Immersive virtual reality is effective in the rehabilitation of older adults with balance disorders: A randomized clinical trial

Question: What are the effects of immersive virtual reality (IVR) training compared to conventional physiotherapy on body balance and risk of falls in older adults with balance disorders? Design: A randomized controlled trial with two intervention arms, concealed allocation, per-protocol analysis, and blinded assessment. Participants: Thirty-seven older adults with balance disorders and risk of falling. Intervention: Participants were randomized into two groups: a control group, which received balance training with conventional physiotherapy using multimodal circuit exercises, and an experimental group, which received balance training using immersive virtual reality. Both groups received 16 individual sessions, twice a week. Outcome measures: The primary outcome was functional balance. Secondary outcomes were static balance, gait speed, functional range, dizziness symptoms, and fear of falling. Safety was ensured by assessing any adverse events during the intervention. Results: After 16 sessions, in the intragroup analysis, the functional balance score in the experimental group increased by 3.00 (95% CI 1.42 to 4.57) and in the control group by 3.88 (95% CI 2.16 to 5.59). Both groups improved in assessments of sensory interaction and anterior reach. Only the experimental group presented increased mobility and reduced dizziness. After two months, there was a maintenance of gains in functional balance and a reduction of the gains in functional reach for both groups. In the intergroup comparison, there was no significant difference. Conclusion: Immersive Virtual Reality training proved to be effective for balance-related outcomes, although it was not superior to conventional therapy. Trial registration: RBR-3tk7fw.