Document Type : Original research
Extended Abstract
The rapid growth of the elderly population worldwide has become a major public health challenge. Aging is typically accompanied by gradual and irreversible declines in physical, cognitive, and social functions, which increase vulnerability to chronic diseases, disability, falls, and reduced independence. Falls are among the leading causes of morbidity and mortality in older adults, often resulting in fractures, hospitalization, and psychological consequences such as fear of falling, depression, and social withdrawal. In parallel, the global rise in life expectancy has intensified the need for effective interventions to maintain functional independence and quality of life. Virtual reality (VR) technologies provide interactive, safe, and engaging environments that simulate real-life tasks, offering opportunities for motor rehabilitation, balance training, and cognitive stimulation. VR-based interventions have shown promise in enhancing motivation, reducing loneliness, and improving adherence to rehabilitation programs. the present study aimed to evaluate the impact of VR-based training on motor proficiency, health-related quality of life, and psychological well-being in older men.
This semi-experimental study employed a pre-test, post-test, and one-month follow-up design with a control group. A total of 45 men aged 65–75 years residing in Tehran were recruited through simple random sampling. Sample size was determined using G*Power software based on effect size and statistical power, with a confidence level of 95% and significance threshold of 0.05. Inclusion criteria for the study included: being male, aged 65 to 75 years, having good general health, not having neurological, musculoskeletal, or cardiovascular diseases that limit physical activities, not having a history of recent fractures, and being able to perform exercises. Exclusion criteria included irregular attendance, onset of illness or injury during the study, or participation in other interventions.
Participants were randomly assigned to two groups: VR training, and control. The VR group completed a 12-week program using Xbox Kinect, with three sessions per week, each lasting 40 minutes. Exercises included skiing (weight shifting and trunk rotation), penalty shooting (lower-limb coordination and balance), darts (hand-eye coordination and static balance), Volleyball
(Hand-eye coordination and Quick reaction) and Rhythmic movements (Static balance and Stretching movements). The control group received no intervention.
Motor proficiency was assessed using the Bruininks–Oseretsky Test of Motor Proficiency for adults (BMAT),
which evaluates fine and gross motor skills, balance, strength, agility, and visual-motor integration. Quality of life was measured using the SF-36 questionnaire, a validated self-report tool covering eight domains: physical functioning, role limitations due to physical and emotional health, energy/fatigue, emotional well-being, social functioning, pain, and general health. Data collection adhered to standardized protocols, with confidentiality ensured.
Descriptive statistics, including mean and standard deviation, were used to summarize the data and describe participants’ demographic characteristics. The normality of data distribution was assessed using the Shapiro–Wilk test, and the assumption of sphericity was examined using Mauchly’s test. When the sphericity assumption was violated, the Greenhouse–Geisser correction was applied. A mixed-design repeated-measures ANOVA was conducted to evaluate the effects of the intervention, with time (pre-test, post-test, and follow-up) as the within-subject factor and group (virtual reality-based exercise and control) as the between-subject factor. The dependent variables included motor proficiency and the physical and mental health components of quality of life. Significant effects were further analyzed using Bonferroni post hoc comparisons. Effect sizes were reported as partial eta squared (ηp²). All analyses were performed using SPSS version 22, with statistical significance set at p ≤ 0.05.
The findings demonstrated significant improvements in motor proficiency among participants in VR group compared to the control group. In the VR group, mean motor proficiency scores rose from 42.3 at baseline to 55.8 post-test and 56.5 at follow-up. The control group showed minimal changes.
Quality of life outcomes also showed notable improvements. Participants in the VR group reported higher scores in physical functioning, vitality, emotional well-being, and social participation, with mean scores increasing from 61.5 at baseline to 74.4 post-test and 73.9 at follow-up. while the control group remained stable. Psychological benefits included reduced fatigue, decreased depressive symptoms, and increased motivation to engage in physical activity.
Table 1 illustrates the structure of the VR exercise package, highlighting the targeted motor skills for each game. Figure 1 presents the comparative changes in SF-36 scores between the experimental and control groups across three time points. Overall, the VR group demonstrated sustained improvements in both physical and psychological domains,and the control group exhibited no significant changes. These results confirm the effectiveness of VR training as a multidimensional intervention for older adults.
This study provides evidence that VR-based training are effective methods to enhance motor proficiency and health-related quality of life in older men. However, VR demonstrated greater improvements in motivation, adherence, and psychological well-being, suggesting its potential as a superior intervention. The interactive nature of VR promotes engagement and reduces monotony, while the controlled environment minimizes risks associated with traditional physical training. Improvements in balance, coordination, and emotional health highlight the role of VR in fall prevention and active aging strategies. Despite limitations such as small sample size and reliance on self-reported measures, the findings underscore the potential of VR technologies in geriatric rehabilitation.
Future research should explore long-term effects, cost-effectiveness, and broader applications across diverse elderly populations.
VR-based training offers a safe, engaging, and effective approach to improve motor proficiency and quality of life in older men. The motivational and multidimensional benefits of these exercises make them a promising tool for integration into empowerment and rehabilitation programs aimed at healthy and active aging, particularly for fall prevention.
Foot notes
Authors’ contribution
All authors participated in the research process, including data collection and analysis, recording results, drafting, reviewing, and editing the article's content.
Conflict of Interest
The authors declare no conflict of interest regarding this study.
Acknowledgments
The authors sincerely acknowledge the support of the Department of Physical Education and Sport Sciences at the Science and Research Branch of Islamic Azad University, the valuable cooperation of all participating retirees, the Ministry of Jihad-e- Agriculture – Institute of Applied Science and Technology of Jihad-e- Agriculture, and the Sport Sciences Research Institute. The authors also express their gratitude to all individuals and groups who assisted in data collection and in conducting the training sessions.
