My first major scientific achievement was the introduction of a paradigm shift in the approach to designing and developing technology-enhanced and individually tailored exergame-based training concepts for older adults. Specifically, in our methodological paper [Publication 2], we highlighted the relevance of contextual research preceding generative co-design. The main novelty was that we suggested that a detailed elaboration of design requirements based on three pillars can build a foundation to better guide the co-design process to fulfill a project’s greater purpose to maximize “real-world” impact. The methodology expanded best practices and built on earlier frameworks [1, 2]. This achievement highlights my commitment to methodological rigor and contributing to advancing user-centered research methodologies – which laid the foundation for the ongoing Co-Develop-IT guideline project. 

Building on this methodology, I coordinated the development of the ‘Brain-IT’ training concept – an individually tailored “exercise as medicine” program for secondary prevention of mNCD that is rooted in years of iterative co-design, purpose-development, and evaluation with continuous patient and public involvement. The project introduced a novel intervention type targeting relevant mechanisms of action to alleviate the pathological state of mNCD by combining, for the first time, exergame-based multidomain training with biofeedback-guided resonance breathing training.  Owing to this rigorous methodology, our work was published in Alzheimer’s & Dementia® [Publication 8] – the “[…] leading peer-reviewed, monthly journal in Alzheimer’s and dementia” according to the Alzheimer’s Association – and was awarded the Vontobel Prize for Age(ing) Research, representing my most significant achievement to date. 

To enhance the credibility and robustness of research on exergame-based training, I initiated and led a systematic review and meta-analysis to unravel dose-response relationships of specific training components of exergame-based training on cognitive functioning in middle-aged to older adults, published in Ageing Research Reviews [Publication 11]. We found that the effectiveness of the training was moderated by several components that have in common that they enhance the ecological validity of the training. Our most significant and novel finding was that body position significantly moderated the effects on global cognition, favoring step-based exergame training over training with only weight shifting or in sitting position. We provided specific evidence-based recommendations for the application of our findings, in research and practical settings and identified and discussed several areas of interest for future research. 

To guide the next generation of serious exergames, I initiated and led the development of the ‘Beyond “Just” Fun of Exergames Framework’ [Publication 16], published in Neuroscience & Biobehavioral Reviews. This framework integrated findings from a comprehensive review on the roles and mechanisms of specific exergame features in supporting adherence to relevant behavior change, neuroscience, and exercise science principles. It delineates best practices for the theoretically grounded selection and implementation of exergame features in health promotion and disease prevention (including rehabilitation). The framework is being applied by game designers, researchers, and exercise and therapy practitioners and is scheduled for integration into teaching contexts.