The effectiveness of intervention with board games: a systematic … · 2019. 10. 21. · Similar to chess and Go, Shogi is a board game for two players that is also referred to as

REVIEW Open Access

The effectiveness of intervention withboard games: a systematic reviewShota Noda1* , Kentaro Shirotsuki2 and Mutsuhiro Nakao3

Abstract

To examine the effectiveness of board games and programs that use board games, the present study conducted asystematic review using the PsycINFO and PubMed databases with the keywords “board game” AND “trial;” in total,71 studies were identified. Of these 71 studies, 27 satisfied the inclusion criteria in terms of program content,intervention style, and pre–post comparisons and were subsequently reviewed. These 27 studies were divided intothe following three categories regarding the effects of board games and programs that use board games:educational knowledge (11 articles), cognitive functions (11 articles), and other conditions (five articles). The effectsizes between pre- and post-tests or pre-tests and follow-up tests were 0.12–1.81 for educational knowledge, 0.04–2.60 and − 1.14 – − 0.02 for cognitive functions, 0.06–0.65 for physical activity, and − 0.87 – − 0.61 for symptoms ofattention-deficit hyperactivity disorder (ADHD). The present findings showed that, as a tool, board games can beexpected to improve the understanding of knowledge, enhance interpersonal interactions among participants, andincrease the motivation of participants. However, because the number of published studies in this area remainslimited, the possibility of using board games as treatment for clinical symptoms requires further discussion.

Keywords: Board game, Systematic review, Education, Cognitive function

BackgroundA board game is a generic term for a game played byplacing, moving or removing pieces on a board and thatutilizes a game format in which pieces are moved inparticular ways on a board marked with a pattern. Ex-amples of board games include chess, Go, and Shogi. Re-search involving chess, which is played by two playerson a board with 64 black and white squares and 16pieces for each player [1], has contributed to the theoret-ical development of cognitive psychology [2]. For ex-ample, Burgoyne et al. [3] conducted a meta-analysisand demonstrated that chess skills are significantly andpositively correlated with four broad cognitive abilities:fluid reasoning, comprehension-knowledge, short-termmemory, and processing speed. Similarly, a meta-analysis by Sala and Gobet [4] found that chess instruc-tion moderately improves the cognitive skills of children.In contrast, Go is ancient board game that consists of

simple elements (a line and circle, black and white

colors, and stone and wood materials) combined withsimple rules that generate subtleties that have enthralledplayers for millennia [5]. Go is a famous board game inAsian countries and has been used as a tool for increas-ing or maintaining brain activity for more than 5000years [6]. It is currently gaining popularity in the UnitedStates and Europe [6], and Kim et al. [7] has suggestedthat playing Go might be effective for children withattention-deficit hyperactivity disorder (ADHD) due toits activation of hypo-aroused prefrontal cortical func-tion and the enhancement of executive function. Linet al. [8] conducted an intervention study using GO inpatients with Alzheimer’s disease and showed that play-ing Go can also improve the clinical symptoms associ-ated with depression, anxiety, and Alzheimer’s Disease.Similar to chess and Go, Shogi is a board game for twoplayers that is also referred to as Japanese chess. Wanet al. [9] conducted an experiment with undergraduatestudents and found that Shogi training is related to acti-vation in the head of the caudate nucleus. Taken to-gether, the abovementioned findings suggest that chess,Go, and Shogi are effective ways to achieve variousoutcomes.

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

* Correspondence: [email protected] School of Human and Social Sciences, Musashino University, 3-3-3Ariake, Koutouku, Tokyo 135-8181, JapanFull list of author information is available at the end of the article

Noda et al. BioPsychoSocial Medicine (2019) 13:22 https://doi.org/10.1186/s13030-019-0164-1

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There are many board games other than chess, Go,and Shogi. For example, educational board games, suchas Kalèdo, have been used to improve nutrition know-ledge and promote a healthy lifestyle for children [10].Zeedyk et al. [11] investigated the effectiveness of aboard game for increasing knowledge about road safetyand danger and found that the interventions were sig-nificantly effective in increasing children’s knowledge.Although the impacts of various board games have beenpreviously examined, their effects have yet to be compre-hensively reviewed. As a result, the functions and effectsof board games as a whole remain unclear. Thus, thepresent review systematically examined the effectivenessof board games and programs that use board games.

MethodsFor the present review, a literature search based on thePreferred Reporting Items for Systematic Reviews andMeta-Analyses [12] using the PsycINFO and PubMeddatabases was conducted to collect findings on the ef-fectiveness of board games and programs using boardgames. The keywords for the literature search were“board game” AND “trial,” and the date selected wasSeptember 13th, 2018. The search identified nine studiesfrom PsycINFO and 32 studies from PubMed. The firstauthor of this review performed a manual search thatidentified six additional studies, and 24 additional stud-ies were extracted from Sala & Gobet [4], which con-ducted a meta-analysis about the benefits of chess.Duplicate studies were deleted and, ultimately, a list ofreferences consisting of 66 articles was prepared.

The inclusion criteria for the present study were asfollows: (a) studied the effects of board games and pro-grams using board games on psychological and educa-tional outcomes, (b) included pre–post comparativetests, (c) used an interventional or experimental ratherthan a review approach, (d) had full text availability, (e)was written in English, and (f) was peer reviewed. Ascreening to remove articles that were judged not to sat-isfy any of the criteria from (a) to (f) was conducted, and29 articles were extracted. Additionally, one study wasexcluded because it did not use a traditional board game(it used a Wii Fit balance board), and one study was ex-cluded because the content details of the board gamewere unclear. Ultimately, 27 articles were selected forthe present study; the literature search process is pre-sented in Fig. 1.Furthermore, in the studies where the means and

standard deviations of the intervention group are de-scribed, Cohen’s d was calculated to assess effect sizesbetween pre- and post-tests or between pre-tests andfollow-up tests with the following formula based onCohen [13].

d ¼ M2‐M1

SDpooled

SDpooled ¼ffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi

n2‐1ð ÞSD22 þ n1‐1ð ÞSD2

1

�

n2 þ n1‐2

!

v

u

u

t

Note: M1 and M2 are the mean of the interventiongroup at the pre-test session and the post-test session or

Fig. 1 PRISMA flow chart of the study selection process

Noda et al. BioPsychoSocial Medicine (2019) 13:22 Page 2 of 21

follow-up test session, respectively. SDpooled is thepooled standard deviation (SD1 is the standard deviationof the intervention group at the pre-test session and SD2

is the standard deviation at the post-test session orfollow-up test session). n1 is the number of samples atthe pre-test session. n2 is the number of samples at thepost-test session or follow-up test session.In the studies where the means and standard devia-

tions are described in the intervention group and theother groups, Cohen’s d was also calculated to assess ef-fect sizes compared to the other groups (control groups)with the following formula based on Sala et al. [14].

d ¼ Mgi‐Mgc

SDpooled‐pre

SDpooled‐pre ¼ffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi

ni‐1ð ÞSDpre:i2 þ nc‐1ð ÞSDpre:c

2�

ni þ nc‐2

!

v

u

u

t

Note: Mgi and Mgc are the mean gain of the interven-tion group and the control group (other group) at thepost-test session or at the follow-up test session, respect-ively, and SDpooled-pre is the pooled standard deviationof the two pre-test standard deviations. SDpre.i is thestandard deviation of the intervention group at the pre-test session, and SDpre.c is the standard deviation of thecontrol group at the pre-test session. ni is the number ofsamples in the intervention group who received the pre-test session and post-test session or the pre-test sessionand follow-up test session. nc is the number of samplesin the control group who received the pre-test sessionand post-test session or the pre- test session and follow-up test session.According to Cohen [13], Cohen’s d of approximately

0.20 is small, 0.50 medium, and 0.80 large.

Results and discussionThe effect of interventions with board gamesIn the present review, the selected studies were dividedinto the following three categories regarding the effectsof board games and programs that use board games:educational knowledge (11 articles), cognitive functions(11 articles), and other conditions (five articles).An overview of the findings about the effects of board

games and programs that use board games related toeducational knowledge is shown in Table 1 [10, 11,15–23]. Board games in this category were used forthe purpose of improving educational knowledge, andthe effect sizes (Cohen’s d) between pre- and post-tests or between pre-tests and follow-up tests rangedfrom 0.12 to 1.81 and between the mean gain of themain intervention group and the other groups rangedfrom 0.81 to 0.93 and − 1.84 to − 1.65.

