A combination of virtual reality and treadmill training could help prevent falls in older adults, according to researchers.
The intervention, which combines the physical and cognitive aspects of walking, helped prevent falls better than treadmill training alone, according to trial data published in The Lancet.
“Our approach combines treadmill exercise and virtual reality to help improve both physical mobility and cognitive aspects”
The study tested an intervention consisting of a camera that records a patient’s feet moving and projects it onto a screen in front of the treadmill, so they can “see” their feet walking in real time.
The game-like simulation was designed to reduce the risk of falls by including real life challenges such as avoiding and stepping over obstacles like puddles or hurdles, and navigating pathways.
Researchers said it could potentially be used in gyms, rehabilitation centres or nursing homes to improve walking and prevent falls in older people or those with movement disorders.
They said evidence suggested 30% of older adults living in the community and 60-80% of older adults with mild cognitive impairment, dementia or Parkinson’s disease, fell at least once a year.
In their trial, the researchers analysed data from 282 participants from five clinical sites in Belgium, Israel, Italy, the Netherlands, and the UK between 2013 and 2015.
“The findings have important implications for clinical practice”
All participants were aged 60-90 and were able to walk at least five minutes unassisted, on stable medication, and had reported at least two falls in the six months before the start of the study.
Nearly half of all participants had Parkinson’s disease, and some had mild cognitive impairment. They were assigned to treadmill training with virtual reality, or treadmill training alone.
On average, participants in each group took part in 16 training sessions over six weeks, with each session lasting about 45 minutes.
Prior to training, participants in the treadmill only group had an average of 10.7 falls per six months, and participants in the treadmill plus virtual reality group averaged 11.9 falls per six months.
During the six months after training, the incidence rate of falls decreased in both groups, but the decrease was only significant in the combination group – a 42% reduction from 11.9 to 6 falls. The biggest improvement was seen in participants with Parkinson’s disease.
Study author Dr Anat Mirelman, from Tel Aviv University in Israel, said: “Falls often start a vicious cycle, which has many important negative health consequences.
Virtual reality can help prevent falls in older people
“Current interventions for falls in older adults typically focus on improving muscle strength, balance, and gait,” she said. “Our approach combines treadmill exercise and virtual reality to help improve both physical mobility and cognitive aspects that are important for safe walking.”
Dr Mirelman added: “Treadmills are widely available, and the additional cost of treadmill training plus virtual reality is about 4,000 Euros [£3,446] for the set-up.
“Our study used personalised supervision, but this might not be necessary in everyday practice where group training might be more suitable,” she said.
Professor Stephen Lord, from the University of New South Wales in Australia, said the study had “important implications for clinical practice”, highlighting that no serious adverse events occurred and adherence was good.
He added that it was “conceivable” that treadmill training with a virtual reality component could be administered in community gyms and rehabilitation clinics.
“Since the intervention is relatively short term in nature, throughput of many people would be possible,” he said in comment piece on the study.