Supplementary Material for: The effects of virtual reality training on muscle strength of the elderly: A systematic review and meta-analysis

Introduction: The purpose of this systematic review is to examine the effects of virtual reality training (VRT) on the muscle strength of the elderly. Methods: Primary sources were obtained from 4 databases including PubMed, SCOPUS, CENTRAL, and Web of Science. The search period covered years from inception to February 1th, 2025. Standardized mean differences (SMDs), weighted mean differences, and 95% CIs were calculated using random or fixed-effect models for outcomes. Results: Following the screening process, 38 studies involving a total of 1280 participants were included in the systematic review. The results of the meta-analysis showed that VRT increased upper-body muscle strength (1.89 [95% CI: 0.65-3.13], p=0.003), lower-body muscle strength (0.68 [95% CI: 0.46-0.91], p=0.001) and handgrip (0.45 [95% CI: 0.26-0.63], p=0.001). Additionally, the results of the meta-analysis demonstrated that there was no significant difference between VRT and traditional training (TT) on lower-body muscle strength (0.04 [95% CI: -0.26-0.36), p=0.75) and handgrip (0.06 [95% CI: -0.11-0.24], p=0.48). Conclusion: The results meta-analysis demonstrated that VRT has a positive effect on the muscle strength of all three parts of the lower limb, upper limb, and HG. Also, comparing VRT with TT, no significant difference was observed between these two types of training.