Search Results (293)

Background: Prolonged sitting during lecture-based academic activities may be accompanied by sustained attentional engagement and cognitive fatigue, with potential consequences for cognitive efficiency and broader psychological functioning. Physical activity breaks (PABs) represent a feasible strategy to interrupt sitting time within university timetables, yet evidence in higher-education settings remains limited, particularly regarding modality-specific effects. This randomized crossover study examined the acute effects of a 10 min PAB on attentional and executive functioning in undergraduate students and compared an outdoor physical activity break (OPAB) with an exergame-based PAB (PABEx) versus a no-break control (NPAB). Methods: Forty-two undergraduate students (26 males, 16 females; mean age = 22.78 ± 5.84 years) completed three weekly conditions in randomized order following two consecutive hours of seated lectures: NPAB (seated rest), OPAB (2 min warm-up, 6 min light-to-moderate walking, 2 min cool-down), and PABEx (2 min warm-up, 6 min Fruit Ninja Kinect, 2 min cool-down). Cognitive performance was assessed immediately after each condition using the Trail Making Test A-B (TMT A-B) and the Stroop Color-Word Test (SCWT). Results: Significant condition effects were found for TMT-A (χ² = 53.976, p < 0.001), TMT-B (χ² = 44.635, p < 0.001), TMT B-A (χ² = 10.841, p = 0.004), SCWT interference time (χ² = 44.714, p < 0.001), and SCWT interference errors (χ² = 23.211, p < 0.001). Post-hoc tests showed that both OPAB and PABEx were associated with better performance on TMT-A, TMT-B, and SCWT interference time versus NPAB (all Benjamini–Hochberg-adjusted p < 0.001); PABEx was associated with better TMT-A performance than OPAB (Benjamini–Hochberg-adjusted p = 0.047). TMT B-A decreased only for OPAB versus NPAB (Benjamini–Hochberg-adjusted p = 0.009). SCWT interference errors were lower for OPAB versus NPAB (Benjamini–Hochberg-adjusted p < 0.001) and for PABEx versus NPAB (Benjamini–Hochberg-adjusted p = 0.012). Conclusions: A 10 min PAB implemented immediately after a lecture-based academic activity was associated with more favorable post-condition attentional and executive performance in undergraduate students compared with a passive no-break condition. OPAB and PABEx yielded broadly comparable benefits across executive outcomes, whereas PABEx showed an additional advantage for TMT-A, suggesting a possible modality-specific effect on processing speed and visuoperceptual tracking. These findings support the integration of brief active breaks into university schedules as a pragmatic strategy to promote post-lecture cognitive efficiency during academically demanding periods. Trial registration: ClinicalTrials.gov, NCT07624084; retrospectively registered on 28 May 2026. Full article

Background/Objectives: Muscular dystrophies (MDs) are progressive neuromuscular disorders in which rehabilitation is central to management, yet conventional physical therapy in children is constrained by motivation, accessibility, and the need to adapt across disease stages. Virtual reality (VR) offers an interactive, adaptable, and home-deliverable alternative, but prior reviews focused narrowly on upper-limb outcomes in Duchenne muscular dystrophy or on motor-learning paradigms. We aimed to evaluate VR-based rehabilitation in children and adolescents with MD across feasibility/adherence, engagement and psychological outcomes, and clinical motor outcomes, and to propose a stage-based conceptual framework. Methods: PubMed, Embase, and Cochrane CENTRAL were searched on 21 April 2026, following PRISMA 2020 (PROSPERO CRD420261380539). Eligible studies enrolled children or adolescents (mean age ≤ 18 years or separable pediatric data) with any MD who received VR/AR/MR/exergame/serious-game rehabilitation. Risk of bias was assessed with RoB 2.0 and ROBINS-I, and certainty with GRADE. Given substantial heterogeneity, findings were synthesized narratively by disease stage. Results: Eight studies (2017–2024; 221 participants) met the inclusion criteria. No serious VR-related adverse events occurred, and feasibility and tolerability were consistently favorable. Engagement and psychological outcomes showed favorable trends, including sustained motivation and reduced perceived fatigue. Clinical motor outcomes were heterogeneous and stage-dependent. Conclusions: The evidence base is limited and clinically heterogeneous, precluding meta-analysis, with Low GRADE certainty for feasibility, safety, and adherence and Very low for the remaining four domains. Key limitations include small sample sizes, substantial clinical and methodological heterogeneity, and only a single advanced-stage study. The findings provisionally support a stage-dependent role for VR-based rehabilitation in pediatric MD: motor training in the ambulatory stage, upper-limb maintenance and interface-adapted training in the transitional stage, and feasibility-, engagement-, and psychological-support applications in advanced disease. Stage-stratified trials with standardized, domain-specific outcomes and explicit virtual-to-real transfer assessment are warranted. Full article

