Cognitive, not physical, engagement in video gaming influences executive functioning

Effects of Exergaming on executive function and motor ability in children: A systematic review and meta-analysis

This study aimed to evaluate the effectiveness of Exergaming in improving executive function and motor ability across different groups of children and adolescents. We searched several databases, including PsycINFO, Web of Science, Embase, PubMed, SPORT Discus, Scopus, and the Cochrane Central Register of Controlled Trials, for randomized controlled trial (RCT) studies published from inception until November 25, 2023, to identify studies investigating the effect of Exergaming on motor and executive function in children. The protocol was registered with PROSPERO (CRD42023482281). A total of 37 randomized controlled trials were included in this study. Our results indicate that Exergaming can influence children's cognitive flexibility [SMD = 0.34, 95%CI(0.13,0.55), I2 = 0.0%, P = 0.738], inhibition control [SMD = 0.51, 95%CI (0.30,0.72), I2 = 0.0%, P = 0.473], global cognitive [SMD = 0.87, 95%CI (0.50,1.23), I2 = 0.0%, P = 0.974], working memory [SMD = 0.18, 95%CI(-0.16, 0.52), I2 = 46.5%, P = 0.096], gross motor skills [SMD = 0.82, 95%CI (0.30, 1.35), I2 = 79.1%, P<0.001], fine motor skills [SMD = 0.71, 95%CI (0.22,1.21), I2 = 78.7%, P<0.001], balance [SMD = 0.61, 95%CI (0.34, 0.88), I2 = 59.5%, P = 0.001], and cardiorespiratory [SMD = 0.48, 95%CI (0.16, 0.79), I2 = 58.4%, P = 0.019]. While these findings suggest that Exergaming can promote children's cognitive flexibility, inhibitory control, global cognition and motor abilities, the effect on working memory was not statistically significant. Further high-quality randomized controlled trials are warranted to explore the potential benefits of Exergaming for different groups of children, including those with specific needs.

Effects of cognitively engaging physical activity interventions on executive function in children and adolescents: a systematic review and meta-analysis

Background

This systematic review and meta-analysis aim to evaluate the effects of cognitively engaging Physical Activity (PA) interventions on Executive Function (EF) in children and adolescents. It examines how different intervention modalities, durations, frequencies, and session lengths influence these effects.

Methods

We followed the PRISMA guidelines and searched PubMed, SPORTDiscus, Embase, and Web of Science for relevant studies. Studies were included if they were Randomized Controlled Trials (RCTs) focusing on PA with cognitive elements targeting EF in healthy children and adolescents. Data were extracted and effect sizes computed using Standardized Mean Differences (SMDs).

Results

From an initial 1,635 articles, 23 studies with 2,857 participants were included. The overall effect of cognitively engaging PA on EF was significant (SMD = 0.32, 95% CI 0.14-0.51), with notable improvements in inhibitory control (SMD = 0.35) and working memory (SMD = 0.34). High heterogeneity was observed (I 2 = 91.1%). Moderator analyses revealed that interventions lasting more than 6 weeks, with sessions over 20 min and conducted more than twice a week, were particularly effective.

Conclusion

Cognitively engaging PA interventions positively impact EF in children and adolescents, particularly in inhibitory control. Effective interventions are characterized by longer duration, higher frequency, and extended session lengths. These findings underscore the importance of integrating cognitive challenges within PA programs to enhance EF, warranting future research and practical applications in educational and developmental settings.

A brief bout of moderate intensity physical activity improves preadolescent children's behavioral inhibition but does not change their energy intake

Children in rural communities consume more energy-dense foods relative to their urban peers. Identifying effective interventions for improving energy intake patterns are needed to address these geographic disparities. The primary aim of this study was to harness the benefits of physical activity on children's executive functioning to see if these improvements lead to acute changes in eating behaviors. In a randomized crossover design, 91 preadolescent (8-10y; M age = 9.48 ± 0.85; 50.5% female; 85.7% White, 9.9% Multiracial, 9.9% Hispanic) children (86% rural) completed a 20-minute physical activity condition (moderate intensity walking) and time-matched sedentary condition (reading and/or coloring) ~ 14 days apart. Immediately following each condition, participants completed a behavioral inhibition task and then eating behaviors (total energy intake, relative energy intake, snack intake) were measured during a multi-array buffet test meal. After adjusting for period and order effects, body fat (measured via DXA), and depressive symptoms, participants experienced significant small improvements in their behavioral inhibition following the physical activity versus sedentary condition (p = 0.04, Hedge's g = 0.198). Eating behaviors did not vary by condition, nor did improvements in behavioral inhibition function as a mediator (ps > 0.09). Thus, in preadolescent children, small improvements in behavioral inhibition from physical activity do not produce acute improvements in energy intake. Additional research is needed to clarify whether the duration and/or intensity of physical activity sessions would produce different results in this age group, and whether intervention approaches and corresponding mechanisms of change vary by individual factors, like age and degree of food cue responsivity.

