Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 1, 2019
Open Peer Review Period: May 6, 2019 - Jul 1, 2019
Date Accepted: Jan 27, 2020
(closed for review but you can still tweet)
Effectiveness of serious games to increase physical activity in children with a chronic disease: a systematic review with meta-analysis
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 the present 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 from January 1990 to May 2018. Both randomized controlled trials and controlled clinical trials were included examining the effects of a serious game on PA levels in children with a chronic disease. Two investigators, independently, assessed all articles on intervention, methods, and methodological quality by using the Cochrane risk of bias tool. Both qualitative and quantitative analyses were performed.
Results:
Nine randomized controlled trials (886 participants) were included in this systematic review. Two included studies reported significant between-group differences in PA levels in favor of the intervention group. The meta-analysis on PA showed a non-significant effect on moderate to vigorous PA min/day between the intervention group and the control group (standardized mean difference 0.30, 95% CI -0.15 to 0.75, P=.19). The analysis on body composition showed that studies reported a reduction in Body Mass Index (BMI) in favor of the intervention group (standardized mean difference -0.24, 95%CI -0.45 to 0.04, P=.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 by a significant reduced BMI scores in favor of the intervention group. A high percentage of non-use was identified in serious games and less 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 intervention contents were the main limitations. Research should find out which strategies enhance the effectiveness of serious games, possibly by incorporating behavior change techniques. Clinical Trial: Systematic review registration number:CRD42018070662
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