Nonphysical effects of exergames on child and adolescent well‐being: a comprehensive systematic review

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Physical activity (PA) is associated with numerous health benefits in children and youth 1. According to WHO recommendations, children and youth should accumulate at least 60 minutes of moderate to vigorous intensity PA daily 2. However, only 20% of children aged 13–15 meet this recommendation 3. In recent years, several methods have therefore been developed to promote PA among children and adolescents 4. Exergames or active (video) games that allow players to perform PA are continuing to increase in popularity 5. Boys and older adolescents are more likely to play nonactive games than girls and younger children 7.
There are several reviews of the effects of exergaming on physical activity among children and adolescents. Some of them have shown that exergaming increases PA 8, energy expenditure 8, maximal oxygen uptake 8, heart rate 8. It has been found that active video games promote only light‐to‐moderate intensity PA 10. A recent review of reviews shows that exergaming does not increase PA levels sufficiently for significant health benefits 11. For instance, energy expenditure appears to be significantly lower in games played primarily through upper body movements compared with those that require both upper and lower body movements 12. In summary, active video games have the potential to increase energy expenditure as well as PA to light‐to‐moderate levels 13.
No evidence has been found that children receiving active video games were spontaneously more active than children receiving inactive video games 14. The effects of field‐based exergaming on children's habitual PA have been remained unclear 15. In summary, more evidence is needed about the effects of exergaming from longitudinal RCT studies 16.
It has been reported that exergaming generates several nonphysical effects, for example social relatedness 17. However, to our knowledge, no review has been published about the nonphysical effects of exergames among schoolchildren. It is obvious that without entertainment and other nonphysical benefits, exergames will soon begin to lose their popularity among this group. It has been suggested that psychological factors such as enjoyment and motivation might play a critical role in physiological outcomes 5. Buday et al. 18 however argued that fun is an entertainment game's payload, but a serious game's payload is delivered through fun. They suspected that in the future instead of comparisons with entertainment game titles, pundits might consider serious videogames on their own merits. Shiroun 19 stated based on her literature review that narrative, such as enhanced engagement with characters, increased motivation, and better consequence would have potential in effective exergames. Also feedback, challenge and rewards may affect enjoyment and active behaviour by increasing feelings of engagement during exergaming 20. Exergaming developers also need more knowledge about what it is that drives the popularity of their products.
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