Effects of virtual reality-based exercise intervention in young people with attention-deficit/ hyperactivity disorder: a systematic review.
Jia-Ling Sun, Xiao-Jun Chaw, Shane Fresnoza and 1 others
PMID 40551134WHAT IT FOUND
Children and adolescents with ADHD showed improved attention and inhibitory control after VR-based exercise, but evidence is preliminary and not all executive functions improved.
Key findings
01All six included studies reported improvements in at least one executive function domain, and all three studies that assessed ADHD symptoms reported improvement.
02Executive function results varied: inhibitory control improved in three of four studies, attention in four of four, working memory in one of two, and planning in one of one; cognitive flexibility improved in one participant and declined in two, and updating showed no significant difference.
03Two studies compared VR-based exercise with traditional exercise; both improved executive function and attention, but actual table tennis improved WCST performance and exergaming increased N2 amplitude, while all dropouts in the bicycle group were attributed to loss of interest.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review included only six studies and 192 participants, with sample sizes ranging from 3 to 51. Because fewer than 10 studies were included, publication bias might not be properly assessed, and no meta-analysis was conducted. Outcome measures were heterogeneous. This made it difficult to compare results across studies. Only one study assessed performance at 6-week follow-up, so durability is unclear. Medication status was inconsistently reported and not systematically analysed. Several studies lacked active control groups, and control conditions varied across studies. All included studies had an unclear overall risk of bias, mainly because of concerns about selective reporting and missing pre-registration. The search used title and abstract terms and English-language studies only, which may have missed relevant work. No formal statistical analyses of mediators or moderators were conducted.
The easy way to misread this
Do not conclude that VR-based exercise is proven to improve every executive function or is better than traditional exercise. The review included six small studies, did not conduct a meta-analysis, had mixed executive function results, and had some concerns about bias.