Effectiveness of exergames for improving mobility and balance in older adults: a systematic review and meta-analysis

Abstract

Background: Exergaming is a fun, engaging, and interactive form of exercising that may help overcome some of the traditional exercise barriers and help improve adherence on the part of older adults, providing therapeutic applications for balance recovery and functional mobility. The purpose of this systematic review is to summarize the effects of exergames on mobility and balance in older adults. Methods: The PRISMA guidelines for systematic reviews were followed. The following databases were searched from inception to August 2019: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro, CINAHL, and INSPEC. We selected randomized controlled trials that assessed the effects of exergames on balance or mobility of older adults without neurological conditions, in comparison to no intervention or health education. Two review authors independently screened the trials' titles and abstracts and identified trials for inclusion according to the eligibility criteria. An almost perfect agreement between the authors was observed with respect to interrater reliability of trial selection (kappa = 0.84; P < 0.001). We performed descriptive analysis of the quantitative data to summarize the evidence. Meta-analysis was carried out using RevMan. A random effects model was used to compute the pooled prevalence with 95% confidence intervals. Results: After screening 822 records, 12 trials comparing exergames with no intervention were included. A total of 1520 older adults participated in the studies, with a mean age of 76 ± 6 years for the experimental group and 76 ± 5 years for the control group. Quantitative synthesis showed significant improvements in balance and mobility based on the center of pressure sway (SMD = − 0.89; 95%CI = − 1.26 to − 0.51; P = 0.0001; I 2 = 58%), Berg Balance Scale (MD = 2.15; 95%CI = 1.77 to 2.56; P = 0.0001; I 2 = 96%), and on Timed Up and Go test (MD = − 2.48; 95%CI = − 3.83 to − 1.12; P = 0.0003; I 2 = 0). Conclusions: Exergames improved balance and mobility in older adults without neurological disorders and motivate patients to keep performing balance exercises. High quality studies with standardized assessment protocols are necessary to improve the strength of the evidence.

Effectiveness of Virtual Reality Systems to Improve the Activities of Daily Life in Older People

“…Moreover, commercial exergames offer a virtual re-creation of environments and challenges that are highly immersive, appealing and enjoyable for the user, thus increasing commitment to the task. In line with other reviews [ 53 , 54 ], our results suggest that the use of commercial virtual reality consoles, such as the Nintendo Wii ® , PlayStation ® and Xbox Kinect ® , can be beneficial and feasible in improving the functional autonomy of older persons.…”

Application of Interactive Video Games as Rehabilitation Tools to Improve Postural Control and Risk of Falls in Prefrail Older Adults

“…A potential reason is that they recruited healthy, highly functioning participants, which limits the generalizability of their results. Overall, a recent meta-analysis by Pacheco et al [37] showed that IVGs yield a significant effect on COP sway (SMD = −0:89; 95%CI = − 1:26 to − 0:51; p = 0:0001; I 2 = 58%). It is worth noting that there is serious heterogeneity in this data; thus, it should be interpreted with caution.…”

Characteristics of Physical Exercise Programs for Older Adults in Latin America: A Systematic Review of Randomized Controlled Trials

“…89% of the interventions were based on traditional PE, while 11% of the studies included interventions based on non-traditional disciplines such as Tai Chi and Pilates, disciplines that in recent years have increased their adherence and level of evidence [ 44 , 81 , 111 , 125 , 148 ] being even included by some countries in their GPAR [ 21 , 27 , 29 , 32 , 33 ]. 7% of the studies included exercise-based interventions with digital support, known as Exergames [ 74 , 78 , 117 , 120 , 126 ] a modality not so well known today, which has been shown to be effective in improving balance and mobility function in OA [ 149 , 150 ]. On the other hand, some authors suggest that more research is lacking regarding this type of interventions and the effects they propose [ 151 ].…”