Exergaming for Physical Therapy in Patients with Down Syndrome: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials.

Abstract

The aim of this systematic review and meta-analysis of randomized-controlled trials was to analyze the effectiveness of exergaming on motor outcomes compared with control in patients with Down syndrome. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was performed up to July 2021 in the following scientific databases: PubMed, CENTRAL, CINAHL, Medline, Scopus, Web of Science, BioMed Central, and Physiotherapy Evidence Database (PEDro). The study eligibility criteria were previously established according to the PICOS model. The PEDro scale was used to assess the methodological quality of the studies, and the Cochrane Collaboration's tool was used to assess the risk of bias. A meta-analysis using standardized mean difference (SMD) and confidence interval (95% CI) was performed using the Review Manager 5.4 software. Eight articles were included in the systematic review and meta-analysis. Statistical analysis showed favorable results for exergaming on balance (SMD = 2.72; 95% CI = 1.68-3.76), functional mobility (SMD = 4.14; 95% CI = 3.69-4.59), and muscle strength (SMD = 6.40; 95% CI = 2.68-10.11). No conclusive results were found on aerobic endurance. In conclusion, the results show the potential benefits of exergaming to recover motor outcomes in patients with Down syndrome, specifically, in balance, functional mobility, and muscle strength. We encourage researchers and clinicians to integrate exergaming in clinical settings since it is an inexpensive and easily accessible therapy for different populations, and it could be a useful tool within the physical therapy interventions in patients with Down syndrome. PROSPERO registration number: CRD42021238335.