Evaluating the Effectiveness of a Multifaceted Intervention Program Including Activity and Balance Exercises, Nutritional, Biomechanical, Pharmacological, and Psychological Components on Improving Balance in Older Adults

To investigate the effectiveness of a multimodal intervention program (including nutritional modification, physical exercise, biomechanical modification, psychological interventions, and drug management) to improve health in the elderly.

Each of the intervention and the control group will consist of 40 subjects. The intervention group will receive medication counseling for polypharmacy, an exercise program in accordance with international standards, biomechanical correction with orthoses, nutritional correction, and psychological counseling, and the control group will receive only routine medical care.

Tehran selected elderly care centers

Inclusion criteria: - Age ≥ 65 years - Ability to walk independently with or without a mobility aid - Score of 21 to 40 on the Berg Balance Scale, indicating moderate balance - Written informed consent to participate in the study Exclusion criteria: - Severe neurological disorders (such as stroke or advanced Parkinson's) - Moderate to severe dementia (MMSE score less than 20) - Severe musculoskeletal problems - Inability to participate in interventions for more than 2 weeks

The intervention group will undergo a multimodal intervention program that includes the following: 1. Nutritional modification and Supplement prescription 2. Selected physical exercises (strength, balance, functional) 3. Biomechanical modification (posture correction, footwear, mobility aids) 4. Medication management (focusing on polypharmacy) 5. Psychological interventions including CBT) The control group will receive usual care.

Balance score of Berg test; Mobility score (TUG); Nutritional status; Polypharmacy index; Depression and anxiety; lower limb strength; Gait speed

In this study, after assessing the inclusion and exclusion criteria, participants will be randomly assigned to two groups: intervention and control. The randomization method will be performed in four-block randomization using Random Allocation Software (RAS). To avoid bias in allocation, the randomization process will be performed by an individual independent of the research team.

For blinding, due to the nature of the intervention, blinding of participants is not possible. However, the outcome assessors and the data analyst will be blinded to the group allocation (single-blind study design). To ensure that blinding is maintained, the groups will be coded and will only be opened after the statistical analysis is completed.

Information about the main research findings will be published in the form of an article.

After the results are published, up to two years later

Employees at academic institutions and well-known researchers

For verification by the editor of the journal or journals in which the articles are published and for researchers who wish to conduct further research in this field.

Email the principal investigator.

After receiving the email, it is discussed with the research center's research council and, with the center's permission, the information is made available to the researchers by removing the subjects' names and carrying out other legal and ethical considerations.