Keywords: Proprioception, Health Span, Balance Training, Single-Leg Stance, Neuromuscular Function, Fall Prevention
Introduction
Among the sensory systems that govern human function, proprioception occupies a uniquely paradoxical position: it is perhaps the most continuously active and physiologically consequential of our senses, yet it remains the least visible to conscious awareness and the most underappreciated in preventive medicine. Dubbed the “sixth sense” by neuroscientists, following vision, hearing, smell, taste, and touch, proprioception encompasses the complex network of receptors, afferent pathways, and central processing centres responsible for detecting and integrating information about body position, movement velocity, joint angles, and muscle force [1,2].
The traditional clinical narrative around proprioception has been largely confined to rehabilitation medicine, reconstructing deficits after anterior cruciate ligament tears, managing vestibular disorders, or preventing falls in high-risk elderly populations. Yet a rapidly expanding body of research reframes proprioception not merely as a protective mechanism against injury, but as a dynamic biological system whose integrity reflects and predicts overall health trajectory across the lifespan [3,4].
Longevity science has increasingly moved beyond the simplistic extension of chronological lifespan toward the cultivation of health span, the period of life characterized by functional independence, metabolic resilience, and cognitive vitality. Within this framework, the “hallmarks of aging”, including mitochondrial dysfunction, cellular senescence, chronic inflammation, and stem cell exhaustion have received extensive attention. Musculoskeletal and neuromuscular pillars of longevity, including cardiorespiratory fitness and muscle strength, are now firmly established as mortality predictors. However, proprioceptive function, which underpins both of these domains, has received comparatively little attention as an independent longevity biomarker or intervention target [5,6,7,8].
This review argues that proprioception deserves recognition as a distinct, trainable pillar of longevity. We examine the neurobiology of proprioception, characterize its age-related decline and metabolic associations, review epidemiological evidence linking proprioceptive function to mortality and health span outcomes, and synthesize the evidence on training interventions capable of restoring and enhancing proprioceptive function across the adult lifespan.
The Neurobiology of Proprioception: A Multi-Receptor Sensory System: A Multi-Receptor Sensory System
Proprioception arises from the integrated activity of multiple peripheral receptor types, ascending spinal pathways, and supraspinal processing networks. Understanding this architecture is essential for appreciating both its vulnerability to aging and its plasticity in response to training.
Peripheral Receptor Architecture
Three primary classes of mechanoreceptors contribute to proprioceptive signalling. Muscle spindles, intrafusal fibres innervated by group Ia and group II afferents, detect muscle length and the rate of length change, and serve as the primary transducers of limb position sense. Golgi tendon organs (GTOs), innervated by group Ib afferents, detect muscle force and tension, providing critical information about load-bearing conditions and effort. Joint mechanoreceptor, including Ruffini endings, Pacinian corpuscles, and free nerve endings encode joint position and movement, particularly at end ranges of motion [1,2,9].
The central integration of these signals occurs across multiple hierarchical levels. Spinal interneuronal circuits mediate rapid postural reflexes and reciprocal inhibition patterns, while supraspinal structures, including the cerebellum, basal ganglia, primary and supplementary motor cortices, and the parietal association cortex, integrate proprioceptive information with visual and vestibular inputs to generate the unified sense of body schema and motor intent [10,11].
Central Processing and Body Schema
The concept of “body schema”, the dynamic, continuously updated internal representation of body configuration in space is critically dependent on proprioceptive input. This representation enables predictive (feedforward) motor control, allowing the nervous system to pre-program motor commands based on anticipated sensory consequences rather than relying solely on reactive (feedback) corrections. Deficits in proprioceptive input, or in central processing of proprioceptive signals, therefore impair not only reactive stability but the predictive neuromuscular coordination that underlies efficient, safe, and metabolically economical movement [10,11,12].
The Sensorimotor Loop
The bidirectional relationship between proprioceptive input and motor output constitutes what may be termed the “sensorimotor loop”, a continuous cycle in which movement generates sensory information, which in turn shapes subsequent movement. This loop is not merely a reactive safety mechanism; it is the substrate through which skilled, habitual movement is encoded, refined, and maintained across decades. Its disruption, through aging, disease, sedentary behaviour, or injury represents a fundamental perturbation in the organism’s capacity for adaptive, efficient motor function [2,13,14].
