Effects of exergaming on motor skill competence, perceived competence, and physical activity in preschool children

Effect of Children's Weight Status on Physical Activity and Sedentary Behavior during Physical Education, Recess, and After School

Children's body mass index may affect physical activity (PA) participation. Therefore, this study examined the effect of children's weight status on underserved elementary school children's PA and sedentary behavior (SB) throughout the segmented day. Participants were 138 children (X¯age = 8.14 years). Children's height and weight were measured with subsequent classification of children as healthy weight or overweight/obese. Durations of moderate-to-vigorous PA (MVPA), light PA (LPA), and SB during physical education (PE), morning recess, lunch recess, after school, and overall were assessed via accelerometry over three days. Independent t-tests evaluated differences in children's MVPA, LPA, and SB during each daily segment by weight status. Significantly higher MVPA was observed for children of healthy weight status versus children with overweight/obesity during morning recess, t(136) = 2.15, p = 0.03, after school, t(136) = 2.68, p < 0.01, and overall, t(136) = 2.65, p < 0.01. Interestingly, comparisons of children of healthy weight status and children with overweight/obesity's LPA and SB during the after-school segment revealed a trend wherein children with overweight/obesity participated in slightly greater LPA/less SB than children of healthy weight status. Higher MVPA was observed among children of healthy weight versus children with overweight/obesity during most daily segments. Concerted efforts should focus on increasing MVPA among children with overweight/obesity.

Associations Between Children's Media Use and Language and Literacy Skills

Media use is a pervasive aspect of children’s home experiences but is often not considered in studies of the home learning environment. Media use could be detrimental to children’s language and literacy skills because it may displace other literacy-enhancing activities like shared reading and decrease the quantity and quality of caregiver–child interaction. Thus, the current study asked whether media use is associated with gains in children’s language and literacy skills both at a single time point and across a school year and whether age moderates any association. Children (N = 1583) were from preschool through third grade classrooms and language and literacy skills were measured in the fall and spring of the school year. Parents reported how much time their child spends using media on a typical school day. Regression analyses showed that using 4 h or more of media was related to lower literacy gains, but not to language gains. Multilevel models conducted as a robustness check showed that this effect did not hold when accounting for classroom. In neither set of models was there an interaction between age and media use. Single-time-point models did show some associations that did not manifest in more stringent models, highlighting the limitations of correlational designs that do not have measures of children’s skills over time. Given the concern and popular press coverage around children’s media use, it is important to acknowledge non-significant effects in this domain. These non-significant associations suggest that societal fears around children’s media use may be exaggerated. Notably, however, characteristics of children’s media use, like educational content or adult co-use, may moderate any effects. The relation between media use and language and literacy growth did not differ across the age range investigated suggesting that, within this range, younger children are not more vulnerable to detrimental effects.

Comparison of College Students' Blood Pressure, Perceived Exertion, and Psychosocial Outcomes During Virtual Reality, Exergaming, and Traditional Exercise: An Exploratory Study

Objective: Integrating novel technologies, such as virtual reality (VR), into traditional exercise apparatuses (e.g., stationary bikes) may assist in promoting physical activity (PA) participation among young adults. Therefore, this study's purpose was to examine young adults' systolic and diastolic blood pressure (BP) change (BP_post - BP_pre), rating of perceived exertion (RPE), enjoyment, and self-efficacy during VR, exergaming, and traditional stationary cycling sessions. Materials and Methods: Forty-nine college students (34 females; M_age = 23.6 ± 3.4 years; M_BMI = 23.8 ± 3.1 kg/m²) participated in three separate 20-minute stationary cycling sessions: (1) PlayStation 4 VR; (2) Xbox 360 exergaming; and (3) traditional stationary cycling. Participants' systolic and diastolic BP change was measured by using an Omron HEM-705CP digital BP cuff. Further, RPE was assessed by using the modified Borg RPE Scale and enjoyment and self-efficacy were evaluated by using validated questionnaires. Results: A multivariate analysis of variance indicated significant differences for systolic BP change, RPE, enjoyment, and self-efficacy between the three cycling sessions (F(2, 144) = 3.3-32.4, P < 0.05, [Formula: see text] = 0.04-0.3). Specifically, participants had significantly higher enjoyment and self-efficacy and lower RPE during VR cycling compared with the other two cycling sessions despite similar or higher change systolic BP during the VR cycling session. There was no statistically significant change in diastolic BP between the three cycling sessions (P > 0.05). Conclusion: Incorporating VR equipment with traditional stationary cycle ergometers may be favorable when seeking to promote enjoyable PA in college students. To further support VR exercise's efficacy, future studies with more rigorous research designs are warranted.

