OBJECTIVE: To assess the effects of an unsupervised virtual reality (VR)-based exercise program on hip muscle strength and balance control in older adults. DESIGN: Controlled cohort repeated-measures experimental design, a pilot study. SETTING: University research laboratory. PARTICIPANTS: Ambulatory older adults (n = 32) from a local community. INTERVENTION: The VR group (n = 18; mean +/- SD 68.28 +/- 3.74y; 4 men) completed the VR-based exercise program, whereas the remaining subjects in the control group (n = 14; mean +/- SD 66.21 +/- 3.87y, 1 man) were asked to continue their daily routine for 8 weeks. MAIN OUTCOME MEASURES: Hip muscle strength was measured using a multimodal dynamometer, and ground reaction force using the backward stepping test and the results of the crossover stepping test were recorded using a force platform. RESULTS: The VR group showed significant improvement in hip muscle strength of the extensors, flexors, adductors, and abductors after 8 weeks (all p <= 0.001). However, no significant improvement was observed in the control group. The VR group had significantly greater ground reaction force on the backward stepping test (with eyes opened and closed) (all p < 0.005) and the crossover stepping test (with eyes opened and closed) (all p <= 0.001) compared with those at baseline. However, no significant improvement was observed in the control group. CONCLUSIONS: The VR-based exercise program includes the role of supervisor and feedback, which is important for older adults. Therefore, a VR-based exercise program may be a useful tool to improve decreased physical function in older adults as a home-based exercise.

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