Evaluation of a Digital Neurorehabilitation Program Using Exergames for Adults With Mild Cognitive Impairment

Digital Exergame Neurorehabilitation to Enhance Quality of Life and Functional Autonomy in Institutionalized Older Adults With Mild Cognitive Impairment: Randomized Controlled Trial

The goal of this clinical trial is to learn whether a semi-autonomous digital telerehabilitation program using therapeutic video games ("exergames") can help improve quality of life and functional independence in older adults living in long-term care centers who have mild cognitive impairment (MCI).

The main questions we want to answer are:

Does this exergame-based program help participants move better, walk more safely, and perform daily activities with more independence? Does it improve confidence while moving and lower the fear of falling? Is this program cost-effective compared with a standard one-to-one physiotherapy program?

Researchers will compare two groups:

Intervention group: participants will use a CE-marked digital rehabilitation platform that provides lower-limb and balance training through interactive exergames.

Control group: participants will receive an individual physiotherapy program of similar duration and intensity.

Participants will:

Take part in a 6-week training program (using exergames or standard physiotherapy, depending on their group).

Complete tests that measure mobility, balance, walking while doing a cognitive task (called "dual task"), confidence in avoiding falls, and daily functioning.

Answer short questionnaires about well-being and quality of life.

This pilot study will help determine whether the exergame-based program is safe, useful, and feasible for older adults with MCI living in long-term care settings.

Inclusion Criteria:

• Age 70 years or older.
• Diagnosis of mild cognitive impairment, defined by Montreal Cognitive Assessment (MoCA) score between 18 and 25.
• Ability to maintain standing and/or ambulate with or without assistive devices.
• Institutional residence for at least 3 months.
• Informed consent provided by participant or legal representative.

Exclusion Criteria:

• Acute illness, musculoskeletal condition, or pain that limits safe participation in training.
• Uncompensated sensory deficits (vision or hearing) that interfere with task performance.
• Disruptive behavior or neuropsychiatric symptoms that impede participation.
• Active epilepsy or medical contraindications for physical exercise.