OBJECTIVE To evaluate systematically the efficacy of exergames for balance dysfunction in neurological conditions and to identify factors of exergaming protocols that may influence their effects. METHODS We searched electronic databases for randomized clinical trials investigating the effect of commercial exergames versus alternative interventions on balance dysfunction as assessed by standard clinical scales in adults with acquired neurological disabilities. Standardized mean differences (Hedge's g) were calculated with random-effects models. Subgroup analyses and meta-regression were run to explore potential modifiers of effect size. RESULTS Out of 106 screened articles, 41 fulfilled criteria for meta-analysis, with a total of 1223 patients included. Diseases under investigation were stroke, Parkinson's disease, multiple sclerosis, mild cognitive impairment or early Alzheimer's disease, traumatic brain injury, and myelopathy. The pooled effect size of exergames on balance was moderate (g = 0.43, p < 0.001), with higher frequency (number of sessions per week) associated with larger effect (β = 0.24, p = 0.01). There was no effect mediated by the overall duration of the intervention and intensity of a single session. The beneficial effect of exergames could be maintained for at least 4 weeks after discontinuation, but their retention effect was specifically explored in only 11 studies, thus requiring future investigation. Mild to moderate adverse events were reported in a minority of studies. We estimated a low risk of bias, mainly attributable to the lack of double-blindness and not reporting intention-to-treat analysis. CONCLUSIONS The pooled evidence suggests that exergames improve balance dysfunction and are safe in several neurological conditions. The findings of high-frequency interventions associated with larger effect size, together with a possible sustained effect of exergaming, may guide treatment decisions and inform future research.

中文翻译：

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神经功能障碍平衡功能障碍的运动游戏：具有元回归的元分析。

目的 系统地评估运动游戏对神经系统疾病平衡功能障碍的疗效，并确定可能影响其效果的运动游戏方案的因素。方法我们在电子数据库中搜索了随机临床试验，这些试验调查了商业运动游戏与替代干预措施对平衡功能障碍的影响，如标准临床量表在患有后天性神经障碍的成人中所评估的。使用随机效应模型计算标准化平均差异 (Hedge's g)。运行亚组分析和元回归以探索影响大小的潜在修饰符。结果 在筛选的 106 篇文章中，41 篇符合荟萃分析的标准，共纳入 1223 名患者。正在调查的疾病包括中风、帕金森病、多发性硬化症、轻度认知障碍或早期阿尔茨海默病、创伤性脑损伤和脊髓病。exergames 对平衡的汇总效应大小适中（g = 0.43，p < 0.001），较高的频率（每周会话数）与较大的效应相关（β = 0.24，p = 0.01）。干预的总持续时间和单次会议的强度没有中介作用。exergames 的有益效果在停药后可以维持至少 4 周，但仅在 11 项研究中专门探讨了它们的保留效果，因此需要进一步调查。少数研究报告了轻度至中度不良事件。我们估计偏倚风险较低，主要是由于缺乏双盲和未报告意向治疗分析。结论汇总的证据表明，运动游戏可以改善平衡功能障碍，并且在几种神经系统疾病中是安全的。与更大效应量相关的高频干预的结果，以及运动游戏可能的持续效应，可能会指导治疗决策并为未来的研究提供信息。