This study investigated whether neuro-exergaming with an interactive physical and cognitive exercise system (iPACES), might alleviate symptoms in college students with symptoms of Attention Deficit Hyperactivity Disorder (sxADHD). It was hypothesized that challenges with attention and executive function, often experienced by those with sxADHD, would improve after an acute bout of pedal-n-play exercise. College students (n = 33; 18 with sxADHD) participated in a 20 min single bout of exercise, pedaling along a virtual pathway (tour), while steering the tablet. Mental exercise included a working memory (focus) task to steer toward assigned locations along the path. An exploratory experimental condition was also embedded in the basic pre/post design, wherein half of the students were randomly assigned collectibles (coins) in the pathway. Cognition was assessed (e.g., paper and digital Stroop, Trails, Digit Span) before and after the acute bout of exercise. Paired t-tests revealed significant improvements in executive function on both paper and electronic Stroop tasks for those with sxADHD, while significant change was also seen on Trails and Digit Span for normative students. Surprisingly, those with sxADHD, assigned to the experimental “multi-tasking” collectible (coin) challenge, performed significantly better on tests of executive functioning than normative peers, who improved more without coins. It is hypothesized that the collectible challenge provided additional mental stimulation or reward needed to increase attentional focus for those with sxADHD, leading to improved performance, post-exercise. While the findings of this study are preliminary, additional research can further explore possible designs for combined, interactive mental and physical exercise challenges, as well as further possible synergistic or differential neural activation, in order to maximize outcomes from the same amount of time exercising. Additionally, future research could examine longer-term use of neuro-exergaming, through a clinical trial, as an alternative to, or in conjunction with, medication for sxADHD treatment and symptom relief. Full article

Background/Objectives: Multiple sclerosis (MS) is a chronic neurological disorder affecting more than 2.8 million individuals worldwide and is commonly associated with cognitive deficits that compromise independence and quality of life. In recent years, virtual reality (VR) has emerged as an innovative rehabilitation strategy, offering immersive and engaging environments that promote neuroplasticity and enhance patient motivation. To evaluate the effectiveness of immersive and non-immersive VR-based interventions in improving cognitive performance among adults diagnosed with MS. Methods: A systematic review was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA 2020 guidelines (PROSPERO registration: CRD420251103762). Comprehensive searches were carried out across seven international databases up to October 2025, including only randomized controlled trials assessing cognitive outcomes after VR-based rehabilitation programs. Results: From 1948 records screened, 13 studies comprising 649 participants met the inclusion criteria. Intervention durations ranged between 6 and 17 weeks, with sessions lasting 30–60 min. The interventions involved treadmill training with VR, exergaming, and cognitive stimulation protocols. Most studies demonstrated significant improvements in processing speed, visuospatial and verbal memory, and executive functioning (p < 0.05). Adherence rates were above 80%, and no serious adverse events were reported. Conclusions: VR-based rehabilitation appears to be a safe, feasible, and effective approach for enhancing cognitive abilities in individuals with MS, particularly in processing speed and visuospatial memory. Nonetheless, the heterogeneity of methodologies underscores the need for standardized intervention frameworks and large-scale multicenter randomized trials to establish optimal parameters and confirm sustained long-term benefits. Full article

