Effects of Exergaming on Balance of Healthy Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

Balance is critical for older adults to perform daily activities. However, age-related declines in balance increase the risk of falls and severe injuries, such as bone fractures and head injuries. Exergames have been widely applied to improve health-related outcomes in older adults. This meta-analysis aims to quantify the effects of exergaming interventions on balance performance in healthy older adults. A literature search was performed using PubMed, ScienceDirect, SPORTDiscus, COCHRANE, EBSCO, and EMBASE. A total of 16 experimental studies met inclusion criteria for a full-text review. Data synthesis examined balance functions, including static, dynamic, proactive, and perceived balance abilities when performing daily activities. Intervention protocols of the reviewed studies included an average of two to three 40-minute exergaming sessions per week for 8 weeks. A random effects model identified significant effects in favor of the exergaming group, with moderate effect size in dynamic balance (Hedges' g = 0.36, 95% CI = 0.26-1.30, P < 0.001), and perceived balance (Hedges' g = 0.31, 95% CI = 0.04-0.58, P = 0.02); and considerable effect size in Chair Stand Test (Hedges' g = 0.78, 95% CI = 0.26-1.30, P = 0.003), and balance test batteries (Hedges' g = 0.72, 95% CI = 0.42-1.02, P < 0.001). No significant effect was found in the static balance (Hedges' g = 0.22, 95% CI =-0.31 to 0.76, P = 0.42), or proactive balance (Hedges' g = 0.54, 95% CI =-0.12 to 1.20, P = 0.11). Metaanalysis identified exergaming-associated benefits in older adults' balance function and confidence. This finding supports the feasibility of exergaming as a supplementary approach to improve balance for healthy older adults. Health professionals may optimize treatment effect by integrating exergaming sessions into a traditional balance exercise program.

Short and Long-Term Trainability in Older Adults: Training and Detraining Following Two Years of Multicomponent Cognitive—Physical Exercise Training

“…The systematic review by Hortobágyi et al [ 23 ] reported a similar effect size for MCTPs on the self-selected gait, compared to resistance and coordination training (0.86 vs. 0.84 and 0.76, respectively). On the other hand, some recent studies [ 19 , 29 , 30 ] highlight that physical–cognitive interventions like dancing [ 30 ], exergames [ 31 , 32 ], or the addition of cognitive demands into physical exercise in the so called multicomponent cognitive training programs (MC cog TPs) [ 30 ], are even better strategies to improve both, physical and cognitive outcomes, compared to training programs with an isolated physical capacity.…”

Beneficial Effects of Interactive Physical-Cognitive Game-Based Training on Fall Risk and Cognitive Performance of Older Adults

“…Moreover, exergames allow concurrent physical and cognitive exercise (dual tasking). Recent systematic reviews have demonstrated that exergames improve the physical health (i.e., balance, mobility, physical fitness, and walking performance/gait parameters) and mental health (i.e., executive functions, reaction time, and processing speed) of older adults [ 19 , 20 , 21 ]. Game-based exercises using the Nintendo, Wii Fit, and Xbox Kinect devices have consistently demonstrated positive effects on balance in healthy older adults.…”

The Effects of Exergaming Training on Balance in Healthy Elderly Women—A Pilot Study

“…They also often do not allow for comparison of the results in various groups of patients [16]. In a very recent review and meta-analysis [17], authors emphasized the need to develop study designs that utilize biomechanical and other objective measures of balance. Only four out of 16 included papers involved objective evaluation.…”