Search Results (265)

Background/Objectives: Sarcopenia is an age-related decline in muscle mass and strength, reducing mobility and functional independence and increasing the risk of falls. Non-pharmacological interventions remain the most effective strategies to prevent or delay its progression, with exercise recognized as the primary approach. Virtual reality (VR)-based training has recently emerged as a promising tool to promote physical activity; however, its application among the oldest-old individuals remains underexplored. This is a randomized controlled pilot study to evaluate the effects of VR-based intervention using the game “Beat Saber” on muscle strength and selected physical performance indicators related to sarcopenia risk in older adults. Methods: Thirty-eight residents (mean age: 87.2) of a long-term care facility were randomly assigned to either a VR group or a control group. The VR group participated in 12 supervised VR-based training sessions of 20 min per session, three times per week for four weeks. Handgrip strength, the arm curl test, 30-s chair stand, a 2-min step-in-place test, and an 8-foot up-and-go test were assessed before and after the intervention. Results: Linear mixed-model analyses revealed significant group-by-time interactions for upper- and lower-limb strength (handgrip, arm curl, chair stand; p < 0.05), favoring the VR group. Agility and endurance (8-foot up-and-go, 2-min step-in-place) showed no significant interactions. In the VR group, the 30-s chair stand performance correlated positively with the arm curl and the 2-min step-in-place tests results, while handgrip strength correlated with the arm curl performance. In the control group, the 30-s chair stand test results correlated strongly with the 8-foot up-and-go and 2-min step-in-place tests, but no significant correlations were found for handgrip strength. Conclusions: The findings indicate short-term functional benefits of VR exercise among the oldest-old adults. VR-based training appears to be an effective and well-tolerated method to enhance physical performance in individuals aged 80 and older and may represent a valuable strategy for improving functional performance indicators associated with sarcopenia risk in adults aged 80 years and older. Full article

Background/Objectives: Children with Down Syndrome (DS) exhibit difficulties in maintaining balance and coordination in addition to limitations in functional mobility. The Cognitive–Motor Dual-Task Exercise Program (CMDT) has shown the ability to improve balance and functional mobility. This study aimed to compare the effect of CMDT versus exergaming on the balance and functional mobility of children with Down Syndrome aged 8–14 years. Methods: A randomized comparative trial was conducted, dividing participants’ children with DS into two intervention groups: CMDT group and exergaming group. Participants were recruited using convenience sampling methods from the Voice of Down Syndrome Association and the Down Syndrome Charitable Association in Riyadh, Saudi Arabia. Both interventions were implemented over a period of six weeks. Outcome measures included the Timed Up and Go (TUG), Four Square Step Test (FSST), and Pediatric Balance Scale (PBS). Results: A total of 23 children with DS participated in the study. A mixed repeated measures ANCOVA shows a significant effect of time across the two groups (p < 0.001) for TUG, FSST, and PBS, indicating improvements in balance and functional mobility. There were no significant differences between the two group interventions. Conclusions: CMDT and exergaming were equally effective in improving balance and functional mobility in children with DS. Trial Registration: Clinicaltrials.gov with ID NCT06146907. Full article

This study aimed to analyze the relationship between moderate to vigorous physical activity (MVPA) and dimensions of emotional intelligence (EI) in Spanish adolescents aged 12 to 16 years, controlling for variables such as gender, age, and body mass index (BMI). A total of 171 students (92 boys; mean age = 13.73 ± 1.34 years) were analyzed, measuring MVPA using the PACE + Adolescent PA Measure and EI using the TEIQue-SF, which includes well-being, self-control, emotionality, and sociability. Physically active adolescents (>4 days/week with ≥60 min of MVPA) showed significantly higher scores in well-being and sociability compared to their inactive peers (p < 0.05), with no differences in emotionality or self-control. Regression analyses confirmed that weekly MVPA was positively associated with well-being and sociability, independent of gender, age, and BMI. These findings suggest that regular MVPA is associated with emotional balance and social competence in adolescents, highlighting the importance of integrating structured PA programs in and out of school. Furthermore, the study underscores the potential of digital and gamified interventions, such as exergames and mobile apps, as promising tools to support the emotional and social correlates of PA by promoting motivation, social interaction, and emotional regulation, offering innovative approaches to support adolescents’ social-emotional development. Full article

