title: The effectiveness of virtual reality interventions in improving balance in adults with impaired balance compared with standard or no treatment: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate whether virtual reality interventions, including interactive gaming systems, are effective at improving balance in adults with impaired balance.
  
  
  METHODS
  Systematic review and meta-analysis of randomized control trials.
  
  
  METHODS
  Studies were identified from electronic databases (CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, PyschINFO, PyschBITE, OTseeker, Ei Compendex, and Inspec) searched to November 2011, and repeated in November 2012. Two reviewers selected studies meeting inclusion criteria and quality of included studies assessed using a Joanna Briggs Institute appraisal tool. Data was pooled and a meta-analysis completed. The systematic review was reported following guidance of the PRISMA statement.
  
  
  RESULTS
  A total of 251 articles were screened. Eight randomized control trials were included. These studies presented the results of 239 participants, with various aetiologies, and used a variety of virtual reality systems. The number of falls was documented in only one included study. Meta-analysis was completed on data from the Berg Balance Scale, walking speed, 30 second sit-to-stand test, and Timed Up and Go Test, and favoured standard therapy when compared with standard plus virtual reality interventions.
  
  
  CONCLUSIONS
  There was a notable inconsistency in the outcome measures, experimental, and control interventions used within the included studies. The pooled results of the studies showed no significant difference. Therefore this review cannot support nor refute the use of virtual reality interventions, rather than conventional physiotherapy, to improve balance in adults with impaired balance.
authors.affiliation: 1Nottingham University Hospitals NHS Trust, UK.
authors.forename: Vicky
authors.initials: V
authors.lastname: Booth
authors.forename: Tahir
authors.initials: T
authors.lastname: Masud
authors.forename: Louise
authors.initials: L
authors.lastname: Connell
authors.forename: Fiona
authors.initials: F
authors.lastname: Bath-Hextall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016206:Databases, Bibliographic; D006801:Humans; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic; D012678:Sensation Disorders / Q000534:rehabilitation*; D063367:Virtual Reality Exposure Therapy; D055815:Young Adult
keywords: Adults; balance; impaired balance; interactive gaming systems; systematic review; virtual reality