Active Video Games Intervention Research Articles

Effects of Active Video Games in Patients With Cancer: Systematic Review.

Physical activity (PA) is now considered an adjuvant therapy in cancer treatment; nevertheless, multiple barriers could reduce PA engagement during treatment. Active video games (AVGs) lead to the achievement of mild- to moderate-intensity PA and represent a promising tool for regular movement and exercise. This paper aims to review the current literature and provide updated content on the physiological and psychological effects of AVG-based interventions in patients with cancer undergoing treatment. Four electronic databases were investigated. Studies reporting on AVG interventions delivered to patients undergoing treatment were included. A total of 21 articles (17 interventions) were identified for data extraction and quality assessment. A total of 362 patients with cancer participated in the studies (number of participants 3-70). The majority underwent treatment for breast, lung, prostate, hematologic, or oral or laryngeal cancer. The types and stages of cancer varied in all studies. Participants ranged in age from 3 to 93 years. Four studies included patients with pediatric cancer. The duration of interventions ranged from 2 to 16 weeks, with a minimum of 2 sessions per week and a maximum of 1 daily session. Sessions were supervised in 10 studies, and 7 included home-based interventions. AVG interventions improved endurance, quality of life, cancer-related fatigue, and self-efficacy. Effects were mixed on strength, physical function, and depression. AVGs did not affect activity level, body composition, or anxiety. Compared with standard physiotherapy, physiological effects were lower or similar, and psychological effects were higher or similar. Overall, our results suggest that AVGs can be recommended to patients undergoing cancer treatment, given the physiological and psychological benefits. When AVGs are proposed, supervision of the sessions should be considered as it can limit dropouts. In the future, it is important to develop AVGs that combine endurance and muscle strengthening, with the possibility of achieving moderate to high exercise intensity, depending on the physical abilities of the patients, as indicated in the World Health Organization's recommendations.

Active Video Game Interventions Targeting Physical Activity Behaviors: Systematic Review and Meta-analysis.

Research on digital games designed to increase physical activity (PA), also known as exergames or active video games (AVGs), has proliferated over the past 2 decades. As a result, reviews of literature in this field can become outdated, revealing the need for updated high-quality reviews that identify overarching insights. Furthermore, given the significant heterogeneity in AVG research, study inclusion criteria may significantly influence conclusions. To the best of our knowledge, no prior systematic review or meta-analysis has specifically focused on studies of longitudinal AVG interventions targeting increases in PA behaviors. The aim of this study was to obtain insights into when and why longitudinal AVG interventions are more or less successful for sustained increases in PA, especially for public health. Six databases (PubMed, PsycINFO, SPORTDiscus, MEDLINE, Web of Science, and Google Scholar) were reviewed until December 31, 2020. This protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, randomized controlled trials had to prominently (>50% of intervention) feature AVG technology, involve repeated AVG exposure, and target changes in PA behavior. Experimental designs had to include ≥2 within- or between-participant conditions with ≥10 participants per condition. A total of 25 studies published in English between 1996 and 2020 were identified, with 19 studies providing sufficient data for inclusion in the meta-analysis. Our findings indicated that AVG interventions had a moderately positive effect, thereby increasing overall PA (Hedges g=0.525, 95% CI 0.322-0.728). Our analysis showed substantial heterogeneity (I2=87.7%; Q=154.1). The main findings were consistent across all subgroup analyses. The comparison between PA assessment type groups showed a moderate effect for objective measures (Hedges g=0.586, 95% CI 0.321-0.852) and a small effect for subjective measures (Hedges g=0.301, 95% CI 0.049-0.554) but no significant difference between the groups (P=.13). The platform subgroup analysis indicated a moderate effect for stepping devices (Hedges g=0.303, 95% CI 0.110-0.496), combination of handheld and body-sensing devices (Hedges g=0.512, 95% CI 0.288-0.736), and other devices (Hedges g=0.694, 95% CI 0.350-1.039). The type of control group showed a wide range of effects sizes, ranging from a small effect size (Hedges g=0.370, 95% CI 0.212-0.527) for the passive control group (nothing) to a moderate effect size for the conventional PA intervention group (Hedges g=0.693, 95% CI 0.107-1.279) and ultimately to a large effect size for sedentary game as control groups (Hedges g=0.932, 95% CI 0.043-1.821). There was no significant difference among the groups (P=.29). AVGs represent a promising tool for PA promotion among the general population and clinical subpopulations. However, significant variabilities in AVG quality, study design, and impact were also detected. Suggestions for improving AVG interventions and related research will be discussed. PROSPERO CRD42020204191; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204191.

