Wei Xiaoyu, Huang Chun, Ding Xinyue, Zhou Zhining, Zhang Yufeng, Feng Xiaofan, Zheng Suwang, Li Tingting, Lü Jiaojiao
Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, 200438, China.
School of Exercise and Health, Shanghai University of Sport, Shanghai, 200438, China.
J Neuroeng Rehabil. 2025 Jun 24;22(1):141. doi: 10.1186/s12984-025-01675-z.
BACKGROUND: Age-related decline in dual-task (DT) performance is closely associated with falls in older adults, posing a significant public health concern. Virtual reality (VR) training has emerged as a novel intervention to enhance motor-cognitive integration, yet its effects on dual-task performance require systematic evaluation. OBJECTIVE: The purpose of this systematic review and meta-analysis was to assess the impact of VR training on dual-task performance in older adults. METHODS: Following PRISMA guidelines, we searched four databases for randomized controlled trials (RCTs) evaluating VR training in adults aged ≥ 60 years. Inclusion criteria required comparisons between VR training and non-VR control groups, with outcome measures including dual-task cost (DTC), dual-task timed up-and-go (DT-TUG), DT gait parameters (speed, stride length, cadence), and DT cognitive performance. Methodological quality was assessed using the Cochrane Risk of Bias tool, and meta-analysis were conducted using RevMan 5.4. RESULTS: Twenty-one RCTs (935 participants) were included. Meta-analysis revealed significant improvements in VR groups for DTC of gait speed [SMD = -0.32, 95% CI (-0.57, -0.07), P = 0.01], stride length [SMD = -0.58, 95% CI: (-0.90 to -0.26), P < 0.001] and cadence [SMD = -0.32, 95% CI (-0.64, 0.00), P = 0.05]. DT-TUG time decreased significantly [SMD = -0.54, 95% CI (-0.89, -0.19), P = 0.002]. VR training also enhanced dual-task gait speed [SMD = 0.38 95% CI (0.03, 0.73), P = 0.03] and stride length [SMD = 1.15, 95% CI (0.81, 1.49), P < 0.001]. Subgroup analyses showed VR brought more notable improvements for MCI and PD patients. For VR interventions, durations over 1 h per session, more than 4 - week duration, and 3-5 sessions per week yielded better results. Yet, no significant improvements were observed in other DT aspects like cognitive reaction times and rapid gait speed. CONCLUSION: VR training effectively reduces DT performance decline in older adults, particularly by lowering DTC and enhancing functional mobility, supporting its potential as a fall prevention strategy.
背景：与年龄相关的双任务（DT）表现下降与老年人跌倒密切相关，这引起了重大的公共卫生关注。虚拟现实（VR）训练已成为一种增强运动认知整合的新型干预措施，但其对双任务表现的影响需要系统评估。 目的：本系统评价和荟萃分析的目的是评估VR训练对老年人双任务表现的影响。 方法：遵循PRISMA指南，我们在四个数据库中搜索了评估60岁及以上成年人VR训练的随机对照试验（RCT）。纳入标准要求比较VR训练组和非VR对照组，结果测量包括双任务成本（DTC）、双任务定时起立行走（DT-TUG）、DT步态参数（速度、步长、步频）和DT认知表现。使用Cochrane偏倚风险工具评估方法学质量，并使用RevMan 5.4进行荟萃分析。 结果：纳入了21项RCT（935名参与者）。荟萃分析显示，VR组在步态速度的DTC方面有显著改善[标准化均数差（SMD）=-0.32，95%可信区间（CI）（-0.57，-0.07），P = 0.01]、步长[SMD = -0.58，95%CI：（-0.90至-0.26），P < 0.001]和步频[SMD = -0.32，95%CI（-0.64，0.00），P = 0.05]。DT-TUG时间显著缩短[SMD = -0.54，95%CI（-0.89，-0.19），P = 0.002]。VR训练还提高了双任务步态速度[SMD = 0.38，95%CI（0.03，0.73），P = 0.03]和步长[SMD = 1.15，95%CI（0.81，1.49），P < 0.001]。亚组分析显示，VR对轻度认知障碍（MCI）和帕金森病（PD）患者带来了更显著的改善。对于VR干预，每次训练时长超过1小时、持续时间超过4周且每周进行3 - 5次训练产生的效果更好。然而，在认知反应时间和快速步态速度等其他DT方面未观察到显著改善。 结论：VR训练有效地减少了老年人DT表现的下降，特别是通过降低DTC和增强功能移动性，支持其作为预防跌倒策略的潜力。
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