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Ahn SJG, Schmidt MD, Tate AD, Rathbun S, Annesi JJ, Hahn L, Novotny E, Okitondo C, Grimsley RN, Johnsen K. Virtual fitness buddy ecosystem: a mixed reality precision health physical activity intervention for children. NPJ Digit Med 2024; 7:134. [PMID: 38773297 PMCID: PMC11109260 DOI: 10.1038/s41746-024-01133-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 05/08/2024] [Indexed: 05/23/2024] Open
Abstract
6-11-year-old children provide a critical window for physical activity (PA) interventions. The Virtual Fitness Buddy ecosystem is a precision health PA intervention for children integrating mixed reality technology to connect people and devices. A cluster randomized, controlled trial was conducted across 19 afterschool sites over two 6-month cohorts to test its efficacy in increasing PA and decreasing sedentary behavior. In the treatment group, a custom virtual dog via a mixed reality kiosk helped children set PA goals while sharing progress with parents to receive feedback and support. Children in the control group set PA goals using a computer without support from the virtual dog or parents. 303 children had 8+ hours of PA data on at least one day of each of the 3 intervention time intervals. Conversion of sedentary time was primarily to light-intensity PA and was strongest for children with low baseline moderate-to-vigorous PA than children above 45 min of baseline moderate-to-vigorous PA. Findings suggest that the VFB ecosystem can promote sustainable PA in children and may be rapidly diffused for widespread public health impact.
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Affiliation(s)
- Sun Joo Grace Ahn
- Grady College of Journalism and Mass Communication, University of Georgia, Athens, GA, USA.
| | | | - Allan D Tate
- Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
| | - Stephen Rathbun
- Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
| | - James J Annesi
- Kinesiology Department, California State University, Monterey Bay, Seaside, CA, USA
| | - Lindsay Hahn
- Department of Communication, University at Buffalo, Buffalo, NY, USA
| | - Eric Novotny
- Workplace Research and Insights, Haworth, Inc., Holland, MI, 49424, USA
| | - Christian Okitondo
- Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
| | - Rebecca N Grimsley
- Center for Advanced Computer-Human Ecosystems, University of Georgia, Athens, GA, USA
| | - Kyle Johnsen
- College of Engineering, University of Georgia, Athens, GA, USA
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França C, Ashraf S, Santos F, Dionísio M, Ihle A, Marques A, de Maio Nascimento M, Gouveia ÉR. Estimated Energy Expenditure in Youth While Playing Active Video Games: A Systematic Review. Sports (Basel) 2024; 12:39. [PMID: 38393259 PMCID: PMC10892794 DOI: 10.3390/sports12020039] [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: 12/14/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
Sedentary behavior and inadequate energy expenditure are serious global public health concerns among youngsters. The exponential growth in technology emerges as a valuable opportunity to foster physical activity, particularly through active video games. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in PubMed, Web of Science, Cochrane, and Scopus to provide a comprehensive view of the literature on energy expenditure levels among adolescents while playing active video games. Among the 574 manuscripts identified at the first screening stage, 23 were retained for analysis. Ten studies were characterized by longitudinal and thirteen by cross-sectional designs. The results showed that short-term active video games elicited energy expenditure values comparable to moderate-intensity physical activity (3-6 METs). However, in intervention programs (with at least six weeks) the results indicate no significant effects of active video games on youngsters' energy expenditure levels and physical activity profiles between baseline and follow-up assessments. Overall, active video games based on sports and dance were the most used, and boys tended to achieve higher energy expenditure than girls. The diversity of methods implemented limits comparing results and drawing generalized conclusions. However, considering its attractiveness to youth, active video games might emerge as a complementary tool to traditional physical activities promoted in schools and local communities. Details regarding gender differences and contradictory results of longitudinal approaches should be considered in future research based on standardized methods.
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Affiliation(s)
- Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 5000-801 Vila Real, Portugal
| | - Sadaf Ashraf
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
| | - Francisco Santos
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
- Faculty of Sport Sciences and Physical Education, CIDAF, University of Coimbra, 3040-248 Coimbra, Portugal
| | - Mara Dionísio
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Faculty of Exact Sciences and Engineering, University of Madeira, 9020-105 Funchal, Portugal
| | - Andreas Ihle
- Department of Psychology, University of Geneva, 1227 Carouge, Switzerland;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1227 Carouge, Switzerland
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
| | - Adilson Marques
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
- CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, 1499-002 Lisboa, Portugal
- Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, 1649-020 Lisbon, Portugal
| | - Marcelo de Maio Nascimento
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, Brazil
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal; (C.F.); (S.A.); (F.S.)
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Swiss Center of Expertise in Life Course Research LIVES, 1227 Carouge, Switzerland; (A.M.); (M.d.M.N.)
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Mohd Sidek NN, Mat Rosly M, Abd Razak NA. Children's Physiological and Perceptual Responses to Sports Exergames When Played in Different Positions. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1489. [PMID: 37761450 PMCID: PMC10529419 DOI: 10.3390/children10091489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/13/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023]
Abstract
Today's children are prone to becoming involved in exergames, but their positions during play have not been sufficiently investigated to determine whether the positions they adopt result in equal responses. The design of this study involved the collection of physiological and perceptual responses (i.e., heart rate (HR), rating of perceived exertion, and enjoyment score) during exergames in three different sports (bowling, tennis, and boxing) with players in different positions (sitting and standing). The participants played each game for 10 min while their HR was recorded. After the gameplay, each perceptual response was retrieved. The results revealed a significant increase in HR above rest during exergaming overall (p < 0.001). Standing gameplay resulted in a significantly higher HR (p < 0.001) than seated gameplay. Compared to tennis and bowling, boxing produced the highest physiological response (p < 0.001) and perceived exertion (p < 0.05) in both positions. The participants perceived all the sports exergames to be enjoyable, as their enjoyment scores did not significantly differ for each game (p > 0.5). For all the variables, no statistically significant differences between genders were identified (p > 0.5). This home-based intervention demonstrated that sports exergames are not only enjoyable; overall, they can provide at least moderately intense physical activity, whether played seated or standing.
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Affiliation(s)
- Nur Nashruha Mohd Sidek
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (N.N.M.S.); (N.A.A.R.)
| | - Maziah Mat Rosly
- Department of Physiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (N.N.M.S.); (N.A.A.R.)
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Seims AL, Hall J, Bingham DD, Creaser A, Christoforou A, Barber S, Daly-Smith A. Interventions targeting children and young people's physical activity behavior at home: A systematic review. PLoS One 2023; 18:e0289831. [PMID: 37556477 PMCID: PMC10411747 DOI: 10.1371/journal.pone.0289831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Increased time at home during the COVID-19 pandemic significantly decreased children's physical activity. This systematic review aimed to evaluate the effectiveness of children's home-based physical activity interventions, and identify 'active ingredients' underpinning these. METHODS Databases searched-AMED, PsychINFO, CINAHL, Cochrane, EMBASE, PubMed/Medline, Scopus, SPORTDiscus and Web of Science, from inception until June 2022. Eligibility criteria-children aged 2-16 years, targeting home-based physical activity, a control group, and physical activity measured pre- and post- intervention. Studies were excluded if it was not possible to identify change in physical activity at home. The review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Study quality was evaluated using the quality assessment tool for quantitative studies. Study design, intervention characteristics, outcome data, behavior change theory, Behavior Change Techniques (BCTs) and process evaluation data were extracted and discussed using narrative syntheses. RESULTS 13 studies (including 1,182 participants) from 25,967 were included. Interventions primarily involved active video games, with the addition of coaching or telehealth support (n = 5). Three of the 13 studies significantly increased children's physical activity (1 = Moderate to vigorous physical activity, 2 = total volume, P<0.05). The largest effect size (d = 3.45) was for moderate to vigorous physical activity. 29% of BCTs were identified across included interventions; the most common being adding objects to the environment. The most effective intervention scored strong for design quality, incorporated telehealth coaching, and included the most commonly coded BCTs. Variation among studies and insufficient reporting of data made a meta-analysis unfeasible. CONCLUSION COVID-19 emphasized the importance of the home for physical activity. Whilst effectiveness of interventions was limited, building social support and self-efficacy are mechanisms that should be explored further. The review provides recommendations to improve the design and evaluation of future interventions. TRIAL REGISTRATION Prospero registration number: CRD42020193110.
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Affiliation(s)
- Amanda L. Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
- Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Amy Creaser
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | | | - Sally Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
- Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
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Chow DHK, Mann SKF. Exergaming and education: a relational model for games selection and evaluation. Front Psychol 2023; 14:1197403. [PMID: 37484077 PMCID: PMC10359147 DOI: 10.3389/fpsyg.2023.1197403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Exergaming, or technology-driven physical exercise, has gained popularity in recent years. Its applications include physical education, health promotion, and rehabilitation. Although studies have obtained promising results regarding the positive effects of exergaming, the outcomes of exergaming for different populations remain undetermined. Inconsistencies in the literature on this topic have multiple potential explanations, including the content and demand of the exergames and the capability of the exergamer. A model with a sound theoretical framework is required to facilitate matching between games and gamers. This article proposes a relational model based on a matrix of Bloom's taxonomy of learning domains and the performance components of exergames. Appropriate matching of the physical demands of an exergame and the ability of the exergamer would enhance the effective usage of exergaming for individuals with various needs. This theory-based exergame model is developed to promote the general development, physical status, and psychosocial well-being of students, older adults, and individuals with rehabilitation needs. This model may provide a resource for future research on the application, effectiveness, and design of exergaming.