A comprehensive systematic review and content analysis of active video game intervention research

ObjectiveIntervention research using digital games to promote physical activity has proliferated. Yet few studies have attempted to systematically catalog features that characterize this research. To address this gap, we undertook a systematic review and content analysis of active video game interventions, examining only published longitudinal interventions that prominently featured active video game technology (≥50% of the intervention).MethodsOur protocol was registered in the International Prospective Register of Systematic Reviews (CRD42020204191). For inclusion, an active video game intervention had to require gross movement beyond finger movement, and target improvement, maintenance, or recovery of health. The intervention design had to include at least two conditions, within- or between-subjects, with ≥10 participants per condition to examine the chronic effects of active video game exposure.ResultsThe search resulted in 232 studies published in English between 1996 and 2020. The majority of active video game interventions (69.8%) targeted physical fitness (physiological functioning as a consequence of physical activity), followed by cognitive performance (11.3%), physical activity (5.5%), or a mixture of those outcomes (13.4%). Total enrollment across all studies was 14,849 participants ( MParticipants = 62, SD = 106; MAge = 50.2, SD = 25.2 years; 47.3% men). A strong majority of the samples (69.8%) were recruited from medical subpopulations, and only 30.2% were recruited from the general (healthy) population. A strong majority of active video games (72.0%) were developed by industry for the commercial market, and only 13.3% were funded by government or foundation grants.ConclusionsSuggested directions for improving future active video game development and intervention research include greater consideration of promising features (social connectedness, novelty, narrative, rhythmic movement to music) and new models for productive collaboration between industry and academia.

Active Video Game On Children And Adolescents’ Physical Activity Levels And Bodyweight Management: Network Meta-analysis

PURPOSE: We synthesised evidence on the effectiveness of active video games (AVGs) versus no AVG-applied comparators on various physical activity (PA) levels and weight management outcomes in children and adolescents. We analysed the comparative evidence on different sub-categories of AVGs and ranking the best option. METHODS: An overview of systematic reviews (SRs) and network meta-analysis (NMA) (PROSPERO: CRD42021248499) was employed. A search for relevant literature published in English was conducted in six electronic databases from their inception until April 2021. SRs consisting of randomised control trials (RCTs) and satisfying our PICOS inclusion criteria were included. RCTs included were a comparison of groups among children and adolescents, where groups with AVG interventions were compared with groups without them. Direct head-to-head pairwise meta-analyses were conducted using weighted mean difference between the two groups, and the comparative effectiveness of different sub-categories of AVGs was analysed indirectly using NMA. RESULTS: Overall, 17 SRs were identified from the 6,036 screened citations. Of these, 350 citations were retrieved, and 12 RCTs were finally included. Compared to no AVG group, AVG groups were shown to be more effective in achieving vigorous, moderate-to-vigorous, and moderate PA levels, and decreased BMI and body fat. NMA showed that rhythmic dance games had the highest probability of being the most effective sub-category for reducing BMI. CONCLUSIONS: AVGs are effective in vigorous, moderate to vigorous, and moderate PA levels and reduce BMI and body fat among children and adolescents. Dance appears to be the best option for reducing BMI among AVG subcategories.

The Effects of Active Video Game Exercise Based on Self-Determination Theory on Physical Fitness and Cognitive Function in Older Adults.

