Exergaming Group Research Articles

Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: A Randomized Controlled Trial

ObjectivesPeople with dementia are known to be physically frailer, more sedentary, and participate less in regular physical exercise compared to their healthy peers. Physical activity interventions have the potential to reduce the level of frailty in community-dwelling older adults. Exergaming combines physical exercise with cognitive stimulation in a virtual environment. It is an innovative and fun way of exercising, which may aid people with dementia to be more physically active. The primary aim of this study was to investigate the efficacy of a 12-week exergame training and equally long aerobic training, both compared to an active control group, on frailty in people with dementia. DesignA 3-armed randomized controlled trial compared exergame training, aerobic training, and an active control intervention. Participants115 people with dementia [mean (standard deviation [SD]) age = 79.2 (6.9) years; mean (SD) Mini-Mental State Examination score = 22.9 (3.4)]. MethodsParticipants were randomized and individually trained 3 times a week during 12 weeks. The Evaluative Frailty Index for Physical activity (EFIP) was used to assess the level of frailty at baseline and after the 12-week intervention period. Between-group differences were analyzed with analysis of covariance. ResultsThe exergame group showed a trend toward higher adherence compared to the aerobic group (87.3% vs 81.1%, P = .05). A significant reduction on the EFIP was found in the exergame group (EG) compared to the active control group (CG) [mean difference (95% confidence interval) between EG and CG: −0.034 [–0.062, −0.007], P = .012], with a small-to-moderate effect size (partial η2 = 0.055). Conclusions and implicationsThis is the first study to show that a 12-week exergame intervention reduces the level of frailty in people with dementia. This is an important and promising result, because frailty is a powerful predictor for adverse health outcomes, and its reduction may have positive effects on health status. Moreover, exergaming resulted in high adherence rates of physical exercise, which makes it an effective strategy to engage people with dementia in physical activity.

Exergaming Improves Executive Functions in Patients With Metabolic Syndrome: Randomized Controlled Trial.

BackgroundRecent studies indicate that participation in exercise-related games can improve executive function, attention processing, and visuospatial skills.ObjectiveThe aim of this study was to investigate whether exercise via exergaming (EXG) can improve executive function in patients with metabolic syndrome (MetS).MethodsA total of 22 MetS patients were recruited and randomly assigned to an EXG group or a treadmill exercise (TE) group. The reaction time (RT) and electrophysiological signals from the frontal (Fz), central (Cz), and parietal (Pz) cortices were collected during a Stroop task after 12 weeks of exercise.ResultsDuring the Stroop congruence (facilitation) judgment task, both the EXG and TE groups showed significantly faster RT after 12 weeks of exercise training. For N200 amplitude, the EXG group demonstrated significantly increased electrophysiological signals from the Fz and Cz cortices. These changes were significantly larger in the EXG group than in the TE group. Separately, for the P300 amplitude, the EXG groups presented significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices, whereas the TE group showed significantly increased electrophysiological signals from the Cz and Pz cortices only. During the Stroop incongruence (interference) judgment task, both the EXG and TE groups showed significantly faster RT. For P300 amplitude, the EXG group had significantly increased electrophysiological signals from the Fz and Cz cortices only, whereas the TE group had significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices.ConclusionsEXG improves executive function in patients with MetS as much as normal aerobic exercise does. In particular, a unique benefit of EXG beyond increased aerobic capacity is the improved selective attention among cognitive functions. Thus, EXG could be recommended to someone who needs to improve their brain responses of concentration and judgment as well as physical fitness.Trial RegistrationClinicalTrials.gov NCT04015583; https://clinicaltrials.gov/ct2/show/NCT04015583

Effects of Kinect-based exergaming on frailty status and physical performance in prefrail and frail elderly: A randomized controlled trial