Virtual Reality Exercise as a Coping Strategy for Health and Wellness Promotion in Older Adults during the COVID-19 Pandemic

The December 2019 COVID-19 outbreak in China has led to worldwide quarantine, as recommended by local governments and the World Health Organization. Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, including declines in motor ability and physical activity (PA) participation, increased obesity, impaired cognition, and various psychological disorders. Thus, given the secular increases in the older adult population, novel and effective intervention strategies are necessary to improve physical activity behaviors and health in this population. Virtual reality (VR)-integrated exercise is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. Therefore, the purpose of this editorial is to synthesize recent research examining the efficacy and effectiveness of VR exercise in the promotion of favorable health outcomes among the older adults. Results indicate the application of VR exercise to facilitate improved physical outcomes (e.g., enhanced motor ability, reduced obesity), cognition and psychological outcomes. VR exercise has also been observed to be an effective intervention strategy for fall prevention in this population. Future research should employ more rigorous research designs to allow for a more robust quantitative synthesis of the effect of VR exercise on the preceding outcomes to elucidate which type(s) of VR-based PA interventions are most effective in promoting improved health outcomes among older adults. Findings from this study will better inform the development of technology-savvy PA programs for wellness promotion in older adults who practice social distancing and exercise from home under the unprecedented global health crisis.

The Effectiveness of Virtual Reality Exercise on Individual's Physiological, Psychological and Rehabilitative Outcomes: A Systematic Review

Objective purpose: This review synthesized the literature examining the effects of virtual reality (VR)-based exercise on physiological, psychological, and rehabilitative outcomes in various populations. Design: A systematic review. Data sources: 246 articles were retrieved using key words, such as "VR", "exercise intervention", "physiological", "psychology", and "rehabilitation" through nine databases including Academic Search Premier and PubMed. Eligibility criteria for selecting studies: 15 articles which met the following criteria were included in the review: (1) peer-reviewed; (2) published in English; (3) randomized controlled trials (RCTs), controlled trials or causal-comparative design; (4) interventions using VR devices; and (5) examined effects on physiological, psychological, and/or rehabilitative outcomes. Descriptive and thematic analyses were used. Results: Of the 12 articles examining physiological outcomes, eight showed a positive effect on physical fitness, muscle strength, balance, and extremity function. Only four articles examined the effects on psychological outcomes, three showed positive effects such that VR exercise could ease fatigue, tension, and depression and induce calmness and enhance quality of life. Nine articles investigated the effects of VR-based exercise on rehabilitative outcomes with physiological and/or psychological outcomes, and six observed significant positive changes. In detail, patients who suffered from chronic stroke, hemodialysis, spinal-cord injury, cerebral palsy in early ages, and cognitive decline usually saw better improvements using VR-based exercise. Conclusion: The findings suggest that VR exercise has the potential to exert a positive impact on individual's physiological, psychological, and rehabilitative outcomes compared with traditional exercise. However, the quality, quantity, and sample size of existing studies are far from ideal. Therefore, more rigorous studies are needed to confirm the observed positive effects.

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.

Home-Based Exergaming on Preschoolers' Energy Expenditure, Cardiovascular Fitness, Body Mass Index and Cognitive Flexibility: A Randomized Controlled Trial

PURPOSE

The effects of exergaming-based physical activity (PA) interventions on preschoolers' health outcomes and cognition remain largely unexplored. Therefore, we conducted a randomized controlled trial to discern the effectiveness of a home-based educational exergaming intervention on preschoolers' energy expenditure, fitness, body mass index, and cognition.

METHODS

Participants were 32 preschoolers (16 girls; 59.4% Asian; M_age = 4.72, SD = ±0.73) recruited from the Twin Cities area in Minnesota. During baseline testing, we measured preschooler's daily energy expenditure (EE), cardiovascular fitness, body mass index, and cognitive flexibility using validated instruments. Participants were then randomly assigned to one of two conditions: (1) the exergaming intervention condition; or (2) control condition. The intervention program requested children participate in home-based educational exergaming using the LeapTV gaming console for at least 30 min/session 5 times/week. The control condition asked children to maintain regular PA patterns without any exergaming gameplay. Each condition lasted 12 weeks. We conducted identical outcome assessments for all children at baseline and post-intervention.

