Effectiveness of exergaming interventions for adults with cancer: a systematic review
Abstract
Background Exergaming, which integrates physical exercise with interactive digital games, has gained attention as a supportive approach in cancer rehabilitation. However, uncertainty remains regarding its effects across different phases of cancer care and its feasibility in clinical and home-based settings. This systematic review synthesized evidence on the feasibility, safety, and effects of exergaming interventions among adults with cancer, with particular attention to interventions delivered during active treatment and after treatment completion. Methods PubMed, Web of Science, the Cochrane Library, Scopus, Embase, CINAHL, and SPORTDiscus were searched from inception to April 2025. Randomized and nonrandomized intervention studies evaluating exergaming among adults with cancer were included. Outcomes were synthesized narratively across physical, psychological, symptom-related, quality-of-life, biological or physiological, and feasibility domains. Results Twenty-five publications representing 19 distinct study cohorts met the inclusion criteria. Interventions varied substantially in platform, setting, duration, and training dose, most commonly lasting 4–16 weeks with 2–5 sessions per week. Reported recruitment rates ranged from 11.8% to 85.7%, adherence from 62% to 100%, and attrition from 0% to 47.4%. No serious intervention-related adverse events were reported among studies that provided safety data, although adverse-event reporting was incomplete. Favorable findings were reported for physical activity, mobility, balance, upper-extremity function, fatigue, and selected psychological and quality-of-life outcomes. In contrast, findings for muscle strength, pain, body composition, and biological or physiological markers were inconsistent. Conclusions Exergaming appears to be a feasible and acceptable adjunct to cancer rehabilitation, with potential benefits for selected physical, symptom-related, and psychosocial outcomes. However, the evidence remains preliminary, and exergaming should be considered an adjunct rather than a replacement for conventional exercise or physiotherapy. Adequately powered randomized trials using standardized intervention protocols, consistent outcome reporting, longer follow-up, and more diverse cancer populations are needed. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024530181, identifier CRD42024530181.