This experimental study aimed to evaluate the effect of Activities of Daily Living (ADL)-simulated exergaming on hand function and reaction time in young-old and middle-old elderly individuals.

Primary Objectives:

1. To assess hand function (gross motor, fine motor, and functional limitation) in the Exergaming group pre-intervention, after one week, and after two weeks using the Minnesota Manual Dexterity Test (MMDT), Purdue Pegboard Test (PPT), and Duruoz Hand Index (DHI).

2. To assess hand function in the control exercise group at the same three time points using the same outcome measures.

3. To assess reaction time in the Exergaming group pre-intervention, after one week, and after two weeks using the Deary–Liewald Reaction Time Test (DLRT).

4. To assess reaction time in the control group at the same three time points using the DLRT.

5. To compare hand function between the Exergaming and control groups using MMDT, PPT, and DHI.

6. To compare reaction time between the Exergaming and control groups using the DLRT.

Methods:
This experimental study included 66 participants, with 33 in the Exergaming group and 33 in the control group. The intervention lasted for two weeks, with 10 supervised sessions administered. Data were analysed using GraphPad Prism 10 Free version. The Shapiro–Wilk test assessed normality. Within-group comparisons at three time points (pre-intervention, post-1-week, post-2-weeks) were analysed with Repeated Measures ANOVA for MMDT, PPT, and DLRT. For DHI (non-parametric), the Wilcoxon matched-pairs signed-rank test was used. Between-group comparisons were analysed with One-Way ANOVA and Tukey’s post-hoc test for parametric data, and the Mann–Whitney U test for DHI. A significance level of p < 0.05 was maintained.

Results:
Both groups demonstrated improvement in hand function over the intervention period; however, participants in the Exergaming group showed significantly greater gains compared to the control group. Improvements were observed consistently across the Minnesota Manual Dexterity Test (MMDT), Purdue Pegboard Test (PPT), and Duruoz Hand Index (DHI), indicating enhanced gross and fine motor dexterity as well as better self-reported functional hand use.

In terms of reaction time, the Exergaming group exhibited significant reductions in Deary-Liewald Reaction Time (DLRT) scores for both simple and choice reaction time, reflecting faster processing speed and improved motor responsiveness. The control group also demonstrated some improvement, though to a lesser extent.

When comparing groups, the Exergaming intervention outperformed the control intervention across all primary outcome measures. Statistically significant between-group differences were observed in MMDT, PPT, DHI, and DLRT, confirming that exergaming provided superior benefits for both hand function and reaction time relative to traditional exercises.

Conclusion:
All study objectives were successfully fulfilled.

ADL-simulated exergaming was found to be a feasible and effective intervention to enhance hand function and reduce reaction time in elderly individuals, and it may be considered as a useful adjunct in geriatric rehabilitation programs.

The findings emphasize that rehabilitation strategies which integrate biological (motor function), psychological (cognitive-motivational), and social (participation, independence) domains may yield more holistic and sustainable outcomes in the elderly. ADL-simulated exergaming therefore represents not only an effective motor training tool but also a comprehensive biopsychosocial intervention that can be incorporated into geriatric rehabilitation programs to promote independence, safety, and quality of life.