Effects of technology-based exercise programs in older adults: A systematic review and meta-analysis

Abstract Background Exergame and virtual reality–based interventions have emerged as innovative strategies to prevent falls in older adults. However, evidence regarding their effects on key outcomes related to fall prevention remains limited. Methods A systematic review and meta-analysis was conducted following PRISMA guidelines. Six electronic databases were searched to identify randomized controlled trials and quasi-experimental studies involving participants aged ≥60 years that reported at least one relevant outcome (mobility, balance, or fear of falling). Data were synthesized using a random-effects model, and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Risk of publication bias was assessed using funnel plots. Results Nine studies met the inclusion criteria. Meta-analysis showed significant improvements in mobility (SMD = –1.05, 95% CI: –1.58 to –0.51) and dynamic balance measured by the Berg Balance Scale (SMD = 0.46, 95% CI: 0.10 to 0.83). No significant effect was found for static balance assessed by the One-Leg Stance test (SMD = –0.28, 95% CI: –1.00 to 0.43). Fear of falling was significantly reduced (SMD = –0.35, 95% CI: –0.61 to –0.08), but the effect became non-significant after excluding a study with median-based statistics (SMD = –0.021, 95% CI: –0.58 to 0.16). Funnel plots indicated possible publication bias for mobility and fear of falling. Conclusions Technology-based interventions may improve mobility and dynamic balance in older adults, but their effects on static balance and fear of falling are less certain. High-quality, methodologically rigorous trials are needed to confirm these findings and guide their integration into geriatric fall-prevention programs.