The ActivLife exergame rehabilitation program improves functional abilities in pre-frail and frail older adults: a clinical trial

Frailty is a multidimensional vulnerability state characterized by diminished physiological reserve and heightened sensitivity to stressors, placing older adults at increased risk of decline in overall health, functional abilities, and independence. Recent research emphasizes that frailty syndrome therapy should be comprehensive, with multicomponent physical activity as first-line treatment. This study evaluated the effects of exercise-based video games (exergames) rehabilitation program on functional abilities in 111 older adults (aged 65–89, M = 75.15, SD = 5.86; females n = 80, 72.07%) at a primary care center in southwest Poland, categorized as frail, pre-frail, or robust according to the Fried frailty criteria. Participants completed a 6-week standardized training program using a Kinect-based ‘ActivLife’ rehabilitation platform. The intervention led to a modest but statistically significant reduction in overall frailty, with the mean Fried frailty score decreasing from 1.52 ± 1.38 to 1.39 ± 1.27 (p = 0.008). Notable improvements were observed across the frailty subgroups following the training program, with the pre-frailty subgroup showing the greatest benefits regarding muscle strength (Arm Curl Test: p = 0.023; 30-Second Chair Stand: p = 0.002), gait speed and endurance (2-Minute Step-in-Place: p < 0.001), and balance (8-Foot Up-and-Go: p = 0.001). Risk of falls, assessed by the Tinetti test, was significantly reduced in both frail (p = 0.008) and pre-frail (p = 0.013) participants. Overall, exergaming positively impacted frailty status and physical function, supporting the early use exergame interventions to enhance adherence and therapeutic outcomes in older adults. Trial registration: This study has been registered in the ClinicalTrials.gov database and has been assigned the ID NCT07036224.