A Systematic Review and Meta-analysis of the Effect of Active Video Games on Postural Balance.

The studies being pooled were mostly low quality. The average GRADE rating was −0.38 on a scale from −1 to +1, and two thirds of the studies did not blind participants or staff. Publication bias is likely. Egger's test was significant (P = .003), the funnel plot was asymmetric, and 211 of 283 balance outcomes improved with none worsening, which the authors say suggests null or negative results were never published. Only English-language articles were included, and about half of the studies came from Asia, which the authors say may have influenced the results. No study tested whether the balance improvements lasted after training stopped, and none reported whether the number of falls decreased. Severity of impairment could not be separated, because most studies grouped people with mild, moderate and severe disease into the same article. Many studies used more than one game, so the effect of any single game could not be isolated. The experimental groups were small: on average 24 participants per study.

The text provided contains no funding or conflict-of-interest declaration for this review itself. Of the included studies, only 19 (14.7%) created their games through government or foundation research funding, and 15 (11.6%) did not report where their games came from.

Do not conclude that video games should replace conventional balance therapy. The pooled advantage over conventional therapy was modest, most of the 102 studies did not blind participants or therapists and were rated low quality, and the authors' own test found publication bias. Nor does this review show that game training prevents falls or that any balance gained lasts once training stops. It also does not show that one game, console or setting is better than another.