Artificial intelligence (AI), virtual reality (VR), and exergame technologies have been increasingly used in dance and movement activities. However, this literature remains dispersed across different areas, making it difficult to determine how the field has developed. This study mapped the research landscape and thematic development of AI-, VR-, and exergame-based dance and movement research on psychological outcomes using bibliometric analysis and latent Dirichlet allocation (LDA) topic modeling. A total of 252 records indexed in the Web of Science Core Collection from 2011 to 2025 were included. Five related thematic strands were identified: immersive dance interaction and technology-supported teaching; rehabilitation-oriented dance or rhythm training; school-based exergaming and psychophysiological assessment; behavioral program design and intervention implementation; and AI-based motion or emotion recognition. These strands indicate that the field has developed into a multi-layered research space shaped by technology functions, movement contexts, intervention formats, and psychological constructs, rather than a single dance-intervention or technology-application domain. At the same time, psychological outcomes were not represented with equal clarity across these strands. Participation-related and psychosocial constructs, including enjoyment, motivation, engagement, self-efficacy, social interaction, emotional expression, and quality of life, were more frequently represented, whereas mental-health-related outcomes such as anxiety, depression, stress, loneliness, and psychological well-being were less consistently connected to technology-supported dance or movement interventions. These findings clarify where evidence is concentrated, how major themes are organized, and where psychological outcome measurement requires clearer theoretical and methodological specification. Future studies should use comparative and longitudinal designs to examine whether VR/AI-based feedback-supported movement training offers added value over conventional dance or movement programs for psychological outcomes, participation, exercise experience, and longer-term behavior change. Full article

Background: Active video games (AVG) may offer an alternative strategy to increase physical activity in adults with obesity. This study compared the acute effects of AVG, moderate-intensity continuous training (MICT), and a seated control condition on capillary blood glucose, physiological responses, and exercise enjoyment in sedentary office workers with overweight or obesity. Methods: Seventeen sedentary middle-aged adults with obesity (41 ± 8 years; BMI: 30.6 ± 5.3 kg/m²) participated in this randomized crossover study conducted at the Human Movement Biosciences Laboratory of the Autonomous University of Baja California, Mexico. Participants completed three conditions: 30 min of AVG, 30 min of treadmill-based MICT, and a seated control session. Capillary blood glucose was measured at baseline, immediately post-exercise, and 24 h post-exercise. Heart rate (HR), rating of perceived exertion (RPE), and exercise enjoyment were also assessed. Results: A significant main effect of time on capillary blood glucose was observed (p = 0.003), with reductions observed immediately and 24 h post-exercise. No significant condition or interaction effects were found. Significant reductions were observed in the AVG condition from baseline to 24 h post-exercise (p = 0.004). AVG and MICT elicited similar moderate-intensity physiological responses (HR and RPE), while AVG produced greater exercise enjoyment than MICT (p = 0.026). Conclusions: AVG appeared to elicit similar moderate-intensity physiological responses in sedentary office workers with overweight or obesity. Additionally, AVG was associated with greater exercise enjoyment and reductions in capillary blood glucose over time, suggesting that AVG could represent a feasible and engaging alternative strategy for promoting physical activity and supporting metabolic health in workplace settings. Full article

Background/Objectives: With the development of the silver economy, older adults have shown increasing interest in digital technologies, such as electronic fitness games (Exergames). This study explores the impact of commercial exergames on the emotional experience of older adults in order to provide novel ideas and applications for healthy aging. Methods: This was a prospective, single-center, unblinded, repeated-measures randomized controlled trial comparing an exergame intervention with traditional indoor exercise. This study included 30 older adults (aged 60–89 years) who were able to move independently. The intervention group performed exergame training using Ring Fit Adventure, whereas the comparison group performed traditional indoor exercise. The intervention lasted four weeks, with two sessions per week (eight sessions). Mood states were assessed using the Brunel Mood Scale, and data were analyzed using a linear mixed-effects model to examine group, time, and interaction effects. Results: Significant group × time interaction effects were observed for confusion, depression, fatigue, tension, and vigor (p < 0.05). No significant interaction effect was found for anger (p = 0.942). Conclusions: This study examined commercial exergames from the perspectives of emotional experience and mental health. Both commercial exergames and traditional indoor exercise were associated with improvements in immediate mood states. The exergame-based training approach was associated with lower levels of confusion, depression, and fatigue, as well as higher vigor scores. The results provide preliminary evidence regarding the role of digital exercise in mood regulation among older adults. Full article

