Effect of Exergames on Depression: A Systematic Review and Meta-Analysis

Abstract

Depression is a major public health concern in current society. In recent years many studies began to investigate the potential benefits of exergames on depression. The current study aimed to provide a systematic review to synthesize the existing studies and discover the overall effect size of exergames on treating depression. A comprehensive literature search was conducted among major bibliographic databases in computer technology, psychology, and medical science. Key study characteristics of participants, interventions, and experiment were extracted in the systematic review. Both studies using independent groups and matched groups were included in meta-analysis. Overall effect size of Hedges' g was calculated, followed by subgroup analyses. Nine studies included in the review, while eight studies applying exergames of Nintendo's Wii or Wii Fit. A random effects meta-analysis on eight studies resulted an overall significant effect size of g = 0.21. Demographic factors, depression severity, number of session, and game type were found to be significant moderators for the effectiveness. The study has not only supported the positive effect of exergames on alleviating depression, but also provided many theoretical and practical implications for health professionals and police makers. More rigorous experimental controlled studies are needed in this new research field.

The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials

“…Recent systematic reviews and meta-analyses of this growing literature have provided preliminary evidence that exergames can improve various health-related outcomes, including reducing childhood obesity, improving balance and falls risk factors in elderly adults, facilitating functional rehabilitation in people with parkinson's disease, and even reduce depression (Barry et al, 2014;Li et al, 2016;van't Riet et al, 2014). However, the effects of exergames on cognitive functioning have not been systematically reviewed, despite many individual studies in this area.…”

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

“…Two reviews (9, 32) examined serious games for depression, while Li et al (31) focused specifically on a subset of serious games, exergames. Fleming et al (9) identified nine studies of six computerized interventions that utilized gaming as a major or primary component to treat or prevent depression.…”

“…Given the heterogeneity of included studies and the nature of many of these being small trials, some not randomized or controlled, stronger conclusions would be premature. In the more narrowly focused review (31), only three Randomised Controlled Trials (RCTs) were identified; however, the authors reported a significant effect of exergames on depressive symptoms. As noted in each review, there was a lack of direct comparison of game-based to non-gaming interventions, and most studies were not independent of the developers.…”

“…Nine of the included studies (across the three reviews) tested the use of exergames for depressive symptoms, primarily among older adults (31). Eight studies used “repurposed games,” games developed for entertainment or commercial purposes and now tested for mental health.…”

“…One was purpose-built. Li et al (31) reported a significant effect of exergames on depressive symptoms, with this being higher among more playful games, over those that included less game elements. However, these results should be interpreted with caution, given that only three of the studies were RCTs, and the sample sizes were small.…”