BACKGROUND: Schizophrenia is a severe mental illness that affects the cognitive, social, and daily functions of patients. Physical activity has been found to be important for maintaining these functions in patients with schizophrenia, but many lack the motivation to participate in physical activities. OBJECTIVE: This study aimed to explore the efficacy of active video games (AVGs) on the behavioral intention and cognitive function of patients with schizophrenia. METHODS: In this experimental study, 103 participants were recruited from 2 medical centers. All participants were randomly assigned to the experimental or control group, and 82 participants (n = 41, 50% in the experimental group and n = 41, 50% in the control group) completed all the processes of our protocol. The experimental group was provided with AVGs for 30 minutes twice per week for 6 weeks. The Mini Mental State Examination and a behavioral intention questionnaire were administered before and after playing the AVGs. Data were collected between April 2021 and January 2022. Generalized estimating equations and 2-tailed paired t tests were used for data analysis. RESULTS: The experimental group showed significant improvements in behavioral intention to participate in AVGs compared with the control group at both T1 (beta 4.88; p = 0.009) and T2 (beta 4.24; p = 0.04). In addition, the experimental group experienced significant improvements in orientation (T2: beta 0.66; p = 0.04) and language (T2: beta 0.28; p = 0.03) among cognitive functions compared to the control group. In contrast, there was no significant change in these variables in the control group. CONCLUSIONS: Playing AVGs can effectively enhance the behavioral intention of patients with schizophrenia to participate in physical activity and exercise and significantly improve their orientation and language. AVGs are inexpensive and easily operated tools for people with mental or physical disabilities. TRIAL REGISTRATION: ClinicalTrials.gov NCT05933356; https://clinicaltrials.gov/study/NCT05933356.

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