QUESTION: What is the effect of a balance training protocol with the Biodex Balance System in institutionalised older people with fear of falling? DESIGN: Randomised controlled trial with concealed allocation and assessor blinding. PARTICIPANTS: Forty older people who lived in a nursing home and had fear of falling. INTERVENTION: The experimental group completed a 12-week balance training protocol based on balancing/rebalancing training with the Biodex Balance System, with two sessions per week. During the training period, participants in both groups received the same multidisciplinary care (such as physiotherapy, occupational therapy and nursing) that they usually received in the nursing home. OUTCOME MEASURES: The primary outcome was fear of falling (Falls Efficacy Scale International questionnaire). Secondary outcomes were dynamic balance (Fall Risk Test) and isometric strength (torque of knee flexor and extensor isometric strength measured with an isokinetic dynamometer). Outcome measures were taken before and after the training program protocol. RESULTS: Compared to the control group, the exercise group had significantly greater improvements at 12 weeks in fear of falling (by 8 points, 95% CI 4 to 12), in dynamic balance (by 2 degrees, 95% CI 1 to 3), and in isometric strength of the knee flexors (by 7 Nm, 95% CI 3 to 11) and knee extensors (by 7 Nm, 95% CI 1 to 13). CONCLUSION: The training program was feasible and effective in reducing fear of falling and improving dynamic balance and isometric strength in institutionalised older people with fear of falling. TRIAL REGISTRATION: ISRCTN21695765.

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