JAL | Free Full-Text | Efficacy of the Use of Exergames in Promoting the Mental Health of the Elderly: Protocol of a Systematic Review

JAL | Free Full-Text | Efficacy of the Use of Exergames in Promoting the Mental Health of the Elderly: Protocol of a Systematic Review

1. Introduction

Games have a strong presence in people’s lives today due to scientific advances and their attractiveness to players. This resource has proven to be an innovative strategy, particularly in the health area, increasing a growing interest in research in this context. This can be seen in several systems and applications that benefit from the fun, motivating, and enjoyable experience games provide, which can enable health interventions through technology [1].
Games can be categorized as competitive, cooperative, and collaborative. Cooperative and collaborative games promote socialization among players, as both players work together to achieve mutual benefits [2]. Over the last decade, there has been a significant increase in the use of exergames. This surge in popularity may be attributed to the improved accessibility of this technology, which was previously inaccessible to several [3]. This can be attributed to the availability and ease of access to active video games for home use, such as PlayStationMove® (Sony Corp, Tokyo, Japan), Kinect® (Microsoft, Redmond, WA, USA), and Wii® (Nintendo Co., Ltd., Kyoto, Japan) [4]. Exergames provide users with an interactive environment that combines physical exercise with cognitive activities, allowing players to move and interact with avatars in a virtual world. This movement activity can be performed individually or in teams, with online connections enabling remote play [3]. While initially designed for recreational purposes, the growing popularity of exergames has piqued the interest of researchers who have evaluated their impact in various contexts and with different groups, including people with neurodegenerative, orthopedic, and neurological diseases.
Exergames are now widely recognized as an effective health intervention in all age groups, particularly among older people, due to their physical, mental [5], and social benefits. Exergames have been demonstrated to improve cognitive functions, visual motor skills, and motor functionality [6,7], particularly executive functioning, which can help prevent falls and promote autonomy in older people, improving their quality of life [2,5,8]. As mentioned before, this type of game can encourage physical activity, which is particularly important for older people, who may face some physical limitations, especially in mobility and balance, which can have positive implications for mental health [9]. Additionally, exergames can also be beneficial in promoting cognition in older adults, including memory, attention, and reasoning [10]. This type of game helps to reduce the possibility of experiencing loneliness and social isolation, as in this type of game, older adults interact with other people, which is positive for their mental health [11]. Immersed in this social environment, exergames can be a fun and enjoyable way to promote mood and self-esteem and reduce stress in older adults [12].
Additionally, exergames offer a fun and motivating experience that is easily accessible, making them a convenient and cost-effective intervention for participants [5,13]. Exergames can overcome traditional games’ limitations, such as security concerns, time constraints, and user demotivation.

This proposed systematic review protocol aims to contribute to the existing literature on exergames and older adults, with a specific focus on the potential cognitive and socialization benefits of exergames for this population. By conducting this review, we intend to enhance our understanding of the subject and fill any gaps in current research. While previous studies have examined the effects of exergames on mental health in older adults, few have specifically explored their potential cognitive, emotional management, and socialization benefits. Our future review will go beyond previous research by synthesizing evidence from randomized clinical trials and observational studies, providing a comprehensive overview of current knowledge on this topic. Finally, the protocol for this review aims to help fill the gap in our understanding of how exergames can be used to improve cognitive, emotional management, and socialization function and highlight the potential benefits of integrating exergames into interventions aimed at promoting healthy mental ageing.

The existence of evidence suggests that cognitive stimulation, emotional management, and socialization are three key areas that can benefit older adults’ health and well-being through exergame use. This protocol for a systematic review focuses on these elements because they have been identified as important factors in promoting successful ageing and maintaining autonomy in older adults. By examining the effects of exergames on these specific areas, we hope to gain a more comprehensive understanding of the potential benefits of exergames for older adults. This protocol is part of a research project that aims to determine the effectiveness of exergames in promoting the autonomy of elderly individuals for potential implementation in clinical practice. The project includes two protocols: Protocol 1, which focuses on identifying exergames that are effective in physical training, and Protocol 2, which aims to determine the effectiveness of exergames in promoting mental health among elderly individuals. In Protocol 2, all types of exergames will be included, as the aim is to evaluate the effectiveness of exergames in cognitive stimulation, emotional management capacity, and socialization, which were not considered in Protocol 1. As both protocols involve systematic reviews of the literature, clear objectives have been established to ensure that the results are not confusing or unclear. Such clear objectives are necessary for obtaining more reliable conclusions.

With regard to their research focus, Protocol 1 is geared towards identifying the effects of Wii games on physical training among elderly individuals [14]. Protocol 2, conversely, is centered around determining the effectiveness of exergames in promoting the mental health and socialization of older people. Although both protocols are interested in exergames, they have different desired outcomes.

In terms of their search terms, Protocol 1 employs keywords related to physical activity and rehabilitation, whereas Protocol 2 employs terms related to mental health and socialization. This distinction in search terms reflects each protocol’s varying outcomes of interest. Based on these results, an intervention plan will be developed aiming to promote autonomy among older people using exergames. This study will be a randomized controlled trial.

Exergames have been found to improve cognitive ability and emotional creativity in mental health [15,16], as well as memory, attention, reaction time, emotional well-being, self-esteem [17], psychosocial capacity, and sleep quality [2,18,19]. Given these benefits, this systematic review proposed in this protocol aims to identify the effectiveness of exergames in promoting mental health by examining the available scientific evidence. The following research questions will be addressed:

What is the effectiveness of exergames in cognitive stimulation, emotional management capacity, and socialization of older people?


What games promote cognitive stimulation, emotional management capacity, and socialization of the elderly?


How long and how often are these games effective for cognitive stimulation, emotional management training, and socialization of older people?

3. Discussion

The proposed systematic review will have distinctive aspects that differentiate it from previous studies. For example, it will focus specifically on exergames for mental health promotion in the elderly population, which is an under-researched area. Specifically, will identify the most effective exergames for cognitive stimulation, emotional management capacity, and socialization of the elderly, which will provide valuable insights for future research and clinical practice. Additionally, it will investigate the duration and frequency with which these games should be used to achieve health improvements, which is an important practical consideration for future implementation. The results of the review will inform the selection of exergames for a randomized controlled trial aimed at promoting the autonomy of the elderly, which has important implications for improving the quality of life for this population.

Previous studies have demonstrated the effectiveness of exergames in improving the health of the elderly [26,27]. Therefore, it is essential to identify those games that show the most significant effect for future implementation. These unique aspects of the proposed review will make it an innovative and important contribution to the field of exergames and mental health promotion in the elderly.

The proposed study will include all articles addressing the topic without a specified time limit and studies written in English, Portuguese, Spanish, and French. However, it is worth noting that the authors speak only a few languages, which may limit the scope of the review.

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