Background: Polyneuropathies impair sensory, motor, and autonomic functions, affecting functional status, cognition, and quality of life. This pilot study investigated the effects of exergame with biofeedback training (Riablo system) versus standard rehabilitation on these outcomes in outpatients with mixed-etiology polyneuropathies. Methods: Seventeen outpatients were assigned to standard rehabilitation (Group 1, n = 9) or combined standard plus Riablo training (Group 2, n = 8) over three weeks. Functional status, pain, cognition, quality of life, and psychological well-being were assessed pre- and post-intervention, with a 6-month follow-up. Outcome measures included the Morse Fall Scale, Visual Analogue Scales for pain and autonomy, Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Stroop Test, Frontal Assessment Battery (FAB), Verbal fluency test, the Short-Form Health Survey-12 (SF-12), and the Patient Health Questionnaire-4 (PHQ-4). Longitudinal changes and between-group differences were analyzed using nonparametric statistics. Results: Both groups showed significant improvements in functional status and global cognition at post-intervention. Group 2 demonstrated greater improvements in executive functions and attention, with significant reductions in pain and fall risk. At 6-month follow-up, Group 2 maintained post-intervention gains in QoL and psychological outcomes, while Group 1 showed a significant decline. Technology evaluation revealed high usability and positive psychosocial impact in Group 2, with strong correlations between executive function improvements and device usability. Conclusions: Integrating exergames with biofeedback into standard rehabilitation may provide broader and longer-lasting benefits for polyneuropathy patients. These findings support further large-scale trials to confirm efficacy and optimize technology-assisted rehabilitation protocols. Full article

Virtual reality (VR) provides immersive, interactive environments that can be carefully controlled for shaping movement during rehabilitation. Game mechanics such as object velocity and trajectory are often manipulated to increase engagement, but their effects on motor control strategies relevant for therapy remain unclear. This study examined how ball velocity and parabolic vertex height influence interception performance and movement patterns in VR dodgeball. Twenty-one healthy adults (10 males and 11 females; mean age of 24 ± 8 years) played virtual dodgeball in two visual environments. In the first visual environment, ‘Cannon’ dodgeball, the vertex heights were 4 m and 8 m. In the second visual condition, ‘Day’ dodgeball, the velocities were set to 40 m/s and 60 m/s. The outcomes included interception success, time to intercept, and joint kinematics (ankle, knee, hip, and lumbar spine flexion angles). Both higher velocity and vertex height reduced interception success (p < 0.001* and p < 0.001* respectively), indicating increased difficulty. However, only vertex height significantly influenced joint flexion patterns during gameplay (ankle p < 0.001*, knee p < 0.001*, hip p = 0.019*, and lumbar p = 0.026*). These results suggest that while both vertex height and velocity modulates task challenge, trajectory and vertex height more effectively shape movement strategies. Tailoring the vertex height of launched virtual objects in VR games may therefore optimize therapeutic engagement and promote desired motor behaviors. Full article

This paper introduces a lightweight and accessible interaction system for treadmill-based video games, relying solely on facial tracking via a smartphone’s front camera. The system enables real-time estimation of running cadence and directional control through natural head movements, providing an immersive and hands-free gaming experience. A key contribution is the implementation of a FFT-based cadence estimation method that achieves accuracy errors below 5% using only 128 frames, enabling real-time feedback. Preliminary evaluations with 11 participants demonstrate that the FFT-based approach outperforms traditional peak detection in both accuracy and robustness across multiple running speeds. These results position the system as a practical, efficient, and scalable solution for fitness-oriented human–computer interaction, with promising implications for digital health and exergaming. Full article

