SYSTEMATIC REVIEW/META-ANALYSIS
Virtual reality technology improves the gait and balance function of the elderly: a meta-analysis of randomized controlled trials
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School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
These authors had equal contribution to this work
Submission date: 2023-11-17
Final revision date: 2024-03-21
Acceptance date: 2024-03-21
Online publication date: 2024-07-26
Corresponding author
Guihua Xu
School of Nursing
Nanjing University
of Chinese Medicine
Nanjing, China
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Improving the gait and balance function is an important part of the health of the elderly. This study aimed to conduct a meta-analysis to evaluate the effects of virtual reality (VR) technology on the gait and balance function of the elderly.
Material and methods:
Two authors independently searched EMBASE, PubMed, Web of Science, ClinicalTrials, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and Weipu databases up to October 20, 2023 for randomized controlled trials (RCTs) on the application of VR in improving the gait and balance function in the elderly. We screened the literature, extracted data and evaluated the bias risk of included RCTs, and used RevMan software for meta-analysis.
Results:
Fourteen RCTs were finally included in this meta-analysis. A total of 662 elderly adults were included, of whom 336 underwent VR intervention. The results of the meta-analysis showed that the gait and balance function of the elderly in the VR group were significantly better than those in the traditional intervention group (all p < 0.05). There was no significant difference in terms of increasing the muscle strength of the lower extremities or alleviating the fear of falling between groups (all p > 0.05).
Conclusions:
VR can effectively improve the gait and dynamic and static balance function of the elderly. However, the effect of VR on increasing the muscle strength of lower extremities and reducing the fear of falling in the elderly is still not obvious.
REFERENCES (60)
1.
Yang ZC, Lin H, Jiang GH, et al. Frailty is a risk factor for falls in the older adults: a systematic review and meta-analysis. J Nutr Health Aging 2023; 27: 487-595.
2.
Ismail AMA, El-Azeim ASA, Saif H. Effect of aerobic exercise alone or combined with Mediterranean diet on dry eye in obese hypertensive elderly. Ir J Med Sci 2023; 192: 3151-61.
3.
Quinlan S, Ryer S. Implementing a fall prevention initiative in nurse-facilitated annual wellness visits: a quality improvement project. J Nurs Care Qual 2023; 38: 243-50.
4.
Ismail AMA, Saif H, Taha MM. Effect of alternate nostril breathing exercise on autonomic functions, ocular hypertension, and quality of life in elderly with systemic hypertension and high-tension primary open-angle glaucoma. Geriatr Nurs 2023; 52: 91-7.
5.
Kang N, Yu H, Lu X. Meta analysis of the incidence of falls in the elderly in China. Chinese J Evid Based Med 2022; 22: 7-11.
6.
Zhang T, Feng Z, Wang W. Current situation and influencing factors of falls among the elderly in China Chinese J Dis Control 2022; 26: 6-10.
7.
Hu Y, Guo R, Min S. Analysis of fall disease burden in Chinese elderly population from 1990 to 2019. Modern Prev Med 2021; 48: 5-7.
8.
Alabdullgader A, Rabbani U. Prevalence and risk factors of falls among the elderly in Unaizah City, Saudi Arabia. Sultan Qaboos Univ Med J 2021; 21: e86-93.
9.
Yang X, Ding X, Mao D: Incidence and influencing factors of falls among rural elderly aged 65 and above in Chongqing. Public Health Prev Med 2023, 34: 5-7.
10.
Shen L, Wang W. Follow-up survey of health and pension in China: analysis of related factors of falls in the middle-aged and elderly and construction of line chart prediction model. Modern Prev Med 2022; 41: 10-3.
11.
Sawe HR, Mulwafu W, Chokotho L, et al. Fall injuries in Sub-Saharan Africa: analysis of prospective injury registry from 23 health facilities in Malawi and Tanzania. BMC Emerg Med 2023; 23: 42.
12.
Yang L, Minyi S, Yulan Z. Investigation on compliance of home rehabilitation exercise in elderly patients with stroke and analysis of its influencing factors. Chin J Pract Nurs 2015; 18: 168-9.
13.
Liu S, Dai F, Jiang M. Relationship between disease perception and home rehabilitation compliance in elderly patients with total knee arthroplasty. J Nurs Manag 2021; 21: 5-7.
14.
Ferreira G, Chagas T, Goncalves LHT, Oliveira MFV, Botelho EP, Polaro SHI. Fall-related hospitalizations in elderly people: temporal trend and spatial distribution in Brazil. Geriatrics (Basel) 2023; 8: 30.
15.
