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Virtual reality exercise to improve balance control in older adults at risk of falling.

It is estimated that 28% to 35% of older adults (age 65 years) experience at least one fall each year; fall is the second leading cause of accidental death worldwide.1 Risk factors of fall include intrinsic and extrinsic factors. Balance control is intrinsic and modifiable. Virtual reality (VR) simulates daily life activities by presenting an illusion of threedimensional vision and direct visual and auditory feedback.2 Interventions using the Nintendo Wii Fit force-sensing platform and its built-in VR games for balance, yoga, aerobic, and strength training have been reported.2 The effectiveness of Wii Fit exercise versus conventional exercise on balance control has been studied. In a study of 36 community living older adults, the Wii Fit balance training group achieved better balance control post intervention, based on the Tinetti test and the Wii Fit centre of gravity test.3 In another study of 32 community living older adults, the Wii-fit group, the traditional exercise group, and the control group achieved significant but comparable improvement in Berg Balance Scale (BBS) score of 3.55, 3.45, and 2.99, respectively.4 However, scientific evidence on the effects of VR exercise using Wii Fit on balance control among institutionalised older adults with a fall history is still lacking. Hence, this randomised clinical study aimed to compare Wii Fit balance training with conventional balance training in this group of older adults.