Virtual reality exergames for improving physical function, cognition and depression among older nursing home residents: A systematic review and meta-analysis

Yu Peng; Ying Wang; Lili Zhang; Yuhan Zhang; Liyan Sha; Jianli Dong; Yang He

doi:10.1016/j.gerinurse.2024.02.032

Virtual reality exergames for improving physical function, cognition and depression among older nursing home residents: A systematic review and meta-analysis

Geriatr Nurs. 2024 Mar 18:57:31-44. doi: 10.1016/j.gerinurse.2024.02.032. Online ahead of print.

Authors

Yu Peng¹, Ying Wang¹, Lili Zhang², Yuhan Zhang³, Liyan Sha⁴, Jianli Dong⁵, Yang He⁶

Affiliations

¹ Department of Nursing, The Second Hospital of Dalian Medical University, Dalian, Liaoning, PR China.
² School of Public Health, Weifang Medical University, Weifang, Shandong, PR China.
³ School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, PR China.
⁴ Department of Nursing, The Second Hospital of Dalian Medical University, Dalian, Liaoning, PR China. Electronic address: slydl2007@163.com.
⁵ Department of Nursing, The Second Hospital of Dalian Medical University, Dalian, Liaoning, PR China. Electronic address: 2444544036@qq.com.
⁶ School of Nursing, Dalian Medical University, Dalian, Liaoning, PR China.

PMID: 38503146
DOI: 10.1016/j.gerinurse.2024.02.032

Abstract

Objective: To explore the effectiveness of virtual reality (VR) exergames on physical function, cognition and depression among older nursing home residents.

Methods: A systematic review and meta-analysis were conducted. The PubMed, Ovid, Embase, Cochrane, CINAHL, and Web of Science databases were searched for relevant studies from inception until June 1, 2023. The reviewers independently completed the study selection, data extraction and quality assessment. Subgroup analyses were conducted to explore the sources of between-study heterogeneity and to determine whether participant or intervention characteristics influenced effect sizes.

Results: Eighteen studies met the inclusion criteria and were selected for qualitative and quantitative synthesis. The overall methodological quality was relatively high, and the overall evidence grade was moderate. VR exergames had a large effect on physical function, including mobility [SMD=-0.66, P < 0.001], balance [SMD=0.95, P < 0.001], and lower limb strength [SMD=0.53, P = 0.0009]; and a moderate effect on cognition [SMD=0.48, P = 0.02] and depression [SMD=-0.72, P = 0.03]. Subgroup analyses revealed that a training frequency of 2 sessions per week and coordinating with physiotherapists yielded greater improvements in mobility (P = 0.009; P = 0.0001). VR exergames had especially beneficial effects on balance for physically fit participants (P = 0.03) and on cognition for participants with cognitive impairment (P = 0.01). Additionally, regarding the improvement of depression, commercial VR exergames were superior to self-made systems (P = 0.03).

Conclusion: VR exergames can provide a positive impact on physical function, cognition and depression among older nursing home residents. The study also demonstrated the different benefits of exergames between participants who were physically fit and those with cognitive impairment, which is considered as an innovative, cost-efficient and sustainable approach. Specifically, commercial VR exergame programs with a frequency of 2 sessions per week and coordinating with physiotherapists may be the most appropriate and effective option.

Keywords: Cognition; Depression; Nursing home; Older adults; Physical function; VR interventions.