About this trial

This study aims to explore a new, engaging approach to support older adults with psychosis-an umbrella term that includes conditions such as schizophrenia, late-onset schizophrenia, and psychotic symptoms resulting from other medical or psychiatric conditions like dementia, delirium, mood disorders, or delusional disorder. As the aging population grows, a rising number of older adults are living with schizophrenia and related disorders, facing not only psychiatric symptoms like hallucinations and delusions but also cognitive impairments, reduced mobility, social isolation, and physical decline. These combined challenges significantly affect daily functioning and quality of life. At present, there are no psychosis treatment guidelines specifically tailored for people aged 60 and above, though general principles from younger populations can be adapted. Evidence suggests that integrating physical and cognitive rehabilitation into standard psychiatric care may enhance treatment outcomes for this age group. One promising method is the use of "exergames"-interactive video games that combine physical movement with cognitive challenges. These games typically require users to perform body movements such as stepping or shifting weight in response to visual and auditory cues, thereby training functions like attention, memory, balance, coordination, and executive function. Exergames offer a playful and stimulating alternative to conventional exercises and are often better accepted by older patients because of their engaging and motivating nature. Previous studies have shown that older adults with schizophrenia not only tolerate these games well but may also experience improvements in mood, cognitive function, and physical activity levels. However, past research has been limited by small sample sizes, lack of control groups, and short intervention periods. This current study, conducted at the Psychiatric University Hospital in Basel, Switzerland, seeks to examine the feasibility and benefits of using an exergame system called Dividat Senso in a more structured and controlled setting. After being screened for eligibility, participants will be randomly assigned to one of two groups. The intervention group will receive usual psychiatric inpatient care, extended with exergame-based motor-cognitive training using the Dividat Senso platform. This device requires full-body interaction, targeting both cognitive functions (such as attention, memory, and executive skills) and physical abilities (such as balance and coordination). The control group will also receive usual care, but instead of exergames, they will participate in traditional strength and balance exercises taken from the Otago falls prevention program. Both groups will train three times a week for four weeks, with each session lasting approximately 20 minutes-totaling 12 sessions. All participants will complete assessments before the intervention begins (T1) and again after four weeks (T2), to measure changes in physical activity, mental well-being, and cognitive performance. By using a structured program and comparing two active interventions, this study aims to generate more robust and generalizable findings on how technology-based, body-and-brain training can support the mental and physical health of older adults with psychosis. If proven feasible and effective, exergame-based rehabilitation could become a valuable and enjoyable addition to psychiatric treatment programs for elderly patients.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Diagnosed psychotic disorders

Able to provide a signed informed consent

Age ≥ 55 years

MoCA ≥ 20

Disqualifiers

Insufficient knowledge of the German language to understand the instructions, the games, and the assessments

Mobility, cognitive, sensory and/or psychiatric limitations or comorbidities that impair the ability to play the exergames and/or conduct the pre-/post assessments

Trial design

Design model

Parallel

Treatments tested in this trial

Dividat Senso
Device
Participants in the intervention group will receive cognitive-motor training using the Dividat Senso exergame platform, which records body movements and adapts game difficulty in real time. The training targets cognitive and physical functions through interactive games involving steps and weight shifts. It follows a progressive structure, with difficulty increasing over time, and can be personalized by investigators using the Dividat Manager.
OTAGO Falls-prevention program
Other intervention
The OTAGO Falls Prevention Program is an evidence-based exercise program designed to reduce falls in older adults. It includes strength and balance training exercises performed at home under the guidance of a physiotherapist. The program aims to improve muscle strength, balance, and mobility, helping to prevent falls and maintain independence.

Treatment groups

32 Participants

are divided into 2 treatment groups

Group A: Dividat Senso (Exergame-Based Motor-Cognitive Training)Experimental treatment 1 intervention

Group B: OTAGO Falls-Prevention Program (Traditional Strength and Balance Exercises)Active comparator 1 intervention

Trial outcomes

Primary outcomes

1

Feasibility of the exergame-based motor-cognitive training: adherence

The adherence protocol measures the percentage of training sessions attended by participants relative to the number of planned sessions. It reflects how consistently participants follow the prescribed training schedule. Adherence is calculated by dividing the attended sessions by the planned sessions and expressing the result as a percentage. High adherence rates suggest that the intervention is feasible for older psychotic inpatients.

Time frame

Throughout the 4-week intervention period.

2

Feasibility of the exergame-based motor-cognitive training: attrition

Attrition: Drop-Out Rates. This refers to the percentage of participants who discontinue or leave the study before its completion. Drop-out rates are calculated by dividing the number of participants who withdraw by the total number initially enrolled, usually expressed as a percentage. High dropout rates may indicate issues with the intervention's feasibility.

Time frame

Time Frame: Throughout the 4-week intervention period

3

Feasibility of the exergame-based motor-cognitive training: safety

Safety, measured through the reporting of adverse events, assesses the occurrence and nature of any negative or unintended effects experienced by participants during the study. These events are systematically recorded, including their type, severity, timing, and potential relation to the intervention. No adverse events indicate that the intervention is safe and feasible.

Time frame

Time Frame: Throughout the 4-week intervention period

Secondary outcomes

1

Cognitive function: inhibitory control

Stroop Color and Word Test (Senso-based): This test measures inhibitory control. Participants are shown words that name colors (e.g., "blue", "red") printed in incongruent ink colors (e.g., the word "blue" printed in red ink). They must name the color of the ink, not read the word, requiring them to suppress the automatic reading response. Reaction time (in milliseconds) and accuracy are recorded. Lower reaction times and fewer errors indicate better executive functioning.

Time frame

Throughout the 4-week intervention period

2

Cognitive function: processing speed

Reaction Time Test (RTT, Senso-based): This test measures basic processing speed. Participants are presented with simple visual stimuli on a screen (e.g., a light or symbol) and must respond as quickly as possible by pressing a button or stepping onto a platform. The test records reaction time in milliseconds and the number of errors (e.g., missed or premature responses). Shorter reaction times and fewer errors indicate better cognitive and motor responsiveness.

Time frame

Time Frame: Throughout the 4-week intervention period

3

Cognitive function: selective attention

Arrow Test (Senso-based): This test assesses inhibitory control. It consists of two phases: * In the first phase, participants stand on a central platform and must step toward the side where an arrow appears on the screen, reacting as quickly as possible. * In the second phase, participants must step in the direction the arrow points, regardless of its position on the screen (e.g., an arrow may appear on the left but point to the right), requiring greater cognitive control to inhibit automatic responses. Reaction time (ms) and number of errors are recorded. Lower reaction times and fewer errors indicate better performance.

Time frame

Time Frame: Throughout the 4-week intervention period

4

Cognitive function: inhibitory control

The Go-NoGo Test (Senso-based) primarily measures inhibitory control. Participants focus on a central gray dot while an "x" or "+" appears to the left or right. When an "x" appears, they must quickly step toward its location; when a "+" appears, they must withhold any response. Reaction time (in milliseconds) and accuracy-both correct responses to "x" and successful inhibitions to "+"-are recorded. Lower reaction times and higher accuracy indicate better cognitive control and response inhibition.

Time frame

Time Frame: Throughout the 4-week intervention period

Study on the Use of Exergames to Support Older Adults With Psychosis

About this trial

Eligibility criteria

Qualifiers

Disqualifiers

Trial design

Treatments tested in this trial

Treatment groups

Trial outcomes

Primary outcomes

Secondary outcomes

Other outcomes

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