Postural sway, quantified through center of pressure (COP)-based measures, is a critical indicator of postural stability and fall risk. Despite growing interest in virtual reality (VR) and technology-assisted rehabilitation, a comprehensive synthesis of how interventions and experimental conditions affect postural sway across adults and older adults is lacking. This review aimed to systematically synthesize the effects of exercise-based interventions and experimental physiological, visual, and sensory conditions on COP-based postural sway in adults and older adults, with an emphasis on acute and short-term effects relevant to VR- and technology-assisted rehabilitation. A systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library was conducted from database inception to 31 March 2025. Studies reporting COP-based postural sway outcomes with extractable quantitative data were included. Narrative synthesis was performed due to substantial clinical and methodological heterogeneity. Ten studies were included (2 RCTs, 6 pre–post, 1 crossover, 1 cross-sectional). Exercise-based interventions—including balance training and visual feedback training—generally reduced postural sway. Acute physical perturbations (fatigue, immobilization, cryotherapy, proprioceptive vibration) consistently worsened stability. Destabilizing visual stimulation increased sway, whereas stabilizing visual feedback reduced it. Exercise-based interventions and sensory-stabilizing conditions show promise for improving postural stability. Fatigue, immobilization, and sensory perturbations represent important modifiable risk factors. IMU-based wearable assessment may serve as a clinically scalable alternative to force plate systems in VR-based and rehabilitation settings.

This cross-sectional study examined associations between lower limb strength, mobility, balance control, and fear of falling (FOF) among older adults attending community-based day-care centers. Seventy-three participants aged ≥65 years underwent assessments of knee extension strength (KES), Timed Up and Go (TUG), Functional Reach Test (FRT), and the Korean Falls Efficacy Scale-International (FES-I). Pearson correlation and simple linear regression analyses were performed. KES was negatively correlated with FES-I (r = −0.421, p < 0.01), TUG was positively correlated with FES-I (r = 0.394, p < 0.01), and FRT was negatively correlated with FES-I (r = −0.361, p < 0.01). Separate simple linear regression analyses likewise showed significant unadjusted associations of FES-I with KES, TUG, and FRT (all p < 0.01). These findings indicate that lower limb strength, mobility, and balance control are significantly associated with FOF. The results support the potential relevance of jointly assessing strength, mobility, balance control, and FOF in older adults attending day-care centers.

With the global population aging, managing fall risk among older adults has become a critical public health concern. Older adults attending adult daycare centers in South Korea are vulnerable due to poorer physical function and higher walking aid usage compared to community-dwelling counterparts. However, existing studies have primarily targeted community-dwelling older adults and rarely integrated both psychological and physical factors comprehensively. This study aimed to bridge these gaps and enhance fall prevention strategies. A study was conducted with 78 older adults (mean age = 83.24 ± 6.50 years; 82.1% female) from adult daycare centers. Physical assessments and structured interviews were conducted to measure strength, balance, and proprioception. Structured interviews collected demographic data and fear of falling. Significant differences in walking aid use, strength, balance, and proprioception were observed between participants with and without a history of falls (p < 0.05). Logistic regression analysis revealed that knee extension strength (OR = 0.893, 95% CI = 0.819–0.973) and longer timed up and go test times (OR = 1.098, 95% CI = 1.012–1.192) were significant predictors of falls. The combined model achieved an AUC of 0.83 (95% CI = 0.73–0.92), demonstrating good discriminative validity for fall prediction. Given the high fall risk in this population, targeted programs emphasizing lower-limb strengthening and mobility enhancement are essential to reduce fall incidence.