Exergames Research Articles

Multi-Context Strategies and Opportunities for Increasing Levels of Physical Activity in Children and Young People: A Literature Review

Background: In today’s society, low levels of physical activity are observed in the child and adolescent population, which can cause numerous pathologies, such as obesity and mental health problems. Objective: This article aims to compile all the contexts and scenarios where it is possible to increase the levels of daily physical activity of children and young people, and which have significant scientific support. Method. To do so, a literature review was carried out examining four key contexts for intervention: school, extracurricular, family, and socio-community. Results: The results indicate that the school context, with strategies such as physical education classes and active breaks, is crucial but insufficient on its own, so it is essential to complement it with interventions in extracurricular, family, and socio-community environments. The involvement of families, access to adequate infrastructure such as parks and green areas, and the responsible use of technology, including active video games and the role of influencers on social networks, are presented as key elements to combat a sedentary lifestyle. Conclusions: It is important to highlight the importance of establishing socio-educational programs that adopt a comprehensive approach to promote physical activity in children and youth, highlighting the scientific evidence that supports the effectiveness of intervening in multiple scenarios. This review concludes that a coordinated approach between different actors (schools, families, communities) is necessary to ensure that children and youth reach adequate levels of physical activity, which not only improves their physical health, but also their mental well-being and cognitive development.

Comparison of the Acute Effects of Virtual Reality Exergames and Core Stability Exercises on Cognitive Factors, Pain, and Fear Avoidance Beliefs in People with Chronic Nonspecific Low Back Pain.

Objective: In this study, we aimed to investigate and compare the acute effects of exergames (EXG) and core stability exercises (CSEs) on cognitive factors, pain, mood, and fear-avoidance beliefs (FAB) in individuals with chronic low back pain (CLBP). Materials and Methods: In a single-blinded clinical trial, 40 participants with CLBP were randomly assigned to either the EXG group or the CSEs group. The EXG group engaged in a single session of exergames using the Xbox Kinect device, while the CSEs group completed a single session of common core stability exercises. Measurements of attention, working memory, pain intensity, mood states, and FAB were taken before and after each intervention. Results: The results showed that a single session of EXG was significantly more effective than CSEs in improving cognitive reaction time, pain intensity, FAB, and positive mood states (P ≤ 0.05). Additionally, participants reported lower perceived exertion due to exercising following EXG compared with CSEs. Conclusion: EXG may have potential therapeutic advantages over traditional exercise interventions for CLBP.

Comparing conventional and action video game training in visual perceptual learning

Action video game (AVG) playing has been found to transfer to a variety of laboratory tasks in visual cognition. More recently, it has even been found to transfer to low-level visual "psychophysics tasks. This is unexpected since such low-level tasks have traditionally been found to be largely “immune” to transfer from another task, or even from the same task but a different stimulus attribute, e.g., motion direction. In this study, we set out to directly quantify transfer efficiency from AVG training to motion discrimination. Participants (n = 65) trained for 20 h on either a first-person active shooting video game, or a motion direction discrimination task with random dots. They were tested before, midway, and after training with the same motion task and an orientation discrimination task that had been shown to receive transfer from AVG training, but not from motion training. A subsequent control group (n = 18) was recruited to rule out any test–retest effect, by taking the same tests with the same time intervals, but without training. We found that improvement in motion discrimination performance was comparable between the AVG training and control groups, and less than the motion discrimination training group. We could not replicate the AVG transfer to orientation discrimination, but this was likely due to the fact that our participants were practically at chance for this task at all test points. Our study found no evidence, in either accuracy or reaction time, that AVG training transferred to motion discrimination. Overall, our results suggest that AVG training transferred little to lower-level visual skills, refining understanding of the mechanisms by which AVGs may affect vision.Protocol registration The accepted stage 1 protocol for this study can be found on the Open Science Framework at https://osf.io/zdv9c/?view_only=5b3b0c161dad448d9d1d8b14ce91ab11.The stage 1 protocol for this Registered Report was accepted in principle on 01/12/22. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/ZDV9C

Health promotion interventions for children and adolescents using e-health: a systematic review

