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Oh S, Choi J, Han DH, Kim E. Effects of game-based digital therapeutics on attention deficit hyperactivity disorder in children and adolescents as assessed by parents or teachers: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024; 33:481-493. [PMID: 36862162 DOI: 10.1007/s00787-023-02174-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/16/2023] [Indexed: 03/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset disorder characterized by pharmacological and non-pharmacological interventions. Despite the available treatment options and prevention measures, conventional treatments have several limitations. Digital therapeutics (DTx) like EndeavorRx® is an emerging alternative to overcome these limitations. EndeavorRx® is the first FDA-approved, game-based DTx approved for the treatment of pediatric ADHD. We investigated the effects of game-based DTx in randomised controlled trials (RCTs) on children and adolescents with ADHD. In this systematic review and meta-analysis, we searched PubMed, Embase, and PsycINFO databases up to January 2022. The protocol was registered (CRD42022299866). The assessor was defined as parents and teachers. The primary outcome was differences in inattention reported by the assessor, and the secondary outcome was differences in hyperactivity and hyperactivity/impulsivity reported by the assessor and the relative comparisons between game-based DTx, medicine, and control with indirect meta-analysis. Game-based DTx improved inattention more than the control upon assessment by assessors (standard mean difference (SMD) 0.28, 95% confidence interval (CI) 0.14-0.41; SMD 0.21, 95% CI 0.03-0.39, respectively), while medication improved inattention more than game-based DTx (SMD - 0·62, 95% CI - 1·04 to - 0·20) upon assessment by the teacher. Game-based DTx improved hyperactivity/impulsivity than the control upon assessment by assessors (SMD 0.28, 95% CI 0.03-0.53; SMD 0.30, 95% CI 0.05-0.55, respectively), and medication improved hyperactivity/impulsivity significantly than game-based DTx upon assessment by the teacher. Hyperactivity has not been reported extensively. As a result, game-based DTx had a more significant effect than the control, however medication was more effective.
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Affiliation(s)
- SuA Oh
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Jina Choi
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, College of Medicine, Chung Ang University Hospital, Seoul, 06974, Republic of Korea
| | - EunYoung Kim
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea.
- Regulatory Science, Pharmaceutical Industry, College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.
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2
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Xu K, Geng S, Dou D, Liu X. Relations between Video Game Engagement and Social Development in Children: The Mediating Role of Executive Function and Age-Related Moderation. Behav Sci (Basel) 2023; 13:833. [PMID: 37887483 PMCID: PMC10604845 DOI: 10.3390/bs13100833] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
The global proliferation of video games, particularly among children, has led to growing concerns about the potential impact on children's social development. Executive function is a cognitive ability that plays a crucial role in children's social development, but a child's age constrains its development. To examine the association between video game engagement and children's social development while considering the mediating role of executive function and the moderating role of age, a questionnaire was distributed to a sample of 431 parents. The results revealed a negative relation between video game engagement and social development in children, with executive function found to mediate this relation fully. Additionally, the negative association between video game engagement and executive function became more pronounced as children grew older. In light of these findings, it is advisable to adopt proactive strategies to limit excessive video game use, consider the developmental characteristics of children at different ages, and prioritize the promotion of executive function to facilitate social development among children.
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Affiliation(s)
- Ke Xu
- College of Preschool Education, Capital Normal University, Beijing 100048, China; (K.X.); (S.G.)
| | - Shuliang Geng
- College of Preschool Education, Capital Normal University, Beijing 100048, China; (K.X.); (S.G.)
| | - Donghui Dou
- School of Sociology and Psychology, Central University of Finance and Economics, Beijing 100081, China;
| | - Xiaocen Liu
- College of Preschool Education, Capital Normal University, Beijing 100048, China; (K.X.); (S.G.)
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3
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He F, Qi Y, Zhou Y, Cao A, Yue X, Fang S, Zheng Y. Meta-analysis of the efficacy of digital therapies in children with attention-deficit hyperactivity disorder. Front Psychiatry 2023; 14:1054831. [PMID: 37260755 PMCID: PMC10228751 DOI: 10.3389/fpsyt.2023.1054831] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that commonly occurs in childhood. The aim of this meta-analysis was to summarize the available evidence for the efficacy of digital therapeutics in children and adolescents with ADHD. Methods We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), and Web of Science (science and social science citation index) databases for relevant studies and used Stata 15.0 software to carry out the meta-analysis. Results A total of 31 studies involving 2169 participants (1665 boys and 504 girls) aged 4-17 years old were included in the final analysis. The meta-analysis results showed that digital interventions improved the symptoms of inattention with an effect value of -0.20 (95% confidence interval [CI] -0.36, -0.04) and decreased the continuous performance task (CPT) reaction time (effect, -0.40, 95% CI -0.73, -0.07) in ADHD patients. The score for impulsive hyperactivity was slightly decreased (effect, -0.07, 95% CI -0.23, 0.09). Moreover, executive function was improved (effect, 0.71, 95% CI 0.37, 1.04). The capability of working memory appeared to be increased (effect, 0.48, 95% CI 0.21, 0.76) between the two groups. Visual appraisal of the sensitivity analysis suggested the absence of heterogeneity, and no obvious publication bias was detected. Discussion Based on the existing literature evidence, we conclude that digital therapy can be a promising therapeutic strategy for ADHD patients.
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Affiliation(s)
- Fan He
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yanjie Qi
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuanyue Zhou
- Department of Medical Psychology, The First Affiliated Hospital, Hainan Medical University, Haikou, Hainan, China
| | - Aihua Cao
- Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Xin Yue
- MaiDeHaiKe Technology, Beijing, China
| | - Shuanfeng Fang
- Children's Hospital Affiliated, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Zheng
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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4
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Foerster FR, Chidharom M, Giersch A. Enhanced temporal resolution of vision in action video game players. Neuroimage 2023; 269:119906. [PMID: 36739103 DOI: 10.1016/j.neuroimage.2023.119906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/16/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Video game play has been suggested to improve visual and attention processing. Nevertheless, while action video game play is highly dynamic, there is scarce research on how information is temporally discriminated at the millisecond level. This cross-sectional study investigates whether temporal discrimination at the millisecond level in vision varies across action video game players (VGPs; N = 23) and non-video game players (NVGPs; N = 23). Participants discriminated synchronous from asynchronous onsets of two visual targets in virtual reality, while their EEG and oculomotor movements were recorded. Results show an increased sensitivity to short asynchronies (11, 33 and 66 ms) in VGPs compared with NVGPs, which was especially marked at the start of the task, suggesting better temporal discrimination abilities. Pre-targets oculomotor freezing - the inhibition of small fixational saccades - was associated with correct temporal discrimination, probably revealing attentional preparation. However, this parameter did not differ between groups. EEG and reconstruction analyses suggest that the enhancement of temporal discrimination in VGPs during temporal discrimination is related to parieto-occipital processing, and a reduction of alpha-band (8-14 Hz) power and inter-trial phase coherence. Overall, the study reveals an enhanced ability in action video game players to discriminate in time visual events in close temporal proximity combined with reduced alpha-band oscillatory activities. Consequently, playing action video games is associated with an improved temporal resolution of vision.
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Affiliation(s)
- Francois R Foerster
- Université de Strasbourg, INSERM U1114, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, France.
| | - Matthieu Chidharom
- Department of Psychology, Lehigh University, Bethlehem, PA, United States
| | - Anne Giersch
- Université de Strasbourg, INSERM U1114, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, France
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5
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Foerster FR, Chidharom M, Bonnefond A, Giersch A. Neurocognitive analyses reveal that video game players exhibit enhanced implicit temporal processing. Commun Biol 2022; 5:1082. [PMID: 36221032 PMCID: PMC9553938 DOI: 10.1038/s42003-022-04033-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/26/2022] [Indexed: 11/25/2022] Open
Abstract
Winning in action video games requires to predict timed events in order to react fast enough. In these games, repeated waiting for enemies may help to develop implicit (incidental) preparation mechanisms. We compared action video game players and non-video game players in a reaction time task involving both implicit time preparations and explicit (conscious) temporal attention cues. Participants were immersed in virtual reality and instructed to respond to a visual target appearing at variable delays after a warning signal. In half of the trials, an explicit cue indicated when the target would occur after the warning signal. Behavioral, oculomotor and EEG data consistently indicate that, compared with non-video game players, video game players better prepare in time using implicit mechanisms. This sheds light on the neglected role of implicit timing and related electrophysiological mechanisms in gaming research. The results further suggest that game-based interventions may help remediate implicit timing disorders found in psychiatric populations.
