ExergamingNCT07308353
Comparative Effects Of Exergaming And Otago Exercise On Anticipatory Postural Control And Sensory Integration In Older Adults
A study testing Otago Exercise Program and Exergaming in people with Exergaming and Exercise Therapy, run by Foundation University Islamabad at 1 site in Pakistan.
Trial summary
This study explores whether non-immersive, interactive Exergaming using Xbox Kinect can go beyond conventional exercise by actively training the brain and body to react faster, balance smarter, and move more confidently. Read more about this study
- Who is it for?
- Ages 55 years and olderHealthy volunteers can take part
- Conditions the study is for
- Exergaming, Exercise Therapy, Frail Elderly
- What is being tested?
- Otago Exercise Program and Exergaming
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 18 Nov 2025to 1 Jul 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 55 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age ≥ 55 years
- Both Genders
- Ambulatory, community-dwelling
- Able to stand unassisted >1 min
- TUG ≤ 13.5 s
- Able to understand and follow command
Who cannot join
- Diagnosed vestibular and neurological conditions affecting balance
- Orthopedic Conditions i.e., Recent fractures or surgeries, cervical spine issues or severe OA
- Severe visual or auditory deficits
- Use of Assistive device
- Currently enrolled in any other balance or exercise program
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Foundation University College of Physical Therapy
Islamabad, 44000
About this study
This study explores whether non-immersive, interactive Exergaming using Xbox Kinect can go beyond conventional exercise by actively training the brain and body to react faster, balance smarter, and move more confidently. Through dynamic games like Reflex Ridge and 20,000 Leaks, we aim to stimulate internal perturbations and real-time Sensory Integration, something Otago doesn't directly target.
In this randomized controlled trial, 36 older adults (aged 55+) will be assigned to either the Exergaming or Otago group. Both groups will receive 6 weeks of supervised balance training (3x/week, 30 mins/session). Primary outcomes include Sensory Integration, measured using modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and Anticipatory postural control assessed through Limits of Stability (LOS) test. Timed up and Go (TUG) will capture functional mobility, which will serve as the secondary outcome in this study.
Read more
Both mCTSIB and LOS will be administered using the Postural Stability System of Biodex, a reliable and valid computerized platform designed to objectively quantify postural control under varying sensory conditions.
With evidence-based outcome tools and rigorous analysis, this project doesn't just aim to compare two programs, it's about challenging tradition, modernizing rehab, and making balance training smarter, safer, and more engaging for the elders we serve.
This research could be a leap forward in community-based fall prevention and a step toward a more responsive, personalized future in Neurological Rehabilitation.
Read the detailed description
Falls are the second leading cause of unintentional injury-related deaths globally and pose as a major public health issue, especially for older individuals. Elderly population experience difficulties in switching quickly between various reliable sensory inputs, which increases risk of falls and injuries. Balance and gait disorders are among the most common causes associated with falls in older individuals. Age-related declines in Sensory Integration and Anticipatory balance responses are one of the leading contributors to falls in older adults.
Rogers et al. in 2021 conducted the only identified head-to-head feasibility RCT directly comparing exergaming interventions with the Otago Exercise Program (OEP) in older adults. This mixed method study establishes the foundational evidence that exergaming and Otago exercise demonstrate comparable clinical benefits on functional balance measures, while identifying need for more detailed comparative studies using objective instrumented measures like Postural Stability System of Biodex.
Chen et al. conducted a comprehensive systematic review and meta-analysis in 2021. This meta-analytic evidence establishes a strong foundation supporting the hypothesis that exergaming interventions can outperform conventional exercise approaches on objective postural control metrics, directly informing the rationale for comparative effectiveness studies examining exergaming versus established fall-prevention programs like the Otago Exercise Program.
The Otago Exercise Program (OEP) is a promising intervention for preventing falls, thereby improving balance and gait. Previous studies reported improved effects on balance using the OEP conducted in a group setting. In 2022 Khumpaneid et al., conducted a study aimed to investigate the effects of a modified-OEP on four components of actual balance (static, dynamic, proactive, and reactive balance) and perceived balance in healthy older adults aged 60-85 years old. The modified-OEP group showed significant improvement in the four components of actual balance and in perceived balance.