An overview of the findings about the effects of boardgames and programs that use board games on cognitivefunctions is shown in Table 2 [6, 24–33]. This categoryincluded board games such as Go, Ska, and chess, andthe effect sizes (Cohen’s d) between pre- and post-testsof cognitive function ranged from 0.04 to 2.60 and − 1.14to − 0.02. The effect size of the exacerbation was calcu-lated in only the chess group of Sala et al. [27]. The ef-fect sizes (Cohen’s d) between the mean gain of themain intervention group and the other groups rangedfrom 0.06 to 2.36 and − 1.38 to − 0.22.An overview of the findings about the effects of board

games and programs that use board games on otherconditions is shown in Table 3 [7, 8, 34–36]. This cat-egory addressed the impacts of board games on physicalactivity, anxiety, ADHD symptoms, and the severity ofAlzheimer’s Disease. The effect sizes (Cohen’s d) be-tween pre- and post-tests or between pre-tests andfollow-up tests ranged from 0.06 to 0.65 for physical ac-tivity and from − 0.87 to − 0.61 for ADHD symptoms.

Board games and educational knowledgeEleven studies that used board games to increase educa-tional knowledge were selected for this review. Thepresent findings showed that board games influenceeducational knowledge and concomitant outcomes, withthe effect sizes for educational knowledge ranging fromvery small to large.Board games can be used as a tool to encourage learn-

ing. In previous studies, specialized board games aimedat improving knowledge in the field of education weretargeted and subsequently developed and investigated.For example, Wanyama et al. [16] conducted a study ofthe Make a Positive Start Today game, which is a boardgame aimed at improving knowledge about human im-munodeficiency virus (HIV) and sexually transmitted in-fections (STIs). Similarly, Kalèdo is an educational boardgame used to increase nutrition knowledge [10, 19, 21].It has been shown that these board games contribute toincreasing knowledge related to each particular field.Board games are also efficacious for goals other than

increasing knowledge. According to Charlier and DeFraine [22], board games can be an enjoyable and motiv-ational method for learning content and enhancinggroup interactions, competition, and fun. Martins et al.[18] reported that board games teach educational con-tent in a playful and enjoyable way and involve interac-tions with family and friends; thus, they favor knowledgeacquisition by enabling exchanges of experiences andlearning. Furthermore, Wanyama et al. [16] showed that,as a method of health education, board games increasethe acquisition of knowledge as well as result in morepositive experiences than do health talks among bothparticipants and facilitators. Amaro et al. [10] found that


Table

1Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

ined

ucationalkno

wledg

e

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestandpo

sttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ard

gamebe

tweenthe

meangain

ofthe

mainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

Khazaal

etal.

(2013)

[15]

RCT

ThePick-Klopgame:itin

clud

esmorethan

300cards

with

questio

ns,eachwith

threerespon

seop

tions.The

questio

nsareabou

t(1)sm

okingandtobaccohistory,(2)

tobaccocompo

nentsand

theirbiolog

icaleffects,(3)

reinforcem

entmechanism

sinvolved

insm

okingaddic

tion,(4)cogn

itive

andbe

hav

ioralm

echanism

sinvolved

inthemainten

ance

ofsm

oking,

(5)sm

okingcigarettes

asa

coping

strategy,(6)

costsof

tobaccoaddictionandthe

bene

fitsof

quittingsm

oking,

(7)stages

ofchange

,(8)

cog

nitiveandbe

havioralmecha

nism

sinvolved

inbe

havioral

change

,and

(9)med

ications

andtreatm

entsthat

help

dur

ingsm

okingcessation.

Playersdraw

acard

inon

eof

thefollowingcatego

ries:

questio

n,surprise,or

tempta

tion.Ifthey

answ

erthequ

estio

ncardscorrectly,p

layers

may

gain

points.Surprise

cardsaddam

usem

ent,allow

ingplayersto

obtain

agiftor

secret

cardsthat

allow

them

tohe

lpor

blockanothe

rplayer

durin

gplay

atthemo

men

tof

theirchoice.The

numbe

rof

temptationcards

which

illustratelapseandre

lapseprocesses,as

wellasre

lapsepreven

tionstrategies,

increasesat

theen

dof

the

gamebo

ard.

Participantswerecurren

tdaily

smokerswho

were

adults(18–65

yearsold).

ThePick-Klopgrou

p:n=120

(meanage:33.7±13.4),2

weeks:com

pletersn=97,3

mon

th:com

pletersn=94.

Thepsycho

educationgrou

p:n=60

(meanage:28.7±

10.8),2weeks:com

pleters

n=43,3

mon

ths:completers

n=38.

Thewaitin

glist:n=60

(mean

age:30.0±10.0),2weeks:

completersn=47,3

mon

ths:

completersn=41.

ThePick-Klopgrou

p:tw

oses

sion

s(1.5heach)of

thePick-

Klop

game.

Thepsycho

educationgrou

p:tw

osessions

(1.5heach)of

psycho

educationabou

tsm

okingandsm

oking

cessation.

Scores

onattitud

estowards

nicotin

ereplacem

ent

therapy,attitud

estowards

smoking,

andsm

okingself-

efficacyim

proved

forparticipantsallo

catedto

thePick-

Klop

grou

pandthe

psycho

education

grou

pwith

respect

tothewaitin

glist.

d=0.71

(betweenpreand

posttest)on

Attitu

des

Towards

Nicotine

Replacem

entTherapyScale

(ANRT)-P

erceived

Advantage

.d=0.59

(betweenpreand

follow-up)

onANRT-

PerceivedAdvantage

.d=0.14

(betweenpreand

posttest)on

ANRT-Drawback.

d=0.23

(betweenpreand

follow-up)

onANRT-

Drawback.

d=−0.46

(betweenpreand

posttest)on

ANRT-"Don

’tknow

”Answers.

d=−0.60

(betweenpreand

follow-up)

onANRT-"Don

’tknow

”Answers.

d=0.21

(betweenpreand

posttest)on

Attitu

des

Towards

SmokingScale

(ATS)-Adverse

Effectsof

Smoking.

d=0.12

(betweenpreand

follow-up)

onATS

-Adverse

Effectsof

Smoking.

d=−0.27

(betweenpreand

posttest)on

ATS-

Psycho

activeBene

fitsof

Smoking.

d=−0.26

(betweenpreand

follow-up)

onATS-

Psycho

activeBene

fitsof

Smoking.

d=−0.30

(betweenpreand

posttest)on

ATS-Pleasureof

Smoking.

d=−0.44

(betweenpreand

follow-up)

onATS-Pleasureof

Smoking.

d=0.15

(betweenpreand

posttest)on

SmokingSelf-

EfficacyQuestionn

aire.

d=0.51

(betweenpreand

Unableto

calculate


Table

1Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

ined

ucationalkno

wledg

e(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestandpo

sttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ard

gamebe

tweenthe

meangain

ofthe

mainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

follow-up)

onSm

okingSelf-

EfficacyQuestionn

aire.

d=−0.09

(betweenpreand

posttest)on

Cigarettes

Smoked

PerDay.

d=−0.67

(betweenpreand

follow-up)

onCigarettes

Smoked

PerDay.

Wanyama

etal.

(2012)

[16]

RCT

The“m

akeapo

sitivestart

today!”bo

ardgame:itisan

educationalb

oard

gameon

theup

take

ofknow

ledg

eabou

tHIV

andsexually

transm

itted

infections.Itis

intend

edto

increase

peop

lelivingwith

HIV’sparticipation

andattention,to

gene

rate

know

ledg

eon

HIV,sexually

transm

itted

infections

and

antiretroviraltreatmen

t,and

toen

hancepreven

tion

behavior.

Participantswere180

patients.

Theinterven

tiongrou

p:n=

90(m

eanage:60).

Thestandard

ofcare

grou

p:n=90

(meanage:55).

