Effect of the Use of New Technologies on Mental Health in Physical Education Students: A Systematic Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Great effort in writing this manuscript. Some things to improve:
a. Mental health was not reflected in your title

b. How do you select the final 27 manuscripts for the reviews?

C. How does each author analyse the manuscripts? 

d. Limitations of this review were not mentioned? 

e. Provide justification of 5 years period of selecting the manuscript

f. Expand the discussion section to provide higher insights for readers

 

Author Response

Firstly, I would like to thank the reviewer for their contributions and recommendations, which are very relevant to the improvement of this manuscript. The changes made to the article, following these considerations, are detailed below:

• Mental health was not reflected in your title

Thank you very much for your comment. The term mentioned by the reviewer is included in the title.

• How do you select the final 27 manuscripts for the reviews?

Thank you very much for your comment. A series of eligibility criteria were established in accordance with the PRISMA Statement, as specified in the flow diagram (Figure 1) and in the explanation thereof.

• How does each author analyse the manuscripts? 

Thank you very much for your comment. The article specifies:  "Subsequently, the methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT), designed to systematically appraise qualitative, quantitative and mixed methods studies within systematic reviews. For this work, we used the updated 2018 version, which includes specific criteria and guidelines for summarising results descriptively or with a standardised scoring system".

• Limitations of this review were not mentioned? 

Thank you very much for your comment. The limitations and future lines of research have been added to the conclusions section.

• Provide justification of 5 years period of selecting the manuscript

Thank you very much for your comment. The section on materials and methods explains the rationale for the period used in this systematic review.

• Expand the discussion section to provide higher insights for readers

In the discussion, the main ideas of the research are clarified further to improve the reader's understanding. In addition, other documentary sources have been added to achieve greater scientific rigour.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review this manuscript.

This manuscript explores an important and timely topic by examining the educational impact of digital technologies and their influence on students’ mental health in the context of Physical Education. The authors carry out a systematic review that addresses pertinent topics such as the integration of digital tools into teaching practice, academic performance and student mental health. The review follows generally accepted methodological procedures, and holds practical implications for educators, researchers, and policymakers.

That said, the manuscript needs to be improved in a few areas in order to enhance the coherence, transparency, and methodological rigor of the work. For convenience, my detailed comments and recommendations are arranged below by section.

Introduction

1 — The introduction is well structured and clearly explains the context, objectives, and relevance of the study. It provides relevant background, but most of the cited literature originates from Spain or Latin American countries. Initially, this appears to introduce a potential cultural bias in framing the research problem. However, the methods section later clarifies (Table 1) that the review is limited to studies conducted in educational systems similar to Spain's. I recommend explicitly stating this geographic and systemic scope in the introduction and abstract to provide early clarity and to justify the predominance of regional literature in the theoretical framework.

2 — Line 46: the term “However” seems inappropriate since is complementing a list of benefits rather than showing a drawback. Consider replacing it with “Moreover”.

Materials and Methods

3 — Line 107: I recommend restating the exact data collection time frame here (not only in the abstract) to maintain clarity.

4 — Lines 107–108: Given the rapid evolution of educational technologies, the decision to limit the included studies to the last five years is understandable. However, I recommend providing a clearer justification for this option and consider whether relevant foundational studies might have been excluded as a result.

5 — Line 114: There appears to be an inconsistency regarding the objectives presented in the abstract/introduction and the research question stated in the methods section - the abstract and introduction mention educational impact and mental health, while the research question introduces "academic performance" as an additional outcome. If academic performance is indeed a core focus of the review (which is reinforced in the discussion), it should be explicitly included in both the abstract and introduction for alignment.

6 — Lines 118–119 and Table 2: There is inconsistency in how the Boolean search strategy is presented. The narrative text omits "Academic Achievement", while Table 2 includes it—more appropriately aligned with the research question. Additionally, the Boolean logic should be clarified using parentheses to avoid ambiguity.

For example, the expression:
"Physical Education" AND ("Digitization" OR "Digital Technology") AND ("Academic Achievement" OR "Mental Health")
ensures inclusion of studies addressing either outcome.

On the other hand, a formulation like:
"Physical Education" AND ("Digitization" OR "Digital Technology") AND "Academic Achievement" AND "Mental Health"
would exclude any study that addresses only one of the two outcomes, which may not reflect the intended scope. Please verify this.

I recommend unifying the presentation of the search string across both the text and Table 2, and clearly presenting the final, definitive version.

7 — Table 2, Exclusion Criteria column: I recommend modifying the sentence “Studies that address digital technology outside the educational context” to include “and at the university or post-graduate level,” to maintain consistency with the exclusion criteria in the PRISMA flow diagram (Figure 1).

