BACKGROUND: The Biodex Balance Training System (BBTS) has been utilized as an imbalance assessment/treatment tool in various populations and diseases. OBJECTIVES: The aim of this study was to investigate the effect of BBTS on dynamic balance and physical performance in hemodialysis (HD) patients with osteopenia. MATERIAL AND METHODS: 58 women with HD and osteopenia were randomly assigned to a 12-week Biodex-training group (BTG, n = 29) or a non-trained group (n = 29). The training, 3 times per week, was conducted using BBTS and lasted for 10 minutes, with the two types of training- weight shift and postural stability- each lasting 5 minutes, allowing the HD patients to relax for 2 minutes between each type of exercise. HD patients' femoral bone mineral density (T-score) was assessed in both groups. Dynamic balance was assessed in both groups via the HD participants' BBTS-extracted overall stability index (OASI), BBTS-extracted anteroposterior stability index (APSI), and BBTS-extracted mediolateral stability index (MLSI). The HD patients' physical performance was also evaluated using a 6-minute walking distance (6MWD) test and total scored points of a 3-component Short Physical Performance Battery (SPPB) test. Results. After using BBTS in a balance-training program, significant improvements in HD participants' OASI, APSI, T-score, MLSI, SPPB, and 6MWT were recorded in the BTG, while all outcomes of the NTG did not show the same results. CONCLUSIONS: It can be concluded that utilizing BBTS in a 12-week balance-training program improves participants' OASI, APSI, T-score, MLSI, SPPB, and 6MWT in HD patients with osteopenia.

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