## 4 Discussion

Table 4: The methodological quality assessment of the articles included in PEDro Scale. On the other hand, older adults focus on perceived health benefits and enjoyment without competition [59]. Similarly, gaming was perceived as a domain of young people. Besides, one should remember that our contemporary digital world was created by a generation of people, who are currently in their 50s. Recent studies have proved that older people draw substantial satisfaction and present good acceptance of virtual reality applications in the process of rehabilitation [42; 43; 44; 45; 47]. Moreover, virtual reality gives many opportunities to provide patient rehabilitation. It appears as a valuable rehabilitation tool regarding older people used in nursing homes, activity centers for the elderly, hospitals, and rehabilitation clinics, where qualified staff take care of the proper adoption and safety of interventions. The development of modern technology allows using VR rehabilitation in patients' homes successfully by means of telerehabilitation [39; 42; 47]. Telerehabilitation increases motivation to home exercises and continuity of rehabilitation after discharge from the hospital [60; 61]. This is especially important during the coronavirus pandemic where many people must stay at home and access to indirect rehabilitation is limited. Additionally, VR rehabilitation seems to be effective in reducing the cost and time of personal staff and the daily commute to the health center [42]. However, most previous implementations relied on telerehabilitation, hence there is only scarce evidence of virtual reality in this field. This review suggests that virtual reality training in rehabilitation appears to be promising complementation or even an alternative to traditional techniques of physiotherapy. However, several factors, which can limit its wider application among elderly people, should be considered. Seniors are frequently reluctant in unassisted habituation of remote rehabilitation, which could be partially explained by still cursory knowledge of modern technologies. Such a situation can be solved by the implementation of possibly simple systems, adopted to requirements and capabilities of elderly people, provided with capabilities to reversely monitor the activity of patients, proper execution of exercises, and supporting mechanisms of motivation. Regarding the quantitative outcomes of this review, the question of whether virtual reality offers greater effectiveness over traditional rehabilitation shifts towards a positive answer. The analysis of studies included in this review suggests that rehabilitation accommodating virtual reality, aimed at improving physical functions, including body balance, gait, and muscular strength, has some effectiveness. However, due to differences in applied technology and protocols, it is difficult to draw clear conclusions. These findings are in compliance with the research works of other authors. [PERSON] et al. [12] found exergames to improve balance and mobility in older adults with impairments without neurological diseases. Accommodation of those elements of motor activity in exergames in the rehabilitation resulted in an improvement of the body balance among elderly people [62]; however, the significant effect was related to the dynamic and perceived balance, but not to the static balance. Several studies show the benefits of tai-chi, yoga, and rehabilitation exercises programs regarding the decreased risk of falls among elderly people [63; 64; 65]. Although their effectiveness is undebatable, elderly patients currently need remote intervention to keep their mobility safe. Therefore, virtual reality rehabilitation and exergames begin playing a role in telerehabilitation, and as is proved in this review, they constitute an equally as effective form of intervention as traditional treatment in view of mobility and balance improvement, as well as reduction of the risk of falls.