Proprioceptive Decline Across the Lifespan
Proprioceptive function is not static; it follows a trajectory of development, maturation, and age-related decline that has important implications for functional independence and longevity.
Age-Related Changes in Peripheral Receptors
Multiple studies have documented structural and functional changes in proprioceptive receptors with advancing age. Muscle spindle density decreases with aging, and remaining spindles exhibit morphological abnormalities including capsular thickening and intrafusal fibre atrophy. Golgi tendon organ sensitivity declines, and joint receptor populations are reduced, particularly in weight-bearing joints. These peripheral changes are compounded by age-related reductions in peripheral nerve conduction velocity and increases in sensory detection thresholds, collectively termed “somatosensory aging” [15,16,17].
Position sense acuity, the ability to detect and reproduce joint position deteriorates measurably from the fifth decade onward, with accelerating decline after age 65. Vibration sense, which shares mechanoreceptor pathways with proprioception, shows similar age-related deterioration and is routinely assessed in clinical neurology as a surrogate for large-fibre afferent integrity [17,18].
Central Contribution to Proprioceptive Decline
Beyond peripheral receptor changes, central nervous system aging contributes substantially to proprioceptive deterioration. White matter changes, reduced cerebellar volume, and cortical thinning in sensorimotor regions diminish the fidelity and speed of proprioceptive signal processing. Dual-task impairments, the inability to maintain postural stability during simultaneous cognitive demands emerge earlier and more severely in those with greater white matter burden, suggesting that proprioceptive-cognitive integration is a particularly vulnerable system [19,20].
Metabolic Disease and Accelerated Proprioceptive Decline
Metabolic diseases accelerate proprioceptive aging through multiple pathways. Diabetic peripheral neuropathy, affecting up to 50% of individuals with long-standing type 2 diabetes, selectively damages large myelinated afferent fibres, impairing proprioceptive and vibration sense before pain and temperature modalities. Insulin resistance, independent of overt neuropathy, is associated with reduced muscle spindle sensitivity, possibly through effects on intrafusal fibre metabolism and neurotrophic factor availability. Obesity compounds these effects through altered joint mechanics, increased joint loading, and systemic inflammation [21,22,23].
This creates a concerning bidirectional relationship: metabolic disease accelerates proprioceptive decline, while impaired proprioception reduces physical activity, worsens musculoskeletal loading patterns, and promotes the sedentary behaviour that further exacerbates metabolic dysfunction [24].
Proprioception as a Biomarker Longevity
Perhaps the most compelling argument for proprioception’s place in longevity medicine is the robust epidemiological evidence linking measures of proprioceptive and neuromuscular function to mortality outcomes.
Balance Performance and All-Cause Mortality
Single-leg stance duration, a widely used clinical proxy for proprioceptive and neuromuscular integration, has emerged as a powerful predictor of mortality across multiple population-based studies. Inability to maintain a one-leg stand for 10 seconds in midlife (ages 51-75) was associated with an approximately 84% increased risk of all-cause mortality over a 7-year follow-up period in a prospective cohort of 1,702 participants, independent of age, sex, BMI, and comorbidity burden [25].
The Sitting-Rising Test (SRT), which assesses the ability to sit and rise from the floor without manual support, a task heavily dependent on proprioceptive coordination, muscle strength, and flexibility demonstrated a graded relationship with all-cause mortality in a cohort of 2,002 adults aged 51-80 years. Participants achieving the highest SRT scores demonstrated a five-fold lower mortality risk compared to those with the lowest scores [26].
Gait and Neuromuscular Coordination as Mortality Predictors
Gait speed, a composite measure of neuromuscular integration, cardiorespiratory fitness, and musculoskeletal health has been extensively validated as a mortality predictor. Meta-analyses of individual participant data from multiple cohort studies demonstrate that each 0.1 m/s increase in gait speed is associated with a 12% reduction in mortality risk. The proprioceptive contribution to gait efficiency is substantial: impaired proprioception increases step-to-step variability, slows gait, and increases the metabolic cost of locomotion [27,28].