Background and Objectives: Multiple sclerosis (MS) is characterized by progressive disability and a spectrum of motor and cognitive impairments. Exergames and virtual reality (VR) are proposed as motivating exercise tools, potentially useful for improving adherence and expanding access to rehabilitation. The objectives are to explore the feasibility and safety of a supervised rehabilitation program based on a high-intensity exercise program with immersive virtual reality (IVR) in people with MS and to describe its effects on physical, cognitive, and functional domains, as well as on the serum biomarker neurofilament light chain (sNfL). Materials and Methods: Pre–post exploratory study in five volunteers from a local MS Association [Vigo, Spain]. Intervention: 8 weeks, two sessions/week, 10 min/session of an IVR boxing-based exergame combined with usual rehabilitation, supervised by a physiotherapist. The variables studied were safety (Simulator Sickness Questionnaire [SSQ]), usability (System Usability Scale [SUS]), disability (Expanded Disability Status Scale [EDSS]), gait (25-Foot Walk Test [25FWT]), manual dexterity (9 Hole Peg Test [9HPT]), cognition (Symbol Digit Modalities Test [SDMT]), and axonal damage biomarker (sNfL). Results: The intervention could be feasible and safe (100% adherence, no adverse events (without SSQ symptoms), 95% usability [SUS]). There were positive changes in all variables studied (mean ± SD): EDSS −0.5 ± 0.9; 25FWT −4.9 ± 9.8 s; right 9HPT −3.3 ± 0.9 s; sNfL −4.4 ± 4.5 pg/mL, except for left 9HPT +0.5 ± 5.0 s and cognition (SDMT −2.4 ± 1.3 points). Conclusions: A brief, supervised exercise program combing an IVR exergame with standard rehabilitation was feasible and safe in people with MS. Although the results seem promising with the proposed design, the clinical and biological changes are merely exploratory, and it is not possible to infer their efficacy. Our findings open the door to future controlled studies including perceived high-intensity exercise programs and larger sample sizes to explore efficacy and estimate clinically relevant effect sizes. Full article

Background: Low-cost virtual reality exergames may help maintain and improve postural control in children with spastic hemiplegia cerebral palsy (CP). This study aimed to evaluate the comparative effectiveness of the same six-week, low-cost exergame programme delivered via telerehabilitation (TR) and face-to-face (FF) in CP children. Methods: In this randomised controlled trial, 15 CP patients completed 18 sessions over 6 weeks. The TR group received remotely delivered sessions, whereas the FF control group completed in-person sessions with a physiotherapist. Outcomes were assessed at baseline; weeks 2, 4, and 6; and follow-ups at weeks 8 and 10. Postural control (centre-of-pressure sway area; CoP_sway) was measured during eyes open (EO), eyes closed (EC), voluntary mediolateral sway to a 30 bpm auditory cue (EO/EC), and during exergames targeting mediolateral (ML-WS) and anteroposterior (AP-WS) weight-shifting. Timed Up and Go (TUG) and Modified Modified Ashworth Scale (MMAS) were also assessed. Results: At week 6, both TR and FF significantly reduced CoP_sway (TR: p = 0.001, EC; FF: p = 0.01, EO). TR also improved dynamic postural control (p < 0.05) and TUG scores (p = 0.03), with functional gains sustained until week 10. Between-group comparisons revealed that TR achieved significantly greater reductions in AP weight-shifting (SD_ML, p = 0.001; V_ML, p = 0.004) and TUG (p = 0.009) than FF, with these advantages persisting throughout follow-up as revealed by post hoc analysis. Conversely, only FF significantly reduced ankle muscle tone (MMAS, p = 0.05). TR demonstrated broader improvements in secondary CoP metrics and superior long-term retention of functional mobility gains. Conclusions: Both six-week exergame interventions led to improvements in postural control. This trial demonstrated that telerehabilitation is a viable, comparable alternative to face-to-face delivery. Long-term retention suggests both modalities are complementary, offering flexible solutions to enhance routine physiotherapy service pathways. These findings provide a basis for validating these models across larger clinical cohorts. Full article

Children with attention deficit/hyperactivity disorder (ADHD) often exhibit deficits in executive functions (EFs), which are crucial for self-regulation and academic performance. Physical activity (PA) has emerged as a promising non-pharmacological approach to support EF development in this population. This scoping review, guided by the PRISMA-ScR framework, examined PA interventions aimed at improving EFs in children aged 6–12 diagnosed with ADHD. Evidence was synthesized narratively by categorizing interventions according to PA modality, intensity, and the specific EF domains targeted, whilst describing the methodological characteristics of existing studies. A systematic search of PubMed, Cochrane Library, Web of Science, Scopus, and PsycINFO up to the end of 2024 yielded 55 peer-reviewed empirical studies involving 3863 participants. Both acute and chronic PA interventions were associated with improvements in EFs, with inhibitory control most commonly enhanced, followed by working memory and cognitive flexibility. Structured sports such as swimming and football, as well as multimodal interventions including physical–cognitive training and exergames, demonstrated positive effects. Intervention efficacy was influenced by factors such as intensity, duration, cognitive engagement, and context. However, variability in study designs, small sample sizes, and lack of standardization limited comparability. These findings suggest that PA interventions can support EF development in children with ADHD, particularly when activities are cognitively engaging. Future research should address methodological limitations and explore mediators and moderators in ecologically valid and theory-driven designs. Full article

