Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Gait Posture. 2024 May;110:129-137. doi: 10.1016/j.gaitpost.2024.03.009. Epub 2024 Mar 21.
To examine whether immersive virtual reality (VR) can improve balance, gait, mobility and fear of falling in older people.
MEDLINE, EMBASE, CINAHL, PsycINFO, ProQuest Central (Engineering and Computer Science) and reference lists of included articles.
Randomised controlled trials that administered immersive VR training and assessed balance, gait and mobility outcomes in older adults without neurological disorders (mean age ≥ 65). Primary outcomes were standing balance (e.g. postural sway), multi-item balance scales (e.g. Berg Balance Scale), gait (e.g. gait speed) and mobility (e.g. Timed Up and Go test). Secondary outcomes comprised measures of enjoyment, fear of falling, adherence (e.g. dropout rate), feasibility/usability and adverse effects (e.g. motion sickness).
Meta-analyses showed that immersive VR training significantly improved standing balance (SMD: 0.51, 95% CI: .15, 0.86, p = 0.005, I = 28% - 3 studies, n = 79) and performance on the Berg Balance Scale (MD: 2.36, 95% CI: 1.17, 3.56, p=0.0001, I=0% - 4 studies, n = 190). No significant improvement in gait, mobility or fear of falling was found. Subgroup analyses revealed higher training doses (≥4.5 total hours) and VR interventions using non-head mounted displays were more likely to improve standing balance. No meta-analyses were conducted for enjoyment, adherence, feasibility/usability and adverse events.
The findings indicate immersive VR has beneficial effects on balance, but not gait, mobility or fear of falling. Further research is required to examine these outcomes in trials that also include quantitative measurements of enjoyment, adherence, clinical feasibility, usability and adverse effects.
研究沉浸式虚拟现实（VR）是否能改善老年人的平衡、步态、移动能力和跌倒恐惧。
MEDLINE、EMBASE、CINAHL、PsycINFO、ProQuest Central（工程与计算机科学）和纳入文献的参考文献列表。
随机对照试验，对无神经障碍的老年人（平均年龄≥65 岁）进行沉浸式 VR 训练，并评估平衡、步态和移动能力结果。主要结果是站立平衡（如姿势摆动）、多项平衡量表（如伯格平衡量表）、步态（如步态速度）和移动能力（如计时起立行走测试）。次要结果包括享受度、跌倒恐惧、依从性（如辍学率）、可行性/可用性和不良反应（如晕动病）的测量。
荟萃分析显示，沉浸式 VR 训练显著改善了站立平衡（SMD：0.51，95%CI：0.15，0.86，p=0.005，I=28% - 3 项研究，n=79）和伯格平衡量表的表现（MD：2.36，95%CI：1.17，3.56，p=0.0001，I=0% - 4 项研究，n=190）。步态、移动能力或跌倒恐惧没有显著改善。亚组分析显示，更高的训练剂量（≥4.5 总小时）和使用非头戴式显示器的 VR 干预更有可能改善站立平衡。没有进行关于享受度、依从性、可行性/可用性和不良反应的荟萃分析。
研究结果表明，沉浸式 VR 对平衡有有益影响，但对步态、移动能力或跌倒恐惧没有影响。需要进一步的研究来在包括享受度、依从性、临床可行性、可用性和不良反应的定量测量的试验中检验这些结果。
