Effects of Exergaming on Balance of Healthy Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

Balance is critical for older adults to perform daily activities. However, age-related declines in balance increase the risk of falls and severe injuries, such as bone fractures and head injuries. Exergames have been widely applied to improve health-related outcomes in older adults. This meta-analysis aims to quantify the effects of exergaming interventions on balance performance in healthy older adults. A literature search was performed using PubMed, ScienceDirect, SPORTDiscus, COCHRANE, EBSCO, and EMBASE. A total of 16 experimental studies met inclusion criteria for a full-text review. Data synthesis examined balance functions, including static, dynamic, proactive, and perceived balance abilities when performing daily activities. Intervention protocols of the reviewed studies included an average of two to three 40-minute exergaming sessions per week for 8 weeks. A random effects model identified significant effects in favor of the exergaming group, with moderate effect size in dynamic balance (Hedges' g = 0.36, 95% CI = 0.26–1.30, P < 0.001), and perceived balance (Hedges' g = 0.31, 95% CI = 0.04–0.58, P = 0.02); and considerable effect size in Chair Stand Test (Hedges' g = 0.78, 95% CI = 0.26–1.30, P = 0.003), and balance test batteries (Hedges' g = 0.72, 95% CI = 0.42–1.02, P < 0.001). No significant effect was found in the static balance (Hedges' g = 0.22, 95% CI = −0.31 to 0.76, P = 0.42), or proactive balance (Hedges' g = 0.54, 95% CI = −0.12 to 1.20, P = 0.11). Meta-analysis identified exergaming-associated benefits in older adults' balance function and confidence. This finding supports the feasibility of exergaming as a supplementary approach to improve balance for healthy older adults. Health professionals may optimize treatment effect by integrating exergaming sessions into a traditional balance exercise program.