This prospective, single-arm feasibility study aims to evaluate the feasibility of a 12-week immersive exergame program using an interactive wall in older adults living in nursing homes (EHPAD) or long-term care units (USLD). Exergames are interactive digital games that integrate physical activity into gameplay, requiring users to perform whole-body movements to achieve game objectives while promoting exercise and energy expenditure. Participants will complete two supervised 40-minute sessions per week over 12 weeks. The primary objective is to assess feasibility through acceptability, adherence, and safety. Secondary objectives include evaluating implementation fidelity, preliminary effects on cognition, quality of life and well-being, and characterizing the physical and cognitive demands of the interactive games. Data will include usability and enjoyment questionnaires, attendance, adverse events, heart rate monitoring, cognitive performance (MoCA), quality of life (EQ-5D-5L), psychological well-being (Mini-GDS and QUALIDEM), and game performance. The results will inform the design of a future larger-scale effectiveness trial of immersive exergaming in institutionalized older adults.
Adults aged 65 years or older.
Resident of a nursing home (EHPAD) or long-term care unit (USLD).
Affiliated with the French national health insurance system.
Able to participate in low-to-moderate intensity adapted physical activity.
Medical contraindication to adapted physical activity.
Severe neurological or psychiatric disorder incompatible with safe participation.
Severe uncorrected visual, auditory or sensory impairment preventing interaction with the immersive wall.
Inability to understand instructions despite adaptation.
Single group
Immersive Interactive Wall Exergame Program
BehavioralParticipants will complete a supervised 12-week adapted physical activity program delivered through an immersive interactive wall (NeoXperience). Sessions will be performed twice weekly in groups of four participants and will last approximately 40 minutes, including a warm-up. Games are adapted to participants' physical and cognitive abilities and combine cognitive stimulation with whole-body movements. Heart rate, physical activity intensity, game performance, perceived exertion, fatigue and enjoyment will be monitored throughout the intervention.
Acceptability of the Mur'Aventure program assessed using the French System Usability Scale (F-SUS)
Acceptability will be assessed using the French version of the System Usability Scale (F-SUS), a validated 10-item questionnaire evaluating the perceived usability of a system. Total scores range from 0 to 100, with higher scores indicating greater usability and acceptability. Acceptability will be considered achieved if at least 70% of participants obtain a score \>70. Feasibility will be considered successful if all three predefined feasibility criteria (acceptability, adherence, and safety) are met. If one or more criteria are not met, the feasibility of the intervention will be interpreted in light of the unmet criterion(ia), and potential modifications to the intervention or study procedures will be discussed.
Program adherence : predefined feasibility criteria
Adherence will be evaluated by the completion rate, defined as the proportion of participants completing the entire 12-week intervention. Adherence will be considered good if the completion rate is ≥70%. Attendance rate and dropout rate will also be reported descriptively.
Safety of the Mur'Aventure program : predefined feasibility criteria
Safety will be assessed by recording the occurrence of serious adverse events (SAEs) throughout the intervention. Safety will be considered acceptable if no serious adverse events related to the intervention occur. Additional descriptive safety measures include perceived fatigue, perceived exertion, and heart rate responses recorded during each intervention session.
Intervention fidelity
To describe the fidelity of program implementation, assessed by the proportion of intervention sessions delivered according to the planned protocol Intervention fidelity will be assessed as the percentage of planned exercise sessions completed according to the study protocol. Higher percentages indicate greater fidelity to the intervention.
Change in Montreal Cognitive Assessment (MoCA) total score
To explore the preliminary effects of the program on cognitive function, assessed by the change in the Montreal Cognitive Assessment (MoCA) total score Cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA), a validated 30-point cognitive screening instrument evaluating memory, executive function, attention, language, visuospatial abilities, abstraction, and orientation. Scores range from 0 to 30, with higher scores indicating better cognitive function. The outcome is the change in total score between baseline and the end of the intervention.
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