8 — The description of the quality assessment process using MMAT (2018) is clear and thorough, including inter-rater agreement. However, considering that one article met only 40% of the criteria, I recommend clarifying whether a minimum quality threshold was applied for inclusion. Additionally, to improve transparency and reproducibility, consider including a supplementary table listing the MMAT criteria applied to each study design.

Results

9 — Line 157: The term "moderating variables" is not appropriate in this context, as the listed elements (e.g., author, year, design) are descriptive coding categories rather than variables used to assess interaction effects. Consider replacing with "study characteristics", "coding categories", or "data extraction variables".

10 — Figure 4: There is a minor inconsistency in terminology. The text refers to "Baccalaureate", but the figure uses "High School" and "Secondary & High School". For consistency, I suggest standardizing the terms—preferably using "Baccalaureate" and "Secondary & Baccalaureate" throughout the text, figure, and Table 3.

11 — Lines 174–176 and Figure 5: While using frequencies in the text and percentages in the figure is acceptable, it would help to state clearly in the text that Figure 5 presents percentage data. Including the absolute values (n = 27) in the figure or caption would improve clarity, especially given the small sample size.

12 — Line 184: The abbreviation "PE" (for Physical Education) is used for the first time here, but it was not introduced earlier. For consistency, I recommend introducing this abbreviation the first time the term appears in the introduction or providing a rationale for its delayed use.

13 — Line 207: The caption of Figure 6 states “Size and number of associated publications”, which is ambiguous. It is unclear what “size” refers to. If the chart shows the number of studies per thematic area, consider revising the caption —e.g., “Number of studies associated with each thematic area.” To improve transparency and reproducibility, I also recommend a brief explanation of how these values were determined.

14 — Table 3, caption: Typo — change "Nota" to "Note" to maintain language consistency.

Discussion

15 — The discussion appears to incorporate both the 27 included studies and additional external literature, which is acceptable, since supplementary references may be used for theoretical support, contextualization, interpretation of findings, or to refer to evidence published after the search cutoff date. However, it is not always clear which references belong to which group. In systematic reviews, the discussion should be based primarily on the selected studies, and any external literature should be clearly identified. I recommend clarifying this distinction to enhance transparency and methodological rigor.

16 — The discussion would benefit from a more critical synthesis of the included studies. In my view, the findings are presented in a largely descriptive manner, with little analysis of study heterogeneity, contradictory findings, or strength of evidence. I suggest addressing these points for greater analytical depth and improvement of the interpretative value of the review.

17 — Some themes are revisited twice throughout the discussion, sometimes with slightly different perspectives. For example, the digital divide theme is addressed in both lines 252–257 and 258–260, and the integration of digital technologies is discussed in lines 269–274 and again in 280–282. While these points are valid, consolidating them thematically would reduce fragmentation and improve clarity, as well as the overall coherence of the section.

18 — While the discussion highlights the challenges of using digital technology, it does not mention the methodological limitations of the studies included in the review (e.g., small samples, study design, context). A brief reflection on these aspects would provide a more balanced view of the findings.

19 — The geographic and systemic scope of the review - educational systems similar to Spain’s - is clearly defined in the methods section. However, this may be considered as a limitation, since it hinders the generalizability of the findings to other international contexts, that is not explicitly acknowledged in the discussion or conclusion. I recommend briefly addressing this as a limitation of the study, to provide a more balanced interpretation of the results and to clarify the scope of applicability.

Conclusion

20 — The conclusion appropriately highlights the value of adopting a constructivist approach in using digital technologies in Physical Education, aligned with the findings (e.g., active learning, student autonomy, feedback, peer collaboration). However, since the discussion does not reference constructivist theory explicitly, I suggest integrating brief mentions or citations earlier in the discussion to anchor this final recommendation more clearly.

References

21 — Reference 53 is missing the access date. I recommend reviewing all references to ensure they comply with the journal’s referencing standards, particularly for online sources.

Final remark

Although the manuscript presents several areas for improvement, I believe that the issues raised are relatively minor and can be addressed through thoughtful revision. With these adjustments, the paper has the potential to offer a meaningful contribution I encourage the authors to view these suggestions as an opportunity to enhance the clarity, rigor, and overall impact of their work.

 

Author Response

Firstly, I would like to thank the reviewer for their contributions and recommendations, which are very relevant to the improvement of this manuscript. The changes made to the article, following these considerations, are detailed below:

INTRODUCTION

1 — The introduction is well structured and clearly explains the context, objectives, and relevance of the study. It provides relevant background, but most of the cited literature originates from Spain or Latin American countries. Initially, this appears to introduce a potential cultural bias in framing the research problem. However, the methods section later clarifies (Table 1) that the review is limited to studies conducted in educational systems similar to Spain's. I recommend explicitly stating this geographic and systemic scope in the introduction and abstract to provide early clarity and to justify the predominance of regional literature in the theoretical framework. Thank you very much for your comment.  

