PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial

PurposeMotor-cognitive exergames may be beneficial for addressing both motor and cognitive residual impairments in chronic stroke, however, effective training schedules are yet to be determined. Therefore, this study investigates the effects of a concept-guided, personalized, motor-cognitive exergam...

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Main Authors: S. K. Huber, R. H. Knols, J. P. O. Held, M. Betschart, S. Gartmann, N. Nauer, E. D. de Bruin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Aging Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2025.1514594/full
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author S. K. Huber
S. K. Huber
R. H. Knols
R. H. Knols
J. P. O. Held
J. P. O. Held
M. Betschart
M. Betschart
S. Gartmann
S. Gartmann
N. Nauer
N. Nauer
E. D. de Bruin
E. D. de Bruin
E. D. de Bruin
author_facet S. K. Huber
S. K. Huber
R. H. Knols
R. H. Knols
J. P. O. Held
J. P. O. Held
M. Betschart
M. Betschart
S. Gartmann
S. Gartmann
N. Nauer
N. Nauer
E. D. de Bruin
E. D. de Bruin
E. D. de Bruin
author_sort S. K. Huber
collection DOAJ
description PurposeMotor-cognitive exergames may be beneficial for addressing both motor and cognitive residual impairments in chronic stroke, however, effective training schedules are yet to be determined. Therefore, this study investigates the effects of a concept-guided, personalized, motor-cognitive exergame training on cognitive functions and gait in chronic stroke survivors.MethodsIn this single-blind, randomized, controlled trial, stroke survivors (at least six-months post-stroke and able to perform step-based exergaming) were allocated either to the intervention (usual care + concept-guided, personalized, motor-cognitive exergame training) or the control group (usual care only). Global cognitive functioning was primarily targeted, while health-related quality of life (HRQoL), cognitive functions, mobility, and gait were evaluated secondarily. Analyses were performed with linear-mixed effect models.ResultsEffects on global cognitive functioning were non-significant, with no differences between responders (participants exhibiting a clinically relevant change) and non-responders (participants exhibiting no clinically relevant change). Among secondary outcomes, the mobility domain of the HRQoL questionnaire, intrinsic visual alertness, cognitive flexibility, working memory, and outdoor walking speed as well as swing width (unaffected side) showed significant interaction effects in favour of the exergame group.DiscussionAdditional exergaming helped maintaining global cognitive functioning and showed encouraging effects in mobility and cognitive outcomes. Responders and non-responders did not differ in adherence, baseline values or age. Enhancing the frequency and intensity of sessions could unlock more substantial benefits. Adopting a blended therapy approach may be key to maximizing positive effects.Clinical trial registrationclinicaltrials.gov, identifier NCT05524727.
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spelling doaj-art-03edb21c2a1f4299a8d3b316fc4ef5282025-08-20T02:04:52ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-03-011710.3389/fnagi.2025.15145941514594PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trialS. K. Huber0S. K. Huber1R. H. Knols2R. H. Knols3J. P. O. Held4J. P. O. Held5M. Betschart6M. Betschart7S. Gartmann8S. Gartmann9N. Nauer10N. Nauer11E. D. de Bruin12E. D. de Bruin13E. D. de Bruin14Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zürich, SwitzerlandMotor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zürich, SwitzerlandPhysiotherapy Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zürich, SwitzerlandMotor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zürich, SwitzerlandRehabilitation Center Triemli Zurich, Valens Clinics, Zürich, SwitzerlandBellevue Medical Group, Zürich, SwitzerlandDepartment of Health, OST – Eastern Swiss University of Applied Sciences, St. Gallen, SwitzerlandInstitute of Therapy and Rehabilitation, Kantonsspital Winterthur, Winterthur, SwitzerlandPhysiotherapy Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zürich, SwitzerlandMotor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zürich, SwitzerlandPhysiotherapy Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zürich, SwitzerlandMotor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zürich, SwitzerlandMotor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zürich, SwitzerlandDepartment of Health, OST – Eastern Swiss University of Applied Sciences, St. Gallen, SwitzerlandDivision of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SwedenPurposeMotor-cognitive exergames may be beneficial for addressing both motor and cognitive residual impairments in chronic stroke, however, effective training schedules are yet to be determined. Therefore, this study investigates the effects of a concept-guided, personalized, motor-cognitive exergame training on cognitive functions and gait in chronic stroke survivors.MethodsIn this single-blind, randomized, controlled trial, stroke survivors (at least six-months post-stroke and able to perform step-based exergaming) were allocated either to the intervention (usual care + concept-guided, personalized, motor-cognitive exergame training) or the control group (usual care only). Global cognitive functioning was primarily targeted, while health-related quality of life (HRQoL), cognitive functions, mobility, and gait were evaluated secondarily. Analyses were performed with linear-mixed effect models.ResultsEffects on global cognitive functioning were non-significant, with no differences between responders (participants exhibiting a clinically relevant change) and non-responders (participants exhibiting no clinically relevant change). Among secondary outcomes, the mobility domain of the HRQoL questionnaire, intrinsic visual alertness, cognitive flexibility, working memory, and outdoor walking speed as well as swing width (unaffected side) showed significant interaction effects in favour of the exergame group.DiscussionAdditional exergaming helped maintaining global cognitive functioning and showed encouraging effects in mobility and cognitive outcomes. Responders and non-responders did not differ in adherence, baseline values or age. Enhancing the frequency and intensity of sessions could unlock more substantial benefits. Adopting a blended therapy approach may be key to maximizing positive effects.Clinical trial registrationclinicaltrials.gov, identifier NCT05524727.https://www.frontiersin.org/articles/10.3389/fnagi.2025.1514594/fullstrokeexergamingrehabilitationcognitiongaitdual-task
spellingShingle S. K. Huber
S. K. Huber
R. H. Knols
R. H. Knols
J. P. O. Held
J. P. O. Held
M. Betschart
M. Betschart
S. Gartmann
S. Gartmann
N. Nauer
N. Nauer
E. D. de Bruin
E. D. de Bruin
E. D. de Bruin
PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial
Frontiers in Aging Neuroscience
stroke
exergaming
rehabilitation
cognition
gait
dual-task
title PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial
title_full PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial
title_fullStr PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial
title_full_unstemmed PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial
title_short PEMOCS: effects of a concept-guided, PErsonalized, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—a randomized, controlled trial
title_sort pemocs effects of a concept guided personalized motor cognitive exergame training on cognitive functions and gait in chronic stroke a randomized controlled trial
topic stroke
exergaming
rehabilitation
cognition
gait
dual-task
url https://www.frontiersin.org/articles/10.3389/fnagi.2025.1514594/full
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