A Systematic Review and Meta-analysis of the Effect of Active Video Games on Postural Balance

Caio Victor Sousa; Kelly Lee; Dar Alon; Dagmar Sternad; Amy S Lu

doi:10.1016/j.apmr.2023.01.002

A Systematic Review and Meta-analysis of the Effect of Active Video Games on Postural Balance

Arch Phys Med Rehabil. 2023 Apr;104(4):631-644. doi: 10.1016/j.apmr.2023.01.002. Epub 2023 Jan 18.

Authors

Caio Victor Sousa¹, Kelly Lee², Dar Alon², Dagmar Sternad³, Amy S Lu⁴

Affiliations

¹ From the Health and Human Sciences, Frank R. Seaver College of Science and Engineering, Loyola Marymount University, Los Angeles, CA.
² Health Technology Lab, Departments of Communication Studies and Health Sciences, College of Arts, Media, and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA.
³ Departments of Biology, Electrical & Computer Engineering, and Physics, Northeastern University, Boston, MA.
⁴ Health Technology Lab, Departments of Communication Studies and Health Sciences, College of Arts, Media, and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA. Electronic address: a.lu@northeastern.edu.

Abstract

Objective: To conduct a comprehensive systematic review and meta-analysis of the effects of active video game (AVG) interventions on postural balance across all ages in populations with and without neurologic impairments, using all types of platforms.

Data source: Six databases (PubMed, PsycINFO, Sport Discus, MEDLINE, Web of Science, and Google Scholar) were reviewed by December 31, 2020.

Study selection: The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, a study must be original, published in English peer-reviewed venues and employed AVGs as the sole or primary intervention to enhance, maintain, or regain postural balance. At least 2 within- or between-subjects conditions must be included with ≥10 participants per condition.

Data extraction: Three reviewers independently performed data extraction and assessed the risk of bias.

Data synthesis: 129 studies were identified, with 102 eligible for meta-analysis. The total number of tested participants was 6407 (60.0% women, M_age=55.1 years, range=3-99 years, SD=22.6). The average intervention duration was 35.6 min/session with 3.1 sessions/week for 7.6 weeks. The overall effect favored AVG interventions (Hedges' g=0.469; 95% confidence interval [CI]=0.407-0.531). Although the overall study quality was relatively low, the analysis expectedly indicated significantly larger effects (P<.001) for AVG-interventions over passive controls (Hedges' g=0.627; 95% CI=0.466-0.788), but importantly also favored AVG-interventions over conventional treatment (Hedges' g=0.389; 95% CI=0.311-0.468). All clinical populations responded positively, although with different effect sizes (P=.023). Children experienced larger treatment effects (Hedges' g=0.550; 95% CI=0.336-0.764), closely followed by seniors (Hedges' g=0.529; 95% CI=0.402-0.656). The largest intervention effect on balance improvements was seen in healthy people without a medical condition (Hedges' g=0.609; 95% CI=0.465-0.753).

Conclusions: AVGs can produce postural balance improvements and better postural maintenance. All populations could benefit from AVG interventions.

Keywords: Active-video gaming; Exergaming; Meta-analysis; Postural balance; Posture sway; Rehabilitation; Systematic review; Telerehabilitation; Video games; Virtual reality; Virtual reality exercise.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Child
Female
Health Status
Humans
Male
Postural Balance
Sports*
Video Games*

Abstract

Publication types

MeSH terms

Grants and funding