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Calcaterra V, Vandoni M, Marin L, Carnevale Pellino V, Rossi V, Gatti A, Patanè P, Cavallo C, Re F, Albanese I, Silvestri D, De Nunzio A, Zuccotti G. Exergames to Limit Weight Gain and to Fight Sedentarism in Children and Adolescents with Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:928. [PMID: 37371160 DOI: 10.3390/children10060928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
Exergames are defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). The players interact with the game through whole-body movements improving energy expenditure. Exergames may be effective in improving physical and psychological aspects of children and adolescents with obesity. In this narrative review, we synthesized the current evidence regarding the role of exergames in modifying body composition and weight and in promoting changes in sedentary behavior to define the benefits of active video games as useful tools for fighting sedentarism and to outline the future directions of exergaming as a supplementation exercise rather than a replacement in educational programs for pediatric obesity. Data from the literature indicate that exergames may offer an interesting impact on childhood obesity and may be considered a potential strategy for controlling weight gain and body composition, promote PA, and decrease time spent on sedentary behavior in children and adolescents with obesity. However, exergame use also has some limits, such as children's poor self-regulation and poor structuring of exergame use. Therefore, a prudent approach should be maintained, and additional high-quality research is needed to determine if exergames can be effectively used in the treatment of childhood obesity and if new digital media, as a supplementation of exercise rather than a replacement, could be considered to combat sedentary behavior in educational programs for pediatric obesity prevention.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Physiotherapy, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Virginia Rossi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Pamela Patanè
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Caterina Cavallo
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Research and Development, LUNEX International University of Health, Exercise and Sports, Avenue du Parc des Sports, 50, 4671 Differdange, Luxembourg
| | - Fabio Re
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
| | - Ilaria Albanese
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
| | - Alessandro De Nunzio
- Department of Research and Development, LUNEX International University of Health, Exercise and Sports, Avenue du Parc des Sports, 50, 4671 Differdange, Luxembourg
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Sciences, Università di Milano, 20122 Milan, Italy
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Röglin L, Stoll O, Ketelhut K, Martin-Niedecken AL, Ketelhut S. Evaluating Changes in Perceived Enjoyment throughout a 12-Week School-Based Exergaming Intervention. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010144. [PMID: 36670694 PMCID: PMC9856556 DOI: 10.3390/children10010144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
This study assessed whether a high-intensity exergame represents an enjoyable training tool for children in the elementary school setting. Furthermore, it evaluated whether gender, body mass index (BMI), waist-to-height ratio (WHtR), fitness level, weekly physical activity level, and general interest in sports moderate perceived enjoyment during the 12-week intervention. Thirty fifth- and sixth-grade students (10.5 ± 0.7 years; 50% girls) participated in this study. During baseline assessments, anthropometric measurements and a shuttle run test were conducted. Throughout the intervention period, the students participated in 15−20-min exergaming sessions (ES) in the ExerCube twice a week during school hours. Enjoyment was assessed after an ES in weeks 2 and 12. Additionally, enjoyment was evaluated after a physical education (PE) class in week 2. The results reveal no significant changes in enjoyment (p = 0.164) over time. The modest changes over time were significantly affected by BMI (p = 0.027), WHtR (p = 0.007), and weekly activity level (p = 0.016). Compared to the PE class, enjoyment was significantly higher during the ES (p < 0.001). None of the covariates showed a significant effect. Mean HR during the ES reached 87.1 ± 1.9% of students’ individual maximum HR. In conclusion, the ExerCube provides a promising tool for schools to promote enjoyable moderate-to-vigorous physical activity.
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Affiliation(s)
- Lisa Röglin
- Institute of Sport Science, Martin-Luther-University Halle-Wittenberg, 06108 Halle (Saale), Germany
- Correspondence: (L.R.); (S.K.)
| | - Oliver Stoll
- Institute of Sport Science, Martin-Luther-University Halle-Wittenberg, 06108 Halle (Saale), Germany
| | - Kerstin Ketelhut
- Department of Medical Education and Health, MSB Medical School Berlin, 14197 Berlin, Germany
| | | | - Sascha Ketelhut
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland
- Correspondence: (L.R.); (S.K.)
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Leung T, Davis D, Young R, Kimani-Swanson E, Wozow C, Wen H, Kim Y, Wilroy J, Rimmer J. The Effects of Virtual Reality Tele-exergaming on Cardiometabolic Indicators of Health Among Youth With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e40708. [PMID: 35976192 PMCID: PMC9434386 DOI: 10.2196/40708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Youth with cerebral palsy do not have enjoyable, accessible, and scalable exercise options that can empower them to independently maintain their cardiometabolic health. OBJECTIVE The primary aim is to examine the preliminary efficacy of a 12-week home-based virtual reality tele-exergaming intervention on several indicators of cardiometabolic health in youth with cerebral palsy compared to the wait list control. A secondary aim is to describe feasibility metrics, namely, recruitment, retention, and adherence rates; perceived enjoyment; intervention safety; and management issues. The tertiary aim is to generate a theory that reveals critical behavioral mechanisms of adherence to tele-exergaming. METHODS In this parallel group design randomized controlled trial, 34 inactive youths with cerebral palsy are randomly allocated to one of two groups: a group that immediately receives 12 weeks of virtual reality exergaming with tele-physical education or a wait list control group that undergoes their habitual activity for 12 weeks. Participants are recruited from a Children's Hospital and community network. At baseline (week 0), week 6, and week 12, high sensitivity C-reactive protein and blood insulin, hemoglobin A1c, triglycerides, cholesterol, and pressure are measured by the youth and a caregiver at home using a blood spot test kit and blood pressure cuff. They will also self-measure their lung function and body weight using a peak flow meter and bathroom scale, respectively. Collections are supervised by research staff via videoconference. Changes in outcomes are compared between and within groups using exploratory statistical analyses and descriptive statistics. At postintervention or dropout, participants will undergo semistructured interviews to identify behavioral mechanisms that underly participation. RESULTS Recruitment procedures started in June 2022. All data are expected to be collected by October 2023. Full trial results are expected to be published by February 2024. Secondary analyses of data will be subsequently published. CONCLUSIONS This trial tests an innovative serious exergaming virtual reality program that includes a completely remote enrollment, assessment, and intervention tele-protocol. The knowledge obtained will inform the development of a larger effectiveness trial for improving the health and well-being of youth with cerebral palsy. TRIAL REGISTRATION ClinicalTrials.gov NCT05336227; https://clinicaltrials.gov/ct2/show/NCT05336227. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40708.
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Affiliation(s)
| | - Drew Davis
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Raven Young
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Erin Kimani-Swanson
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Cynthia Wozow
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Huacong Wen
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Yumi Kim
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jereme Wilroy
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - James Rimmer
- Dean's Office, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
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Ufholz KE, Flack KD, Roemmich JN. The influence of active video game play upon physical activity and screen-based activities in sedentary children. PLoS One 2022; 17:e0269057. [PMID: 35700210 PMCID: PMC9197033 DOI: 10.1371/journal.pone.0269057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Few children meet physical activity recommendations, partly due to the prevalence of screen-based sedentary activities. Active video game (AVG) play produces light to moderate physical activity. Yet, providing children access to AVG does not increase physical activity, possibly because children who play AVG may also tend towards sedentary screen-based activities. How multiple days of AVG play influences children’s choice of other activities is not yet known.
Purpose
To examine how AVG influences children’s physical activity, sedentary screen-based activities, and other alternative activities.
Methods
Sedentary children (N = 49) played AVG 3 times/week and sedentary video games (SVG) ad libitum for 6 weeks, followed by 4 weeks of ad libitum play of both AVG and SVG. Participants wore an activity monitor for 7 days and completed a 24-hour activity recall on 4 randomly selected days at baseline, week 6, and week 10.
Results
AVG play increased during the intervention (p < 0.01). Light activity and SVG play both decreased baseline to 10 weeks (p = 0.006) and 6 to 10 weeks (p = 0.017). Non-SVG sedentary behavior increased from baseline to 10 weeks (p = 0.005) and 6 to 10 weeks (p = 0.007). Changes over time were not observed in physical activity, or recall-measured active play, social activities, other hobbies, television or computer/phone use.
Conclusion
AVG play did not change children’s objectively-measured physical activity or subjectively measured active play. SVG time was substituted with other sedentary behaviors. AVG did not increase time engaged in SVG or screen-based devices.
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Affiliation(s)
- Kelsey E. Ufholz
- Grand Forks Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Grand Forks, North Dakota, United States of America
- * E-mail:
| | - Kyle D. Flack
- Grand Forks Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Grand Forks, North Dakota, United States of America
| | - James N. Roemmich
- Grand Forks Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Grand Forks, North Dakota, United States of America
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A Serious Game for the Prevention of Obesity in School Children–Impact of Parent’s Involvement: A Randomized Controlled Trial. Life (Basel) 2022; 12:life12060779. [PMID: 35743810 PMCID: PMC9225572 DOI: 10.3390/life12060779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/21/2022] [Indexed: 12/11/2022] Open
Abstract
Serious games convey information and use interactive components to reinforce and train behaviours. A serious game addressing nutrition, physical activity and stress coping—the Kids Obesity Prevention Program (KOP)—was previously evaluated for efficacy in children. This study aimed at evaluating the KOP-game regarding: (i) its acceptance and efficacy with respect to parents of primary school children receiving the same game intervention as the children; and (ii) whether the children could benefit by parental involvement. A randomized controlled trial with two groups of children aged 9 to 12 years was conducted which included a 6-month follow-up period. All children played the game twice in two weeks. In the family-intervention group, the parents additionally played the game. The primary outcome was the gain in knowledge in parents and children measured with a pretested questionnaire. The secondary outcomes were knowledge maintenance as well as several behavior changes. Parents and children in both groups improved and maintained their knowledge equally. The KOP-game increases knowledge of nutrition in children independently of the involvement of their parents. KOP games are well accepted in children; further research should examine the structured involvement of parents.
