Virtual reality game-based training for preventing falls among community-dwelling older adults with mild cognitive impairment: a pilot randomized control trial study

Using a Virtual Reality (VR) game-based application represents an innovative approach to falls prevention in community aged care service. The study investigated the effects of VR training on falls prevention among community-dwelling older adults with mild cognitive impairment. A pilot randomized controlled trial was conducted to compare the effects of full-immersive VR training with group-based exercise (Baduanjin) training on falls prevention. Eighteen participants were recruited through convenience sampling and were randomly assigned to either the VR group or the non-VR exercise group. Both groups participated in 16 falls prevention training sessions over eight weeks. Participants, identified with mild cognitive impairment (MCI), underwent three fall risk measurements. They had been screened using Montreal Cognitive Assessment (HK-MoCA). The primary outcomes assessed included changes in physical risk factors of falls (i.e. functional mobility, walk speed and postural balance), and the secondary outcomes assessed included changes in executive function and fall efficacy. The measurement of physical outcomes was Time Up and Go test (TUG), Berg balance scale (BBS) and Six-minute Walk Test (6MWT). The participants' executive function and fear of falling were assessed through the Trail marking test (TMTA and TMTB) and the Fall Efficacy International scale (FES-I). The results showed that the VR group had significantly greater improvement than the non-VR group on measures of cognitive-motor performance, such as global cognition, functional mobility, balance and walk speed over time. However, no significant differences were observed between the two groups in executive functions and the fall efficacy. The study provides potential evidence that VR game-based cognitive-motor training can be effective for fall prevention in community dwelling older adults with MCI. However, the findings do not support significant improvements in secondary outcomes. Despite this, the growing trend of VR research suggests increasing interest and potential for future applications in aged care and rehabilitation services.