Electrical Vestibular Stimulation for Balance With Exercise in Older Adults

This study will test whether electrical stimulation of the balance system adds benefit to an exercise program for adults aged 60 years and older. The treatment is called noisy electrical vestibular stimulation (nEVS). It uses low-level electrical current delivered through electrodes placed behind the ears and on the neck. Participants who join the trial will be assigned by chance, in equal numbers, to active nEVS or sham nEVS. Sham sessions use the same equipment and preparation and will have no current delivered. Both groups will attend the RISE STRONG exercise program for 12 weeks. Exercise classes take place twice weekly and last about 35 to 45 minutes. Participants will attend 18 active or sham sessions over six weeks. Each session lasts 20 minutes. Two sessions each week may take place on exercise days, and one additional weekly visit is expected. The stimulation course may take place during exercise weeks 1 to 6 or 7 to 12. Standing balance will be measured before and after the six-week course to compare the two groups. Other assessments examine walking, physical function, cognition, and self-reported health. The study will also record attendance, treatment completion, and adverse events.