Frailty status can be improved by intervention. Both exergaming and combined exercise have been proposed for improving physical performance in community-dwelling elderly. However, whether frailty status can be improved by exergaming is unclear. Moreover, whether Kinect-based exergaming training can exert a stronger effect on improving frailty status than combined exercise needs to be established. The aim of this study was to investigate the effects of Kinect-based exergaming on improving frailty status and physical performance in the prefrail and frail elderly by comparing its effects with those of combined exercise. Fifty-two prefrail and frail elderly were recruited and randomized to the Kinect-based exergaming group (EXER group) or combined exercise group (CE group), emphasizing resistance, aerobic, and balance training for 36 sessions over 12 weeks. Our results showed that both groups improved the frailty status (EXER group: p = 0.016, effect size = 2.29; and CE group: p = 0.031, effect size = 2.67). Three out of 5 physical characteristics of the frailty phenotype, namely, weakness, slow walking speed, and low activity level, were significantly reversed by both exergaming and combined exercise. However, the exergaming training also significantly reversed exhaustion. Furthermore, compared with the CE group, the EXER group showed greater improvement in dynamic balance control, as indicated by the forward reaching test (p = 0.0013, effect size = 0.40) and single leg stance test (p = 0.049, effect size = 0.42). Thus, Kinect-based exergaming exerted effects that were at least as beneficial as those of combined exercise in improving frailty status and the frailty phenotype. We recommend the use of exergaming aided by Kinect in the prefrail and frail elderly.

Home-based 'exergaming' was safe and significantly improved 6-min walking distance in patients with prostate cancer: a single-blinded randomised controlled trial.

To explore the effects of 12weeks of unsupervised home-based 'exergaming' (i.e., technology-driven exercise) compared to usual care on physical function, body composition, quality of life (QoL), and fatigue in patients with prostate cancer on androgen-deprivation therapy (ADT). In an assessor-blinded randomised controlled trial, 46 patients with prostate cancer (aged >65years) with locally advanced or advanced stage disease undergoing ADT were randomised to 12weeks of unsupervised home-based exergaming or usual care from two hospitals in Denmark. The primary outcome of the study was 6-min walking test (6MWT). Secondary outcomes were leg extensor power (LEP), body composition (lean- and fat-mass), self-reported physical functioning and global health status (European Organisation for Research and Treatment of Cancer quality of life questionnaire 30-item core [EORTC QLQ-C30]), QoL (Functional Assessment of Cancer Therapy - Prostate [FACT-P]) and fatigue (FACT - fatigue [FACT-F]). There was significant improvement in the exergaming group compared to the usual care group in the primary outcome of 6MWT (mean difference: 21.5m; 95% confidence interval ([CI]) 3.2-39.9; P=0.023). There were no differences between the groups for LEP (P=0.227), lean body mass (P=0.100), fat body mass (P=0.092), self-reported physical functioning (P=0.084) and global health status (P=0.113), QoL (P=0.614), and fatigue (P=0.147). Unsupervised home-based exergaming for 12weeks had an effect on the primary outcome of 6MWT in patients with prostate cancer receiving ADT. However, no significant effects were found in secondary outcomes. The exergaming intervention appeared safe and could be an alternative to traditional aerobic and resistance training in this patient group.

Effects of Exergaming on Preschoolers' Executive Functions and Perceived Competence: A Pilot Randomized Trial.

Purpose: This study aimed to evaluate the effects of a child-centered exergaming program and a traditional teacher-led physical activity (PA) program on preschoolers’ executive functions and perceived competence. Methods: Sixty children aged 4–5 years from an urban childcare center in China completed an 8-week exergaming/traditional PA intervention. After baseline measurements of executive functions and perceived competence (i.e., perceived physical competence and social acceptance), children were randomly assigned to either an exergaming group or traditional PA group (30 children per group). Exergaming and traditional PA programs were offered 20 min/session by trained instructors for 8 weeks. Post-intervention measures were identical to baseline measures. Results: In general, children’s executive functions, perceived physical competence, and perceived social acceptance were enhanced over time. Analysis of variance revealed significant time by group interaction effects for executive functions, F(1, 58) = 12.01, p = 0.01, and perceived social acceptance, F(1, 58) = 6.04, p = 0.02, indicating that the exergaming intervention group displayed significantly greater increases in executive functions and perceived social acceptance in comparison with traditional PA children. In addition, children’s executive functions and perceived physical and social competence significantly improved from baseline to post-intervention. However, there was no significant difference in the increase of children’s perceived physical competence across groups over time. Conclusion: The results suggested exergaming to be beneficial in enhancing young children’s executive functions and perceived social acceptance compared to the traditional PA program. More diverse samples with a longer intervention duration in preschool children in urban areas are warranted.