The impact of an immersive digital therapeutic tool on experimental pain: a pilot randomized within-subject experiment with an active control condition

Background

Pain is a complex and multifaced sensory and emotional experience. Virtual reality (VR) has shown promise in reducing experimental pain and chronic pain. This study examines an immersive VR environment initially designed for endometriosis patients, which demonstrated short-term analgesic effects. The research aims to determine the impact of the VR environment on experimental pain intensity and unpleasantness both during and after VR exposure (3D with binaural beats), while using an active control condition (2D with no binaural beats). Additionally, a secondary objective of the study was to identify the psychological and psychophysical factors that predict the analgesic effects of the immersive digital therapeutic tool.

Methods

The study involved twenty-one healthy individuals and used a within-subject design, comparing a VR treatment with an active control condition. Continuous heat stimulation was applied to the left forearm with a Peltier thermode. Pain ratings were collected for immediate and short-term effects.

Results

In both the VR and Control conditions, there were no significant differences in pain intensity before, during, and after exposure. However, during VR exposure, there was a significant decrease in pain unpleasantness as compared to before exposure (p < 0.001), with a 27.2% pain reduction. In the Control condition, there were no significant differences in pain unpleasantness during and after exposure. Furthermore, no psychological and psychophysical factors predicted the analgesic effects.

Discussion

The study investigated how a VR environment affected experimentally induced pain in healthy volunteers. It showed that VR reduced pain unpleasantness during exposure but had no lasting impact. The VR environment mainly influenced the emotional aspect of pain, possibly due to its inclusion of binaural beats and natural stimuli. The study suggests that the VR environment should be tested in chronic pain population with high distress levels.

Registration number clinicaltrialsgov

NCT06130267.

Effects of Commercial Exergames and Conventional Exercises on Improving Executive Functions in Children and Adolescents: Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Exergames are promising exercise tools for improving health. To the best of our knowledge, no systematic review has compared the effects of commercial exergames and conventional exercises on improving executive functions (EFs) in children and adolescents.

OBJECTIVE

This study aimed to investigate the effects of commercial exergames and conventional exercises on improving EFs in children and adolescents.

METHODS

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 5 randomized controlled trial (RCT) databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were searched from their inception to July 7, 2022, to identify relevant RCTs. The Cochrane Collaboration tool was used to evaluate the risk of bias for each study. GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) was used to evaluate the overall quality of evidence.

RESULTS

In total, 8 RCTs including 435 children and adolescents were included in the analysis. Commercial exergames had no significant benefit on overall EFs compared to conventional exercises (Hedges g=1.464, 95% CI -0.352 to 3.280; P=.06). For core EFs, there was no evidence to suggest that commercial exergames are more beneficial for improving cognitive flexibility (g=0.906, 95% CI -0.274 to 2.086; P=.13), inhibitory control (g=1.323, 95% CI -0.398 to 3.044; P=.13), or working memory (g=2.420, 95% CI -1.199 to 6.038; P=.19) than conventional exercises. We rated the evidence for overall EFs, cognitive flexibility, inhibitory control, and working memory as being of very low quality due to inconsistency (large heterogeneity) and imprecision (low number of people). Additionally, no effects of the intervention were observed in the acute and chronic groups.

CONCLUSIONS

We do not have strong evidence to support the benefit of commercial exergaming on EFs because we did not observe a Hedges g close to 0 with tight CIs. Further research is needed to confirm this hypothesis.

TRIAL REGISTRATION

PROSPERO CRD42022324111; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=324111.

Effects of exergaming on executive functions of children: a systematic review and meta-analysis from 2010 to 2023

BACKGROUND

Executive function plays a crucial role in children's cognitive development, academic performance, as well as their physical and mental health. This study aims to assess the impact of exergaming on executive functions in pediatric populations.