Falls, Fractures, and Downstream Longevity
Falls represent one of the most consequential proximal causes of morbidity and mortality in older adults, and proprioceptive impairment is among the strongest modifiable risk factors. Approximately 30% of individuals over 65 and 50% of those over 80 fall at least once annually [29]. Hip fracture, the most serious consequence of falls in older adults, carries a one-year mortality rate of 20-30%, with many survivors experiencing permanent functional decline [30]. Importantly, proprioceptive deficits independently predict fall risk beyond the contributions of muscle weakness, medication use, and visual impairment [16,18].
Proprioception, Neuroinflammation, and Metabolic Health
The relationship between proprioception and metabolic health extends beyond the mechanical consequences of obesity and the neurotoxic effects of hyperglycaemia. Emerging evidence implicates neuroinflammation and altered neurotrophic signaling as shared pathological mechanisms linking metabolic dysfunction to proprioceptive decline.
Neuroinflammation and Sensorimotor Pathways
Chronic low-grade inflammation, a hallmark of metabolic syndrome, obesity, and type 2 diabetes, impairs neuronal function through multiple mechanisms including increased neuroinflammatory cytokine production (IL-6, TNF-alpha, IL-1beta), mitochondrial dysfunction in peripheral neurons, and microglial activation in sensorimotor brain regions. Experimentally induced neuroinflammation in animal models impairs muscle spindle sensitivity and reduces position sense acuity, suggesting a direct mechanistic link between systemic inflammation and proprioceptive function [22,31].
Brain-Derived Neurotrophic Factor as a Shared Mediator
Brain-derived neurotrophic factor (BDNF) plays critical roles in both metabolic regulation and sensorimotor maintenance. BDNF supports the survival and function of muscle spindle afferents and central proprioceptive circuits, and its expression is markedly reduced in metabolically compromised states including obesity, insulin resistance, and type 2 diabetes. Physical exercise, particularly proprioceptively demanding exercise, is among the most potent stimulators of BDNF production, suggesting a shared biological pathway through which movement simultaneously benefits metabolic and sensorimotor health [32,33].
Skeletal Muscle as a Proprioceptive Organ
Recent perspectives position skeletal muscle not merely as the effector of proprioceptive motor commands but as an active participant in proprioceptive signalling. Muscle-derived factors including irisin, IL-6, and diverse myokines interact with intrafusal fibres and peripheral sensory neurons, potentially modulating proprioceptive sensitivity in response to exercise and metabolic state. This “proprioceptive myokine hypothesis” remains an active area of investigation but underscores the intimate biological linkage between muscle metabolic function and sensorimotor integrity [34].
Neuroplasticity and Proprioceptive Training: Evidence-Based Interventions
The most clinically significant property of the proprioceptive system, from a longevity medicine perspective, is its robust plasticity. Unlike many biological systems whose age-related decline is largely irreversible, proprioceptive function demonstrates substantial capacity for improvement across all adult age groups in response to targeted training [35].
Balance and Perturbation Training
Progressive balance training, involving progressively destabilizing surfaces, reduced base of support, and visual perturbations is the most extensively studied proprioceptive intervention. Randomised controlled trials consistently demonstrate improvements in position sense acuity, postural stability, and fall risk following 8-12 weeks of structured balance training in older adults. Perturbation-based training, in which unexpected balance disturbances are applied via moveable platforms or harness systems, produces particularly robust improvements in reactive postural control by training the neural circuits responsible for rapid proprioceptive-to-motor response [36,37].
Tai Chi and Mind-Body Movement Practices
Tai chi chuan, a traditional Chinese movement practice characterised by slow, controlled, multi-planar movement has been the subject of multiple high-quality randomised controlled trials examining proprioceptive and fall prevention outcomes. A landmark trial by Li et al. demonstrated that 26 weeks of tai chi practice in adults aged 70 years and older reduced fall rate by 55% compared to stretching controls and significantly improved single-leg stance performance and perceived confidence. Meta-analyses confirm that tai chi consistently improves proprioceptive measures including ankle joint position sense and postural sway across multiple demographic groups [38,39].
