ABSTRACT

ObjectivesFear of falling is common among older adults and can increase fall-risk through premature activity restriction. Exergames, an emerging tool in fall prevention, combine exercise with interactive and adaptive game elements. This review examines the extent to which exergame interventions reduce fear of falling among community-dwelling older adults.

Method: Guided by the PRISMA methodology, we reviewed peer-reviewed studies that were published in English between 2006 and 2019 and employed a comparative design to test the effect of exergames on fear of falling in community-dwelling older adults. Two reviewers screened the literature and extracted data on the exergame platform, participants, study design, and results. A modified PEDro scale was used to assess study quality. Disagreements were resolved through discussion with the third reviewer.

Results: Our literature search resulted in 23 eligible studies on exergame interventions where fear of falling was the primary or secondary outcome. Most interventions (35%) occurred within hospitals and were delivered via a Wii-based system (61%). Fear of falling was most commonly measured using the Falls Efficacy Scale, the Activities-specific Balance Scale and their modified versions. A total of 15 of the 23 studies reported statistically significant changes in fear of falling. Quality assessment showed 10 studies to be rated as 'good.'

Conclusion: This review showed that exergame may have a positive effect in reducing fear of falling in community-dwelling older adults. The finding provides a direction for clinical practice in the research area of intervention on fear of falling in older adults.

摘要

目标害怕跌倒在老年人中很常见，并且会因过早限制活动而增加跌倒风险。Exergames 是一种新兴的跌倒预防工具，将锻炼与互动和自适应游戏元素相结合。本综述考察了运动游戏干预在多大程度上减少了社区老年人对跌倒的恐惧。

方法：在 PRISMA 方法的指导下，我们回顾了 2006 年至 2019 年间以英语发表的同行评议研究，并采用比较设计来测试运动游戏对社区老年人跌倒恐惧的影响。两名审稿人筛选文献并提取有关 exergame 平台、参与者、研究设计和结果的数据。使用改良的 PEDro 量表来评估研究质量。分歧通过与第三位评审员讨论解决。

结果：我们的文献检索产生了 23 项关于运动游戏干预的合格研究，其中对跌倒的恐惧是主要或次要结果。大多数干预措施 (35%) 发生在医院内，并通过基于 Wii 的系统 (61%) 进行。跌倒恐惧最常用的是跌倒功效量表、特定活动平衡量表及其修改版本。在 23 项研究中，共有 15 项报告了跌倒恐惧的统计学显着变化。质量评估显示 10 项研究被评为“良好”。

结论：本综述表明，运动游戏可能对减少社区老年人跌倒恐惧有积极作用。该发现为老年人跌倒恐惧干预研究领域的临床实践提供了方向。