Augmented Reality for Balance Rehabilitation in Older Persons: A Scoping Review

Abstract

Background

Falls are a leading cause of injury and loss of independence in older adults. Impaired balance is a modifiable risk factor yet traditional rehabilitation approaches may not fully address balance control. Augmented reality (AR) provides an interactive method to support balance training and fall prevention. This scoping review summarizes key characteristics of AR interventions for balance rehabilitation in older adults, as well as associated outcome measures.

Methods

Literature searches were performed across CENTRAL, CINAHL, EMBASE, Medline, PubMed, ScienceDirect, SCOPUS, and Web of Science from inception to July 2024. Using Arksey and O’Malley’s framework, we included studies meeting the following criteria: (i) older adults (65+), (ii) AR-based balance rehabilitation, (iii) randomized control trials (RCTs) or observational studies, and (iv) outcomes related to balance, balance confidence, or fear of falling, categorized using the Balance Evaluation Systems Test (BESTest) framework. Two reviewers independently screened and extracted data.

Results

Ten studies (six RCTs, four observational) involving 235 participants (ages 64.70-75.8 yrs) met inclusion. AR interventions were delivered 1–5 times/week over 4 to 12 weeks (4–36 total hr), with adherence rates of 83.3% to 100%. The most frequently assessed balance systems were stability in gait (100%) and anticipatory postural adjustments (90%), which improved with AR. Only one study evaluated all balance systems. RCTs showed statistically significant improvements in balance, while observational studies mainly reported associations and trends.

Conclusions
This review highlights AR as a complementary tool for fall prevention, supporting tailored interventions across balance domains. Clinicians may find AR useful for engaging older adults in targeted, functional rehabilitation.