Yoga similarly incorporates proprioceptively demanding postures, slow transitions, and sustained single-limb challenges. Evidence from systematic reviews indicates that yoga practice improves static and dynamic balance in older adults, with improvements partially attributable to enhanced proprioceptive acuity [40].
Vibration Therapy
Whole-body vibration (WBV) and focal vibration directly stimulate muscle spindles through the tonic vibration reflex, providing a form of proprioceptive challenge without requiring high-intensity voluntary movement. WBV training has demonstrated benefits for postural stability, neuromuscular control, and proprioceptive acuity in older adults, though optimal dosing parameters like frequency, amplitude, and session duration, remain areas of active investigation. Focal vibration of specific muscle groups shows promise for improving position sense acuity in both age-related and neurological proprioceptive deficits [41,42].
Proprioceptive Enrichment Environment
Emerging evidence suggests that unstructured exposure to proprioceptively enriched environments like terrain walking, barefoot movement, and variable surface training may provide cumulative proprioceptive benefits beyond those achievable in standardised training protocols. The “sensorimotor enrichment hypothesis” posits that the neurological variability inherent in complex, unpredictable movement environments drive adaptive proprioceptive neuroplasticity analogous to the cognitive benefits of environmental enrichment on brain structure and function [43].
Resistance Training and Neuromuscular Specificity
High-resistance training with an emphasis on eccentric loading and slow tempos, conditions that maximally challenge muscle spindle stretch reflexes, demonstrates proprioceptive benefits beyond those attributable to strength gains alone. Eccentric resistance training has been shown to improve position sense acuity at the knee and ankle, possibly through enhanced intrafusal fibre sensitivity and gamma motor neuron activity [44].
Incorporating Proprioceptive Assessment into Longevity Medicine
For proprioception to fulfil its potential as a longevity biomarker and intervention target, validated assessment tools must be integrated into clinical practice alongside existing health metrics.
Clinical Assessment Tools
Several validated clinical tools provide accessible proprioceptive assessment without specialised equipment. The single-leg stance test, performed with eyes open and closed on firm and foam surfaces, quantifies postural stability and the proprioceptive contribution to balance. The Timed Up and Go (TUG) test assesses dynamic postural transitions and gait initiation. For research settings, computerised force plate posturography, isokinetic joint position reproduction testing, and vibration detection threshold measurement provide objective, quantitative proprioceptive characterization [16,35,45].
Wearable Technology and Continuous Monitoring
Advances in wearable inertial measurement unit (IMU) technology enable continuous, real-world monitoring of gait variability, postural sway, and movement quality, surrogate measures of proprioceptive function, outside of clinical settings. Machine learning approaches applied to wearable sensor data show promise for detecting early proprioceptive decline before clinical manifestation, potentially enabling preventive intervention at earlier stages of the longevity trajectory [46].
Integration with Existing Longevity Protocols
We propose that proprioceptive assessment be incorporated alongside existing longevity markers including VO₂max testing, grip strength dynamometry, DEXA body composition analysis, and comprehensive metabolic panels. A composite “neuromuscular longevity score” incorporating measures of strength, balance, gait quality, and proprioceptive acuity may offer superior mortality prediction compared to any single metric [47].
Future Direction
Several important research gaps remain. Longitudinal studies tracking proprioceptive function from midlife through late life with mortality and morbidity endpoints are needed to establish definitive temporal relationships and causal inference. Mechanistic studies examining the effects of proprioceptive training on neuroinflammation, BDNF levels, and intrafusal fiber morphology in human participants would substantially strengthen the biological plausibility of proprioceptive interventions. Dose-response relationships for proprioceptive training, identifying optimal frequency, intensity, and duration parameters require investigation across diverse populations including those with metabolic disease, diabetes, and obesity.
The potential synergistic effects of combining proprioceptive training with nutritional interventions targeting peripheral nerve health, including omega-3 fatty acids, B-complex vitamins, alpha-lipoic acid, and magnesium merit formal clinical investigation. Finally, the development of standardized, internationally validated proprioceptive assessment batteries suitable for integration into large-scale epidemiological studies would considerably advance the field.