The effectiveness and cost-effectiveness of strength and balance Exergames to reduce falls risk for people aged 55\u2009years and older in UK assisted living facilities: a multi-centre, cluster randomised controlled trial

BackgroundFalls are the leading cause of fatal and non-fatal unintentional injuries in older people. The use of Exergames (active, gamified video-based exercises) is a possible innovative, community-based approach. This study aimed to determine the effectiveness of a tailored OTAGO/FaME-based strength and balance Exergame programme for improving balance, maintaining function and reducing falls risk in older people.MethodsA two-arm cluster randomised controlled trial recruiting adults aged 55 years and older living in 18 assisted living (sheltered housing) facilities (clusters) in the UK. Standard care (physiotherapy advice and leaflet) was compared to a tailored 12-week strength and balance Exergame programme, supported by physiotherapists or trained assistants. Complete case analysis (intention-to-treat) was used to compare the Berg Balance Scale (BBS) at baseline and at 12 weeks. Secondary outcomes included fear of falling, mobility, fall risk, pain, mood, fatigue, cognition, healthcare utilisation and health-related quality of life, and self-reported physical activity and falls.ResultsEighteen clusters were randomised (9 to each arm) with 56 participants allocated to the intervention and 50 to the control (78% female, mean age 78 years). Fourteen participants withdrew over the 12 weeks (both arms), mainly for ill health. There was an adjusted mean improvement in balance (BBS) of 6.2 (95% CI 2.4 to 10.0) and reduced fear of falling (p = 0.007) and pain (p = 0.02) in the Exergame group. Mean attendance at sessions was 69% (mean exercising time of 33 min/week). Twenty-four percent of the control group and 20% of the Exergame group fell over the trial period. The change in fall rates significantly favoured the intervention (incident rate ratio 0.31 (95% CI 0.16 to 0.62, p = 0.001)). The point estimate of the incremental cost-effectiveness ratio (ICER) was £15,209.80 per quality-adjusted life year (QALY). Using 10,000 bootstrap replications, at the lower bound of the NICE threshold of £20,000 per QALY, there was a 61% probability of Exergames being cost-effective, rising to 73% at the upper bound of £30,000 per QALY.ConclusionsExergames, as delivered in this trial, improve balance, pain and fear of falling and are a cost-effective fall prevention strategy in assisted living facilities for people aged 55 years or older.Trial registrationThe trial was registered at ClinicalTrials.gov on 18 Dec 2015 with reference number NCT02634736.

A 12-week randomized controlled pilot study of dance exergaming in a group: Influence on psychosocial factors in adolescent girls.

Dance exergaming, which involves playing an interactive video game that requires the player to make upper and lower body movements by dancing to music, may provide a social physical activity experience that positively impacts psychosocial health. The objective of this randomized controlled study was to examine the effects of group-based dance exergaming on adolescent girls' psychosocial health including enjoyment, subjective health, perceived peer support, and health-related quality of life. Forty-one adolescents with overweight/obesity were randomly assigned to a 12-week dance exergaming intervention or to a control group. Peer support, subjective health, and health-related quality of life (HRQOL) were assessed pre- and post-intervention, and intervention participants rated enjoyment after each exergaming session. Repeated measures analysis of covariance models controlling for age and baseline body mass index were used to examine condition differences. Results indicated that subjective health improved in the exergaming condition more than control (p = .02). Ratings of peer conflict after the intervention were significantly different by condition (p = .01), with peer conflict stabilizing in the exergaming group and worsening in the control group. There was no difference by condition for HRQOL. Enjoyment remained high throughout the intervention. In summary, group exergaming improved subjective health, stabilized peer conflict, and provided an enjoyable physical activity experience for overweight adolescent girls.