Children with Autism Spectrum Disorder (ASD) frequently present impairments in executive functions and motor skills, which can negatively affect academic performance, adaptive behavior, and daily functioning. Exergames have emerged as a potentially engaging cognitive–motor intervention. The objective of this systematic review was to analyze the effects of exergame-based interventions on executive function components (particularly inhibitory control and cognitive flexibility) and motor skills in children with ASD. A systematic review was conducted in accordance with PRISMA guidelines, with the protocol registered in PROSPERO. Electronic searches were performed in PubMed, Scopus, Web of Science, and ERIC. Intervention studies published within the last five years and assessing exergame-based interventions in children with ASD were included. Methodological quality was evaluated using the PEDro scale. Six studies met the inclusion criteria. Exergame-based interventions were associated with improvements in executive functions, particularly inhibitory control (reported in two studies using Stroop- and Flanker-type tasks) and cognitive flexibility (assessed in two studies using the Wisconsin Card Sorting Test), although results varied depending on intervention duration and design. Acute interventions (single-session) primarily influenced inhibitory control, whereas longer-term programs showed broader cognitive and motor adaptations. Improvements in motor outcomes, including gross motor development, coordination, and fundamental motor skills, were reported in four studies. Methodological quality ranged from 4 to 6 points on the PEDro scale, indicating fair to good quality. Considerable heterogeneity was observed in intervention protocols, duration, and outcome measures. Exergame-based interventions may represent a potentially promising approach for targeting executive functions and motor skills in children with ASD; however, the current evidence is limited and heterogeneous. Not all included studies assessed both cognitive and motor outcomes, and findings should therefore be interpreted with caution. Further high-quality randomized controlled trials are needed to confirm these effects and establish optimal intervention parameters. Full article

Hand range of motion (ROM) measurement is crucial for diagnosing joint limitations, tracking rehabilitation progress, and creating personalized treatment plans. In recent years, exergames combined with dedicated game controllers have emerged as promising tools to complement traditional hand rehabilitation; however, their validity as motor function assessment tools remains insufficiently explored. This study evaluates the validity of the eJamar game controller as a tool for measuring hand ROM and hand grip strength (HGS), by comparing its outputs with standard goniometry and dynamometry. In a prior technical validation using a robotic arm under controlled conditions, the device showed a mean error of approximately 1.5°, indicating high measurement precision under ideal conditions. In the clinical validation with 32 patients undergoing hand rehabilitation, performance was movement-dependent. Pronation and supination showed strong agreement (MAE < 3°) and higher agreement compared with other movements, whereas flexion, extension, and radial-ulnar deviation exhibited weaker correlations and substantially higher errors (around 20°). In contrast, grip strength measurements for more and less affected hands, respectively, showed high correlation (0.88–0.91) and moderate agreement (ICC 0.81–0.66) with MAE values around 4 kg-f. Overall, results suggest that the eJamar shows preliminary suitability for assessing HGS and forearm pronation and supination in clinical settings. However, for HGS, agreement should be interpreted with caution due to the observed bias and error levels, indicating that further validation and calibration are required before stronger clinical claims can be made. For wrist flexion, extension, and radial-ulnar deviation, the device currently shows limited accuracy and requires further improvement. Full article

