BACKGROUND: Individuals with intellectual disability (ID) exhibit various problems, such as attention, learning, and physical-motor difficulties. The study is aimed at investigating the effects of video game-based therapy programs on cognitive and physical functions in individuals with ID. METHODS: The study, conducted through a three-arm randomized trial, involved 45 adults aged 18 to 30 with mild to moderate ID. Participants were divided into three groups: Group 1 received home-based video game-based therapy, supervised video game-based therapy, and occupational therapy-based activity training. Group 2 received video game-based therapy supervised by a therapist and an occupational therapy-based activity training program. Group 3 received occupational therapy-based activity training only. MOXO d-CPT was used to evaluate attention; sit-to-stand test, joint position sense, and nine-hole peg test were used to assess physical-motor functionality. RESULTS: Results showed significant improvements in attention, functional performance, proprioception, and fine motor skills in all groups (p < 0.05). Group 1 was superior to Group 3 in nondomit JPS-flexion, sit-to-stand test, and nondomit JPS-abduction parameters (p < 0.017). When comparing Group 1 and Group 2, Group 1 was found to be more effective in the sit-to-stand test parameter compared to Group 2 (p < 0.017), while the other parameters of the two groups were similar to each other (p > 0.017). There were no significant differences between groups for different outcome measures (p > 0.017). CONCLUSION: The study suggests that video-based game exercises combined with occupational therapy interventions can effectively enhance cognitive functions, functional performance, proprioception, and fine motor skills in adults with ID. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06097819.

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