Using Virtual Reality to Help Prevent Falls in the Elderly

Can virtual reality help prevent falls in elderly patients? A small study suggests that it can.

Falls can have devastating effects on people with osteoporosis. They may result in the limitation of patients’ independence, lowering their quality of life, as well as their long-term immobilization, or even hasten their death. Falls can lead to a risk of hospitalization or longer and more costly hospital stays. In addition, osteoporosis can also be a risk factor for falls, as can other musculoskeletal disorders, nervous system disorders, cardiovascular disease, and metabolic disorders.

One aim for rehabilitation of elderly patients is to slow down involutional processes and, if possible, to improve physical and mental fitness. From the point of view of rehabilitation, it is important not only that traditional approaches are used but that interventions complement patients’ main problems with everyday functioning. Function-oriented exercises can minimize the risk of falls by improving balance, gait parameters, and the muscle strength of the lower limbs.

The aim of this study was to assess the effectiveness of virtual reality (VR) training in people older than 60 years. The participants underwent 30-day VR training using an Xbox 360 Kinect. They trained 3 times a week, with each exercise lasting 30 minutes.

This study involved 23 people, including 19 women and 4 men (the mean age was nearly 75 years). They were screened with 6 functional tests: the 6-minute walking test (6MWT), the Dynamic Gait Index (DGI), the tandem stance test (TST), the tandem walk test (TWT), and the Beck Depression Inventory (BDI). A spring hand dynamometer was also used.

Technology such as VR creates the effect of a 3-dimensional, interactive world where all objects, events, and feelings perceived through the senses seem real and present. In addition, VR can be used at home, with remote monitoring. This training consisted of a warm-up, plus football, bowling, and downhill skiing games in the Kinect Sports series. Each player could choose from a dozen or so games, both full games (6) and shorter ones (12), which differed in terms of duration and number of repetitions. The subjects could also choose the number of players (from 1 to 4) and competitors (computer, friends, or people on the internet).

The 6MWT (P <.001), the DGI (P = .008), the TST (P <.001), the TWT (P = .002), and the BDI (P <.001) outcomes were significantly improved.

There were differences in the results for the strength of the “pressing muscles” in the right (P = .106) and left (P = .043) hands of the participants. Both participants younger than 80 years and those 80 years and older had visibly better results on the 6MWT (P <.001 and P = .008, respectively), the TST (P <.001 and P = 0.008, respectively), and the BDI (P = .003 and P = .012, respectively).

Interestingly, in addition to the physical results, the participants reported that they felt less depressed and more “included” in the digital world.

One limitation of the study is that patients’ cognitive status was not evaluated. In addition, this was a small sample that was not divided up into study and control groups.

Nonetheless, the researchers said that training via VR can help reduce the risk of falls by improving the static and dynamic balance.

Reference

Kami&#324;ska MS, Miller A, Rotter I, Szyli&#324;ska A, Grochans E. The effectiveness of virtual reality training in reducing the risk of falls among elderly people [published online November 14, 2018]. Clin Interv Aging. doi: 10.2147/CIA.S183502.