Physical inactivity and increasing sedentary behavior amongst school going children necessitate new interventions to enhance their overall quality of life (QoL). A potential tool is Virtual Reality (VR) exergaming, a combination of physical activity and an immersive gameplay. This is a prospective systematic literature review that attempts to integrate and discuss the available literature on the impacts of VR exergaming on the multi-dimensional quality of life of school children, in particular, its association with physical, mental (resilience included), cognitive, and social areas. A systematic search was undertaken in accordance with PRISMA guidelines of electronic databases (PubMed, Scopus, PsycINFO, Web of Science, and Cochrane Library) since inception until 31^st may, 2024. Included articles were peer-reviewed randomized controlled trials or quasi experimental articles that reviewed VR exergaming interventions in school-aged children (5-18 years) and assessed QoL or its central subdomains. Two reviewers conducted study selection, data extraction, and quality assessment with the use of the relevant tools (e.g., Cochrane Risk of Bias tool). Total of 1263 studies were found in search, and 12 of these studies passed the entire inclusion criteria. The evidence that has been synthesized suggests that VR exergaming is the factor with a stable positive impact on physical health, including cardiovascular fitness and motor competence. It was also strongly linked with a better psychological health, lower levels of anxiety, and improved mood. Cognitive benefits, especially in the executive functions, have promising evidence although with a lesser amount of literature. Positive effects on social QoL but under-investigated.

The evidence in the existing literature demonstrates that VR exergaming is a useful, entertaining and can have improved impact on various aspects of QoL among school children. It also has a great psychological and possible cognitive advantage in addition to encouraging physical activity. This review points out the necessity of more high-quality and long-term research with standardized outcomes measures in order to solidify evidence and make the application in educational settings.