## 4 Discussion
In contrast to our study and training protocol, in other studies that employed the TUG assessment, significant improvements were observed [16]. The nature of our training was based on in-place balance exercises; thus, in future investigations, we could explore if more dynamic tasks would impact TUG and gait speed. There was a lack of significance in the results for both groups in the ABC assessment after testing. A longer timeframe might have afforded participants more opportunity to adapt and enhance their confidence levels. Furthermore, considering the participants' FoF prior to their involvement in this study, it is possible that some of the activity questions in the ABC assessment were outside their comfort zone due to their tendency to avoid such activities in their daily lives. For example, during the ABC assessments, it became apparent that when queried about their confidence levels in scenarios like walking outside on icy sidewalks without losing balance or becoming unsteady, most participants across both groups scored below 90%. This particular question appeared to pose significant challengesfor all participants, indicating a common area of concern or struggle regarding balance confidence among the study cohort. It is worth noting that while our study's findings are insightful, there is a scarcity of comparable research specifically focusing on balance confidence in older adults undergoing VR balance training, limiting direct comparisons with the existing literature. While one study demonstrated significant changes in fear of falling [17], our study did not yield similar findings, suggesting potential variations in intervention modalities or participant characteristics across studies. The FES scores provided valuable insights into the participants' perceived confidence in their ability to avoid falling during daily activities. The results for both groups in our study were insignificant after testing. This could be because of several factors. The variability in the participants' responses to the intervention, including the differences in physical fitness or cognitive abilities, may have influenced the absence of significant findings. Individuals with diverse baseline characteristics might have responded differently to the intervention, impacting the overall effectiveness observed in this study. Moreover, the responses to questions on the FES are subjective, which could have introduced variability in the participants' ratings. This subjectivity may have made it challenging to detect significant changes in FES scores, as perceptions of falls efficacy can vary widely among individuals. Addressing these factors is essential for interpreting this study's outcomes accurately and understanding the potential nuances underlying the lack of significance in the FES scores. The results for both groups were unchanged in the GDS assessment. A possible explanation for the lack of significant changes in the GDS assessment for both groups could be related to the nature of the training. The relatively short duration of the intervention (six weeks) might have been inadequate to induce noticeable changes in depressive symptoms, which often necessitate longer-term interventions or comprehensive mental health support. It is noteworthy and reassuring that the MMSE scores either maintained or increased across both the control and VR groups throughout the study period. In concordance with our study, where cognitive function improvements were measured using the MMSE, a separate study employing the Montreal Cognitive Assessment (MoCA) also reported significant changes in cognitive function. However, while our study revealed enhancements in the control group, contrasting findings from the MoCA study showed improvements primarily in the intervention group [18]. The MoCA is a cognitive assessment tool comprising 30 dichotomous items, where each correct answer is assigned a score of 1 point. Total scores on the MoCA range from 0 to 30, with higher scores indicative of better cognitive function.