The Effect of Mixed Reality Technologies for Falls Prevention Among Older Adults: Systematic Review and Meta-analysis (Preprint)

Abstract

BACKGROUND Falling is one of the most common and serious age-related issues, and falls can significantly impair the quality of life of older adults. Approximately one-third of people over 65 experience a fall annually. Previous research has shown that physical exercise could help reduce falls among older adults and improve their health. However, the elderly often find it challenging to follow and adhere to physical exercise programs. Interventions using mixed reality technology could help to address these issues. Mixed reality is a combination of artificial augmented computer-generated elements with the real world. It have frequently been used for training and rehabilitation purposes. OBJECTIVE The aim of this systematic literature review and meta-analysis was to investigate the use of the full spectrum of mixed reality technologies for fall prevention intervention and summarize evidence of the effectiveness of this approach. METHODS In our qualitative synthesis, we analyzed a number of features of the selected studies, including aim, type of exercise, technology used for intervention, study sample size, participant demographics and history of falls, study design, involvement of health professionals or caregivers, duration and frequency of the intervention, study outcome measures, and results of the study. To systematically assess the results of the selected studies and identify the common effect of MR interventions, a meta-analysis was performed. RESULTS Seven databases were searched, and the initial search yielded 5838 results. With the considered inclusion and exclusion criteria, 21 studies were included in the qualitative synthesis, and 12 were included in meta-analysis. The majority of studies demonstrated a positive effect of a mixed reality intervention on fall risk factors among older participants. The meta-analysis demonstrated a statistically significant difference in Berg balance scale score between the intervention and control groups (ES: 0.564, 95% CI: 0.246–0.882; p < 0.001) with heterogeneity statistics of I2 = 54.9 % and Q = 17.74 (p = 0.023), and a statistical difference in Timed Up and Go test scores between the intervention and control groups (ES: 0.318, 95% CI: 0.025–0.662; p < 0.001) with heterogeneity statistics of I2 = 77.6% and Q = 44.63 (p = 0.000). The corresponding funnel plot and the Egger’s test for small-study effects (p = 0.763 and p = 0.110 for BBS and TUG, respectively) indicate that a minor publication bias in the studies might be present in the Berg balance scale results. CONCLUSIONS The literature review and meta-analysis demonstrate that the use of mixed reality interventions can have a positive effect on physical functions in the elderly. Mixed reality has the potential to help older users to perform physical exercises that could improve their health conditions. However, more research on the effect of MR fall prevention interventions should be conducted with special focus given to MR usability issues.