IntroductionOsteoporosis is a debil

Introduction
Osteoporosis is a debilitating, widespread disease, which affects approximately 55% of the population above 50 years
old in the USA [1]. Falls among the elderly, especially for those with osteoporosis, are associated with high morbidity
and mortality and can involve high-cost medical intervention [2]. In fact, falls are responsible for 90% of the
growing increase in hip fractures [3] and are the sixth cause of death among patients aged over 65 [4].
Falls are multifactorial, and their causes are categorized as intrinsic (personal) and extrinsic (environmental) factors
[5, 6]. Some examples of intrinsic factors include: altered balance, neurological diseases, sensory deterioration, musculoskeletal diseases, postural hypertension and the use of medication [7].
Research shows that altered balance is the greatest collaborator towards falls in the elderly [6, 8–12], with a high correlation between balance deficit and the incidence of falls [13, 14].
For this reason, studies regarding the risk of falling in osteoporosis are of high priority in clinical intervention.
Diminishing the incidence of falls is a health priority, which reflects on both the quality of life and health costs [2].
Moreover, evidence suggests that exercise reduces the risk of fractures, showing an effect on the maintenance of
bone mass and, more importantly, improving postural stability, mobility and, consequently, diminishing the risk
of falls [15]. Indeed, improving balance should be an objective in the prevention of falls [16].
However, knowledge regarding balance deficit and the probability of falls is limited and controversial [17]. The
literature shows that exercise may or may not be efficient in the control of falls [18], and the impact of prevention
programs with balance training in diminishing falling frequency has yet to be established, principally in women
with osteoporosis.
Balance training has been investigated in healthy elderly individuals [3, 16, 19–21]; however, only one study
regarding balance training in women with osteoporosis exists. Since patients with osteoporosis are at greater risk of
fractures resulting from falls, further research in this group should be prioritized [22].
The purpose of the present study was to investigate the effect of a 12-month balance training program on functional
and static balance, mobility and falling frequency in women with osteoporosis.