The effects of video-based exergames on balance and agility in children with and without developmental coordination disorder: a meta-analysis.

Developmental coordination disorder, a condition affecting roughly 5 to 6% of school-age children, makes everyday movement tasks like balance and quick direction changes harder to master. Because traditional therapy can be repetitive and hard to sustain in children, researchers have been curious whether video-based exergames, movement games played through a screen, might offer a more engaging way to build these skills. This meta-analysis pooled randomized controlled trials comparing children who used exergames against those who did not, looking separately at children with the disorder and typically developing children. The pooled results showed a statistically significant improvement in balance for children with the disorder, and both balance and agility improved in typically developing children.

However, the effect on agility in children with the disorder was not statistically significant, and the evidence for that comparison was highly inconsistent across studies. This pattern makes balance the more dependable finding here, while the agility question for children with the disorder remains genuinely unresolved rather than disproven.

If your child has developmental coordination disorder, everyday tasks like keeping balance or quickly changing direction can feel more challenging than they do for other kids. This can make structured exercises for these skills tricky to keep up with, so researchers looked at whether video-based exergames, essentially movement-based video games, could help. Pooling results from several randomized trials, the researchers found that children with the disorder who used these games showed a statistically significant improvement in balance compared to those who didn't.

Interestingly, in typically developing children, both balance and agility (quick, controlled movement) improved with exergame use. But for children with the disorder specifically, the agility results were inconsistent across studies and did not reach statistical significance, meaning we can't yet say whether exergames reliably help with that particular skill. This is encouraging for balance, but it's an early picture.

The evidence comes from a limited number of trials, and the mixed results for agility in this group mean more consistent research is needed before drawing firm conclusions about that outcome.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This meta-analysis speaks to a practical question clinicians working with developmental coordination disorder often face: can technology-based, potentially more engaging interventions like video-based exergames meaningfully improve balance and agility, and do effects differ between children with the disorder and typically developing peers? Pooling data from randomized controlled trials, the authors found a statistically significant improvement in balance for children with the disorder (SMD 0.82, 95% CI 0.53 to 1.11) with moderate heterogeneity (I² = 45%). In typically developing children, both balance (SMD 0.84, 95% CI 0.61 to 1.07) and agility (SMD 0.47, 95% CI 0.15 to 0.78) improved significantly, with no heterogeneity reported.

The agility finding for children with the disorder is the key caveat: the pooled effect was not statistically significant (SMD 0.93, 95% CI -0.28 to 2.14) and heterogeneity was substantial (I² = 86%), meaning the included studies disagreed considerably and this result should not be read as evidence that exergames don't help agility, only that the current evidence doesn't establish a reliable effect. Given this inconsistency and the reliance on pooled trial data without details on trial size, blinding, or risk of bias reported here, clinicians should treat the balance finding as the more dependable contribution and view agility outcomes for this population as an open question requiring more consistent trial evidence.