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Objectives: To review the literature that describes effective intervention strategies to improve balance in older community-dwelling adults. Data Sources: CINAHL, PubMed, Cochrane, and Cochrane Center Register for Controlled Trial Databases. Review Methods: A search of the terms "balance and exercise," "fall risk and exercise," "fall risk and physical therapy," and "balance and rehabilitation" in Community Index to Nursing and Allied Health Literature (CINAHL) and PubMed. Interventions must be able to be reproduced in standard rehabilitation practice or at home or easily in the community recreation center. Results: The literature is robust with reports that describe the benefits and limitations of balance retraining exercises programs, most in combination with other objectives such as strength training, mobility improvement, functional improvement, and fall prevention within the timeframe of 2000 to 2013. Randomized controlled trial studies are becoming more evident in the literature and assist with greater generalizability; however, much more study is warranted to understand priorities of intervention selection, dosing, duration, and sensitive outcome measures. Conclusion: Multicomponent exercise programs that specifically address the older adult's physical impairments based on a therapist evaluation is more effective in promoting increased strength, balance, and fall prevention than general, nonspecific approaches. This individualized approach, whether conducted in a health care facility or at home guided specifically by a rehabilitation clinician, will result in more immediate gains. This may also improve the long-term compliance that is needed for long-term balance improvement, fall prevention, and maximizing physical function in older adults. Rehabilitation professionals should consider expanding their role in prevention and ongoing primary care practices that monitor the physical function of older adults on a routine basis to assist in optimal aging. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to explore the experiences of cultural competence and humility among patients of the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community in physical therapy. Researchers sought to understand the perspectives of adults over 18 years old who have received physical therapy and identify as a member of the LGBTQIA+ community., Methods: A phenomenological qualitative approach was utilized for this study. Patients were recruited through social media and LGBTQIA+ advocacy organizations across the United States. Twenty-five patients agreed to participate in the study. Focus groups and individual interviews were conducted using a semi-structured interview guide informed by Campinha-Bacote's domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, discussions, thoughts, perceptions, and opinions., Results: Three central themes and subthemes emerged from the data and were categorized according to cultural acceptance (societal impact, implicit and explicit bias), power dynamics between the in-group and out-group (out-group hyperawareness of their otherness), and participant solutions (policy, training, education)., Conclusion: An LGBTQIA+ patient's experience is influenced by the provider cultural acceptance, and the resulting power dynamics that impact LGBTQIA+ patients' comfort, trust, and perceptions of care. Enhanced patient experiences were found more prevalent with providers that possessed elevated levels of education or experience with this community, supporting Campinha-Bacote's assumption that there is a direct relationship between level of competence in care and effective and culturally responsive service., Impact: Awareness of the underlying issues presented in these themes will assist in the development of effective solutions to improve LGBTQIA+ cultural competence among physical therapists and physical therapist assistants on a systemic level., (© Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)