Energy expended by boys playing active video games

Motion-based technology to support motor skills screening in developing children: A scoping review

BACKGROUND

Acquiring motor skills is fundamental for children's development since it is linked to cognitive development. However, access to early detection of motor development delays is limited.

AIM

This review explores the use and potential of motion-based technology (MBT) as a complement to support and increase access to motor screening in developing children.

METHODS

Six databases were searched following the PRISMA guidelines to search, select, and assess relevant works where MBT recognised the execution of children's motor skills.

RESULTS

164 studies were analysed to understand the type of MBT used, the motor skills detected, the purpose of using MBT and the age group targeted.

CONCLUSIONS

There is a gap in the literature aiming to integrate MBT in motor skills development screening and assessment processes. Depth sensors are the prevailing technology offering the largest detection range for children from age 2. Nonetheless, the motor skills detected by MBT represent about half of the motor skills usually observed to screen and assess motor development. Overall, research in this field is underexplored. The use of multimodal approaches, combining various motion-based sensors, may support professionals in the health domain and increase access to early detection programmes.

Alternative Model for Physical Activity: Active Video Games Lead to High Physiological Responses

Purpose: This study aimed to i) investigate the physiological and perceptual responses to two different active video games (AVGs), ii) compare the physiological and perceptual responses to AVGs with those encountered during classic exercise and daily sedentary routines, and iii) compare the examined variables between the sexes. Methods: Forty-three (n = 22 male, n = 21 female) volunteers participated in the study and were tested in five different conditions (resting, watching television (TV), brisk walking, AVG dancing, and AVG fighting). Oxygen consumption (VO₂) and heart rate (HR) were measured continuously, whereas energy expenditure (EE) and metabolic equivalent (MET) were calculated. Rating of perceived exertion (RPE) and enjoyment scores were recorded. Results: AVG dancing and AVG fighting significantly increased VO₂, MET, EE, and HR compared with brisk walking, resting, and watching TV. Comparing with brisk walking the AVG dancing yielded similar RPE and higher enjoyment scores. However, the highest physiological responses, RPE, and enjoyment scores were obtained during AVG fighting. There were significant sex x condition interactions for VO₂, MET, EE, and HR. VO₂, MET, and EE were significantly higher in males for all conditions, whereas HR was significantly higher in females. The mean EE values during AVG fighting and AVG dancing were 13.12 ± 2.2 kcal.min^-1 and 9.69 ± 2.0 kcal.min^-1, respectively in males, and 9.31 ± 1.9 kcal.min^-1 and 7.07 ± 1.3 kcal.min^-1, respectively in females. Conclusions: AVG dancing (MET >7) and AVG fighting (MET >9) are enjoyable, vigorous physical activities that can be recommended as an alternative home-based physical activity.

Feasibility and Effectiveness of a Motion Tracking-Based Online Fitness Program for Office Workers

The development of technology-based home fitness has emerged from the booming digital healthcare market and recent demands for at-home fitness and health equipment due to the COVID-19 pandemic. Digital healthcare company Alyce Healthcare recently developed Weelo, which is a web-based online fitness program. Weelo recommends an exercise protocol through machine-learning-enabled recognition of the user’s motion and provides visual and auditory feedback. We evaluated whether Weelo improves physical and mental well-being to assess its capabilities and effectiveness. Thirty-two participants performed a total of 20 exercise sessions following the Weelo guide on a laptop. The participants were evaluated using a before and after exercise program, body composition, handgrip strength, six-minute walk test, modified star excursion balance test, short form 36, fatigue severity scale, Beck depression index, and a satisfaction survey. Overall, there was a significant improvement in muscle strength, endurance, and balance ability, as well as an improved quality of life and significant reduction in fatigue and depression. Participants showed high motivation to continue following the Weelo exercise program. In conclusion, utilizing Weelo improved physical and mental well-being and is considered to be an individual-use indoor exercise program that serves as an alternative to traditional face-to-face exercise.

Influence of the Use of Wii Games on Physical Frailty Components in Institutionalized Older Adults

Aging is a multifactorial physiological phenomenon in which cellular and molecular changes occur. These changes lead to poor locomotion, poor balance, and an increased falling risk. This study aimed to determine the impact and effectiveness of the use of the Wii^® game console on improving walking speed and balance, as well as its influence on frailty levels and falling risk, in older adults. A longitudinal study was designed with a pretest/post-test structure. The study population comprised people over 75 years of age who lived in a nursing home or attended a day care center (n = 80; 45 women; 84.2 ± 8.7 years). Forty of them were included in the Wii group (20 rehabilitation sessions during 8 consecutive weeks), and the other 40 were in the control group. Falling risk and frailty were evaluated using the Downton scale and Fried scale; balance and walking speed were assessed with the Berg Balance scale and the Gait Speed Test, respectively, as well as the Short Physical Performance Battery (SPPB). The results showed that there was no significant association between Frailty Phenotype and study groups in baseline. However, there was significant association between Frailty Phenotype and study groups at the end of study. Moreover, a significantly higher and negative percentage change (Δ) in the Wii group with respect to the control group on the in falling risk (−20.05 ± 35.14% vs. 7.92 ± 24.53%) and in walking speed (−6.42 ± 8.83% vs. −0.12 ± 4.51%) during study, while there was a higher and positive significant percent change in static balance (6.07 ± 5.74% vs. 2.13 ± 4.64%) and on the SPPB (20.28 ± 20.05% vs. 0.71 ± 7.99%) after 8 weeks of study. The main conclusion of this study was that the use of the Wii^® video console for 8 weeks positively influenced walking speed, falling risk, static balance, and frailty levels in older adults. Through a rehabilitation program with the Wii^® game console in the older adults, frailty levels are reduced, accompanied by a reduction in falling risk and an increase in static balance and walking speed.