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Ho RST, Chan EKY, Liu KKY, Wong SHS. Active video game on children and adolescents' physical activity and weight management: A network meta-analysis. Scand J Med Sci Sports 2022; 32:1268-1286. [PMID: 35485251 DOI: 10.1111/sms.14176] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
We synthesized evidence on the effectiveness of active video games (AVGs) versus no AVG-applied comparators on various physical activity (PA) levels and weight management outcomes in children and adolescents. We analyzed the comparative evidence on different sub-categories of AVGs and ranking the best option. An overview of systematic reviews (SRs) and network meta-analysis (NMA) (PROSPERO: CRD42021248499) was employed. A search for relevant literature published in English was conducted in six electronic databases from their inception until April 2021. SRs consisting of randomized control trials (RCTs) and satisfying our PICOS inclusion criteria were included. RCTs included were a comparison of groups among children and adolescents between 6 and 21, where groups with AVG interventions were compared with groups without them. Direct head-to-head pairwise meta-analyses were conducted using weighted mean difference between the two groups, and the comparative effectiveness of different sub-categories of AVGs was analyzed indirectly using NMA. Overall, 17 SRs were identified from the 6036 screened citations. Of these, 350 citations were retrieved, and 12 RCTs were finally included. Compared with no AVG group, AVG groups were shown to be more effective in achieving vigorous, moderate-to-vigorous, and moderate PA levels, and decreased BMI and body fat. NMA showed that rhythmic dance games had the highest probability of being the most effective sub-category for reducing BMI. AVGs are effective in attaining vigorous, moderate to vigorous, and moderate PA levels, and reducing BMI and body fat among children and adolescents. Dance appears to be the best option for reducing BMI among AVG subcategories.
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Affiliation(s)
- Robin Sze-Tak Ho
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Eddie Ka-Yui Chan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Kenneth Kang-Yue Liu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
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12
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Lowe M, Singh S, Apple DE, Mayer L, Rosenbaum M, Espel-Huynh H, Thomas JG, Neff KM, Zhang F. Traditional versus developmental measures of weight suppression: Exploring their relationships with bulimic psychopathology. EUROPEAN EATING DISORDERS REVIEW 2022; 30:412-425. [PMID: 35474260 DOI: 10.1002/erv.2903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Weight suppression (WS) is related to a wide variety of eating disorder characteristics. However, individuals with eating disorders usually reach their highest premorbid weight while still developing physically. Therefore, a more sensitive index of individual differences in highest premorbid weight may be one that compares highest premorbid z-BMI to current z-BMI (called developmental weight suppression [DWS] here). METHOD In this exploratory study, we compared the relationships between traditional weight suppression (TWS) and DWS and a variety of measures related to bulimic psychopathology in 91 females (M age, 25.2; 60.5% White), with clinical or sub-clinical bulimia nervosa. RESULTS TWS and DWS were correlated (r = 0.40, p < 0.001). TWS was only significantly related to a measure of physical activity whereas DWS was related to 14 outcomes. DWS showed consistent positive relations with behavioural outcomes (e.g., binge eating) but consistent negative relations with cognitive/affective outcomes (e.g., weight concerns). CONCLUSIONS Findings indicated much more consistent relationships between the novel DWS measure and bulimic characteristics than with the TWS measure. DWS showed both positive and negative relations with bulimic symptoms, though these findings require replication to confirm their validity. Consistent evidence indicated that the two WS measures served as mutual suppressor variables.
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Affiliation(s)
- Michael Lowe
- Department of Psychological and Clinical Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Simar Singh
- Department of Psychological and Clinical Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Danielle E Apple
- Department of Psychological and Clinical Science, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Michael Rosenbaum
- Department of Pediatrics, Columbia University, New York, New York, USA
| | - Hallie Espel-Huynh
- Weight Control and Diabetes Research Center, Brown University, Providence, Rhodes Island, USA
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, Brown University, Providence, Rhodes Island, USA
| | - Kirstie M Neff
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Fengqing Zhang
- Department of Psychological and Clinical Science, Drexel University, Philadelphia, Pennsylvania, USA
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Interactive Video Games as a Method to Increase Physical Activity Levels in Children Treated for Leukemia. Healthcare (Basel) 2022; 10:healthcare10040692. [PMID: 35455869 PMCID: PMC9025872 DOI: 10.3390/healthcare10040692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023] Open
Abstract
Despite the beneficial effect of exercise, children treated for cancer do not engage in sufficient physical activity. It is necessary to search for attractive forms of physical activity, including interactive video games (IVGs). The aim of this study was to verify the effectiveness of the rehabilitation model developed by the authors based on the use of IVGs in children undergoing leukemia treatment. The study included a group of 21 children aged 7–13 years (12 boys, 9 girls) undergoing treatment for acute lymphoblastic leukemia (ALL) (n = 13) and acute myeloid leukemia (AML) (n = 8). The children were randomly assigned to an intervention group and a control group. To assess the level of cardiorespiratory fitness (CRF), each child participated in a Cardiopulmonary Exercise Test. Daily physical activity was assessed using the HBSC questionnaire. The study also used the Children’s Effort Rating Table Scale (CERT) to assess the intensity of physical effort. The children in the intervention group participated in 12 sessions of. The study participants managed to complete all stages of a progressive training program, which confirmed the feasibility of such physical effort by patients with cancer. Pediatric patients reported that the IVG training required a light to moderate physical effort despite high values of energy expenditure (EE).
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Polechoński J, Nierwińska K, Kalita B, Wodarski P. Can Physical Activity in Immersive Virtual Reality Be Attractive and Have Sufficient Intensity to Meet Health Recommendations for Obese Children? A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8051. [PMID: 33139604 PMCID: PMC7662304 DOI: 10.3390/ijerph17218051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023]
Abstract
Immersive virtual reality (IVR) is a technology that blurs the line between the physical world and a digital environment. Using appropriate pointing devices, it is possible to engage in physical activity (PA). The main aim of the study was to assess the attractiveness and intensity of physical exercise while playing active video games (AVGs) in IVR on an omnidirectional treadmill by obese children and to present the results compared to health recommendations (PA). It was also assessed whether the AVGs storyline can effectively motivate the participants to undertake locomotor activity by increasing the intensity of their effort (moving in a limited space vs. having to follow a set route). Eleven children aged 8 to 12 years with diagnosed obesity participated in the experiment. The attractiveness of PA was assessed with a questionnaire, while the intensity of exercise was estimated on the basis of heart rate. The answers show that AVGs are attractive and more enjoyable for the respondents than conventional video games. All participants declared their willingness to practice this form of PA. The intensity of PA of obese children during two games was high but during the game where the player was supposed to follow a set route, it was significantly higher (83.3 ± 9.2% HRmax) than during the game whose storyline assumed moving in a limited space (77.4 ± 9.8% HRmax). Due to the high intensity of PA while playing the AVGs studied, it can be assumed that obese children can benefit for their health if the games are used on a regular basis. However, further research is needed to verify this thesis.
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Affiliation(s)
- Jacek Polechoński
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland
| | - Katarzyna Nierwińska
- Department of Physiological and Medical Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland;
| | - Barbara Kalita
- Metabolic Diseases Clinic, the Voivodeship Specialist Clinic Complex in Katowice, 40-038 Katowice, Poland;
| | - Piotr Wodarski
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, 41-800 Zabrze, Poland;
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15
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Liang Y, Lau PWC, Jiang Y, Maddison R. Getting Active with Active Video Games: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217984. [PMID: 33143064 PMCID: PMC7663622 DOI: 10.3390/ijerph17217984] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023]
Abstract
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.
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Affiliation(s)
- Yan Liang
- Department of Physical Education, China Women’s University, Beijing 100101, China;
| | - Patrick W. C. Lau
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Correspondence: ; Tel.: +852-3411-5634
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, 1010 Auckland, New Zealand;
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia;
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Hahn L, Schmidt MD, Rathbun SL, Johnsen K, Annesi JJ, Ahn SJG. Using virtual agents to increase physical activity in young children with the virtual fitness buddy ecosystem: Study protocol for a cluster randomized trial. Contemp Clin Trials 2020; 99:106181. [PMID: 33096225 DOI: 10.1016/j.cct.2020.106181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/17/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Designing and implementing a truly self-determined physical activity (PA) intervention has required excessive amounts of labor and expenses that, until recently, have made it prohibitively costly to implement in the field at scale. METHODS Guided by self-determination theory, and harnessing the power of consumer-grade interactive technologies, we developed the Virtual Fitness Buddy (VFB) Ecosystem. Designed to foster intrinsic motivation toward adopting PA as a lifestyle change in 6-10-year-old children, the Ecosystem features a mixed-reality kiosk which houses a personalized virtual pet for each user. Each time a child visits the kiosk, the pet (a mid-sized dog) automatically detects its owner based on the data from a child's Fitbit, assists the child in setting daily PA goals and provides tailored feedback on the child's PA progress. The pet alerts parents in real-time by sending text messages and relaying the parents' response to the child, so that parents and children can remain connected about the child's PA progress even when they are physically apart. We aim to implement the kiosk in 12 after-school sites, plus use 12 additional sites as controls, where children can still set and view progress toward their PA goals without access to a virtual pet. CONCLUSION The VFB Ecosystem represents a new generation of technology-mediated health interventions for children to promote sustainable PA lifestyle changes. Because the VFB Ecosystem is a cost- and labor-effective solution that integrates consumer-grade technology with low barriers for continued use, it has the potential for rapid diffusion and widespread public health impact.