Strokes are one of the leading causes of adult disability. There are a wide range of therapies available in stroke care for people with stroke, but there can be wide variations in the effectiveness of these therapies, so it is essential to review and compare them from time to time. In our study, we measured and compared the effectiveness of three high-intensity therapies: an agility training program without technological tools, a virtual reality exergaming training program with a low-cost device, and a high-cost robotic training program using augmented and virtual reality. All three therapies helped to improve the patients’ functional abilities, balance, and gait. On average, endurance increased by 104–177%, balance scores by 36–53%, and gait speed by 5–10% depending on the intervention. Robotic therapy and exergaming facilitate greater improvements in walking speed, step length, and balance-related gait metrics. These findings have profound implications for stroke rehabilitation, advocating for the prioritization of robotic and exergaming interventions over conventional functional therapies, like agility training. Given the limited sample size, the results should be interpreted as preliminary, highlighting the need for further studies with larger cohorts. Full article

Background: The consequences of video games have been a hotly debated topic in recent decades. While the media tend to focus on and publicize the alleged negative effects of video games, the empirical literature continues to research to illustrate the benefits of playing certain types of video games. Objective: With this paper we want to highlight the utility of virtual reality technology for improving reaction time. Methods: A total of 32 Romanian students, aged 17 to 19, were recruited from a high school in Cluj-Napoca. The experimental group took part in a virtual realitybased intervention, while the control group only attended the standard physical education classes included in the school curriculum. To assess simple and complex reaction time, we used the Deary–Liewald reaction time test. Descriptive statistics and t-tests were used to compare participant characteristics between the two groups. The significance level for all statistical analyses was set at p < 0.05. Results: Subjects in the experimental group (M = 382.75, SD = 21.30) showed statistically significant improvements (p < 0.05) at final testing compared to the control group (M = 396.88, SD: 25.37) in the complex reaction time Deary–Liewald test (t = −1.70, p = 0.04, d = −0.60). Conclusions: As technology continues to advance, new possibilities have emerged for reducing reaction time through cutting-edge tools like virtual reality. Our study shows that a well-structured 6-month virtual reality program can improve simple and complex reaction time in high school students. Full article

Background: The increasing prevalence of Alzheimer’s disease and related dementia are a global problem generating social and economic burdens. Cognitive Stimulation Therapy is a non-pharmaceutical aid for people with dementia. In this context, digital and virtual reality approaches are underinvestigated, especially with respect to explorable open-world environments. The pilot aims to evaluate the feasibility, acceptability, and safety of an immersive, open-world virtual reality application for people with dementia. Methods: We conducted a single-arm, unrandomised study with three male participants diagnosed with dementia. The intervention consisted of a single virtual reality session in an immersive, open-world environment, where participants were able to explore freely while seated, using arm movements and head control to navigate an avatar. Results: All three participants finished the session without the occurrence of adverse events. The mean session time was 28 min, and the average walking distance was 0.9 km, with 1210 steps on average. Questionnaire results indicate acceptance and a positive attitude toward the usability of the intervention. We measured minimal changes in mood. Anecdotal reports indicate high immersion and autobiographical stimulation. We detected no adverse events or occurrences of cybersickness. Conclusions: Immersive, open-world virtual reality proved to be feasible, safe, and well accepted by the participants. The combination of state-of-the-art hardware and exploration-based software design enabled cognitive and motoric stimulation. The results indicate strong feasibility for the application of exploratory three dimensional virtual reality applications and further support the execution of controlled trials to assess therapeutic outcomes. Full article

