The Effects of Exergames on Fundamental Movement Skills in Childhood: A Systematic Review and Meta-analysis
Sports medicine - open · 2026
A 'meta-analysis' built only from significant comparisons claims exergames match traditional activity for kids' movement skills, but no pooled effect size is reported.
The paper
Systematic review and meta-analysis, 12 studies (17 statistically significant comparisons), children, examining exergame effects on fundamental movement skills (FMS).
What they found
The authors report no differential effect of exergame status on FMS outcomes; variability across the 17 significant comparisons was instead linked to coaching level and activity structure. No pooled effect size, confidence interval, or heterogeneity statistic (e.g. SMD, I²) is reported in the abstract.
Study design
Systematic review labelled as a meta-analysis, searching 10 databases from Jan 2000 to Dec 2025, screening down to 12 included studies and 17 statistically significant between-group comparisons, in children.
Methodology
The search strategy is broad and well described, but the analytic method is unusual: 'set theory and order theory' applied to only the statistically significant comparisons found, with no mention of a pooled effect size, forest plot, heterogeneity statistic, or a formal risk-of-bias/GRADE assessment in the abstract. Restricting analysis to comparisons that were already statistically significant is a form of vote-counting that discards non-significant and null findings, which will bias conclusions about what does and doesn't explain variability. A clinician should look for PRISMA flow, risk-of-bias ratings per study, and actual effect sizes in the full text before trusting the 'no differential effect' claim.
The appraisal
Even if the coaching/structure finding is real, restricting analysis to only the 17 comparisons that already reached statistical significance is a form of selection on the outcome itself. That's closer to vote counting than meta-analysis, and it can't separate a true null effect of exergame status from confounds like which studies happened to be adequately powered or which had tighter coaching protocols. Reading it as a standard pooled meta-analytic estimate would be a mistake, so treat the 'just as effective' language, and the coaching/structure explanation, as a hypothesis worth testing properly rather than a settled finding.
The gap
No pooled effect size, no heterogeneity statistic, and no visible risk-of-bias grading for the 12 included studies. More fundamentally, only statistically significant comparisons were analysed, comparisons that failed to reach significance were dropped before the variability question was even asked. That's selection on the outcome variable, and it means the coaching/structure explanation could just as easily reflect which studies had bigger samples or tighter designs as it could a real effect. Until the excluded non-significant comparisons and a proper pooled estimate are available, 'just as effective' isn't demonstrated, it's asserted.
Landmark context
This sits within a growing but methodologically inconsistent literature on active/exergaming interventions and children's motor skill development; the authors themselves note this inconsistency is the paper's starting problem, but their proposed 'systematic hypothesis testing' approach is a departure from standard PRISMA/GRADE meta-analytic conventions used in that literature rather than an extension of a specific landmark trial.
What to do Monday
Nothing changes for individual programming decisions on the strength of this paper alone. Physios and S&C coaches should keep treating exergames as one option among several for engaging kids in movement, chosen on practicality and enjoyment, not as an evidence-backed equivalent to coached activity, and shouldn't cite this review as proof that modality doesn't matter until a proper pooled analysis with all comparisons, not just the significant ones, is published.
In practice
This applies to paediatric physios managing kids with movement delays or DCD, and to youth S&C coaches building FMS into early athletic development, wherever exergames come up as a session option. Nothing changes in exercise selection or dosage based on this paper: keep prioritising coached, structured FMS practice, whether that's a games-based circuit, a traditional drill progression, or an exergame, since the one signal in this review worth taking seriously is that coaching quality and structure, not the exergame label, seem to drive adaptation. In the clinic that means don't hand a child a Kinect or Switch session unsupervised and call it equivalent to a coached session; on the performance floor it means exergames are fine as an engagement or variety tool for low-motivation kids, but they don't replace a coach's eyes on landing mechanics, balance, or catching technique. Caveat: that coaching-matters signal comes from a methodologically shaky synthesis, so use it to justify keeping coaches in the loop, not to redesign a whole FMS curriculum around it.
The five papers that matter — every week, free.
We read the whole sports-medicine, rehab & performance literature and appraise the papers worth your time.
Get the free weekly issue