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

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

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

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

Active Video Games Versus Traditional Exercises: Energy Expenditure and Blood Lactate Responses

Purpose: The current study aimed to investigate the exercise intensity and exercise characteristics of active video games (AVGs) by measuring various physiological responses, and to test whether AVGs can be used in components of training in sports branches. Methods: Twenty-two male athletes with good aerobic fitness level (age = 20.6 ± 2.2 years; maximum oxygen consumption (VO₂max) = 52.2 ± 3.5 ml.kg^-1.min^-1) visited the laboratory three times (D1, D2, and D3). After taking measurements during rest, the VO₂max was assessed (D1). Traditional brisk walking and running exercises were performed consecutively (D2), and AVGs-dancing and fighting-were performed at random (D3); each exercise session lasted 20 minutes, and for each experiment session oxygen consumption (VO₂), heart rate (HR) were recorded, VO₂max%, metabolic equivalent (MET), and energy expenditure (EE) were calculated. Results: No significant differences were found between AVG-dancing and brisk walking (p > .05) for VO₂ (25.96 ± 3.3 vs. 24.39 ± 2.3 ml.kg^-1.min^-1), HR (137.02 ± 20.15 vs. 125.61 ± 6.49 beats.min^-1) VO₂max% (49.99 ± 7.00 vs. 46.84 ± 4.06), MET (7.49 ± 0.94 vs. 6.96 ± 0.65), and EE (181.19 ± 27.65 vs. 171.21 ± 22.51 Kcal). Additionally, no significant differences were found between AVG-fighting and running (p > .05) for VO₂ (33.96 ± 5.88 vs. 33.13 ± 2.52 ml.kg^-1.min^-1), HR (155.66 ± 15.05 vs. 153.30 ± 6.83 beats.min^-1), VO₂max% (65.05 ± 9.76 vs. 63.60 ± 3.51), MET (9.70 ± 1.68 vs. 9.47 ± 0.72), and EE (236.75 ± 37.20 vs. 232.70 ± 27.06). Conclusions: AVG-dancing and fighting were defined as moderate (MET>7) and high (MET>9) intensity intermittent exercises, respectively. Consequently, AVGs can be a part of training for athletes; as a block, modified block or a traditional training cycle involving enjoyable alternative exercises, especially when the appropriate AVGs are chosen.

Does exergaming drive future physical activity and sport intentions?

We studied how usability and playability of sport exergames affect future intentions of participation in physical activity or actual sport. We employed questionnaires to measure participants' enjoyment, usability, game-experience, and future intentions of physical activity and real sport. We compared the outcomes based on players' gender, previous real-swimming, and exergame experience. Psychological parameters were not different between groups but players without exergame experience enjoyed the game more. Physical activity intentions increased for all participants but not swimming intentions. The limitations of current gaming systems and their effects on players' gaming experience and intentions are discussed.

Rehabilitation and Disability Spectrum From Adverse Childhood Experience: The Impact of the Movement Cognition and Narration of Emotions Treatment (MCNT) Version 2.0

Adverse Childhood Experiences (ACE) are associated with an increased risk of cerebral, behavioral, and cognitive outcomes, and vulnerability to develop a Borderline Intellectual Functioning (BIF). BIF is characterized by an intelligence quotient (IQ) in the range 70-85, poor executive functioning, difficulties in emotion processing, and motor competencies. All these difficulties can lead to mental and/or neurodevelopmental disorders that require long-term care. Accordingly, we developed an intensive and multidomain rehabilitation program for children with ACE and BIF, termed the Movement Cognition and Narration of emotions Treatment (MCNT1.0). The efficacy of MCNT1.0 on cognitive and social functioning was demonstrated with a previously reported randomized controlled trial (RCT). To extend the impact of the treatment also to the motor domain a new version, called MCNT2.0, was implemented. The present study aims to verify the feasibility of MCNT2.0 and its effects on the motor domain. A quasi-experimental approach was used in which a group of 18 children with ACE and BIF were consecutively recruited and participated in the MCNT 2.0 program. Participants were compared with the MCNT1.0 group as an active comparator, using the dataset of the RCT. The two groups received a full evaluation comprising: the Wechsler Intelligent Scale for Children-IV (WISC-IV), the Movement-ABC (M-ABC), the Test of Gross Motor Development (TGMD), the Social Skills from Vineland Adaptive Behavioral Scale-II (VABS-II) and the Child Behavior Check List 6-18 (CBCL). An ANCOVA was carried out on changes in the scale scores from baseline with age and baseline score as covariates. Results showed a mean adherence to treatment of 0.85 (sd = 0.07), with no differences between groups in IQ, and Social Skills changes, while greater improvements for motor abilities were shown in the MCNT 2.0 group: M-ABC (p = 0.002), and TGMD (p = 0.002). Finally, greater improvement in the CBCL scale was observed in the MCNT 1.0 group (p = 0.002). Results indicate that due to its positive effects on cognitive, social participation and motor domains, MCNT2.0 may represent a protective factor against maladaptive outcomes of children with ACE and BIF.

Virtual Reality Gaming Elevates Heart Rate but Not Energy Expenditure Compared to Conventional Exercise in Adult Males

Virtual reality using head-mounted displays (HMD) could provide enhanced physical load during active gaming (AG) compared to traditional displays. We aimed to compare the physical load elicited by conventional exercise and AG with an HMD. We measured energy expenditure (EE) and heart rate (HR) in nine healthy men (age: 27 ± 5 years) performing three testing components in a randomised order: walking at 6 km/h (W6), AG, and AG with an additional constraint (AG^W; wrist-worn weights). Although we found that HR was not significantly different between W6 and the two modes of AG, actual energy expenditure was consistently lower in AG and AG^W compared to W6. We observed that playing AG with wrist-worn weights could be used as a means of increasing energy expenditure only at maximum game level, but ineffective otherwise. Our findings indicate that AG in an HMD may not provide a sufficient stimulus to meet recommended physical activity levels despite increased psychophysiological load. The differential outcomes of measures of HR and EE indicates that HR should not be used as an indicator of EE in AG. Yet, adding a simple constraint (wrist-worn weights) proved to be a simple and effective measure to increase EE during AG.

Impact of Active Video Games on Body Mass Index in Children and Adolescents: Systematic Review and Meta-Analysis Evaluating the Quality of Primary Studies

OBJECTIVE

To study the impact of active video games on Body Mass Index (BMI) in children and adolescents.

DESIGN AND METHODS

A systematic review and meta-analysis. Data were pooled in meta-analysis using the method of random effects or fixed effects, as appropriate, after examination of statistical heterogeneity. Data sources and eligibility criteria for selecting studies. A comprehensive literature research was conducted in Medline (PubMed), ISI web of Knowledge, and SCOPUS up to April 2018, in relation to clinical trials (both controlled and non-controlled) in children and adolescents, whose intervention was based on active video games.