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Affiliation(s)
- Francois R Foerster
- Université de Strasbourg, INSERM U1114, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.
| | - Matthieu Chidharom
- Université de Strasbourg, INSERM U1114, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
- Department of Psychology, Lehigh University, Bethlehem, PA, USA
| | - Anne Bonnefond
- Université de Strasbourg, INSERM U1114, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Anne Giersch
- Université de Strasbourg, INSERM U1114, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
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6
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Kovbasiuk A, Lewandowska P, Brzezicka A, Kowalczyk-Grębska N. Neuroanatomical predictors of complex skill acquisition during video game training. Front Neurosci 2022; 16:834954. [PMID: 35937888 PMCID: PMC9354597 DOI: 10.3389/fnins.2022.834954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
It is known that the outcomes of complex video game (VG) skill acquisition are correlated with individual differences in demographic and behavioral variables, such as age, intelligence and visual attention. However, empirical studies of the relationship between neuroanatomical features and success in VG training have been few and far between. The present review summarizes existing literature on gray matter (GM) and white matter correlates of complex VG skill acquisition as well as explores its relationship with neuroplasticity. In particular, since age can be an important factor in the acquisition of new cognitive skills, we present studies that compare different age groups (young and old adults). Our review reveals that GM in subcortical brain areas predicts complex VG learning outcomes in young subjects, whereas in older subjects the same is true of cortical frontal areas. This may be linked to age-related compensatory mechanisms in the frontal areas, as proposed by The Scaffolding Theory of Aging and Cognition. In the case of plasticity, there is no such relationship - in the group of younger and older adults there are changes after training in both cortical and subcortical areas. We also summarize best practices in research on predictors of VG training performance and outline promising areas of research in the study of complex video game skill acquisition.
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Affiliation(s)
- Anna Kovbasiuk
- Neurocognitive Research Center, Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
- Department of Management in Networked and Digital Societies, Kozminski University, Warsaw, Poland
| | - Paulina Lewandowska
- Neurocognitive Research Center, Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
- Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Aneta Brzezicka
- Neurocognitive Research Center, Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Natalia Kowalczyk-Grębska
- Neurocognitive Research Center, Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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7
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The Benefits of Video Games on Brain Cognitive Function: A Systematic Review of Functional Magnetic Resonance Imaging Studies. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Benefits of video games on cognitive function have been proved by increasing evidence. However, reasons for game-induced changes in cognitive function are still elusive. Therefore, this study conducted a systematic review of brain function activation changes in association with video games. We retrieved publications from three electronic databases (PubMed, Web of Science, and PsycInfo), with publication dates before 8 February 2021. After screening the study with fMRI data, 13 studies were included in this work, including 9 cross-sectional studies and 4 types of research. In this review, we summarized the potential benefits of video games on cognitive function and discussed the effects of different types of video games on cognitive function. In particular, we highlighted the effect of video games on attention ability and visuospatial ability and addressed the functional brain activation changes in frontal and parietal lobes and other related brain regions induced by games. Finally, we pointed out that when discussing the effect of video games on brain function, types of video games should be carefully categorized.
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8
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Wei Q, Zhang S, Pan Y, Hu H, Chen F, Yin W, Lin Q, Pan S, Tham C, Wu J. Epidemiology of gaming disorder and its effect on anxiety and insomnia in Chinese ethnic minority adolescents. BMC Psychiatry 2022; 22:260. [PMID: 35413829 PMCID: PMC9006600 DOI: 10.1186/s12888-022-03894-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/28/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The growing popularity and frequency of online game use have resulted in a large number of studies reporting various mental problems associated with game abuse in adolescents. In this article, we examined the prevalence of gaming disorder (GD) and explored the associations of GD with anxiety and insomnia symptoms in minority youth in China. METHODS A total of 1494 students completed the Problematic Online Gaming Questionnaire Short-Form (POGQ-SF), the Generalized Anxiety Disorder 7-item questionnaire (GAD-7), and Athens Insomnia Scale (AIS). Chi-square and binary logistic regression analyses were used to explore the associations between gaming disorder and anxiety/insomnia. RESULTS A total of 356 (23.83%) respondents reported that they had gaming disorder. Chi-square analysis showed that gender, grade, marital status of parents and exercise situation were significantly associated with GD. Binary logistic regression analysis showed that those who had GD were at significantly higher risk for anxiety and insomnia than those without GD. CONCLUSION We found a high incidence of GD and a positive association among anxiety, insomnia and GD. Thus, special attention should be paid to those who have suffered from GD. It is worth addressing the adverse effects of GD on anxiety and insomnia.
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Affiliation(s)
- Qiaoyue Wei
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Shengjie Zhang
- grid.256607.00000 0004 1798 2653Department of Graduate Management, Guangxi Medical University Cancer Hospital, 71 Hedi Road, Nanning, 530021 China
| | - Yuli Pan
- grid.418332.fDepartment of Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, 18 Jinzhou Road, Nanning, 530028 China
| | - Hong Hu
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Fenglan Chen
- grid.256607.00000 0004 1798 2653Department of Guangxi Medical University Wuming Hospital, 26 Yongning Road, 530199 Nanning, China
| | - Wenwen Yin
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Qinghong Lin
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Shuibo Pan
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Chingyuan Tham
- grid.256607.00000 0004 1798 2653Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021 China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China.
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9
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Molina R, Díaz-Oliván I, Girela B, Moreno M, Jiménez-Muñoz L, Delgado-Gómez D, Peñuelas-Calvo I, Baca-García E, Porras-Segovia A. Video Games as a Complementary Therapy for Schizophrenia: A Systematic Review. J Psychiatr Pract 2022; 28:143-155. [PMID: 35238826 DOI: 10.1097/pra.0000000000000614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Schizophrenia is a prevalent and serious disorder. Video games have shown potential as an aid in health care for people who suffer from schizophrenia. Although video games may contribute benefit in the treatment of schizophrenia, reviews on this topic are scarce. In this article, we systematically review the evidence concerning video game-based therapeutic interventions for people diagnosed with schizophrenia. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in the PROSPERO database. We searched 4 databases-PubMed, Web of Science, EMBASE, and clinicaltrials.gov-to identify original studies exploring video game-based therapeutic interventions for people with schizophrenia. RESULTS After initial screening, full-text review, and study selection, 11 articles were included in the review. Most studies used video consoles as the platform, with a minority using a personal computer. Video game-based therapeutic interventions were well accepted and generally effective in improving cognitive areas. CONCLUSIONS Cognitive training could be one of the main mechanisms underlying the usefulness and effectiveness of video game-based therapeutic interventions. Software optimization and greater collaboration between developers and health care professionals are some of the priorities for future research in this area.
