Abstract

Purpose: Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promising strategy for fall prevention by improving balance, reducing fear of falling, and enhancing confidence. However, the impact of VR interventions on specific outcomes such as fear of falling, balance, and postural control in older adults remains insufficiently synthesized. Design: Systematic review and meta-analysis. Methods: A comprehensive systematic search of six databases was conducted from inception to January 20, 2025. Randomized controlled trials (RCTs) evaluating VR interventions targeting fear of falling, balance, and postural control in older adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB-2). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome. Findings: Seventeen RCTs involving 988 older adults, published between 2016 and 2025, met the inclusion criteria. VR interventions demonstrated significant effects in reducing fear of falling (SMD = −0.40; 95% CI: −0.72 to −0.08; I² = 45.10%; p = 0.02), improving balance (SMD = 0.45; 95% CI: 0.07–0.83; I² = 73.54%; p = 0.02), and enhancing postural control (SMD = 0.50; 95% CI: 0.13–0.86; I² = 46.89%; p = 0.01). Conclusion: This meta-analysis highlights the effectiveness of VR interventions in reducing fear of falling and improving balance and postural control among older adults. Clinical Relevance: VR represents a valuable tool in fall prevention strategies, addressing key outcomes essential for maintaining independence and mobility in this population.