The study conducted by Sápi et al., in 2021 aimed to evaluate whether Kinect exergame balance training could beneficially impact sensory reweighting in women over 60 years old. 14 healthy women participated in a single-group pretest/posttest/follow-up usability study. Participants engaged in Kinect for Xbox 360 console games three times a week, for 30 minutes per session, over a 6-week period (18 visits in total). This usability study provides evidence that Kinect exergaming can be a valuable intervention for improving balance and reducing fall risk in older women by enhancing mediolateral stability and sensory reweighting. This implies that the Exergaming may have improved proprioceptive function by providing visual feedback and challenging motor skills.
Pacheco et al., in 2020 conducted a research aimed to evaluate the effectiveness of exergames in improving mobility and balance among older adults without neurological conditions. Exergames led to significant improvements in mobility, as evidenced by better performance on the TUG. The study also found that older adults generally adhered well to exergame programs, with reported adherence rates of up to 100% in some trials.
In this study participants will be randomly allocated in 2 groups, A and B. Each group will contain 18 participants.
Group A will receive Otago Exercise Program Group B will receive treatment through Xbox Exergaming. Otago Exercise Program (OEP) consist of 5 Strengthening Exercises , 12 Progressive Balance Exercises and Walking Training (as tolerated).
Non-immersive exergaming using the Xbox Kinect system, designed to engage multisensory balance responses, anticipatory postural adjustments, and internal perturbation mechanisms through gamified movement. Games Include: 20,000 Leaks, Reflex Ridge , River Rush, Rally Ball.
It is imperative to explore and compare the efficacy of Xbox Kinect-based exergaming versus the Otago Exercise Program in improving sensory integration and anticipatory postural control in older adults. By addressing this research gap, the current study aims to contribute novel insights into the development of more responsive, engaging, and relevant balance interventions for the aging population.
- Conditions
- Exergaming, Exercise Therapy, Frail Elderly, Healthy Aging, Mobility Limitation, Muscle Strength
- Being tested
- Otago Exercise Program, Exergaming
- Keywords
- Exergaming, Exercise Therapy, Frail Elderly, Healthy Aging, Mobility limitation, Muscle Strength, Postural Balance, Proprioception
- Medical subject headings
- Mobility Limitation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Otago Exercise ProgramProcedure or surgery
It will consist of 5 Strengthening Exercises, 12 Progressive Balance Exercises and Walking Training (as tolerated). Protocol will include 3 sessions per week 30 minutes per session for total of 6 weeks Strength exercises will be progressed by increasing repetitions, weight, or duration. Balance tasks will be made challenging by reducing upper limb support, altering base of support, or eyes closing. Progression will be adjusted weekly based on performance and comfort.
All sessions will be delivered under physiotherapist supervision using the official OEP manual.
ExergamingProcedure or surgery
This intervention involves non-immersive exergaming using the Xbox Kinect system.
Games Included are 20,000 Leaks, Reflex Ridge, River Rush and Rally Ball. Games will be played 3 times per week for 30 minutes for total of 6 weeks. Three difficulty levels include Basic, Intermediate and Advance. Progression based on participant performance, game scores (gold/silver pins, stars), and therapist observation. For first three weeks 2/3 Game Plays and last three weeks there will be 4/5 game plays.
Sessions will be supervised one-on-one by a physiotherapist. Participant performance, fatigue, and safety will be monitored throughout the session.
| Study group | Role | What they receive |
|---|---|---|
| Otago Exercise Program | Active comparator | Strengthening exercises
1. Knee extensor (front knee strength)
2. Knee flexor (Back knee strength)
3. Hip abductor (side hip strength)
4. Ankle plantarflexors (calf raises)
5. Ankle dorsiflexors (toe raises) Balance retraining exercises
1. Knee bends 2. Backwards walking 3. Walking and turning around 4. Sideways walking 5. Tandem stance (Heel toe stand) 6. Tandem walk (heel toe walk) 7. One leg stand 8. Heel walking 9. Toe walk 10. Heel toe walking backwards 11. sit to stand 12. Stair walking
Levels:
LEVEL A 10 repetitions Hold support LEVEL B 10 repetitions, no support or 10 repetitions, hold support, repeat LEVEL C 10 repetitions No support, repeat LEVEL D 3 x 10 repetitions No support Receives: Procedure: Otago Exercise Program |
| Exergaming | Experimental | Games Included:
20,000 Leaks - multi-directional reaching, internal perturbations Reflex Ridge - anticipatory jumping, ducking, trunk-limb coordination River Rush - dynamic weight shifting, lateral stepping Rally Ball - anticipatory posture control, bilateral upper limb coordination Levels: Basic, Intermediate and Advance Receives: Procedure: Exergaming |
What is being measured
The primary outcome is the main question the study is designed to answer.
