UNASSIGNED: Exergames are an innovative method that can promote neuroplasticity and improve the cognitive abilities of the elderly. This study aimed to compare the effects of single-task and multi-task exergames on the cognitive ability of the elderly with mild cognitive impairment (MCI).
UNASSIGNED: Computerized literature search was performed using PubMed, Web of Science, EBSCO, Elsevier, ProQuest, China National Knowledge Infrastructure (CNKI), Wanfang and VIP database to identify relevant articles from the establishment of the database from inception to April 1, 2024. The inclusion criteria were: (i) participants aged 60 or older diagnosed with mild cognitive impairment, regardless of gender; (ii) use of randomized controlled trials (RCTs); (iii) interventions involving exergames with physical activity or as the primary variable; and (iv) outcome measures using standardized neuropsychological instruments to assess cognitive function, including statistical data on sample size, mean, and standard deviation. Finally, the included study comprised a total of 526 participants. Mean difference (MD) and 95% confidence interval (CI) were used to synthesize the effect size in the data.
UNASSIGNED: 11 studies were included. Due to the differences in the intervention methods, subgroup analysis was performed on the included research. Compared with the control group assessed by the Montreal Cognitive Assessment Scale, the single-task intervention improved the cognitive ability of the elderly with MCI (MD 3.40, 95% CI 2.43-4.37), the Mini-Mental State Examination Scale (MD 2.38, 95% CI -2.03 to 2.72), the Trail Making Test (MD -3.89, 95% CI -6.45 to -1.33), and the Digit Span Forward test (MD 1.16, 95% CI 0.73-1.60).
UNASSIGNED: This meta-analysis supports that exergames could be an effective cognitive rehabilitation method for MCI patients. Our study recommends that patients implement a customized exergames program and adhere to it for a long time. It is necessary to pay attention to the exercise guidelines and provide evidence from clinicians.
UNASSIGNED: (1) This meta-analysis supports that exergames could be an effective cognitive rehabilitation method for MCI patients. Our study recommends that patients implement a customized exergames program and adhere to it for a long time. It is necessary to pay attention to the exercise guidelines and provide evidence from clinicians. (2) This research provides preliminary evidence for the clinical utility of VR tasks developed for mild cognitive impairment. (3) In this paper, only relevant studies in Chinese and English were searched, and no studies in other languages were searched.

BACKGROUND: A large proportion of adolescents with developmental coordination disorder (DCD) are physically inactive. Physical literacy has been described as an important determinant in promoting health behaviours. The potential of exergames to improve physical literacy and activity has been recognized in typically developing children. The aim of the present scoping review was to identify and map the available evidence of this potential for adolescents with DCD.
METHODS: A scoping review was performed via a literature search in PubMed, Web of Science, Embase, ERIC and CINHAIL.
RESULTS: From 2860 search records, six studies (two studies in DCD and four studies in cerebral palsy [CP]) assessed physical activity, 12 studies discussed exergame features and 16 studies assessed physical literacy domains. In DCD, one study showed positive effects of exergaming on physical activity and the other failed to show any significant effects of exergaming. In CP, all four studies demonstrated positive effects of exergaming on energy expenditure and daily physical activity. Furthermore, positive effects of exergames on the different physical literacy domains were shown, namely motor competence, self-concept and affect, motivation and social/experiential. Finally, exergame features including multiplayer modes, realism, game rewards, challenges and enjoyment were shown to have a significant effect on motivating and encouraging adolescents to exert more effort while playing.
CONCLUSIONS: Based on the positive effects of exergaming on physical activity in other populations, more in-depth research in adolescents with DCD is warranted such that the decline in physical activity behaviour that is present in individuals with DCD can be counteracted. Physical literacy should be regarded as an important determinant in this regard.