EXERGAMES TO REDUCE FALLS RISK IN OLDER PEOPLE IN UK ASSISTED LIVING FACILITIES: A MULTI-CENTRE, CLUSTER RCT

Falls are the leading cause of fatal and non-fatal unintentional injuries in older people. The use of Exergames (active video-games) is a possible innovative, community-based approach to reduce falls risk. The objective of this study was to evaluate the effectiveness of a tailored physiotherapy-based Exergame programme for reducing falls risk in older residents of assisted living facilities in the UK. A multi-site, two-arm cluster randomised controlled trial with 3 month follow up of falls in eighteen assisted-living facilities in the UK was conducted. Tailored 12-week strength and balance Exergame programme, supported by physiotherapists or assistants plus standard care (physio advice and leaflet) against standard care only, in older adults dwelling in assisted living facilities. The primary outcome measure was balance as assessed by the Berg Balance scale (BBS). Secondary outcomes included fear of falling, mobility, pain, falls risk, fatigue, cognition and incidence of falls. Eighteen sites were recruited and randomised to each intervention (106 participants of which 56 Exergames; 50 control). Intention-to-treat analysis revealed that balance was significantly improved at 12 wks in the Exergame group with an adjusted mean increase in BBS of 6.18 (95% CI 2.38 to 9.97) and significant improvements in secondary outcomes of fear of falling and pain. Falls rate was significantly lower in the Exergames group (incidence rate ratio 0.40, (95%CI 0.22 to 0.74, p=0.001). Exergames, as delivered in this trial, improve balance, pain and fear of falling and may be considered as a fall prevention strategy in assistive living facilities for older people.

The Effectiveness and Cost-Effectiveness of Strength and Balance Exergames to Reduce Falls Risk for Older People in UK Assisted Living Facilities: A Multi-Centre, Cluster Randomised Controlled Trial

Background: Falls are the leading cause of fatal and non-fatal unintentional injuries in older people. In the community, 30% of adults aged 65 fall per year. The use of Exergames (active video-based exercise games) is a possible innovative, community-based approach to improve balance and function, and thus reduce falls risk. Objective: To determine the effectiveness of a tailored OTAGO based strength and balance Exergame programme for improving balance, maintaining function and reducing falls risk in older residents of assisted living facilities in the UK. Design: A two-arm cluster randomised controlled trial. Participants and setting Adults aged 55 years and older living in 18 assisted-living (sheltered housing) facilities (clusters) in the UK. Interventions: Tailored 12-week strength and balance Exergame programme, supported by physiotherapists or trained assistants plus standard care (physiotherapy advice and leaflet) versus standard care only. Main outcome measures: The primary outcome measure was balance at 12 weeks post-baseline, as assessed by the Berg Balance Scale (BBS). Secondary outcomes included: fear of falling, mobility, self-reported physical activity, falls risk, pain, mood, fatigue, cognition, healthcare utilisation and health-related quality of life; and self-reported falls over a 3-month period. Randomisation and blinding Clusters were randomised in blocks of two after participants were recruited and baseline data were collected. No blinding of those delivering or receiving the interventions, collecting or analysing data was possible. Results: Eighteen clusters were randomised (9 to each arm) with 56 participants allocated to the intervention and 50 to the control condition (78% female, mean age 78 years). Fourteen participants withdrew over the 12 weeks, mainly due to ill health, drop out rates did not differ per arm. Intention-to-treat analysis of respondents (49 Exergames; 43 control) revealed that balance was significantly improved at 12 weeks in the Exergame group; adjusted mean improvement in balance (BBS) of 6.2 (95% CI 2.4 to 10.0) and significant improvements in falls rate (p=0.001), fear of falling (p=0.007) and pain (p=0.02).The mean attendance at Exergames sessions during 12 weeks was 69% with a mean exercising time of 33 minutes/week. In the control group 12 (24%) participants fell 38 times over 3 months compared to 11 (20%) participants of the Exergame group who fell 17 times. The change in falls rates significantly favoured the intervention (incident rate ratio 0.31 (95% CI 0.16 to 0.62, p=0.001)). The point estimate of the incremental cost effectiveness ratio (ICER) was £15,209.80 per QALY. Using 10,000 bootstrap replications, at the lower bound of the NICE threshold of £20,000 per QALY, there was a 61% probability of Exergames being cost-effective. This rose to 73% at the upper bound of £30,000 per QALY. Conclusion: Exergames, as delivered in this trial, improve balance, pain and fear of falling and are an effective fall prevention strategy in assisted living facilities for older people. Health economic analysis suggests that Exergames represent a cost-effective fall prevention strategy. Clinical Trial Registration: Trial Registration ClinicalTrials.gov: NCT02634736 Funding Statement: This study was funded by Innovate UK through their SBRI programme. LM acknowledges financial support from the MRC Skills Development Fellowship (MR/N015126/1). The authors would like to acknowledge the contributions of Ms Kelly Banham, Ms Margaret Clarke, Ms Tina Duckworth, Ms Megan Lloyd, Dr Katie Thomson, Dr Calum Leask, Trafford Housing Trust, Pennine Care NHS Falls Service (Ms Debra Maloney, Dr Jay Chillala, Ms Angela Easdon), Mr Bibhas Roy, Dr Richard Deed, Prof Jackie Oldham, Dr Mark Pilling, Ms Joanne Thomas, Ms Bernadette O’Dowd. Declaration of Interests: Dawn Skelton is a Director of Later Life Training, a not for profit training company that provides training in delivery of the Otago and FaME Programmes with the UK, Europe and Singapore. No other conflicts of interest are declared. Ethics Approval Statement: Ethics approvals for this study were obtained from London - Camden & Kings Cross Research Ethics Committee, reference number 16/LO/0200.

