JMIR Publications

ABSTRACT

Background:

Background:

Exergaming, an emerging intervention modality that integrates physical activity with video gaming, has demonstrated positive effects on the physical activity levels, physical fitness, and mental health of children and adolescents. However, its specific mechanisms and effects within school settings have not yet been systematically synthesized.

Objective:

Objective:

This study aims to systematically review the effects of school-based exergaming interventions on the physical and mental health outcomes of healthy children and adolescents.

Methods:

Methods:

A comprehensive search of six electronic databases (PubMed, Web of Science, Scopus, Cochrane Library, ScienceDirect, and PsycINFO) was conducted from their inception to June 30, 2026. The search focused on school-based exergaming interventions implemented during physical education (PE) classes, after-school programs, recess, and classroom activity breaks. Data concerning study methodology, assessment duration, participant characteristics, intervention typology, implementation setting, and delivery agents/modes were extracted. Methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale.

Results:

Results:

A total of 24 studies were included. The evaluated outcome dimensions encompassed physical activity and energy expenditure (n=4), physical fitness and body composition (n=5), motor skills and coordination (n=6), cognitive development and academic achievement (n=6), and psychological state and motivation (n=7). The overall methodological quality of the included studies was moderate to high.Generally, school-based exergaming increased physical activity levels and energy expenditure, improved cardiorespiratory fitness, muscular strength, and certain body composition indices. It also exerted positive effects on executive function, spatial cognition, academic performance, exercise motivation, enjoyment, and physical literacy.Results regarding motor skills were somewhat inconsistent; however, interventions utilizing structured teaching and professional guidance yielded superior effects compared to free play. Overall, intervention efficacy was moderated by factors such as game type, cognitive load, organizational format, and intervention duration.

Conclusions:

Conclusion: School-based exergaming represents a promising health promotion strategy capable of simultaneously improving physical activity, physical fitness, cognitive function, and psychological outcomes in children and adolescents.Because its efficacy is influenced by game type, organizational format, cognitive load, and intervention duration, structured and goal-oriented exergaming combined with teacher guidance is likely to yield more consistent benefits. Future research should prioritize large-scale, high-quality studies with long-term follow-ups to further elucidate the optimal intervention paradigms and long-term health benefits. Clinical Trial: Trial Registration: PROSPERO CRD420261447156;https://www.crd.york.ac.uk/PROSPERO/view/CRD420261447156