OBJECTIVE: This study aimed to assess the effectiveness of virtual reality-based treadmill training on gait performance and tolerance in the elderly. DESIGN: Two-armed randomized controlled trial. Setting: The Medical Rehabilitation Sciences Department, Umm Al Qura University, Saudi Arabia. PARTICIPANTS: Sixty Saudi elderly of both sexes, aged 65 to 75 years, were included. INTERVENTIONS: Participants were divided into two groups. The control group received treadmill training without virtual reality, alongside a conventional exercise program. The experimental group received a training program that was similar to the control group's exercises but with C-Mill virtual reality treadmill training. The program lasted one hour, three times per week, over four consecutive weeks. MAIN MEASURES: The study assessed changes in outcome measures at baseline, post-1 (after four weeks of training), and post-2 (four weeks post-training). These measures encompassed the primary outcome, the 6-minute walk test (meter), as well as secondary outcomes such as stride length (meter), stride time (second), cadence (steps/minute), and velocity (meter/second). These parameters were evaluated using the GaitRite electronic gait analysis walkway. RESULTS: The experimental group showed better improvement in the mean values of the 6-minute walk test, stride length, stride time, cadence, and velocity compared to the control group at post-1 and post-2. The p-values were respectively at post-1 (0.019, 0.015, 0.041, 0.013, and 0.021) and (0.011, 0.025, 0.073, 0.061, and 0.017) at post-2 (all, p < 0.05). CONCLUSIONS: C-Mill virtual reality treadmill training shows potential in improving gait parameters and walking tolerance in the elderly in Saudi Arabia.

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