Exergaming and active video gaming are two terms for the same thing (in this review called exergaming), namely being physically active while gaming. Exergaming has emerged as a novel intervention to promote physical activity among children with neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). These conditions are often associated with reduced physical activity and increased sedentary behavior, contributing to health risks like obesity and poor motor development. This review evaluated the effect of exergaming on physical activity levels and inactivity in children with ADHD and ASD, addressing a gap in understanding how technology-based interventions can support health outcomes in these populations.

The review followed a systematic approach, searching PubMed, PsycINFO, Scopus, and ERIC databases using terms like "exergaming," "active video gaming," "ADHD," "ASD," "physical activity," and "inactivity" for studies published between 2000 and 2025. The study adhered to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to ensure a rigorous, transparent, and replicable process. From an initial pool of 1,192 articles, a stepwise screening process (title/abstract review, full-text assessment, and quality evaluation) yielded 11 high-relevance studies, including randomized controlled trials (RCTs), pilot studies, and systematic reviews. These studies focused on children aged 6-18 years with ADHD and/or ASD, examining exergaming’s impact on physical activity, inactivity, and related outcomes like motor skills.

Results indicated that exergaming increased physical activity and/or motor skills across both ADHD and ASD populations, with studies reporting improved energy expenditure and/or motor coordination compared to sedentary gaming or no intervention. For children with ADHD, exergaming improved executive functions and increased physical activity, with participants taking up to 1,500–2,000 additional steps per day, while in ASD, it reduced repetitive behaviors and inactivity by up to 30%. Study designs ranged from small-scale pilots (n=5-12) to larger RCTs (n=50+), with exergames like "Dance Dance Revolution" and "Shape Up" showing promise.

In conclusion, exergaming offers a feasible, engaging method to boost physical activity and reduce inactivity in children with ADHD and ASD, supporting its potential within exercise biomedicine for health promotion. Its ability to transform screen time into active time makes it a practical tool for these populations, who often struggle with traditional exercise. While results are promising, the current evidence is limited by short intervention periods and lack of follow-up. Future research should explore sustained benefits and optimal designs to maximize its impact, which in turn reinforces exergaming’s role in improving well-being.