Effectiveness of virtual reality‐based balance and gait in older adults with fear of movement: A systematic review and meta‐analysis

Abstract

ObjectiveTo summarize the current evidence from randomized controlled trials (RCTs) regarding the effectiveness of Virtual Reality (VR) training and functional mobility in older adults with fear of movement.TypeSystematic review and meta‐analysis of randomized clinical trials.MethodologyAn electronic search was performed using PubMed, Embase, Medline, SPORTDiscus, Scopus, and CINAHL. A data search from January 2015 to December 2022 and a manual electronic literature search were conducted to identify published RCTs. The effectiveness of VR‐based balance training for balance and gait was evaluated in older adults with a fear of movement, which was measured by the Timed Up and Go (TUG) test and the Falls Efficacy Scale (FES). Three reviewers independently performed the study selection, and the quality assessment of the included studies was performed using the Physiotherapy Evidence Database (PEDro) scale. The reporting was based on the new Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) Guidelines.SynthesisThe search product produced 345 results, from which 23 full text articles were studied. Seven RCTs of good methodological quality, including 265 participants, were included in the review. Overall, the studies reported that VR had a significant improvement on the TUG (Cohen's d = −0.91 [−1.38; −0.44], p = 0.001), while the FES was not significantly different (Cohen's d = −0.54 [−1.80; 0.71] p = 0.40). The average for PEDro scores (6.14) was good, and the risk of bias revealed that more than one‐third of the studies correctly described the random sequence generation and allocation concealment procedures.ConclusionVR‐based training is effective on balance or gait training based on the TUG; however, there were mixed results to improve FES scores following VR intervention. These inconsistent results might be limited due to variations in the studies, including heterogeneous training paradigms, sensitive outcome measures, small sample sizes, and short intervention durations, which limit the validity of our findings. Future investigations should compare different VR protocols to help establish better guidelines for clinicians.

Involuntary Falls in Patients with Chronic Kidney Diseases on Nephrology Wards: Research Advances and Future Perspectives

“…76 In addition, the integration of virtual reality and augmented reality technologies in the development of training and intervention resources for fall prevention can significantly enhance patients' balance and movement control, ultimately reducing the risk of falling. [80][81][82] Moreover, in addition to prioritizing fall prevention within healthcare organizations, future research endeavors could concentrate on extending fall prevention initiatives to the community level. 83,84 Implementing measures such as public education and the establishment of community support networks can effectively enhance fall awareness and prevention among older adults residing in the community.…”