Background: Aging and physical inactivity are associated with declines in physical fitness and cognitive function. Active video games have proven to be beneficial for the physical health of older adults, but the exact effect of active video games on physical fitness and cognitive function was still unclear. Based on self-determination theory (SDT), which is a widely used theory of healthy behavior change, this study aimed to explore the effects of an active video game intervention on fitness and cognitive function in older adults. Methods: A total of 38 participants (mean age = 65.68 ± 3.78 years, 24 female) were randomly assigned to either an intervention group (active video game training) or a control group (no additional intervention). The participants in the intervention group trained for a total of 36 sessions (3 times per week for 50–55 min each) for 12 weeks. The control group continued with their normal daily living. The pre- and posttest measurements included: IPAQ-C score and physical fitness (BMI, body fat percent, blood pressure, reaction time, sit and reach, vital capacity, grip strength, static balance, blood biochemical tests for liver function, kidney function, blood lipids, glucose and insulin levels) and cognitive functions (processing speed, spatial ability, working memory, language ability, associative memory). Result: The intervention group showed a significantly smaller decrease in total average physical activity relative to the control group. BMI, vital capacity, systolic blood pressure, diastolic blood pressure, and spatial cognition significantly improved after training in the intervention group (BMI: F = 9.814, p = 0.004, d = −0.93, vital capacity: F = 4.708, p = 0.038, d = 0.67, systolic blood pressure: F = 5.28, p = 0.028, d = −0.68, diastolic blood pressure: F = 6.418, p = 0.016, d = −0.86, spatial cognition: F = 8.261, p = 0.007, d = 0.72). Three measures of static balance (closed eyes) also showed improvements after training (total length of swing: F = 3.728, d = −0.62, total velocity of swing: F = 3.740, d = −0.62, total area of swing: F = 2.920, d = −0.70). No significant training effects were evident in the results from the blood biochemical tests. Conclusion: This study indicates a positive influence of active video game training on physical fitness and cognitive function. The use of SDT-based active video game exercise as a feasible, safe, and effective training method for improving community older adults’ healthy, promoting group cohesion, and increasing motivation to exercise.

Effect of an Active Video Game Intervention Combined With Multicomponent Exercise for Cardiorespiratory Fitness in Children With Overweight and Obesity: Randomized Controlled Trial.

BackgroundChildhood overweight and obesity have become major global health problems and are negatively related with the cardiorespiratory fitness (CRF) level in school children and adolescents. Exercise, specifically multicomponent training, is effective for CRF improvement, but the main challenge is to ensure adherence to exercise in children with overweight and obesity. Therefore, new ways of exercising that are more attractive and motivational for this population are needed and playing or training with active video games (AVGs) has been proposed as an effective alternative because they require full-body movement and therefore increase energy expenditure.ObjectiveThe main aim of this study was to investigate the effects of an AVG intervention combined with multicomponent training on CRF at maximal and submaximal intensities in children with overweight or obesity.MethodsWe recruited 28 children (13 girls and 15 boys) aged 9 to 11 years with overweight or obesity from medical centers and divided them into 2 groups, an intervention group (n=20) that participated in a 5-month supervised AVG exercise program combined with multicomponent exercise, and a control group (n=8) that continued daily activities without modification. A maximal stress test to measure CRF using a walking-graded protocol with respiratory gas exchange was performed by the participants.ResultsThe AVG group showed a significant decrease in heart rate and oxygen uptake for the same intensities in the submaximal stages of the maximal treadmill test, as well as a lower oxygen uptake percentage according to the individual maximal oxygen uptake, whereas the control group did not show overall changes. No change in the peak oxygen uptake (VO2peak) was found.ConclusionsA 5-month AVG intervention combined with multicomponent exercise had positive effects on CRF at submaximal intensity, showing a lower heart rate and oxygen uptake at the same intensities and displaying a lower oxygen uptake percentage according to the individual (VO2peak). Greater benefits were found in children with the highest fat percentage.Trial RegistrationClinicalTrials.gov NCT04418713; https://clinicaltrials.gov/show/NCT04418713

Active video game on children and adolescents' physical activity and weight management: A network meta-analysis.

