The Effectiveness of Training Using Exergaming on Selected Physical and Psychological Parameters in a Population of Patients Over the Age of 65 Belonging to Specific Subgroups of the Frailty Syndrome

Frailty status will be assessed using the Fried Frailty Phenotype, which includes five criteria: unintentional weight loss, weakness (handgrip strength), slowness (gait speed), exhaustion (CES-D), and low physical activity (IPAQ-SF). Each criterion met scores 1 point (range: 0-5). Participants are classified as: robust (0 points), pre-frail (1-2 points), or frail (≥3 points). The outcome is the change in frailty category from baseline to study completion. Improvement is defined as transition to a lower-risk category (e.g., frail to pre-frail), while worsening is a shift to a higher-risk category. A decrease in frailty category indicates improvement.

Frailty will be assessed using the Fried frailty phenotype scale, which includes five criteria: unintentional weight loss, weakness (handgrip strength), slowness (gait speed), exhaustion (CES-D items), and low physical activity (IPAQ-SF). The score ranges from 0 to 5; higher scores indicate a worse frailty status.

The Geriatric Depression Scale (GDS-15) includes 15 yes/no questions. Scores range from 0 to 15; higher scores indicate more severe depressive symptoms. A score ≥6 indicates increased risk of depression.

The MoCA evaluates cognitive domains including memory, attention, and visuospatial abilities. Total score ranges from 0 to 30; higher scores indicate better cognitive function. A score below 26 suggests mild cognitive impairment.

The ADL index assesses six basic self-care activities. Scores range from 0 to 6; higher scores indicate greater independence.

The IADL scale evaluates 8 instrumental daily tasks. Scores range from 8 to 24; higher scores indicate greater functional independence.

The Fullerton Fitness Test evaluates physical fitness in older adults across six domains.

Chair Stand Test: number of stands in 30 seconds (lower body strength). Arm Curl Test: arm curls in 30 seconds with 2 kg (women) or 3.6 kg (men) dumbbell (upper body strength).

Chair Sit and Reach: distance (cm) between fingertips and toes while reaching forward from a seated position (lower body flexibility).

Back Scratch Test: distance (cm) between fingertips reaching behind the back (upper body flexibility).

8-Foot Up and Go: time (sec) to stand, walk 2.44 m, turn, and sit (balance/agility).

6-Minute Walk or 2-Minute Step: total distance or number of steps (aerobic endurance).

Each test is scored separately; higher values generally indicate better fitness, except for the Up and Go test, where lower times reflect better performance.

The POMA evaluates balance and gait. Scores range from 0 to 28; scores <25 indicate risk of falling, and <19 indicate high fall risk.

The SF-36 measures quality of life across 8 domains. Scores range from 0 to 100 for each domain; higher scores indicate better perceived health.

The VES-13 evaluates self-reported physical function and age-related risk. Scores range from 0 to 10; a score ≥3 indicates increased risk of functional decline.

The Geriatric Depression Scale (GDS-15) is a screening tool consisting of 15 yes/no questions. Scores range from 0 to 15; higher scores indicate more severe depressive symptoms. A score of 6 or higher suggests an increased risk of depression in older adults.