RESULTS

The overall intragroup effect of the intervention based on active video games was in favor of the intervention, reaching statistical significance using the fixed effects model: (standardized mean difference (SMD) = -0.138; 95% CI (-0.237 to -0.038), p = 0.007 and was of borderline statistical significance in the random effects model: SMD= -0.191; 95% CI (-0.386 to 0.003), p = 0.053. The individual results of the determinations of the 15 included studies for this analysis showed a high heterogeneity among them (I2 = 82.91%). When the intervention was applied to children and adolescents with greater than or equal to 85 (overweight or obese) BMI percentile showed a greater effect in favor of the active video games: SMD= -0.483, p = 0.012. The overall intra-group effect in the control group was close to zero (SMD = 0.087). With respect to the non-standardized mean difference (MD) between groups, it was also in favor of active video games for both BMI (Kg/m2): DM = -0.317, 95% CI (-0.442 to -0.193), p = < 0.001 and BMI z-score: DM = -0.077, 95% CI (-0.139 to -0.016), p = 0.013.

CONCLUSIONS

Our meta-analysis show a statistically significant effect in favor of using active video games on BMI in children and adolescents. The clinical relevance of this positive effect must be evaluated.

AR Using NUI Based Physical Therapy Rehabilitation Framework with Mobile Decision Support System

This article describes how physical therapy rehabilitation promotes functional ability of the disabled people to improve quality of life using Range of Motion exercises. The conventional rehabilitation seems to be effective; however, the efficiency of the treatment sessions is not guaranteed resulting in longer recovery period. Thus, there is a need of self-motivating and engaging training solution to support rehabilitation and enhance continuous assessment of disabled patients. The proposed framework is “AR-NUI-REHAB-MDSS,” augmented reality (AR) using natural user interface (NUI) based physical therapy rehabilitation with personalized exercise rendering and monitoring system for patients and mobile decision support system (MDSS) for therapists leading to a global solution for remote assistance. NUI allows human computer interaction intuitively through human body gestures. AR provides an entertaining environment for treatments with less-assistance. MDSS enables therapist to customize treatment plans at dynamic environments. Upper limb is considered as its functional recovery is significant and more challenging.

OXYGEN CONSUMPTION AND ENERGY EXPENDITURE DURING AND AFTER STREET GAMES, ACTIVE VIDEO GAMES AND TV

ABSTRACT Introduction: Physical activity has become less frequent since the 1980s, even among more active children. Objective: To analyze excess post-exercise oxygen consumption (EPOC) and total energy expenditure (TEE) in children during and after three different activities. Methods: Sixteen healthy children (9.6±0.1 yrs.) randomly underwent the following procedures lasting 30 minutes on different days: (a) traditional games (PLAY), (b) active video game (Dance Dance Revolution; DDR), and (c) watching television (TV). Oxygen consumption (VO2) was measured at rest, at the 10th, 20th, and 30th minute of intervention, and for 40 minutes post-intervention. TEE was also measured. Results: At the end of intervention, VO2 had increased by 330% and 166% for PLAY and DDR, respectively, compared to the rest. EPOC in PLAY was seen to occur at the 10th, 20th, and 30th post-interventional minutes from 7.00±1.02 (at rest) to 10.83±0.94, 10.03±0.58, and 9.80±0.77mL.kg-1.min-1, respectively. However, EPOC in DDR occurred at only the 10th postinterventional minute (7.04 to 8.61 mL.kg-1.min-1; p<0.01). After intervention, TEE in PLAY was greater than in DDR and TV (112.08±19.45 vs 56.98±6.34 vs 36.39±4.5 kcal; p<0.01), respectively. Conclusions: PLAY induced children to reach a greater VO2 during activity and greater EPOC and TEE compared to DDR and TV. Level of evidence A1b; Crossover study.

Energy Expenditure and Intensity of Active Video Games in Children and Adolescents

PURPOSE

This study aimed to compare the energy expenditure and intensity of active video games to that of treadmill walking in children and adolescents.

METHOD

Seventy-two boys and girls (aged 8-13 years) were recruited from local public schools. Energy expenditure and heart rate were measured during rest, during 3-km/hr, 4-km/hr, and 5-km/hr walks, and during active games (Adventure, Boxing I, Boxing II, and Dance). During walking and active games, we also assessed physical activity using an accelerometer.

RESULTS

The energy expenditure of the active games Adventure, Boxing I, Boxing II, and Dance was similar to that of treadmill walking at 5 km/hr in boys and girls. Heart rate was significantly higher for the game Adventure compared with walking at 3 km/hr, 4 km/hr, and 5 km/hr and the game Dance in both genders. The heart rate of girls during the games Adventure and Dance was significantly higher compared with boys. There was a statistically significant difference (p < .05, with an effect size ranging from 0.40 to 3.54) in the counts·min^-1, measured through accelerometry, between activities.

CONCLUSION

XBOX 360 Kinect games provide energy expenditure and physical activity of moderate intensity for both genders. The use of active video games can be an interesting alternative to increase physical activity levels.

The contribution of Nintendo Wii Fit series in the field of health: a systematic review and meta-analysis

Background

Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which the Wii Fit series has been tested, (2) clarifying the effect of Wii Fit in those identified health-related domains and (3) quantifying this effect.

Method

A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term “Wii-Fit.” Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG).

Findings

A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N = 55). This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data (N = 25). For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training.

Conclusion

Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.

Cardiovascular Response of an Acute Exergame Session in Prepubertal Obese Children

PURPOSE

We aimed to analyze the acute autonomic response of obese and eutrophic prepubertal boys to an exergame (EXG) session.

MATERIALS AND METHOD

Nine eutrophic (8.89 ± 2.71 years of age and 16.42% ± 6.30% body fat) and nine obese boys (8.70 ± 1.16 years of age and 40.76% ± 4.2% body fat) participated. Nutritional state was determined using World Health Organization guidelines. Variables were collected at rest, immediately post (IP), and 60 minutes after a 20 minutes EXG session. Autonomic nervous system (ANS) activity was assessed using heart rate variability in time and frequency domains, and data were analyzed using Shapiro-Wilk and ANOVA tests with Tukey post hoc.

