Effect of virtual reality-based exergaming on multidimensional outcomes in individuals with cognitive impairment: a three-level meta-analysis based on the ICF framework
10.3969/j.issn.1006-9771.2026.09.002
- VernacularTitle:虚拟现实运动游戏对认知功能障碍人群多维结局的影响：基于ICF框架的三水平Meta分析
- Author:
Yang JIANG
1
;
Hao PENG
1
;
Xingxiao YIN
1
;
Yanqi LI
1
;
Yanping SONG
2
;
Na YAO
2
;
Zhen SHEN
2
;
Qigang CHEN
2
Author Information
1. College of Physical Education, Yunnan Normal University, Kunming, Yunnan 650500, China
2. Department of Rehabilitation, the Third Affiliated Hospital of Yunnan University of Chinese Medicine (Kunming Municipal Hospital of Traditional Chinese Medicine), Kunming, Yunnan 650011, China
- Publication Type:Journal Article
- Keywords:
exergaming;
virtual reality;
exercise intervention;
cognitive impairment;
executive function;
International Classification of Functioning, Disability and Health;
meta-analysis
- From:
Chinese Journal of Rehabilitation Theory and Practice
2026;32(9):1003-1015
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo systematically quantify the multidimensional effect of virtual reality-based exergaming (VREG) on health outcomes among individuals with cognitive impairment under the framework of the International Classification of Functioning, Disability and Health (ICF). MethodsMeta-analysis was conducted in accordance with the PRISMA statement. PubMed, Cochrane Library, Embase, Scopus, Web of Science, CNKI, Wanfang Data and VIP were researched for randomized controlled trials (RCTs) investigating VREG for cognitive impairment, with the search deadline set on February 1, 2026. The Cochrane Risk of Bias 2.0 tool was adopted to evaluate the methodological quality of included studies. A three-level meta-analytic model was implemented with R 4.4.2. The GRADE framework was further used to rate the certainty of pooled evidence. ResultsA total of 22 RCTs were included. VREG might improve global cognitive function (SMD = 0.69, 95%CI 0.11 to 1.28, P = 0.022), memory (SMD = 0.47, 95%CI 0.07 to 0.87, P = 0.023), attention (SMD = 0.62, 95%CI 0.23 to 1.01, P = 0.004), executive function (SMD = 0.42, 95%CI 0.09 to 0.75, P = 0.013), balance (SMD = 0.54, 95%CI 0.07 to 1.00, P = 0.027), muscle strength (SMD = 0.63, 95%CI 0.37 to 0.88, P = 0.001), mobility (SMD = 0.29, 95%CI 0.04 to 0.54, P = 0.024) and quality of life (SMD = 0.29, 95%CI 0.03 to 0.56, P = 0.029). No significant effect was observed for depressive symptoms, comprehensive physical fitness and fall risk (all P > 0.05). Subgroup and meta-regression analyses indicated that session duration < 45 minutes produced the largest improvement in attention (SMD = 0.95, 95%CI 0.55 to 1.34, P < 0.001); intervention cycles of twelve to 24 weeks were optimal for mobility (SMD = 0.85, 95%CI 0.44 to 1.25, P < 0.001); age negatively correlated to balance improvement (β = -0.11, 95%CI -0.20 to -0.02, P = 0.020), suggesting less intervention benefits among older participants. ConclusionVREG is an effective non-pharmacological intervention to improve multidimensional physical and mental health in people with cognitive impairment. Protocols featuring short single sessions with long-term duration should be prioritized.