Background: The purpose of this study was to compare the effects of two months of exergaming, conventional resistance exercise training, and no exercise on body composition and cardiometabolic risk factors in physically inactive older adults. Methods: For the preliminary study, twenty-four physically inactive adults aged 60–74 yrs. were allocated to an active video game training group (AVG n = 8), a conventional exercise group (CEG n = 7), or a non-exercising control group (CON n = 9). The AVG and CEG completed 24 supervised exercise training sessions over two months (three sessions per week) at self-selected, predominantly moderate-to-vigorous intensity, while the CON maintained usual daily activities. Body weight, skeletal muscle mass, body fat percentage, phase angle, and fasting blood biomarkers (glucose, total cholesterol, LDL, HDL, VLDL, and triglycerides) were assessed before and after the intervention. Results: No significant interactions were observed for body composition variables. Body weight decreased significantly following exercise training in both the AVG and CEG (p < 0.05). Significant interactions were found for total cholesterol (p = 0.001) and LDL cholesterol (p = 0.009). The AVG demonstrated significant reductions in fasting glucose, total cholesterol, and LDL cholesterol (p < 0.05), whereas the CEG showed a significant reduction only in total cholesterol. In contrast, the CON exhibited a significant increase in total cholesterol over the same period (p < 0.05). Conclusions: Two months of exergaming-based exercise training may lead to greater improvements in lipid-related cardiometabolic risk factors compared with conventional resistance exercise training in physically inactive older adults. These findings suggest that exergaming could be a promising exercise modality for supporting cardiometabolic health in aging populations. Full article

Aging is a progressive and heterogeneous biological process influenced by multiple factors that may compromise physical and cognitive capacities and increase the risk of frailty, functional decline, and falls in older adults. Falls represent a major public health concern due to their impact on independence and long-term care demand. Immersive virtual reality (IVR) delivered through active video games (exergames) has emerged as a preventive strategy that integrates sensory, motor, and cognitive stimulation within controlled and engaging environments, particularly where traditional programs face challenges related to adherence and individual adaptation. This study aims to determine the feasibility and implementation of an IVR-based program for falls prevention in older adults at risk of frailty in primary health care (PHC). A quasi-experimental pre–post design will be conducted with an intervention group (IVR/exergames) and a conventional control group, including a total sample of 40 participants (20 per group). The protocol comprises three phases: baseline assessment and IVR familiarization; a 12-week intervention delivered twice weekly; and post-intervention assessment. The primary outcome will be fall risk assessed using the Timed Up and Go (TUG) test. Secondary outcomes include physical performance (Short Physical Performance Battery, SPPB, and handgrip dynamometry) and psychological aspects related to falls (Falls Efficacy Scale International, FES-I, and Activities-specific Balance Confidence Scale, ABC). Feasibility indicators will include recruitment, adherence, retention, and cybersickness. A reduction in TUG time is expected, providing preliminary evidence on the feasibility of integrating IVR-based programs for falls prevention within PHC systems. Full article

Background: Μetabolic syndrome (MetS)—comprises central adiposity, elevated blood pressure, dyslipidaemia, and dysglycaemia, increasing the risk of type 2 diabetes and cardiovascular disease. Exercise training improves cardiorespiratory fitness and several MetS components, but real-world effectiveness is limited by poor adherence, restricted supervision, and insufficient personalisation. Objective: This scoping review mapped the clinical intervention evidence on technology-enhanced exercise and structured physical activity relevant to MetS, while distinguishing direct MetS evidence from translational evidence. Methods: In accordance with PRISMA-ScR, we searched PubMed and extended the search to Scopus and Web of Science; a supplementary IEEE Xplore search and a post hoc Embase check were also conducted. Eligible studies were interventions using web-based delivery, wearables, telemonitoring/mobile health (mHealth), artificial intelligence (AI) coaching, virtual reality (VR)/exergaming, or continuous glucose monitoring (CGM) alongside exercise training or structured physical activity. Results: Nineteen studies met the eligibility criteria. The evidence base was weighted toward wearable/app-based feedback and telemonitoring/mHealth/web-based approaches, with fewer studies on VR/exergaming, CGM-enabled exercise, and AI coaching. Most studies were randomised or cluster-randomised, but interventions were usually short term. Across categories, technology most consistently supported adherence, self-monitoring, accountability, remote supervision, and, in selected cases, physiology-informed personalisation. Direct MetS evidence was strongest for wearables with structured feedback, telemonitoring, mHealth, and web-based delivery, whereas AI coaching and CGM were supported by adjacent translational evidence. Conclusions: Technology-enhanced exercise and structured physical activity show promising but heterogeneous and still preliminary potential for MetS management. Key limitations include short follow-up, uneven representation across categories, inconsistent reporting of exercise dose/intensity fidelity and adverse events, and limited equity and implementation outcomes. Full article