The randomised controlled trial followed hundreds of older adults using the smart±step system for gamified balance exercises versus a control group over one year. The results, published in Nature Medicine, revealed a major benefit – 26% fewer falls compared to older people who didn’t use smart±step.
With one in three seniors falling every year, falls carry massive costs for independence and well-being. But co-lead researcher Dr Daina Sturnieks called smart±step “encouraging proof” that even unsupervised at-home balance challenges can cut risks.
“Regular balance challenging exercise is effective at preventing falls, so we tried to make exercise fun and easy to do,” said Dr Sturnieks, a senior scientist at NeuRA and UNSW Sydney.
The smart±step consists of a step mat and TV screen for rapid stepping games. Unlike traditional programs focused purely on movement, guiding older people through activities like dodging obstacles, collecting treasures and stomping bugs also trains cognition.
“Exergames are like a two-in-one: you get physical benefits but also you are keeping yourself cognitively challenged, which is good for the brain and healthy ageing. Plus, it’s fun!” explained Dr Sturnieks.
And that engagement clearly translated to results. Previous studies have found only 5-7 hours of supervised balance exercise over three years could prevent around 40% of falls. Yet, averaging just 10 hours per week, smart±step users with no therapist oversight saw a 26% reduction—proving feasibility and scalability.
“It was really encouraging to see that smart±step, an exergaming console that anyone can enjoy at home completely unassisted from a therapist, brought a benefit to older people by preventing falls,” said Dr Sturnieks.
As the country’s over-65 population grows from 16% to an expected 22% by 2066, cost-effective solutions enabling seniors to stay active and reduce fall risks are urgently needed. Dr Sturnieks believes smart exergames can play a key role in filling the gap:
“People get addicted to games because they are fun and they become motivated to beat their high score and just get lost in the game.”
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
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