The overlooked role of exergames in cognitive-motor neurorehabilitation: a systematic review.

Exergames are emerging tools for cognitive-motor neurorehabilitation, but their effects in adults with neurological conditions remain insufficiently explored. This systematic review examined studies from PubMed, Scopus, Embase, and Web of Science, assessing the impact of exergames on motor and cognitive outcomes. Eligible studies included randomized controlled trials (RCTs), non-RCTs, and experimental designs. The protocol was registered on PROSPERO (CRD420250655053) and followed PRISMA and Cochrane guidelines. Eleven studies (8 RCTs, 2 feasibility studies, 1 secondary analysis) reported improvements in balance, gait, executive function, and memory, with high adherence (85-100%) and minimal adverse effects. While the overall risk of bias was low, heterogeneity in interventions, populations, and outcome measures limited comparability and generalizability. Additionally, the absence of long-term follow-up hindered conclusions on sustained benefits. Exergames appear promising for cognitive-motor rehabilitation in neurological conditions. Future studies should adopt standardized protocols, include long-term follow-up, and explore neurophysiological mechanisms to support clinical implementation.