Bossen Daniël, Broekema Aline, Visser Bart, Brons Annette, Timmerman Annieck, van Etten-Jamaludin Faridi, Braam Katja, Engelbert Raoul
ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
Digital Life Centre, Faculty of Digital Media and Creative Industries, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
J Med Internet Res. 2020 Apr 1;22(4):e14549. doi: 10.2196/14549.
Physical activity (PA) is important for children with a chronic disease. Serious games may be useful to promote PA levels among these children.
The primary purpose of this systematic review was to evaluate the effectiveness of serious games on PA levels in children with a chronic disease.
PubMed, EMBASE, PsycINFO, ERIC, Cochrane Library, and CINAHL were systematically searched for articles published from January 1990 to May 2018. Both randomized controlled trials and controlled clinical trials were included to examine the effects of serious games on PA levels in children with a chronic disease. Two investigators independently assessed the intervention, methods, and methodological quality in all articles using the Cochrane risk of bias tool. Both qualitative and quantitative analyses were performed.
This systematic review included 9 randomized controlled trials (886 participants). In 2 of the studies, significant between-group differences in PA levels in favor of the intervention group were reported. The meta-analysis on PA levels showed a nonsignificant effect on moderate to vigorous PA (measured in minutes per day) between the intervention and control groups (standardized mean difference 0.30, 95% CI -0.15 to 0.75, P=.19). The analysis of body composition resulted in significantly greater reductions in BMI in the intervention group (standardized mean difference -0.24, 95% CI -0.45 to 0.04, P=.02).
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 with significantly greater reductions in BMI in favor of the intervention group. A high percentage of nonuse was identified in the study of serious games, and little 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 the interventions were the main limitations. Future research should determine which strategies enhance the effectiveness of serious games, possibly by incorporating behavior change techniques.
身体活动对患有慢性病的儿童很重要。严肃游戏可能有助于提高这些儿童的身体活动水平。
本系统评价的主要目的是评估严肃游戏对患有慢性病儿童身体活动水平的有效性。
系统检索了1990年1月至2018年5月发表在PubMed、EMBASE、PsycINFO、ERIC、Cochrane图书馆和CINAHL上的文章。纳入随机对照试验和对照临床试验，以研究严肃游戏对患有慢性病儿童身体活动水平的影响。两名研究者使用Cochrane偏倚风险工具独立评估所有文章的干预措施、方法和方法学质量。进行了定性和定量分析。
本系统评价纳入了9项随机对照试验（886名参与者）。在2项研究中，报告了干预组和对照组在身体活动水平上存在显著的组间差异，干预组更优。对身体活动水平的荟萃分析显示，干预组和对照组之间在中度至剧烈身体活动（以每天分钟数衡量）方面的效果不显著（标准化均数差0.30，95%可信区间-0.15至0.75，P=0.19）。身体成分分析结果显示，干预组的体重指数显著降低（标准化均数差-0.24，95%可信区间-0.45至0.04，P=0.02）。
本评价不支持严肃游戏能提高患有慢性病儿童身体活动水平这一假设。身体成分的荟萃分析显示出积极的干预效果，干预组的体重指数显著降低。在严肃游戏研究中发现有很高比例的未使用情况，并且很少关注行为改变理论和在严肃游戏中增强身体活动的具体理论方法。样本量小、干预设计之间差异大以及干预细节有限是主要局限性。未来的研究应确定哪些策略能提高严肃游戏的有效性，可能需要纳入行为改变技术。