RESULTS

The obese group demonstrated an increased sympathetic activity at rest when compared with the eutrophic group (P < 0.05). The obese group also demonstrated an increased parasympathetic activity 60 minutes after the EXG session when compared with the eutrophic group (P < 0.05).

CONCLUSION

We concluded that an acute session of EXG promoted ANS super compensation. We encourage research on chronic ANS response to EXG.

Estimating Whether Replacing Time in Active Outdoor Play and Sedentary Video Games With Active Video Games Influences Youth's Mental Health

PURPOSE

The primary objective was to use isotemporal substitution models to estimate whether replacing time spent in sedentary video games (SVGs) and active outdoor play (AOP) with active video games (AVGs) would be associated with changes in youth's mental health.

METHODS

A representative sample of 20,122 Canadian youth in Grades 6-10 was studied. The exposure variables were average hours/day spent playing AVGs, SVGs, and AOP. The outcomes consisted of a negative and internalizing mental health indicator (emotional problems), a positive and internalizing mental health indicator (life satisfaction), and a positive and externalizing mental health indicator (prosocial behavior). Isotemporal substitution models estimated the extent to which replacing time spent in SVGs and AOP with an equivalent amount of time in AVGs had on the mental health indicators.

RESULTS

Replacing 1 hour/day of SVGs with 1 hour/day of AVGs was associated with a 6% (95% confidence interval: 3%-9%) reduced probability of high emotional problems, a 4% (2%-7%) increased probability of high life satisfaction, and a 13% (9%-16%) increased probability of high prosocial behavior. Replacing 1 hour/day of AOP with 1 hour/day of AVGs was associated with a 7% (3%-11%) increased probability of high emotional problems, a 3% (1%-5%) reduced probability of high life satisfaction, and a 6% (2%-9%) reduced probability of high prosocial behavior.

CONCLUSIONS

Replacing SVGs with AVGs was associated with more preferable mental health indicators. Conversely, replacing AOP with AVGs was associated with more deleterious mental health indicators.

Comparison of short-term energy intake and appetite responses to active and seated video gaming, in 8-11-year-old boys

The acute effects of active and seated video gaming on energy intake (EI), blood glucose, plasma glucagon-like peptide-1 (GLP-17-36) and subjective appetite (hunger, prospective food consumption and fullness) were examined in 8-11-year-old boys. In a randomised, crossover manner, twenty-two boys completed one 90-min active and one 90-min seated video gaming trial during which food and drinks were provided ad libitum. EI, plasma GLP-17-36, blood glucose and subjective appetite were measured during and following both trials. Time-averaged AUC blood glucose was increased (P=0·037); however, EI was lower during active video gaming (1·63 (sem 0·26) MJ) compared with seated video gaming (2·65 (sem 0·32) MJ) (P=0·000). In a post-gaming test meal 1 h later, there were no significant differences in EI between the active and seated gaming trials. Although estimated energy expenditure was significantly higher during active video gaming, there was still no compensation for the lower EI. At cessation of the trials, relative EI (REI) was significantly lower following active video gaming (2·06 (sem 0·30) MJ) v. seated video gaming (3·34 (sem 0·35) MJ) (P=0·000). No significant differences were detected in time-averaged AUC GLP-17-36 or subjective appetite. At cessation of the active video gaming trial, EI and REI were significantly less than for seated video gaming. In spite of this, the REI established for active video gaming was a considerable amount when considering the total daily estimated average requirement for 8-11-year-old boys in the UK (7·70 MJ).

Assessing the Physiological Cost of Active Videogames (Xbox Kinect) Versus Sedentary Videogames in Young Healthy Males

OBJECTIVES

The aims of this study were twofold: (1) to compare the physiological costs of active videogames (AVGs) and sedentary videogames (SVGs) and (2) to compare the exercise intensities attained during AVGs with the exercise intensity criteria for moderate and vigorous physical activity, as stated in current physical activity recommendations for improving public health.

MATERIALS AND METHODS

Nineteen young males participated in the study (age, 23 ± 3 years; height, 178 ± 6 cm; weight, 78 ± 15 kg). Participants completed a maximum oxygen uptake ([Formula: see text]) test and a gaming session, including AVGs ("Reflex Ridge," "River Rush," and "Boxing" for the Microsoft [Redmond, WA] Kinect™) and SVGs ("FIFA 14" [Electronic Arts, Burnaby, BC, Canada] and "Call of Duty" [Activision, Santa Monica, CA]). Heart rate (HR) and oxygen uptake [Formula: see text]) were recorded continuously during all videogames. Rating of perceived exertion (RPE) was taken every 3 minutes during AVGs and SVGs. Energy expenditure (EE), expressed as metabolic equivalents (METs), was calculated. One MET was defined as the volume of oxygen consumed at rest in a seated position and is equal to 3.5 mL of O2/kg of body mass/minute. The exercise intensity for each game was expressed as a percentage of [Formula: see text] and percentage of age-predicted maximum HR (HRmax).

RESULTS

Exercise intensity (percentage HRmax, percentage [Formula: see text], and RPE) and EE (METs) were significantly higher during active gaming compared with sedentary gameplay (P < 0.01). AVGs elicited moderate levels of exercise intensity (64-72 percent HRmax) in line with current recommended physical activity guidelines.

CONCLUSIONS

Our results indicate AVGs provoke physiological responses equivalent to a moderate-intensity physical activity.

Acute effects of active gaming on ad libitum energy intake and appetite sensations of 8–11-year-old boys

The present study examined the acute effects of active gaming on energy intake (EI) and appetite responses in 8–11-year-old boys in a school-based setting. Using a randomised cross-over design, twenty-one boys completed four individual 90-min gaming bouts, each separated by 1 week. The gaming bouts were (1) seated gaming, no food or drink; (2) active gaming, no food or drink; (3) seated gaming with food and drink offered ad libitum; and (4) active gaming with food and drink offered ad libitum. In the two gaming bouts during which foods and drinks were offered, EI was measured. Appetite sensations – hunger, prospective food consumption and fullness – were recorded using visual analogue scales during all gaming bouts at 30-min intervals and at two 15-min intervals post gaming. In the two bouts with food and drink, no significant differences were found in acute EI (MJ) (P=0·238). Significant differences were detected in appetite sensations for hunger, prospective food consumption and fullness between the four gaming bouts at various time points. The relative EI calculated for the two gaming bouts with food and drink (active gaming 1·42 (sem 0·28) MJ; seated gaming 2·12 (sem 0·25) MJ) was not statistically different. Acute EI in response to active gaming was no different from seated gaming, and appetite sensations were influenced by whether food was made available during the 90-min gaming bouts.

