Work

Comparative efficacy of different virtual reality-based interventions for static balance, dynamic balance, and fear of falling in older adults: a systematic review and network meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background and objectives: Virtual reality (VR) is increasingly used to improve balance and reduce fear of falling in older adults, but comparative effectiveness of different VR types remains unclear. This network meta-analysis (NMA) aimed to compare and rank the efficacy of various VR interventions against usual care for static balance, dynamic balance, and fear of falling. Methods: Two investigators independently searched Embase, PubMed, PsycINFO, Cochrane Library, CNKI, and VIP for RCTs published from inception to May 30, 2026. Eligible studies included older adults receiving VR versus usual care or active control, with outcomes measured by validated tools. Risk of bias was assessed using RoB 2. A random-effects consistency model was applied, using MDs or SMDs with 95% CIs. Results: Nineteen RCTs (1,815 participants) were included. For static balance, Kinect (MD = 6.83, 95% CI: 1.78-11.89), IVR (6.80, 0.28-13.30), and Wii (3.89, 0.34-7.44) significantly outperformed UC; SUCRA rankings placed Kinect first (82.2%), followed by IVR (78.1%) and BTSNVR (56.8%). For dynamic balance, BTSNVR (SMD = -3.66, -5.22 to -1.20), Wii (-2.79, -3.93 to -1.66), Kinect (-1.87, -2.53 to -1.22), and AC (-1.66, -2.35 to -0.97) were superior to UC; SUCRA ranked BTSNVR best (87.5%), Wii (82.0%), and Kinect (57.1%). For fear of falling, only Kinect showed significant reduction (SMD = -3.52, -5.48 to -1.56), ranking highest (78.7%), with IVR (66.3%) and BTSNVR (60.9%) less effective. However, several comparisons were based on few studies, so findings are preliminary. Conclusion: Specific VR interventions offer distinct advantages: Kinect may benefit static balance and fear reduction, while BTSNVR improves dynamic balance. Rankings should be interpreted cautiously. Larger head-to-head RCTs with standardized protocols and longer follow-up are needed to validate these findings and establish clinical recommendations. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261464816, CRD420261464816.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1973306

Authors: Meng Tian, Qiang Chen, Tianwei Lou

Institutions: Shandong University of Traditional Chinese Medicine, Shandong Sport University, Affiliated Hospital of Shandong University of Traditional Chinese Medicine

Language: English

Topic: Balance, Gait, and Falls Prevention

Subfield: Physical Therapy, Sports Therapy and Rehabilitation

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801