physioscience 2025; 21(S 03): S11
DOI: 10.1055/s-0045-1812370
Abstracts
Präsentationen/Presentations
PS 5

PEMOCS: PErsonalized, MOtor-Cognitive exergame training in chronic Stroke

Authors

  • S K Huber

    1   Universitätsspital Zürich, Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, Zürich, Switzerland
    2   ETH Zürich, Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Zürich, Switzerland

  • R Knols

    1   Universitätsspital Zürich, Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, Zürich, Switzerland
    2   ETH Zürich, Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Zürich, Switzerland

  • J P Held

    3   Kliniken Valens, Rehabilitation Center Triemli Zurich, Valens, Switzerland
    4   Bellevue Medical Group, Bellevue Medical Group, Zürich, Switzerland

  • M Betschart

    5   OST – Eastern Swiss University of Applied Sciences, Department of Health, St. Gallen, Switzerland
    6   Kantonsspital Winterthur, Institute of Therapy and Rehabilitation, Winterthur, Switzerland

  • S Gartmann

    1   Universitätsspital Zürich, Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, Zürich, Switzerland
    2   ETH Zürich, Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Zürich, Switzerland

  • N Nauer

    1   Universitätsspital Zürich, Physiotherapy Occupational Therapy Research Center, Directorate of Research and Education, Zürich, Switzerland
    2   ETH Zürich, Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Zürich, Switzerland

  • E D de Bruin

    2   ETH Zürich, Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Zürich, Switzerland
    5   OST – Eastern Swiss University of Applied Sciences, Department of Health, St. Gallen, Switzerland
    7   Karolinska Institutet, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
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Background Many chronic stroke survivors struggle with residual motor and cognitive impairments when their rehabilitation is over. Motor-cognitive exergames may help addressing these residual impairments, however, effective training schedules are yet to be determined. Therefore, the PEMOCS training concept for PErsonalized, MOtor-Cognitive exergaming in chronic Stroke was developed. This study investigated the effects of PEMOCS concept-guided, exergame training performed additionally to usual care on cognitive functions and gait in chronic stroke survivors.

Methods In 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 group (usual care+PEMOCS exergame training) or the control group (usual care only). The exergame training was performed for 30–40 minutes, twice per week for 12 weeks. Global cognitive functioning (Montreal Cognitive Assessment) was the primary outcome, while health-related quality of life (HRQoL), cognitive functions (attention, executive and visuospatial functions), mobility, as well as indoor and outdoor gait parameters were evaluated secondarily. Effects were analysed using linear-mixed effect models. Responder analyses was performed to identify differences between responders (participants exhibiting a clinically relevant change) and non-responders (participants exhibiting no clinically relevant change).

Results Effects on global cognitive functioning were non-significant in both groups. Within the exergame group, there were no differences in adherence, baseline cognitive status or age between responders and non-responders. Among secondary outcomes, mobility within the HRQoL questionnaire, intrinsic visual alertness, cognitive flexibility, working memory, and outdoor walking speed showed significant interaction effects in favour of the exergame group. Adherence to the exergame training was high.

Conclusions Additional exergaming helped maintaining global cognitive functioning and showed encouraging effects in mobility and cognitive outcomes. Enhancing the frequency and intensity of sessions, for example by enabling additional home-based sessions, could unlock more substantial benefits. Therefore, motor-cognitive exergaming may be a promising complementation for chronic stroke survivors and help increasing motivation and adherence to long-term therapy. Additionally, exergames could be a possible tool for chronic stroke survivors to keep training motor and cognitive functions when their therapy prescriptions are terminated.



Publication History

Article published online:
23 October 2025

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