Evaluation of exergames intervention on the functional abilities of 65+ older adults with frailty and pre-frailty syndrome

Abstract Background. Frailty is an increasingly diagnosed condition of increased susceptibility of older people to deterioration of their overall health, functional capacity and independence. According to the latest scientific reports, frailty syndrome therapy should be comprehensive, and the first-line treatment should include a multi-component physical activity program. The aim of the study was to evaluate the impact of exercise games intervention (exergames) on the functional abilities of 65+ older adults with frailty and pre-frailty syndrome. Methods. The study was conducted in 111 patients (31 men, 80 women) aged 65–89 who volunteered for an exergames rehabilitation program. The diagnosis of frailty was based on the Linda Fried criteria. A 6-week standardized training program was carried out with the use of the game rehabilitation platform with Kinect sensor. The subjects exercised under the supervision of an instructor for at least 30 minutes twice a week. The comprehensive geriatric assessment was conducted before and after the intervention. Results. The study showed significant improvement in the frailty status and scores with Kinect-based exergaming for the frail older adults. The exergames intervention elicited a modest but statistically significant reduction in overall frailty and the mean Fried frailty score decreased from 1.52 ± 1.38 before intervention to 1.39 ± 1.27 after intervention (W=72.5, p = 0.008, power=0.79). The most pronounced functional gains—including significant improvements in muscle strength (arm curl test repetitions: p = 0.023, power = 0.65, 30-second chair stand performance: p = 0.002, power = 0.90), gait speed and endurance (2-Minute Step-in-Place test: p < 0.001, power = 0.98) and balance (8-Foot Up-and-Go test: p = 0.001, power = 0.95) —were observed among pre-frail individuals. A positive effect of intervention on reducing the risk of falls was found in both pre-frail (p=0.013, power=0.77) and frail older adults (p=0.008, power=0.85). Conclusions. Exergaming exerts positive effect on the functional abilities of frail and pre-frail older adults and could be considered in clinical settings to address frailty. The findings highlight the importance of initiating physical interventions as early as possible, ideally before the onset of full frailty, to maximize adherence and therapeutic effect of the intervention. Trial registration. This study has been registered in the ClinicalTrials.gov database and has been assigned the ID NCT07036224.