Acute Physical Activity Enhances Executive Functions in Children with ADHD

Acute physical activity of moderate to vigorous intensity has been shown to improve cognitive functions in children. However, the empirical evidence associated with Attention Deficit Hyperactivity Disorder (ADHD) in children is still limited, in particular regarding which specific cognitive functions benefit. This study investigated the effects of an acute bout of physical activity on multiple aspects of executive functions (inhibition, switching, and visual working memory) in children with ADHD. Forty-six children (8–12 years old; 82.6% boys) were randomly assigned to either 15 minutes of acute exergaming (physical activity of moderate intensity) or to a control condition (sedentary). Executive function performance in inhibition, switching and visual working memory were assessed before and after each condition, using a modified version of both the Flanker and the Color Span Backwards Task. The results revealed that participants in the exergaming group performed significantly faster than those in the control group in terms of both inhibition and switching, but there was no significant difference in the accuracy of the two tasks nor in visual working memory performance. These findings suggest that acute physical activity utilizing exergaming has the potential to improve specific aspects of executive functions (reaction times in inhibition and switching) in children with ADHD.

Concurrent exergaming and transcranial direct current stimulation to improve balance in people with Parkinson\u2019s disease: study protocol for a randomised controlled trial

BackgroundPeople with Parkinson’s disease (PD) commonly experience postural instability, resulting in poor balance and an increased risk of falls. Exercise-based video gaming (exergaming) is a form of physical training that is delivered through virtual reality technology to facilitate motor learning and is efficacious in improving balance in aged populations. In addition, studies have shown that anodal transcranial direct current stimulation (a-tDCS), when applied to the primary motor cortex, can augment motor learning when combined with physical training. However, no studies have investigated the combined effects of exergaming and tDCS on balance in people with PD.Methods/designTwenty-four people with mild to moderate PD (Hoehn and Yahr scale score 2–4) will be randomly allocated to receive one of three interventions: (1) exergaming + a-tDCS, (2) exergaming + sham a-tDCS or (3) usual care. Participants in each exergaming group will perform two training sessions per week for 12 weeks. Each exergaming session will consist of a series of static and dynamic balance exercises using a rehabilitation-specific software programme (Jintronix) and 20 minutes of either sham or real a-tDCS (2 mA) delivered concurrently. Participants allocated to usual care will be asked to maintain their normal daily physical activities. All outcome measures will be assessed at baseline and at 6 weeks (mid-intervention), 12 weeks (post-intervention) and 24 weeks (3-month follow-up) after baseline. The primary outcome measure will be the Limits of Stability Test. Secondary outcomes will include measures of static balance, leg strength, functional capacity, cognitive task-related cortical activation, corticospinal excitability and inhibition, and cognitive inhibition.DiscussionThis will be the first trial to target balance in people with PD with combined exergaming and a-tDCS. We hypothesise that improvements in balance, functional and neurophysiological outcome measures, and neurocognitive outcome measures will be greater and longer-lasting following concurrent exergaming and a-tDCS than in those receiving sham tDCS or usual care.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12616000594426). Registered on 9 May 2016.

Differences in Step Counts, Motor Competence, and Enjoyment Between an Exergaming Group and a Non-Exergaming Group.

