Personalized home exergame program to improve balance and thinking in frail older adults
S.M.A.R.T: A Pragmatic Randomised Controlled Trial of Personalized Cognitive-Motor Exergame Training in Frail Community-Dwelling Adults
This program will test whether a personalized, home-based exergame training helps frail adults improve balance and their thinking-and-movement skills.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 344 (estimated) |
| Ages | 50 Years and up |
| Sex | All |
| Sponsor | Swiss Federal Institute of Technology Academic / other |
| Locations | 1 site (Zurich) |
| Trial ID | NCT07074639 on ClinicalTrials.gov |
What this trial studies
This is a pragmatic, multicenter randomized controlled trial that will enroll 344 frail adults across five European countries and randomize them to a personalized cognitive-motor exergame program or the Otago Exercise Program for 12 weeks. The intervention is delivered at home via games on a TV or large screen and tailored to each participant's abilities. The primary outcome is balance, with secondary outcomes including cognitive and motor fall-risk factors, fall incidence, cost-effectiveness, and psychosocial measures. Participants must be able to consent, understand game instructions, and have internet access and a compatible screen at home.
Who should consider this trial
Good fit: Ideal candidates are community-dwelling adults aged 50 or older with frailty (Fried score ≥3 and/or MoCA 10–25) who can give informed consent, understand game instructions, and have internet access and a TV or large screen at home.
Not a fit: Patients with severe mobility or sensory impairments, advanced dementia or other comorbidities that prevent safe participation, or those without the required home technology are unlikely to benefit from this intervention.
Why it matters
Potential benefit: If successful, the program could improve balance, reduce falls, and help preserve cognitive and functional independence in frail older adults.
How similar studies have performed: Previous smaller trials of dual-task and exergame approaches have shown promising effects on balance and cognition, but large multicenter randomized trials in frail populations remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * 50 years and older * Fried Frailty Phenotype score 3 or higher and/or MoCA score between 10-25 * Must be able to give informed consent * Access to internet and a TV/large screen at home Exclusion Criteria: * Mobility limitations (e.g., severe arthritis or lower extremity amputation) * Cognitive limitations (e.g., advanced Alzheimer's disease, frontotemporal/Lewy body/vascular dementia) * Sensory limitations (e.g., color-blindness, complete hearing loss and neuropathy causing significant loss of sensation) * Psychiatric limitations (e.g., acute, or uncontrolled affective disorders) * Comorbidities that would impair their ability to engage in the training * Simultaneous participation in other clinical trials/intervention studies * Inability to understand game instructions and play the games safely, based on judgement of a therapist
Where this trial is running
Zurich
- Institute of Human Movement Sciences and Sport, ETH Zürich — Zurich, Switzerland (Recruiting)
Study contacts
- Principal investigator: Eleftheria Giannouli, PhD — ETH Zurich
- Study coordinator: Eleftheria Giannouli, PhD
- Email: eleftheria.giannouli@hest.ethz.ch
- Phone: +41 44 633 90 58
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.