Design of virtual reality training program for prevention of falling in the elderly: A pilot study on complex versus balance exercises

Introduction: Virtual reality (VR) exercises have been investigated as a rehabilitation paradigm to reduce the risk of falling in the elderly. This study aimed to compare a VR program consisted of complex exercises and that of balance exercises. Methods: The study was a single-blind, randomized, comparative trial conducted over 5 weeks. Twenty subjects over 65 years of age were divided into a complex exercise with virtual reality (CEVR) group and a balance exercise with virtual reality (BEVR) group. CEVR consisted of strengthening, flexibility, endurance, and balance exercises, while BEVR focused on balance exercises only. Before and after 10 times of 1 h training sessions, we measured isokinetic peak torque and total work of knee muscles using a dynamometer. The Timed Up & Go (TUG) test was also conducted to evaluate dynamic balance. Results: Knee extension peak torque was significantly enhanced only in the CEVR group (p < 0.05), but there was no difference between groups. Both groups showed significant improvement of dynamic balance measured by TUG after training sessions, but the CEVR group exhibited greater improvement than the BEVR group (p < 0.05). Conclusions: Our findings demonstrate the superiority of the virtual reality training with a complex exercise program to improve balance and muscle strength in the elderly when compared to the BEVR. As a training for prevention of falling in the elderly, we recommend a virtual reality program including various exercises for strength, endurance, balance, and flexibility.