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A Systematic Review and Meta-analysis of the Effect of Active Video Games on Postural Balance
Caio Victor Sousa1, Kelly Lee2, Dar Alon2
1From the Health and Human Sciences, Frank R. Seaver College of Science and Engineering, Loyola Marymount University, Los Angeles, CA.
Objective:
To conduct a comprehensive systematic review and meta-analysis of the effects of active video game (AVG) interventions on postural balance across all ages in populations with and without neurologic impairments, using all types of platforms.
Data Source:
Six databases (PubMed, PsycINFO, Sport Discus, MEDLINE, Web of Science, and Google Scholar) were reviewed by December 31, 2020.
Study Selection:
The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, a study must be original, published in English peer-reviewed venues and employed AVGs as the sole or primary intervention to enhance, maintain, or regain postural balance. At least 2 within- or between-subjects conditions must be included with ≥10 participants per condition.
Data Extraction:
Three reviewers independently performed data extraction and assessed the risk of bias.
Data Synthesis:
129 studies were identified, with 102 eligible for meta-analysis. The total number of tested participants was 6407 (60.0% women, Mage=55.1 years, range=3-99 years, SD=22.6). The average intervention duration was 35.6 min/session with 3.1 sessions/week for 7.6 weeks. The overall effect favored AVG interventions (Hedges' g=0.469; 95% confidence interval [CI]=0.407-0.531). Although the overall study quality was relatively low, the analysis expectedly indicated significantly larger effects (P<.001) for AVG-interventions over passive controls (Hedges' g=0.627; 95% CI=0.466-0.788), but importantly also favored AVG-interventions over conventional treatment (Hedges' g=0.389; 95% CI=0.311-0.468). All clinical populations responded positively, although with different effect sizes (P=.023). Children experienced larger treatment effects (Hedges' g=0.550; 95% CI=0.336-0.764), closely followed by seniors (Hedges' g=0.529; 95% CI=0.402-0.656). The largest intervention effect on balance improvements was seen in healthy people without a medical condition (Hedges' g=0.609; 95% CI=0.465-0.753).
Conclusions:
AVGs can produce postural balance improvements and better postural maintenance. All populations could benefit from AVG interventions.