Abstract Background The utilization of e-health in healthcare interventions has become increasingly prevalent due to its cost-effectiveness. Nevertheless, there is a paucity of evidence regarding the use of e-health in children, as the majority of e-health interventions are focused on adults. This study aimed to identify the components and effects of e-health intervention for the promotion of children’s health and to suggest strategies for their implementation. Methods A systematic review was conducted in accordance with the PRISMA guidelines. A literature review of relevant studies published between January 2013 and November 2023 was conducted. A search of databases including PubMed, EMBASE, CINAHL, MEDLINE, and Cochrane Review Library was conducted using a combination of medical subject headings (MeSH) and keywords. A qualitative appraisal of the studies was conducted using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). Results Sixteen studies were selected. Most studies showed good methodological quality. The majority of studies (n = 15) focused on improving children’s physical health, while only one study focused on mental health. There were a variety of components to the intervention, including internet education, web-based home-exercise, serious games, mobile apps, email counseling, and active video games, and only one type of intervention was provided, or a combination with additional methods such as phone calls and counseling. A review of the literature indicates that e-health interventions have been effective in increasing children’s physical activity, reducing weight, relieving stress, and reducing depression. Conclusions This study identified the effectiveness of e-health interventions for improving children’s physical and mental health. The use of e-health to promote children’s health should be actively developed and implemented in a variety of clinical and community settings. Key messages • E-health interventions have been demonstrated to be an effective means of improving the physical and mental health of children and adolescents. • It is recommended that health promotion interventions utilizing e-health be developed and tested in a variety of communities and settings for children and adolescents.

A Pilot Controlled Trial of Relaxation Training Combined with a Video Game Reinforcing Emotional Regulation to Improve Anger Management in Children and Adolescents.

Untreated anger and aggression in youth confer heightened risk for subsequent psychosocial problems. However, engaging youth in treatment for anger can be difficult given barriers to accessing care and high rates of attrition. This study examined whether learning relaxation skills and practicing them using a videogame, whose operation was contingent upon keeping heart rate close to baseline levels, could help children learn to manage anger and aggression. Youth ages 7-17 with elevated levels of anger (N = 39) were randomized to receive the active video game condition or a control game that displayed heart rate but did not stop the game if heart rate became elevated. Youth underwent baseline screening, 6 treatment sessions, and follow-up assessments at 2-weeks and 3-months. Compared to the control condition, children in the active condition demonstrated significantly greater improvements in clinician-rated aggression severity (d = 1.48) and youth-rated emotion dysregulation (d = 3.46) at 2-weeks post-treatment. The active group maintained these improvements at 3-month follow-up, but no longer significantly differed from the control group. Intervention effects were nonsignificant for parent-reported emotion dysregulation and aggression. In addition, the intervention group youth, but not control group, experienced increased time with heart rate below baseline over the course of the 6 sessions. Findings suggest a promising brief intervention for reducing aggression and emotion dysregulation in children while they are waiting for longer-term outpatient therapy. Clinical Trial Registration Number: NCT03270813.

Multidisciplinary teaching with an active video game: the effect on learning in mathematics and physical education

ABSTRACT Practising active video games (AVGs) requires performing motor and cognitive tasks, which might foster success in physical education and other school subjects but remains poorly investigated. This study examined the learning effects of six lessons using AVGs with physical education and mathematics content. Overall, 216 school-students composed an experimental group (n = 99) and a control group (n = 107). Both attended six lessons, each on using a Cartesian coordinate system and ball-throwing accurately, with AVGs in the experimental group only. Learning was assessed at Lessons 1 and 6, situational interest and moderate-to-vigorous physical activity (MVPA) at Lessons 3 and 5. MANOVAs showed no between-group differences in situational interest and higher MVPA for the control group at Lesson 3 only. Statistical analysis showed higher learning scores (mathematics and physical education) for the experimental group at Lesson 6, suggesting possible interest in AVGs during multidisciplinary sequences connecting physical education and mathematics.

