Functional balance and coordination system

A force platform records how the body sways while standing — under different conditions, with eyes open and closed, on firm and unstable surfaces. That produces a numerical balance profile rather than an impression, and identifies which of the three balance systems is failing: vision, inner ear, or sensation from the feet and joints.

The same platform then delivers training tasks that challenge balance in the specific direction and condition the assessment identified as weak.

Balance disorders after stroke and brain injury, in Parkinson's disease and multiple sclerosis, in peripheral neuropathy where foot sensation is lost, in vestibular disorders, and in older adults with falls or fear of falling.

It is also used after ankle and knee injury, where joint position sense is impaired and single-leg balance remains deficient long after strength has returned.

Someone whose balance depends heavily on vision needs different training from someone with vestibular loss or with numb feet. Generic balance exercises help all three a little; targeted training helps the affected one substantially more.

Falls are reduced most by programmes that genuinely challenge balance and involve more than three hours of exercise a week 2. Comfortable balance exercises do little, which is why falls guidelines ask for exercises that are challenging but safe, reviewed and progressed regularly as ability improves 3.

The platform provides visual feedback during balance tasks, which allows practice at a difficulty just beyond current ability — where balance actually improves.

It also identifies whether a person is relying on vision to compensate for a deficit elsewhere, which changes what should be trained.

By narrowing the base of support, removing vision, adding an unstable surface, adding head movement, and finally adding a cognitive task — because real-world balance failures happen while thinking about something else.

That last progression is frequently omitted, and it is the one that most resembles the situations in which people actually fall.

Not clearly. Balance exercise itself has strong evidence behind it for preventing falls in older adults 1. Evidence that a platform’s feedback adds to it is much thinner. A Cochrane review of force-platform feedback after stroke found that it made standing weight more even between the legs, but did not improve sway, clinical balance scores or independence 4. Its seven trials were small, with 246 participants in total 4.

The platform’s practical value therefore lies elsewhere: showing which balance system is failing, setting the difficulty precisely, keeping practice at the edge of ability and recording whether anything changed between the first and last session. The balance exercise itself does the work, and it has to be hard enough and frequent enough to matter.