Effectiveness of Exergame Intervention on Walking in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Heterogeneity was substantial (I² = 76.3%), meaning the included studies varied widely in their populations, interventions, and outcome measures, so the pooled estimate is an average across quite different situations. Many individual studies had small sample sizes (below 20 in one or both groups), which limits the precision of each study's estimate and makes the meta-regression findings less reliable. 84.7% of included studies had concerns about selective reporting, mainly because they lacked prespecified analysis plans, so the results may overstate the true effect. The overall effect size was small (SMD = -0.21), and against an active control it was not statistically significant, so the practical benefit over existing exercise programmes is uncertain. In 12.3% of interventions, exergaming was combined with other exercise, so the contribution of the exergame component alone cannot be separated from the co-intervention. Publication bias was possible (funnel plot asymmetry), though the authors judged the risk to be low given the extensive search strategy.

Funded by Business Finland and SE Innovations Oy. The authors state the funders played no role in the design, conduct, or reporting of the study.

Do not read this as evidence that exergames outperform other exercise. Against an active control the effect was minuscule (SMD = -0.03, 95% CI = -0.20 to 0.15, which includes zero), and the overall effect was small (SMD = -0.21) with substantial heterogeneity (I² = 76.3%). The meaningful benefit was seen only when the comparison group did no structured exercise.