Anticipatory Postural Control
It will be assessed using the Limits of Stability test of Postural Stability System (Biodex Balance System). The LOS test measures anticipatory postural control by evaluating the participant's ability to voluntarily shift their center of gravity (COG) toward multiple targets without losing balance. Participants will be instructed to shift their weight toward 8 targets displayed on a screen, using ankle and trunk strategies while standing on a stable platform. Overall LOS Score and Time to complete test will be recorded. Higher values of Overall Directional control indicate better anticipatory balance. Whereas shorter Time to Complete Test reflects quicker anticipatory responses.
Measured: 6 weeks
Sensory Integration
The mCTSIB will be used to assess sensory integration.This test includes the four conditions:
Eyes Open on Firm Surface, Eyes Closed on Firm Surface, Eyes Open, Foam Surface and Eyes Closed, Foam Surface. Each condition will be tested for 30 seconds, and the system will automatically calculate an overall composite sway score. Higher Sway Index shows lower sensory integration
Measured: 6 weeks
Functional Mobility
The Timed Up and Go (TUG) test will be used to measure functional mobility before and after the intervention. Time to complete (in seconds) will be recorded using a stopwatch. Score ≤13.5 seconds is considered normal for community-dwelling older adults. Score >13.5 seconds indicates reduced functional mobility
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Dec 2025
- Study start18 Nov 2025
- Primary completion1 Jun 2026 (estimated)
- Study completion1 Jul 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for ExergamingStudies of the same condition, open and under way.
- More trials run by Foundation University IslamabadThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Foundation University Islamabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07308353
- Sponsor's protocol ID
- FUI/CTR/2025/14
- Status last verified
- Dec 2025
- First submitted
- 15 Dec 2025
- Last updated
- 29 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects Of Exergaming And Otago Exercise On Anticipatory Postural Control And Sensory Integration In Older Adults
- ClinicalTrials.gov ID
- NCT07308353
- Acronym / sponsor ID
- FUI/CTR/2025/14
- Conditions
- Exergaming, Exercise Therapy, Frail Elderly, Healthy Aging, Mobility Limitation, Muscle Strength
- Keywords
- Exergaming, Exercise Therapy, Frail Elderly, Healthy Aging, Mobility limitation, Muscle Strength, Postural Balance, Proprioception
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Foundation University IslamabadUniversity, hospital or other
- Study start
- 18 Nov 2025 (actual)
- Primary completion
- 1 Jun 2026 (estimated)
- Study completion
- 1 Jul 2026 (estimated)
- First posted
- 29 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study explores whether non-immersive, interactive Exergaming using Xbox Kinect can go beyond conventional exercise by actively training the brain and body to react faster, balance smarter, and move more confidently. Through dynamic games like Reflex Ridge and 20,000 Leaks, we aim to stimulate internal perturbations and real-time Sensory Integration, something Otago doesn't directly target.
In this randomized controlled trial, 36 older adults (aged 55+) will be assigned to either the Exergaming or Otago group. Both groups will receive 6 weeks of supervised balance training (3x/week, 30 mins/session). Primary outcomes include Sensory Integration, measured using modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and Anticipatory postural control assessed through Limits of Stability (LOS) test. Timed up and Go (TUG) will capture functional mobility, which will serve as the secondary outcome in this study.
Both mCTSIB and LOS will be administered using the Postural Stability System of Biodex, a reliable and valid computerized platform designed to objectively quantify postural control under varying sensory conditions.
