Is exergaming really effective in improving participation in people with multiple sclerosis? A systematic review.

BACKGROUND

Exergaming has been frequently used in rehabilitation programs for people with multiple sclerosis (PwMS). However, its effects on the participation domain of the International Classification of Functioning, Disability, and Health (ICF) remain uncertain.

OBJECTIVE

To examine the effects of exergaming on participation and the assessment tools used to evaluate participation in PwMS.

METHOD: The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the protocol was registered on PROSPERO. Three databases (PubMed, Web of Science, and Scopus) were searched through February 2024. Selection of eligible studies was conducted by two independent reviewers and only randomized controlled trials were included. The methodologic quality of the included studies was determined using the PEDro scale. Data were categorized by two independent researchers as follows: demographic and clinical characteristics of the participants, content and duration of the treatment, outcome measures used, and the effects of exergaming on participation.

RESULTS

Seventeen randomized controlled trials with a total of 942 participants were included. The outcome measures used in the studies were not specific to the participation component of the ICF. It was observed that participation was most frequently evaluated through quality-of-life questionnaires, as well as mood, motivation/satisfaction, technology acceptance, or adherence assessments were used. Seven studies assessing quality of life reported statistically significant differences after exergaming.

CONCLUSION

Exergame interventions have been shown to improve participation-related factors including quality of life, mood, and treatment adherence in PwMS. However, future studies should prioritize increasing participation and assess improvements using targeted outcome measures.