2 — Line 46: the term “However” seems inappropriate since is complementing a list of benefits rather than showing a drawback. Consider replacing it with “Moreover”. Thank you very much for your comment. The modification suggested by the reviewer has been made.

MATERIAL AND METHODS

Materials and Methods

3 — Line 107: I recommend restating the exact data collection time frame here (not only in the abstract) to maintain clarity. Thank you very much for your comment. The modification suggested by the reviewer has been made.

4 — Lines 107–108: Given the rapid evolution of educational technologies, the decision to limit the included studies to the last five years is understandable. However, I recommend providing a clearer justification for this option and consider whether relevant foundational studies might have been excluded as a result. Thank you very much for your comment. A comprehensive justification of the choice of the article search period has been provided for the reader's further clarification.

5 — Line 114: There appears to be an inconsistency regarding the objectives presented in the abstract/introduction and the research question stated in the methods section - the abstract and introduction mention educational impact and mental health, while the research question introduces "academic performance" as an additional outcome. If academic performance is indeed a core focus of the review (which is reinforced in the discussion), it should be explicitly included in both the abstract and introduction for alignment. Thank you very much for your comment. The modification suggested by the reviewer has been made.

6 — Lines 118–119 and Table 2: There is inconsistency in how the Boolean search strategy is presented. The narrative text omits "Academic Achievement", while Table 2 includes it—more appropriately aligned with the research question. Additionally, the Boolean logic should be clarified using parentheses to avoid ambiguity.

For example, the expression:
"Physical Education" AND ("Digitization" OR "Digital Technology") AND ("Academic Achievement" OR "Mental Health")
ensures inclusion of studies addressing either outcome.

On the other hand, a formulation like:
"Physical Education" AND ("Digitization" OR "Digital Technology") AND "Academic Achievement" AND "Mental Health"
would exclude any study that addresses only one of the two outcomes, which may not reflect the intended scope. Please verify this.

I recommend unifying the presentation of the search string across both the text and Table 2, and clearly presenting the final, definitive version. 

Thank you very much for your comment. First, the initial search was conducted using the following string: ‘Physical education’ AND (“Digitalisation” OR ‘Digital technology’) AND ‘Academic performance’ AND ‘Mental health’. However, upon verifying that there were no manuscripts with this restrictive combination, and after consensus among the authors, it was decided to broaden the strategy by removing the term ‘academic performance.’

Nevertheless, academic performance was repeatedly addressed in the selected articles, which is why we have emphasised this aspect and consider it relevant to highlight it. After reviewing the search strategy again, we proceeded to:

Modify the PICO question to ensure it was consistent with the terms ultimately used.

Correct Table 2, standardising its presentation with the narrative description and avoiding the inconsistency noted.

Clarify the Boolean logic with parentheses to avoid ambiguities in interpretation.

7 — Table 2, Exclusion Criteria column: I recommend modifying the sentence “Studies that address digital technology outside the educational context” to include “and at the university or post-graduate level,” to maintain consistency with the exclusion criteria in the PRISMA flow diagram (Figure 1). Thank you very much for your comment. Table 2, column ‘Exclusion criteria’ has been modified.

8 — The description of the quality assessment process using MMAT (2018) is clear and thorough, including inter-rater agreement. However, considering that one article met only 40% of the criteria, I recommend clarifying whether a minimum quality threshold was applied for inclusion. Additionally, to improve transparency and reproducibility, consider including a supplementary table listing the MMAT criteria applied to each study design. Thank you very much for your positive observation regarding the thoroughness of the description of the methodological quality assessment process. With respect to your comment, we clarify that all the studies included satisfactorily passed the initial MMAT screening questions (S1 and S2), which guarantees that the studies had clearly formulated research questions and adequate data to address them, and therefore were eligible for inclusion in the review (Hong et al., 2018). This criterion was considered an essential requirement for the inclusion of the articles in the review. Thus, even in the case of the article that achieved 40% compliance with the specific items, it was decided to retain it in the analysis since it met the minimum validity requirements necessary to address its objectives.

RESULTS

9 — Line 157: The term "moderating variables" is not appropriate in this context, as the listed elements (e.g., author, year, design) are descriptive coding categories rather than variables used to assess interaction effects. Consider replacing with "study characteristics", "coding categories", or "data extraction variables". Thank you very much for your comment. The term ‘moderating variables’ has been changed to the suggested ‘study characteristics’.