With evidence-based outcome tools and rigorous analysis, this project doesn't just aim to compare two programs, it's about challenging tradition, modernizing rehab, and making balance training smarter, safer, and more engaging for the elders we serve.
This research could be a leap forward in community-based fall prevention and a step toward a more responsive, personalized future in Neurological Rehabilitation.
Detailed description
Falls are the second leading cause of unintentional injury-related deaths globally and pose as a major public health issue, especially for older individuals. Elderly population experience difficulties in switching quickly between various reliable sensory inputs, which increases risk of falls and injuries. Balance and gait disorders are among the most common causes associated with falls in older individuals. Age-related declines in Sensory Integration and Anticipatory balance responses are one of the leading contributors to falls in older adults.
Rogers et al. in 2021 conducted the only identified head-to-head feasibility RCT directly comparing exergaming interventions with the Otago Exercise Program (OEP) in older adults. This mixed method study establishes the foundational evidence that exergaming and Otago exercise demonstrate comparable clinical benefits on functional balance measures, while identifying need for more detailed comparative studies using objective instrumented measures like Postural Stability System of Biodex.
Chen et al. conducted a comprehensive systematic review and meta-analysis in 2021. This meta-analytic evidence establishes a strong foundation supporting the hypothesis that exergaming interventions can outperform conventional exercise approaches on objective postural control metrics, directly informing the rationale for comparative effectiveness studies examining exergaming versus established fall-prevention programs like the Otago Exercise Program.
The Otago Exercise Program (OEP) is a promising intervention for preventing falls, thereby improving balance and gait. Previous studies reported improved effects on balance using the OEP conducted in a group setting. In 2022 Khumpaneid et al., conducted a study aimed to investigate the effects of a modified-OEP on four components of actual balance (static, dynamic, proactive, and reactive balance) and perceived balance in healthy older adults aged 60-85 years old. The modified-OEP group showed significant improvement in the four components of actual balance and in perceived balance.
The study conducted by Sápi et al., in 2021 aimed to evaluate whether Kinect exergame balance training could beneficially impact sensory reweighting in women over 60 years old. 14 healthy women participated in a single-group pretest/posttest/follow-up usability study. Participants engaged in Kinect for Xbox 360 console games three times a week, for 30 minutes per session, over a 6-week period (18 visits in total). This usability study provides evidence that Kinect exergaming can be a valuable intervention for improving balance and reducing fall risk in older women by enhancing mediolateral stability and sensory reweighting. This implies that the Exergaming may have improved proprioceptive function by providing visual feedback and challenging motor skills.
Pacheco et al., in 2020 conducted a research aimed to evaluate the effectiveness of exergames in improving mobility and balance among older adults without neurological conditions. Exergames led to significant improvements in mobility, as evidenced by better performance on the TUG. The study also found that older adults generally adhered well to exergame programs, with reported adherence rates of up to 100% in some trials.
In this study participants will be randomly allocated in 2 groups, A and B. Each group will contain 18 participants.
Group A will receive Otago Exercise Program Group B will receive treatment through Xbox Exergaming. Otago Exercise Program (OEP) consist of 5 Strengthening Exercises , 12 Progressive Balance Exercises and Walking Training (as tolerated).
Non-immersive exergaming using the Xbox Kinect system, designed to engage multisensory balance responses, anticipatory postural adjustments, and internal perturbation mechanisms through gamified movement. Games Include: 20,000 Leaks, Reflex Ridge , River Rush, Rally Ball.
