Effectiveness of Serious Games to Increase Physical Activity in Children With a Chronic Disease: Systematic Review With Meta-Analysis (Preprint)

Abstract

BACKGROUND Physical activity (PA) is important for children with a chronic disease. Serious games may be useful to promote PA levels among these children. OBJECTIVE The primary purpose of this systematic review was to evaluate the effectiveness of serious games on PA levels in children with a chronic disease. METHODS PubMed, EMBASE, PsycINFO, ERIC, Cochrane Library, and CINAHL were systematically searched for articles published from January 1990 to May 2018. Both randomized controlled trials and controlled clinical trials were included to examine the effects of serious games on PA levels in children with a chronic disease. Two investigators independently assessed the intervention, methods, and methodological quality in all articles using the Cochrane risk of bias tool. Both qualitative and quantitative analyses were performed. RESULTS This systematic review included 9 randomized controlled trials (886 participants). In 2 of the studies, significant between-group differences in PA levels in favor of the intervention group were reported. The meta-analysis on PA levels showed a nonsignificant effect on moderate to vigorous PA (measured in minutes per day) between the intervention and control groups (standardized mean difference 0.30, 95% CI –0.15 to 0.75, <i>P</i>=.19). The analysis of body composition resulted in significantly greater reductions in BMI in the intervention group (standardized mean difference –0.24, 95% CI –0.45 to 0.04, <i>P</i>=.02). CONCLUSIONS This review does not support the hypothesis that serious games improve PA levels in children with a chronic disease. The meta-analysis on body composition showed positive intervention effects with significantly greater reductions in BMI in favor of the intervention group. A high percentage of nonuse was identified in the study of serious games, and little attention was paid to behavior change theories and specific theoretical approaches to enhance PA in serious games. Small sample sizes, large variability between intervention designs, and limited details about the interventions were the main limitations. Future research should determine which strategies enhance the effectiveness of serious games, possibly by incorporating behavior change techniques.

Comparison of effectiveness of Nintendo Wii-based exergaming and home-based fun video exercises in pediatric patients with chronic kidney disease

“…In contrast, Akber et al [23] did not find a significant improvement in the mean daily step count of pediatric patients with CKD. Bossen et al [33] stated that serius games (webbased or exergame) are not effective to increase the PA level of children with chronic diseases. However, homebased or intradialytic exergames with Nintendo Wii were found to be effective in increasing daily PA in pediatric kidney transplant and adult HD patients [12,27].…”

Kurdish Language Learning Tool in Serious Game

“…[2]. Using a serious game to learn children with special disorders, for instance, children with autism confirmed that learning of vocabulary items among children with autism enhanced significantly when they experience this category of the game [4], [5]. Moreover, physical activities using a serious game for children with a chronic disease may have some positive impact on the children to promote physical activity levels among these children [2].…”