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10
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Cuevas-Lara C, Sáez de Asteasu ML, Ramírez-Vélez R, Izquierdo M, Zambom-Ferraresi F, Antoñanzas-Valencia C, Galbete A, Zambom-Ferraresi F, Martínez-Velilla N. Effects of game-based interventions on functional capacity in acutely hospitalised older adults: results of an open-label non-randomised clinical trial. Age Ageing 2022; 51:6514235. [PMID: 35077558 DOI: 10.1093/ageing/afab247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Hospitalisation-associated disability due to reduced physical activity levels and prolonged bedrest episodes are highly prevalent in older adults. OBJECTIVE To assess the effect of gamified interventions on functional capacity in hospitalised older adults. METHODS A three-armed non-randomised controlled trial with two experimental intervention groups and a control group was conducted in a tertiary public hospital in Navarre, Spain. Participants were allocated to a simple gamification group (SGG) (n = 21), a technology-based gamification group (TGG) (n = 23) or a control group (CG) (n = 26). The end points were changes in functional capacity, muscle strength, cognition, mood status and quality of life. RESULTS Seventy patients (mean age 86.01 ± 4.27 years old) were included in the study; 29 (41.4%) were women. At discharge, compared to CG, a mean increase of 1.47 points (95%CI, 0.15-2.80 points) and 2.69 points (95%CI, 1.32-4.06 points) was observed (SGG and TGG, respectively) in the SPPB test; as well as an increase of 5.28 points (95%CI, 0.70-9.76 points) in the Barthel Index and 2.03 kg (95%CI, 0.33-3.72 kg) in handgrip strength in the TGG. Regression mediation analyses demonstrated that muscle strength changes (β = 1.30; 95%CI, 0.45-2.14; indirect effect 0.864; 95%CI, 0.09-1.90) significantly mediated the TGG effect on the SPPB score. CONCLUSIONS The TGG intervention programme may provide significant benefits in physical and muscle function over usual care and seems to reverse the functional decline frequently associated with acute hospitalisation in older adults.
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11
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Peñuelas-Calvo I, Jiang-Lin LK, Girela-Serrano B, Delgado-Gomez D, Navarro-Jimenez R, Baca-Garcia E, Porras-Segovia A. Video games for the assessment and treatment of attention-deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2022; 31:5-20. [PMID: 32424511 DOI: 10.1007/s00787-020-01557-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and serious disorder among children. Video games have shown potential for aiding in child healthcare. Video games could contribute to the assessment and management of ADHD, but there are no previous reviews on this topic. Here, we systematically review the evidence about video game-based assessment tools and interventions for children diagnosed with ADHD. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered in PROSPERO database. We searched four databases-PubMed, PsycInfo, Embase and clinicaltrials.gov-to identify original studies exploring either video game-based interventions or video game-based assessment tools in children with ADHD. After initial screening, full text revision and study selection, 22 articles were finally included in the review. Most studies used PC as platform, with a minority using a video console, pad, or 3D device. Video game-based assessment tools were generally effective in discriminating ADHD cases from controls, and in discriminating between ADHD subtypes. Video game-based therapeutic interventions were well accepted and generally effective in improving cognitive areas and decreasing ADHD symptoms. Gamification and cognitive training could be the main mechanisms underlying the usefulness and effectiveness of video game-based assessment tools and interventions. Software optimization and greater collaboration between developers and healthcare professionals are some of the priorities for future research in this area.
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Affiliation(s)
- Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. .,Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain. .,Department of Psychology, Universidad Complutense de Madrid, Madrid, Spain.
| | - Lin Ke Jiang-Lin
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Braulio Girela-Serrano
- Mood Instability Research Group, Centre for Psychiatry, Imperial College London, London, UK
| | | | - Rocio Navarro-Jimenez
- Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Enrique Baca-Garcia
- Department of Child and Adolescent Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain.,CIBERSAM, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain.,Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain.,Department of Psychiatry, Universidad Católica del Maule, Talca, Chile
| | - Alejandro Porras-Segovia
- Translational Psychiatry Research Group, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
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12
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Ferreira SA, Stein AM, Stavinski NGDL, Teixeira DDC, Queiroga MR, Bonini JS. Different types of physical exercise in brain activity of older adults: A systematic review. Exp Gerontol 2021; 159:111672. [PMID: 34958870 DOI: 10.1016/j.exger.2021.111672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/24/2021] [Accepted: 12/16/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND To verify the effects of different modalities of physical exercise on brain activity of older adults. METHODS Systematic searches were conducted according to the PICOS strategy and the following databases were searched: PubMed, Web of Science, PsycInfo and Scielo. Two independent evaluators performed the initial selection from reading the title and abstract based on the stipulated eligibility criteria. RESULTS The searches resulted in 1935 titles, of which 97 were duplicated and 1793 were excluded based on reading the titles and abstracts. This phase resulted in 45 articles for detailed analysis. At this stage, 35 articles were excluded because they did not meet the eligibility criteria. The information for qualitative analysis was extracted from 10 articles that met the criteria. CONCLUSION There was improvement in the brain activity of older adults regardless of the type of physical exercise performed (aerobic, neuromuscular, flexibility or neuromotor), but with a discrete advantage for balance and coordination exercises (neuromotor).
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Affiliation(s)
- Sandra Aires Ferreira
- Department of Physical Education, Midwestern Parana State University (UNICENTRO), Guarapuava, Brazil.
| | - Angelica Miki Stein
- Department of Physical Education, Midwestern Parana State University (UNICENTRO), Guarapuava, Brazil; The Human Performance Research Group, Technological Federal University of Paraná (UTFPR), Curitiba, Brazil
| | - Natã Gomes de Lima Stavinski
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sports Center (UEL), State University of Londrina, Londrina, Brazil
| | | | - Marcos Roberto Queiroga
- Department of Physical Education, Midwestern Parana State University (UNICENTRO), Guarapuava, Brazil; Associated Graduate Program in Physical Education UEM/UEL, Londrina, Brazil
| | - Juliana Sartori Bonini
- Department of Pharmacy, Midwestern Parana State University (UNICENTRO), Guarapuava, Brazil
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13
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Casale S, Musicò A, Schimmenti A. Beyond internalizing and externalizing symptoms: The association between body disconnection and the symptoms of Internet gaming disorder. Addict Behav 2021; 123:107043. [PMID: 34315095 DOI: 10.1016/j.addbeh.2021.107043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/18/2021] [Accepted: 07/05/2021] [Indexed: 11/30/2022]
Abstract
As the vast majority of online videogames imply the immersion into an alternative reality where a virtual body is also involved, the current cross-sectional study aims to investigate the contribution of low body awareness (i.e. low attention to sensory cues indicating bodily state) and body dissociation (i.e. low emotional connection with one's own body) in predicting Internet gaming disorder (IGD) symptoms, after controlling for internalizing (i.e., depression, anxiety, and stress) and externalizing symptoms (i.e., aggression). A total of 370 online-game players (73% men; mean age 29.63 ± 7.64 years) recruited in online player communities took part in the study and were given a survey that included gaming characteristics, the Depression, Anxiety and Stress Scale -21, the Aggression Questionnaire, the Body Disconnection Scale, and the Internet Gaming Disorder Scale- Short Form. A hierarchical regression analysis showed that low body awareness and high body dissociation predicted IGD scores after controlling for all the other factors. Moreover, we found an interaction effect between physical aggression and body dissociation in predicting IGD scores. On the one hand, these results provide support to previous studies that stressed the potential association between dissociative detachment (in terms of bodily disconnections) and problematic videogaming; on the other hand, the current study provides first evidence of the opportunity to focus on the integration of bodily experiences in clinical practice with people suffering from problematic gaming, as this factor might be incisively related to their aggressive and internalizing symptoms.