A meta-analysis of active video games on health outcomes among children and adolescents

This meta-analysis synthesizes current literature concerning the effects of active video games (AVGs) on children/adolescents' health-related outcomes. A total of 512 published studies on AVGs were located, and 35 articles were included based on the following criteria: (i) data-based research articles published in English between 1985 and 2015; (ii) studied some types of AVGs and related outcomes among children/adolescents and (iii) had at least one comparison within each study. Data were extracted to conduct comparisons for outcome measures in three separate categories: AVGs and sedentary behaviours, AVGs and laboratory-based exercise, and AVGs and field-based physical activity. Effect size for each entry was calculated with the Comprehensive Meta-Analysis software in 2015. Mean effect size (Hedge's g) and standard deviation were calculated for each comparison. Compared with sedentary behaviours, AVGs had a large effect on health outcomes. The effect sizes for physiological outcomes were marginal when comparing AVGs with laboratory-based exercises. The comparison between AVGs and field-based physical activity had null to moderate effect sizes. AVGs could yield equivalent health benefits to children/adolescents as laboratory-based exercise or field-based physical activity. Therefore, AVGs can be a good alternative for sedentary behaviour and addition to traditional physical activity and sports in children/adolescents.

The role of exergaming in improving physical activity: a review

BACKGROUND

The high prevalence of obesity in America can be attributed to inadequate energy expenditure as a result of high levels of physical inactivity. This review presents an overview of the current literature on physical activity, specifically through active videogame systems (exergaming) and how these systems can help to increase physical activity levels.

METHODS

The search strategy for this review was to identify previous studies that investigated energy expenditure levels using a single active video game or a combination of active videogames.

RESULTS

Based on data from 27 studies, a strong correlation exists between exergaming and increased energy expenditure (up to 300% above resting levels). The majority of active videogames tested were found to achieve physical activity levels of moderate intensity, which meet American College of Sports Medicine guidelines for health and fitness.

CONCLUSIONS

Exergaming is a new and exciting strategy to potentially improve physical activity levels and reduce obesity among Americans.

Active Videogaming Compared to Unstructured, Outdoor Play in Young Children: Percent Time in Moderate- to Vigorous-Intensity Physical Activity and Estimated Energy Expenditure

OBJECTIVE

The majority of children do not achieve recommended amounts of moderate- to vigorous-intensity physical activity (MVPA). Active videogames (AVGs) may be a source of MVPA for young children. Thus, the purpose of this study was to compare, in children 5-8 years of age, percentage of time engaged in MVPA, assessed via accelerometry and direct observation (DO), and estimated energy expenditure (EE), assessed via accelerometry, while playing AVG and unstructured, outdoor play (OP).

MATERIALS AND METHODS

Sixteen normal-weight young children (6.4±0.8 years old, 62.5 percent male, 81.3 percent white, standardized body mass index=-0.18±0.66) completed two 15-minute sessions of AVG and OP. For AVG, participants played "River Rush" (Xbox(®) 360 Kinect(®); Microsoft Corp., Redmond, WA), and OP was conducted in an outdoor playground. Three Actical (Philips Respironics Co. Inc., Bend, OR) accelerometers (hip and left and right wrists) measured percentage MVPA and estimated EE. DO was conducted using the Children's Activity Rating Scale, from which percentage MVPA was coded.

RESULTS

Repeated-measures analysis of variance controlling for condition differences in humidity and condition order found greater percentage MVPA in AVG condition with the accelerometer located on the hip (AVG=74.6±31.1 percent versus OP=67.5±31.1 percent; P<0.05, d=0.23) and with DO (AVG=23.8±12.4 percent versus OP=13.2±13.0 percent; P<0.05, d=0.83).

CONCLUSIONS

These findings suggest that AVGs may be a source of MVPA for young children.

Evaluating the Nintendo Wii for assessing return to activity readiness in youth with mild traumatic brain injury

Adolescents with mild traumatic brain injuries (MTBI) are at substantial risk for repeat injury if they return to activity too soon. Post-concussion symptoms and impaired balance are two factors that limit return to activity. Post-injury assessments that challenge activity tolerance and balance skills are needed to ensure readiness to return to activity. This cross-sectional study evaluated the Nintendo Wii as a measure of exertion (heart rate [HR], respiration rate [RR], and caloric expenditure) and balance testing for youth with MTBI in a clinical setting. Twenty-four youth with MTBI, ages 9-18, played six Wii games. The Bruininks-Oseretsky Test of Motor Proficiency 2nd edition (BOT-2) and the Community Balance and Mobility Scale (CBM) were used as balance indicators. The Wii Fit Running game demonstrated the highest caloric expenditure and HR (p = .010). Frequency counts of balance loss during Wii game play did not correlate with performance on the BOT-2 or the CBM. Type, number, and time since injury were predictive of balance performance on the CBM (p = .008). Findings provide preliminary evidence for the use of the Wii as an exertion challenge to evaluate tolerance for exercise post-concussion. Frequency count of balance loss during Wii game play, however, was not a valid measure of balance impairment post-MTBI.

