Abstract
A randomized, controlled trial tested the hypothesis that a combined treadmill training with virtual reality (TT+VR) intervention would lead to fewer falls, compared to treadmill training alone (TT). 302 community-living older adults (age: 73.8 ± 6.7 yrs; 60.3% women) with a history of multiple falls and a range of motor and cognitive deficits were randomly assigned to six weeks of TT+VR or TT. The primary outcome was the falls incident rate (IR) during the 6 months post-training. Before training, the IR was similar in both training arms (p=0.29). Following training, the IR was 42% lower (p=0.033) in TT+VR, compared to TT (IRR:0.58; 95%CI:0.36–0.96). Post training, gait variability during obstacle negotiation, physical performance-based measures, and health-related QOL were significantly better in TT+VR post-training, compared to TT. An integrated, multi-modal approach targeting relevant motor and cognitive functions led to lower fall rates than treadmill training alone, with added benefits to mobility and QOL.