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Affiliation(s)
- Silvia Casale
- Department of Health Sciences, Psychology Unit, via di San Salvi12, 50135, University of Florence, Italy.
| | - Alessia Musicò
- Department of Experimental and Clinical Medicine, Largo Brambilla3, 50134, University of Florence, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
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14
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Otero P, Cotardo T, Blanco V, Vázquez FL. Development of a Videogame for the Promotion of Active Aging Through Depression Prevention, Healthy Lifestyle Habits, and Cognitive Stimulation for Middle-to-Older Aged Adults. Games Health J 2021; 10:264-274. [PMID: 34283917 DOI: 10.1089/g4h.2020.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The objective of this pilot study was to analyze the efficacy on perceived health and the feasibility of a multicomponent psychological intervention to promote active aging through depression prevention, healthy lifestyle habits, and cognitive stimulation in middle-to-older adulthood administered through an interactive multimedia online videogame with a complementary smartphone app. Materials and Methods: Twenty-five participants from the general population aged 45 or older with computer and smartphone access and no difficulties in communication, sensory or mental health condition (64.0% women, mean age 54.9 years) participated in the intervention, which consisted of eight modules with tasks between sessions. The multicomponent intervention consisted of three components (depression prevention, healthy lifestyle habits, and cognitive stimulation) and was administered using an interactive online multimedia videogame (graphic adventure type), with a complementary smartphone app. Perceived health, dropouts, adherence to the intervention (performed modules and completed intersession tasks), and engagement were independently assessed. Results: After the intervention, participants exhibited significant improvement in their scores for General Health, Physical Functioning, Social Functioning, and Mental Health, with effect sizes ranging from small (d = 0.38) to medium (d = 0.59). The dropout rate was only 8%. The mean number of completed modules was 7.5 (SD = 1.8), and the mean number of tasks performed was 232.4 (out of 259) (SD = 15.4). Participants were highly satisfied (M = 27.7; SD = 3.1) and engaged (M = 42.7; SD = 4.7) with the intervention. Conclusion: The results support the efficacy and feasibility of using the videogame to promote active aging, and they encourage further evaluation through a randomized-controlled clinical trial. ClinicalTrials.gov NCT03643237.
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Affiliation(s)
- Patricia Otero
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Tania Cotardo
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vanessa Blanco
- Department of Evolutionary and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando L Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
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15
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Kelly S, Leung J. The New Frontier of Esports and Gaming: A Scoping Meta-Review of Health Impacts and Research Agenda. Front Sports Act Living 2021; 3:640362. [PMID: 33796849 PMCID: PMC8008070 DOI: 10.3389/fspor.2021.640362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/22/2021] [Indexed: 12/03/2022] Open
Abstract
Given the rapid evolution of the gaming industry and the rising popularity of a hyper-connected, competitive esports version of online gaming, a meta-review of the impact of online competitive gaming upon health is timely. A scoping meta-review was conducted on 10 reviews that reported on any health consequences (physical, lifestyle, cognitive, mental, or social) of esports, online competitive gaming, or video gaming participation, as a player or spectator. While past reviews have examined health effects of video gaming, few have focused upon the newly evolved gaming context, incorporating both playing and streamed viewing, recognition as a professional sport, and potential career and exponential participation. Most past reviews have focused upon physical health impacts of video gaming among adolescents and young adults, but none have examined impacts of different forms of gaming participation in the new gaming era, and their potential differential health impacts. A scoping meta-review was undertaken on the physical, social, and psychological health outcomes of competitive online gaming and associated screen use, revealing a need for further review and research into lifestyle health outcomes including diet and sedentary behavior among young esports and competitive video gaming participants.
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Affiliation(s)
- Sarah Kelly
- UQ Business School, University of Queensland, Brisbane, QLD, Australia
| | - Janni Leung
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
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16
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Effects of excessive video game playing on event-related brain potentials during working memory. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01573-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Pandian GSB, Jain A, Raza Q, Sahu KK. Digital health interventions (DHI) for the treatment of attention deficit hyperactivity disorder (ADHD) in children - a comparative review of literature among various treatment and DHI. Psychiatry Res 2021; 297:113742. [PMID: 33515870 DOI: 10.1016/j.psychres.2021.113742] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/16/2021] [Indexed: 01/21/2023]
Abstract
The objective of this study is to compare game-based digital therapeutic device and other DHI like (smartphone apps, wearable technologies) for ADHD with the current pharmacological and behavior therapy. The FDA has approved a game-based digital therapeutic device - EndeavorRx, for the treatment of ADHD in pediatric patients belonging to the age group of 8-12 years old. This has been primarily recommended for the treatment of inattentive or combined-type ADHD who have demonstrated an attention issue. This is the first game-based therapeutic device to be approved by the FDA for any type of condition. According to the FDA, this has been shown to improve attention which is measured by computer-based testing. Objective: The objective of this study is to compare a game-based digital therapeutic device and other DHI (smartphone apps, wearable technologies) with the current pharmacological and behavior therapy used in the treatment of ADHD.
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Affiliation(s)
| | - Ankit Jain
- Assistant Professor of Psychiatry Penn State College of Medicine, Milton S Hershey Medical Center, Hershey, PA, USA
| | - Qasim Raza
- Assistant Professor of Psychiatry Penn State College of Medicine, Milton S Hershey Medical Center, Hershey, PA, USA
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18
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Välimäki M, Yang M, Lam YTJ, Lantta T, Palva M, Palva S, Yee B, Yip SH, Yu KSD, Chang HCC, Cheng PYI, Bressington D. The impact of video gaming on cognitive functioning of people with schizophrenia (GAME-S): study protocol of a randomised controlled trial. BMC Psychiatry 2021; 21:46. [PMID: 33461506 PMCID: PMC7814579 DOI: 10.1186/s12888-020-03031-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/22/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Video gaming is a promising intervention for cognitive and social impairment in patients with schizophrenia. A number of gaming interventions have been evaluated in small-scale studies with various patient groups, but studies on patients with schizophrenia remain scarce and rarely include the evaluation of both clinical and neurocognitive outcomes. In this study, we will test the effectiveness of two interventions with gaming elements to improve cognitive and clinical outcomes among persons with schizophrenia. METHODS The participants will be recruited from different outpatient units (e.g., outpatient psychiatric units, day hospitals, residential care homes). The controlled clinical trial will follow a three-arm parallel-group design: 1) cognitive training (experimental group, CogniFit), 2) entertainment gaming (active control group, SIMS 4), and 3) treatment as usual. The primary outcomes are working memory function at 3-month and 6-month follow-ups. The secondary outcomes are patients' other cognitive and social functioning, the ability to experience pleasure, self-efficacy, and negative symptoms at 3-month and 6-month follow-ups. We will also test the effectiveness of gaming interventions on neurocognitive outcomes (EEG and 3 T MRI plus rs-fMRI) at a 3-month follow-up as an additional secondary outcome. Data will be collected in outpatient psychiatric services in Hong Kong. Participants will have a formal diagnosis of schizophrenia and be between 18 and 60 years old. We aim to have a total of 234 participants, randomly allocated to the three arms. A sub-sample of patients (N = 150) will be recruited to undergo an EEG. For neuroimaging assessment, patients will be randomly allocated to a subset of patients (N=126). We will estimate the efficacy of the interventions on the primary and secondary outcomes based on the intention-to-treat principle. Behavioural and EEG data will be analysed separately. DISCUSSION The study will characterise benefits of gaming on patients' health and well-being, and contribute towards the development of new treatment approaches for patients with schizophrenia. TRIAL REGISTRATION ClinicalTrials.gov NCT03133143 . Registered on April 28, 2017.
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Affiliation(s)
- Maritta Välimäki
- Xiangya Nursing School, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China. .,School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, Hong Kong SAR. .,Department of Nursing Science, Faculty of Medicine, University of Turku, 20014, Turku, Finland.