Can playing video games enhance reading skills through more efficient serial visual search mechanisms? Insights from an eye tracking study

ABSTRACT Reading disorders are associated with atypical top-down visual attention (VA) processes like reduced VA span and slower serial visual search (SVS). In contrast, expert action video game (AVG) players, known for their efficient top-down VA, exhibit improved reading abilities. It is unclear whether these benefits stem solely from AVGs or apply to other gaming experiences. To explore this, AVG players (AVGPs), players of genres excluding AVGs (VGPs), and non-players were evaluated on their VA span, and behavioural and oculomotor performance in SVS. VGPs, but not AVGPs, demonstrated enhanced performance and oculomotor behaviour in SVS compared to non-players, while both player groups showed a trend towards better VA span skills. Notably, reading-related skills were enhanced in the two player groups, but particularly more so in VGPs. These findings support the existence of potential benefits of playing video games different from classical AVGs for the development of top-down VA and reading-related abilities.

Development of an Instrument for Evaluating Action Video Game Elements

Background Studies on the impact of videogame play on the brain and behavior demonstrates potential benefits of playing action video games (AVGs) for cognitive enhancements. However, it is becoming increasingly challenging to distinguish between AVGs and non-AVGs due to the emergence of new video game genres and platforms that incorporate action elements in historically non-action genres. Thus, more research is needed to understand AVG mechanics. Objective This study developed an Action Video Game Elements (AVGE) Likert-type scale for differentiating an AVG from a non-AVG and examined its performance in an AVG and a non-AVG. Method We employed standardized lab data collection procedures to administer the AVGE scale in undergraduate education majors after they played either an AVG ( n = 144) or a non-AVG ( n = 48). Results Exploratory factor analysis revealed a five-factor theoretically sensible structure: (1) focus, (2) pacing & goal setting, (3) challenge, (4) sensory stimulation, and (5) speed. Using an experimental research design, we examined the AVGE scale for its ability to distinguish an AVG from a non-AVG. Players who played the AVG rated the game significantly higher in all AVGE categories than their peers who played a non-AVG, thus providing empirical evidence regarding the scale’s discriminant validity of the game. Additionally, we explored the AVGE score differences in players with and without prior AVG experience in the AVG and non-AVG. Conclusion The AVGE scale has a promising internal consistency and discriminant validity. Future research can use it for examining AVG elements in various games as well as guiding the design and development of video games that aim to enhance cognition and better align these games with players’ demographics.

The Effects of Active Video Games on Physical Activity among Overweight and Obese Adolescents: A Systematic Review

The Effects of Active Video Games on Physical Activity among Overweight and Obese Adolescents: A Systematic Review

Energy Expenditure And Mood States During Two Modes Of A Virtual Reality Fitness Game

Energy Expenditure And Mood States During Two Modes Of A Virtual Reality Fitness Game

Effects of Active Video Games on Parental Support among Overweight and Obese Adolescents in China: A Pilot Study

Effects of Active Video Games on Parental Support among Overweight and Obese Adolescents in China: A Pilot Study

Effect of Action Video Games in Eye Movement Behavior: A Systematic Review.

Previous research shows that playing action video games seems to modify the behavior of eye movements such as eye fixations and saccades. The aim of the current work was to determine the effect of playing action video games on eye movements behavior such as fixations, saccades and pursuits. A systematic research review in PubMed and Scopus databases was conducted to identify articles published between 2010 and 2022 which referred to action video games and eye movements, including fixations, saccades and pursuits. We included those that were experimental and quasi-experimental, comparing at least two groups between action vs. non-action video games players. All the studies included used an eye tracker to study eye movements. A total of 97 scientific articles were found in the databases. After inclusion criteria, thirteen articles (N=13) were analyzed for the present work, of which ten (n=10) had a cross-sectional design, and three (n=3) were randomized intervention studies. Playing regularly or training with action video games is not likely to produce changes in eye movements, based on the literature research analyzed. For future research, more interventional studies, with less gender bias, more sample participants and general consensus on the distinction between the action and non-action video games is needed.

Effects of Active Video Games on Parent-Child Relationships among Overweight and Obese Adolescents in China: A Pilot Study

Effects of Active Video Games on Parent-Child Relationships among Overweight and Obese Adolescents in China: A Pilot Study

The impact of digital devices on the mental and physical health of primary school children: systematic review

The use of digital technology has permeated the lives of elementary school children, affecting aspects of their mental and physical health. While these technologies offer various benefits, there are concerns about their negative impacts such as anxiety, sleep disturbances and decreased physical activity. This study aims to evaluate the impact of digital devices on primary school children's mental and physical health through a systematic review. Using the PRISMA method, literature from PubMed, and Scopus was selected based on quality, relevance, and completeness of data. Of the initial 150 publications, 7 articles were relevant after being pre-analyzed. The results showed that physical activity is important for the health of children who actively use digital devices. Some active apps and video games increase physical activity and emotional well-being, but excessive use may pose a risk for anxiety, depression and obesity. Digital device use affects the mental and physical health of primary school children. The conclusion of this study is that parents and educators should supervise the use of digital devices to reduce negative impacts and optimally utilize technology to support children's development. Keywords: Digital technology; Mental health; Physical health; Elementary school children

Do action video game players search faster than non-players?

