A comprehensive systematic review and content analysis of active video game intervention research

Intervention research using digital games to promote physical activity has proliferated. Yet few studies have attempted to systematically catalog features that characterize this research. To address this gap, we undertook a systematic review and content analysis of active video game interventions, examining only published longitudinal interventions that prominently featured active video game technology (≥50% of the intervention).

Our protocol was registered in the International Prospective Register of Systematic Reviews (CRD42020204191). For inclusion, an active video game intervention had to require gross movement beyond finger movement, and target improvement, maintenance, or recovery of health. The intervention design had to include at least two conditions, within- or between-subjects, with ≥10 participants per condition to examine the chronic effects of active video game exposure.

The search resulted in 232 studies published in English between 1996 and 2020. The majority of active video game interventions (69.8%) targeted physical fitness (physiological functioning as a consequence of physical activity), followed by cognitive performance (11.3%), physical activity (5.5%), or a mixture of those outcomes (13.4%). Total enrollment across all studies was 14,849 participants (M _Participants = 62, SD = 106; M _Age = 50.2, SD = 25.2 years; 47.3% men). A strong majority of the samples (69.8%) were recruited from medical subpopulations, and only 30.2% were recruited from the general (healthy) population. A strong majority of active video games (72.0%) were developed by industry for the commercial market, and only 13.3% were funded by government or foundation grants.

Suggested directions for improving future active video game development and intervention research include greater consideration of promising features (social connectedness, novelty, narrative, rhythmic movement to music) and new models for productive collaboration between industry and academia.