Objetiveto analytically and systematically review and integrate the available evidence of the effects of virtual reality-based aerobic endurance training on functional fitness of healthy older adults.Materials and MethodsThis systematic review of randomized controlled trials was conducted through searches in Pubmed, Science Direct, Scopus, PEDro, Web of Science, Lilacs, Scielo, Dialnet, and IEEE Xplore between February and May 2021. The evaluation of bias and methodological quality was performed following the parameters proposed by the Cochrane Manual of Systematic Reviews of Interventions and the PEDro Scale. Review Manager Software (Version 5.4.1) served for a summary of bias.ResultsThree clinical trials were selected. None of the selected studies employed any exclusively aerobic intervention with virtual reality; however, statistically significant findings for this type of intervention were found in functional fitness such as aerobic endurance, upper and lower limb strength, agility, and dynamic balance.Conclusionsaerobic endurance training through the use of virtual reality may provide positive effects on the functional fitness of the healthy elderly. This has implications for clinical practice, as it fosters the development of more beneficial, attractive, motivational, and quality interventions, the prevention of common conditions, and the use of technological tools by the elderly population. However, as for research implications, an increase of knowledge on the effects of technologies in the elderly functional capacity, and an implementation of scientific models or theories on physical activity and exercise are recommended with the purpose of explaining the phenomena due to the use of technologies within the processes of functional rehabilitation.

IntroductionExergames are used in the clinical practice of geriatric rehabilitation to increase physical activity levels and motivate players/patients. Their use in the home environment makes it possible to perform fun, engaging and interactive training with a large number of repetitions, thereby reducing the negative repercussions of postural imbalance in older adults. The aim of this systematic review is to collate and analyse evidence on the usability of exergames as a tool for home-based balance training for older adults.Methods and analysisWe will include randomised controlled trials involving healthy older adults (aged 60 years or older) who are described as having impaired static or dynamic balance using any subjective or objective assessment criteria. We will search Web of Science, MEDLINE, Embase, Scopus, ScienceDirect and the Cochrane Library from database inception to December 2022. ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform and ReBEC will be searched for ongoing or unpublished trials. Two independent reviewers will screen the studies and extract the data. The findings will be presented in the text and tables, and if possible, relevant meta-analyses will be performed. The risk of bias and the quality of evidence will be assessed based on the recommendations of the Cochrane Handbook and Grading of Recommendations, Assessment, Development and Evaluation, respectively.Ethics and disseminationEthical approval was not required because of the nature of this study. Findings will be disseminated through peer-reviewed publications, conference presentations and through clinical rehabilitation networks.PROSPERO registration numberCRD42022343290.