RESULTS

Analysis of covariance with repeated measures yielded significant time x group interaction effects for cognitive flexibility, Wilks' Lambda = 0.81, F(1, 29) = 6.98, p = 0.01, η² = 0.19, suggesting children in the exergaming group demonstrated significantly greater increases in cognitive flexibility as compared to those in the control group over time. There were no significant differences for time x group changes between the two groups for EE, Wilks' Lambda = 0.92, F(1, 29) = 2.29, p = 0.14, η² = 0.08; cardiovascular fitness, Wilks' Lambda = 0.96, F(1, 29) = 1.07, p = 0.31, η² = 0.04; and BMI, Wilks' Lambda = 0.99, F(1, 29) = 0.05, p = 0.82, η² = 0.01. However, our data did suggest a marginal effect of time for EE, Wilks' Lambda = 0.89, F(1, 29) = 3.26, p = 0.08, η² = 0.08, indicating that children's daily EE increased from baseline to post-intervention.

CONCLUSIONS

Home-based educational exergaming may positively impact cognitive flexibility in preschoolers. Studies with larger sample sizes in multiple geographic locations are needed, with our study suggesting a longer intervention period might also be warranted.

The Effect of Virtual Reality Games on the Gross Motor Skills of Children with Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials

This review aimed to systematically evaluate the rehabilitatitive effect of Virtual Reality Games (VRGs) for gross motor skills of children with cerebral palsy (CP), and to give scientific grounds for the formulation of rehabilitation therapy for these children. To this end, the literature in Chinese databases (CNKI and Wanfang Data) as well as the databases of other countries (Web of Science, PubMed, EBSCOhost, Informit, Scopus, Science Direct and ProQuest) from the establishment dates of these databases to June 3rd 2019 was retrieved in order to collect randomized controlled trials with regard to the intervention effect of VRGs and traditional therapy on gross motor skills of children with CP, and the literature was screened as per inclusion and exclusion criteria. The PEDro scale was then used to evaluate the methodological quality of the included literature, and the software Review Manager 5.3 was employed to analyze the combined effect size. As a result, 7 randomized controlled trials and 234 children with CP were included. Meta-analysis showed that VRGs could improve gross motor skills of children with CP. Combined effect size of gross motor skills SMD = 0.37 [95% CI = (0.06, 0.68), p = 0.02)]. In conclusion, the VRG intervention program can enhance gross motor skills of children with CP to some extent. In view of the limitations regarding methodologies and the quality and quantity of the literature in this research, more quality randomized controlled trials are needed so as to draw convincing conclusions of effect of VRG intervention on gross motor skill development of children with CP in future studies.

Longitudinal Trajectories of Children's Physical Activity and Sedentary Behaviors on Weekdays and Weekends

BACKGROUND

The objective was to examine changes of children's time spent in sedentary, light physical activity, moderate to vigorous physical activity (MVPA), and estimated energy expenditure (EE) rates during weekdays and weekends across 3 years.

METHODS

An initial sample of 261 children's (mean age = 7.81 y) 5-day physical activity and EE were assessed annually via accelerometry across 3 years using repeated-measures multivariate analysis of variance. The outcome variables were time spent in sedentary, light physical activity, MVPA, and kilocalories per day for weekdays and weekends.

RESULTS

A significant decrease in MVPA and EE occurred during weekdays across the 3 years (P = .01). Only the second-year data demonstrated an increase (+2.49 min) in weekend MVPA (P = .04). Children's sedentary time during weekdays increased significantly in years 1 and 2 (P = .01), yet significantly decreased in the third year (-44.31 min). Children's sedentary time during weekends significantly decreased in the first year (-27.31 min), but increased in the following 2 years (P = .01). Children's light physical activity demonstrated a statistically significant increase in year 2 (+3.75 min) during weekdays (P = .05).

CONCLUSIONS

Children's MVPA and EE generally declined during weekdays but were maintained during weekends across a 3-year time span. Children may benefit most from weekday intervention strategies.

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 ( X ¯ age = 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.

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.