The rehabilitation of burn patients is essential and is intrinsically linked to conventional rehabilitation; the motivational challenges faced by burn patients in maintaining engagement with these rehabilitation programs are well known. It is understood that the use of other resources, particularly technological ones, associated with conventional rehabilitation could overcome these constraints and thereby optimize the rehabilitation program and health outcomes. The objective of this study is to synthesize the available evidence on the use of exergames in rehabilitation programs for burn patients. This systematic review was developed following the guidelines of the Joanna Briggs Institute (JBI). The search was conducted in the following databases: Medline^®, CINAHL^®, Sports Discus^®, Cochrane^®, and Scopus^® during May 2025. The PRISMA Checklist Model was used to organize the information from the selected studies. Seven RCTs were included, involving a total of 236 participants. Outcomes related to the use of exergames in the rehabilitation of burn patients were identified, including increased range of motion, functionality, strength, speed of movement, improved balance, reduced fear and pain, and satisfaction with the technological resource used. It is believed that the results of this review, which confirmed the advantage of using exergames, such as Nintendo Wii, PlayStation, Xbox Kinect, or Wii Fit, to optimize the functionality of burn patients, can support clinical decision-making and encourage the integration of exergames to improve rehabilitation programs for burn patients. Full article

Most existing virtual reality exergames rely on generic VR devices, which can limit the physical exertion in VR-based exercises. In contrast, physical props can enhance exercise intensity, yet their impact on users’ performance and experience remains understudied, particularly in skill-based tasks. Meanwhile, physical props offer richer tactile and kinesthetic feedback, which, combined with the visual effects of head-mounted displays, presents a potential solution for improving user experience in VR. To explore this, this study developed a sensor-driven experimental framework for investigating high-skill VR tasks. By integrating vision sensors with standard VR devices, we constructed a VR archery system that enables objective quantification of motor performance. Leveraging the sensor-driven framework, we investigate the effects of physical props and physics-associated visual feedback on players’ performance and experience in VR tasks through an experiment involving 33 participants. By objectively quantifying performance, we reveal a dual-pathway mechanism: physical props significantly increased hand tremor, which in turn impaired aiming accuracy, but this negative effect was effectively moderated by time and physics-associated visual feedback that enabled real-time sensorimotor compensation. While complex physical props reduced task performance, they substantially enhanced enjoyment and presence, particularly demonstrating a synergistic effect on users’ flow experience when combined with physics-associated visual feedback. These findings elucidate the complex interplay between physical prop interfaces and visual feedback in high-skill VR tasks, providing valuable insights for designing VR experiences which balance performance requirements and engagement enhancement. Full article

Background: A systematic exercise programme using low-cost virtual reality devices can help maintain and improve postural control in older adults. This study aimed to evaluate the effectiveness of two different exergame programme modalities: telerehabilitation (TR) and face-to-face (FF). Methods: A randomised controlled trial was conducted with 16 participants aged 65 to 75. Both groups completed an 18-session exergame intervention over six weeks, with the TR group (exposure) receiving remote sessions and the FF group having in-person (control) sessions with a physiotherapist. Assessments were carried out at baseline, at weeks 2, 4, and 6, with two follow-ups at weeks 8 and 10. Centre of Pressure (CoP) measures in tasks: eyes open (EO), eyes closed (EC), medial-lateral (ML) weight-shifting exergame and anterior–posterior (AP) weight-shifting exergame, and clinical tests were used to evaluate postural control. Results: TR and FF significantly reduced the CoP_Sway-area during EC (TR: p < 0.01; FF: p = 0.01) at 6 weeks and only FF demonstrated a significant reduction during EO (p < 0.01). Post hoc analysis revealed that TR maintained a significant reduction in the secondary outcomes of the CoP at 8 and 10 weeks, while FF did not sustain these effects over time. Between-group comparisons revealed a greater effect of TR in CoP_Sway-area, and secondary outcomes during the AP weight-shifting task (p < 0.01) at 6 weeks, whereas the FF had a greater effect in secondary CoP outcomes during the ML weight-shifting task (p < 0.01) at 6 weeks. Conclusion: Both six-week exergame programmes were equally effective at improving postural control. Given the observed specific effects of TR and FF delivery, physiotherapists can consider either modality to suit individual needs and access, or as a complementary approach to maintain and improve postural control in older adults. Full article

