Exergaming for Healthy Aging: Associations with Functional Capacity, Social Participation, Self-Efficacy for Exercise, and Adherence to Inform Exergame Development

This study explores current applications of exergaming in healthcare, with a focus on how the Otago Exercise Program—a structured, evidence-based program designed to improve strength and balance in older adults—integrated into the FallSensing exergames, contributes to improving older adults’ functioning. It also aims to generate evidence to support the optimization of sensor-based technologies for more personalized and adaptable exercise interventions. Community-dwelling older adults (≥60 years) were recruited from facilities in Coimbra, Portugal, and allocated into an exergames group (IG; n = 27) and a control group (CG; n = 34). The CG maintained usual daily activities, while the IG completed an 8-week (16-session) exergame-based program. After completing the program, the CG showed a decline in functional ability, whereas the IG demonstrated significant improvements in the Step Test (p = 0.001), Four-Stage Balance Modified Test (p = 0.001), Self-Efficacy for Exercise Scale (p = 0.009), and Activities and Participation Profile Related to Mobility questionnaire (p < 0.001). Exergaming was safe and effective in enhancing functional ability, participation, and self-efficacy in older adults. However, careful consideration of exercise frequency, intensity, and participants’ age is recommended when prescribing exergame-based interventions. These results also highlight another interesting topic among physiotherapists who prescribe and monitor exergames, that technology developers should consider exercise-time monitoring systems that integrate physical (e.g., eye, facial, and mouth features) and physiological signals to enhance fatigue detection accuracy.