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Affiliation(s)
- Lindsay Hahn
- Department of Communication, University at Buffalo, State University of New York, United States.
| | | | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, University of Georgia, United States
| | - Kyle Johnsen
- College of Engineering, University of Georgia, United States
| | - James J Annesi
- YMCA of Metro Atlanta, United States; School of Health Professions, University of Alabama at Birmingham, United States
| | - Sun Joo Grace Ahn
- Grady College of Journalism & Mass Communication, University of Georgia, United States
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Gao Z, Zeng N, McDonough DJ, Su X. A Systematic Review of Active Video Games on Youth's Body Composition and Physical Activity. Int J Sports Med 2020; 41:561-573. [PMID: 32375184 DOI: 10.1055/a-1152-4959] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the past decade, active video games (AVGs) have started to find their way into communities, schools, and homes as a possible solution to promote physical activity (PA) and prevent childhood obesity. However, the evidence regarding its effectiveness on body composition and objectively measured PA in youth remains inconclusive. Thus, a systematic review on this topic is needed. This review synthesizes effects of AVGs on body composition and PA in youth. The initial search yielded 260 articles from 10 databases and 18 randomized-controlled trials were included after evaluating against eligibility and removing duplicates. Overall, AVGs showed positive effects in improving body composition and PA in overweight/obese youth as compared to the control conditions with only 2 studies displaying neutral effects on these outcomes as compared to traditional PA or comparison programs. For healthy youth, more than half of the studies (n = 10) demonstrated neutral effects of AVGs on these outcomes whereas only 6 yielded positive effects compared to the control conditions. Further, one study indicated that the control condition observed greater improvement in body composition compared with an AVG intervention in healthy youth. In summary, AVGs are deemed a promising addition to promote PA and health among overweight/obese youth with the goal of fighting childhood obesity.
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Affiliation(s)
- Zan Gao
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, United States
| | - Nan Zeng
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, United States
| | - Daniel J McDonough
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, United States
| | - Xiwen Su
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, United States
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18
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Bossen D, Broekema A, Visser B, Brons A, Timmerman A, van Etten-Jamaludin F, Braam K, Engelbert R. Effectiveness of Serious Games to Increase Physical Activity in Children With a Chronic Disease: Systematic Review With Meta-Analysis. J Med Internet Res 2020; 22:e14549. [PMID: 32234697 PMCID: PMC7160705 DOI: 10.2196/14549] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 11/21/2019] [Accepted: 01/27/2020] [Indexed: 12/18/2022] Open
Abstract
Background Physical activity (PA) is important for children with a chronic disease. Serious games may be useful to promote PA levels among these children. Objective The primary purpose of this systematic review was to evaluate the effectiveness of serious games on PA levels in children with a chronic disease. Methods PubMed, EMBASE, PsycINFO, ERIC, Cochrane Library, and CINAHL were systematically searched for articles published from January 1990 to May 2018. Both randomized controlled trials and controlled clinical trials were included to examine the effects of serious games on PA levels in children with a chronic disease. Two investigators independently assessed the intervention, methods, and methodological quality in all articles using the Cochrane risk of bias tool. Both qualitative and quantitative analyses were performed. Results This systematic review included 9 randomized controlled trials (886 participants). In 2 of the studies, significant between-group differences in PA levels in favor of the intervention group were reported. The meta-analysis on PA levels showed a nonsignificant effect on moderate to vigorous PA (measured in minutes per day) between the intervention and control groups (standardized mean difference 0.30, 95% CI –0.15 to 0.75, P=.19). The analysis of body composition resulted in significantly greater reductions in BMI in the intervention group (standardized mean difference –0.24, 95% CI –0.45 to 0.04, P=.02). Conclusions This review does not support the hypothesis that serious games improve PA levels in children with a chronic disease. The meta-analysis on body composition showed positive intervention effects with significantly greater reductions in BMI in favor of the intervention group. A high percentage of nonuse was identified in the study of serious games, and little attention was paid to behavior change theories and specific theoretical approaches to enhance PA in serious games. Small sample sizes, large variability between intervention designs, and limited details about the interventions were the main limitations. Future research should determine which strategies enhance the effectiveness of serious games, possibly by incorporating behavior change techniques.
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Affiliation(s)
- Daniël Bossen
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Aline Broekema
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Bart Visser
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Annette Brons
- Digital Life Centre, Faculty of Digital Media and Creative Industries, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | | | | | - Katja Braam
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Raoul Engelbert
- ACHIEVE Center of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.,Amsterdam University Medical Center, Rehabilitation, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam University Medical Center, Pediatrics, University of Amsterdam, Amsterdam, Netherlands
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19
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Moran CA, Corso SD, Bombig MT, Serra AJ, Pereira SA, Peccin MS. Heart rate agreement between the 20-meter shuttle run test and virtual system in healthy children: a cross-sectional study. BMC Pediatr 2019; 19:491. [PMID: 31830948 PMCID: PMC6907110 DOI: 10.1186/s12887-019-1861-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Earlier studies evaluated the physiological responses to video games in children with different clinical conditions; however, no study has compared active video games with an incremental field test in healthy children. The purpose of this study was to verify the agreement between the 20-m shuttle run test (20 m-SRT) and virtual system (VS). METHODS This is a cross-sectional study of 235 children (9.0 ± 0.8 years, 109 boys). The two tests were performed one week apart and the children were instructed not to engage in any physical exercise or sports in the 24 h preceding each test. Their resting heart rate was monitored for one minute and then throughout the tests. To evaluate the influence of motivation on the 20 m SRT and (VS), at the end of the tests the children were asked to rate their motivation on a scale of zero to 10, zero being "not cool" and 10 "awesome". Perceived exertion at the end of the tests was assessed using the modified Borg scale. RESULTS Maximum heart rate (HRmax) did not differ between the 20 m-SRT and VS (194.4 ± 10.2 bpm vs. 193.2 ± 13.8 bpm, respectively). Both tests were similar for intensity > and < 96% HRmax. The children showed greater exertion on the Borg scale and motivation during the VS. The multiple logistic regression model showed that motivation (p = 0.98), sex (p = 0.53), age (p = 0.61), nutritional status (p = 0.65), and speed (p = 0.18) were not predictive factors of the child's reaching HRmax. CONCLUSION VS can be used as a tool to evaluate the intensity of maximal exercise tests, given that the percentage of children who achieved HRmax did not differ between the VS and 20 m SRT. The perceived exertion scales were correlated, but only the modified Borg scale correlated with HRmax in the 20 m SRT. The tests are motivational, and most children obtained the maximum VS score.
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Affiliation(s)
- Cristiane A Moran
- Departamento de Ciências da Saúde, Federal University of Santa Catarina, Campus Jardim das Avenidas, Rod. Gov. Jorge Lacerda, 3201, Araranguá, Santa Catarina, CEP 88.906-072, Brazil.
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20
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Ufholz K, Flack KD, Johnson L, Roemmich JN. Active Videogames to Promote Traditional Active Play: Increasing the Reinforcing Value of Active Play Among Low-Active Children. Games Health J 2019; 9:208-214. [PMID: 31800323 DOI: 10.1089/g4h.2019.0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Exercise reinforcement predicts physical activity of children. Repeated exposures of physical activity may increase physical activity reinforcement (incentive sensitization). Active videogame (AVG) play produces light-to-moderate-intensity physical activity. Ideally, AVG play would transition to nonscreen-based active play through incentive sensitization of traditional active play (TAP), providing AVG does not increase sedentary videogame (SVG) reinforcement. Greater autonomy increases motivation toward traditional physical activity, but whether autonomy enhances incentive sensitization has not been studied. Objectives: To determine whether autonomy over AVG play promotes incentive sensitization of TAP or SVG. Methods: Inactive children (ages 8-12; 5th-97th body mass index percentile) were provided with AVG and SVG for 6 weeks and assigned to either a high autonomy (n = 25) or low autonomy (n = 24) group, differentiated by AVG choice and more freedom over amount of play. Both groups played AVG 3 days per week. SVG were played ad libitum. Participants completed an operant responding task to measure the relative reinforcing value (RRV) of AVG versus SVG (RRVAVG vs. SVG) and AVG versus TAP (RRVAVG vs. TAP) at baseline, 6 weeks, and 10 weeks. Results: RRVAVG vs. SVG increased over time (P = 0.056) but did not differ by autonomy or autonomy × time (P = 0.184). RRVAVG vs. TAP decreased over time (P = 0.033) but did not differ by autonomy or autonomy × time (P = 0.73). Conclusion: AVG play does not increase motivation toward SVG and increases motivation to play AVG relative to TAP. Providing higher autonomy did not promote incentive sensitization of play.
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Affiliation(s)
- Kelsey Ufholz
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
| | - Kyle D Flack
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky
| | - LuAnn Johnson
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
| | - James N Roemmich
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, North Dakota
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21
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Kari T, Salo M, Frank L. Role of situational context in use continuance after critical exergaming incidents. INFORMATION SYSTEMS JOURNAL 2019. [DOI: 10.1111/isj.12273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tuomas Kari
- Faculty of Information TechnologyUniversity of Jyvaskyla Jyvaskyla Finland
| | - Markus Salo
- Faculty of Information TechnologyUniversity of Jyvaskyla Jyvaskyla Finland
| | - Lauri Frank
- Faculty of Information TechnologyUniversity of Jyvaskyla Jyvaskyla Finland
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22
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Home-Based Exergaming on Preschoolers' Energy Expenditure, Cardiovascular Fitness, Body Mass Index and Cognitive Flexibility: A Randomized Controlled Trial. J Clin Med 2019; 8:jcm8101745. [PMID: 31640158 PMCID: PMC6832462 DOI: 10.3390/jcm8101745] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/12/2019] [Accepted: 10/18/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The effects of exergaming-based physical activity (PA) interventions on preschoolers' health outcomes and cognition remain largely unexplored. Therefore, we conducted a randomized controlled trial to discern the effectiveness of a home-based educational exergaming intervention on preschoolers' energy expenditure, fitness, body mass index, and cognition. METHODS Participants were 32 preschoolers (16 girls; 59.4% Asian; Mage = 4.72, SD = ±0.73) recruited from the Twin Cities area in Minnesota. During baseline testing, we measured preschooler's daily energy expenditure (EE), cardiovascular fitness, body mass index, and cognitive flexibility using validated instruments. Participants were then randomly assigned to one of two conditions: (1) the exergaming intervention condition; or (2) control condition. The intervention program requested children participate in home-based educational exergaming using the LeapTV gaming console for at least 30 min/session 5 times/week. The control condition asked children to maintain regular PA patterns without any exergaming gameplay. Each condition lasted 12 weeks. We conducted identical outcome assessments for all children at baseline and post-intervention. RESULTS Analysis of covariance with repeated measures yielded significant time x group interaction effects for cognitive flexibility, Wilks' Lambda = 0.81, F(1, 29) = 6.98, p = 0.01, η2 = 0.19, suggesting children in the exergaming group demonstrated significantly greater increases in cognitive flexibility as compared to those in the control group over time. There were no significant differences for time x group changes between the two groups for EE, Wilks' Lambda = 0.92, F(1, 29) = 2.29, p = 0.14, η2 = 0.08; cardiovascular fitness, Wilks' Lambda = 0.96, F(1, 29) = 1.07, p = 0.31, η2 = 0.04; and BMI, Wilks' Lambda = 0.99, F(1, 29) = 0.05, p = 0.82, η2 = 0.01. However, our data did suggest a marginal effect of time for EE, Wilks' Lambda = 0.89, F(1, 29) = 3.26, p = 0.08, η2 = 0.08, indicating that children's daily EE increased from baseline to post-intervention. CONCLUSIONS Home-based educational exergaming may positively impact cognitive flexibility in preschoolers. Studies with larger sample sizes in multiple geographic locations are needed, with our study suggesting a longer intervention period might also be warranted.
