Preprint · Jan 2026
Influence of Intensity on Physical Function Improvements Through Exergame Interventions in Older People: A Scoping Review
By Vásquez-Carrasco E
While there is evidence (J. Hernandez-Martinez, F. Ramos-Espinoza, et al., 2024; Hernandez-Martinez et al., 2026), on the benefits of different types of consoles as a training method for older adults, there are still limitations in the reports regarding the intensity of these interventions using exergames (Kubica et al., 2023). Exercise intensity is a key component of training dose because it determines the magnitude of physiological stimulus required to induce adaptations in older people (Garber et al., 2011). In interventions to EXG, intensity is particularly relevant because the playful and self-paced nature of these programs may lead participants to exercise below the threshold needed to improve physical function (Kubica et al., 2023; Peng et al., 2013). Based on physical exercise prescription guidelines for older adults, it is recommended to combine different types of training, including aerobic, resistance, flexibility, and/or balance exercises, with controllable intensities indirectly monitored through heart rate or rating of perceived exertion (RPE) scales, thereby ensuring the safety of the intervention’s implementation (Chodzko-Zajko et al., 2009; Fragala et al., 2019). These interventions show low adherence over time as a decrease in the enjoyment of the activity (Rivera-Torres et al., 2019). In contrast, evidence suggests that EXGs have demonstrated high adherence as an enjoyable intervention (Cacciata et al., 2019), by generating mild to moderate physiological demands in older adults, with mean values close to 108 bpm, RPE 11-12 and approximately 2.7 METs, which may be sufficient for sedentary or frail individuals, but could be insufficient to maximize functional adaptations if progression is not prescribed appropriately (Kubica et al., 2023). Therefore, it is important to monitor and report on intensity using the rating of perceived exertion (RPE) scale or heart rate to interpret the effectiveness of EXG-based interventions by comparing studies between different protocols and to determine if improvements in physical function outcomes are related to an adequate exercise stimulus.