10 — Figure 4: There is a minor inconsistency in terminology. The text refers to "Baccalaureate", but the figure uses "High School" and "Secondary & High School". For consistency, I suggest standardizing the terms—preferably using "Baccalaureate" and "Secondary & Baccalaureate" throughout the text, figure, and Table 3. Thank you very much for your comment. Figure 4 has been modified, as have the terms in the text and Table 3, to maintain consistency and ensure that the terminology is correct.

11 — Lines 174–176 and Figure 5: While using frequencies in the text and percentages in the figure is acceptable, it would help to state clearly in the text that Figure 5 presents percentage data. Including the absolute values (n = 27) in the figure or caption would improve clarity, especially given the small sample size. Thank you very much for your comment. The absolute values have been added to the caption of Figure 5, and the text has been clarified to indicate that the figure shows the data in percentages.

12 — Line 184: The abbreviation "PE" (for Physical Education) is used for the first time here, but it was not introduced earlier. For consistency, I recommend introducing this abbreviation the first time the term appears in the introduction or providing a rationale for its delayed use. Thank you very much for your comment. The abbreviation PE (Physical Education) has been incorporated since its first mention in the introduction and applied consistently throughout the manuscript.

13 — Line 207: The caption of Figure 6 states “Size and number of associated publications”, which is ambiguous. It is unclear what “size” refers to. If the chart shows the number of studies per thematic area, consider revising the caption —e.g., “Number of studies associated with each thematic area.” To improve transparency and reproducibility, I also recommend a brief explanation of how these values were determined. Thank you very much for your comment. The title of Figure 6 has been modified and an explanation has been added to the text regarding the values in the figure.

14 — Table 3, caption: Typo — change "Nota" to "Note" to maintain language consistency. Thank you very much for your comment. the error has been modified.

DISCUSSION

15 — The discussion appears to incorporate both the 27 included studies and additional external literature, which is acceptable, since supplementary references may be used for theoretical support, contextualization, interpretation of findings, or to refer to evidence published after the search cutoff date. However, it is not always clear which references belong to which group. In systematic reviews, the discussion should be based primarily on the selected studies, and any external literature should be clearly identified. I recommend clarifying this distinction to enhance transparency and methodological rigor. Thank you for your comment. Various changes have been made to the discussion to provide greater clarity for the reader, improve scientific rigour, and address the different sections in response to the research question.

16 — The discussion would benefit from a more critical synthesis of the included studies. In my view, the findings are presented in a largely descriptive manner, with little analysis of study heterogeneity, contradictory findings, or strength of evidence. I suggest addressing these points for greater analytical depth and improvement of the interpretative value of the review. Thank you for your comment. Various changes have been made to the discussion to provide greater clarity for the reader, improve scientific rigour, and address the different sections in response to the research question.

17 — Some themes are revisited twice throughout the discussion, sometimes with slightly different perspectives. For example, the digital divide theme is addressed in both lines 252–257 and 258–260, and the integration of digital technologies is discussed in lines 269–274 and again in 280–282. While these points are valid, consolidating them thematically would reduce fragmentation and improve clarity, as well as the overall coherence of the section. Thank you for your comment. The ideas have been combined for greater clarity and to improve the scientific rigour of the research.

18 — While the discussion highlights the challenges of using digital technology, it does not mention the methodological limitations of the studies included in the review (e.g., small samples, study design, context). A brief reflection on these aspects would provide a more balanced view of the findings. Thank you very much for your comment. Limitations of the study have been included in the conclusions section

19 — The geographic and systemic scope of the review - educational systems similar to Spain’s - is clearly defined in the methods section. However, this may be considered as a limitation, since it hinders the generalizability of the findings to other international contexts, that is not explicitly acknowledged in the discussion or conclusion. I recommend briefly addressing this as a limitation of the study, to provide a more balanced interpretation of the results and to clarify the scope of applicability. Thank you very much for your comment. The limitations of the study have been addressed in the conclusions section.

CONCLUSIONS

20 — The conclusion appropriately highlights the value of adopting a constructivist approach in using digital technologies in Physical Education, aligned with the findings (e.g., active learning, student autonomy, feedback, peer collaboration). However, since the discussion does not reference constructivist theory explicitly, I suggest integrating brief mentions or citations earlier in the discussion to anchor this final recommendation more clearly. Thank you for your comment. A quote about constructivist theory has been added to the discussion, as suggested.

REFERENCES

21 — Reference 53 is missing the access date. I recommend reviewing all references to ensure they comply with the journal’s referencing standards, particularly for online sources. Thank you for your comment. All references have been modified to comply with APA guidelines.

Author Response File: Author Response.pdf