The purpose of this study was to examine the effect of an exergaming program on physical activity, motor competence, and enjoyment in preschool children. A sample of 65 preschool children was recruited from an urban preschool located in the Western United States. Children were randomly assigned to either an exergaming (n = 36) or a free-play group (n = 29). The intervention was 30 min/day, 5 days/week for 12 weeks for both groups, and all outcome variables were measured once during the final week of the intervention. The exergaming program included three active videogames: GoNoodles, Adventure to Fitness, and Cosmic Kids Yoga. Children in the free-play group were offered a variety of sport activities. School-day step counts were recorded using pedometers, motor competence was assessed by the Test for Gross Motor Development-Edition 3 (TGMD-3), and enjoyment was accessed using one subscale of the Intrinsic Motivational Inventory. A 2 × 2 multivariate analysis of variance (MANOVA) test was employed to examine the differences between sexes and groups on the outcome variables. The omnibus MANOVA yielded a statistically significant multivariate group main effect (F = 3.71, P = 0.016). Follow-up tests revealed statistically significant differences between groups on average school step counts (mean difference = 785 steps, P = 0.003, d = 0.68) and total TGMD-3 scores (mean difference = 8.7, P = 0.019, d = 0.51), with the exergaming group displaying higher mean scores compared with the free-play group. Young children who were randomly assigned to the exergaming group demonstrated higher school-day step counts and higher motor competence levels compared with the free-play group. These results support the use of this modality in childcare settings.

Kinect-based exergaming to improve frailty status and physical performances in the frail and pre frail elderly

Frailty is a multisystem degeneration. It is becoming recognized that frailty may be a pre-disability state. Exercise training is proved to improve physical performance and health status in the elderly. Kinect is an affordable and accessible exergaming systems. Whether Kinect-based exergaming is efficient in improving physical performances and reverse the deterioration process in frail and pre-frail elderly require further investigation. The purpose of this study is to investigate the effect of Kinect-based exergaming on frailty status, physical performances in pre-frail and frail elderly. We recruited frail and pre-frail elderly people in the elderly day care centers and institutions. Participants were randomized to two group and received 60 minutes Kinect-based exergaming or multi-component exercise for 36 sessions over 12 weeks according to their group assignment. Programs in both groups include muscle strengthening, aerobic exercise, balance training and cognitive training. Outcome measures include frailty status and physical performances. Fifty-two pre-frail and frail elderly finished all the intervention and assessment. Both groups showed improvements in frailty scores after intervention. The frailty components revealed that weakness, exhaustion, low physical activity, and slow walking speed were reversed in both group, but unintentional weight loss did not significantly changed. Both groups also showed improvements in most parts of the physical performances after intervention. For between group differences, Kinect-based exergaming group showed more improvement in forward reaching distance than multi-component exercise group. Kinect-based exergaming can reverse the frailty status and improve physical performances. Our results provided information to support the possibility of therapeutic use of exergaming training in the frail and pre-frail elderly.

A randomized controlled pilot trial of game-based training in individuals with spinocerebellar ataxia type 3

Exergames are interactive video games used for exercise and may have therapeutic value in people with degenerative ataxia. The purpose of this study was to investigate potential effects of exergaming training on cerebellar ataxia in people with spinocerebellar ataxia type 3 (SCA3). Nine individuals with SCA3 were recruited and randomized to either exergaming or conventional group for a 4-week training period. The severity of ataxia was measured as the primary outcome by the Scale for the Assessment and Rating of Ataxia (SARA) and by the directional control of the limit of stability test. The secondary outcomes included upper-limb function and gait performance. After training, participants in the exergaming group had a significant decrease in the total SARA score and the gait-posture SARA subscore. Participants in the conventional training group did not show a significant improvement in selected outcome measures after the 4-week training period. No significant difference was found between groups for any of these measures. Our results suggested that the exergaming training program significantly decreased ataxia. These results support implementation of exergaming training for people with SCA3.

