Exergames for Patients in Acute Care Settings: Systematic Review of the Reporting of Methodological Quality, FITT Components, and Program Intervention Details.
OBJECTIVE
This study was designed to summarize (1) the evidence from studies investigating the use of exergames in acute care settings, (2) the methodological quality of these studies, (3) the reporting of frequency, intensity, time, and type (FITT) of exergaming components and adherence, and (4) reporting of intervention details enabling study replication.


METHODS
Medline-Ovid, EMBASE, CINAHL, PsychInfo, and the Cochrane Library were consulted. Two authors independently selected and systematically reviewed the included reports. Study quality was scored for each study.


RESULTS
Of the nine reports representing five randomized clinical trials, one controlled clinical trial, and three single-group studies, the methodological quality was rather low, and the majority of the reports appeared to have a high risk of bias. Altogether, 365 patients were included in the selected articles. Energy expenditure, 6-Minute Walking Test, Timed Up and Go Test, Modified Berg Balance Scale, level of enjoyment, Transitional Dyspnea Index, upper limb activity, cognitive performance, and length of hospital stay favored exergaming. Three studies considered 70 percent or more of methodological quality items. Two studies reported all four FITT components. No studies reported adherence. Three studies each included descriptions of six intervention details.


CONCLUSIONS
The included studies suggest that patients in acute care settings may benefit from exergaming. The relationship between exergaming and patient outcomes requires, however, further exploration. Future adequately powered studies with low risk of bias and with acute care populations that are followed over extended time periods should be performed to substantiate or refute the advantageous effect of exergaming in acute care settings. Future studies should pay attention to the description of FITT components and adherence to the intervention. Attention to include details of the used exergaming intervention is important for replication purposes.
1 Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich , Zurich, Switzerland .
Ruud H
RH
Knols
2 Nursing and Allied Health Professions Office, Physiotherapy Occupational Therapy, University Hospital Zurich , Zurich, Switzerland .
Tom
T
Vanderhenst
3 Department of Physiotherapy, Berne University Hospital , Berne, Switzerland .
Martin L
ML
Verra
4 Institute of Human Movement Sciences and Sport , Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland .|5 Centre for Evidence Based Physiotherapy, Maastricht University , Maastricht, The Netherlands .|6 Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht, The Netherlands .
Eling D
ED
de Bruin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D015444:Exercise; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000379:methods*; D012107:Research Design / Q000706:statistics & numerical data*; D013673:Technology Assessment, Biomedical; D018910:Video Games