VR-Shuttlecock: Toward Enhancing Older Adults' Balance Through Kicking Shuttlecock in VR with Multi-Sensory Feedback

The decline in balance among older adults is a pressing public health issue that significantly impacts their well-being and independence. While traditional balance training methods are effective, they often face challenges with adherence, particularly among those living alone. Virtual reality (VR) presents a promising solution through immersive and gamified experiences. Although some VR exergames have shown potential for improving balance, their long-term effectiveness remains uncertain due to a lack of fundamental exercise principles and complexities that may hinder sustained engagement. To address these challenges, we developed VR-Shuttlecock, a customized VR exergame that incorporates shuttlecock kicking. This game features effective leg exercises, diverse gamification designs, progressive difficulty levels, and protection measures to promote long-term participation while minimizing fall risks. The VR environment enables home-based exercise free from weather constraints and offers social interaction with virtual characters to reduce loneliness. In a four-week controlled study, 14 older adults trained with VR-Shuttlecock, while 13 in the control group received no intervention. The experimental group demonstrated significant improvements in four balance assessments (SLST, TUG, FRT, and YBT) and expressed positive attitudes toward continued training. These findings highlight the potential of VR-Shuttlecock as an effective, engaging, and safe balance training tool for older adults.