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Baranowski T, Lyons EJ, Thompson D. Experimental Design to Systematically Develop a Knowledge Base for Effective Games for Health. Games Health J 2019; 8:307-312. [DOI: 10.1089/g4h.2019.0057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Elizabeth J. Lyons
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, Texas
| | - Debbe Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
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Oliveira CB, Pinto RZ, Saraiva BTC, Tebar WR, Delfino LD, Franco MR, Silva CCM, Christofaro DGD. Effects of active video games on children and adolescents: A systematic review with meta-analysis. Scand J Med Sci Sports 2019; 30:4-12. [PMID: 31418915 DOI: 10.1111/sms.13539] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/07/2019] [Accepted: 08/07/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the effectiveness of active video games (AVGs) on obesity-related outcomes and physical activity levels in children and adolescents. DESIGN Systematic review with meta-analysis. METHODS Literature search was performed in five electronic databases and the main clinical trials registries. Randomized controlled trials investigating the effect of AVGs compared with no/minimal intervention on obesity-related outcomes (body mass index [BMI], body weight, body fat, and waist circumference) and physical activity levels of children and adolescents were eligible. Two independent reviewers extracted the data of each included study. PEDro scale was used to assess risk of bias and GRADE approach to evaluate overall quality of evidence. Pooled estimates were obtained using random effect models. RESULTS Twelve studies were considered eligible for this review. Included studies mostly reported outcome data at short-term (less or equal than three months) and intermediate-term follow-up (more than 3 months, but <12 months). AVGs were more effective than no/minimal intervention in reducing BMI/zBMI at short-term (SMD = -0.34; 95% CI: -0.62 to -0.05) and intermediate-term follow-up (SMD = -0.36; 95% CI: -0.01 to -0.71). In addition, AVGs were more effective in reducing body weight compared with no/minimal intervention at intermediate-term follow-up (SMD = -0.25; 95% CI: -0.46 to -0.04). Regarding physical activity levels, AVGs were not more effective compared with minimal intervention at short-term and intermediate-term follow-up. CONCLUSIONS Our review identified that AVGs were better than minimal intervention in reducing BMI and body weight, but not for increasing physical activity in young people.
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Affiliation(s)
- Crystian B Oliveira
- Department of Physiotherapy, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Rafael Z Pinto
- Department of Physiotherapy, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil.,Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Bruna T C Saraiva
- Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - William R Tebar
- Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Leandro D Delfino
- Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | | | - Claudiele C M Silva
- Department of Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Diego G D Christofaro
- Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
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Active Gaming Prevalence and Correlates by Type of Day in Spanish Youth. J Phys Act Health 2019; 16:715-721. [PMID: 31310996 DOI: 10.1123/jpah.2018-0448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 03/17/2019] [Accepted: 05/05/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Active gaming has emerged as a new option to foster physical activity in youth. The aim of this study was to estimate the prevalence of active gaming in adolescents, to determine differences between active and nonactive gamers by type of day, and to examine predictors of being an active gamer. METHODS A cross-sectional study was conducted with 3095 Spanish adolescents aged 12 to 18 years who self-reported their involvement in moderate to vigorous physical activity, sedentary behaviors, and active gaming. Those engaging in active gaming for at least 10 minutes per day were considered active gamers. Student's 2-tailed t tests, chi-square test, and binomial logistic regression were performed. RESULTS About 25.9% of the adolescents were active gamers. They were younger, had higher body mass index, and spent more time on moderate to vigorous physical activity, television viewing, and sedentary video games with computer/console than nonactive gamers. There were more active gamers on weekends than on weekdays. On weekdays, more males than females were active gamers. Adolescents who did not meet sleep time guidelines were more likely to be active gamers on weekdays, whereas on weekends, being a girl, overweight/obese, and having a high socioeconomic status were predictors of being an active gamer. CONCLUSION Because active gaming may contribute to meeting physical activity guidelines, the present findings could enable better targeting of physical activity promotion programs.
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Baranowski T, Lyons EJ. Scoping Review of Pokémon Go: Comprehensive Assessment of Augmented Reality for Physical Activity Change. Games Health J 2019; 9:71-84. [PMID: 31386564 DOI: 10.1089/g4h.2019.0034] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pokémon Go™ (PG) is a mobile videogame that requires real-world walking to "catch" augmented reality (AR) virtual creatures. Media attention speculated that extensive physical activity (PA) could result from PG play, which could have public health benefit. Little is known about contextual factors related to PG play and how they may impact play initiation or duration. A systematic search of articles reporting the words PG was conducted with PubMed and Google Scholar. To understand the many possible influences on and outcomes of PG play, a scoping review was conducted by employing a conceptual model to organize the literature. Although large numbers of people started playing PG, these were a relatively small proportion of the relevant populations, but PG may have activated some of those most in need of PA. Diverse factors predicted who initiated PG play, but they tended to emphasize anticipated fun, escapism, nostalgia, social ties, and desire for PA. Environmental factors (e.g., unavailable GPS signals, trespassing laws) limited PG play for some. Diverse factors predicted duration of gameplay, but fun appeared to be prominent. The level of increases in PA from PG among youth and young adults appeared to be small or undetected, and of a relatively short duration (<2 months). Among older adults, however, there were modest increases in PA for up to 7 months post-release. This intensity and duration of increased PA appears to be inadequate to stem the epidemic of obesity but may have mental and social health benefits. Although many adverse outcomes from playing PG were reported, these appear to be low incidence, which should primarily influence PG players to knowingly exercise caution. Many research issues were identified to specify who might play AR games and effective strategies to enhance game design to increase PA.
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Affiliation(s)
- Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Elizabeth J Lyons
- The University of Texas Medical Branch, Institute for Translational Sciences, Galveston, Texas
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Brown T, Moore TH, Hooper L, Gao Y, Zayegh A, Ijaz S, Elwenspoek M, Foxen SC, Magee L, O'Malley C, Waters E, Summerbell CD. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2019; 7:CD001871. [PMID: 31332776 PMCID: PMC6646867 DOI: 10.1002/14651858.cd001871.pub4] [Citation(s) in RCA: 275] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
EDITORIAL NOTE This Cochrane review is now out of date and should not be used for reference. It has been split into four age groups and updated. Please refer to the 5‐11 and 12‐18 age group Cochrane reviews which were published in May 2024: https://doi.org/10.1002/14651858.CD015328.pub2 https://doi.org/10.1002/14651858.CD015330.pub2 The 2‐4 age group Cochrane review is planned for publication in September 2024. BACKGROUND Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies to prevent obesity is very large and is accumulating rapidly. This is an update of a previous review. OBJECTIVES To determine the effectiveness of a range of interventions that include diet or physical activity components, or both, designed to prevent obesity in children. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsychINFO and CINAHL in June 2015. We re-ran the search from June 2015 to January 2018 and included a search of trial registers. SELECTION CRITERIA Randomised controlled trials (RCTs) of diet or physical activity interventions, or combined diet and physical activity interventions, for preventing overweight or obesity in children (0-17 years) that reported outcomes at a minimum of 12 weeks from baseline. DATA COLLECTION AND ANALYSIS Two authors independently extracted data, assessed risk-of-bias and evaluated overall certainty of the evidence using GRADE. We extracted data on adiposity outcomes, sociodemographic characteristics, adverse events, intervention process and costs. We meta-analysed data as guided by the Cochrane Handbook for Systematic Reviews of Interventions and presented separate meta-analyses by age group for child 0 to 5 years, 6 to 12 years, and 13 to 18 years for zBMI and BMI. MAIN RESULTS We included 153 RCTs, mostly from the USA or Europe. Thirteen studies were based in upper-middle-income countries (UMIC: Brazil, Ecuador, Lebanon, Mexico, Thailand, Turkey, US-Mexico border), and one was based in a lower middle-income country (LMIC: Egypt). The majority (85) targeted children aged 6 to 12 years.Children aged 0-5 years: There is moderate-certainty evidence from 16 RCTs (n = 6261) that diet combined with physical activity interventions, compared with control, reduced BMI (mean difference (MD) -0.07 kg/m2, 95% confidence interval (CI) -0.14 to -0.01), and had a similar effect (11 RCTs, n = 5536) on zBMI (MD -0.11, 95% CI -0.21 to 0.01). Neither diet (moderate-certainty evidence) nor physical activity interventions alone (high-certainty evidence) compared with control reduced BMI (physical activity alone: MD -0.22 kg/m2, 95% CI -0.44 to 0.01) or zBMI (diet alone: MD -0.14, 95% CI -0.32 to 0.04; physical activity alone: MD 0.01, 95% CI -0.10 to 0.13) in children aged 0-5 years.Children aged 6 to 12 years: There is moderate-certainty evidence from 14 RCTs (n = 16,410) that physical activity interventions, compared with control, reduced BMI (MD -0.10 kg/m2, 95% CI -0.14 to -0.05). However, there is moderate-certainty evidence that they had little or no effect on zBMI (MD -0.02, 95% CI -0.06 to 0.02). There is low-certainty evidence from 20 RCTs (n = 24,043) that diet combined with physical activity interventions, compared