Background: People with rare neurological diseases (RNDs) often experience symptoms related to movement disorders, requiring a multidisciplinary approach, including rehabilitation. Telemedicine applied to rehabilitation and symptom monitoring may be suitable to ensure treatment consistency and personalized intervention. The objective of this scoping review aimed to emphasize the potential role of telerehabilitation and teleassessment in managing movement disorders within RNDs. By providing a systematic overview of the available literature, we sought to highlight potential interventions, outcomes, and critical issues. Methods: A literature search was conducted on PubMed, Google Scholar, IEEE, and Scopus up to March 2024. Two inclusion criteria were followed: (1) papers focusing on telerehabilitation and teleassessment and (2) papers dealing with movement disorders in RNDs. Results: Eighteen papers fulfilled the inclusion criteria. The main interventions were home-based software and training programs, exergames, wearable sensors, smartphone applications, virtual reality and digital music players for telerehabilitation; wearable sensors, mobile applications, and patient home video for teleassessment. Key findings revealed positive outcomes in gait, balance, limb disability, and in remote monitoring. Limitations include small sample sizes, short intervention durations, and the lack of standardized protocols. Conclusion: This review highlighted the potential of telerehabilitation and teleassessment in addressing movement disorders within RNDs. Data indicate that these modalities may play a major role in supporting conventional programs. Addressing limitations through multicenter studies, longer-term follow-ups, and standardized protocols is essential. These measures are essential for improving remote rehabilitation and assessment, contributing to an improved quality of life for people with RNDs.

This study aims to identify effective ways to design virtual rehabilitation to obtain physical improvement (e.g. balance and gait) and support engagement (i.e. motivation) for people with osteoporosis or other musculoskeletal disorders. Osteoporosis is a systemic skeletal disorder and is among the most prevalent diseases globally, affecting 0.5 billion adults. Despite the fact that the number of people with osteoporosis is similar to, or greater than those diagnosed with cardiovascular disease and dementia, osteoporosis does not receive the same recognition. Worldwide, osteoporosis causes 8.9 million fractures annually; it is associated with substantial pain, suffering, disability and increased mortality. The importance of physical therapy as a rehabilitation strategy to avoid osteoporosis fracture cannot be over-emphasised. However, the main rehabilitation challenges relate to engagement and participation. The use of virtual rehabilitation to address such challenges in the delivery of physical improvement is gaining in popularity. As there currently is a paucity of literature applying virtual rehabilitation to patients with osteoporosis, the authors broadened the search parameters to include articles relating to the virtual rehabilitation of other skeletal disorders (e.g. Ankylosing spondylitis, spinal cord injury, motor rehabilitation, etc.). This systematic review initially identified 130 titles, from which 23 articles (involving 539 participants) met all eligibility and selection criteria. Four groups of devices supporting virtual rehabilitation were identified: a head-mounted display, a balance board, a camera and more specific devices. Each device supported physical improvement (i.e. balance, muscle strength and gait) post-training. This review has shown that: (a) each device allowed improvement with different degrees of immersion, (b) the technology choice is dependent on the care need and (c) virtual rehabilitation can be equivalent to and enhance conventional therapy and potentially increase the patient\'s engagement with physical therapy.

Sedentary behavior and inadequate energy expenditure are serious global public health concerns among youngsters. The exponential growth in technology emerges as a valuable opportunity to foster physical activity, particularly through active video games. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in PubMed, Web of Science, Cochrane, and Scopus to provide a comprehensive view of the literature on energy expenditure levels among adolescents while playing active video games. Among the 574 manuscripts identified at the first screening stage, 23 were retained for analysis. Ten studies were characterized by longitudinal and thirteen by cross-sectional designs. The results showed that short-term active video games elicited energy expenditure values comparable to moderate-intensity physical activity (3-6 METs). However, in intervention programs (with at least six weeks) the results indicate no significant effects of active video games on youngsters\' energy expenditure levels and physical activity profiles between baseline and follow-up assessments. Overall, active video games based on sports and dance were the most used, and boys tended to achieve higher energy expenditure than girls. The diversity of methods implemented limits comparing results and drawing generalized conclusions. However, considering its attractiveness to youth, active video games might emerge as a complementary tool to traditional physical activities promoted in schools and local communities. Details regarding gender differences and contradictory results of longitudinal approaches should be considered in future research based on standardized methods.

Many studies have shown that personalized exergames have a positive effect on promoting regular and proper exercise. However, there is no consensus on the design characteristics and evaluation of exergames. This systematic review of published research literature aimed to explore the general characteristics, personalization characteristics, and evaluation of personalized exergames for middle-aged and older people. We screened published studies in the Web of Science, Scopus, PubMed, ACM, and IEEE Xplore databases, extracted data, and performed a thematic analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Three main themes and nine subthemes were generated from 24 included papers. Moreover, a personalization model (FACTS) and evaluation system (PMSS) of exergames were developed. Personalized exergames had potential positive effects on motivating middle-aged and older people to exercise and improve their health, particularly physical, mental, and social health. However, more fine-grained studies on personalized exergames are necessary in the future.

