Effects of exergaming on balance and functional performance in older adults with chronic conditions living in the community: a systematic review and meta-analysis.

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.