Abstract Most balance training regimens for elderly
individuals focus on self-controlled exercises, although
automatic postural responses after a balance perturbation
are not under direct volitional control. We critically review
the literature on this topic, and notice that several studies
fail to comply with basic principles of training and
therefore show little improvement in function. Some
present the view that physical function in the too frail and
too fit cannot be improved, which we instead argue would
be the effect of nonspecific training programs. We propose
a concept for balance training that incorporates voluntary
exercises as well as perturbation and dual-task exercises to
improve balance control. The program is performed on five
different levels where levels 1–4 exercises focus on the skill
to maintain balance and level 5 adds perturbation exercises
that focus on the skill to recover balance as well as dual
task exercises providing a cognitive load during execution
of a balance motor task. Functional requirements for muscle
strength and power are directly incorporated into the
program. The feasibility of the concept has been demonstrated
on elderly fallers. A randomized control trial is
underway to investigate the effects on healthy elderly
individuals. Further intervention studies using this concept
are encouraged