We synthesized evidence on the effectiveness of active video games (AVGs) versus no AVG-applied comparators on various physical activity (PA) levels and weight management outcomes in children and adolescents. We analyzed the comparative evidence on different sub-categories of AVGs and ranking the best option. An overview of systematic reviews (SRs) and network meta-analysis (NMA) (PROSPERO: CRD42021248499) was employed. A search for relevant literature published in English was conducted in six electronic databases from their inception until April 2021. SRs consisting of randomized control trials (RCTs) and satisfying our PICOS inclusion criteria were included. RCTs included were a comparison of groups among children and adolescents between 6 and 21, where groups with AVG interventions were compared with groups without them. Direct head-to-head pairwise meta-analyses were conducted using weighted mean difference between the two groups, and the comparative effectiveness of different sub-categories of AVGs was analyzed indirectly using NMA. Overall, 17 SRs were identified from the 6036 screened citations. Of these, 350 citations were retrieved, and 12 RCTs were finally included. Compared with no AVG group, AVG groups were shown to be more effective in achieving vigorous, moderate-to-vigorous, and moderate PA levels, and decreased BMI and body fat. NMA showed that rhythmic dance games had the highest probability of being the most effective sub-category for reducing BMI. AVGs are effective in attaining vigorous, moderate to vigorous, and moderate PA levels, and reducing BMI and body fat among children and adolescents. Dance appears to be the best option for reducing BMI among AVG subcategories.

Get Fit with Ring-Fit Adventure™: Physiological Outcomes of a Novel Active Video Game Intervention among Women

Get Fit with Ring-Fit Adventure™: Physiological Outcomes of a Novel Active Video Game Intervention among Women

Ring-Fit Adventure™: Psychological and Qualitative Outcomes of a Novel Active Video Game Intervention

Ring-Fit Adventure™: Psychological and Qualitative Outcomes of a Novel Active Video Game Intervention

Effects of Active Video Games on Health-Related Physical Fitness and Motor Competence in Children and Adolescents With Overweight or Obesity: Systematic Review and Meta-Analysis.

BackgroundChildhood obesity is one of the most important public health problems. Active video games (AVGs) have been proposed as an attractive alternative to increase energy expenditure and are being investigated to determine their effectiveness against childhood obesity.ObjectiveThe aim of this study is to summarize the existing research and draw conclusions about the effects of AVGs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity.MethodsThe search strategy was applied to PubMed, MEDLINE, Web of Science, and SPORTDiscus, including randomized and nonrandomized controlled trials investigating the effects of AVG programs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. To measure the risk of bias in randomized and nonrandomized controlled trials, 2 different quality assessment tools were used. In total, 15 articles met the inclusion criteria, and the variables of interest were BMI, body fat percentage, cardiorespiratory fitness (CRF), waist circumference, fat-free mass, muscular fitness, and motor competence. A meta-analysis was performed.ResultsPositive effects were found for BMI and body fat percentage, favoring the AVG group compared with a control group with no intervention (mean difference −0.209; 95% CI −0.388 to −0.031 vs mean difference −0.879; 95% CI −1.138 to −0.602). Positive effects seem to be observed for CRF. The effects of AVG interventions on muscular fitness, fat-free mass, waist circumference, and motor competence are unclear.ConclusionsAVG programs showed positive effects on BMI, body fat percentage, and CRF. AVG could be a good strategy to combat childhood obesity.

The Effects of Active Video Games on Health-Related Physical Fitness and Motor Competence in Children and Adolescents with Healthy Weight: A Systematic Review and Meta-Analysis.

