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- Game-based balance training in older adults: systematic review and meta-analysisPublication . Tome, Ana Maria; Castro, Sílvia; Rosa, Marlene; Tomás, Maria Teresa; de Almeida Fontes, Ana Paula; Pais, SandraFunctional decline in older adults is a major contributor to both falls and increased fall risk. Nevertheless, such decline may be mitigated through multidimensional interventions. Game-based and gamified interventions have emerged as promising alternative strategies. This study aimed to evaluate the effectiveness of these approaches in improving balance and reducing fall risk among community-dwelling adults aged 65 years and over. The research question was: Do serious games and gamification improve balance and reduce fall risk in community-dwelling older adults, compared with exercise programmes, non-gamified interventions, or control conditions? A systematic search of randomised controlled trials was conducted in accordance with PRISMA guidelines, resulting in the inclusion of nine studies from 634 records screened. Meta-analysis demonstrated significant improvements in the Functional Reach Test and the Berg Balance Scale. However, no significant overall effects were observed for the Timed Up and Go Test or the Single-Leg Stance Test. Although game-based interventions may improve specific dimensions of balance in community-dwelling older adults, the findings should be interpreted with caution. The limited number of studies, small sample sizes, heterogeneity of interventions, and reliance on balance-related surrogate outcomes rather than direct measures of fall incidence highlight the need for further high-quality research