Frailty syndrome is a state of reduced physiological reserve that leaves older people more vulnerable to illness and other stressors. It is associated with an increased risk of functional decline, falls and loss of independence.

The condition develops gradually, making the earlier “pre-frailty” stage an important target for intervention. At this point, signs of physical weakness are already visible, but full frailty has not yet developed.

Regular physical activity, including exercises that improve muscle strength, balance and flexibility, is a key way of maintaining fitness with age. However, sticking to an exercise routine over the long term can be difficult.

One possible solution is exergaming – interactive games in which participants control what happens on screen through their body movements. Instead of simply repeating exercises, they complete tasks within a game and receive immediate feedback on their performance.

The Wroclaw Medical University study used the ActivLife rehabilitation platform and a Kinect sensor to track participants’ movements. The participants exercised while standing and controlled therapeutic games with their bodies. A harness with a seat provided additional stability.

The study involved 111 people aged 65 to 89. Researchers assessed whether they were physically fit, pre-frail or had full frailty syndrome.

“After six weeks of training, the average score on the frailty scale improved slightly, yet statistically significantly. Positive changes were also observed in specific areas of physical fitness,” the university said in a press release.

The greatest improvements were seen among participants in the pre-frailty group, who improved their scores for muscle strength, gait, endurance and balance. The risk of falls, assessed using the Tinetti test, also decreased among both pre-frail and frail participants.

“The research demonstrated that exergaming not only has a beneficial effect on functional fitness parameters but also significantly improves cognitive functions, including memory, mood, and the older adults' quality of life,” said Maria Bujnowska-Fedak, PhD, first author of the study and a researcher at the Department of Family Medicine at Wroclaw Medical University.

Exergaming also appeared to be particularly well tolerated by the pre-frailty group. These participants were more willing to continue exercising and were significantly less likely to drop out because of health or logistical problems, such as needing help from family members to attend sessions.

The findings suggest that the period between full physical fitness and frailty may be an important window for intervention, when appropriately tailored physical activity could help maintain physical function.

The technology does not change the basic principle: physical movement remains essential. But turning exercises into interactive tasks can make them more engaging by providing feedback and allowing participants to see the results of their movements.

This could be particularly useful when barriers to regular exercise include boredom, declining motivation or fear of losing balance and being injured.

However, the researchers caution that the study does not show that exergaming is more effective than conventional exercise.

“Based on this study, we cannot yet claim that training with ActivLife is more effective than traditional exercises,” Bujnowska-Fedak said.

The study did not include a formal control group following a different exercise programme or not using the platform. The researchers therefore cannot determine how much of the improvement was specifically attributable to exergaming. They did, however, observe improvements in most of the functional measures assessed, as well as in cognitive function and quality of life, after six weeks of training.

The findings raise further questions about how technology can be used to encourage physical activity among older adults, how long the benefits last and which groups are most likely to benefit.

“In an ageing society, we need not only effective but also attractive and engaging ways to help older adults maintain their physical fitness,” Bujnowska-Fedak said.

She said combining physical activity with gaming could offer more than rehabilitation, potentially creating opportunities for social interaction and spending time together.

The Wrocław study reflects growing interest in approaches that combine physical movement with activities involving memory, attention and coordination. Early intervention may be particularly important in preventing physical decline from progressing to loss of mobility and independence. (PAP)

PAP - Science in Poland

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