Falls are common among adults over age 65 with 30% reporting at least 1 fall in 2014 in the United States. Falls can cause life-threatening injuries leading to emergency department visits, hospitalizations, and even death. The good news is that exercise-based falls prevention programs have been proven effective across several studies, leading to a reduction in falls by more than 20%. Australian researchers are now showing the benefits of virtual reality training for falls prevention in a study published in Clinical Interventions in Aging.
In their study of 195 adults (median age, 78 years) who were at risk or had a history of falls, the researchers compared the effects of the Balance Rehabilitation Unit (BRU) to exercises from the Otago Exercise Programme (EX) in the short-term care setting of a gait and balance gym. For the study, participants were assigned to either BRU (n=63) or EX (n=82); both groups received supervised sessions twice a week for 6 weeks; they were compared to a control group (n=50) with similar characteristics who received no intervention. Assessments for balance and physical performance, taken at study initiation and conclusion included: 5 Times Sit to Stand (5STS) test; Timed Up and Go (TUG), gait speed, and posturography assessment using the BRU.
Posturography assessment used the BRU and required participants to stand on the BRU platform and undertake various static tasks for 1 minute, including: standing with: eyes open (firm surface) (EOEA); eyes closed (firm surface) (ECEA); standing on foam with eyes closed (FECEA); performing a saccadic task (SEA) and exposure to 2 visual-vestibular interaction tasks (VVIEA). The Falls Efficacy Scale (FES) was used to determine fear of falling, and handgrip strength and adherence were also monitored.
After completing the program, both EX and BRU reported similar adherence rates (71% vs 72%, respectively). Both intervention groups showed significant improvements in all physical performance and subjective measures (5STS, TUG, FSST, gait speed, FES-I, and handgrip strength); the control group reported no improvements in TUG, FES-I score, or handgrip strength. There were significant differences among the 3 groups for physical performance and fear of falling (see Table).
Both interventions showed significantly better improvement—at least 20%—than the non-intervention group in limits of stability in posturography assessment (P = 0.008). Only the BRU group improved control of static posture in the eyes closed (P = 0.002) and foam eyes closed (P=0.006) tasks.
The authors concluded that their study highlights the potential use of virtual reality as a practical alternative to improve outcomes of balance training for reduction of falls risk in older adults.
Source: Phu S, Vogrin S, Al Saedi A, Duque G. Balance Training using virtual reality improves balance and physical performance in older adults at high risk of falls. Clin Interv Aging. 2019;14:1567-1577.