Exergame-based Cognitive-Motor Training
Within this research line, we investigate cognitive-motor training across diverse populations and care settings, including individuals with stroke, Parkinson’s disease, mild cognitive impairment and dementia, geriatric syndromes, and affective disorders. Our work spans inpatient and outpatient rehabilitation, acute hospital settings, long-term care facilities and workplace. We aim to advance evidence-based, scalable, and personalised cognitive-motor interventions that can be translated effectively into real-world clinical and community settings.
Both cognitive and physical training have demonstrated substantial potential to improve cognitive performance and to slow functional decline across the lifespan and in clinical populations. In recent years, converging evidence has shown that combined cognitive and physical training constitutes one of the most effective non-pharmacological approaches for enhancing cognitive functioning and multiple parameters of motor performance across a wide range of patient groups. In particular, simultaneous cognitive-motor training where cognitive tasks are embedded directly within motor tasks appears to be especially effective, likely due to synergistic effects on neural plasticity and sensorimotor integration.
Exergames, defined as interactive digital games controlled through full-body movements, provide an ideal platform for delivering such integrated cognitive-motor training. From a technological perspective, exergames allow precise control and real-time adaptation of both cognitive and motor task demands. Moreover, they can be implemented in home-based telerehabilitation settings, thereby substantially increasing accessibility, scalability, and continuity of care. Importantly, the gamification elements inherent to exergames such as feedback and adaptive challenge have been shown to enhance motivation and long-term adherence, which are critical factors for maximizing training effects in both clinical and non-clinical populations.
Within this research line, we investigate cognitive-motor training across diverse populations and care settings, including individuals with stroke, Parkinson’s disease, mild cognitive impairment and dementia, geriatric syndromes, and affective disorders. Our work spans inpatient and outpatient rehabilitation, acute hospital settings, and long-term care facilities.
Key conceptual and methodological pillars include:
- Personalisation frameworks to adapt training difficulty and content to individual cognitive and motor capacities
- Progressive load schemes to ensure optimal challenge and long-term training progression
- Instrumented cognitive–motor assessments to sensitively quantify training-related changes and functional outcomes
- Assessment of effectiveness within pragmatic randomised controlled trials, evaluating real-world effectiveness, feasibility, and implementation across diverse clinical and care settings
- Experimental studies using multimodal data to quantify cognitive and motor load and to investigate underlying mechanisms during cognitive-motor exergame training
Specific Research Lines
Personalized, Home-Based Cognitive-Motor Training Using Exergames to Improve Cognitive and Motor Functioning in Frail Adults (S.M.A.R.T)
Amid growing demands for rehabilitation and shortages in the healthcare workforce, scalable and motivating interventions are urgently needed. Cognitive-motor training, particularly through exergames, offers a promising solution by integrating cognitive tasks with physical activity in an engaging and accessible home-based format.
Within the scope of the PROHEALTH project, the “S.M.A.R.T: Personalized, Home-Based Cognitive-Motor Training Using Exergames to Improve Cognitive and Motor Functioning in Frail Adults” trial will take place.
This international, multicenter, pragmatic, randomized controlled trial evaluates the effectiveness of personalized, home-based cognitive-motor training using exergames to improve cognitive and motor function in frail older adults.
Funding:
This project is funded by the European Partnership on Transforming Health and Care Systems (THCS) under the Horizon Europe Programme (Funding Agreement Number: FP-1516).
Principal Investigator:
Dr. Eleftheria Giannouli
Trial Sites:
- ETH Zurich/University Hospital Zurich (Zurich, Switzerland)
- Don Carlo Gnocchi Foundation (Milan, Italy)
- Alma Mater Europaea University/General Hospital Izola (Koper/Izola, Slovenia)
- Materia Agecare (Nicosia, Cyprus)
- Saint Vincent De Paul long term care facility (Luqa, Malta)
Prescription of cognitive-motor exergaming in residents of long-term care facilities with cognitive impairments (xGameCare)
This study aims to develop a conceptual framework for integrating exergame training into long-term care facilities, by selecting appropriate games based on motor and cognitive functioning profiles and determining the optimal level of support for older adults with neurocognitive disorders using machine learning.
xGameCare is a crossectional study in cooperation with following long-term care facilities:
- Begegnungs- und Pflegezentrum Holbeinhof (Basel)
- Stiftung Wohnen im Alter Hinwil
- Senevita Mühlibach (Buchs-Dällikon)
- Pflegezentrum im Spitz (Kloten)
- Alterszentrum Adlergarten (Winterthur)
- Adullam Pflegezentrum Basel
- Adullam Pflegezentrum Riehen
Funding:
This project is funded by the Alois & Auguste Foundation
Principal Investigator:
Dr. Eleftheria Giannouli