Effects of exergaming on balance and functional performance in older adults with chronic conditions living in the community: a systematic review and meta-analysis
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Background Older adults with chronic diseases often experience impaired balance and functional performance, increasing their risk of falls and disability. Exergaming has emerged as a promising intervention; however, its effectiveness in community-dwelling older adults with chronic conditions remains unclear. Objective To systematically review and meta-analyze the effects of exergaming on balance and functional performance in community-dwelling older adults with chronic diseases. Methods Following PRISMA guidelines, PubMed, Embase, Web of Science, Cochrane Library, Scopus, and CINAHL were searched from inception to April 10, 2026. Randomized controlled trials involving exergaming interventions in adults aged ≥60 years with chronic conditions were included. Primary outcomes were balance and functional mobility. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Pooled effects were calculated using mean differences (MDs) or standardized mean differences (SMD) with 95% confidence intervals (CIs) according to outcome measurement scales. Results Eleven randomized controlled trials were included. Compared with control interventions, exergaming significantly improved balance measured by the Berg Balance Scale (MD = 2.93, 95% CI 0.44–5.41, p = 0.021) and dynamic gait ability measured by the Dynamic Gait Index (MD = 0.72, 95% CI 0.09–1.35, p = 0.025). Subgroup analyses indicated greater benefits for interventions lasting at least 8 weeks and those involving supervised training. Heterogeneity was low to moderate. Conclusion Exergaming may be a promising adjunctive approach for improving balance and functional performance in community-dwelling older adults with chronic diseases. Further high-quality trials with larger sample sizes and long-term follow-up are needed. Systematic review registration PROSPERO registration number: CRD420261368359.