Balance Training Using Virtual Reality in Elderly Population: Experimental Study

Abstract

Background:
Balance impairment is a major contributor to falls among older adults and is associated with injury, fear of falling, and loss of independence. Conventional balance training improves postural control, yet adherence and engagement often remain limited. Virtual reality–based training has emerged as an innovative rehabilitation approach that combines interactive tasks with real-time feedback, potentially enhancing balance outcomes and motivation. Evidence from local geriatric populations, however, remains limited.

Objective:
To determine the effect of virtual reality–based balance training on balance performance, functional mobility, and fear of falling among elderly individuals living in an urban setting.

Methods:
An experimental study was conducted in rehabilitation centers in urban Islamabad between August 2022 and February 2023. Forty community-dwelling adults aged 60–75 years with balance impairment were randomly allocated to a virtual reality balance training group or a conventional balance training group. Both groups received supervised training three times per week for six weeks. Balance was assessed using the Berg Balance Scale, functional mobility using the Timed Up and Go Test, and fear of falling using the Falls Efficacy Scale–International. Pre- and post-intervention comparisons were analyzed using paired and independent sample t-tests, assuming normal data distribution.

Results:
Both groups demonstrated significant improvements in balance and mobility; however, gains were greater in the virtual reality group. Berg Balance Scale scores increased by 8.4 points in the virtual reality group compared with 2.6 points in the conventional group (p = 0.001). Timed Up and Go performance improved by 3.4 seconds in the virtual reality group versus 0.9 seconds in controls (p = 0.002). Fear of falling decreased more substantially following virtual reality training (p = 0.01).

Conclusion:
Virtual reality–based balance training produced superior improvements in balance, mobility, and confidence compared with conventional exercises. This approach appears to be a safe and effective strategy for fall prevention in elderly urban populations.

Keywords:
Accidental Falls, Aged, Balance Training, Geriatric Rehabilitation, Postural Balance, Virtual Reality, Walking