Background: Exergame applications were introduced recently for orthopedic rehabilitation. This study aimed to evaluate the effectiveness of a 6-week home-based quadriceps exercise with mobile exergaming for treatment of primary knee osteoarthritis (KOA). Methods: A prospective randomized controlled trial was conducted in 56 primary KOA patients. All patients were allocated into two groups (n = 28 each group). Intervention group received the 6-week mobile exergaming program using a smartphone exercise game with a wearable wireless motion sensor. Control group received a standard 6-week exercise program. Outcomes were active knee arc of motion, quadriceps muscle power, visual analog scale score, timed “Up and Go” (TUG) test, and Knee Injury and Osteoarthritis Outcome Score (KOOS) at a 6-week follow-up. Results: At 6-week post-exercise, the intervention group significantly improved quadriceps power, arc of motion, VAS score at rest and on motion, TUG test, and KOOS-symptom domain compared to the control group (p < 0.05 all). No device- or exercise-related complications were found. Conclusions: Mobile exergaming with visual feedback control using a wearable wireless sensor significantly improves KOA outcomes compared to standard home-based exercise as early as 6 weeks post-application. Full article

Background and Objectives: This systematic review aimed to analyze published peer-reviewed studies on the effects of exergaming (EXG) compared to conventional physical exercise (CPE) interventions on health status in older people with Parkinson’s disease (PD) according to training dose. Materials and Methods: Using six generic databases: PubMed, EBSCO, Medline, CINAHL Complete, Scopus, and Web of Science, the PRISMA, TESTEX, RoB 2, and GRADE tools assessed methodological quality and certainty. The protocol was registered in PROSPERO (code: CRD42024575969). Results: Out of 805 records, 14 randomized controlled trials with 406 older people with PD were included. Seven overall meta-analyses showed significant improvements (p < 0.01) in favor of EXG in the Berg Balance Scale (BBS, ES = 0.90), Dynamic Gait Index (DGI, ES = 0.77) and quality of life questionnaire (PDQ-39, ES = 0.52), without significant improvements (p > 0.05) in the Unified PD Rating Scale, Montreal Cognitive Assessment, Timed Up-and-Go and Falls Efficacy Scale-International. Four subgroup meta-analyses, according to training schedules, showed that there were significant improvements (p < 0.05) in BBS in favor of EXG at >8 weeks of training (ES = 1.38), >3 weeks per week (ES = 1.18), <45 min duration (ES = 0.99), and with >20 total sessions (ES = 1.31). Both weeks and total sessions were predictors of BBS performance in EXG interventions in older people with PD. Conclusions: EXG is an innovative alternative to improve the health status in balance, gait, and quality of life variables in older people with PD, with a high potential for clinical practice in this population. The training dose is a determinant (weeks and total sessions) that varies the response to intervention in the BBS. Full article

The continuous growth of the older adult population demands an urgent need to provide innovative ways to stimulate physical activity and promote functional health. This study presents FitFest, a custom-made virtual reality (VR) designed to deliver a complete physical activity (PA) session for older adults. A pilot study involving seven older adults (67.0 ± 3.8 years) was conducted, comprising 18 user testing sessions of two VR exergames: Wine Fest and Flower Fest. PA intensity and heart rate (HR) were measured. The rate of perceived exertion (RPE) and the participants’ rating of the system’s usability were also registered. Overall, sessions involved mostly sedentary behavior (56.5 ± 20.4%) and light PA (42.1 ± 19.3%), with an average of 436.7 steps and 92.1 bpm. Wine Fest elicited less sedentary behavior (53.6 ± 22.1% vs. 62.8 ± 16.2%), higher light PA intensity (44.7 ± 20.4% vs. 36.4 ± 17.0%), and a higher step count (503.0 ± 345.4 vs. 291.0 ± 143.1) than the Flower Fest, although not significantly. Tasks requiring cardiovascular effort and strength were rated as more physically demanding. Most participants found the system user-friendly and showed interest in continued use, though technical support was essential due to limited familiarity with VR. The findings suggest FitFest has potential to promote light PA in older adults, highlighting the importance of usability and support in tech-based interventions. Full article