Effectiveness of Active Exergames for Improving Cognitive Function in Patients with Neurological Disabilities: A Systematic Review and Meta-Analysis.

Active exergaming for improving cognitive function is a relatively novel concept as it has certain unique features that could prove advantageous in improving patient outcomes, particularly in patients with neurological disabilities. Hence, we have conducted this review to obtain a comprehensive estimate of effectiveness of active exergames for improving cognitive functioning in patients with neurological disabilities. Literature search was done in PubMed Central, SCOPUS, MEDLINE, and Cochrane Library, ScienceDirect, and Google Scholar until February 2022. We carried out a meta-analysis with a random-effects model and reported pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs). In total, we analyzed 21 studies and half of them had a high risk of bias and were conducted in Korea and the United States. The pooled SMD for global cognition was 0.46 (95% CI: -0.01 to 0.94; I 2  = 81.2%), pooled SMD for attention function was 0.49 (95% CI: -0.12 to 0.10; I 2  = 81%), pooled SMD for perception function was 0.31 (95% CI: -0.02 to 0.65; I 2  = 0%), and pooled SMD for executive function was -0.26 (95% CI: -0.86 to 0.33; I 2  = 86.7%). Active exergames can have a beneficial effect on most cognitive outcomes, although not statistically significant for managing patients with neurological disabilities.