| | - Min Yang
- grid.13291.380000 0001 0807 1581West China School of Public Health, Sichuan University, Chengdu, China ,grid.1027.40000 0004 0409 2862Faculty of Health, Art and Design, Swinburne University of Technology, Melbourne, Victoria 3122 Australia
| | - Yuen Ting Joyce Lam
- grid.16890.360000 0004 1764 6123School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, Hong Kong SAR
| | - Tella Lantta
- grid.1374.10000 0001 2097 1371Department of Nursing Science, Faculty of Medicine, University of Turku, 20014 Turku, Finland
| | - Matias Palva
- grid.7737.40000 0004 0410 2071Neuroscience Center, University of Helsinki, Helsinki, Finland
| | - Satu Palva
- grid.7737.40000 0004 0410 2071Neuroscience Center, University of Helsinki, Helsinki, Finland
| | - Benjamin Yee
- grid.16890.360000 0004 1764 6123Department of Rehabilitation Sciences, Hung Hom, Kowloon, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | - Siu Hung Yip
- grid.415504.10000 0004 1794 2766Department of Psychiatry, Kowloon Hospital, Hong Kong, Hong Kong SAR
| | - Kin-sun Dan Yu
- The Mental Health Association of Hong Kong, 2 Kung Lok Road, Hong Kong, Hong Kong SAR
| | - Hing Chiu Charles Chang
- grid.194645.b0000000121742757Department of Diagnostic Radiology, The Hong Kong Jockey Club for Interdisciplinary Research, The University of Hong Kong, 5 Sassoon Road, Hong Kong, Hong Kong SAR
| | - Po Yee Ivy Cheng
- grid.417134.40000 0004 1771 4093Department of Psychiatry, Community Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR
| | - Daniel Bressington
- grid.1043.60000 0001 2157 559XCollege of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
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Cuevas-Lara C, Izquierdo M, Sáez de Asteasu ML, Ramírez-Vélez R, Zambom-Ferraresi F, Zambom-Ferraresi F, Martínez-Velilla N. Impact of Game-Based Interventions on Health-Related Outcomes in Hospitalized Older Patients: A Systematic Review. J Am Med Dir Assoc 2020; 22:364-371.e1. [PMID: 32873472 DOI: 10.1016/j.jamda.2020.07.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/11/2020] [Accepted: 07/18/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine the effectiveness of game-based interventions compared with usual care on health-related outcomes for acutely hospitalized older patients. DESIGN Systematic review of randomized controlled trials (RCT) and nonrandomized trials. SETTING AND PARTICIPANTS Adults aged 65 years or older admitted to an Acute Care for Elderly unit were selected. MEASURES Health-related outcomes (eg, functional capacity, quality of life, adherence to treatment). RESULTS Four RCTs were included in the review. The interventions were based on the implementation of serious-game programs using Nintendo Wii in acute medical patients. Across the included studies, no significant differences were observed between groups on functional capacity and health-related quality of life. Significant differences were found between groups on the adherence to treatment (in favor of the control group), but no differences were obtained in other outcomes such as enjoyment and motivation. CONCLUSIONS AND IMPLICATIONS In general, there is very limited evidence for the efficacy to reach conclusions about the effects of game-based interventions on health-related outcomes in acutely hospitalized older patients. Future studies are needed to improve our knowledge in the field; however, we consider that these strategies should be considered in the future complementary to usual care.
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Affiliation(s)
- César Cuevas-Lara
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain.
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Mikel L Sáez de Asteasu
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Fabiola Zambom-Ferraresi
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain
| | - Fabricio Zambom-Ferraresi
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Hospital Complex of Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Geriatric Department, Hospital Complex of Navarra (CHN), Pamplona, Navarra, Spain.
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20
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Rudolf K, Bickmann P, Froböse I, Tholl C, Wechsler K, Grieben C. Demographics and Health Behavior of Video Game and eSports Players in Germany: The eSports Study 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1870. [PMID: 32183070 PMCID: PMC7142975 DOI: 10.3390/ijerph17061870] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 01/29/2023]
Abstract
The number of video game and eSports players is steadily rising. Since little is known about their health behavior to date, the present study examines the demographics and health behavior of video game and eSports players. In this cross-sectional study, data on demographics, health status, physical activity, nutrition, sleep, and video game usage were assessed via a web-based survey of n = 1066 players (91.9% male; 22.9 ± 5.9 years; body mass index (BMI): 24.6 ± 4.8 kg/m²) in Germany in 2018. The majority of respondents (95%) reported a good to excellent health status. Two thirds (66.9%) engaged in moderate to vigorous physical activity for more than 2.5 h/week. The average duration of sitting and sleep time was 7.7 ± 3.6 h/day and 7.1 ± 1.3 h/day, respectively. Mean fruit and vegetable consumption was 2.7 ± 1.8 portions/day. Video games were played for 24.4 ± 15.9 h/week on average. Partial Spearman correlations revealed poor positive associations of video game play time to sedentary behavior (rho = 0.15; p < 0.01) and BMI (rho = 0.11; p < 0.01), as well as a poor negative association to self-reported health status (rho = -0.14; p < 0.01). These results indicate the good subjective health of this target group. Nevertheless, the high amount of video game play time and its poor negative association to health status indicate a need for specific health promotion strategies for this target group.
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Affiliation(s)
- Kevin Rudolf
- Institute of Movement Therapy and movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany; (P.B.); (I.F.); (C.T.); (K.W.); (C.G.)
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21
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Kollins SH, DeLoss DJ, Cañadas E, Lutz J, Findling RL, Keefe RSE, Epstein JN, Cutler AJ, Faraone SV. A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial. LANCET DIGITAL HEALTH 2020; 2:e168-e178. [PMID: 33334505 DOI: 10.1016/s2589-7500(20)30017-0] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is a common paediatric neurodevelopmental disorder with substantial effect on families and society. Alternatives to traditional care, including novel digital therapeutics, have shown promise to remediate cognitive deficits associated with this disorder and may address barriers to standard therapies, such as pharmacological interventions and behavioural therapy. AKL-T01 is an investigational digital therapeutic designed to target attention and cognitive control delivered through a video game-like interface via at-home play for 25 min per day, 5 days per week for 4 weeks. This study aimed to assess whether AKL-T01 improved attentional performance in paediatric patients with ADHD. METHODS The Software Treatment for Actively Reducing Severity of ADHD (STARS-ADHD) was a randomised, double-blind, parallel-group, controlled trial of paediatric patients (aged 8-12 years, without disorder-related medications) with confirmed ADHD and Test of Variables of Attention (TOVA) Attention Performance Index (API) scores of -1·8 and below done by 20 research institutions in the USA. Patients were randomly assigned 1:1 to AKL-T01 or a digital control intervention. The primary outcome was mean change in TOVA API from pre-intervention to post-intervention. Safety, tolerability, and compliance were also assessed. Analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02674633 and is completed. FINDINGS Between July 15, 2016, and Nov 30, 2017, 857 patients were evaluated and 348 were randomly assigned to receive AKL-T01 or control. Among patients who received AKL-T01 (n=180 [52%]; mean [SD] age, 9·7 [1·3] years) or control (n=168 [48%]; mean [SD] age, 9·6 [1·3] years), the non-parametric estimate of the population median change from baseline TOVA API was 0·88 (95% CI 0·24-1·49; p=0·0060). The mean (SD) change from baseline on the TOVA API was 0·93 (3·15) in the AKL-T01 group and 0·03 (3·16) in the control group. There were no serious adverse events or discontinuations. Treatment-related adverse events were mild and included frustration (5 [3%] of 180) and headache (3 [2%] of 180). Patient compliance was a mean of 83 (83%) of 100 expected sessions played (SD, 29·2 sessions). INTERPRETATION Although future research is needed for this digital intervention, this study provides evidence that AKL-T01 might be used to improve objectively measured inattention in paediatric patients with ADHD, while presenting minimal adverse events. FUNDING Sponsored by Akili Interactive Labs.
