Geriatrik Bilimler Dergisi · Oct 9, 2026
Virtual Reality-Based Interventions for Fall Prevention in Older and High Fall-Risk Adults: A Systematic Review of Randomized Controlled Trials
By Kayral İH
Objective: This systematic review evaluated the effects of virtual reality (VR)-based interventions on prospectively recorded fall outcomes in older adults and high fall-risk adult populations.Materials and Methods: PubMed and Scopus were systematically searched for randomized controlled trials published between January 2015 and December 2025. Eligible studies included adults aged ≥60 years or populations explicitly characterised as high fall-risk (e.g., neurological conditions associated with increased fall risk), a VR-based or interactive virtual training intervention targeting fall prevention, balance, gait, or mobility, a comparator group, and prospective reporting of fall outcomes (e.g., fall incidence, fall rate, proportion of fallers, or incidence rate ratio). Six randomized and RCT-derived reports met the inclusion criteria. Due to heterogeneity in intervention modalities, fall outcome definitions, and follow-up durations, meta-analysis was not performed; instead, a structured narrative synthesis was conducted. Risk of bias was assessed using the Cochrane RoB 2 tool.Results: Six randomized and RCT-derived reports were included, with sample sizes ranging from 26 to 302 participants and follow-up periods ranging from 3 to 12 months where available. The included interventions were mainly based on non-immersive VR or interactive virtual training systems integrated with gait, balance, or cognitive–motor tasks. Fall outcomes were reported using heterogeneous metrics, including fall incidence, fall rate, fall frequency, fall counts, and incidence rate ratios. The most favourable signals were observed in treadmill-based gait training combined with non-immersive VR and cognitive–motor challenges. No study was judged as having high risk of bias; one trial demonstrated overall low risk, while the remaining trials presented some concerns.Conclusion: VR-based interventions, particularly non-immersive systems integrating cognitive–motor demands within structured gait training, may contribute to fall prevention in older and high fall-risk adults. However, the small number of trials, heterogeneity in intervention designs and fall outcome reporting, and relatively short follow-up periods warrant cautious interpretation. Future pragmatic randomized trials should use standardized fall definitions and prospectively recorded fall incidence or fall-event outcomes as primary endpoints.