Theinterven

tiongrou

pplayed

the“m

akeapo

sitive

starttoday!”bo

ardgame.

Thestandard

ofcare

grou

pparticipated

astandardized

health

talk.

Theinterven

tion

grou

pwhich

played

the“m

akeapo

sitive

starttoday!”bo

ard

gamehashigh

erup

take

ofknow

ledg

eof

HIV

andsexually

transm

itted

infections

than

the

standard

ofcare

grou

p.

Unableto

calculate

Unableto

calculate

Nieh&Wu

(2018)

[17]

cRCT

TheGalaxyRescuersgame:it

isde

sign

edfor2to

6players.

Thestorylineof

thegameis

abou

t6charactersattend

ing

thetraining

scho

olto

becometherescuersof

the

Galaxy.Thegameinclud

es3

stages.A

tthefirststage,the

playersearn

pointsby

answ

eringqu

estio

nsabou

tbu

llying.

Atthesecond

stage,

theplayerscompleteamix

andmatch

gameby

matchingcharacters,suchas

abu

lly,a

victim

,areinforcer,

orade

fend

erandtheirroles

inabu

llyingincide

nt.The

third

stageisacollabo

rative

gamein

which

theplayers

need

toworktoge

ther

toaccomplishtheirtraining

tasks.

Participantswere328

stud

ents(11–12

yearsold).

Thegame-on

lygrou

p:n=

116.

Thegame-with

-deb

riefing

grou

p:n=125.

Thecontrolg

roup

:n=87.

Thegame-on

lygrou

pplayed

theGalaxyRescuersgame.

Thegame-with

-deb

riefing

grou

pplayed

theGalaxyRes

cuersgameandcond

ucted

reflectionanddiscussion

.Thecontrolg

roup

cond

ucted

regu

larbu

lling

curriculum

usingconven

tionalteaching

metho

ds,suchas

antib

ullying

vide

osandworkshe

etassign

men

ts.

TheGalaxyRescuers

gamesign

ificantly

increasedplayers’

know

ledg

eabou

tbu

llying.

Thegame-with

-de

briefinggrou

pshow

edalarger

increase

inbu

llying

know

ledg

ethan

the

game-on

lygrou

p.Thegame-with

-de

briefinggrou

palso

show

eda

change

inbu

llying

attitud

eand

empathy.

Unableto

calculate

Unableto

calculate


Table

1Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

ined

ucationalkno

wledg

e(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestandpo

sttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ard

gamebe

tweenthe

meangain

ofthe

mainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

Martin

set

al.

(2018)

[18]

cRCT

Thebo

ardgameed

ucational

interven

tion“Trilha

Família

Amam

enta”(Breastfe

eding

Family’sTrail).

Participantswere171

childrenin

thethird

gradeof

elem

entary

scho

ol.A

nalyzed

participantswere99.

Theinterven

tiongrou

p:n=

51,p

ost-assessmen

tafter

30th:n

=48.

Thecontrolg

roup

:n=56,

post-assessm

entafter30th:

n=51.

Theinterven

tiongrou

p:childrenparticipated

inthe

educationalinterventionwith

thebo

ardgame.

Thecontrolg

roup

:children

didno

tparticipatein

the

educationalinterventionwith

thebo

ardgame.

Scores

for

know

ledg

eon

breastfeed

ingwere

high

erin

the

interven

tiongrou

p,on

the7thand

30th,thanthe

controlg

roup

.With

inthe

interven

tiongrou

p,therewas

asign

ificant

increase

ofthemeans

ofscores

for

know

ledg

eon

breastfeed

ingin

the

posttestforthe

30th

day.

d=1.50

(betweenpreand

posttestat

the7thday)on

Breastfeed

ingKn

owledg

e.d=1.81

(betweenpreand

posttestat

the30th

day)on

Breastfeed

ingKn

owledg

e.

d=0.81

(betweenthe

meangain

ofthe

interven

tiongrou

pandthecontrolg

roup

atthe7thday)on

Breastfeed

ing

Know

ledg

e.d=0.93

(betweenthe

meangain

ofthe

interven

tiongrou

pandthecontrolg

roup

atthe30th

day)on

Breastfeed

ing

Know

ledg

e.

Vigg

iano

etal.

(2018)

[19]

cRCT

Thebo

ardgame“Kaled

o”:it

isane

wed

ucationalb

oard

gameto

improvenu

trition

know

ledg

eandto

prom

otea

healthylifestyle.The

gameis

design

edto

beattractivefor

peop

leof

everyagefro

mkids

toadults.A

typicalg

ame

sessionrequ

irestw

oto

four

playersandlastsabou

t15–

30min.

Participantswere1313

children.

Thetreatm

entgrou

p:n=837,

thefirstpo

st-assessm

entat

8mon

ths:n=651,thesecond

post-assessm

entat

18mon

ths:n=254.

Thecontrolg

roup

:n=476,

thefirstpo

st-assessm

entat

8mon

ths:n=356,thesecond

post-assessm

entat

18mon

ths:n=202.

Thetreatm

entgrou

p:the

childrenparticipated

inon

esession(15–30

min)with

the

boardgameKaledo

,every

weekfor20

weeks.

Thecontrolg

roup

:the

childrendidno

tplay

with

Kaledo

.

Thetreatedgrou

psign

ificantly

increasedthe

consum

ptionof

healthyfood

,and

decreasedjunk

food

consum

ption

comparedto

the

controlg

roup

.Thetreatedgrou

psign

ificantly

increasedin

frequ

ency

and

duratio

nof

physical

activity

compared

tothecontrol

grou

p.TheBM

Iz-score

inthetreatedgrou

psign

ificantlyde

creasedcompared

tothat

inthecon

trol

grou

p.

Unableto

calculate

Unableto

calculate

Karbow

nik

etal.

(2016)

[20]

RCT

Thebo

ardgame

“Antim

icroGAME”

was

design

edto

integrate

Participantswere124

stud

ents.

Thebo

ardgamegrou

p:n=

Thebo

ardgamegrou

p:participantsplayed

board

game“Antim

icroGAME”.

Thebo

ardgame

grou

psign

ificantly

increases

Unableto

calculate

Unableto

calculate


Table

1Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

ined

ucationalkno

wledg

e(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestandpo

sttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ard

gamebe

tweenthe

meangain

ofthe

mainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

bacteriology

and

mechanism

sof

actio

nof

antim

icrobialdrug

s.The

factualcon

tent

ofthe

“Antim

icroGAME”

was

based

arou

ndtheexistin

gbasic

med

icalph

armacolog

ysyllabu

sforthe

unde

rgradu

atecourse

inmed

icineandfurthe

rrevised

byan

inde

pend

entsenior

specialistin

med

ical

pharmacolog

y.

63(m

eanage:23.2±1.1).

Thecontrolg

roup

(lecture-

basedseminar):n=61

(mean

age:23.6±1.7).

Thecontrolg

roup

:participantsreceived

lecture-

basedseminar.

know

ledg

eretentionat

post-

testin

final

exam

ination.

Know

ledg

eretentionof

board

gamegrou

pwas

high

erthan

lecture-

basedseminar

grou

p.

Vigg

iano

etal.

(2015)

[21]

cRCT

Thebo

ardgame“Kaled

o”Participantswere3110

(9–19

yearsold).

Thetreatm

entgrou

p:n=

1663

(meanage:13.3),the

follow-upafter6mon

ths:n=

1076,the

follow-upafter18

mon

ths:n=624.

Thecontrolg

roup

:n=1447

(meanage:13.0),thefollow-

upafter6mon

ths:n=1080,

thefollow-upafter18

mon

ths:n=421.

Thetreatm

entgrou

p:the

treatm

entgrou

preceived

Kaledo

each

weekover

20consecutiveweeks.

Thecontrolg

roup

:the

controlg

roup

didno

treceive

anyinterven

tion.

Atthefirstpo

st-

assessmen

tafter6

mon

ths,thetreat

men

tgrou

pob

tained

sign

ificantly

high

erscores

than

thecontrolg

roup

ontheadolescent

food

habitschecklist

(the

exam

inationof

healthyeatin

gbe

haviorsin

adoles

cents),nutrition

know

ledg

e,he

althy

andun

healthydiet

andfood

,physical

activity

andlifestyle,

food

habits.