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Affiliation(s)
- Scott H Kollins
- Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA.
| | | | | | | | - Robert L Findling
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard S E Keefe
- Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; VeraSci, Durham, NC, USA
| | - Jeffery N Epstein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew J Cutler
- Meridien Research & Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | - Stephen V Faraone
- Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
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22
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Sosso FAE, Kuss DJ, Vandelanotte C, Jasso-Medrano JL, Husain ME, Curcio G, Papadopoulos D, Aseem A, Bhati P, Lopez-Rosales F, Becerra JR, D'Aurizio G, Mansouri H, Khoury T, Campbell M, Toth AJ. Insomnia, sleepiness, anxiety and depression among different types of gamers in African countries. Sci Rep 2020; 10:1937. [PMID: 32029773 PMCID: PMC7005289 DOI: 10.1038/s41598-020-58462-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/15/2020] [Indexed: 11/24/2022] Open
Abstract
Gaming has increasingly become a part of life in Africa. Currently, no data on gaming disorders or their association with mental disorders exist for African countries. This study for the first time investigated (1) the prevalence of insomnia, excessive daytime sleepiness, anxiety and depression among African gamers, (2) the association between these conditions and gamer types (i.e., non-problematic, engaged, problematic and addicted) and (3) the predictive power of socioeconomic markers (education, age, income, marital status, employment status) on these conditions. 10,566 people from 2 low- (Rwanda, Gabon), 6 lower-middle (Cameroon, Nigeria, Morocco, Tunisia, Senegal, Ivory Coast) and 1 upper-middle income countries (South Africa) completed online questionnaires containing validated measures on insomnia, sleepiness, anxiety, depression and gaming addiction. Results showed our sample of gamers (24 ± 2.8 yrs; 88.64% Male), 30% were addicted, 30% were problematic, 8% were engaged and 32% were non-problematic. Gaming significantly contributed to 86.9% of the variance in insomnia, 82.7% of the variance in daytime sleepiness and 82.3% of the variance in anxiety [p < 0.001]. This study establishes the prevalence of gaming, mood and sleep disorders, in a large African sample. Our results corroborate previous studies, reporting problematic and addicted gamers show poorer health outcomes compared with non-problematic gamers.
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Affiliation(s)
- F A Etindele Sosso
- Center for Advanced Studies in Sleep Medicine, Hopital du Sacré-Coeur de Montreal, Research Center of Cognitive Neurosciences, Institut Santé et Société, Université du Québec à Montreal, Québec, Canada.
| | - D J Kuss
- School of Social Sciences, Department of Psychology, International Gaming Research Unit and the Cyberpsychology Group, Nottingham Trent University, Nottingham, UK
| | - C Vandelanotte
- School of Health, Medical and Applied Sciences, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - J L Jasso-Medrano
- Center for Research in Nutrition and Public Health, Autonomous University of Nuevo Leon, Monterrey, N.L., Mexico
| | - M E Husain
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - G Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - D Papadopoulos
- Department of Pulmonology, Army Share Fund Hospital, Athens, Greece
| | - A Aseem
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - P Bhati
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - F Lopez-Rosales
- Innovation and Evaluation in Health Psychology, Faculty of Psychology, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - J Ramon Becerra
- Innovation and Evaluation in Health Psychology, Faculty of Psychology, Autonomous University of Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - G D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - H Mansouri
- Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - T Khoury
- Department of Biomedical sciences, Faculty of Arts and Sciences, University of Montréal, Montréal, Québec, Canada
| | - M Campbell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - A J Toth
- Lero Irish Software Research Centre, University of Limerick, Limerick, Ireland
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23
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Etindele-Sosso FA. Insomnia, excessive daytime sleepiness, anxiety, depression and socioeconomic status among customer service employees in Canada. Sleep Sci 2020; 13:54-64. [PMID: 32670493 PMCID: PMC7347365 DOI: 10.5935/1984-0063.20190133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/28/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE It is the first study investigating deeply symptoms of neuropsychiatric diseases among a large population of customer service employees (n=1238, 640 females and 598 males). The study's goals were document presence of sleep disorders, anxiety and depression among customer service advisors and determine the influence of the socioeconomic status (pSES), duration in position and full-time or part-time shift on the diseases above. METHODS Linear regressions and ANOVA with a Tukey multiple comparisons of means was performed to analyze correlation and differences between citizens, international students and immigrants in their pSES and neuropsychiatric diseases. RESULTS Customer service employees (578 Canadians, 264 immigrants and 358 international students) are in majority undergraduate students (286 men and 289 females) with a high school degree (280 men and 308 women). They work full-time (560 men and 548 women) and are single (420 men and 560 women). Among customer service advisors, the time spent as an advisor was an excellent predictor of insomnia, sleepiness and anxiety (respectively with R2=91,83%, R2=81,23% and R2=87,46%) but a moderate predictor of depression (R2=69,14%). The pSES was a moderate predictor of sleep disorders (respectively R2=62,04% for insomnia and R2=53,62% for sleepiness) and strongly associated with anxiety and depression (R2=82,95% for anxiety and R2=89,77% for depression). DISCUSSION Insomnia, sleepiness and anxiety are more prevalent for full-time employees (higher for immigrants and international students compared to Canadians) compared with part-time employees, while depression was similarly higher for Canadian and immigrants compared to international students. Regarding full-time employees, symptoms of insomnia, anxiety and depression were higher for men compared to women. Regarding part-time employees, symptoms of insomnia and sleepiness were higher for women compared to men. Employees working full-time with rotating shifts are more exposed to insomnia, sleepiness and anxiety than employees working part-time. More research is needed to understand mental health of customer service employees regardless of their area and it is worthy of interest to study the link between sleep disorders and mood disorders with work conditions. Here some practical suggestions are made to reduce neuropsychiatric disorders for customer service employees or to at least mitigate the work burden on their brains.
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Affiliation(s)
- Faustin Armel Etindele-Sosso
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine (CEAMS) - Montréal - Qc - Canada
- Université du Québec à Montréal, Institut Santé et Société - Montréal - Qc - Canada
- Douglas Institute of Mental Health, Quebec Network on Suicide, Mood Disorders and Related Disorders (RQSHA) - Montréal - Qc - Canada
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Receptive versus interactive video screens: A role for the brain's default mode network in learning from media. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.05.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Does Video Gaming Have Impacts on the Brain: Evidence from a Systematic Review. Brain Sci 2019; 9:brainsci9100251. [PMID: 31557907 PMCID: PMC6826942 DOI: 10.3390/brainsci9100251] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 01/05/2023] Open
Abstract
Video gaming, the experience of playing electronic games, has shown several benefits for human health. Recently, numerous video gaming studies showed beneficial effects on cognition and the brain. A systematic review of video gaming has been published. However, the previous systematic review has several differences to this systematic review. This systematic review evaluates the beneficial effects of video gaming on neuroplasticity specifically on intervention studies. Literature research was conducted from randomized controlled trials in PubMed and Google Scholar published after 2000. A systematic review was written instead of a meta-analytic review because of variations among participants, video games, and outcomes. Nine scientific articles were eligible for the review. Overall, the eligible articles showed fair quality according to Delphi Criteria. Video gaming affects the brain structure and function depending on how the game is played. The game genres examined were 3D adventure, first-person shooting (FPS), puzzle, rhythm dance, and strategy. The total training durations were 16–90 h. Results of this systematic review demonstrated that video gaming can be beneficial to the brain. However, the beneficial effects vary among video game types.
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Wu S, Jo EA, Ji H, Kim KH, Park JJ, Kim BH, Cho KI. Exergaming Improves Executive Functions in Patients With Metabolic Syndrome: Randomized Controlled Trial. JMIR Serious Games 2019; 7:e13575. [PMID: 31368441 PMCID: PMC6693301 DOI: 10.2196/13575] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/07/2019] [Accepted: 05/25/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Recent studies indicate that participation in exercise-related games can improve executive function, attention processing, and visuospatial skills. OBJECTIVE The aim of this study was to investigate whether exercise via exergaming (EXG) can improve executive function in patients with metabolic syndrome (MetS). METHODS A 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. RESULTS During 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. CONCLUSIONS EXG 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 REGISTRATION ClinicalTrials.gov NCT04015583; https://clinicaltrials.gov/ct2/show/NCT04015583.
