Li Si-Jia, Ma Hao-Ming, Zhu Lin-Qing, Yu Hong-Yu, Wang Ao-Qi, Tang Xing-Yi, Pei Run-Yuan, Piao Mei-Hua
Chinese Academy of Medical Sciences, Peking Union Medical College School of Nursing, No. 33 Ba Da Chu Road, Shijingshan District, Beijing, 100144, China.
Department of Nursing, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China.
J Med Internet Res. 2025 Aug 8;27:e62906. doi: 10.2196/62906.
Physical inactivity is defined to be an activity level insufficient to meet recommendations. Exergame, which refers to a combination of exercise and video games, has the potential to promote physical activity (PA). Behavior change techniques (BCTs), the minimal, replicable components of an intervention, are widely used to identify components used in health behavior promotion.
A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to examine the overall effects of exergame-based interventions for promoting PA and their influencing factors. BCTs were also identified and discussed in this review.
We searched for relevant RCTs across 6 databases from their inception to March 21, 2024. Meta-analyses using random-effects models assessed the effects on PA, moderate to vigorous physical activity (MVPA), light physical activity, moderate physical activity, vigorous physical activity, sedentary time, step count, and BMI. Subgroup analyses of PA were conducted to explore the influencing factors of exergame-based behavior change interventions. Review Manager software (version 5.3; Cochrane Collaboration) and Stata software (version 16; StataCorp) were used to analyze data.
A total of 20 RCTs targeting populations with various medical conditions (aged between 7.5 and 79 years; 1073/2211, 48.5% female) were included in this review, with sample sizes ranging from 16 to 1112. Exergame-based behavior change interventions significantly increased PA (standard mean difference [SMD] 0.19, 95% CI 0.05-0.33), MVPA (SMD 0.48, 95% CI 0.12-0.85), and step counts (SMD 0.54, 95% CI 0.13-0.94). Furthermore, subgroup analyses showed that intervention implementer (research assistants vs other implementers), game console (Microsoft Xbox vs Sony PlayStation vs Nintendo Wii), game participation type (individual game vs nonindividual game), measurement method (subjective vs objective), and the number of BCTs (n<7 vs 7≤n<10 vs n≥10) used significantly influenced the effectiveness of these interventions. The most frequently used BCTs included "1.4 action planning" (n=15), "1.1 goal setting" (n=13), "12.5 adding objects to the environment" (n=13), "2.3 self-monitoring of behavior" (n=11), and "4.1 instruction on how to perform the behavior" (n=11).
Our review has demonstrated that exergame-based interventions are effective in promoting PA. Future trials are needed to further validate the insights proposed in our studies and assess the long-term effects on PA.
身体活动不足被定义为活动水平不足以达到推荐标准。运动游戏，即运动与电子游戏的结合，有促进身体活动（PA）的潜力。行为改变技术（BCTs）是干预措施中最小的、可重复的组成部分，被广泛用于确定健康行为促进中使用的组成部分。
进行一项随机对照试验（RCTs）的系统评价和荟萃分析，以检验基于运动游戏的干预措施对促进PA的总体效果及其影响因素。本评价还识别并讨论了BCTs。
我们检索了6个数据库从创建到2024年3月21日的相关RCTs。使用随机效应模型进行荟萃分析，评估对PA、中度至剧烈身体活动（MVPA）、轻度身体活动、中度身体活动、剧烈身体活动、久坐时间、步数和体重指数的影响。对PA进行亚组分析，以探索基于运动游戏的行为改变干预措施的影响因素。使用Review Manager软件（5.3版；Cochrane协作网）和Stata软件（16版；StataCorp）分析数据。
本评价共纳入20项针对各种医疗状况人群（年龄在7.5至79岁之间；1073/2211，48.5%为女性）的RCTs，样本量从16到1112不等。基于运动游戏的行为改变干预措施显著增加了PA（标准均值差[SMD]0.19，95%置信区间0.05 - 0.33）、MVPA（SMD 0.48，95%置信区间0.12 - 0.85）和步数（SMD 0.54，95%置信区间0.13 - 0.94）。此外，亚组分析表明，干预实施者（研究助理与其他实施者）、游戏机（微软Xbox与索尼PlayStation与任天堂Wii）、游戏参与类型（单人游戏与非单人游戏）、测量方法（主观与客观）以及使用的BCTs数量（n<7 vs 7≤n<10 vs n≥10）对这些干预措施的有效性有显著影响。最常用的BCTs包括“1.4行动计划”（n = 15）、“1.1目标设定”（n = 13）、“12.5在环境中添加物品”（n = 13）、“2.3行为自我监测”（n = 11）和“4.1关于如何执行行为的指导”（n = 11）。
我们的评价表明，基于运动游戏的干预措施在促进PA方面是有效的。未来需要进行试验以进一步验证我们研究中提出的见解，并评估对PA的长期影响。
