JMIR Publications

ABSTRACT

Background:

Background:

Physical inactivity in youth remains a major public health concern. Exergames, defined as video games that require physical movement for gameplay, have been proposed as an innovative strategy to promote physical activity and related health outcomes in children and adolescents.

Objective:

Objective:

This systematic review aimed to synthesize the evidence on the effectiveness of exergaming interventions for promoting physical activity, health-related fitness, and body composition, and on related cognitive and psychosocial outcomes, in youth aged 10–18 years, and to explore pooled effects where sufficiently comparable data were available.

Methods:

Methods:

A systematic search was conducted in six databases (PubMed, Web of Science, Scopus, ERIC, SPORTDiscus, and PsycINFO) for studies published between January 2010 and July 2026 (last search: 7 July 2026). Eligible studies included youth aged 10-18 years, implemented an exergaming intervention, reported outcomes related to physical activity, fitness, body composition, physiological, cognitive, psychosocial, or engagement domains, and used randomized, controlled, crossover, quasi-experimental, or structured comparative designs. Risk of bias was assessed using RoB 2 and ROBINS-I. Because of substantial heterogeneity across study designs, interventions, comparators, and outcome measures, findings were synthesized narratively and, where at least three studies reported comparable data, combined using exploratory random-effects meta-analyses of standardized mean differences. The review was registered in PROSPERO: CRD420261443125.

Results:

Results:

Thirty-two studies met the inclusion criteria. Overall, exergaming showed the most consistent benefits for short-term physical activity outcomes, including increases in moderate-to-vigorous physical activity, step counts, and active minutes, particularly in structured or supervised interventions. Evidence for fitness and body composition outcomes was less consistent, although some studies reported improvements in cardiorespiratory fitness, BMI-related indicators, resting heart rate, and waist-to-hip ratio, especially in youth with overweight or obesity. A smaller subset of studies suggested favorable effects on cognitive and psychosocial outcomes, including cognitive flexibility, attention, concentration, sociability, and enjoyment. However, adherence and engagement varied considerably across studies, long-term follow-up was uncommon, and the overall certainty of evidence was limited by methodological and clinical heterogeneity. In the primary analyses restricted to randomized trials, random-effects meta-analysis yielded a small but statistically significant favourable pooled effect on body composition (Hedges g = 0.30, 95% CI 0.13 to 0.48; I-squared = 0%) and a small, non-significant effect on cardiorespiratory fitness (Hedges g = 0.10, 95% CI -0.11 to 0.30); results were consistent when non-randomized studies were added.

Conclusions:

Conclusions:

Exergaming appears to be a promising complementary strategy for increasing movement in youth and may also support selected short-term fitness, cognitive, and psychosocial outcomes. However, the evidence is stronger for immediate and short-term effects than for sustained behavioral change or broader health improvement. Exergaming should therefore be considered a supplementary tool within broader physical activity promotion strategies rather than a stand-alone solution.