METHODS

The criteria of inclusion were randomized controlled trials of exergaming intervention and evaluation of executive function in children aged 4-12 years. A meta-analysis was performed in databases of China National Knowledge Infrastructure (in Chinese), Wan Fang (in Chinese), Web of Science, Embase, and PubMed, from January 2010 to February 2023, following the PRISMA guidelines. Risk of bias was assessed by the Jadad scale, the Cochrane risk of bias assessment tool, funnel plot, and regression-based Egger test. The Review Manager 5.3 was used to analyze the included articles using a random-effects model, and the effects were calculated as standardized mean difference (SMD).

RESULTS

Eleven experimental studies with children (n = 508) were included. Exergaming was found to have a positive impact on children's cognitive flexibility (SMD = 0.34, 95%CI [0.17,0.52], P < 0.01), inhibitory control (SMD = 0.57, 95%CI [0.31,0.83], P < 0.01), and working memory (SMD = 0.26, 95%CI [0.02,0.51], P < 0.05). The publication bias were observed.

CONCLUSIONS

Exergaming has the potential to improve executive functions in children. More studies with rigorous designs are warranted to explore the specific effects of exergaming intervention. This study was registered on the PROSPERO (CRD42023401526).

Relations between Video Game Engagement and Social Development in Children: The Mediating Role of Executive Function and Age-Related Moderation

The global proliferation of video games, particularly among children, has led to growing concerns about the potential impact on children's social development. Executive function is a cognitive ability that plays a crucial role in children's social development, but a child's age constrains its development. To examine the association between video game engagement and children's social development while considering the mediating role of executive function and the moderating role of age, a questionnaire was distributed to a sample of 431 parents. The results revealed a negative relation between video game engagement and social development in children, with executive function found to mediate this relation fully. Additionally, the negative association between video game engagement and executive function became more pronounced as children grew older. In light of these findings, it is advisable to adopt proactive strategies to limit excessive video game use, consider the developmental characteristics of children at different ages, and prioritize the promotion of executive function to facilitate social development among children.

Acute exercise and children's cognitive functioning: What is the optimal dose of cognitive challenge?

Acute bouts of exercise have the potential to benefit children's cognition. Inconsistent evidence on the role of qualitative exercise task characteristics calls for further investigation of the cognitive challenge level in exercise. Thus, the study aim was to investigate which "dose" of cognitive challenge in acute exercise benefits children's cognition, also exploring the moderating role of individual characteristics. In a within-subject experimental design, 103 children (Mage = 11.1, SD = 0.9, 48% female) participated weekly in one of three 15-min exergames followed by an Attention Network task. Exergame sessions were designed to keep physical intensity constant (65% HRmax) and to have different cognitive challenge levels (low, mid, high; adapted to the ongoing individual performance). ANOVAs performed on variables that reflect the individual functioning of attention networks revealed a significant effect of cognitive challenge on executive control efficiency (reaction time performances; p = .014, ƞ2p = .08), with better performances after the high-challenge condition compared to lower ones (ps < .015), whereas alerting and orienting were unaffected by cognitive challenge (ps > .05). ANOVAs performed on variables that reflect the interactive functioning of attention networks revealed that biological sex moderated cognitive challenge effects. For males only, the cognitive challenge level influenced the interactive functioning of executive control and orienting networks (p = .004; ƞ2p = .07). Results suggest that an individualized and adaptive cognitively high-challenging bout of exercise is more beneficial to children's executive control than less challenging ones. For males, the cognitive challenge in an acute bout seems beneficial to maintain executive control efficiency also when spatial attention resources cannot be validly allocated in advance. Results are interpreted referring to the cognitive stimulation hypothesis and arousal theory.

Acute Effects of Exergaming on Students' Executive Functions and Situational Interest in Elementary Physical Education

