Effects of Exergaming on Physical Activity in Individuals with Obesity and Type 2 Diabetes Mellitus - A Systematic Review

Background
The worldwide prevalence of obesity and overweight substantially increased (Raj, 2012). Although there is a clear association between low levels of physical activity (PA), obesity and type 2 diabetes mellitus (T2DM) (Cardoso et al., 2008), 70-80% of all adults do not meet the PA-recommendations (Corbin et al., 2004; Duncan et al., 2007). Therefore, exergaming is a promising alternative to exercise, given that people are encouraged to move while engaging in an activity they enjoy.
Methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Pubmed/MEDLINE, EMBASE, Web of Science, Opengrey and the metaRegister of Controlled Trials to July 2014, following the PRISMA statement by Moher et al. (2013).
Results
12 trials (783 participants) fulfilled our inclusion criteria. Multiple sources of bias were found in most of the trials. Randomization and blinding was adequately concealed in only one study.
Of the 12 trials, seven reported Energy Expenditure (EE), five reported VO2 and five reported metabolic equivalents (METs). A variety of other scales were also used.
Discussion
Exergaming lead to an increase of several PA-parameters, such as EE, VO2 and METs as well as parameters of enjoyment, such as the Intrinsic Motivation Inventory (IMI). However, besides one trial, bias was moderate to high and levels of evidence were low (level III). Therefore, the results need to be handled with care. Further longterm, high quality studies are needed to confirm these results.
Keywords: energy expenditure, exergame, metabolic equivalent, motivation, obesity,
overweight, physical activity, PRISMA statement, systematic review, type 2 diabetes
mellitus.