Exergames (video games that promote cognitive and physical activity simultaneously) benefit executive function in elderly populations. It has been suggested that exergames may induce larger effects than cognitive or exercise training alone, but few reviews have synthesized the causal factors of exergames on executive function from experimental research with youth. This review investigates (1) the various types of exergames and associated comparison conditions (2) the executive function outcome assessments commonly utilized in exergame research with youth (3) the efficacy of exergames by evaluating experimental studies that compared exergaming to cognitive, exercise, and passive control conditions inclusive of effect sizes and (4) the potential mechanisms underlying the changes in executive function induced from exergames. Eligible outcome data were available from 607 participants across ten studies, with the age of participants ranging from 4-21 (Mage=10.46). The findings indicate that exergames improve aspects of executive function from both acute and chronic studies. Despite the high variability of exergame contexts, dosage, populations, and outcome assessments, improvements in executive function comparing exergaming to passive control conditions were exhibited across all studies. While there is evidence of exergaming demonstrating advantages over passive control conditions, evidence is mixed when comparing exergaming to sedentary cognitive and exercise comparison conditions. Potential sources of these mixed results and future directions to address current gaps in the field are identified. As video game and technology use grows exponentially and concerns of childhood sedentary behavior and play deprivation increase, evidence-based practices that promote both physical and cognitive activity are needed.

Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis.
This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment.
Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate.
Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (P=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (P=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (P=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; P=.03) and conventional cognitive training (2/11, 18%; P<.001) in enhancing nonverbal learning.
Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods.
PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa.

People with Parkinson disease suffer from a loss of dopaminergic neurons, which are involved in walking speed. Currently, virtual reality (VR) has emerged as a useful tool for the rehabilitation of people with neurological diseases, optimizing results in balance and gait. This review aimed to evaluate the effectiveness of VR or video games (through face-to-face sessions and not telerehabilitation) in improving walking speed and other spatio-temporal parameters of gait, balance, and quality of life in patients with Parkinson disease. A bibliographic search was carried out in the MEDLINE, Web of Science, Scopus, and PEDro databases. This systematic review adhered to the PRISMA guideline statement and was registered in PROSPERO (CRD42020180836). From a total of 119 records, 5 studies met the inclusion criteria for qualitative analysis, of which 3 contributed to the meta-analysis; inconclusive findings were found on gait speed, balance, and quality of life after the use of non-immersive VR systems face-to-face. A greater number of studies are necessary, with a greater number of participants, to differentiate between those VR specific systems (specifically designed for rehabilitation) from commercial video games, including immersive systems, and obtain more conclusive evidence. Furthermore, it would be interesting to compare the administration of this treatment in person versus its administration via telerehabilitation, which will help plan treatment programs.

BACKGROUND: Sedentary lifestyles have been identified as a major risk factor for cardiovascular complications for individuals with type 2 diabetes mellitus (T2DM). Using video-gaming components, game-based exercise interventions can encourage these individuals to engage in regular physical activity (PA), given their favorable interactive interfaces, feedback, and on-demand flow experiences.
OBJECTIVE: To evaluate the effectiveness of game-based exercise interventions, on modifiable cardiovascular risk factors, quality of life, and PA levels among individuals with T2DM.
METHODS: Published and unpublished studies were retrieved from eight electronic databases and reference lists of the included studies. Articles included in this study were from the inception of the databases to January 2022. Two reviewers performed screening, quality appraisal, and data extraction independently. Meta-analyses were conducted for the primary and secondary outcomes through RevMan. The protocol was registered on PROSPERO (CRD42022298894).
RESULTS: Of the 11 selected studies involving 1045 individuals of both genders with T2DM, 9 were included in the meta-analyses for glycosylated hemoglobin, blood pressure (BP), low-density lipoprotein cholesterol, quality of life, and physical activity levels. The meta-analyses reported very small to large effect sizes favoring game-based exercise interventions. Large effect sizes were reported for systolic BP, diastolic BP, and quality of life measured through SF-12 Mental Component Summary scores.
CONCLUSIONS: Game-based exercise interventions may improve modifiable cardiovascular risk factors, quality of life, and PA levels among individuals with T2DM. Supervision, PA levels, or motivation can affect the effectiveness of game-based exercise interventions.