The effect of a peer on VO2 and game choice in 6-10 year old children

Relative to sedentary video games (e.g., Playstation 2®), playing physically active video games (e.g., Nintendo Wii Sports Boxing®) significantly increases caloric expenditure in children. Studies have demonstrated that the presence of a peer increases physical activity in children. We sought to determine if children would expend more energy and find playing the “exergame” (Wii) more motivating than the sedentary video game (Playstation 2) when with a peer. Seventeen children (age 8.5 ± 0.4 years) rested, played the sedentary video game and “exergame” for 10 min each, in two conditions: one in which the children rested/played the games alone (alone condition) and another in which they played with a peer (peer condition). Oxygen consumption (VO₂), and liking (visual analog scale) was assessed for each 10-min condition. After three 10-min resting/gaming conditions, motivation was assessed using a relative reinforcing value task in which children performed computer mouse presses to gain additional access for either the sedentary video game or “exergame.” VO₂ was greater (p < 0.001) during “exergame” play (mean = 12.17 ± 4.1 ml·kg⁻¹·min⁻¹) vs. rest (mean = 5.14 ± 1.46 ml·kg⁻¹·min⁻¹) and the sedentary video game (mean = 5.83 ± 2.1 ml·kg⁻¹·min⁻¹). During the peer condition, there were no significant differences (p > 0.05) in VO₂ relative to the alone condition. In an exploratory analysis boys exhibited a greater (p = 0.02) increase in VO₂ from rest to “exergame” (Δ 9.0 ± 3.7 ml·kg⁻¹·min⁻¹), relative to girls (Δ 4.9 ± 2.9 ml·kg⁻¹·min⁻¹). Boys showed a significantly greater increase (p = 0.05) in VO₂ from the resting condition to “exergame” in the presence of a peer (Δ 11.1 ± 5.3 ml·kg⁻¹·min⁻¹) vs. the alone condition (Δ 6.8 ± 3.1 ml·kg⁻¹ ·min⁻¹). Liking was significantly (p < 0.001) greater for “exergame” (7.7 ± 1.9 cm) and the sedentary video game (8.3 ± 1.3 cm) relative to rest (4.0 ± 2.8 cm). Motivation for “exergame” significantly decreased (p = 0.03) from alone (340.8 ± 106.8 presses) to the peer condition (147.8 ± 81.6 presses).

Conclusion: VO₂ was greater during “exergame” play relative to the sedentary video game. The presence of a peer did not increase VO₂ during “exergame” play. Surprisingly, the presence of a peer decreased children's motivation to play “exergame” vs. the sedentary video game.

Active Screen Time Among U.S. Youth Aged 9-18 Years, 2009

OBJECTIVE

This study documented the prevalence of active screen time (i.e., screen time that includes active games, exercise or dance videos, or TV exercise programs) and identified characteristics associated with it among youth 9-18 years of age.

SUBJECTS AND METHODS

This cross-sectional study was conducted on a convenience sample of 1,165 youth using the 2009 Styles Surveys; data were weighted to approximate the Current Population Survey. We calculated descriptive statistics and conducted multivariable logistic regression to identify characteristics associated with active screen time by estimating adjusted odds ratio (aOR) and 95 percent confidence intervals (CIs).

RESULTS

The sample comprised 51.4 percent boys, and almost 60 percent were non-Hispanic white. The prevalence of active screen time ≥1 hour/day was 31.2 percent on a typical school day and 41.6 percent on a typical weekend day. Logistic regression revealed youth with physical activity of 3-5 days/week had higher odds of active screen time ≥1 hour/day compared with youth with no physical activity (aOR school day=2.8, 95 percent CI 1.5-5.2; aOR weekend day=2.3, 95 percent CI 1.4-3.9). Certain characteristics (i.e., sex, age group, race/ethnicity, income, and sedentary screen time) were significantly associated with active screen time ≥1 hour/day, but associations were inconsistent for school and weekend days.

CONCLUSIONS

Three in 10 youth are engaging in at least 1 hour of active screen time on school days, and about 4 in 10 youth are engaging in at least one hour on weekend days. Understanding the use of active screen time and associated characteristics are important for developing interventions addressing screen time and physical activity.

The efficacy of two task-orientated interventions for children with Developmental Coordination Disorder: Neuromotor Task Training and Nintendo Wii Fit Training

Neuromotor Task Training (NTT) and Nintendo Wii Fit Training (Wii training) are both task-based interventions used to improve performance in children with motor coordination problems. The aim of this study was to compare the efficacy of these two interventions on the motor performance, isometric strength and cardiorespiratory fitness (aerobic and anaerobic capacity) of children with Developmental Coordination Disorder (DCD) attending mainstream schools in a low-income setting. A pragmatic, quasi-experimental study design was utilized. Children between the ages of 6-10 years, who scored at or below the 16th percentile on the Movement Assessment Battery for Children-2 (MABC-2) and whose teacher reported a functional motor problem, were allocated to either NTT (n=37) or Wii training (n=19) groups depending on school of attendance. The MABC-2, a hand-held dynamometer, the Functional Strength Measure, the Muscle Power Sprint Test and the 20m Shuttle Run Test were used to assess performance at baseline and after the intervention. The main findings show that the mean motor performance scores of both groups improved over the study period. However, significant differences in improvement were detected between groups, with the NTT group showing greater improvement in motor performance, functional strength and cardiorespiratory fitness. No improvements in isometric strength were seen in either group. The Wii training group showed significant improvement in anaerobic performance. This study provides evidence to support the use of both the Wii Training and NTT for children with DCD. However, in comparison to Wii training, the NTT approach yields superior results across measures of motor proficiency, cardiorespiratory fitness and functional strength. The decision to use either approach may be influenced by resources and time constraints.

Exercise intensity levels in children with cerebral palsy while playing with an active video game console

BACKGROUND

Children with cerebral palsy (CP) are prone to secondary complications related to physical inactivity and poor cardiorespiratory capacity. This problem could be greatly attenuated through the use of video games that incorporate physical activity for 2 reasons: Video games already represent an important component of leisure time in younger people, and such games can lead to a high level of exercise intensity in people who are healthy.

OBJECTIVE

The study objective was to evaluate exercise intensity in children with spastic diplegic CP and children who were typically developing while playing with an active video game console.

DESIGN

This was a cross-sectional study.

METHODS

Ten children (7-12 years old) with spastic diplegic CP (Gross Motor Function Classification System level I or II) and 10 children who were age matched and typically developing were evaluated in a movement analysis laboratory. Four games were played with the active video game console (jogging, bicycling, snowboarding, and skiing) for 40 minutes. Heart rate was recorded during the entire playing period with a heart rate belt monitor. Exercise intensity was defined as the percentage of heart rate reserve (HRR). In addition, lower extremity motion analysis was carried out during the final minute of the playing period for the jogging and bicycling games.

