Effects of exergaming on executive functions of children: a systematic review and meta-analysis from 2010 to 2023

Background Executive function plays a crucial role in children's cognitive development, academic performance, as well as their physical and mental health. This study aims to assess the impact of exergaming on executive functions in pediatric populations.Methods The criteria of inclusion were randomized controlled trials of exergaming intervention and evaluation of executive function in children aged 4-12 years. A meta-analysis was performed in databases of China National Knowledge Infrastructure (in Chinese), Wan Fang (in Chinese), Web of Science, Embase, and PubMed, from January 2010 to February 2023, following the PRISMA guidelines. Risk of bias was assessed by the Jadad scale, the Cochrane risk of bias assessment tool, funnel plot, and regression-based Egger test. The Review Manager 5.3 was used to analyze the included articles using a random-effects model, and the effects were calculated as standardized mean difference (SMD).Results Eleven experimental studies with children (n = 508) were included. Exergaming was found to have a positive impact on children's cognitive flexibility (SMD = 0.34, 95%CI [0.17,0.52], P < 0.01), inhibitory control (SMD = 0.57, 95%CI [0.31,0.83], P < 0.01), and working memory (SMD = 0.26, 95%CI [0.02,0.51], P < 0.05). The publication bias were observed.Conclusions Exergaming has the potential to improve executive functions in children. More studies with rigorous designs are warranted to explore the specific effects of exergaming intervention. This study was registered on the PROSPERO (CRD42023401526).