(1) Background: Poor levels of physical fitness and motor skills are problems for today’s children. Active video games (AVG) could be an attractive strategy to help address them. The aim was to investigate the effects of AVG on health-related physical fitness and motor competence in children and adolescents with healthy weight. (2) Methods: Randomized and non-randomized controlled trials investigating the effects of AVG programs on health-related physical fitness and motor competence were included. Two different quality assessment tools were used to measure the risk of bias. Twenty articles met the inclusion criteria and the variables of interest were body mass index (BMI), body fat, cardiorespiratory fitness (CRF), muscular fitness and motor competence. (3) Results: AVG interventions seem to have benefits in BMI when lasting longer than 18 weeks (SMD, −0.590; 95% IC, −1.071, −0.108) and in CRF (SMD, 0.438; 95% IC, 0.022, 0.855). AVG seems to be a promising tool to improve muscular fitness and motor competence but the effects are still unclear due to the lack of evidence. (4) Conclusions: AVG seem to be an effective tool for improving some components of health-related physical fitness and motor competence in healthy-weight children and adolescents, but the effect on some fitness components needs further research. Therefore, AVG may be included as a strategy to improve health.

Getting Active with Active Video Games: A Quasi-Experimental Study

Given the cultural emphasis on academic achievement and environmental constraints to physical activity (PA), active video games (AVGs) may be used to decrease sedentary behavior and increase PA of Hong Kong children. This study explored the potential of a school-based AVG intervention on sedentary time, PA, body composition, and psychosocial factors among children. Eighty-seven children (intervention n = 30) were recruited from one primary school. Classes in Grades 4–6 were allocated to either the intervention group or the control group in a 2:1 ratio. The eight-week intervention involved children playing AVGs in an after-school class twice a week. Participants in the control group continued with their usual activities. Outcome included the change of participants in sedentary time, PA, percentage body fat, body mass index (BMI), and psychosocial variables (enjoyment, self-efficacy and social support), from baseline to eight weeks. No significant group differences were observed in sedentary time (−33.9 min/day, 95% CI −70.8 to 4.8; p = 0.07). The intervention group significantly increased total PA (53.7 counts/min, 95% CI 8.6 to 104.2; p = 0.04) compared with those in the control condition. No differences were found in body composition and psychosocial variables. However, significant treatment effects were found on BMI z score among boys (−0.1, 95% CI −0.2 to 0; p = 0.04). An eight-week school-based AVG intervention delivered during after-school hours was effective in increasing activity levels among Hong Kong children. The treatment effects of AVGs on sedentary behavior and body composition need to be further demonstrated in a more robust study, especially in boys.

Effectiveness of active video game usage on body composition, physical activity level and motor proficiency in children with intellectual disability.

Interventions with active video games (AVGs) can promote physical activity (PA) and health and are compatible with a school setting. The needs of children with intellectual disability (ID) in this area have been neglected. A two-arm trial was conducted among 203 students with intellectual disability. The intervention group was prescribed a 12-week intervention with AVG. The control group continued with usual PA. Children's BOT-2 short-form score increased in both the intervention and control groups. However, the AVG intervention had no statistically significant effect on children's body composition, PA and motor proficiency overall, or in analyses of subgroups based on age, body weight and comorbid autism. Active video game intervention had no marked effect on body composition, PA and motor proficiency in children with intellectual disability. The reasons for the lack of effectivity of the intervention are discussed; these may provide better guidelines for future AVG intervention in children with intellectual disability.

Assessment of Active Video Games' Energy Expenditure in Children with Overweight and Obesity and Differences by Gender.