Zhao R, Zhao X, Guan J, Zhang C, Zhu K. The effect of virtual reality technology on anti-fall ability and bone mineral density of the elderly with osteoporosis in an elderly care institution. Eur J Med Res 2023; 28: 204.
16.
Yamagami M, Imsdahl S, Lindgren K, et al. Effects of virtual reality environments on overground walking in people with Parkinson disease and freezing of gait. Disabil Rehabil Assist Technol 2023; 18: 266-73.
17.
Shousha TM, Abo-Zaid NA, Hamada HA, Abdelsamee MYA, Behiry MA. Virtual reality versus Biodex training in adolescents with chronic ankle instability: a randomized controlled trial. Arch Med Sci 2023; 19: 1059-68.
18.
Ismail AMA. Rehabilitation With virtual reality for leukemic children during the fourth COVID-19 wave. Integr Cancer Ther 2021; 20: 15347354211049341.
19.
Ismail AMA. Cancelled elderly exercise sessions during the COVID-19 crisis: can physical therapists help from their homes. Eur J Physiother 2020; 22: 235.
20.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71.
21.
Higgins JP, Altman DG, Gotzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928.
22.
Bieryla KA, Dold NM. Feasibility of Wii Fit training to improve clinical measures of balance in older adults. Clin Interv Aging 2013; 8: 775-81.
23.
Franco JR, Jacobs K, Inzerillo C, Kluzik J. The effect of the Nintendo Wii Fit and exercise in improving balance and quality of life in community dwelling elders. Technol Health Care 2012; 20: 95-115.
24.
Gomes GCV, Simoes MDS, Lin SM, et al. Feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit Plus(TM) for frail older adults: a randomized feasibility clinical trial. Maturitas 2018; 118: 20-8.
25.
Gschwind YJ, Schoene D, Lord SR, et al. The effect of sensor-based exercise at home on functional performance associated with fall risk in older people – a comparison of two exergame interventions. Eur Rev Aging Phys Act 2015; 12: 11.
26.
Hu D, He J, Ding Y. Application effect of virtual reality technology in rehabilitation training of elderly patients with chronic obstructive pulmonary disease. J Pract Cardiac Cerebropulmon Vasc Dis 2018; 16: 8-11.
27.
Jung DI, Ko DS, Jeong MA. Kinematic effect of Nintendo Wii(TM) sports program exercise on obstacle gait in elderly women with falling risk. J Phys Ther Sci 2015; 27: 1397-400.
28.
Lee Y, Choi W, Lee K, Song C, Lee S. Virtual reality training with three-dimensional video games improves postural balance and lower extremity strength in community-dwelling older adults. J Aging Phys Act 2017; 25: 621-7.
29.
Oungphalachai T, Siriphorn A. Effects of training with a custom-made visual feedback device on balance and functional lower-extremity strength in older adults: a randomized controlled trial. J Bodyw Mov Ther 2020; 24: 199-205.
30.
Sapi M, Domjan A, Feherne Kiss A, Pinter S. Is kinect training superior to conventional balance training for healthy older adults to improve postural control? Games Health J 2019; 8: 41-8.
31.
Sato K, Kuroki K, Saiki S, Nagatomi R. Improving walking, muscle strength, and balance in the elderly with an exergame using kinect: a randomized controlled trial. Games Health J 2015; 4: 161-7.
32.
Schoene D, Valenzuela T, Toson B, et al. Interactive cognitive-motor step training improves cognitive risk factors of falling in older adults – a randomized controlled trial. PLoS One 2015; 10: e0145161.
33.
Sun Z, Wang T, Wang Q. Effect of virtual reality training on risk factors related to falls in elderly people in nursing homes. Chin J Rehabil Med 2018; 33: 6-8.
34.
Toulotte C, Toursel C, Olivier N. Wii Fit(R) training vs. adapted physical activities: which one is the most appropriate to improve the balance of independent senior subjects? A randomized controlled study. Clin Rehabil 2012; 26: 827-35.
35.
Xu R, Wang Y, Zhang Y. Effect of virtual reality rehabilitation training on limb motor function and life satisfaction of the elderly. Chin J Phys Med Rehabil 2021; 43: 3-6.
36.
Maia JC, Diniz JL, Sousa CR, et al. Interactive gerontechnology for fall prevention in the elderly: a descriptive study. Rev Bras Enferm 2023; 76: e20220739.
37.
Saunders H, Anderson C, Feldman F, et al. Developing a fall prevention intervention economic model. PLoS One 2023; 18: e0280572.
38.
