Abstract
BACKGROUND: Falls are a major public safety issue, and improving the posture control ability of elderly people is highly important for preventing falls. Transcranial direct current stimulation (tDCS) and virtual reality-based balance training (VRBT) have been proven to be effective in improving postural stability and balance ability. The combination of these two methods may achieve better therapeutic effects. At present, there is a lack of research on the effects of tDCS combined with VRBT on postural stability and fall prevention in elderly individuals. METHODS: This 4-week single-blind, parallel-group randomized controlled trial will allocate 64 participants into the experimental or control group at a 1:1 ratio. The experimental group will undergo cerebellar tDCS combined with VRBT, whereas the control group will receive sham cerebellar tDCS paired with conventional exercise guidance. The outcome measures will be single leg stance with eyes closed, timed up and go, activities-specific balance confidence scale, modified falls efficacy scale, center of pressure measurements, and functional near-infrared spectroscopy. Assessments will be conducted at 0, 4, 8 and 12 weeks. DISCUSSION: Studies examining the effects of cerebellar tDCS combined with VRBT on postural stability and fall risk among older adults are lacking. This study aims to comprehensively assess the effects of cerebellar tDCS combined with VRBT on postural stability and balance function through clinical scales and objective instrumental assessments. The findings of this study are anticipated to enhance existing intervention strategies for fall prevention and inspire researchers to develop innovative treatment methods for older adults. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2300078998, Registered on 22 December 2023. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12906-025-05114-3.