(1) Background: Childhood obesity has become a main global health problem and active video games (AVG) could be used to increase energy expenditure. The aim of this study was to investigate the energy expenditure during an AVG intervention combined with exercise, differentiating by gender. (2) Methods: A total of 45 children with overweight or obesity (19 girls) performed an AVG intervention combined with exercise. The AVG used were the Xbox Kinect, Nintendo Wii, dance mats, BKOOL cycling simulator, and Nintendo Switch. The energy expenditure was estimated from the heart rate recorded during the sessions and the data from the individual maximal tests. (3) Results: The mean energy expenditure was 315.1 kilocalories in a one-hour session. Participants spent the most energy on BKOOL, followed by Ring Fit Adventures, Dance Mats, Xbox Kinect, and the Nintendo Wii, with significant differences between BKOOL and the Nintendo Wii. Significant differences between boys and girls were found, but were partially due to the difference in weight, VO2max, and fat-free mass. (4) Conclusions: The energy expenditure with AVG combined with multi-component exercise was 5.68 kcal/min in boys and 4.66 kcal/min in girls with overweight and obesity. AVG could be an effective strategy to increase energy expenditure in children and adolescents with overweight and obesity.

A Systematic Review of Active Video Games on Youth's Body Composition and Physical Activity.

In the past decade, active video games (AVGs) have started to find their way into communities, schools, and homes as a possible solution to promote physical activity (PA) and prevent childhood obesity. However, the evidence regarding its effectiveness on body composition and objectively measured PA in youth remains inconclusive. Thus, a systematic review on this topic is needed. This review synthesizes effects of AVGs on body composition and PA in youth. The initial search yielded 260 articles from 10 databases and 18 randomized-controlled trials were included after evaluating against eligibility and removing duplicates. Overall, AVGs showed positive effects in improving body composition and PA in overweight/obese youth as compared to the control conditions with only 2 studies displaying neutral effects on these outcomes as compared to traditional PA or comparison programs. For healthy youth, more than half of the studies (n = 10) demonstrated neutral effects of AVGs on these outcomes whereas only 6 yielded positive effects compared to the control conditions. Further, one study indicated that the control condition observed greater improvement in body composition compared with an AVG intervention in healthy youth. In summary, AVGs are deemed a promising addition to promote PA and health among overweight/obese youth with the goal of fighting childhood obesity.

Effects of Active Video Games on Children’s Psychosocial Beliefs and School Day Energy Expenditure

Purpose: Examine the effects of active video games (AVGs) on children’s school-day energy expenditure (EE) and physical activity (PA)-related self-efficacy, social support, and outcome expectancy over 9 months. Method: Participants were 81 fourth grade students ( = 9.23 years, SD = 0.62; 39 girls) from two urban Minnesota elementary schools. A once-weekly 50 min AVG intervention was implemented in the intervention school for 9 months in 2014–2015 while the control school continued regular recess. Children’s school-day EE (daily caloric expenditure) and mean daily metabolic equivalent (MET) values were estimated via accelerometry whereas self-efficacy, social support, and outcome expectancy were assessed with psychometrically-validated questionnaires. All measures were completed at baseline and at the 4th and 9th months. Results: We observed significant interaction effects for daily caloric expenditure, F(1, 58) = 15.8, p < 0.01, mean daily MET values, F(1, 58) = 11.3, p < 0.01, and outcome expectancy, F(1, 58) = 4.5, p < 0.05. Specifically, intervention children had greater increases in daily caloric expenditure (91 kilocalorie/day post-intervention group difference), with control children decreasing daily caloric expenditure over time. We observed identical trends for mean daily MET values (0.35 METs/day post-intervention group difference). Interestingly, we observed outcome expectancy to increase in the control children, but decrease among intervention children, at post-intervention (1.35 group difference). Finally, we observed a marginally significant interaction effect for social support, F(1, 58) = 3.104, p = 0.08, with an increase and decrease seen in the intervention and control children, respectively. We observed no interaction or main effects for self-efficacy. Discussion: Observations suggested an AVG intervention contributed to longitudinal increases in school-day EE and social support compared to the control condition. Future research should examine how self-efficacy and outcome expectancy might be promoted during school-based AVG interventions.

Active Video Games for Rehabilitation in Respiratory Conditions: Systematic Review and Meta-Analysis.

