Rodríguez Timaná Luis Carlos, Castillo García Javier Ferney, Bastos Filho Teodiano, Ocampo González Alvaro Alexander, Hincapié Monsalve Nazly Rocio, Valencia Jimenez Nicolas Jacobo
Faculty of Engineering, Universidad Santiago de Cali, Santiago de Cali, Colombia.
Faculty of Engineering, Universidad Autónoma de Occidente, Santiago de Cali, Colombia.
JMIR Serious Games. 2024 Dec 18;12:e59053. doi: 10.2196/59053.
Serious games (SG) have emerged as promising tools for cognitive training and therapeutic interventions, especially for enhancing executive functions. These games have demonstrated the potential to support individuals with diverse health conditions, including neurodevelopmental and cognitive disorders, through engaging and interactive experiences. However, a comprehensive understanding of the effectiveness of SG in enhancing executive functions is needed.
This systematic review aims to assess the impact of serious games on executive functions (EF), focusing on attention, working memory, cognitive flexibility, and inhibitory control. In addition, it explores the integration of SG into educational and therapeutic settings for individuals with cognitive and neurodevelopmental conditions. Only open access articles published from 2019 to the search date were included to capture the most recent advancements in the field.
A comprehensive search was conducted on June 20, 2024, across Scopus, Web of Science, and PubMed databases. Due to limited direct results linking SG and neurodiversity, separate searches were performed to analyze the relationship between SG and EF, as well as SG and neurodiverse populations. Two independent reviewers assessed the quality and risk of bias of the included studies using the Risk of Bias 2 tool for randomized studies and the Risk of Bias in Non-Randomized Studies of Interventions tool for nonrandomized studies.
The review identified 16 studies that met the inclusion criteria. Of these, 15 addressed the use of SG for improving EF in neurodiverse populations, such as children with attention-deficit/hyperactivity disorder, autism spectrum disorder, and down syndrome. These studies demonstrated significant improvements in various EF domains, including attention, working memory, and cognitive flexibility. However, there was notable heterogeneity in sample sizes, participant ages, and game types. Three studies specifically focused on individuals with down syndrome, showing promising results in improving cognitive functions.
SG hold considerable potential as therapeutic tools for enhancing EF across neurodiverse populations. They have shown positive effects in improving cognitive skills and promoting inclusion in both educational and therapeutic settings. However, further research is required to optimize game design, assess long-term outcomes, and address the variability in study quality. The exclusive inclusion of open access studies may have limited the scope of the review, and future research should incorporate a broader range of studies to provide a more comprehensive understanding of SG's impact on neurodiversity.
PROSPERO CRD42024563231; https://tinyurl.com/ycxdymyb.
严肃游戏（SG）已成为认知训练和治疗干预的有前景的工具，特别是在增强执行功能方面。这些游戏已证明有潜力通过引人入胜的互动体验来支持患有各种健康状况的个体，包括神经发育和认知障碍。然而，需要全面了解SG在增强执行功能方面的有效性。
本系统评价旨在评估严肃游戏对执行功能（EF）的影响，重点关注注意力、工作记忆、认知灵活性和抑制控制。此外，它还探讨了将SG整合到针对认知和神经发育状况个体的教育和治疗环境中的情况。仅纳入了2019年至搜索日期发表的开放获取文章，以捕捉该领域的最新进展。
2024年6月20日在Scopus、科学网和PubMed数据库中进行了全面搜索。由于将SG与神经多样性联系起来的直接结果有限，因此分别进行搜索以分析SG与EF之间的关系以及SG与神经多样化人群之间的关系。两名独立评审员使用随机研究的偏倚风险2工具和非随机干预研究的偏倚风险工具评估纳入研究的质量和偏倚风险。
该评价确定了16项符合纳入标准的研究。其中，15项研究探讨了SG在改善神经多样化人群（如注意力缺陷/多动障碍儿童、自闭症谱系障碍儿童和唐氏综合征儿童）的EF方面的应用。这些研究表明，在包括注意力、工作记忆和认知灵活性在内的各个EF领域都有显著改善。然而，样本量、参与者年龄和游戏类型存在显著异质性。三项研究专门针对唐氏综合征个体，在改善认知功能方面显示出有希望的结果。
SG作为增强神经多样化人群EF的治疗工具具有相当大的潜力。它们在提高认知技能以及促进教育和治疗环境中的融合方面已显示出积极效果。然而，需要进一步研究来优化游戏设计、评估长期结果并解决研究质量的变异性问题。仅纳入开放获取研究可能限制了评价的范围，未来的研究应纳入更广泛的研究，以更全面地了解SG对神经多样性的影响。
PROSPERO CRD42024563231；https://tinyurl.com/ycxdymyb。
