Effects of Virtual Reality Training and Whole-Body Vibration Training on Fall-Related Functional Outcomes in Older Adults: A Systematic Review and Meta-Analysis

Objective: To evaluate the effects of virtual reality (VR) and whole-body vibration (WBV) training on muscle strength and balance-related functional outcomes in older adults. Methods: PubMed, Web of Science, the Cochrane Library, CNKI, and Embase were searched from inception to March 2026. Randomised controlled trials assessing VR or WBV training in samples with a mean participant age of ≥60 years were included. Outcomes were the Timed Up and Go (TUG) test, handgrip strength, Tinetti score, five-times sit-to-stand test, and gait speed. Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Subgroup analyses and Bucher-adjusted indirect comparisons were used to explore potential relative effects. Results: Thirty-two trials involving 1359 participants were included. VR training reduced TUG completion time (MD = −1.13, 95% CI −1.70 to −0.55, p = 0.0001) and improved handgrip strength (MD = 3.49, 95% CI 0.46 to 6.52, p = 0.02), Tinetti scores (MD = 0.84, 95% CI 0.46 to 1.21, p < 0.0001), and gait speed (MD = 0.16, 95% CI 0.07 to 0.24, p = 0.0003). WBV training reduced TUG completion time (MD = −3.92, 95% CI: −6.36 to −1.48, p = 0.002) and five-times sit-to-stand completion time (MD = −1.20, 95% CI −2.03 to −0.38, p = 0.004). Conclusions: VR and WBV training may improve functional mobility and dynamic balance in older adults, although their effects may vary across functional domains. Because direct head-to-head trials are lacking, comparative findings should be interpreted as exploratory evidence.