with control, reduced zBMI (MD -0.05 kg/m2, 95% CI -0.10 to -0.01). There is high-certainty evidence that diet interventions, compared with control, had little impact on zBMI (MD -0.03, 95% CI -0.06 to 0.01) or BMI (-0.02 kg/m2, 95% CI -0.11 to 0.06).Children aged 13 to 18 years: There is very low-certainty evidence that physical activity interventions, compared with control reduced BMI (MD -1.53 kg/m2, 95% CI -2.67 to -0.39; 4 RCTs; n = 720); and low-certainty evidence for a reduction in zBMI (MD -0.2, 95% CI -0.3 to -0.1; 1 RCT; n = 100). There is low-certainty evidence from eight RCTs (n = 16,583) that diet combined with physical activity interventions, compared with control, had no effect on BMI (MD -0.02 kg/m2, 95% CI -0.10 to 0.05); or zBMI (MD 0.01, 95% CI -0.05 to 0.07; 6 RCTs; n = 16,543). Evidence from two RCTs (low-certainty evidence; n = 294) found no effect of diet interventions on BMI.Direct comparisons of interventions: Two RCTs reported data directly comparing diet with either physical activity or diet combined with physical activity interventions for children aged 6 to 12 years and reported no differences.Heterogeneity was apparent in the results from all three age groups, which could not be entirely explained by setting or duration of the interventions. Where reported, interventions did not appear to result in adverse effects (16 RCTs) or increase health inequalities (gender: 30 RCTs; socioeconomic status: 18 RCTs), although relatively few studies examined these factors.Re-running the searches in January 2018 identified 315 records with potential relevance to this review, which will be synthesised in the next update. AUTHORS' CONCLUSIONS Interventions that include diet combined with physical activity interventions can reduce the risk of obesity (zBMI and BMI) in young children aged 0 to 5 years. There is weaker evidence from a single study that dietary interventions may be beneficial.However, interventions that focus only on physical activity do not appear to be effective in children of this age. In contrast, interventions that only focus on physical activity can reduce the risk of obesity (BMI) in children aged 6 to 12 years, and adolescents aged 13 to 18 years. In these age groups, there is no evidence that interventions that only focus on diet are effective, and some evidence that diet combined with physical activity interventions may be effective. Importantly, this updated review also suggests that interventions to prevent childhood obesity do not appear to result in adverse effects or health inequalities.The review will not be updated in its current form. To manage the growth in RCTs of child obesity prevention interventions, in future, this review will be split into three separate reviews based on child age.
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Affiliation(s)
- Tamara Brown
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
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Ameryoun A, Sanaeinasab H, Saffari M, Koenig HG. Impact of Game-Based Health Promotion Programs on Body Mass Index in Overweight/Obese Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Child Obes 2019; 14:67-80. [PMID: 29185787 DOI: 10.1089/chi.2017.0250] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Sedentary lifestyle is growing among children and adolescents that may contribute to problems such as overweight and obesity. Consequently, interventions to improve weight loss in this population are necessary. The aim of this current review was to evaluate the effectiveness of game-based interventions to reduce body mass index (BMI) among children who were overweight or obese. METHODS All randomized controlled trials with a game-based approach for lowering weight in obese/overweight youths aged 5-18 years old were identified from January 2005 to June 2017 across PubMed, Web of Science, Embase, Scopus, and ScienceDirect. Two independent reviewers completed data extraction sheets on information such as sample size, country of origin, age of participants, type of interventions, and BMI change from pre- to posttest. A consensus on collected data was obtained, and a final list of studies meeting inclusion and exclusion criteria was arrived at. Data were analyzed using Comprehensive Meta-analysis software, and effect size was measured by standardized mean difference (SMD) and Hedges' g measure. Heterogeneity and publication bias were also examined using I2 index and funnel plot. RESULTS A total of 388 articles were identified from electronic and manuals' searches. After deletion of duplicated articles, 138 articles remained that were then screened in terms of relevance. Of those, 41 articles were examined to determine eligibility. Finally, 10 articles met inclusion/exclusion criteria and were entered into the quantitative meta-analysis. Results indicated a small but significant effect size in terms of BMI reduction [SMD, -0.234; standard error (SE), 0.069] among included studies. The average BMI z-score reduction was -0.181 (SE, 0.071). Trials which used other types of interventions along with active game-based approaches achieved greater effect sizes than single game-based interventions. There was a significant difference between studies based on their country of origin, BMI value, and intervention type. Those conducted in United States, those including participants with BMI ≥30, and studies with multicomponent intervention reported a higher reduction of BMI than others. However, no significant difference in BMI was found in terms of variables such as age, sample size, type of participant (overweight/obese), intervention duration, or participant gender. No publication bias was identified, and studies were homogenous (I2 = 22.5%). CONCLUSIONS Interventions that involve active gaming may produce small effects in terms of improving BMI among children who are overweight/obese. Therefore, we recommend that supplemental interventions be used to enhance the effectiveness of game-based interventions.
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Affiliation(s)
- Ahmad Ameryoun
- 1 Health Management Research Center, Baqiyatallah University of Medical Sciences , Tehran, Iran
| | - Hormoz Sanaeinasab
- 2 Department of Health Education, Faculty of Health, Baqiyatallah University of Medical Sciences , Tehran, Iran
| | - Mohsen Saffari
- 2 Department of Health Education, Faculty of Health, Baqiyatallah University of Medical Sciences , Tehran, Iran .,3 Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences , Tehran, Iran
| | - Harold G Koenig
- 4 Psychiatry and Behavioral Sciences, Duke University Medical Center , Durham, NC.,5 King Abdulaziz University , Jeddah, Saudi Arabia .,6 Ningxia Medical University , Yinchuan, China
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Conlon BA, Mcginn AP, Isasi CR, Mossavar-Rahmani Y, Lounsbury DW, Ginsberg MS, Diamantis PM, Groisman-Perelstein AE, Wylie-Rosett J. Home Environment Factors and Health Behaviors of Low-income, Overweight, and Obese Youth. Am J Health Behav 2019; 43:420-436. [PMID: 30808480 DOI: 10.5993/ajhb.43.2.17] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: Home environment may influence children's health behaviors associated with obesity. In this study, we examined home environment factors associated with diet and physical activity behaviors of overweight or obese youth. Methods: We analyzed baseline data from child and parent/caregiver dyads enrolled in an urban family weight management program. Multivariable logistic regression examined how home environment (parenting practices, family meal habits, and home availability of fruits/vegetables, sugar-sweetened beverages (SSBs), screen media, and physical activity resources) are related to children's intake of fruit, vegetables, and SSBs, and moderate-vigorous physical activity and sedentary time (ST) after adjusting for potential confounders. Results: Children were more likely to consume fruit if their families frequently ate meals together and infrequently watched TV during meals, and more likely to consume vegetables with high fruit/vegetable availability and low SSB availability. Children were more likely to engage in ST if parents practiced monitoring and frequently watched TV during meals. Conclusions: Overweight or obese children appear to have healthier habits if their families eat meals together without watching TV and if healthy food choices are available in the home. Encouraging parents to focus these practices may promote healthier body weight in children.
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Affiliation(s)
- Beth A. Conlon
- Postgraduate Student, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY;,
| | - Aileen P. Mcginn
- Associate Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Carmen R. Isasi
- Associate Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Yasmin Mossavar-Rahmani
- Associate Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - David W. Lounsbury
- Assistant Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Mindy S. Ginsberg
- Senior Associate, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Pamela M. Diamantis
- Attending Physician, Department of Pediatrics, Children's Health Services Jacobi Medical Center, Bronx, NY
| | | | - Judith Wylie-Rosett
- Professor, Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
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Ahn SJG, Johnsen K, Ball C. Points-Based Reward Systems in Gamification Impact Children's Physical Activity Strategies and Psychological Needs. HEALTH EDUCATION & BEHAVIOR 2019; 46:417-425. [PMID: 30678507 DOI: 10.1177/1090198118818241] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Gamification is an increasingly popular form of health intervention but its efficacy remains elusive due to a lack of clarity in its conceptualization and operationalization. This study aimed to isolate and determine the direct causal effect of one of the most popular game elements used in gamified interventions, the points-based reward system, on physical activity (PA) in children. A 72-hour field study with children aged 9 to 13 ( N = 67) was conducted using a digital PA intervention featuring a virtual dog, with and without a points-based reward system. PA was assessed with an activity monitor, and overall PA, three levels of PA intensity, and PA strategies during the 3-day intervention were measured. Guided by self-determination theory, the impact of the points-based reward system on children's basic psychological needs was also investigated. Results indicated that the points-based reward system briefly increased PA engagement but did not significantly affect overall PA over time. When given equal number of points regardless of intensity, children approached the PA intervention strategically by engaging in significantly more light intensity and significantly less vigorous intensity PA than children who did not receive points. Results also suggested that the points-based reward system might promote perceptions of relatedness with the virtual agent featured in the gamified intervention.