BackgroundExercise and physical activity are key components of treatment for chronic respiratory diseases. However, the level of physical activity and adherence to exercise programs are low in people with these diseases. Active video games (AVGs) may provide a more engaging alternative to traditional forms of exercise.ObjectiveThis review examines the effectiveness of game-based interventions on physiological outcome measures, as well as adherence and enjoyment in subjects with chronic respiratory diseases.MethodsA systematic search of the literature was conducted, with full texts and abstracts included where they involved an AVG intervention for participants diagnosed with respiratory conditions. A narrative synthesis of included studies was performed. Additionally, meta-analysis comparing AVGs with traditional exercise was undertaken for 4 outcome measures: mean heart rate (HR) during exercise, peripheral blood oxygen saturation (SpO2) during exercise, dyspnea induced by the exercise, and enjoyment of the exercise.ResultsA total of 13 full-text papers corresponding to 12 studies were included in the review. Interventions predominantly used games released for the Nintendo Wii (8 studies) and Microsoft Xbox Kinect (3 studies). There were 5 studies that examined the acute effects of a single session of AVGs and 7 studies that examined the long-term effects after multiple sessions of AVGs. Trials conducted over more than 1 session varied in duration between 3 and 12 weeks. In these, AVG interventions were associated with either similar or slightly greater improvements in outcomes such as exercise capacity when compared with a traditional exercise control, and they also generally demonstrated improvements over baseline or nonintervention comparators. There were a few studies of unsupervised AVG interventions, but the reported adherence was high and maintained throughout the intervention period. Additionally, AVGs were generally reported to be well liked and considered feasible by participants.For outcome measures measured during a single exercise session, there was no significant difference between an AVG and traditional exercise for HR (mean difference 1.44 beats per minute, 95% CI –14.31 to 17.18), SpO2 (mean difference 1.12 percentage points, 95% CI –1.91 to 4.16), and dyspnea (mean difference 0.43 Borg units, 95% CI –0.79 to 1.66), but AVGs were significantly more enjoyable than traditional exercise (Hedges g standardized mean difference 1.36, 95% CI 0.04-2.68).ConclusionsThis review provides evidence that AVG interventions, undertaken for several weeks, can provide similar or greater improvements in exercise capacity and other outcomes as traditional exercise. Within a single session of cardiovascular exercise, an AVG can evoke similar physiological responses as traditional exercise modalities but is more enjoyable to subjects with chronic respiratory diseases. However, there is very limited evidence for adherence and effectiveness in long-term unsupervised trials, which should be the focus of future research.

Energy Expenditure and Enjoyment During Active Video Gaming Using an Adapted Wii Fit Balance Board in Adults with Physical Disabilities: Observational Study.

BackgroundIndividuals with physical disabilities have fewer opportunities to participate in enjoyable physical activity. One option for increasing physical activity is playing active video games (AVGs); however, many AVGs are inaccessible or offer limited play options.ObjectiveThis study aimed to examine energy expenditure and enjoyment in adults with mobility impairment during AVG play using off-the-shelf (OTS) and adapted versions of the Wii Fit balance board (Nintendo).MethodsDuring visit 1, participants completed a functional assessment and the familiarization period. During visit 2, metabolic data were collected during a 20-minute baseline and four 10-minute bouts of Wii Fit Plus game play, with two bouts on each of the boards. During the resting period, participants completed the Physical Activity Enjoyment Scale (PACES). Statistical analyses were computed using SPSS software. Data were analyzed separately for individuals who were able to play while standing on both boards (StdStd); those who could not play while standing on the OTS board, but were able to play while standing on the adapted board (aStd); and those who could only play while sitting on the adapted board (aSit).ResultsData were collected for 58 participants (StdStd, n=17; aStd, n=10; aSit, n=31). The sample included 31 men and 27 women with a mean age of 41.21 (SD 12.70) years. Energy expenditure (metabolic equivalent [MET]) during game play was significantly greater than that during rest for all players. Only 17 participants (StdStd group) were able to play using the OTS board. During game play on the adapted board, the average MET values for the two game sets were 2.261 (SD 0.718) kcal/kg/hour and 2.233 (SD 0.751) kcal/kg/hour for the aSit group, 3.151 (SD 1.034) and 2.990 (SD 1.121) for the aStd group, and 2.732 (SD 0.655) and 2.777 (SD 0.803) for the StdStd group. For game play on the adapted board, self-reported ratings of perceived exertion on a 0-10 scale suggested greater exercise intensity levels, with median scores ranging from moderate (3) to very hard (7). The PACES scores indicated that all players enjoyed using the adapted board, with a median score of 4 on a 5-point scale.ConclusionsThe adapted Wii Fit balance board provided an opportunity for individuals with mobility impairments, including wheelchair users, to engage in AVG. All participants were able to utilize the adapted controller and enjoyed the AVG activity. Although the average MET values achieved during AVG represented light-intensity exercise (<3 METs), 16% of sitting participants and 41% of standing participants achieved moderate-intensity exercise (3-6 METs) in at least one of the games. Factors not accounted for, which may have influenced the intensity of exercise, include game selection, limited familiarization period, and discomfort wearing the COSMED portable metabolic system for measurement of oxygen consumption. Accessible AVG controllers offer an innovative approach to overcome various barriers to participation in physical activity. The next steps include assessment of an AVG intervention using an adapted board gaming controller on health and fitness outcomes.Trial RegistrationClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by Webcite at http://www.webcitation.org/75fc0mN39).