RESULTS

No difference between groups was observed for any variables. A main effect of games was observed for the amount of time spent at an intensity greater than 40% of HRR. Specifically, more than 50% of the playing time for the jogging game and more than 30% of the playing time for the bicycling game were spent at an intensity greater than 40% of HRR. In addition, the jogging game produced a larger range of motion than the bicycling game.

LIMITATIONS

A limitation of this study was the relatively small and heterogeneous sample.

CONCLUSIONS

For all 4 games, similar exercise intensity levels were observed for children who were typically developing and children with CP, suggesting that children with CP could obtain exercise-related benefits similar to those obtained by children without CP while playing with an active video game console.

Active video games and health indicators in children and youth: a systematic review

Background

Active video games (AVGs) have gained interest as a way to increase physical activity in children and youth. The effect of AVGs on acute energy expenditure (EE) has previously been reported; however, the influence of AVGs on other health-related lifestyle indicators remains unclear.

Objective

This systematic review aimed to explain the relationship between AVGs and nine health and behavioural indicators in the pediatric population (aged 0–17 years).

Data sources

Online databases (MEDLINE, EMBASE, psycINFO, SPORTDiscus and Cochrane Central Database) and personal libraries were searched and content experts were consulted for additional material.

Data selection

Included articles were required to have a measure of AVG and at least one relevant health or behaviour indicator: EE (both habitual and acute), adherence and appeal (i.e., participation and enjoyment), opportunity cost (both time and financial considerations, and adverse events), adiposity, cardiometabolic health, energy intake, adaptation (effects of continued play), learning and rehabilitation, and video game evolution (i.e., sustainability of AVG technology).

Results

51 unique studies, represented in 52 articles were included in the review. Data were available from 1992 participants, aged 3–17 years, from 8 countries, and published from 2006–2012. Overall, AVGs are associated with acute increases in EE, but effects on habitual physical activity are not clear. Further, AVGs show promise when used for learning and rehabilitation within special populations. Evidence related to other indicators was limited and inconclusive.

Conclusions

Controlled studies show that AVGs acutely increase light- to moderate-intensity physical activity; however, the findings about if or how AVG lead to increases in habitual physical activity or decreases in sedentary behaviour are less clear. Although AVGs may elicit some health benefits in special populations, there is not sufficient evidence to recommend AVGs as a means of increasing daily physical activity.

Experiência de treinamento com Nintendo Wii sobre a funcionalidade, equilíbrio e qualidade de vida de idosas

O objetivo desse relato de experiência foi analisar a funcionalidade, equilíbrio e qualidade de vida em duas idosas não institucionalizadas, após serem submetidas a um protocolo de treinamento em Realidade Virtual composto por nove sessões com duração de 50 minutos cada e frequência de três vezes por semana. Para tanto, utilizou-se os jogos do software Wii Fit, bem como o acessório Balance Board do console Nintendo Wii, a partir de um programa de treinamento elaborado fundamentado em diretrizes gerais de agência de saúde, tais como o Colégio Americano de Medicina do Esporte (ASCM). A avaliação da funcionalidade foi realizada com o uso dos Testes de Aptidão Física para Idosos (TAFI), o equilíbrio foi avaliado com a Escala de Berg e a qualidade de vida foi mensurada com o questionário SF-36. Os resultados apontaram melhora nos valores absolutos de todos os testes analisados, permitindo concluir acerca do potencial do programa de treinamento elaborado para a melhora da independência funcional de idosos. Esperamos que este estudo auxilie pesquisadores a dar continuidade à pesquisa e às ações envolvendo o uso do Nintendo Wii como ferramenta assistiva a idosos.

Effectiveness and safety of Nintendo Wii Fit Plus™ training in children with migraine without aura: a preliminary study

BACKGROUND

Migraine without aura (MoA) is a painful syndrome, particularly in childhood; it is often accompanied by severe impairments, including emotional dysfunction, absenteeism from school, and poor academic performance, as well as issues relating to poor cognitive function, sleep habits, and motor coordination.

MATERIALS AND METHODS

The study population consisted of 71 patients affected by MoA (32 females, 39 males) (mean age: 9.13±1.94 years); the control group consisted of 93 normally developing children (44 females, 49 males) (mean age: 8.97±2.03 years) recruited in the Campania school region. The entire population underwent a clinical evaluation to assess total intelligence quotient level, visual-motor integration (VMI) skills, and motor coordination performance, the later using the Movement Assessment Battery for Children (M-ABC). Children underwent training using the Wii-balance board and Nintendo Wii Fit Plus™ software (Nintendo Co, Ltd, Kyoto, Japan); training lasted for 12 weeks and consisted of three 30-minute sessions per week at their home.

RESULTS

The two starting populations (MoA and controls) were not significantly different for age (P=0.899) and sex (P=0.611). M-ABC and VMI performances at baseline (T0) were significantly different in dexterity, balance, and total score for M-ABC (P<0.001) and visual (P=0.003) and motor (P<0.001) tasks for VMI. After 3 months of Wii training (T1), MoA children showed a significant improvement in M-ABC global performance (P<0.001), M-ABC dexterity (P<0.001), M-ABC balance (P<0.001), and VMI motor task (P<0.001).

CONCLUSION

Our study reported the positive effects of the Nintendo Wii Fit Plus™ system as a rehabilitative device for the visuomotor and balance skills impairments among children affected by MoA, even if further research and longer follow-up are needed.

Assessment of Voluntary Exercise Behavior and Active Video Gaming Among Adolescent and Young Adult Patients During Hematopoietic Stem Cell Transplantation

This pilot study sought to examine the exercise behavior and preferences among adolescent and young adult (AYA) hematopoietic stem cell transplant (HSCT) recipients. Eighteen patients aged 19 to 25 years were recruited to engage in unsupervised exercise activities lasting at least 60 minutes/week during hospitalization for HSCT. Enrolled patients had access to standard exercise activities (walking, resistance training, and basketball) and active video gaming equipment. Physical function (6-Minute Walk Test and Timed-Up-and-Go test) and quality of life (Behavioral, Affective, and Somatic Experiences Scale) were assessed at different time points during admission. Participants exercised an average of 76% of the days during admission and spent an average of 36.5 minutes per day exercising. The Nintendo Wii was the preferred active video gaming equipment, but standard exercises accounted for 73% of all exercise time. Neither functional capacity nor quality of life improved. Results suggest that AYAs voluntarily exercise during HSCT admission, prefer to use standard exercise activities, and may require supervision in order to derive maximum benefits from their efforts. These results provide guidance for developing rehabilitation interventions for AYA HSCT recipients.