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Baranowski T. Increasing physical activity among children and adolescents: Innovative ideas needed. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:1-5. [PMID: 30719376 PMCID: PMC6349620 DOI: 10.1016/j.jshs.2018.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 05/09/2023]
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Staiano AE, Beyl RA, Guan W, Hendrick CA, Hsia DS, Newton RL. Home-based exergaming among children with overweight and obesity: a randomized clinical trial. Pediatr Obes 2018; 13:724-733. [PMID: 30027607 PMCID: PMC6203598 DOI: 10.1111/ijpo.12438] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/30/2018] [Accepted: 05/26/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Given children's low levels of physical activity and high prevalence of obesity, there is an urgent need to identify innovative physical activity options. OBJECTIVE This study aims to test the effectiveness of exergaming (video gaming that involves physical activity) to reduce children's adiposity and improve cardiometabolic health. METHODS This randomized controlled trial assigned 46 children with overweight/obesity to a 24-week exergaming or control condition. Intervention participants were provided a gaming console with exergames, a gameplay curriculum (1 h per session, three times a week) and video chat sessions with a fitness coach (telehealth coaching). Control participants were provided the exergames following final clinic visit. The primary outcome was body mass index (BMI) z-score. Secondary outcomes were fat mass by dual energy X-ray absorptiometry and cardiometabolic health metrics. RESULTS Half of the participants were girls, and 57% were African-American. Intervention adherence was 94.4%, and children's ratings of acceptability and enjoyment were high. The intervention group significantly reduced BMI z-score excluding one control outlier (intervention [standard error] vs. control [standard error]: -0.06 [0.03] vs. 0.03 [0.03], p = 0.016) with a marginal difference in intent-to-treat analysis (-0.06 [0.03] vs. 0.02 [0.03], p = 0.065). Compared with control, the intervention group improved systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein-cholesterol and moderate-to-vigorous physical activity (all p values <0.05). CONCLUSIONS Exergaming at home elicited high adherence and improved children's BMI z-score, cardiometabolic health and physical activity levels. Exergaming with social support may be promoted as an exercise option for children.
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Affiliation(s)
| | - Robbie A. Beyl
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Win Guan
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Daniel S. Hsia
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Robert L. Newton
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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Militello LK, Hanna N, Nigg CR. Pokémon GO Within the Context of Family Health: Retrospective Study. JMIR Pediatr Parent 2018; 1:e10679. [PMID: 31518294 PMCID: PMC6715058 DOI: 10.2196/10679] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/09/2018] [Accepted: 08/26/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Pokémon GO illuminated the potential for mobile phone gaming apps to engage users and promote health. However, much work is needed to fully understand the mechanisms through which digitally supported behavior change interventions operate, particularly for children and families. OBJECTIVE The aims of this study were (1) to explore the Pokémon GO user experience from a family perspective and (2) to investigate Pokémon GO within the context of family health. METHODS Between January and February 2017, congruent with one of the largest anticipated Pokémon GO updates Gen 2, participants were recruited from parks, word of mouth, and social media to complete a Web-based survey. Participants were surveyed about family characteristics, interest, and experiences playing Pokémon GO and healthy lifestyle beliefs. Using a revised Godin Leisure-Time Exercise Questionnaire, a retrospective pre-post design assessed changes in parent physical activity (PA) before and after playing Pokémon GO. RESULTS Self-reported data from 160 parents and 31 children were included in the final analyses (representing 129 parents and 31 parent-child dyads). Gameplay most often occurred between sons aged 10 years or younger and mothers. "Spending time together" was the most cited reason for gameplay by both parents (122/160, 76.3%) and children (24/31, 77%), followed by "it helped me go outdoors" for parents (113/160, 70.1%) and "I am a Pokémon fan" by children (21/31, 68%). Interestingly, open-ended responses indicated that gameplay could trigger both positive and negative emotional parent response. The most cited reason for app disengagement was boredom; conversely, the most cited reason for app re-engagement was in-app events. For parents, there were significant increases in minutes spent in mild (mean 23.36 [SD 66.02]; t97=3.50, P<.001) and moderate (mean 21.76 [SD 53.04]; t130=4.70, P<.001) PA per week after playing Pokémon GO. However, child perceptions of parental influence on PA most significantly associated with parents who reported weekly strenuous PA both before (rs=.514, P=.003) and after (rs=.536, P=.003) Pokémon GO uptake. CONCLUSIONS Pokémon GO transcended traditional understanding of digital health and uniquely reached across generations to engage users. Findings from this study highlight that, for a period of time, Pokémon GO fostered social and physical well-being for children and families through a multifaceted approach.
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Affiliation(s)
- Lisa K Militello
- Martha S Pitzer Center for Women, Children, and Youth, College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Nathan Hanna
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Claudio R Nigg
- Office of Public Health Studies, University of Hawaii, Honolulu, HI, United States
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Garde A, Chowdhury M, Rollinson AU, Johnson M, Prescod P, Chanoine JP, Ansermino JM, Dumont GA. A Multi-Week Assessment of a Mobile Exergame Intervention in an Elementary School. Games Health J 2018; 7:1-8. [PMID: 29394109 DOI: 10.1089/g4h.2017.0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Exergaming is potentially useful to promote physical activity in children; however, long-term effectiveness is unclear. MobileKids Monster Manor (MKMM) is a mobile exergame developed with the help of young advisors. The game wirelessly transmits physical activity data from an accelerometer to a mobile device. Players' steps are redeemed for in-game rewards, for example, new characters. OBJECTIVE First, to evaluate whether increased physical activity previously observed in a 1-week intervention is sustained over a 2-week intervention and 1-week follow-up, and second, to compare impact in schools within different socioeconomic environments. METHODS Thirty-seven elementary school students participated in a 4-week randomized controlled study (1-week baseline; 2-week intervention [with only the Game group receiving MKMM]; and 1-week follow-up). All participants wore a Tractivity® accelerometer throughout. Linear mixed models were applied to assess sustainability; a second 42-children-based dataset and age-/sex-adjusted linear regression models were used to compare effect across socioeconomic environments. RESULTS In the first week of intervention, the Game group compared to the Control group showed a greater increase in physical activity (of 1,758 steps/day [95% confidence interval, CI = 133-3,385] and 31 active minutes/day [95% CI = 4-59]), relative to baseline (13,986 steps/day; 231 active minutes/day). However, this was not sustained in the second intervention week or follow-up. The school within a lower socioeconomic status environment showed lower baseline activity and the 1-week intervention resulted in a greater increase relative to baseline (3,633 steps/day more [95% CI = 1,281-5,985]). CONCLUSION MKMM could be a useful short-term physical activity promotion tool; however, effectiveness may decrease as novelty diminishes.
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Affiliation(s)
- Ainara Garde
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia , Vancouver, Canada .,2 Department of Pediatric Anesthesia, British Columbia's Children's Hospital , Vancouver, Canada .,3 Department of Biomedical Signals and Systems, University of Twente , Enschede, The Netherlands
| | - Manil Chowdhury
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia , Vancouver, Canada .,2 Department of Pediatric Anesthesia, British Columbia's Children's Hospital , Vancouver, Canada
| | - Aryannah U Rollinson
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia , Vancouver, Canada .,2 Department of Pediatric Anesthesia, British Columbia's Children's Hospital , Vancouver, Canada
| | - Mika Johnson
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia , Vancouver, Canada .,2 Department of Pediatric Anesthesia, British Columbia's Children's Hospital , Vancouver, Canada
| | - Paul Prescod
- 4 Ayogo Health, Inc. , Information Technology and Services, Vancouver, Canada
| | - Jean Pierre Chanoine
- 2 Department of Pediatric Anesthesia, British Columbia's Children's Hospital , Vancouver, Canada .,5 Endocrinology and Diabetes Unit, Department of Pediatrics, The University of British Columbia , Vancouver, Canada
| | - John Mark Ansermino
- 6 Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia , Vancouver, Canada .,7 Department of Anesthesia, BC Children's Hospital , Vancouver, Canada
| | - Guy A Dumont
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia , Vancouver, Canada .,2 Department of Pediatric Anesthesia, British Columbia's Children's Hospital , Vancouver, Canada
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Abstract
Social media and new media are becoming increasingly important in the lives of preteens and teens. This article reviews what is currently known about positive and negative effects of social media, social networking, and internet use and what safety measures should be considered.
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Affiliation(s)
- Marjorie Hogan
- 1 University of Minnesota School of Medicine, Minneapolis, MN, USA
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Rhodes RE, Nwachukwu N, Quinlan A. Family Exergaming: Correlates and Preferences. Games Health J 2018; 7:188-196. [DOI: 10.1089/g4h.2017.0177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ryan E. Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
| | - Nnenna Nwachukwu
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
| | - Alison Quinlan
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
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Effect of an Active Video Gaming Classroom Curriculum on Health-Related Fitness, School Day Step Counts, and Motivation in Sixth Graders. J Phys Act Health 2018; 15:644-650. [PMID: 29741441 DOI: 10.1123/jpah.2017-0481] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to explore the effect of an active video gaming (AVG) classroom curriculum on health-related fitness, school day steps, and motivation in sixth graders. METHODS A convenience sample of 65 sixth graders were recruited from 2 classrooms from a school located in the Western United States. One classroom served as the comparison group (n = 32) that participated in active free play, and one classroom served as the intervention group (n = 33) that participated in an AVG curriculum for 30 minutes per day, 3 days per week, for 18 weeks. Cardiorespiratory endurance was assessed using Progressive Aerobic Cardiovascular Endurance Run laps. School day steps were recorded, and motivational variables were collected using questionnaires. Measures were collected at baseline and an 18-week posttest time point. RESULTS There was a significant group × time interaction for Progressive Aerobic Cardiovascular Endurance Run laps (b = 20.7 laps; 95% confidence interval, 14.6 to 26.8; P < .001). No statistically significant interactions were found for step counts or any of the motivational variables. CONCLUSIONS An 18-week AVG classroom curriculum improved cardiorespiratory endurance relative to the comparison group in sixth graders. This study supports the use of low-cost AVG curricula to improve the health-related fitness of youth.