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Affiliation(s)
- Shanshan Wu
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Eun-Ah Jo
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea
| | - Hongqing Ji
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Kyung-Hee Kim
- Department of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Bo Hyun Kim
- Department of Internal Medicine, Pusan National University Hospital and Biomedical Research Institute, Busan, Republic of Korea
| | - Kyoung Im Cho
- Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea
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Vázquez FL, Otero P, García-Casal JA, Blanco V, Torres ÁJ, Arrojo M. Efficacy of video game-based interventions for active aging. A systematic literature review and meta-analysis. PLoS One 2018; 13:e0208192. [PMID: 30533015 PMCID: PMC6289420 DOI: 10.1371/journal.pone.0208192] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/13/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Due to the appeal and recent technological advances of video games, the games have gained interest as an intervention tool for active aging. The aim of this systematic literature review and meta-analysis was to determine the efficacy of video games for active aging and to examine the influence of potential moderator variables. METHODS A systematic search was done using the following databases: Medline, PsycINFO, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. In addition, previous reviews and meta-analyses were used to identify randomized controlled trials (RCT) of video game-based interventions for active aging published through February 28, 2018. An evaluation of the methodological quality of the articles and a meta-analysis and moderator analysis was conducted. RESULTS A total of 22 articles depicting 21 RCT with 1125 participants were included. The results indicated that video game-based interventions produced positive effects on objectively measured physical health, negative affect and social health, with small effect sizes (d = 0.41, d = 0.26 and d = 0.40, respectively). The magnitude of this effect was moderated by the presence of subclinical conditions of participants, the type of game (exergames), the presence of physical activity, the type of prevention (indicated), non-blinded assignation, and older age of participants. The methodological quality of the studies was acceptable, the weakest area being external validity. CONCLUSION These finding indicate that video game-based interventions may assist adults in leading active aging processes and preventing secondary aging. Although more research is needed, video game-based interventions are a promising and accessible tool for active aging promotion.
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Affiliation(s)
- Fernando L. Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Otero
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - J. Antonio García-Casal
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vanessa Blanco
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángela J. Torres
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela, SERGAS, Santiago de Compostela, Spain
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Abstract
Survival alone is no longer an adequate outcome for persons with brain tumors; the quality of the survivorship experience should be viewed with equal importance. Symptom management is a significant component of quality survivorship care. Regardless of their histology, brain tumors and therapies used to treat them produce symptoms that affect an individual's ability to function in everyday life. Common symptoms include fatigue, cognitive impairment, distress, and sleep disturbance. Symptom-based interventions for persons with brain tumors focus on prevention, self-management, and prescriptive interventions targeted to these problems. Unfortunately, little evidence exists to support many interventions, making it challenging for clinicians to provide concrete recommendations. Research is needed to provide evidence in support of symptom-based interventions while novel approaches to these challenging problems are developed.
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Affiliation(s)
- Christina Amidei
- Northwestern Medicine, Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Li Y, Zhang L, Long K, Gong H, Lei H. Real-time monitoring prefrontal activities during online video game playing by functional near-infrared spectroscopy. JOURNAL OF BIOPHOTONICS 2018; 11:e201700308. [PMID: 29451742 DOI: 10.1002/jbio.201700308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/14/2018] [Indexed: 06/08/2023]
Abstract
A growing body of literature has suggested that video game playing can induce functional and structural plasticity of the brain. The underlying mechanisms, however, remain poorly understood. In this study, functional near-infrared spectroscopy (fNIRS) was used to record prefrontal activities in 24 experienced game players when they played a massively multiplayer online battle arena video game, League of Legends (LOL), under naturalistic conditions. It was observed that game onset was associated with significant activations in the ventrolateral prefrontal cortex (VLPFC) and concomitant deactivations in the dorsolateral prefrontal cortex (DLPFC) and frontal pole area (FPA). Game events, such as slaying an enemy and being slain by an enemy evoked region-specific time-locked hemodynamic/oxygenation responses in the prefrontal cortex (PFC). It was proposed that the VLPFC activities during LOL playing are likely responses to visuo-motor task load of the game, while the DLPFC/FPA activities may be involved in the constant shifts of attentional states and allocation of cognitive resources required by game playing. The present study demonstrated that it is feasible to use fNIRS to monitor real-time prefrontal activity during online video game playing.
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Affiliation(s)
- Yue Li
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Wuhan 430071, China
| | - Lei Zhang
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Kehong Long
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Wuhan 430071, China
| | - Hui Gong
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Hao Lei
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
- National Center for Magnetic Resonance in Wuhan, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Wuhan 430071, China
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30
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Välimäki M, Mishina K, Kaakinen JK, Holm SK, Vahlo J, Kirjonen M, Pekurinen V, Tenovuo O, Korkeila J, Hämäläinen H, Sarajuuri J, Rantanen P, Orenius T, Koponen A. Digital Gaming for Improving the Functioning of People With Traumatic Brain Injury: Randomized Clinical Feasibility Study. J Med Internet Res 2018; 20:e77. [PMID: 29555622 PMCID: PMC5881042 DOI: 10.2196/jmir.7618] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 11/15/2017] [Accepted: 01/02/2018] [Indexed: 11/13/2022] Open
Abstract
Background Traumatic brain injury (TBI) is a major health problem that often requires intensive and long-term rehabilitation. Objective The aim of this study was to determine whether rehabilitative digital gaming facilitates cognitive functioning and general well-being in people with TBI. Methods A total of 90 Finnish-speaking adults with TBI (18-65 years) were recruited from an outpatient neuroscience clinic. The participants were randomly allocated to one of the three groups: a rehabilitation gaming group (n=29, intervention), an entertainment gaming group (n=29, active control), or a passive control group (n=32). The gaming groups were instructed to engage in gaming for a minimum of 30 min per day for 8 weeks. Primary and secondary outcomes were measured at three time points: before the intervention, after the intervention, and 3 months following the intervention. The primary outcome was cognitive status measured by processing speed and visuomotor tasks (The Trail Making Test; Wechsler Adult Intelligence Scale-Fourth Edition, WAIS-IV, symbol search, coding, and cancellation tasks). Secondary outcomes were attention and executive functions (Simon task), working memory (WAIS-IV digit span and Paced Auditory Serial Addition Test, PASAT), depression (Patient Health Questionnaire-9), self-efficacy (General Self-efficacy Scale), and executive functions (Behavior Rating Inventory of Executive Function-Adult Version). Feasibility information was assessed (acceptability, measurement instruments filled, dropouts, adherence, usability, satisfaction, and possible future use). Cognitive measurements were conducted in face-to-face interviews by trained psychologists, and questionnaires were self-administered. Results The effects of rehabilitation gaming did not significantly differ from the effects of entertainment gaming or being in a passive control group. For primary outcomes and PASAT tests, the participants in all three groups showed overall improvement in test scores across the three measurement points. However, depression scores increased significantly between baseline and after 8 weeks and between baseline and after 3 months in the rehabilitative gaming group. No differences were found in patients’ self-efficacy between the three measuring points in any of the groups. Participants did use the games (rehabilitation group: 93%, 27/29; entertainment group 100%, 29/29). Games were seen as a usable intervention (rehabilitation group: 70%, 14/29; entertainment group: 83%, 20/29). The rehabilitation group was less satisfied with the gaming intervention (68%, 13/29 vs 83%, 20/29), but they were more willing to use the game after the intervention period (76%, 16/29 vs 63%, 15/29). Total time spent on gaming during the intervention period was low (15.22 hour rehabilitation gaming group, 19.22 hour entertainment gaming group). Conclusions We did not find differences between the groups in improvement in the outcome measures. The improvements in test performance by all three groups may reflect rehearsal effects. Entertainment gaming had elements that could be considered when rehabilitative games are designed for, implemented in, and assessed in larger clinical trials for persons with TBI. Trial Registration ClinicalTrials.gov NCT02425527; https://clinicaltrials.gov/ct2/show/NCT02425527 (Archived by WebCite at http://www.webcitation.org/6esKI1uDH)
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Affiliation(s)
- Maritta Välimäki
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Kaisa Mishina
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Johanna K Kaakinen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Suvi K Holm
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Jukka Vahlo
- Turku School of Economics, Centre for Collaborative Research, University of Turku, Turku, Finland
| | - Markus Kirjonen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Virve Pekurinen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Olli Tenovuo
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Faculty of Medicine, University of Turku, Turku, Finland
| | - Jyrki Korkeila
- Faculty of Medicine, University of Turku, Turku, Finland.,Psychiatric Care Division, Satakunta Hospital District, Harjavalta, Finland
| | - Heikki Hämäläinen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | | | | | - Tage Orenius
- Orton Orthopaedic Hospital, Orton, Helsinki, Finland
| | - Aki Koponen
- Turku School of Economics, Centre for Collaborative Research, University of Turku, Turku, Finland
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Schättin A, Baur K, Stutz J, Wolf P, de Bruin ED. Effects of Physical Exercise Combined with Nutritional Supplements on Aging Brain Related Structures and Functions: A Systematic Review. Front Aging Neurosci 2016; 8:161. [PMID: 27458371 PMCID: PMC4933713 DOI: 10.3389/fnagi.2016.00161] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 06/20/2016] [Indexed: 01/12/2023] Open
Abstract
Age-related decline in gray and white brain matter goes together with cognitive depletion. To influence cognitive functioning in elderly, several types of physical exercise and nutritional intervention have been performed. This paper systematically reviews the potential additive and complementary effects of nutrition/nutritional supplements and physical exercise on cognition. The search strategy was developed for EMBASE, Medline, PubMed, Cochrane, CINAHL, and PsycInfo databases and focused on the research question: “Is the combination of physical exercise with nutrition/nutritional supplementation more effective than nutrition/nutritional supplementation or physical exercise alone in effecting on brain structure, metabolism, and/or function?” Both mammalian and human studies were included. In humans, randomized controlled trials that evaluated the effects of nutrition/nutritional supplements and physical exercise on cognitive functioning and associated parameters in healthy elderly (>65 years) were included. The systematic search included English and German language literature without any limitation of publication date. The search strategy yielded a total of 3129 references of which 67 studies met the inclusion criteria; 43 human and 24 mammalian, mainly rodent, studies. Three out of 43 human studies investigated a nutrition/physical exercise combination and reported no additive effects. In rodent studies, additive effects were found for docosahexaenoic acid supplementation when combined with physical exercise. Although feasible combinations of physical exercise/nutritional supplements are available for influencing the brain, only a few studies evaluated which possible combinations of nutrition/nutritional supplementation and physical exercise might have an effect on brain structure, metabolism and/or function. The reason for no clear effects of combinatory approaches in humans might be explained by the misfit between the combinations of nutritional methods with the physical interventions in the sense that they were not selected on sharing of similar neuronal mechanisms. Based on the results from this systematic review, future human studies should focus on the combined effect of docosahexaenoic acid supplementation and physical exercise that contains elements of (motor) learning.