Thetreatedgrou

phadsign

ificantly

lower

BMIz-score

with

respectto

the

controlsat

thefirst

post-assessm

ent

after6mon

ths,and

second

post-

assessmen

tafter18

mon

ths.

Unableto

calculate

Unableto

calculate

Charlier

&Fraine

(2013)

[22]

cRCT

Theed

ucationalb

oard

game

infirstaid:

thegamebo

ardis

aland

scapeof

ade

veloping

Participantswere120

childrenin

gene

ral

second

ary.

Thebo

ardgamegrou

p:participantsplayed

thebo

ard

game.

Thebo

ardgame

grou

pandthe

lecturegrou

p

d=1.40

(betweenpreand

posttest)on

Know

ledg

eof

FirstAid.

d=−1.84

(between

themeangain

ofthe

interven

tiongrou

p


Table

1Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

ined

ucationalkno

wledg

e(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestandpo

sttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ard

gamebe

tweenthe

meangain

ofthe

mainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

coun

trybu

iltby

theplayers

asthegameprog

ress.The

goalof

thegameisto

build

themostfirstaidpo

stsand

hospitalsby

collecting

questio

ncards(re

presen

ting

buildingmaterial).

Thebo

ardgamegrou

p:n=

62.

Thelecturegrou

p:n=58.

Thelecturegrou

p:participantsreceived

alectureabou

tfirstaidwith

vide

o,pictures,and

demon

stratio

ns.

show

edsign

ificantly

increase

infirstaid

know

ledg

e.Thelecturegrou

pwas

sign

ificantly

moreeffectivein

increasing

know

ledg

eforfirst

aid,

ascomparedto

thebo

ardgame

grou

p.

d=0.78

(betweenpreand

retentiontest)on

Know

ledg

eof

FirstAid.

andthelecture

grou

p)on

Know

ledg

eof

FirstAid.

d=−1.65

(between

themeangain

ofthe

interven

tiongrou

pandthelecture

grou

p)on

Know

ledg

eof

FirstAid.

Amaro

etal.

(2006)

[10]

cRCT

Thebo

ardgame“Kaled

o”Participantswere291(11–14

yearsold).

Thetreatm

entgrou

p:n=188,

thecompletepo

stassessmen

t:n=153(m

ean

age:12.3±0.8).

Thecontrolg

roup

:n=103,

thecompletepo

stassessmen

t:n=88

(mean

age:12.5±0.7).

Treatm

entgrou

p:the

treatm

entgrou

pparticipated

Kalèdo

everyweekin

one

play

session(15–30

min),

durin

g24

weeks.

Con

trol

grou

p:controlg

roup

didno

treceiveany

interven

tion.

Thetreatm

ent

grou

pshow

eda

sign

ificant

increase

innu

trition

know

ledg

eandin

weeklyvege

table

intake

with

respect

tothecontrol

grou

p.

Unableto

calculate

Unableto

calculate

Zeed

yket

al.

(2001)

[11]

RCT(the

control

grou

pon

lyis

conven

ience

sampling)

Theroad

safety

boardgame:

playerstake

thepartof

characterswho

have

toge

tho

mefro

mscho

olsafely,b

yrolling

dice

andmovingthe

playingpiecearou

ndthe

board.

Intheprocessof

gettingho

me,charactersare

requ

iredto

carryou

ta

numbe

rof

errand

s(e.g.,

postingaletter

atthepo

stoffice,returningabo

okto

thelibrary),each

ofwhich

involves

crossing

theroad.

Theplayersmustde

cide

the

safestway

ofaccomplishing

theroad

crossing

.The

first

player

toge

ttheirplaying

piece‘hom

e’,having

completed

allthe

taskssafely,

isde

clared

thewinne

r.

Participantswere120(4–5

yearsold).

Theplaymat

mod

elgrou

p:n=27.

Thebo

ardgamegrou

p:n=29.

Thetalkusingillustrated

postersandflip-chartmate

rialsgrou

p:n=29.

Thecontrolg

roup

:n=35.

Theplaymat

mod

elgrou

p,thebo

ardgamegrou

p,and

thetalkusingillustrated

postersandflip-chartmate

rialsgrou

p:each

interven

tion

was

administeredforon

lya

sing

lesession,lastingap

proxim

ately20

min.

Thecontrolg

roup

:con

trol

grou

pdidno

treceiveany

interven

tion.

Each

interven

tions

weresign

ieficantly

effctivein

increasing

children’s

know

ledg

eabou

tsafe

anddang

erou

slocatio

nsat

which

tocrossthestreet,

andthat

the

know

ledg

ewas

retained

fora

perio

dof

6mon

ths.

Atpo

st-test,score

oftheknow

ledg

eforthecontrol

grou

pwas

siginifi

cantlylower

than

scores

fortheinter

ventiongrou

ps.

Unableto

calculate

Unableto

calculate

Bartfay&

Bartfay

Aqu

asi-

rand

omized

Thelifestylesbo

ardgame:it

isabo

ardgame(50by

60Participantswere23

stud

ents.

Thebo

ardgamegrou

p:n=

Thebo

ardgamegrou

p:the

boardgamegrou

pThebo

ardgame

grou

psign

ificantly

Unableto

calculate

Unableto

calculate


Table

1Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

ined

ucationalkno

wledg

e(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestandpo

sttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ard

gamebe

tweenthe

meangain

ofthe

mainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

(1994)

[23]

expe

rimen

tal

stud

ycm

)that

consistsof

dice,

plastic

tokens,sixlifestylerisk

factor

scorecards,and40

gamequ

estio

ncards.The

games

canbe

played

bytw

oto

sixindividu

alsandrequ

ires

approxim

ately60

min

tocomplete.Playersattempt

tocollect

tokens

awarde

dby

thenu

rseto

cancelthe10

lifestyleriskfactorsde

picted

ontheirscorecards,by

providingcorrectansw

ersto

questio

nson

the40

game

cards.

12.

Thecontrolg

roup

:n=11.

participated

twice,2weeks

apart,forape

riodof

60min.

Thecontrolg

roup

:the

controlg

roup

carriedon

with

theirregu

larly

sche

duled

classroo

mactivities.

increased

know

ledg

eof

anatom

yand

physiology,d

ietand

nutrition

,and

lifestyleriskfactors.

Thegain

know

ledg

eon

post-testwere

foun

dto

besign

ificant

betw

eenthe

boardgamegrou

pandthecontrol

grou

p.


Table

2Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

incogn

itive

functio

ns

Autho

rsDesign

Con

tent

ofbo

ard

game

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

Iizukaet

al.

(2018)

[6]

RCT

Thebo

ardgame“Go”:

itisafamou

sbo

ard

gamein

Asian

coun

tries,particularly

Japan,China,and

Korea,anditis

gainingpo

pularityin

theUnitedStates

and

Europe

.

Thereare33

participantsat

rand

omization.

Analyzed

participantswere

17.

Theinterven

tion

grou

p:n=9(m

ean

age:89.1±4.1).

Thecontrolg

roup

:n=8(m

eanage:

89.1±6.6).

Theinterven

tiongrou


the

inteventionprog

ram

once

aweekfor1h,fora

totalo

f15classes.Each

1-hsessionconsistedof

alectureon

thebasicrules

andtechniqu

esof

the

gameGO(15min),solv

ingGOgameexercises

(15min),andplaying

games

(30min).

Thecontrolg

roup


the

usualcare.

Theinterven

tiongrou

pshow

edim

proved

attentionandworking

mem

oryscores,w

hilethe

controlg

roup

show

edde

clines

inthesescores.

d=0.13

(betweenpre

andpo

sttest)on

Mon

trealC

ognitive

Assessm

ent.

d=0.46

(betweenpre

andpo

sttest)on

totalo

fDigitSpan

Test.

d=0.49

(betweenpre

andpo

sttest)on

Digit

Span

Forw

ardTask.

d=0.16

(betweenpre

andpo

sttest)on

Digit

Span

BackwardTask.

d=0.41

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

Mon

trealC

ognitive

Assessm

ent.

d=0.85

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

totalo

fDigitSpan

Test.

d=0.55

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

DigitSpan

Forw

ardTask.

d=0.57

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

DigitSpan

BackwardTask.