Two studies were conducted to examine the acute effects of exergaming on students' executive functions and to explore their situational interest regarding these games in elementary physical education. The first study involved a two-group, repeated measures, cross-over quasi-experimental design. Participants were 74 (36 boys) fourth- and fifth-grade students who were assigned to the experimental (38 students) and the waiting list control (36 students) group. The single physical education session with exergames was first implemented with the initial experimental group and after the post-test, the waiting list control group received the intervention. In the second study, a pre-test post-test, within-subjects design was involved with the experimental group students (48 fourth- and fifth-grade students, 27 boys) who participated in a booster single physical education session with exergames two months after their involvement in a four-week intervention with cognitively challenging physical activity games. Both studies involved pre- and post-intervention measures for executive functions using the design fluency test and a post-test measure for situational interest. During the acute session, students had to follow the movements of an on-screen dancing character in time to a chosen song of the Just Dance 2015 exergame. The results of the first study showed that experimental group students improved significantly from pre- to post-test their scores in design fluency and in cognitive flexibility and in the total score of the design fluency test and their improvements were higher compared to the waiting list control group. The waiting list control group students, after receiving the acute session with exergames, significantly improved their scores in design fluency, inhibition, and cognitive flexibility and in the total score of the design fluency test compared to their pre-intervention scores. Moreover, the second study showed that students' total score in the design fluency test improved significantly from pre- to post-intervention. In both studies, students reported generally high scores in all subscales of the situational interest questionnaire. These results suggested that an acute exergame-based physical education session attracted students' interest and positively triggered their executive functions.

The impact of digital media on children's intelligence while controlling for genetic differences in cognition and socioeconomic background

Digital media defines modern childhood, but its cognitive effects are unclear and hotly debated. We believe that studies with genetic data could clarify causal claims and correct for the typically unaccounted role of genetic predispositions. Here, we estimated the impact of different types of screen time (watching, socializing, or gaming) on children’s intelligence while controlling for the confounding effects of genetic differences in cognition and socioeconomic status. We analyzed 9855 children from the USA who were part of the ABCD dataset with measures of intelligence at baseline (ages 9–10) and after two years. At baseline, time watching (r = − 0.12) and socializing (r = − 0.10) were negatively correlated with intelligence, while gaming did not correlate. After two years, gaming positively impacted intelligence (standardized β =  + 0.17), but socializing had no effect. This is consistent with cognitive benefits documented in experimental studies on video gaming. Unexpectedly, watching videos also benefited intelligence (standardized β =  + 0.12), contrary to prior research on the effect of watching TV. Although, in a posthoc analysis, this was not significant if parental education (instead of SES) was controlled for. Broadly, our results are in line with research on the malleability of cognitive abilities from environmental factors, such as cognitive training and the Flynn effect.

Effects of exergame and video game training on cognitive and physical function in older adults: A randomized controlled trial

Few studies have simultaneously explored the training effects of exergame and video game. The purpose of this study was to investigate the effects of exergame and video game training on cognitive and physical function in healthy older adults. Eighty-four healthy older adults were randomly assigned to exergame training group, video game training group, and control group. Cognitive and physical function was measured before and after the training. Both training groups improved in verbal memory and aerobic endurance, but the training effects were greater in the exergame training group. The exergame training group also showed significant improvement in lower limb strength and balance. The current study provides evidence that exergame training, incorporating both cognitive engagement and physical activity, exerts greater benefits than cognitively engaging video game training alone. The findings shed lights into the future use of exergame in preventing cognitive and physical function decline in older adults.

Prosocial Video Game Content, Empathy and Cognitive Ability in a Large Sample of Youth

Whether playing video games with prosocial content has an influence on empathy among players remains contentious in the research literature. Some evidence suggests playing cooperatively with other gamers enhances empathy, but data have not conclusively linked prosocial content with empathy. Further, mechanisms of this potential relationship are unclear, and little work has been conducted on how cognitive skills, such as fluid reasoning, may mediate this relationship. The current study examines these relationships with a large sample of 3034 youth (27.2% female, Mage = 11.2; range 8-17 at time 1) in Singapore. Data were considered longitudinally across two years in three waves. Ultimately, no evidence emerged that prosocial content in video games had any impact on empathy related outcomes, nor was fluid reasoning a mediator variable for any relationship. However, variables such as social competence and depression and anxiety symptoms were highly related to empathy measures. This evidence adds to the growing debate in the field that video games may not dramatically alter, whether positively or negatively, the development of emotional and behavioral outcomes for youth.

Do embodiment and fictionality affect young children's learning?

Preschool-aged children can learn from fictional, pretend, and imaginative activities. However, many studies showing this learning involve children as physically passive while consuming fictional narratives rather than as actively, physically engaged. Physical engagement may add to cognitive processes already at play when watching narratives, making children more likely to retain or understand information. Children's natural pretend involves physical movement, role play, and embodiment. To test learning from embodied pretense, we conducted two studies in which we experimentally manipulated whether children were physically passive while consuming narratives or physically actively engaged with them through embodied pretend play using puppets or costumes. In Study 1, children were shown/engaged in television-based narratives, all of which contained fantastical content. In Study 2, children were shown/engaged in lab-created stories, some of which contained fantastical elements. We measured children's learning and perceptions of realism. In Study 1, neither perception of fictionality nor embodiment immediately affected learning, although older preschoolers learned more than younger preschoolers. In Study 2, neither perception nor presence of fantastical content affected learning, but embodiment did. Children learned more from both embodied conditions compared with the physically passive condition. We also included 2-week follow-up tests of recall and found that although children retained very little, embodiment still affected retention in both studies. Overall, children did not use realism judgments to differentiate learning. These findings show the complexity of different elements involved in children's learning from pretense and the need to understand what elements affect learning from fantastical and embodied pretend play and stories.