Conclusion
Proprioception, the neurosensory system through which the body knows itself in space represents far more than a mechanism for avoiding falls. It is a continuously active, metabolically integrated, and clinically measurable biological system whose integrity tracks closely with overall health trajectory and longevity outcomes. The evidence reviewed here supports three core conclusions: first, proprioceptive function declines with age and metabolic disease through well-characterized peripheral and central mechanisms; second, the integrity of proprioceptive function predicts mortality and health span outcomes in population-based studies; and third, proprioception is robustly trainable across the adult lifespan through a range of accessible, low-cost interventions.
For practitioners in longevity medicine, these conclusions carry actionable implications. Proprioceptive assessment should enter the standard battery of longevity biomarkers alongside cardiorespiratory fitness, muscle strength, and metabolic health indices. Proprioceptively demanding exercise, balance training, tai chi, terrain walking, and perturbation-based programmes should feature prominently in exercise prescriptions for health optimization across the lifespan. The intimate relationship between proprioceptive function and metabolic health should motivate integrated approaches that simultaneously target neuroinflammation, insulin sensitivity, and neuromuscular coordination.
We live in an age of unprecedented interest in the science of human longevity. The proprioceptive system, silent, continuous, and remarkably trainable deserves its place at the centre of that conversation. As clinicians, researchers, and health advocates, our challenge is to translate this biological understanding into actionable protocols that extend not merely the quantity, but the quality and functional richness of human life.
Reference
1. Proske U, Gandevia SC. The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiol Rev. 2012;92(4):1651-97.
2. Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basis of functional joint stability. J Athl Train. 2002;37(1):71-9.
3. Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci. 2015;8:1075.
4. Behm DG, Muehlbauer T, Kibele A, Granacher U. Effects of strength training using unstable surfaces on strength, power and balance performance across age groups: a systematic review and meta-analysis. Sports Med. 2015;45(12):1645-69.
5. Lopez-Otin C, Galluzzi L, Freije JMP, Madeo F, Kroemer G. Metabolic control of longevity. Cell. 2016;166(4):802-21.
6. Lopez-Otin C, Blasco MA, Partridge L, Serrano M, Kroemer G. Hallmarks of aging: an expanding universe. Cell. 2023;186(2):243-78.
7. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301(19):2024-35.
8. Ortega FB, Silventoinen K, Tynelius P, Rasmussen F. Muscular strength in male adolescents and premature death: cohort study of one million participants. BMJ. 2012;345:e7279.
9. Johansson H, Sjolander P, Sojka P. A sensory role for the cruciate ligaments. Clin Orthop Relat Res. 1991;268:161-78.
10. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(Suppl 2):ii7-11.
11. Wolpert DM, Ghahramani Z, Jordan MI. An internal model for sensorimotor integration. Science. 1995;269(5232):1880-2.
12. Nashner LM, McCollum G. The organization of human postural movements: a formal basis and experimental synthesis. Behav Brain Sci. 1985;8(1):135-50.
13. Gandevia SC. Spinal and supraspinal factors in human muscle fatigue. Physiol Rev. 2001;81(4):1725-89.
14. Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237-52.
15. Swash M, Fox KP. The effect of age on human skeletal muscle: studies of the morphology and innervation of muscle spindles. J Neurol Sci. 1972;16(4):417-32.
16. Lord SR, Clark RD, Webster IW. Postural stability and associated physiological factors in a population of aged persons. J Gerontol. 1991;46(3):M69-76.
17. Shaffer SW, Harrison AL. Aging of the somatosensory system: a translational perspective. Phys Ther. 2007;87(2):193-207.
18. Goble DJ, Coxon JP, Wenderoth N, Van Impe A, Swinnen SP. Proprioceptive sensibility in the elderly: degeneration, functional consequences and plastic-adaptive processes. Neurosci Biobehav Rev. 2009;33(3):271-8.