Feng Q, Liu Y, Wang H. Influencing factors of postoperative rehabilitation exercise compliance in elderly patients with hip fracture. Henan Med Res 2022; 22: 31-5.
39.
Wen Y, Dong M. Research progress on fall prevention compliance of elderly inpatients. Nurs Rehabil 2016; 15: 3-5.
40.
Raffegeau TE, Clark M, Fawver B, et al: The effect of mobility-related anxiety on walking across the lifespan: a virtual reality simulation study. Exp Brain Res 2023; 241: 1757-68.
41.
Yalfani A, Abedi M, Raeisi Z. Effects of an 8-week virtual reality training program on pain, fall risk, and quality of life in elderly women with chronic low back pain: double-blind randomized clinical trial. Games Health J 2022; 11: 85-92.
42.
Aganov S, Nayshtetik E, Nagibin V, Lebed Y. Pure purr virtual reality technology: measuring heart rate variability and anxiety levels in healthy volunteers affected by moderate stress. Arch Med Sci 2022; 18: 336-43.
43.
Zak M, Sikorski T, Wasik M, Courteix D, Dutheil F, Brola W. Frailty syndrome-fall risk and rehabilitation management aided by virtual reality (VR) technology solutions: a narrative review of the current literature. Int J Environ Res Public Health 2022; 19: 2985.
44.
Muhla F, Duclos K, Clanche F, et al. Does the management of visual and audible motion information during an immersive virtual reality timed up and go test impact locomotor performance in the elderly? Gerontology 2022; 68: 456-64.
45.
Kim SH, Cho SH. Benefits of virtual reality program and motor imagery training on balance and fall efficacy in isolated older adults: a randomized controlled trial. Medicina (Kaunas) 2022; 58: 1545.
46.
Mangalam M, Skiadopoulos A, Siu KC, Mukherjee M, Likens A, Stergiou N. Leveraging a virtual alley with continuously varying width modulates step width variability during self-paced treadmill walking. Neurosci Lett 2023; 793: 136966.
47.
Zahedian-Nasab N, Jaberi A, Shirazi F, Kavousipor S. Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial. BMC Geriatr 2021; 21: 509.
48.
Du X, Wang K. Effect of stimulating psychological nursing combined with comfort nursing on rehabilitation exercise compliance of elderly patients with pelvic fracture. Shanxi Med J 2020; 49: 3-6.
49.
Wang Y, Wang Y, Liao Z. Analysis of exercise compliance and related factors in inpatients with senile weakness. Qilu J Nurs 2017; 23: 3-5.
50.
Liu H, Yin H, Yi Y, Liu C, Li C. Effects of different rehabilitation training on balance function in stroke patients: a systematic review and network meta-analysis. Arch Med Sci 2023; 19: 1671-83.
51.
Aslam M, Ain QU, Fayyaz P, Malik AN. Exer-gaming reduces fall risk and improves mobility after stroke. J Pak Med Assoc 2021; 71: 1673-75.
52.
Yu Q, Xu D, Ma S, Ge W. Meta analysis of the effectiveness of virtual reality Technology in preventing falls in the elderly. Nurs Manag China 2021; 21: 532-9.
53.
Ming L, Zhen W, Rong X. Meta analysis of the effect of Virtual reality Technology on balance function Rehabilitation of the elderly. Theory Pract Rehabil China 2020; 26: 11-4.
54.
Sadeghi H, Jehu DA, Daneshjoo A, et al. Effects of 8 weeks of balance training, virtual reality training, and combined exercise on lower limb muscle strength, balance, and functional mobility among older men: a randomized controlled trial. Sports Health 2021; 13: 606-12.
55.
Nishchyk A, Chen W, Pripp AH, Bergland A. The effect of mixed reality technologies for falls prevention among older adults: systematic review and meta-analysis. JMIR Aging 2021; 4: e27972.
56.
Afridi A, Rathore FA, Nazir SNB. Wii fit for balance training in elderly: a systematic review. J Coll Phys Surg Pak 2021; 30: 559-66.
57.
Thalmann M, Ringli L, Adcock M, et al.Usability study of a multicomponent exergame training for older adults with mobility limitations. Int J Environ Res Public Health 2021; 18: 13422.
58.
Chen M, Pan Z, Song J. Virtual reality technology in preventing falls in the elderly: current progress. Health Res 2020; 40: 5-7.
59.
Dykes PC, Curtin-Bowen M, Lipsitz S, et al. Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. JAMA Health Forum 2023; 4: e225125.
60.
Khalifa M. Improving patient safety by reducing falls in hospitals among the elderly: a review of successful strategies. Stud Health Technol Inform 2019; 262: 340-3.