Falls are common in older adults due to aging-related problems with walking (gait) and balance. Virtual Reality (VR) is a new technology that creates interactive video game-like exercises. This study aims to see if VR training works better than traditional physical therapy exercises for improving walking and balance in adults aged 60 years and older who live in the community. Half of the 36 participants will use a VR headset to play movement games, while the other half will do standard exercises like tandem walking. We will measure their walking speed, step length, and balance before and after 4-6 weeks of training.

This is a single-center, parallel-group, randomized controlled trial conducted at Madinah Teaching Hospital, Faisalabad. Participants (N=36) are community-dwelling adults aged >=60 years, ambulatory with or without aids, with no severe cognitive impairment or uncontrolled cardiovascular disease. After baseline assessment (including Image-based modeling using OpenPose software, 6-Meter Walk Test, and Berg Balance Scale), participants are randomly allocated to Group A (VR) or Group B (Control). The VR group uses a head-mounted display (Oculus/Meta type) and a computer screen displaying a 3D world for gait and balance tasks. The control group performs conventional rehabilitation including tandem walking, weight shifts, and postural control exercises on different surfaces. Both interventions are delivered 30-45 minutes per session, 2-3 times per week for 4-6 weeks. The primary outcome is gait (speed and kinematics). The secondary outcome is balance (BBS). Statistical analysis will be performed using IBM SPSS v22.

Inclusion Criteria:

• Community dwelling adults aged >= 60 years.
• Able to follow instructions.
• Able to walk with or without an assistive device.
• Vital signs stable.
• No severe cognitive impairment.

Exclusion Criteria:

• Severe visual or vestibular disorders.
• Uncontrolled cardiovascular disease.
• Severe musculoskeletal impairments.
• Recent major surgery or spinal surgery.