Bespoke Exergames for Balance Improvement and Fall Risk Reduction in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Bespoke exergames have been designed for balance improvement and fall risk reduction in community-dwelling older adults. However, the overall effectiveness of bespoke exergames and their compliance with exercise prescription principles is unclear. This systematic review aims to critique the technology and effectiveness of bespoke balance exergames prescribed for older adults. A literature search was performed for randomized controlled trials that implemented bespoke exergame interventions among community-dwelling older adults. The standardized mean difference was obtained for each study, and the pooled effect size was calculated based on the random effects inverse variance model. This review had 870 participants, and 12 of the 15 studies were classified with a low risk of bias. Bespoke exergames have an effect size of 0.75 (95% CI: 0.57 – 0.93; I <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> = 7.92%), 0.62 (95% CI: 0.48 – 0.77; I <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> = 11.7%), 0.52 (95% CI: 0.24 – 0.80; I <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> = 0%), and 0.54 (95% CI: 0.23 – 0.86; I <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> = 9.9%) on balance functional tests, static balance, dynamic balance, and psychological outcome measure, respectively. Bespoke balance exergames have a moderate and consistent effect on fall risk factors. Several recommendations were offered to improve future exergame programs for balance improvement and future research on the topic.