Tech Report: Combined Training and VR Can Lower Fall Risk

A randomized controlled trial involving five different European countries examined elderly adults with a high risk for falls, based on a history of two or more falls within the last six months prior to the study. The aim was to determine whether forcing subjects to continually adjust their steps on a treadmill by imposing obstacles in a virtual reality (VR) environment would improve the incident rate of falls by the end of training, which consisted of 45 minutes on the treadmill three times per week for six weeks.

The 302 study participants were aged 60 to 90 with varying levels of motor and cognitive deficits, from mild cognitive impairment to Parkinson’s disease. They were each randomly assigned to either a treadmill routine or treadmill-plus-VR, which consisted of a motion-capture camera and a computer generated simulation projected onto a large screen. The visuals displayed real-life challenges including obstacles, multiple pathways and distractions that required continual adjustment of steps.

The incident rate of falls during the six months after the end of training was significantly lower in the treadmill-plus-VR group than it had been before training, whereas the incident rate did not decrease significantly in the treadmill-alone group. At six months post-training, the incident rate of falls was also significantly lower in the treadmill-plus-VR group than in the treadmill-alone group. No serious training-related adverse events occurred.

Age-associated motor and cognitive deficits increase the risk of falls, a major cause of morbidity and mortality. Because of the significant ramifications of falls, many interventions have been proposed, but few have aimed to prevent falls via an integrated approach targeting both motor and cognitive function. Older adults often fall due to problems negotiating obstacles, and these falls can involve both cognitive and motor deficits. The study shows that interventions to prevent falls should target both deficits. It also opens the imagination to how virtual and/or augmented reality might contribute to training and health in ways we have only begun to explore.

The Lancet, 2016, Vol. 388, No. 10050, p 1170–1182, http://dx.doi.org/10.1016/S0140-6736(16)31325-3

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