Alternative and Complementary Interventions for Improving Gait and Balance in Older Adults: An Evidence-Based Review

Abstract

Background: Gait and balance impairments are highly prevalent among older adults and represent major contributors to falls, disability, and loss of independence. Age-related neuromuscular decline, sensory deterioration, and cognitive changes significantly compromise postural control and mobility. While conventional physiotherapy and exercise programs remain central to rehabilitation, alternative and complementary interventions have gained increasing attention as accessible, low-cost, and holistic strategies for improving functional mobility in the elderly.
Objective: This review aims to synthesize scientific evidence on alternative and complementary therapies for improving gait and balance among older adults and to present a conceptual framework explaining their mechanisms of action and functional outcomes.
Methods: A comprehensive literature search was conducted using electronic databases including PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2000 and 2025. Search terms included gait impairment, balance disorders, elderly, falls, Tai Chi, yoga, Pilates, dance therapy, virtual reality, dual-task training, aquatic therapy, and whole-body vibration. Randomized controlled trials, systematic reviews, and meta-analyses involving adults aged ≥60 years were included.
Results: Strong evidence supports the effectiveness of Tai Chi, dual-task training, and virtual reality–based interventions in improving balance performance, gait speed, and functional mobility. Moderate evidence exists for yoga, Pilates, dance therapy, aquatic therapy, and rhythmic auditory cueing. These interventions improve gait and balance through neuromuscular strengthening, sensory integration, cognitive-motor interaction, and psychological mechanisms such as improved confidence and reduced fear of falling.

Conclusion: Alternative and complementary therapies represent valuable adjuncts to conventional rehabilitation for gait and balance impairments in older adults. Multimodal and mind–body approaches appear particularly beneficial. Future research should focus on standardized intervention protocols and long-term follow-up to strengthen clinical translation.