Effects of Exergaming on Motor Skills, Cognitive Skills, and Physical Activity Among Children in Early Childhood: A Systematic Review and Meta-Analysis.

OBJECTIVE: Exergaming engages individuals in physical activity, but its efficacy is not well established in children. This study aims to synthesize evidence of exergaming on motor skills, cognitive skills, and physical activity in early childhood. METHODS: We searched 6 electronic databases (eg, MEDLINE, CINAHL) for randomized controlled trials and quasi-experimental studies published between 2000 and 2025 to investigate the effects of exergaming on motor skills, cognitive skills, and physical activity in children aged 8 or below. RESULTS: We removed 257 duplications from the initial pool of 2584 records. Twelve studies were included after screening the remaining records. Evidence was generally moderate to high quality as assessed by the JBI critical appraisal tools. Potential biases (eg, selection) were identified that may have influenced the overall findings. Meta-analysis revealed that exergaming has significant effects on cognitive flexibility (P < .01; I2 = 0%; χ2 = 1.72; standardized mean difference = 0.7; 95% CI, 0.39 to 1.01) and physical activity level (P < .01; I2 = 28%; χ2 = 1.38; standardized mean difference = 0.61; 95% CI, 0.17 to 1.05) in children. The effects of exergaming on gross motor performance, working memory, and inhibitory control were not statistically significant (P > .05). CONCLUSIONS: Our findings suggest that exergaming can promote physical activity with increased cognitive flexibility in children. Its effect on motor ability, working memory, and inhibitory control was not statistically significant. Further studies of rigorous methodological quality are recommended to explore its potential to promote health and development in early childhood.