Additional Exergames to Regular Tennis Training Improves Cognitive-Motor Functions of Children but May Temporarily Affect Tennis Technique: A Single-Blind Randomized Controlled Trial

This study evaluated the effects of an exergame program (TennisVirtua-4, Playstation Kinect) combined with traditional tennis training on autonomic regulation, tennis technique, gross motor skills, clinical reaction time, and cognitive inhibitory control in children. Sixty-three children were randomized into four groups (1st - two exergame and two regular trainings sessions/week, 2nd - one exergame and one regular training sessions/week, 3rd - two regular trainings sessions/week, and 4th - one regular training session/week) and compared at baseline, 6-month immediately post intervention and at 1-year follow-up post intervention. At 6-month post intervention the combined exergame and regular training sessions revealed: higher breathing frequency, heart rate (all ps ≤ 0.001) and lower skin conductance levels (p = 0.001) during exergaming; additional benefits in the point of contact and kinetic chain elements of the tennis forehand and backhand technique (all ps ≤ 0.001); negative impact on the shot preparation and the follow-through elements (all ps ≤ 0.017); higher ball skills (as part of the gross motor skills) (p < 0.001); higher percentages of clinical reaction time improvement (1st -9.7% vs 3rd group -7.4% and 2nd -6.6% vs 4th group -4.4%, all ps ≤ 0.003) and cognitive inhibitory control improvement in both congruent (1st -20.5% vs 3rd group -18.4% and 2nd -11.5% vs 4th group -9.6%, all ps ≤ 0.05) and incongruent (1st group -19.1% vs 3rd group -12.5% and 2nd group -11.4% vs 4th group -6.5%, all ps ≤ 0.001) trials. The 1-year follow-up test showed no differences in the tennis technique, clinical reaction time and cognitive inhibitory control improvement between groups with the same number of trainings per week. The findings support exergaming as an additional training tool, aimed to improve important cognitive-motor tennis skills by adding dynamics to the standardized training process. Caution should be placed to planning this training, e.g., in a mesocycle, since exergaming might decrease the improvement of specific tennis technique parts of the trainees. (ClinicalTrials.gov; ID: NCT03946436).

Comparison of Inhibitory Control After Acute Bouts of Exergaming Between Children with Obesity and Their Normal-Weight Peers

Objective: The benefits of exergaming on executive function in children have been increasingly reported; however, weight-dependent effects of exergames on executive function, and inhibitory control in particular, remain poorly understood. We examined performance on an inhibitory control task at baseline and following acute bouts of exergaming in children who varied in weight status. Materials and Methods: Forty 8-12-year-old children with obesity (n = 20) and normal weight (n = 20) performed neutral, congruent, and incongruent conditions of a Victoria Stroop Test (VST) before and after exergames through an Xbox One in an elementary classroom. We measured time spent in moderate-to vigorous-intensity activity through ActiGraph accelerometers and recorded gameplay time. Results: At baseline, children with obesity relative to their normal-weight peers had significantly longer reaction times (P = 0.011), resulting in significantly longer completion time (P = 0.005) during incongruent trials requiring greater inhibitory control, and therefore had higher interference scores (P = 0.024). However, following acute bouts of exergames, children with obesity compared with their normal-weight counterparts significantly decreased completion time (P = 0.013), made fewer errors (P = 0.012) during incongruent trials, and subsequently had reduced interference effects (P = 0.037). Children with obesity and normal-weight children spent similar time (minutes) (7.8 vs. 8.6, P = 0.725) in moderate-to vigorous-intensity activity during similar gameplay time (8.7 vs. 10.5, P = 0.819). Conclusion: Our results suggest that greater, acute cognitive gains occur in children with obesity relative to normal-weight children following similar intensity and duration of exergames, which may be due to reduced inhibitory control capacity at baseline in childhood obesity.