Falls are the leading cause of accidental death among people over the age of 65. Beyond the physical trauma, it often leads to a loss of confidence and deconditioning that increases the risk of recurrence. For physiotherapists and occupational therapists, fall prevention is therefore a central issue in geriatric care. How can virtual reality strengthen this prevention and support post-fall rehabilitation? This article provides an update on the clinical data and specialized exercises of the H’ability device.

Fall prevention: a major challenge in geriatric rehabilitation

Every year in France, falls affect a large proportion of the elderly and are a public health problem. About one in three people over the age of 65 experience at least one fall per year, and this risk increases with age.

But the danger is not limited to the fall itself. After a first episode, many patients develop post-fall syndrome : the fear of falling again leads them to reduce their movements and physical activity. However, this reduction in activity leads to muscle wasting and a deterioration in balance, which paradoxically increases the risk of falling again.

Breaking this vicious circle is one of the priority objectives of rehabilitation. It is about restoring not only balance and strength, but also the patient’s confidence in their own movement abilities.

What the science says about VR and fall prevention

The effectiveness of virtual reality in this field is now solidly documented. Several recent meta-analyses confirm this.

The most comprehensive review is by Wang et al. (2024), published in Geriatric Nursing. From 22 randomized controlled trials, the authors conclude that virtual reality training improves walking, static and dynamic balance, builds lower limb strength, and reduces the risk of falls in non-dependent older adults. VR is thus presented as a relevant complementary tool to limit falls and their consequences.

For its part, the meta-analysis by Lee et al. (2024), published in Gait & Posture, confirms the benefitsof immersive virtual reality training on balance, walking and mobility in older adults. These results reinforce the interest of immersive devices such as H’ability.

Finally, the Beauclair clinical study (2025), conducted on post-femoral neck fracture patients, showed a significant reduction in kinesiophobia (fear of movement) in the group that benefited from virtual reality. However, this fear of movement is a key factor in post-fall syndrome. To learn more, see our clinical study on fall patients.

How does virtual reality affect the risk of falling?

The mechanisms by which VR contributes to fall prevention are now well understood. There are three main ones.

• Balance work in a controlled situation: VR places the patient in situations of instability (moving ground, lateral movements, visual disturbances) that solicit his postural reflexes, without any risk of real fall during the exercise.
• The cognitive-motor dual task: many falls occur when the person does two things at once (walking while talking, avoiding an obstacle). VR trains precisely this ability, by combining motor exercise and cognitive solicitation.
• Restoring confidence: by performing movements in a safe and fun environment, the patient gradually regains confidence, which reduces the fear of falling and breaks the vicious circle of post-fall syndrome.

H’ability exercises dedicated to fall prevention

The H’ability system offers several categories of exercises specially adapted to fall prevention and post-fall rehabilitation:

• Static and dynamic balance: sitting or standing exercises, at 180° or 360°, to work on postural control, support transfers and stability.
• Lower limb rehabilitation: thanks to ankle trackers, the patient works on the strength and coordination of the legs, which are essential for stability. Learn about lower limb rehabilitation in VR.
• Vestibular stimulation: exercises targeting balance and the management of sensory conflicts, often involved in balance disorders in the elderly.
• Dual cognitive and motor task: exercises combining attention, working memory and movement, to prepare the patient for real everyday situations.
• Mixed reality mode: For the most frail elderly patients, the mixed reality mode retains the real visual cues, which makes the session safer and reassures the patient.

To discover all the clinical situations covered, consult our H’ability therapeutic indications.

A supervised and complementary use

It is essential to remember that virtual reality does not replace conventional fall prevention exercises or the expertise of the practitioner. It acts as a complementary tool, which enriches the care and strengthens the patient’s motivation. Evaluation and follow-up are still carried out by the physiotherapist or occupational therapist. In addition, the H’ability device is not indicated for patients with severe behavioral disorders, and a prior evaluation is recommended for patients sensitive to motion sickness.

FAQs — Frequently Asked Questions About Virtual Reality Fall Prevention

Is virtual reality effective for fall prevention?
Yes. A meta-analysis by Wang et al. (2024), looking at 22 randomized controlled trials, shows that virtual reality training improves walking, static and dynamic balance, strengthens lower limb muscle strength, and reduces the risk of falls in non-dependent older adults.

Why is rehabilitation after a fall important?
After a fall, the patient often develops a fear of falling again (post-fall syndrome), which leads to a reduction in activity. Indeed, this deconditioning aggravates the loss of balance and paradoxically increases the risk of a new fall. This is why post-fall rehabilitation aims to restore balance, strength and above all confidence in movement.

How does virtual reality reduce the risk of falling?
Virtual reality places the patient in situations of controlled and secure instability, which solicit dynamic balance, proprioception and postural reflexes. In addition, it allows you to work on the dual cognitive-motor task, which is common in everyday falls, without the risk of real falls during exercise.

Which patients can benefit from RV fall prevention?
Fall prevention by virtual reality is mainly aimed at elderly people with a balance disorder, patients in post-fracture rehabilitation, as well as neurological patients (stroke, Parkinson’s). On the other hand, use is always done under the supervision of a health professional.

Does VR replace conventional fall prevention exercises?
No. Virtual reality is a complement to conventional balance exercises, not a substitute. Indeed, studies show that it acts as an effective additional tool to improve outcomes, in particular by increasing patient motivation and engagement over time.

References:

• Wang, X., et al. (2024). Effectiveness of virtual reality in preventing falls in non-disabled older adults: A meta-analysis and systematic review. Geriatric Nursing, 58, 15–25. Read the study
• Lee, J., Phu, S., Lord, S. R., & Okubo, Y. (2024). Effects of immersive virtual reality training on balance, gait and mobility in older adults: A systematic review and meta-analysis. Gait & Posture, 110, 129–137. Read the study
• Beauclair, C. (2025). Impact of immersive virtual reality on post-fracture rehabilitation of the femoral neck. Master’s thesis in physiotherapy, Haute École Robert Schuman, Luxembourg. Read the study