Do action video game players search faster than non-players?

Investigating the Effects of Exergame Training on Functional Activities Among Newly-Fitted Patients with Unilateral Transtibial Amputation: A Preliminary Study

Introduction: This preliminary study investigates the effects of adding exergame (EG) training to conventional exercises on the functional activities of newly fitted patients with unilateral transtibial amputation. Materials and Methods: A total of 22 newly fitted patients with unilateral transtibial amputation were equally and randomly divided into two groups as follows: the EG group who performed exercises and EG training and the control group who performed exercise only. The 2-min walk test, timed up and go test, amputee mobility predictor with prosthesis test, and physiological cost index were assessed at baseline and after 2 and 4 weeks of the intervention. Results: Both interventions effectively improved the 2-min walk test distance, timed up-and- go test, and the amputee mobility predictor with prosthesis test scores in patients with newly fitted transtibial amputation (P<0.001). Additionally, a significant improvement was observed in the timed up-and-go test time in the EG group versus the control group after the 4-week intervention (P=0.04, effect size=0.53). Conclusion: The findings of this preliminary study further support that adding EG to exercises significantly increases movement speed among amputee patients.

Enhanced “learning to learn” through a hierarchical dual-learning system: the case of action video game players

In contrast to conventional cognitive training paradigms, where learning effects are specific to trained parameters, playing action video games has been shown to produce broad enhancements in many cognitive functions. These remarkable generalizations challenge the conventional theory of generalization that learned knowledge can be immediately applied to novel situations (i.e., immediate generalization). Instead, a new “learning to learn” theory has recently been proposed, suggesting that these broad generalizations are attained because action video game players (AVGPs) can quickly acquire the statistical regularities of novel tasks in order to increase the learning rate and ultimately achieve better performance. Although enhanced learning rate has been found for several tasks, it remains unclear whether AVGPs efficiently learn task statistics and use learned task knowledge to guide learning. To address this question, we tested 34 AVGPs and 36 non-video game players (NVGPs) on a cue-response associative learning task. Importantly, unlike conventional cognitive tasks with fixed task statistics, in this task, cue-response associations either remain stable or change rapidly (i.e., are volatile) in different blocks. To complete the task, participants should not only learn the lower-level cue-response associations through explicit feedback but also actively estimate the high-level task statistics (i.e., volatility) to dynamically guide lower-level learning. Such a dual learning system is modelled using a hierarchical Bayesian learning framework, and we found that AVGPs indeed quickly extract the volatility information and use the estimated higher volatility to accelerate learning of the cue-response associations. These results provide strong evidence for the “learning to learn” theory of generalization in AVGPs. Taken together, our work highlights enhanced hierarchical learning of both task statistics and cognitive abilities as a mechanism underlying the broad enhancements associated with action video game play.

Assessment of the intensity and attractiveness of physical exercise while playing table tennis in an immersive virtual environment depending on the game mode