19. Ward NS. Compensatory mechanisms in the aging motor system. Ageing Res Rev. 2006;5(3):239-54.
20. Holtzer R, Wang C, Verghese J. The relationship between attention and gait in aging: facts and fallacies. Motor Control. 2012;16(1):64-80.
21. Boulton AJM, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4):956-62.
22. Fernandes J, Arida RM, Bhanu NV, Bhanu LM. Proprioceptive dysfunction in metabolic syndrome: neuroinflammatory mechanisms and rehabilitation implications. J Neuroinflammation. 2021;18(1):147.
23. Vincent HK, Vincent KR, Lamb KM. Obesity and mobility disability in the older adult. Obes Rev. 2010;11(8):568-79.
24. Dunstan DW, Daly RM, Owen N, Jolley D, de Courten M, Shaw J, et al. High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care. 2002;25(10):1729-36.
25. Araujo CG, de Souza e Silva CG, Laukkanen JA, Fiatarone Singh M, Kunutsor SK, Myers J, et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. Br J Sports Med. 2022;56(17):975-80.
26. Brito LBB, Ricardo DR, de Araujo DSMS, Ramos PS, Myers J, de Araujo CGS. Ability to sit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol. 2014;21(7):892-8.
27. Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50-8.
28. Verghese J, Holtzer R, Lipton RB, Wang C. Quantitative gait markers and incident fall risk in older adults. J Gerontol A Biol Sci Med Sci. 2009;64(8):896-901.
29. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35(Suppl 2):ii37-41.
30. Haentjens P, Magaziner J, Colon-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, et al. Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152(6):380-90.
31. Pickering ME, Chapurlat R. Where two common conditions of aging meet: osteoarthritis and sarcopenia. Calcif Tissue Int. 2020;107(3):203-11.
32. Wrann CD, White JP, Salogiannnis J, Laznik-Bogoslavski D, Wu J, Ma D, et al. Exercise induces hippocampal BDNF through a PGC-1alpha/FNDC5 pathway. Cell Metab. 2013;18(5):649-59.
33. Voss MW, Vivar C, Kramer AF, van Praag H. Bridging animal and human models of exercise-induced brain plasticity. Trends Cogn Sci. 2013;17(10):525-44.
34. Pedersen BK, Febbraio MA. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012;8(8):457-65.
35. Roijezon U, Clark NC, Treleaven J. Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Man Ther. 2015;20(3):368-77.
36. Granacher U, Muehlbauer T, Gruber M. A qualitative review of balance and strength performance in healthy older adults: impact for testing and training. J Aging Res. 2012;2012:708905.
37. Mansfield A, Aqui A, Danells CJ, Knorr S, Centen A, DePaul VG, et al. Does perturbation-based balance training prevent falls among individuals with chronic stroke? A randomised controlled trial. BMJ Open. 2018;8(8):e021510.
38. Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, et al. Tai chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2005;60(2):187-94.
39. Huang ZG, Feng YH, Li YH, Lv CS. Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open. 2017;7(2):e013661.
40. Youkhana S, Dean CM, Wolff M, Sherrington C, Tiedemann A. Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis. Age Ageing. 2016;45(1):21-9.
41. Lam FM, Lau RW, Chung RC, Pang MY. The effect of whole body vibration on balance, mobility and falls in older adults: a systematic review and meta-analysis. Maturitas. 2012;72(3):206-13.
42. Cordo PJ, Bevan L, Gurfinkel VS, Carlton L, Carlton M, Kerr G. Proprioceptive consequences of tendon vibration during movement. J Neurophysiol. 1995;74(4):1675-88.
43. Bherer L, Erickson KI, Liu-Ambrose T. A review of the effects of physical activity and exercise on cognitive and brain functions in older adults. J Aging Res. 2013;2013:657508.
44. LaStayo P, Marcus R, Dibble L, Frajacomo F, Lindstedt S. Eccentric exercise in rehabilitation: safety, feasibility, and application. J Appl Physiol (1985). 2014;116(11):1426-34.
45. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8.
46. Mancini M, Horak FB. The relevance of clinical balance assessment tools to differentiate balance deficits. Eur J Phys Rehabil Med. 2010;46(2):239-48.
47. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.