Panp

hunp

hoet

al.(2013)

[24]

RCT

Thebo

ardgame

“Ska”:itisatradition

albo

ardgamein

Thailand

.The

players

movethepieces

intheho

lesprovided

onthebo

ard.

These

holesarecalled

‘Joom

s’.Each

side

ofthebo

ardcontains

1to

12Joom

s.

Participantswere40.

TheSkagrou

p:n=20

(meanage:64.20±

3.22).

Thecontrolg

roup

:n=20

(meanage:

65.15±3.19).

IntheSkagrou

pandthe

controlg

roup

,the

duratio

nof

thepractice

was

50min

perday,three

sessions

perweekforthe

continuo

usdu

ratio

nof

16weeks.

TheSkagrou

p:the

participantsreceived

Ska

prog

ram.

Thecontrolg

roup

:the

activities

ofthecontrol

grou

pinclud

ed1)

Self-

introd

uctio

n,2)

Back

grou

ndtelling

,3)

Chang

esin

olde

rage,4)

Our

body,5)Food

pyra

mid,6)W

atchingtelevi

sion

,7)Listen

ingto

the

radio,8)

Wateringtrees,

9)Parties,10)Cleaning,

11)Listen

ingto

dham

ma

talks,12)Diseasesin

the

elde

rly,and

13)Yo

urow

nhe

alth.

TheSkagrou

pshow

edsign

ificant

better

scores

ofcogn

itive

functio

nsin

mem

ory,attention,

executivefunctio

ncomparedto

thecontrol

grou

p.

d=2.07

(betweenpre

andpo

sttest)on

Verbal

PairAssociatio

nI.

d=2.60

(betweenpre

andpo

sttest)on

Verbal

PairAssociatio

nII.

d=1.54

(betweenpre

andpo

sttest)on

Visual

Reprod

uctio

nI.

d=1.82

(betweenpre

andpo

sttest)on

Visual

Reprod

uctio

nII.

d=−1.02

(betweenpre

andpo

sttest)on

Trail

MakingTestpartA.

d=−1.14

(betweenpre

andpo

sttest)on

Wisconsin

CardSorting

Test.

d=0.09

(betweenpre

andpo

sttest)on

Acetylcho

linesterase

Activity.

d=2.36

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

VerbalPairAssociatio

nI.

d=2.32

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

VerbalPairAssociatio

nII.

d=2.24

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

VisualReprod

uctio

nI.

d=2.00

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

VisualReprod

uctio

nII.

d=−1.20

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

TrailM

akingTestpartA.


Table

2Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

incogn

itive

functio

ns(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ard

game

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

d=−1.38

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

Wisconsin

CardSorting

Test.

d=0.06

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

Acetylcho

linesterase

Activity.

Dem

ilyet

al.

(2009)

[25]

RCT

Thechessgame

Participantswere26

with

schizoph

renia.

Thechessgrou

p:n=

13(m

eanage:34.7

yearsold).

Thetreatm

entas

usualg

roup

:n=13

(meanage:38.9years

old).

Thechessgrou

p:the

chessgrou

ppracticed

chess10

times

(twicepe

rweek;60

min

persession).

Thechessgrou

psign

ificantlymademore

perseverativeerrorson

Wisconsin

SortingCard

Testthan

thetreatm

ent

asusualg

roup

inthepre-

testassessmen

t.Bu

t,thisdifferencewas

nolong

erpresen

tin

the

second

assessmen

t.OntheStroop

Test,the

numbe

rof

read

itemsof

chessgrou

pwas

sign

ificantlyincreasedin

thesecond

assessmen

tfortheStroop

A(Colou

r)andC(Interfe

rence).

Unableto

calculate

Unableto

calculate

Salaet

al.

(2015)

[26]

Aqu

asi-

expe

rimen

tal

long

itudinal

stud

y:tw

ogrou

ppre-po

stcomparative

test

Thechessgame

Participantswere560

stud

entsin

thethird

,fourth,and

fifth

grades.

Theinterven

tion

grou

p:n=309(169

males

and140

females).

Thecontrolg

roup

:n=251(116

males

and135females).

Theinterven

tiongrou

p:theinterven

tiongrou

preceived

amandatory

chesscourse

(che

sscourse

andon

line

training

).Thechess

courseslasted

betw

een

10and15

h(1

or2hpe

rweek).

Thecontrolg

roup

:the

controlg

roup

perfo

rmed

onlytheno

rmalscho

olactivities

with

outany

chess-relatedactivity.

Theinterven

tiongrou

psign

ificantlyim

proved

mathe

maticalprob

lem-

solvingscores

compared

with

thecontrolg

roup

.

d=0.34

(betweenpre

andpo

sttest)on

mathe

maticalprob

lem-

solvingscores.

d=0.33

(betweenthe

meangain

ofthe

interven

tiongrou

pand

thecontrolg

roup

)on

mathe

maticalprob

lem-

solvingscores.

Sala&Gob

et.

(2017)

[27]

Aqu

asi-

expe

rimen

tal

Thechessgame,the

checkersgameand

Expe

rimen

t1

Participantswere233

Expe

rimen

t1

Thechessgrou

p:the

Expe

rimen

t1

Theresults

show

edno

Expe

rimen

t1

d=0.04

(betweenpre

Expe

rimen

t1

d=−0.23

(betweenthe


Table

2Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

incogn

itive

functio

ns(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ard

game

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

long

itudinalstudy:

threegrou

ppre-po

stcomparativetest

theGogame

stud

entsin

three

classesof

third

and

fourth

grades

from

eigh

tItalianscho

ols

(meanage8.50:±

0.67

years).

Thechessgrou

p:n=

53 Thecheckergrou

p:n=82

Theregu

larscho

olactivitesgrou

p:n=98

Expe

rimen

t2

Participantswere52

stud

entsin

three

classesof

fourth

grades

prim

aryscho

ol(m

eanage:9.32

±0.32

years).

Thethreeclasses

wererand

omly

assign

edto

three

grou

ps(achess

grou

p,aGogrou

p,a

controlg

roup

).

participantsattend

ed25

hof

chesslesson

s.Thecheckersgrou

p:the

participantsattend

ed25

hof

checkerslesson

s.Theregu

larscho

olactivities

grou

p:the

participantsattend

edregu

larscho

olactivities

only.

Expe

rimen

t2

Thechessgrou

p:the

participantsattend

ed15

hof

chesslesson

sdu

ring

scho

olho

urs,alon

gwith

regu

larscho

olactivities.

TheGogrou

p:the

participantsattend

ed15

hof

Golesson

sdu

ring

scho

olho

urs,alon

gwith

regu

larscho

olactivities.

Theregu

larscho

olactivities

grou

p:the

participantsattend

edregu

larscho

olactivities

only.

siginificantdifferences

betw

eenthethree

grou

psin

mathm

atical

ability

ormetacog

nitive

ability.

Expe

rimen

t2

Thechessgrou

pmarginally

outperform

edtheGogrou

pin

mathe

maticalability.

Nosign

ificant

difference

was

foun

dbe

tweenthe

controland

thechess

grou

pin

mathe

matical

ability.

Nosign

ificant

differences

werefoun

dbe

tweenthe

threegrou

pswith

regard

tometacog

nitio

n.

andpo

sttest)on

mathe

maticalprob

lem-

solvingscores

inthe

chessgrou

p.d=0.30

(betweenpre

andpo

sttest)on

mathe

maticalprob

lem-

solvingscores

inthe

checkergrou

p.d=0.36

(betweenpre

andpo

sttest)on

mathe

maticalprob

lem-

solvingscores

inthe

regu

larscho

olactivites.

d=−0.14

(betweenpre

andpo

sttest)on

matacog

nitiveability

scores

inthechessgrou

p.d=0.07

(betweenpre

andpo

sttest)on

matacog

nitiveability

scores

inthechecker

grou

p.d=0.09

(betweenpre

andpo

sttest)on

matacog

nitiveability

scores

intheregu

lar

scho

olactivites.

