Gait-Based Interventions for Fall Prevention in Older Adults: A Systematic Review

Abstract

Background: Falls are a major public health concern among older adults and are commonly associated with gait and balance impairments. Various gait-based interventions have been developed to improve mobility and reduce fall risk, although their effectiveness remains inconsistent.

Objective: To evaluate the effectiveness of gait-based interventions in improving gait parameters and reducing fall risk in older adults.

Methods: This systematic review followed PRISMA 2020 guidelines. Searches were conducted in PubMed, Scopus, and Google Scholar for studies published between 2020 and 2025. Eligible studies included randomized controlled trials, pilot randomized trials, and controlled intervention studies involving adults aged ≥60 years. Interventions included conventional and technology-based gait training such as Taekkyon exercise, proprioceptive training, perturbation-based treadmill training, and virtual reality interventions. Due to methodological heterogeneity, data were synthesized narratively.

Results: Ten studies involving approximately 425 older adults were included. Conventional interventions significantly improved gait speed, cadence, step length, and balance performance (p < 0.05). Technology-based interventions showed greater improvements in reactive balance and fall-related outcomes, with fall rate reductions ranging from 22% to 46%. However, reductions in real-life fall incidence were not consistently significant across studies.

Conclusion: Gait-based interventions effectively improve gait performance and may reduce fall risk in older adults. Conventional approaches appear more feasible for community settings, whereas technology-based interventions may provide additional benefits in supervised rehabilitation.