SynthesisFrontiers in public health2026
Pilates and AR/VR-based and other technology-assisted exercise for balance and postural control in older-adult and aging-related rehabilitation contexts: a systematic review and exploratory network meta-analysis.
Synthesis in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Background: Population aging has increased demand for scalable strategies supporting balance-oriented rehabilitation, fall-risk management, and functional independence in older adults. Pilates and technology-assisted exercise, including AR/VR, exergaming, motion-sensing exercise, telerehabilitation, and technology-delivered Pilates, may be relevant, but comparative evidence and older-adult applicability remain uncertain. Objective: To compare Pilates, technology-assisted exercise, technology-delivered Pilates, conventional exercise, and control for balance- and postural-control-related outcomes using exploratory network meta-analysis and aging-public-health applicability mapping. Methods: We searched eight sources through 2 May 2026. The primary network included source-verified randomized trials with eligible balance/postural-control endpoints and extractable post-intervention arm-level data. Hedges' g used exact small-sample correction, and random-effects frequentist network meta-analysis used restricted maximum likelihood. Risk of bias and certainty were assessed using RoB2 and a conservative GRADE/CINeMA-informed framework. Results: The primary network included 12 studies, 25 analytic arms, and 491 participants; the broader sensitivity network included 14 studies, 29 arms, and 606 participants. Estimates versus control were 0.33 (95% CI -0.04 to 0.69) for conventional exercise, 0.64 (0.18 to 1.09) for Pilates, 0.69 (0.38 to 1.01) for technology-assisted exercise, and 0.69 (0.14 to 1.25) for technology-delivered Pilates. Applicability mapping identified direct older-adult community evidence (4 studies, 187 participants), aging-related clinical rehabilitation evidence (6 studies, 216 participants), and indirect non-geriatric evidence (2 studies, 88 participants). Certainty was low for technology-assisted exercise and very low for other active-versus-control comparisons. Conclusion: Active interventions generally favoured the intervention over control, but sparse evidence, heterogeneity, control variability, outcome-domain sensitivity, clinically fragile transitivity, and low/very low certainty preclude a definitive hierarchy. Findings may inform risk-stratified community programmes, home-based support, digital-equity planning, and implementation trials rather than justify a single preferred intervention, platform, or automated decision-support model. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261383909, PROSPERO, CRD420261383909.
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