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Peer-reviewedCC BYGeriatrics (Basel, Switzerland)

Effects of Virtual Reality-Based Rehabilitation on Postural Balance in Older Adults: A Systematic Review.

6 more authors
8 affiliations
  1. 1Graduate Program in Human Movement and Rehabilitation (PPGMHR), Evangelical University of Goiás (UNIEVANGELICA), Anápolis 75083-515, GO, Brazil.
  2. 2Department of Physical Therapy, Evangelical University of Goiás (UniEVANGÉLICA), Anápolis 75083-515, GO, Brazil.
  3. 3Health Sciences Graduate Program (PPGCS), Faculty of Medical Sciences (FCMSCSP), Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo 01221-010, SP, Brazil.
  4. 4Department Rehabilitation, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil.
  5. 5Professional Master's Program in Health Innovation, Hospital de Câncer de Barretos, Barretos 14784-400, SP, Brazil.
  6. 6Graduate Program in Dentistry (PPGO), Evangelical University of Goiás (UNIEVANGELICA), Anápolis 75083-515, GO, Brazil.
  7. 7Orthopaedic Rehabilitation Unit, Research Laboratory for Biomechanics, Rehabilitation and Ergonomics, Ospedale San Giuseppe, 20123 Milan, Italy.
  8. 8Physical and Rehabilitation Medicine Sector, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy.

Abstract

Background

Population aging has been accompanied by an increased incidence of falls, fractures, and functional disability, representing a major global public health challenge. In this context, virtual reality (VR)-based rehabilitation has emerged as an innovative therapeutic strategy providing multimodal sensory and motor stimulation, facilitating motor learning, and enhancing treatment adherence through gamified, interactive environments.Objective

To investigate the effectiveness of VR-based rehabilitation on postural balance training in older adults through a systematic review.Methods

This systematic review was conducted in accordance with PRISMA 2020 and prospectively registered in PROSPERO (CRD420261303119). Comprehensive literature searches were performed in PubMed, Scopus, Web of Science, LILACS, and SciELO to identify studies published between 2015 and 2026. Randomized and non-randomized clinical trials evaluating VR rehabilitation in adults aged 60 years and older, with postural balance as the primary outcome, were eligible. Methodological quality was assessed using the PEDro Scale, and certainty of evidence was evaluated using GRADE. Data were synthesized using a qualitative, descriptive approach.Results

Nine clinical trials of moderate-to-good methodological quality were included, evaluating non-immersive commercial exergames, semi-immersive, and immersive rehabilitation-dedicated systems. Overall, findings indicated that VR was associated with improvements in static and dynamic balance and functional mobility. Between-group analyses showed no statistically significant differences between VR and conventional rehabilitation in several trials, whereas superior effects for VR were reported in others, alongside greater participant engagement and adherence.Conclusions

VR-based rehabilitation is an effective intervention for improving static and dynamic balance and functional mobility in older adults. As a complementary strategy in geriatric physiotherapy, VR has the potential to reduce fall risk, preserve functional independence, and enhance rehabilitation outcomes. Nevertheless, additional high-quality randomized controlled trials with standardized protocols and long-term follow-up are warranted to strengthen the current evidence.

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BibTeX
@article{neiva2026effects,
  title = {{Effects of Virtual Reality-Based Rehabilitation on Postural Balance in Older Adults: A Systematic Review.}},
  author = {Barbara O M Neiva and Andressa Maysa S Martins and Murilo Antônio R Beze and Silvia Priscilla R Oliveira and João Pedro R Afonso and Rodrigo Antônio C Andraus and Rodrigo F Oliveira and Deise A A P Oliveira and Tiago V Fernandes and Daniel G Marconi and Karla Cristina N Carvalho and Claudia S Oliveira and Carlos Hassel M Silva and Orlando A Guedes and Luciana P Maia and Paolo Capodaglio and Miriã C Oliveira and Luis Vicente F Oliveira},
  journal = {Geriatrics (Basel, Switzerland)},
  year = {2026},
  month = oct,
  doi = {10.3390/geriatrics11050143},
  url = {https://europepmc.org/article/MED/42930022},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Effects of Virtual Reality-Based Rehabilitation on Postural Balance in Older Adults: A Systematic Review.
AU  - Barbara O M Neiva
AU  - Andressa Maysa S Martins
AU  - Murilo Antônio R Beze
AU  - Silvia Priscilla R Oliveira
AU  - João Pedro R Afonso
AU  - Rodrigo Antônio C Andraus
AU  - Rodrigo F Oliveira
AU  - Deise A A P Oliveira
AU  - Tiago V Fernandes
AU  - Daniel G Marconi
AU  - Karla Cristina N Carvalho
AU  - Claudia S Oliveira
AU  - Carlos Hassel M Silva
AU  - Orlando A Guedes
AU  - Luciana P Maia
AU  - Paolo Capodaglio
AU  - Miriã C Oliveira
AU  - Luis Vicente F Oliveira
PY  - 2026
DA  - 2026/10/07
JO  - Geriatrics (Basel, Switzerland)
DO  - 10.3390/geriatrics11050143
UR  - https://europepmc.org/article/MED/42930022
AB  - Background  Population aging has been accompanied by an increased incidence of falls, fractures, and functional disability, representing a major global public health challenge. In this context, virtual reality (VR)-based rehabilitation has emerged as an innovative therapeutic strategy providing multimodal sensory and motor stimulation, facilitating motor learning, and enhancing treatment adherence through gamified, interactive environments.Objective  To investigate the effectiveness of VR-based rehabilitation on postural balance training in older adults through a systematic review.Methods  This systematic review was conducted in accordance with PRISMA 2020 and prospectively registered in PROSPERO (CRD420261303119). Comprehensive literature searches were performed in PubMed, Scopus, Web of Science, LILACS, and SciELO to identify studies published between 2015 and 2026. Randomized and non-randomized clinical trials evaluating VR rehabilitation in adults aged 60 years and older, with postural balance as the primary outcome, were eligible. Methodological quality was assessed using the PEDro Scale, and certainty of evidence was evaluated using GRADE. Data were synthesized using a qualitative, descriptive approach.Results  Nine clinical trials of moderate-to-good methodological quality were included, evaluating non-immersive commercial exergames, semi-immersive, and immersive rehabilitation-dedicated systems. Overall, findings indicated that VR was associated with improvements in static and dynamic balance and functional mobility. Between-group analyses showed no statistically significant differences between VR and conventional rehabilitation in several trials, whereas superior effects for VR were reported in others, alongside greater participant engagement and adherence.Conclusions  VR-based rehabilitation is an effective intervention for improving static and dynamic balance and functional mobility in older adults. As a complementary strategy in geriatric physiotherapy, VR has the potential to reduce fall risk, preserve functional independence, and enhance rehabilitation outcomes. Nevertheless, additional high-quality randomized controlled trials with standardized protocols and long-term follow-up are warranted to strengthen the current evidence.
SN  - 2308-3417
ER  -