It is imperative to explore and compare the efficacy of Xbox Kinect-based exergaming versus the Otago Exercise Program in improving sensory integration and anticipatory postural control in older adults. By addressing this research gap, the current study aims to contribute novel insights into the development of more responsive, engaging, and relevant balance interventions for the aging population.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Otago Exercise Program | Active comparator | Procedure: Otago Exercise ProgramStrengthening exercises 1. Knee extensor (front knee strength) 2. Knee flexor (Back knee strength) 3. Hip abductor (side hip strength) 4. Ankle plantarflexors (calf raises) 5. Ankle dorsiflexors (toe raises) Balance retraining exercises 1. Knee bends 2. Backwards walking 3. Walking and turning around 4. Sideways walking 5. Tandem stance (Heel toe stand) 6. Tandem walk (heel toe walk) 7. One leg stand 8. Heel walking 9. Toe walk 10. Heel toe walking backwards 11. sit to stand 12. Stair walking Levels: LEVEL A 10 repetitions Hold support LEVEL B 10 repetitions, no support or 10 repetitions, hold support, repeat LEVEL C 10 repetitions No support, repeat LEVEL D 3 x 10 repetitions No support |
| Exergaming | Experimental | Procedure: ExergamingGames Included: 20,000 Leaks - multi-directional reaching, internal perturbations Reflex Ridge - anticipatory jumping, ducking, trunk-limb coordination River Rush - dynamic weight shifting, lateral stepping Rally Ball - anticipatory posture control, bilateral upper limb coordination Levels: Basic, Intermediate and Advance |
Who may qualify
- Ages
- 55 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Age ≥ 55 years
- Both Genders
- Ambulatory, community-dwelling
- Able to stand unassisted >1 min
- TUG ≤ 13.5 s
Key exclusion criteria (5 listed)
- Diagnosed vestibular and neurological conditions affecting balance
- Orthopedic Conditions i.e., Recent fractures or surgeries, cervical spine issues or severe OA
- Severe visual or auditory deficits
- Use of Assistive device
- Currently enrolled in any other balance or exercise program
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Otago Exercise ProgramIt will consist of 5 Strengthening Exercises, 12 Progressive Balance Exercises and Walking Training (as tolerated). Protocol will include 3 sessions per week 30 minutes per session for total of 6 weeks Strength exercises will be progressed by increasing repetitions, weight, or duration. Balance tasks will be made challenging by reducing upper limb support, altering base of support, or eyes closing. Progression will be adjusted weekly based on performance and comfort. All sessions will be delivered under physiotherapist supervision using the official OEP manual. | Procedure or surgery | Otago Exercise Program |
| ExergamingThis intervention involves non-immersive exergaming using the Xbox Kinect system. Games Included are 20,000 Leaks, Reflex Ridge, River Rush and Rally Ball. Games will be played 3 times per week for 30 minutes for total of 6 weeks. Three difficulty levels include Basic, Intermediate and Advance. Progression based on participant performance, game scores (gold/silver pins, stars), and therapist observation. For first three weeks 2/3 Game Plays and last three weeks there will be 4/5 game plays. Sessions will be supervised one-on-one by a physiotherapist. Participant performance, fatigue, and safety will be monitored throughout the session. | Procedure or surgery | Exergaming |
Primary outcome
Anticipatory Postural Control
Time frame: 6 weeks
It will be assessed using the Limits of Stability test of Postural Stability System (Biodex Balance System). The LOS test measures anticipatory postural control by evaluating the participant's ability to voluntarily shift their center of gravity (COG) toward multiple targets without losing balance. Participants will be instructed to shift their weight toward 8 targets displayed on a screen, using ankle and trunk strategies while standing on a stable platform. Overall LOS Score and Time to complete test will be recorded. Higher values of Overall Directional control indicate better anticipatory balance. Whereas shorter Time to Complete Test reflects quicker anticipatory responses.
Sensory Integration
Time frame: 6 weeks
The mCTSIB will be used to assess sensory integration.This test includes the four conditions: Eyes Open on Firm Surface, Eyes Closed on Firm Surface, Eyes Open, Foam Surface and Eyes Closed, Foam Surface. Each condition will be tested for 30 seconds, and the system will automatically calculate an overall composite sway score. Higher Sway Index shows lower sensory integration
Functional Mobility
Time frame: 6 weeks
The Timed Up and Go (TUG) test will be used to measure functional mobility before and after the intervention. Time to complete (in seconds) will be recorded using a stopwatch. Score ≤13.5 seconds is considered normal for community-dwelling older adults. Score >13.5 seconds indicates reduced functional mobility
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Dec 2025.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Otago Exercise Program and Exergaming in people with Exergaming and Exercise Therapy, run by Foundation University Islamabad at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 29 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Anticipatory Postural Control (time frame: 6 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Dec 2025.