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Affiliation(s)
- Alexandra Schättin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Kilian Baur
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Jan Stutz
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Peter Wolf
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
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Loewy R, Fisher M, Schlosser DA, Biagianti B, Stuart B, Mathalon DH, Vinogradov S. Intensive Auditory Cognitive Training Improves Verbal Memory in Adolescents and Young Adults at Clinical High Risk for Psychosis. Schizophr Bull 2016; 42 Suppl 1:S118-26. [PMID: 26903238 PMCID: PMC4960436 DOI: 10.1093/schbul/sbw009] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Individuals at clinical high risk (CHR) for psychosis demonstrate cognitive impairments that predict later psychotic transition and real-world functioning. Cognitive training has shown benefits in schizophrenia, but has not yet been adequately tested in the CHR population. METHODS In this double-blind randomized controlled trial, CHR individuals (N = 83) were given laptop computers and trained at home on 40 hours of auditory processing-based exercises designed to target verbal learning and memory operations, or on computer games (CG). Participants were assessed with neurocognitive tests based on the Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative (MATRICS) battery and rated on symptoms and functioning. Groups were compared before and after training using a mixed-effects model with restricted maximum likelihood estimation, given the high study attrition rate (42%). RESULTS Participants in the targeted cognitive training group showed a significant improvement in Verbal Memory compared to CG participants (effect size = 0.61). Positive and Total symptoms improved in both groups over time. CONCLUSIONS CHR individuals showed patterns of training-induced cognitive improvement in verbal memory consistent with prior observations in schizophrenia. This is a particularly vulnerable domain in individuals at-risk for psychosis that predicts later functioning and psychotic transition. Ongoing follow-up of this cohort will assess the durability of training effects in CHR individuals, as well as the potential impact on symptoms and functioning over time. Clinical Trials Number: NCT00655239. URL: https://clinicaltrials.gov/ct2/show/NCT00655239?term=vinogradov&rank=5.
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Affiliation(s)
- Rachel Loewy
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Melissa Fisher
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Danielle A Schlosser
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Bruno Biagianti
- Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Barbara Stuart
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Department of Psychiatry, San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA
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Eggenberger P, Wolf M, Schumann M, de Bruin ED. Exergame and Balance Training Modulate Prefrontal Brain Activity during Walking and Enhance Executive Function in Older Adults. Front Aging Neurosci 2016; 8:66. [PMID: 27148041 PMCID: PMC4828439 DOI: 10.3389/fnagi.2016.00066] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 03/21/2016] [Indexed: 11/13/2022] Open
Abstract
Different types of exercise training have the potential to induce structural and functional brain plasticity in the elderly. Thereby, functional brain adaptations were observed during cognitive tasks in functional magnetic resonance imaging studies that correlated with improved cognitive performance. This study aimed to investigate if exercise training induces functional brain plasticity during challenging treadmill walking and elicits associated changes in cognitive executive functions. Forty-two elderly participants were recruited and randomly assigned to either interactive cognitive-motor video game dancing (DANCE) or balance and stretching training (BALANCE). The 8-week intervention included three sessions of 30 min per week and was completed by 33 participants (mean age 74.9 ± 6.9 years). Prefrontal cortex (PFC) activity during preferred and fast walking speed on a treadmill was assessed applying functional near infrared spectroscopy pre- and post-intervention. Additionally, executive functions comprising shifting, inhibition, and working memory were assessed. The results showed that both interventions significantly reduced left and right hemispheric PFC oxygenation during the acceleration of walking (p < 0.05 or trend, r = 0.25-0.36), while DANCE showed a larger reduction at the end of the 30-s walking task compared to BALANCE in the left PFC [F (1, 31) = 3.54, p = 0.035, r = 0.32]. These exercise training induced modulations in PFC oxygenation correlated with improved executive functions (p < 0.05 or trend, r = 0.31-0.50). The observed reductions in PFC activity may release cognitive resources to focus attention on other processes while walking, which could be relevant to improve mobility and falls prevention in the elderly. This study provides a deeper understanding of the associations between exercise training, brain function during walking, and cognition in older adults.
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Affiliation(s)
- Patrick Eggenberger
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich Zurich, Switzerland
| | - Martin Wolf
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich Zurich, Switzerland
| | - Martina Schumann
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich Zurich, Switzerland
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH ZurichZurich, Switzerland; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht UniversityMaastricht, Netherlands; Centre for Evidence Based Physiotherapy, Maastricht UniversityMaastricht, Netherlands
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34
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Brühl AB, Sahakian BJ. Drugs, games, and devices for enhancing cognition: implications for work and society. Ann N Y Acad Sci 2016; 1369:195-217. [PMID: 27043232 DOI: 10.1111/nyas.13040] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 02/15/2016] [Accepted: 02/18/2016] [Indexed: 12/11/2022]
Abstract
As work environments change, the demands on working people change. Cognitive abilities in particular are becoming progressively more important for work performance and successful competition in a global environment. However, work-related stress, performance over long hours, lack of sleep, shift work, and jet lag affect cognitive functions. Therefore, an increasing number of healthy people are reported to use cognitive-enhancing drugs, as well as other interventions, such as noninvasive brain stimulation, to maintain or improve work performance. This review summarizes research on pharmacological and technical methods as well as cognitive training, including game apps for the brain, in healthy people. In neuropsychiatric disorders, impairments in cognitive functions can drastically reduce the chances of returning to work; therefore, this review also summarizes findings from pharmacological and cognitive-training studies in neuropsychiatric disorders.
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Affiliation(s)
- Annette B Brühl
- Department of Psychiatry, and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom.,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zürich, Switzerland
| | - Barbara J Sahakian
- Department of Psychiatry, and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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