Feasibility Study of an Interactive Wall-Based Intervention Program for Nursing Home Residents and Patients in Long-Term Care Facilities: Mur'Aventure

Acceptability will be assessed using the French version of the System Usability Scale (F-SUS), a validated 10-item questionnaire evaluating the perceived usability of a system. Total scores range from 0 to 100, with higher scores indicating greater usability and acceptability. Acceptability will be considered achieved if at least 70% of participants obtain a score >70.

Feasibility will be considered successful if all three predefined feasibility criteria (acceptability, adherence, and safety) are met. If one or more criteria are not met, the feasibility of the intervention will be interpreted in light of the unmet criterion(ia), and potential modifications to the intervention or study procedures will be discussed.

Adherence will be evaluated by the completion rate, defined as the proportion of participants completing the entire 12-week intervention. Adherence will be considered good if the completion rate is ≥70%. Attendance rate and dropout rate will also be reported descriptively.

Safety will be assessed by recording the occurrence of serious adverse events (SAEs) throughout the intervention. Safety will be considered acceptable if no serious adverse events related to the intervention occur. Additional descriptive safety measures include perceived fatigue, perceived exertion, and heart rate responses recorded during each intervention session.

To describe the fidelity of program implementation, assessed by the proportion of intervention sessions delivered according to the planned protocol Intervention fidelity will be assessed as the percentage of planned exercise sessions completed according to the study protocol. Higher percentages indicate greater fidelity to the intervention.

To explore the preliminary effects of the program on cognitive function, assessed by the change in the Montreal Cognitive Assessment (MoCA) total score Cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA), a validated 30-point cognitive screening instrument evaluating memory, executive function, attention, language, visuospatial abilities, abstraction, and orientation. Scores range from 0 to 30, with higher scores indicating better cognitive function. The outcome is the change in total score between baseline and the end of the intervention.

To explore the preliminary effects of the program on health-related quality of life, assessed by the change in the EuroQol 5-Dimension 5-Level (EQ-5D-5L) score from baseline to post-intervention.

Health-related quality of life will be assessed using the EQ-5D-5L questionnaire, which evaluates mobility, self-care, usual activities, pain/discomfort, and anxiety/depression across five severity levels. Responses are converted into an EQ-5D index value, with higher index values indicating better health-related quality of life. The change in EQ-5D index score between baseline and the end of the intervention will be analyzed

To explore the preliminary effects of the program on self-reported psychological well-being, assessed by the change in the 4-item Mini-Geriatric Depression Scale (Mini-GDS) score from baseline to post-intervention.

Psychological well-being will be assessed using the 4-item Mini-Geriatric Depression Scale (Mini-GDS). Scores range from 0 to 4, with higher scores indicating more depressive symptoms and poorer psychological well-being. The outcome is the change in total score between baseline and the end of the intervention

To explore the preliminary effects of the program on caregiver-observed well-being, assessed by the change in the French version of the QUALIDEM total score from baseline to post-intervention.

Observed well-being will be assessed using the French version of the QUALIDEM questionnaire, a proxy-rated instrument evaluating quality of life in older adults with cognitive impairment.

Higher score indicating better quality of life. The outcome is the change in total score between baseline and the end of the intervention.

To describe the physical stimulation induced by the intervention sessions, assessed using heart rate and measured during each session with the Polar Unite wearable device Heart rate will be continuously recorded during each exercise session using a Polar Unite heart rate monitor. Mean heart rate (beats per minute) as well as maximal heart rate will be calculated for each participant during each session. Higher values indicate greater cardiovascular response to exercise.

To describe cognitive stimulation during the intervention, assessed using the game score, number of errors, and completion time automatically recorded during each session Cognitive stimulation will be assessed using the total score, number of errors and completion time automatically recorded by the Mur'Aventure interactive wall software during each exercise session. Higher scores indicate better cognitive stimulation.

To describe the physical stimulation induced by the intervention sessions, assessed using heart rate and physical load measured during each session with the Polar Unite wearable device Physical load will be estimated using the Polar Unite wearable device. The device provides a proprietary estimate of exercise load based on heart rate and movement data recorded during each session. Higher values indicate greater physical exercise load.

To describe game engagement during the intervention, assessed using the game score, number of errors, and completion time automatically recorded during each session Game engagement will be assessed using the total score, number of errors and completion time automatically recorded by the Mur'Aventure interactive wall software during each exercise session. Higher scores indicate better game performance.