Impact of virtual reality versus conventional balance training on balance function and fear of falling in older adults: a single blinded, randomized controlled trial

Balance issues and the fear of falling are among the primary factors contributing to falls in older people, leading to injury and a decline in quality of life.

A single-blind, randomized, controlled trial was conducted involving 34 older adult participants (17 males and 17 females). The participants in the virtual reality group performed exercises using Kinect and a balance board, while those in the conventional interventions group performed balance exercises. The participants received interventions twice weekly for six weeks, each lasting 50 min. Fear of falling and balance performance were assessed using the Falls Efficacy Scale, Activities-specific Balance Confidence Scale, Berg Balance Scale, Time Up and Go Test, and Functional Reach Test. Evaluations were conducted at three time points: pre-intervention, post-intervention, and follow-up. The participants' motivation levels were also evaluated using the Intrinsic Motivation Inventory.

A total of 34 older adults (mean age 71.3 ± 5.4 years) completed the study. For the primary outcomes, a significant group-by-time interaction was found for both the Falls Efficacy Scale (FES-I, p = 0.04) and the Berg Balance Scale (BBS, p < 0.001). Post-intervention, the virtual reality (VR) group showed a significant reduction in fear of falling (mean change in FES-I: -4.2 points, p < 0.001), whereas the conventional group did not. Both groups demonstrated significant and sustained improvements in balance on the BBS from baseline to follow-up (VR group mean change: + 6.1 points; Conventional group mean change: + 4.3 points; both p < 0.001), with no significant difference between the groups. Functional mobility also improved significantly in both groups over time (Timed Up and Go, p < 0.001). Furthermore, the VR group reported significantly higher motivation scores, specifically in enjoyment (p < 0.001) and perceived competence (p < 0.001), compared to the conventional group.

Virtual reality interventions were associated with reduced fear of falling, enhanced confidence in balance abilities, increased participants' engagement in the intervention process, and offered more favorable experiences of balance interventions within the older population. However, causal pathways cannot be established from this study, and the findings should be interpreted considering the limited sample size.