOI":"10.3389\/fnagi.2017.00273","article-title":"Balance training enhances vestibular function and reduces overactive proprioceptive feedback in elderly","volume":"9","author":"Wiesmeier","year":"2017","journal-title":"Front. Aging Neurosci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1007\/s40279-015-0375-y","article-title":"Effects of Balance Training on Balance Performance in Healthy Older Adults: A Systematic Review and Meta-analysis","volume":"45","author":"Lesinski","year":"2015","journal-title":"Sports Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.4172\/2165-7025.1000e147","article-title":"Getting the Dosage Right in Balance Exercise Prescription: The Intensity Problem","volume":"7","author":"Reinthal","year":"2017","journal-title":"J. Nov. Physiother."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/8\/3014\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:54:16Z","timestamp":1760136856000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/8\/3014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,14]]},"references-count":53,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["s22083014"],"URL":"https:\/\/doi.org\/10.3390\/s22083014","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,14]]}}}