Expe

rimen

t2

Unableto

calculate

meangain

ofthechess

grou

pandthecheckers

grou

p)on

mathe

matical

prob

lem-solving

scores.

d=−0.32

(betweenthe

meangain

ofthechess

grou

pandtheregu

lar

scho

olactivities

grou

p)on

mathe

matical

prob

lem-solving

scores.

d=−0.22

(betweenthe

meangain

ofthechess

grou

pandthecheckers

grou

p)on

matacog

nitive

ability

scores.

d=−0.22

(betweenthe

meangain

ofthechess

grou

pandtheregu

lar

scho

olactivities

grou

p)on

matacog

nitiveability

scores.

Expe

rimen

t2

Unableto

calculate

Acieg

oet

al.

(2012)

[28]

Aqu

asi-experim

ental

long

itudinalstudy:

twogrou

ppre-po

stcomparativetest

Thechessgame

Participantswere230

stud

ents.

Theextracurricular

activity

ofchess

grou

p:n=170

Theextracurricular

activities

ofsoccer

orbasketballgrou

p:n=

60

Theextracurricular

activity

ofchessgrou

p:the

participantswere

cond

uctedchessas

extracurricular.

Theextracurricular

activities

ofsoccer

orbasketballgrou

p:the

participantswere

cond

uctedsoccer

orbasketballas

extracurricular.

Theextracurricular

activity

ofchessgrou

psign

ificantlyim

proved

cogn

itive

abilities

(sim

ilarities,digitspan

object

assemblymazes)

andcoping

(iden

tifiesthe

prob

lem,thinksof

alternatives,assessesthe

alternatives,con

fiden

tpe

rform

ance)compared

totheextracurricular

activities

ofsoccer

orbasketballgrou

p.

d=0.38

(betweenpre

andpo

sttest)on

similaritiesin

Wechsler

Intellige

nceScalefor

children(W

ISC-R).

d=0.55

(betweenpre

andpo

sttest)on

digit

span

inWISC-R.

d=0.41

(betweenpre

andpo

sttest)on

object

assemblyin

WISC-R.

d=0.38

(betweenpre

andpo

sttest)on

mazes

inWISC-R.

d=0.82

(betweenpre

andpo

sttest)on

d=0.26

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe

extracurricular

activities

ofsoccer

orbasketball

grou

p)on

similaritiesin

WechslerIntellige

nce

Scaleforchildren(W

ISC-

R).

d=0.43

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe

extracurricular

activities

ofsoccer

orbasketball


Table

2Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

incogn

itive

functio

ns(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ard

game

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

iden

tifiestheprob

lem

incoping

.d=0.71

(betweenpre

andpo

sttest)on

thinks

ofalternatives

incoping

.d=0.77

(betweenpre

andpo

sttest)on

assesses

thealternatives

incoping

.d=0.65

(betweenpre

andpo

sttest)on

confiden

tpe

rform

ance

incoping

.

grou

p)on

digitspan

inWISC-R.

d=0.30

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe

extracurricular

activities

ofsoccer

orbasketball

grou

p)on

object

assemblyin

WISC-R.

d=0.25

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe

extracurricular

activities

ofsoccer

orbasketball

grou

p)on

mazes

inWISC-

R. d=0.52

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe

extracurricular

activities

ofsoccer

orbasketball

grou

p)on

iden

tifiesthe

prob

lem

incoping

.d=0.48

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe

extracurricular

activities

ofsoccer

orbasketball

grou

p)on

thinks

ofalternatives

incoping

.d=0.60

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe

extracurricular

activities

ofsoccer

orbasketball

grou

p)on

assesses

the

alternatives

incoping

.d=0.33

(betweenthe

meangain

ofthe

extracurricular

activity

ofchessgrou

pandthe


Table

2Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

incogn

itive

functio

ns(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ard

game

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

extracurricular

activities

ofsoccer

orbasketball

grou

p)on

confiden

tpe

rform

ance

incoping

.

Aydin

(2015)

[29]

Aqu

asi-experim

ental

long

itudinalstudy:

twogrou

ppre-po

stcomparativetest

Thechessgame

Participantswere26

stud

ents.

Thechessgrou

p:n=

14(9

males

and5

females)

Thecontrolg

roup

:n=12

(8males

and4

females)

Thechessgrou

p:the

participantsweretraine

dforchessover

a12

week-

perio

d(1

dayaweek,4h)

Thecontrolg

roup

:the

participantswereno

ttraine

dforchess.

Thechessgrou

psign

ificantlyim

proved

mathscores.

d=1.72

(betweenpre

andpo

sttest)on

math

scores.

d=1.73

(betweenthe

meangain

ofthechess

grou

pandthecontrol

grou

p)on

mathscores.

Barrett&Fish

(2011)

[30]

Aqu

asi-experim

ental

long

itudinalstudy:

twogrou

ppre-po

stcomparativetest

Thechessgame

Participantswere31

stud

ents.

Thetreatm

entgrou

p:n=15

(5males

and

10females)

Thecomparison

grou

p:n=16

(6males

and10

females)

Thechessgrou

p:the

stud

entsreceived

chess

instruction(1

dayaweek

for30

weeks)instead

ofthestandard

math

curriculum

.Thecomparison

grou

p:thestud

entsreceived

instructionin

the

standard

mathcurriculum

that

was

individu

alized

tomeetthego

alsand

objectives

ofeach

stud

ent’s

individu

alized

educationprog

ram.

Thechessgrou

psign

ificantlyim

proved

“end

ofyear

course

grades”,“num

ber,

operations

and

quantitativereason

ing”

and“probabilityand

statistics”comparedwith

thecomparison

grou

p.

d=0.21

(betweenpre

andpo

sttest)on

endof

year

course

grades.

d=−0.02

(betweenpre

andpo

sttest)on

numbe

r,op

erations

and

quantitativereason

ing.

d=0.13

(betweenpre

andpo

sttest)on

prob

ability

andstatistics.

d=0.84

(betweenthe

meangain

ofthechess

grou

pandthe

compairson

grou

p)on

endof

year

course

grades.

d=0.76

(betweenthe

meangain

ofthechess

grou

pandthe

compairson

grou

p)on

numbe

r,op

erations

and

quantitativereason

ing.

d=0.48

(betweenthe

meangain

ofthechess

grou

pandthe

compairson

grou

p)on

prob

ability

andstatistics.

Gliga&Flesne

r(2014)

[31]

RCT

Thechessgame

Participantswere38

stud

ents.

Thechessgrou

p:n=

20(m

eanage:9.85

±0.67,10males

and10

females)

Thecontrolg

roup

:n=18

(meanage:

9.71

±0.77,10males

and8females)

Thechessgrou

p:the


one

training

sessionof

chess

perweekfor10

weeks.

Thecontrolg

roup

:the


ina

funmathprog

ram.

Thechessgrou

psign

ificantlyincreased

scho

olpe

rform

ance

with

respectto

thecontrol

grou

p.

Unableto

calculate

Unableto

calculate

Hon

g&Bart

(2007)

[32]

RCT

Thechessgame

Participantswere38

stud

ents.

Thechessgrou

p:n=

18(m

eanage:9.71,

12males

and6

Thechessgrou

p:the


a90

minutechesslesson

once

perweekover

athree-

mon

thpe

riod.

Thechessgrou

ppe

rform

ance

onthe

nonverbalabilitieswas

notdifferent

from

the

controlg

roup

d=0.29

(betweenpre

andpo

sttest)on

Testof

Non

verbalIntellige

nce-

Third

Edition

.

d=−0.39

(betweenthe

meangain

ofthechess

grou

pandthecontrol

grou

p)on

Testof

Non

verbalIntellige

nce-


Table

2Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

incogn

itive

functio

ns(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ard

game

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

females)

Thecontrolg

roup

:n=20

(meanage:

9.74,15males

and5

females)

Thecontrolg

roup

:the

participantsregu

larly

attend

edscho

olactivities

afterclass.

perfo

rmance.

Third

Edition

.

Scho

lzet

al.,

(2008)

[33]

Aqu

asi-experim

ental

long

itudinalstudy:

twogrou

ppre-po

stcomparativetest

Thechessgame

Participantswere53

stud

ents.

