Virtual Reality-Based Multisensory Exercise Enhances Balance Control in Community-Dwelling Older Adults: A Preliminary Randomized Controlled Trial

PURPOSE: Conventional fall prevention programs in older adults typically prioritize physical components while underrepresenting the integration of multisensory stimulation and cognitive engagement—factors critical for sensorimotor coordination and neuroplasticity. This study examined the effects of a virtual reality (VR)-based multisensory exercise intervention on functional balance and neurophysiological correlates of fall risk in community-dwelling older adults.METHODS: In randomized controlled trial, 30 community-dwelling older adults (mean age 71.5±4.5 years) were randomly assigned to either VR intervention (n=15) or control (n=15) groups. The VR group engaged in 16 sessions (twice weekly, 30 minutes per session) of immersive training over 8 weeks, while the control group maintained typical daily activities. Balance assessments included Center of Pressure (COP) path length, Five Times Sit-to-Stand Test (FTSST), Timed Up and Go (TUG), and neurophysiological measurements using electroencephalography (EEG).RESULTS: After the 8-week intervention, the VR group demonstrated significant improvements in postural stability (COP path length: 10.0% reduction, <i>p</i>=.04) and functional lower extremity strength (FTSST: 17.4% reduction, p=.04) compared to controls. TUG time improved in the VR group (7.6% reduction; <i>p</i>=.04) compared to stability in the control group, though the interaction effect approached but did not reach statistical significance (<i>p</i>=.10). EEG analysis showed that delta band activity was stable in the frontal regions and increased gamma band activity in temporo-parietal regions in the intervention group, indicating improved neural efficiency and multisensory integration.CONCLUSIONS: VR-based multimodal exercise-sensory interventions effectively improve balance parameters through simultaneous multisensory stimulation and enhanced neural efficiency in regions critical for sensorimotor integration. These neurophysiological and functional improvements support implementing VR technology as an innovative strategy for comprehensive fall prevention programs.