Is virtual reality exercise effective in reducing falls among older adults with a history of falls?

Abstract

BACKGROUND: Falls have been identified as one of the major causes of morbidity and mortality in the older adults. Virtual reality (VR) technologies have been used as an assessment and treatment tool in rehabilitation. PURPOSE: This single-blinded randomized controlled clinical trial was to determine the effectiveness of VR exercise in reducing falls risk and incidence among the older adults with a history of falls using Nintendo's Wii Fit® balance board. METHODS: Sixty older subjects aged 65 and above who lived in a nursing home participated this study. They were randomly allocated to balance training with either Wii Fit equipment or conventional exercise. The exercise was organized in one hour session which was held on three days a week for six weeks. Physiological Profile Assessment (PPA) scores and incidence of falls were observed with subsequent intent-to-treat statistical analyses. RESULTS: Independent t-tests showed that there was no statistically significant difference in the average pre-test PPA values and numbers of falls over previous one year between the two groups. Two-way repeated measures of ANOVA did, however, show significant interactions in the PPA z-scores and falls incidence. Within both the Wii Fit and conventional training groups, paired t-tests showed that there were significant differences in their PPA z-scores and falls incidence before and after the respective interventions. However, independent t-tests showed that there were statistically significant differences in the post-test PPA z-scores and number of falls between the two groups. The subjects of the Wii Fit training group showed significantly greater improvement in both outcome measures. CONCLUSIONS: Wii Fit balance training was more effective than conventional balance training in reducing falls risk and incidence among these institutionalized older persons with a history of falls.