Game-Based eHealth Interventions for the Reduction of Fatigue in People With Chronic Diseases

Game-based eHealth interventions, particularly those incorporating exergaming and virtual reality, serve as effective tools for mitigating fatigue in patients suffering from chronic conditions such as multiple sclerosis, cancer, and renal disease. A systematic review and meta-analysis of 17 randomized controlled trials demonstrates a significant moderate effect size of -0.65 when these digital interventions are compared against conventional or no-care control groups. These findings suggest that integrating technology into therapeutic regimens offers a viable pathway for symptom management, with balance-focused exercises and supervised, hospital-based programs yielding the most favorable clinical outcomes.

Despite these promising results, the current evidence base remains constrained by methodological limitations. The overall quality of existing research is classified as low to moderate, hampered by inconsistent randomization processes, missing data, and a lack of standardized, prespecified analysis plans. Furthermore, substantial heterogeneity across the analyzed studies and evidence of potential publication bias indicate that the field is still in an emerging state. The scope of these findings is currently limited by a lack of long-term follow-up data, which prevents a comprehensive understanding of the durability of these fatigue-reduction effects.

Future progress in this sector requires a shift toward more rigorous, standardized research designs. Prioritizing intention-to-treat analyses and developing personalized, multi-modal interventions that combine physical activity with psychological support will be essential for validating these early findings. While exergaming currently dominates the literature, expanding research into non-exergaming game interventions is necessary to diversify therapeutic options. Establishing a more robust framework for clinical evaluation will ultimately determine the long-term viability and scalability of game-based eHealth as a standard component of chronic disease management.