Effects of interactive videogames on postural control and risk of fall outcomes in frail and pre-frail older adults: a systematic review and meta-analysis

Background: Interactive videogames have been used to reduce risk of falls in the older adult and improve Postural control outcomes.
Objective: To systematically review trials that examine whether Interactive videogames training is effective in improving Postural control and managing falls in frail and pre-frail older adult.
Data sources: Four databases were searched, Scopus, Web of science, PubMed, and MEDLINE from JAN 2007 to March 2019.
Eligibility criteria: Frail and pre-frail older adults aged 65+. Interventions were any Nintendo Wii training. The outcome measures were Postural control and risk of falls as measured by any validated outcome measure. Studies appraisal method: The PEDro scale and Cochrane risk of bias tool were used by two independent authors.
Results: Eleven papers were included, involving 388 participants, with a mean age of 79 ± 5.7 years. The mean duration of Interactive videogames sessions was 8.8 ± 3.8 weeks, the mean total number of sessions was 20 ±11.1 session and the mean length of training was 44 ± 15.7 minutes.
Meta-analysis: IVGs achieved better results compared to traditional exercises and control on the Berg Balance Scale [mean difference (MD) 2.80; 95% CI 1.21 to 4.39; p<0.001; I²=16%], as well as in the short-term on Timed Up and Go (MD -1.23; 95% CI -2.37 to -0.09; p =0.03; I²=0%).
Limitation: Definitive judgement could not be made due to the variability in training, training duration and outcomes measurement. Conclusion: Interactive videogames is promising modality that has a positive effect on Postural control but not on the outcome of falls, so should be prescribed with caution among the frail older adults.