<p>Balance training using virtual reality improves balance and physical performance in older adults at high risk of falls</p>

Abstract

PurposeExercise programs designed for falls prevention have been proven effective in reducing falls by approximately 21%. Virtual reality may provide a viable alternative intervention for falls prevention. This study compared the effects of virtual reality training using the Balance Rehabilitation Unit (BRU) versus exercise using a modified Otago Exercise Programme (EX) on improving balance and physical performance in the short-term restorative care setting of the Gait and Balance Gym (Gabagym).Patients and methodsThis was a pre- and post-intervention study of 195 participants (median age 78 years, IQR 73–84; 67% female) who presented with a risk and/or history of falls. Participants were assigned to either EX (n=82) or BRU (n=63). Supervised sessions occurred twice a week for 6 weeks. Participants receiving interventions were compared to a separate group (n=50) with similar characteristics who did not receive any intervention. Balance and physical performance were assessed at initial and final attendance and included the 5 Times Sit to Stand (5STS) test, Timed Up and Go (TUG), gait speed and posturography assessment using the BRU. Fear of falling was assessed using the Falls Efficacy Scale. Handgrip strength and adherence were also monitored.ResultsPost-intervention, EX and BRU groups achieved similar improvements and reported similar adherence rates (71% vs 72%, respectively). Both intervention groups improved in balance and physical performance measures. Both interventions showed significantly better improvement than the non-intervention group in TUG (p<0.001), gait speed (p=0.021), limits of stability in posturography assessment (p=0.008), FES-I score (p=0.013) and handgrip strength (p=0.021). Only the BRU group improved control of static posture in the eyes closed (p=0.002) and foam eyes closed (p=0.006) tasks.ConclusionThis study highlights the potential use of virtual reality as a practical alternative to improve outcomes of balance training for reduction of falls risk in older adults.

Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance

“…Additionally, VR games can be used as an affordable tool for home exercise in older adults [ 11 , 13 ]. VR games are mostly used in restoring body balance and gait functions [ 11 , 14 ] and, less often, to improve other functions, such as muscle strength [ 11 ]. Despite promising effects, the quality of scientific evidence supporting the use of VR is insufficient to recommend using it in everyday rehabilitation routines, especially in patients with orthopedic conditions or dysfunctions [ 7 ].…”

Acceptance of a Virtual Reality Headset Designed for Fall Prevention in Older Adults: Questionnaire Study

“…A number of recent reviews and meta-analyses revealed that new technologies (eg, virtual reality [VR], augmented reality, exergames, and artificial intelligence) have opened the door to a new generation of intervention programs designed to prevent the occurrence of falls [ 6 - 8 ]. Recent studies also demonstrated the effectiveness of training programs implemented via new technologies for improving the control mechanisms involved in balance [ 9 , 10 ] and goal-directed locomotion [ 11 , 12 ] in older adults. For instance, specific exergames have been designed to train balance control, focusing on either the static control of the center of mass or its control while performing precise, rapid, and well-directed steps in balance-threatening situations [ 13 , 14 ].…”

“…However, to the best of our knowledge, acceptance before a first use of a VRH designed to reduce older adults’ risk of falling through their use in intervention programs has not yet been studied. The fact that the positive influence on fall prevention of training programs using VRHs has been validated [ 10 ] reinforces the relevance of studying acceptance of such a VRH. Indeed, older adults who have a low acceptance score also have a very high probability of never adopting this kind of VRH despite its objective usefulness to maintain and improve their functional capacities, but this hypothesis has not yet been tested.…”

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

“…The participants were also informed that they could leave the study at any time without any explanation. The results of previous studies [21][22][23][24][25] indicate that posturographic variables in static and dynamic tests in healthy elderly people remain stable over time (6,9,12, or 14 weeks). Hence, based on results previously published in the literature, we decided not to include the control group in our preliminary research.…”