Lessons learned during formative phase development of an asynchronous, active video game intervention: Making sedentary fantasy sports active

ObjectivesActive fantasy sports is a type of active video game (AVG) developed using principles from self-determination theory and the trans-contextual motivation model. The game leverages elements of a popular, previously sedentary game -- traditional fantasy sports -- but incorporates and encourages physical activity (PA) of participants ("fantasy team owners"). Early proof-of-concept stage research demonstrated potential for active fantasy sports to increase PA in adults (Moller et al., 2014). However, more formative research identifying factors that influence enjoyment of active fantasy sports and PA goal achievement could improve efficacy and inform the development of alternative AVGs. DesignThree active fantasy sports leagues were organized and data from the three leagues were combined to examine intervention and social factors that predicted enjoyment and PA goal achievement. MethodParticipants (N = 33, 15.2% female, M-Age = 34.0 years) wore an accelerometer to track PA and completed self-report measures about their experience upon league conclusion (league duration ranged from 16 to 17 weeks). ResultsFindings revealed that average steps significantly increased during the first six weeks of the intervention and then significantly decreased during subsequent weeks. Frequency of checking the league website was associated with greater PA goal achievement. Greater frequency of checking the accelerometer website and the league website were also associated with greater league enjoyment. ConclusionsPromoting greater frequency of using the league and accelerometer websites is important to achieving greater impact on PA and league enjoyment through active fantasy sports. Future studies of active fantasy sports leagues could use randomized controlled trial and multiphase optimization strategy designs to vary game components in order to test which components sustain intrinsic motivation and increase PA. Lessons may be further applied to the development of other AVGs, especially those that build on established and popular sedentary video games.

Correlates of Active Videogame Use in Children.

Active videogames (AVGs) could provide a novel approach to increasing physical activity and decreasing sedentary activity in children, but little is known about which children are likely to use AVGs. This study examined whether youth demographics, social support, and AVG engagement influence use of AVGs and physical activity. A diverse sample of youth participants (42.4% non-Hispanic white), aged 8-14 years (n = 85), who owned an AVG console, completed surveys, wore an activity monitor, and logged AVG use for 1 week. Regression analyses were used to examine variables associated with daily AVG minutes and to examine the relationship between daily AVG minutes and daily steps. Older and non-Hispanic white children played AVGs for fewer minutes per day (P's < 0.03). Greater peer support for playing AVGs was associated with greater daily AVG minutes (P = 0.003). Daily AVG minutes were not associated with daily steps. Results suggest that younger children and children who do not identify as non-Hispanic white may be more open to playing AVGs. Targeting social support in AVG interventions may increase time spent playing AVGs.