Using Active Video Games for Physical Activity Promotion

This systematic review evaluates interventions using active video games (AVGs) to increase physical activity and summarizes laboratory studies quantifying intensity of AVG play among children and adults. Databases (Cochrane Library, PsychInfo, PubMed, SPORTDiscus, Web of Science) and forward citation and reference list searches were used to identify peer-reviewed journal articles in English through March 2011. Studies that used off-the-shelf AVGs to increase physical activity with quantitative outcomes or studies that quantified intensity of AVG play were included. Information on sample characteristics, AVGs employed, study design and conditions, outcome measures, results, and conclusions was extracted by two researchers. Intervention studies were ranked on design quality. Thirteen interventions and 28 laboratory studies were identified. All laboratory studies demonstrated that AVGs are capable of providing light-to-moderate intensity physical activity. However, only three interventions supported AVGs as an effective tool to significantly increase physical activity or exercise attendance. As AVGs are becoming more popular, additional research is needed to determine how to capitalize on the potential of AVGs to increase physical activity.

Combined influence of media use on subjective health in elementary school children in Japan: a population-based study

BACKGROUND

In recent years in Japan, electronic games, home computers, and the internet have assumed an important place in people's lives, even for elementary school children. Subjective health complaints have also become a problem among children. In the present study, we investigated the relationship between media use and health status in elementary school children in Japan.

METHODS

A cross-sectional school-based population survey was conducted in 2009 with a sample of fourth-, fifth-, and sixth-grade children (age range: 10-12 years old) in elementary schools in Japan (n = 3,464). Self-reported health, lifestyle habits, and time spent using media were assessed.

RESULTS

The use of games, television, and personal computers was significantly associated with lifestyle (p < 0.05) and subjective health (p < 0.05). In addition, the use of games, the use of television, and the use of personal computers were mutually associated. The greater the number of media used for more than 1 hour was, the higher the odds ratio of the association of media use with unhealthy lifestyle and subjective health complaints was. The plural use of these media had stronger associations with unhealthy lifestyle and subjective health complaints.

CONCLUSIONS

Game, television, and personal-computer use were mutually associated, and the plural use of these media had stronger associations with unhealthy lifestyle and subjective health complaints. Excessive use of media might be a risk for unhealthy lifestyle and subjective health complaints.

SECULAR CHANGES IN HEIGHT, BODY WEIGHT, BODY MASS INDEX AND PUBERTAL DEVELOPMENT IN MALE CHILDREN AND ADOLESCENTS IN KRAKOW, POLAND

This study examined the secular changes in height, body weight, body mass index and pubertal development in male children and adolescents in Krakow (Poland) over the past 80 years, with an emphasis on the last decade (2000–2010). The survey of the population of Krakow is a continuation of observations conducted in that area for many years. The analysis aims to determine whether in the last decade Krakow still witnessed the secular trend, and what form the trend took. The body height and weight, and body mass index (BMI), of 1862 boys aged 3.5–18.5 years were analysed, against the background of a survey series from the years 1938 (N=1801), 1971 (N=2045), 1983 (N=3124) and 2000 (N=2328). The mean body height, in almost all age categories, was greater than in the past; however the final height over the last decade remained the same. The mean values of body weight and BMI increased, especially in the last decade. Also, an acceleration of puberty in boys was observed. The last 10 years saw an over 3-month decrease in the age of initial appearance of pubic hair in boys. In conclusion, the last decade saw cessation of the growing taller trend: maximum body height stabilized at approximately 179 cm, but weight and BMI increased. Also, a distinct acceleration of puberty was noticed. Lack of height increase, at the same time as weight gain and puberty acceleration, indicate a progressing developmental disharmony.

[Therapy of juvenile obesity from the sports medicine/science viewpoint]

Overweight and obesity in children and adolescents had reached its highest level worldwide. In the development of overweight and within interdisciplinary training programs, physical activity and the avoidance of sedentary habits play an important role. Not only is there an increase in energy consumption, but potential comorbidities (e.g., cardiovascular risk factors) are improved. In addition, positive psychosocial benefits occur, e.g., increasing self-esteem, personal, and social skills. During realization, possible risks (e.g., exercise-induced asthma) and barriers have to be taken into account. In terms of physical activity programs, the child's surroundings have to be integrated, and transfer into daily routine should be promoted. Therefore, in addition to athletic content, daily activities have to be trained and supported, e.g., via pedometers. At least 60, better 90 and more minutes of physical activity per day are recommended; the use of audiovisual media should be reduced to a minimum (max. 120 minutes).

Changes in balance in older adults based on use of physical therapy vs the Wii Fit gaming system: a preliminary study

OBJECTIVES

To determine the effectiveness of Wii Fit training on balance control in older adults compared with physical therapy training.

DESIGN

Quasi-experimental design.

PARTICIPANTS

Eight males and nine females aged 53 to 91 years.

MATERIALS AND METHODS

Participants were divided into three groups: one group received both physical therapy training and Wii Fit training (PW group), one group received Wii Fit training alone (WI group), and one group received physical therapy training alone (PT group). Training consisted of three sessions per week for 4 weeks.

MAIN OUTCOME

Berg Balance Scale (all groups) and Bubble Test (PW and WI groups) scores.

STATISTICAL ANALYSIS

Descriptive statistics, medians, interquartile ranges and 95% confidence intervals are reported to identify trends in balance control as a result of different types of training.

RESULTS

All subjects showed improvement in the Berg Balance Scale and Bubble Test scores. The PT and PW groups tended to perform better than the WI group on the Berg Balance Scale following treatment. Although the differences in the Bubble Test score were not substantial between the PW and WI groups, the PW group performed slightly better than the WI group on the Berg Balance Scale.

CONCLUSIONS

Wii Fit training appears to improve balance. However, physical therapy training on its own or in addition to Wii Fit training appears to improve balance to a greater extent than Wii Fit training alone.