Effect of Nintendo WII Brain Training Games on Perceptual Speed, Working Memory and Spatial Orientation in Young Adults

Young adults are presumed to be healthy but the available evidences indicates a gradual decline of about -0.02SD of fluid abilities starting in third decade of life. Brain training games are the new emerging methods for various domains of cognitive training. The purpose of this study is to identify the effectiveness of brain training games for perceptual speed, working memory and spatial orientation in young adults. Forty-eight healthy young adults who were willing to participate in the study were recruited. After taking informed consent, participants were assigned to either of two groups by lottery method (Nintendo WII brain training group, Nintendo WII Exergame group). Participants in both the groups played their games for about 30-45 minutes per day, 5 days a week for 4 weeks. Measures of the cognitive function the Number Comparison Test, Trail Making Test, Backward Digit Span Test and Perspective Taking Spatial Orientation Test were conducted before and after intervention. The comparison of pre-intervention result of the two groups revealed no significant difference in all variables, while significant improvements were observed in all measuring variables of the two groups when comparing their pre and post treatment mean values. Furthermore, the Nintendo brain training groups showed a significant improvement in Number Comparison Test (p=0.02), Trail Making Test Part A (p=0.03) And B (p=0.05), Backward Digit Span Score Measure (P=0.02) and Perspective Taking Spatial Orientation Test (p=0.01) as compared to the Nintendo WII exergaming group. However no significant difference was noted on Backward Digit Span Length Measure. Nintendo WII brain training games are more efficient in improving perceptual speed, working memory and spatial orientation in young adults than Nintendo WII exergames.

Exergames Designed for Older Adults: A Pilot Evaluation on Psychosocial Well-Being.

Exergames are increasingly been used in the primary healthcare domain for older adults who are 65 years and above. However, most of the exergames on current market are not designed for the aging population. The current study introduced five new exergames developed for elderly and evaluated their benefits. Five new exergames were developed by researchers from Finland, Singapore, and Japan, in which the game topics, difficulties, and user interface were designed particularly for older adults. A between-group pilot study was further conducted to evaluate their psychosocial effects by comparing to traditional exercise and care-as-usual program, with a sample of 30 community-dwelling older adults in Singapore. Results showed that exergame group had significantly higher exercise enjoyment over other two groups. Exergame group has lower self-efficacy than other two groups, although it was not statistically significant. Significant subgroup difference was detected in neither life satisfaction nor loneliness across the three groups. The study highlighted the effect of fun and entertainment elements on the psychosocial effect of exergames and called for simpler interactive systems and easier exergame tasks for the older adults.

Serious games for arm rehabilitation of persons with multiple sclerosis. A randomized controlled pilot study

ObjectivesThe feasibility and preliminary evidence for efficacy of a serious games platform compared to exergame using the Wii for arm rehabilitation in persons with multiple sclerosis (MS) was investigated. MethodsA pilot single-blind randomized (2:1) controlled in clinic trial was carried out. Sixteen persons with MS participated (age years 56.8 (SD 12.3), MS-onset years 19.4 (SD 12.3), EDSS 6.5). Ten participants used a serious games platform (Rehab@Home) while 6 participants played with the commercial Wii platform, for four weeks (40min, 12 sessions/4 weeks). Feasibility and user experience measures were collected. Primary outcomes were the 9 Hole Peg Test (9HPT) and the Box and Block test (BBT). Secondary outcomes were the EQ-5D visual analogue scale (EQ-VAS) and the SF-12. Nonparametric analysis was used to verify changes from pre to post rehabilitation within group and treatment effect was verified with Mann-Whitney U test. P value was set at 0.10 and clinical improvement was set at 20% improvement from baseline. ResultsSerious games were perceived positively in terms of user experience and motivation. There were clinically significant improvements in arm function in the serious games group as measured by 9HPT (38–29.5s, P = 0.046, > 20%) and BBT 32–42 cubes, P = 0.19, > 20%) following the 12 gaming sessions while the exergame group did not improve on either test (9HPT 34.5–41.5s, P = 0.34; BBT 38,5 to 42 cubes, P = 0.34). Only the exergame group perceived themselves as having improved their health. There was a significant between groups treatment effect only in perception of health (EQ-VAS) (Z = 1.93, P = 0.06) favouring the exergame group. ConclusionsVirtual reality in a serious gaming approach was feasible and beneficial to arm function of persons with MS but motivational aspects of the approach may need further attention.