Thechessgrou

p:n=

31 Thecontrolg

roup

:n=22

Thechessgrou

p:the


1ho

urof

chesslesson

insteadof

1ho

urof

regu

larmathm

atics

lesson

spe

rweekforthe

duratio

nof

onescho

ol-

year.

Thecontrolg

roup

:the


the

planne

dfiveregu

lar

lesson

sof

mathe

matics

perweek.

Calculatio

nabilitiesfor

simpleadditio

ntasksand

coun

tingim

proved

sign

ificantlymorein

the

chessgrou

pthan

inthe

controlg

roup

.

Unableto

calculate

Unableto

calculate


Table

3Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

intheothe

rcond

ition

s

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

Mou

ton

etal.

(2017)

[34]

Aqu

asi-

expe

rimen

tallon

gitudinalstudy:

twogrou

ppre-

postcomparative

test

Thegiantexercising

boardgame:itrequ

ired

participantsto

perfo

rmstreng

th,flexibility,

balanceanden

durance

activities.The

tarpaulin

surface

was

printedwith

24nu

mbe

redsquaresof

50×50

cmand

surrou

nded

byawalking

lane

.Eachsquare

was

coloredaccordingto

the

compo

nent

ofph

ysical

fitne

ssthat

was

tobe

perfo

rmed

(ie,6

squares/

compo

nent):streng

th,

flexibility,balance,and

endu

rance.Therules

weresimpleandmade

availableto

the

participantsin

afolder

adjacent

tothemat.

Taking

turns,participants

turned

thewhe

eland

hadreachthene

xtsquare

with

thecolor

targeted

bythearrow.

Afte

rcompletingthe

requ

estedexercises,

participantswere

expe

cted

todo

system

aticallytw

olaps

onthewalking

lane

.Participantsmadetheir

way

throug

hthesquares

until

thefinishlineafter

the24th

square.The

playingtim

eof

asession

rang

edbe

tween30

and

60min

andthegame

requ

iresaminim

umof

2participants.

Participantswere21.

Theinterven

tiongrou

p:n=10

(meanage:82.5±

6.3),the

post-in

terven

tion:

n=9,thefollow-upafter

3mon

ths:n=8.

Thecontrolg

roup

:n=11

(meanage:89.9±3.1),the

post-in

terven

tion:n=10,

thefollow-upafter3

mon

ths:n=9.

Theinterven

tiongrou

p:4

supe

rvised

exercising

sessions

wereplanne

don

thebo

ardgamedu

ring

thefirstweekandthen

3,2,and1sessions

were

planne

ddu

ringthe

second

,third,and

fourth

weekof

theinterven

tion.

Thecontrolg

roup

:participantsin

thecontrol

grou

pwererequ

ested

neith

erto

change

their

lifestyledu

ringthestud

yno

rto

getinvolved

inanyne

wtype

ofph

ysical

activity.

Theinterven

tiongrou

psign

ificantlyincreases

step

spe

rday(num

ber),

energy

expe

nditu

repe

rdayandqu

ality

oflife

andim

proves

body

balanceandgait

abno

rmalities,the

streng

thof

ankle

extensorsandflexors.

d=0.06

(betweenpre

andpo

sttest)on

Step

sPerDay

(num

ber).

d=0.50

(betweenpre

andfollow-up)

onStep

sPerDay

(num

ber).

d=0.36

(betweenpre

andpo

sttest)on

Tine

tti

Test.

d=0.65

(betweenpre

andfollow-up)

onTine

tti

Test.

Unableto

calculate

Fernande

set

al.

(2014)

[35]

RCT

Theed

ucationalb

oard-

game:in

thisstud

y,the

educationalm

aterialsare

compo

sedof

sevenparts,

Participantswere125

children(m

eanage:

10.09±1.43).

Theexpe

rimen

talg

roup

:

Theexpe

rimen

talg

roup


educationalm

aterials

abou

tsurgeryand

Childrenin

the

expe

rimen

talg

roup

show

edsign

ificant

lower

preo

perativeworriesthan

Unableto

calculate

Unableto

calculate


Table

3Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

intheothe

rcond

ition

s(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

illustratingtheho

spital

stages:(i)Hospitaladm

ission

;(ii)Health

care

pro

fessionalsandho

spital

rules;(iii)Med

icalinstru

men

ts;(iv)Med

icalproce

dures;(v)Ane

sthe

siaand

Surgeryroom

;(vi)Recov

eryroom

;and

(vii)Afte

rcare

andGoing

home.

Each

partiscompo

sedof

clearexplanations

abou

tspecifictopics

andinter

ventionstages

(e.g.infor

mationabou

the

althcare

profession

als,med

icalin

strumen

ts,clinicalproce

duresandindu

ctionof

anesthesia),as

wellasex

planations

ofspecificho

spitaland

med

icalrules

(e.g.reasons

why

they

shou

ldno

teator

drink

before

surgery,thechan

ging

ofclothe

sandpar

entalsep

arationdu

ring

surgery).The

seed

uca

tionalinformationwas

provided

thou

ghabo

ard

game.

n=45

(meanage:

10.29±1.25),the

educationalb

ooklet

(n=

15),theed

ucationalvideo

(n=15),theed

ucational

board-game(n=15).

Thecomparison

grou

p:n=45

(meanage:9.84

±1.48),theen

tertainm

ent

booklet(n=15),the

entertainm

entvide

o(n=

15),theen

tertainm

ent

board-game(n=15).

Thecontrolg

roup

:n=35

(meanage:10.14±1.57).

hospitalizationin

the

form

atof

abo

ardgame,

avide

oor

abo

oklet.

Thecomparison

grou


materialsin

theform

atof

abo

ardgame,avide

oor

abo

okletbu

tthe

materialscontaine

dno

inform

ationabou

tsurgery

orho

spitalization.

Thecontrolg

roup

did

notreceiveanymaterial.

childrenin

both

the

comparison

grou

pand

thecontrolg

roup

.Childrenreceived

the

educationalb

oard-gam

eshow

edlower

preo

pera

tiveworriesthan

children

received

theen

tertain

men

tbo

oklet,vide

o,or

board-gamegrou

p.

Blasco-

Fontecilla

etal.

(2016)

[36]

Aqu

asi-

expe

rimen

tallon

gitudinalstudy:

onepre-po

stcomparativetest

Thechessgame

Participantswere44

childrenwith

Atten

tion

deficithype

ractivity

disorder

(ADHD)(6–17

yearsold).

Allchildrenhadweekly1

hsessions

over

ape

riod

of11

consecutiveweeks

taug

htby

achessexpe

rt.

Participantstook

chess

training

lesson

sin

grou

psof

upto

10individu

als.

Childrenwith

ADHD

sign

ificantlyde

creasedin

theseverityof

ADHD

(bothinattentionand

hype

ractivity-im

pulsivity).

d=−0.85

(betweenpre

andpo

sttest)on

Swanson,Nolan

and

Pelham

Scaleforparents

(SNAP-IV)-total.

d=−0.87

(betweenpre

andpo

sttest)on

SNAP-

IV-In

attention.

d=−0.61

(betweenpre

andpo

sttest)on

SNAP-

IV-Hyperactivity-

Impu

lsivity.

d=−0.86

(betweenpre

andpo

sttest)on

Abb

reviated

Con

ner’s

Ratin

gScales

forparents.

Unableto

calculate


Table

3Overview

ofthestud

iesrepo

rtingtheeffectiven

essof

boardgames

intheothe

rcond

ition

s(Con

tinued)

Autho

rsDesign

Con

tent

ofbo

ardgame

Participants

Interven

tion

Impact

Effect

size

ofbo

ardgame

betw

eenpretestand

posttestor

follow-uptest

(Coh

en’sd)

Effect

size

ofbo

ardgame

betw

eenthemeangain

ofthemainexpe

rimen

tal

grou

pandtheothe

rgrou

ps(Coh

en’sd)

Kim

etal.

(2014)

[7]

Aqu

asi-

expe

rimen

tallon

gitudinalstudy:

twogrou

ppre-

postcomparative

test

TheGogame

Participantswere34

children.

TheADHDgrou

p:17

drug

-naïve

childrenwith

ADHD(m

eanage:10.1±

1.5).

