Background: Aging is characterized by reduced cognitive and physical functions; consequently, balance, falling and different activities of daily living get exaggerated reductions. Psychological status and falling are related bidirectionally. Depression is a common mental or mood disorder affecting more than 264 million people worldwide. It is a recurrent state of unhappiness and loss of interest. It is not simple as fluctuating mood because of short emotional response. To prevent falling, functional mobility and impairment of balance should be addressed. Many studies have shown that treadmill training is effective in improving the elderly person's ability to walk. The C-Mill treadmill afford a safe virtual reality environment and challenging obstacles and balance games, which increase of walking and improve everyday life performance. Aims: This study aims are to investigate the clinical effectiveness of virtual reality treadmill training on psychological status and balance in elderly population in addition to compare the significant differences between them. Materials \& Methods: Fifty-Eight elderly participants will be equally and randomly assigned to Group-I: Twenty-Nine participants will be trained on C-Mill treadmill for 50 minutes per session /2 session /week for six successive weeks. Group-II: Twenty-Nine participants will be trained on conventional treadmill for 50 minutes per session /2 session /week for six successive weeks. Psychological status and Depression will be evaluated by using the Depression Anxiety Stress Scale-2, Geriatric Depression Scale and the Beck Depression Inventory while the balance will be evaluated by using Berge balance scale and timed up and go test, whereas the functional capacity will be measured by using 6 MWT. Statistical analysis: The data will be statistically analysis by using (SPSS version 25). The Shapiro walk test will be used to examine the normality of data distribution. Independent t- test will be used to determine significant differences between two groups (between groups) and paired t- test to determine significant differences before and after intervention in both groups. Significance level at \<0.05 and confidence interval CI with 95%.
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Biodex Balance System (BBS; Biodex Inc., Shirley, NY)
Timeframe: 6 Weeks
Berg Balance Scale
Timeframe: 6 weeks
The Timed Up and Go Test (TUG)
Timeframe: 6 weeks
The six-minute walk test (6MWT)
Timeframe: 6 Weeks
The Beck Depression Inventory (BDI)
Timeframe: 6 Weeks
Geriatric Depression Scale - 15 (short form) (GDS-15)
Timeframe: 6 Weeks
Depression in Old Age Scale (DIA-S
Timeframe: 6 Weeks
Depression Anxiety Stress Scale-21 (DASS-21) Arabic version
Timeframe: 6 Weeks