Abstract 4219: An exergaming intervention to reduce breast cancer risk in Black women

Abstract Obesity and low physical activity rates contribute to high rates of postmenopausal breast cancer in Black women. Use of new and exciting strategies to increase physical activity should be tested in health disparity populations at high risk of cancer. We tested the effect of a six-month exercise intervention using the active videogaming systems (exergaming) on anthropometric markers, body composition, and cardiovascular fitness (VO2max) in overweight and obese Black women. We conducted a six-month, two-arm randomized clinical trial comparing an exergaming intervention group to a control group in 100 cancer-free, overweight/obese, sedentary Black women who were 40-59 years of age. Participants were randomized to a supervised facility-based exergaming group (n=50) or a usual care control group (n=50). Participants in the exergaming group followed an exercise program using the Nintendo Wii Fit and/or the X-Box Kinect gaming systems under supervision of a clinical exercise physiologist. Control group participants were asked to maintain their normal daily activities. Endpoints were assessed at baseline, 3 months, and 6 months. Assessments included measurements of demographic variables, medical history, physical activity, VO2max, anthropometric variables (height, weight, waist and hip circumferences), and body composition. Distribution of baseline characteristics between exergaming and control groups was comparable except for education status and BMI. Data on 3 month and 6-month follow-up were available for 66 participants. Follow-up rates were similar for exergaming and control groups. Compared to control group participants whose waist circumference on average remained unchanged, exergaming group participants had lower waist circumference at 3-months and 6- months compared to baseline (mean change: -2.54 cm, P=0.05). Exergaming participants also had small changes in weight (-1.4 lbs) at 6 months compared to control group in whom average weight remained unchanged but this finding was not statistically significant. Fat mass and lean mass as measured by DXA did not show any changes at 3-months or 6-months in either the exergaming or the control group. This pilot study of a short-term exergaming in overweight/obese Black women was associated with small changes in waist circumference in the intervention group. Given the challenges associated with traditional physical activity interventions to reduce cancer risk, new and non-traditional interventions like exergaming should be tested in larger studies in health disparity populations. Citation Format: Chiranjeev Dash, Jennifer Hicks, Vivian Watkins, Mary Mills, James Hagberg, Lucile L. Adams-Campbell. An exergaming intervention to reduce breast cancer risk in Black women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4219. doi:10.1158/1538-7445.AM2017-4219

Stationary cycling exergame use among inactive children in the family home: a randomized trial.

Exergames may be one way to increase child physical activity, but long term adherence has seen little research attention. The primary objective of this study was to evaluate the usage of an exergame bike in comparison to a stationary bike in front of a TV across 3-months within a family home environment among children aged 10-14years old. Seventy-three inactive children were recruited through advertisements and randomized to either the exergame condition (n=39) or the standard bike condition (n=34). Weekly bike use was recorded in a log-book. Both groups declined in bike use over time (t=3.921, p<.01). Although the exergame group reported higher use (t=2.0045, p<.05), this was most prominent during the first week. Overall, these results do not support exergames as a standalone physical activity intervention, and suggest that short duration examinations of exergames may be misleading.

An interactive videogame for arm and hand exercise in people with Parkinson's disease: A randomized controlled trial

IntroductionPeople with Parkinson's disease (PD) have difficulty performing upper extremity (UE) activities. The aim of this study was to investigate if exergames targeting the UE improve arm and hand activities and impairments and to establish the acceptability and feasibility of these games in people with PD. MethodsTwo tablet-based exergames were developed which were controlled with finger movements or unimanual whole arm movements. Participants with PD were randomized to an exergame (n = 19) or control (n = 19) group. The exergame group performed UE exergames at home, 3 times per week for 12 weeks. The primary outcome measure was the nine hole peg test. Secondary outcomes included measures of UE activities and impairments, including the tapping test [speed (taps/60s), and error (weighted error score/speed)]. ResultsThere were no between group differences in the nine hole peg test, or in any secondary outcome measures except for the tapping test. Horizontal tapping test results showed that exergame participants improved their speed (mean difference = 10.9 taps/60s, p < 0.001) but increased error (mean difference = 0.03, p = 0.03) compared to the control group. Participants enjoyed the games and improved in their ability to play the games. There were no adverse events. ConclusionThe UE exergames were acceptable and safe, but did not translate to improvement in functional activities. It is likely that the requirement of the games resulted in increased movement speed at the detriment of accuracy. The design of exergames should consider task specificity.