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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2017 Oct 25

DOI: 10.23736/S1973-9087.17.04680-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Active exergames to improve cognitive functioning in neurological disabilities: a systematic review and meta-analysis

Gioia MURA 1 , Mauro G. CARTA 1, Federica SANCASSIANI 1, Sergio MACHADO 2, 3, Luca PROSPERINI 4, 5

1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; 2 National Institute of Translational Medicine (INCT-™), Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil; 3 Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University, Niterói, Brazil; 4 Department of Neurology and Psychiatry, Sapienza University, Rome, Italy; 5 Neurology Unit, S. Camillo-Forlanini Hospital, Rome, Italy


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INTRODUCTION: Exergames represent a way to perform physical activity through active video games, serving as potentially useful tool in the field of neurorehabilitation. However, little is known regarding the possible role of exergames in improving cognitive functions in persons suffering from neurological disabilities.
EVIDENCE ACQUISITION: A search for relevant articles was carried out on PubMed/Medline, Scopus, PEDro, and Google Scholar. Only randomized controlled studies and non-randomized but controlled studies were retained. The following additional inclusion criteria were applied: studies focused on physical activity interventions carried out by means of exergames; populations targeted were affected by neurological disabilities; and reported results were related to cognitive outcomes. We calculated standardized mean differences (SMD) and pooled results using a random effects meta-analysis.
EVIDENCE SYNTHESIS: Of 520 abstracts screened, thirteen studies met the criteria to be included yielding a total of 465 participants, 233 randomized to exergames, and 232 allocated to the alternative or no intervention. The included studies varied in terms of studied populations (e.g., multiple sclerosis, post-stroke hemiparesis, Parkinson’s disease, dementia, dyslexia, Down syndrome), type and duration of interventions, and cognitive outcome measures. Exergames significantly improved executive functions (SMD=0.53, p=0.005; 8 studies, n=380) and visuo-spatial perception (SMD=0.65, p<0.0001; 5 studies, n=209) when compared to the alternative or no intervention. There were no significant differences for attention (SMD=0.57, p=0.07; 7 studies, n=250) and global cognition (SMD=0.05, p=0.80; 6 studies, n=161).
CONCLUSIONS: Exergames are a highly-flexible tool for rehabilitation of both cognitive and motor functions in adult populations suffering from various neurological disabilities and developmental neurological disorders. Additional high-quality clinical trials with larger samples and more specific cognitive outcomes are needed to corroborate these preliminary findings.
CLINICAL REHABILITATION IMPACT: Exergames could be considered either as a supplemental treatment to conventional rehabilitation, or as strategy to extend benefits of conventional programs at home.


KEY WORDS: Video games - Neurological disorders - Rehabilitation - Cognition

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Publication History

Article first published online: October 25, 2017
Manuscript accepted: October 25, 2017
Manuscript revised: September 15, 2017
Manuscript received: January 31, 2017

Cite this article as

Mura G, Carta MG, Sancassiani F, Machado S, Prosperini L. Active exergames to improve cognitive functioning in neurological disabilities: a systematic review and meta-analysis. Eur J Phys Rehabil Med 2017 Oct 25. DOI: 10.23736/S1973-9087.17.04680-9

Corresponding author e-mail

mura.gioia@virgilio.it