Effects of game-based virtual reality balance training on postural stability and mobility in community-dwelling older adults: an exploratory randomized controlled trial.

backgroundFalls are a major contributor to reduced independence in older adults and are associated with both physical decline and impaired cognitive-motor integration. Emerging evidence suggests that game-based virtual reality (VR) training may enhance engagement and balance performance; however, its application in community-based settings remains limited.

objectiveTo examine the effects of an individualized, game-based VR balance training program on postural stability, functional mobility, and fall-related concern in community-dwelling older adults.

methodsIn this exploratory randomized controlled trial, 40 participants aged ≥ 65 years were assigned to either a VR-based balance training group or a control group receiving unsupervised home-based exercise guidance. The intervention group completed an 8-week supervised VR training program using the Biodex Balance System (2 sessions per week for 8 weeks). The control group received exercise videos and health education without direct supervision or formal adherence monitoring; however, participants received brief weekly telephone reminders to encourage engagement. Primary outcomes included postural sway indices measured by the Biodex Balance System under single- and dual-task conditions. Secondary outcomes included the Timed Up and Go (TUG) test, Single-Leg Stance (SLS), and Falls Efficacy Scale-International (FES-I). Data were analyzed using generalized estimating equations, with group × time interaction effects reported.

resultsAll participants completed baseline and post-intervention assessments. Compared with the control group, the intervention group demonstrated statistically significant group × time interactions for multiple sway indices under single-task conditions and selected measures under dual-task conditions (p < 0.05), indicating differences in change over time between groups. Statistically significant interactions were also observed for functional mobility (TUG) and SLS performance (p < 0.05). FES-I scores increased in both groups, with a statistically significant group × time interaction observed, indicating an increase in self-reported concern about falling. This finding should be interpreted cautiously. Sensitivity analyses showed generally consistent results, although potential sex-related effects were observed and should be interpreted as exploratory. No adverse events were reported.

conclusionsAn 8-week game-based VR balance training program was associated with changes in postural stability and functional mobility in community-dwelling older adults. Changes in fall-related concern were also observed. These findings support the feasibility of a supervised, technology-assisted training approach, although confirmation in larger trials is needed.

trial registrationClinicalTrials.gov Identifier NCT05779189.