BackgroundIt appears that active video games (AVGs) and training apps that allow for physical activity (PA) in immersive virtual reality (VR) may be useful for sports, health-enhancing PA, and physical education (PE). Therefore, research is needed to identify their potential.ObjectiveThe study aimed to evaluate the intensity and attractiveness of exercise during table tennis (TT) training in VR in arcade and simulation modes and to assess the potential for using such exercises in health-enhancing PA, sport, and PE.MethodsThe research used the Racket Fury: Table Tennis VR. Exercise intensity during TT training in VR was evaluated by heart rate (HR) monitoring and rating of perceived exertion (RPE 6–20). The effectiveness of short-term TT training in VR was estimated based on the user’s performance in playing against an opponent with artificial intelligence (AI), satisfaction with playing TT was measured using the Physical Activity Enjoyment Scale (PACES), and the potential usefulness of the tested app in PA, sport, and PE was assessed based on a questionnaire for participating PE teachers (30 participants).ResultsPA intensity during TT training in VR expressed as a percentage of maximum heart rate (HRmax) was moderate but was significantly (p < 0.001; d=-0.830) higher in the easier arcade mode (69.50 ± 12.58%HRmax) than in the simulation mode (64.10 ± 9.67%HRmax). Despite the greater fatigue of respondents, user satisfaction was significantly higher in arcade mode. Users’ performance when playing with AI was significantly better after 20 min of training in VR than before training. PE teachers recognize the great potential of the app.ConclusionsThe application tested is characterized by a beneficial PA intensity, with its level depending on the game mode. Facilitating strokes during a game of virtual TT promotes increased intensity of exercise and increased enjoyment of the PA. Short-term TT training in VR improves playing skills in a virtual environment. PE teachers spoke highly of the app and recognized the potential for using VR technology in PA, sports, and school PE.

Effect of Elastic Resistance on Exercise Intensity and User Satisfaction While Playing the Active Video Game BoxVR in Immersive Virtual Reality: Empirical Study.

One of the main contemporary forms of physical activity (PA) involves exercises and games in an immersive virtual reality (VR) environment, which allows the user to practice various forms of PA in a small space. Unfortunately, most of the currently available VR games and workout applications are mostly based on upper body movements, especially the arms, which do not guarantee sufficiently high exercise intensity and health benefits. Therefore, it is worth seeking solutions to help increase the exercise load during PA in VR. The main aim of this study was to evaluate the effect of elastic arm resistance in the form of latex resistance bands of different elasticity levels on the intensity of students' PA while playing the BoxVR game. We further assessed the satisfaction of this form of exercise and its associations with PA intensity. A total of 21 healthy and physically fit men (mean age 22.5, SD 2.0 years) were included in the study. The tests consisted of 3 10-minute games. One game was run with no load and the other two were run with 1.5-meter latex resistance bands (low and high resistance). The order of the tests was randomized and the participants rested for 20 minutes after each exercise. Exercise intensity was estimated using objective (heart rate monitoring) and subjective (Borg scale) methods. The Physical Activity Enjoyment Scale was used to assess satisfaction with the PA. The effect of elastic resistance on exercise intensity and user enjoyment was estimated using ANOVA for repeated measures. The ANOVA results indicated that incorporation of elastic resistance caused a significant change (F2,40=20.235, P<.001; η²p=0.503) in the intensity of PA in VR, which was low while playing without resistance and then increased to a moderate level with additional resistance. The use of elastic bands also changed participants' perceptions of the enjoyment of exercise in VR (F2,40=9.259, P<.001; η²p=0.316). The students rated their satisfaction with PA in VR on a 7-point scale highly and similarly when exercising without an upper limb load (mean 6.19, SD 0.61) and with slight elastic resistance (mean 6.17, SD 0.66), whereas their satisfaction declined significantly (mean 5.66, SD 0.94) when incorporating a higher load. The intensity of PA among students playing the BoxVR game is at a relatively low level. With the added resistance of elastic bands attached to the upper limbs, the intensity of the exercise increased to a moderate level, as recommended for obtaining health benefits. Participants rated the enjoyment of PA in VR highly. The use of slight elastic resistance did not negatively affect satisfaction with the BoxVR game, although user satisfaction declined with a higher load. Further research should be undertaken to increase the effectiveness of exercise in VR so that regular users can enjoy the health benefits.

Active video games as an adjunct to pulmonary rehabilitation of patients with Chronic Obstructive Pulmonary Disease: a commentary on a systematic review

Pulmonary rehabilitation is a key evidence-based intervention to improve the outcomes of people living with Chronic Obstructive Pulmonary Disease (COPD). However, there are challenges in delivering pulmonary rehabilitation including reduced referral rates and suboptimal uptake and completion rates. Active video game interventions, when used as an adjunct, may increase the adoption of and access to pulmonary rehabilitation. This commentary summarises and critically appraises a systematic review which investigated the effectiveness of active video games as a supplementary component in the pulmonary rehabilitation of individuals suffering from chronic obstructive pulmonary disease.