EXERGAMES
Fewer falls than usual care
A review of nine trials found exergames may reduce fall rates compared with usual care, on low to moderate certainty evidence.
See the numbers
WHAT THE REVIEWS SAY
Play, balance
and steadier feet.
Exergames mix exercise with a game on screen.
Researchers have tested them in fall-prevention programmes for people over 60. The early results are encouraging, but the reviews are clear that the evidence is still limited.
9 TRIALS 1,385 people over 60
Compare the evidence- Balance work matters most
- Games may help people keep going
- The evidence is still young
- Informational, not a prescription
THE SHORT ANSWER
Promising, but
not yet proven.
Exercise in general has strong evidence.
Exergames are newer and less certain.
EXERCISE
Balance work has the best evidence
Cochrane found exercise based mainly on balance and functional training reduces falls, with high-certainty evidence. Tai chi may also help.
Compare the evidence
NHS GUIDANCE
Strength and balance twice a week
The NHS asks adults 65 and over to do activities that improve strength, balance and flexibility on at least 2 days a week.
Read the guidanceGeneral information only, not medical advice. For advice about your own health, speak to a doctor, pharmacist or other qualified health professional.
READING THE RESEARCH
Four things
the reviews point out.
Exergame headlines can sound more certain than the studies. These caveats come from the researchers themselves.
Small and varied trials
Only nine trials met the criteria, and the interventions varied so much that comparing types of game was not meaningful.
Short follow-up
Effects were not consistent at 3 or 6 months, and the authors call for larger, longer trials.
Usual care is not exercise
Against other active programmes, exergames showed no consistent advantage in falls.
Confidence, too
Exergames did reduce concerns about falling compared with evidence-based controls, an outcome that matters to many people.
TWO NUMBERS WORTH KNOWING
A big effect
from small trials.
One figure from the exergame trials,
one from the much larger exercise evidence.
≈ 50%
Reduction in fall rates vs control
Nine randomised trials with 1,385 people aged 60 or over. At 12 months, fewer people in exergame groups had fallen than with usual care, but there were no consistent reductions at 3 or 6 months.
EXERGAMES · BGS ABSTRACT
23%
Reduction in the rate of falls
From a review of 108 trials with 23,407 people in 25 countries. As an example, 850 falls in 1,000 people over a year would become about 195 fewer falls.
ALL EXERCISE · COCHRANE
A separate 2023 meta-analysis of 20 studies in community centres and nursing homes also found reduced fall risk and better balance with exergames, but many studies had a high risk of bias and only one had a long follow-up.
HOW SURE IS THE EVIDENCE?
Different kinds of exercise,
different certainty.
Pick a type of programme to see what reviews found for falls and how certain they rate the evidence. The bar shows the certainty, not the size of the effect.
Figures from the Cochrane review on exercise for preventing falls (community-dwelling older people) and a British Geriatrics Society abstract of an exergame meta-analysis. General information only, not personal medical advice.
WHAT THE NHS SAYS
Strength and balance,
at least twice a week.
NHS guidelines for adults 65 and over are to be active every day, do activities that improve strength, balance and flexibility on at least 2 days a week, and do at least 150 minutes of moderate activity a week, or 75 minutes of vigorous activity if already active.
The NHS says to see a GP if you are worried about your balance or mobility. A GP may check balance, look for problems such as muscle weakness, weak bones or eyesight, and arrange strength and balance training.
Questions
Questions people ask
What is an exergame?
A game that combines physical exercise with interactive digital play. Researchers describe features such as real-time feedback, goal setting and progress tracking, which may help people stay motivated.
Do exergames prevent falls?
A meta-analysis of nine trials found they may reduce fall rates and the number of fallers compared with usual care, but on low to moderate certainty evidence, and not consistently compared with other active exercise.
What kind of exercise has the strongest evidence for falls?
A Cochrane review of 108 trials found that programmes mainly of balance and functional exercises reduce falls, with high-certainty evidence. Programmes combining several types probably reduce falls, and tai chi may too.
How much activity does the NHS suggest for over-65s?
Be active every day, do activities that improve strength, balance and flexibility on at least 2 days a week, and do at least 150 minutes of moderate activity a week, or 75 minutes of vigorous activity if already active.
Who should I speak to about balance worries?
The NHS says to see a GP if you are worried about your balance or mobility. It adds that after a fall you might be able to refer yourself directly to services that can help; ask your GP surgery reception or check its website.
Sources
- British Geriatrics Society: From play to prevention, exergames for preventing falls in older adults (systematic review and meta-analysis abstract)
- Cochrane: Exercise for preventing falls in older people living in the community
- Healthcare (2023): Exergames in older adult community centers and nursing homes, a systematic review and meta-analysis
- NHS: Physical activity guidelines for older adults
- NHS: Falls
Updated