Personalized Home-Based Cognitive-motor Training using Exergames in Community-Dwelling Older Adults: a Pragmatic Randomized Controlled Trial

In an aging population, exergames, a means for simultaneous cognitive-motor training, in a telerehabilitation setting show promise in overcoming treatment accessibility issues. This study aimed to investigate feasibility and effectiveness of a 10-week home-based stepping exergame training program (60 min/week) under remote supervision in older adults as compared to usual care. An international pragmatic randomized controlled trial (RCT) was conducted in Switzerland, Italy, and Cyprus, including 127 older adults aged [≥]60 years, who were randomly allocated to an intervention (n=62) or a control group (n=65). The adherence rate was 101.4%, the attrition rate 11.8%, and the average exergame enjoyment was rated with 69.1{+/-}18.7 out of 100 points. Significant interaction effects were observed in the Go/No-Go test (Q(1, 53.17)=5.44, p=.02) and significant differences between pre- and post-measurements in the intervention group were found when analyzing the 3 study sites separately (ABC (CY, r=.38, p=.05), Go/No-Go (IT, r=3.0, p=.03), Flexi (CH, r=.67, p=.007), TUG (CH, r=.52, p=.04; CY=r.46, p=.02)). Thus, the step-based exergame intervention appeared to be feasible and safe for older adults, supporting its application in out-patient rehabilitation settings. Additionally, it was effective in improving response inhibition. However, to enhance physical functions, especially in non-acute patients, it may be necessary to increase the training load. Trial Registration: ClinicalTrials.gov NCT05751551