Thecontrolg

roup

:17

age-

andsex-matched

comparison

subjects

with

-out

ADHD(m

ean

age:10.2±1.6).

Duringthe16

weeks,

both

ADHDchildren

with

outmed

icationand

childrenof

controlg

roup

wereaskedto

learnand

play

Gofor2ho

urs/day

with

aninstructor

ofthe

gameof

Go.Participants

played

Goun

derthe

instructor’sed

ucationfor

2hadaydu

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class teachers noted improvements in student interestand appreciation of the board game. Taken together,these findings suggest that board games may improvethe motivation of participants. Furthermore, Karbowniket al. [20] showed that a board game was warmly wel-comed by students; in their opinion, it facilitated clinicalthinking and peer communication. Therefore, boardgames may also have a positive influence on interper-sonal interactions among participants.Based on the above findings, board games can be used

as a tool to encourage learning as well as to enhancemotivation and interpersonal interactions. In clinicaltreatment, it is important to increase motivation becauselow motivation to cooperate with a particular interven-tion may lead to a patient dropping out of treatment orto interference with the therapeutic effects. Based on theabove findings, the use of board games may help in-crease the benefit of treatment for less motivatedpatients.

Board games and cognitive functionsIn the present review, 11 of the assessed studies investi-gated the effects of board games and programs that useboard games on cognitive functions. These studies usedGo, chess, and Ska, which are not educational games butabstract strategy games. Studies investigating the use ofGo found that older adults experiencing cognitive de-cline and/or living in nursing homes showed improve-ments in attention and working memory after regularlyplaying the game [6]. Studies assessing the use of Skafound that the game appeared to enhance the cognitivefunctioning of older adults in terms of memory, atten-tion, and executive function [24]. Studies evaluatingchess showed that training with the game improved theplanning ability of patients with schizophrenia and themathematical ability of children [25, 26]. But, Sala &Gobet [27] indicated that interventions that use chessare not significantly different from interventions that usecheckers and regular school activities that address themathematical and metacognitive ability of children.The effect sizes for cognitive functions ranged from

very small to large, but the effect size of exacerbation onmetacognitive ability was shown in the chess training ofSala & Gobet [27]. The number of studies included inthis category was relatively limited. Further investiga-tions will be necessary to clarify the more detailed effectsof board games on cognitive function. Articles aboutShogi were not selected for this category in the presentreview. Because Shogi was also included with the ab-stract strategy games, this may influence cognitive func-tions. In the future, it will be necessary to useintervention studies to examine the effects of additionaltypes of board games, including Shogi, on cognitivefunction.

Board games and other conditionsThe “other studies” category in the present review includedfive studies that examined the effects of board games onphysical activity, physical and psychological outcomes,ADHD symptoms, and the severity of Alzheimer’s Disease.Mouton et al. [34] showed that a giant board game inter-vention for nursing home residents led to significant in-creases in ambulatory physical activity, daily energy output,quality of life, balance and gait, and ankle strength. The ef-fect sizes in the present review of studies related to physicalactivity ranged from very small to medium. Fernandes et al.[35] reported that board games used as educational pre-operative materials decreased the preoperative anxiety ofchildren. Additionally, the use of board games contributedto improvements in the ADHD symptoms of children [7,35]. The effect sizes for ADHD symptoms in the present re-view ranged from medium to large. Lin et al. [8] showedthat playing Go improved the symptoms of depression andanxiety and ameliorated the manifestations of Alzheimer’sDisease. Although a study by Barzegar and Barzegar [37]was not selected for the present review because it was acase report, these authors found that playing chess pre-vented panic attacks and contributed to the amelioration ofthis condition. Taken together, these findings indicate thatboard games might be an effective complementary inter-vention for the treatment of the clinical symptoms ofADHD and Alzheimer’s Disease.In terms of Alzheimer’s disease, board games may also

play a role in the prevention of the onset of this disorder.According to an epidemiological survey in Japan [38], theprevalence rates of dementia in 1980, 1990, and 2000 were4.4, 4.5, and 5.9, respectively, for all types of dementia and1.9, 2.5, and 3.6, respectively for Alzheimer’s Disease. InJapan, the number of patients with Alzheimer’s diseasehas increased, and the prevention of this disorder is aproblem that must be addressed. Because playing boardgames ameliorates the manifestations of Alzheimer’s dis-ease [8], these types of games may contribute to the pre-vention of this disorder. However, the number of studiesin the present review that investigated the effects of boardgames on clinical symptoms was quite small, and furtherresearch will be required.

Possible clinical applications of board gamesIt is also important to note that board games can beplayed without the use of language. Language-basedtherapies may not be appropriate for people with under-developed linguistic functions, such as children and pa-tients with speech disorders. However, board games maybe a viable treatment option for these populations. Inthe present review, the subjects in 18 of the assessedstudies included children, which is a group that is stilldeveloping linguistic functions and is more likely to havepoor knowledge about diseases. The present review also


revealed that board games and programs that use boardgames are effective for achieving various outcomes forchildren, including increasing educational knowledge, en-hancing cognitive functions, and decreasing anxiety andthe severity of ADHD. Furthermore, board games can bean enjoyable and motivational tool for children [22]. Basedon these findings, it is possible that board games can be auseful intervention for children in particular because suchgames can be expected to result in the maintenance andpromotion of health and the prevention of disease.

Limitations and future directionsSeveral limitations of the present study must be consid-ered. First, the number of studies assessed in the presentreview was rather limited. Therefore, further investigationsof the effects of board games will be necessary. Second,many of the papers selected for the present review exam-ined the effectiveness of board games by comparing pre-post intervention for a single group or by comparing witha control group without intervention. These research de-signs do not control for the possibility of placebo effects.Intervention studies must include an active control groupto control for possible placebo effects [39], thus it will benecessary to compare the effect of board game groups andactive control groups in future research. Third, in the arti-cles selected for the present review, some studies wereconducted with relatively small sample sizes. In cases inwhich the sample size is small, there is the possibility ofincreased sampling error. In order to reduce samplingerror, it is necessary to do a power analysis to set an ap-propriate sample size in intervention studies. In addition,it is desirable that multiple assessment indicators be usedto examine the effects of board games in various perspec-tives and to reduce measurement errors.

ConclusionsThe present systematic review showed that board gamesand programs that use board games have positive effects onvarious outcomes, including educational knowledge, cogni-tive functions, physical activity, anxiety, ADHD symptoms,and the severity of Alzheimer’s Disease. Additionally, boardgames were shown to contribute to improving these vari-ables, enhancing the interpersonal interactions and motiv-ation of participants, and promoting learning. Takentogether, these findings suggest that board games would bean effective complementary therapy that would contributeto the improvement of many clinical symptoms.

AbbreviationsADHD: Attention-deficit hyperactivity disorder; cRCT: cluster randomizedcontrolled trial; HIV: Human immunodeficiency virus; RCT: Randomizedcontrolled trial; STIs: Sexually transmitted infections

AcknowledgementsThe authors appreciate the support of the members of the Japan ShogiAssociation and the officials in Kakogawa City for conceptualizing health

promotion models using board games, such as Shogi and other traditionalgames.

Research involving animalsNot applicable.

NoteThis paper was proofread in English by Textcheck (reference number:19022617).

Authors’ contributionsSN designed the study and conducted the literature searches. SN wrote thefirst draft of the manuscript. KS and MN revised the draft of the manuscript.All authors approved the final version of the manuscript.

FundingNot applicable.

Availability of data and materialsNot applicable.

Ethics approval and consent to participateNot applicable.

Consent for publicationNot applicable.

Competing interestsThe authors declare that they have no competing interests.

Author details1Graduate School of Human and Social Sciences, Musashino University, 3-3-3Ariake, Koutouku, Tokyo 135-8181, Japan. 2Faculty of Human Sciences,Musashino University, Tokyo, Japan. 3Department of PsychosomaticMedicine, School of Medicine, International University of Health and Welfare,Chiba, Japan.

Received: 23 March 2019 Accepted: 25 September 2019

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The effectiveness of intervention with board games: a systematic … · 2019. 10. 21. · Similar to chess and Go, Shogi is a board game for two players that is also referred to as