Disability and Rehabilitation Assistive Technology · Oct 31, 2026

Comparison of the effects of artificial intelligence, virtual reality, and traditional balance training programs on balance and gait in older adults

By Yousefi Babadi S, Norasteh AA, Shamsi Majelan A

Purpose With ageing, the ability to maintain balance and gait declines, leading to falls and reduced independence. This trial compared an AI-generated, human-delivered exercise program (ChatGPT-4o), a virtual reality (VR) exergaming program, and a traditional balance (TB) training program on balance and gait in older adults residing in retirement homes. Materials and Methods In this stratified, parallel-group, randomised controlled trial, 48 older adults aged 60–75 years were allocated 1:1:1 to VR (Xbox Kinect; n = 16), AI (ChatGPT-4o–generated program; n = 16), or TB (n = 16). All groups completed 60-min sessions, three times per week for 8 weeks, with a 2-month follow-up. Balance, mobility, balance confidence, gait speed, cadence, Gait Stability Ratio (GSR), and usability (System Usability Scale, SUS) were assessed at all three time points. Results All groups improved significantly over time (p < .001); group × time interactions were significant for all outcomes (ηp² = .195–.631) except ABC (p = .063 after Greenhouse–Geisser correction). VR and AI produced greater gait-speed gains than TB (both p < .001, no VR–AI difference); VR produced the largest cadence gains and AI the largest GSR reduction. Usability was excellent for VR (SUS 82.4) and good for the instructor-delivered AI program (74.6). No adverse events occurred. Conclusion AI-, VR-, and traditional balance training can each improve balance and gait in older adults, while technology-assisted programs provide additional gait benefits, supporting more personalised, hybrid rehabilitation approaches. Clinical trial registration IRCT20181113041645N2 (May 18 2025).

doi.org/10.1080/17483107.2026.2754660PubMed 42965934Interventions