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39
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[Serious video games in pediatrics]. Arch Pediatr 2017; 25:48-54. [PMID: 29269184 DOI: 10.1016/j.arcped.2017.10.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 08/04/2017] [Accepted: 10/26/2017] [Indexed: 11/23/2022]
Abstract
Playing video games has been associated with several negative effects in children. However, serious games, which are video games designed for a primary purpose other than pure entertainment, should not be neglected by pediatricians. In the field of public health, some serious games are a means to decrease drug consumption and improve sexual health behavior in adolescents. In schools, serious games can be used to change students' perception of the disease of one of their classmates, or to train students on basic life support. Serious games are also used with patients: they can distract them from a painful procedure, increase their compliance to treatments, or participate in their rehabilitation. Finally, serious games allow healthcare professionals to train on the management of various medical situations without risk. For every field of application, this review presents the rationale of the use of video games, followed by concrete examples of video games and the results of their scientific evaluation.
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Falbe J, Willett WC, Rosner B, Field AE. Body mass index, new modes of TV viewing and active video games. Pediatr Obes 2017; 12:406-413. [PMID: 27334546 PMCID: PMC5568509 DOI: 10.1111/ijpo.12158] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 04/24/2016] [Accepted: 04/27/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Recent technologies have changed screen time. TV can be viewed anywhere, anytime. Content can be collected via digital recorders and online streaming and viewed on smartphones. Video games are no longer strictly sedentary. OBJECTIVES We sought to assess the unknown relations between new modes of TV viewing - recorded, online, downloaded and on hand-held devices - and active video games with body mass index (BMI). METHODS Cross-sectional analysis of the 2011 wave of the Growing Up Today Study 2 cohort. We used gender-specific generalized estimating equations to examine screen time and BMI among 3071 women and 2050 men aged 16-24 years. RESULTS Among women, each hour/day of online TV (0.47; confidence interval [CI]: 0.12, 0.82) and total non-broadcast TV (0.37; CI: 0.14, 0.61) was associated with higher BMI, as was watching ≥ 1/2 h week-1 of TV on hand-held devices (1.04; CI: 0.32-1.77). Active video games were associated with BMI among women, but not after restricting to those not trying to lose/maintain weight. Broadcast TV was associated with higher BMI (kg m-2 ) among women and men (P < 0.05). CONCLUSIONS Among women, online TV, TV viewed on hand-held devices and the sum of non-broadcast TV time were associated with higher BMI. Broadcast TV was also associated with BMI in women and men.
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Affiliation(s)
- Jennifer Falbe
- Department of Nutrition, Harvard T.H. Chan School of Public Health,Department of Epidemiology, Harvard T.H. Chan School of Public Health
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health,Department of Epidemiology, Harvard T.H. Chan School of Public Health,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
| | - Alison E. Field
- Department of Epidemiology, Harvard T.H. Chan School of Public Health,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School,Division of Adolescent Medicine, Boston Children’s Hospital
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41
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Van Rooij AJ, Daneels R, Liu S, Anrijs S, Van Looy J. Children’s Motives to Start, Continue, and Stop Playing Video Games: Confronting Popular Theories with Real-World Observations. CURRENT ADDICTION REPORTS 2017. [DOI: 10.1007/s40429-017-0163-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
There is a long history of using videogames in a therapeutic capacity including rehabilitation for stroke patients, people with traumatic brain injuries, burns victims, wheelchair users, Erb's palsy sufferers, children undergoing chemotherapy, children with muscular dystrophy, autistic children and individuals looking to overcome real-life challenges (including symptoms of depression) and boost their wellbeing (including boosting life satisfaction, self-efficacy and social support). This paper briefly and selectively examines a number of areas including: (1) videogames as physiotherapy and occupational therapy, (2) videogames as distractors in the role of pain management, (3) videogames and cognitive rehabilitation, (4) videogames and the development of social and communication skills among the learning disabled, (5) videogames and impulsivity/attention deficit disorders, (6) videogames and therapeutic benefits in the elderly, (7) videogames in psychotherapeutic settings, (8) videogames and health care, (9) videogames and anxiety disorders, and (10) videogames and psychological wellbeing. It is concluded that there has been considerable success when games are specifically designed to address a specific problem or to teach a certain skill. However, generalizability outside the game-playing situation remains an important consideration.
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Affiliation(s)
- Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Daria J. Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Angelica B. Ortiz de Gortari
- International Gaming Research Unit, Psychology Division, Nottingham Trent University, Nottingham, UK & Psychology and Neuroscience of Cognition Research Unit, University of Liège, Belgium
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Rhodes RE, Blanchard CM, Bredin SSD, Beauchamp MR, Maddison R, Warburton DER. Stationary cycling exergame use among inactive children in the family home: a randomized trial. J Behav Med 2017. [PMID: 28631101 DOI: 10.1007/s10865-017-9866-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Exergames may be one way to increase child physical activity, but long term adherence has seen little research attention. The primary objective of this study was to evaluate the usage of an exergame bike in comparison to a stationary bike in front of a TV across 3-months within a family home environment among children aged 10-14 years old. Seventy-three inactive children were recruited through advertisements and randomized to either the exergame condition (n = 39) or the standard bike condition (n = 34). Weekly bike use was recorded in a log-book. Both groups declined in bike use over time (t = 3.921, p < .01). Although the exergame group reported higher use (t = 2.0045, p < .05), this was most prominent during the first week. Overall, these results do not support exergames as a standalone physical activity intervention, and suggest that short duration examinations of exergames may be misleading.
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Affiliation(s)
- Ryan E Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3010, STN CSC, Victoria, B.C., V8W 3N4, Canada.
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Mack I, Bayer C, Schäffeler N, Reiband N, Brölz E, Zurstiege G, Fernandez-Aranda F, Gawrilow C, Zipfel S. Chances and Limitations of Video Games in the Fight against Childhood Obesity-A Systematic Review. EUROPEAN EATING DISORDERS REVIEW 2017; 25:237-267. [PMID: 28467004 DOI: 10.1002/erv.2514] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/18/2016] [Accepted: 02/27/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE AND METHOD A systematic literature search was conducted to assess the chances and limitations of video games to combat and prevent childhood obesity. This search included studies with video or computer games targeting nutrition, physical activity and obesity for children between 7 and 15 years of age. RESULTS The study distinguished between games that aimed to (i) improve knowledge about nutrition, eating habits and exercise; (ii) increase physical activity; or (iii) combine both approaches. Overall, the games were well accepted. On a qualitative level, most studies reported positive effects on obesity-related outcomes (improvement of weight-related parameters, physical activity or dietary behaviour/knowledge). However, the observed effects were small. The games did not address psychosocial aspects. CONCLUSIONS Using video games for weight management exclusively does not deliver satisfying results. Video games as an additional guided component of prevention and treatment programs have the potential to increase compliance and thus enhance treatment outcome. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Carolin Bayer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Norbert Schäffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Nadine Reiband
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Ellen Brölz
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Guido Zurstiege
- Department of Media Studies, University of Tübingen, Tübingen, Germany
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN, ISCIII), Barcelona, Spain
| | - Caterina Gawrilow
- Department of School Psychology, University of Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Weihrauch-Blüher S, Koormann S, Brauchmann J, Wiegand S. [Electronic media in obesity prevention in childhood and adolescence]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:1452-1464. [PMID: 27757512 DOI: 10.1007/s00103-016-2455-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The increasing prevalence of childhood obesity is - amongst other factors - due to changed leisure time habits with decreased physical activity and increased media consumption. However, electronic media such as tablets and smartphones might also provide a novel intervention approach to prevent obesity in childhood and adolescence. OBJECTIVES A summary of interventions applying electronic media to prevent childhood obesity is provided to investigate short term effects as well as long term results of these interventions. METHODS A systematic literature search was performed in PubMed/Web of Science to identify randomized and/or controlled studies that have investigated the efficacy of electronic media for obesity prevention below the age of 18. RESULTS A total of 909 studies were identified, and 88 studies were included in the analysis. Active video games did increase physical activity compared to inactive games when applied within a peer group. Interventions via telephone had positive effects on certain lifestyle-relevant behaviours. Interventions via mobile were shown to decrease dropout rates by sending regular SMS messages. To date, interventions via smartphones are scarce for adolescents; however, they might improve cardiorespiratory fitness. The results from internet-based interventions showed a trend towards positive effects on lifestyle-relevant behaviors. The combination of different electronic media did not show superior results compared to interventions with only one medium. Interventions via TV, DVD or video-based interventions may increase physical activity when offered as an incentive, however, effects on weight status were not observed. DISCUSSION Children and adolescents currently grow up in a technology- and media-rich society with computers, tablets, smartphones, etc. used daily. Thus, interventions applying electronic media to prevent childhood obesity are contemporary. Available studies applying electronic media are however heterogeneous in terms of applied medium and duration. Positive effects on body composition were not observed, but only on certain lifestyle-relevant behaviours. In addition, these effects could only be seen in the short term. Follow-up data are currently scarce.
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Affiliation(s)
- Susann Weihrauch-Blüher
- IFB Adipositas Erkrankungen, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Deutschland.
| | - Stefanie Koormann
- IFB Adipositas Erkrankungen, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Deutschland
| | - Jana Brauchmann
- Interdisziplinäres SPZ, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Susanna Wiegand
- Interdisziplinäres SPZ, Charité Universitätsmedizin Berlin, Berlin, Deutschland
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Staiano AE, Marker AM, Beyl RA, Hsia DS, Katzmarzyk PT, Newton RL. A randomized controlled trial of dance exergaming for exercise training in overweight and obese adolescent girls. Pediatr Obes 2017; 12:120-128. [PMID: 26918815 PMCID: PMC5191971 DOI: 10.1111/ijpo.12117] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/17/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Structured exergaming with prescribed moderate intensity physical activity has reduced adiposity among adolescents. The extent to which adolescents reduce adiposity when allowed to self-select intensity level is not known. OBJECTIVE The objective of the study was to examine the influence of exergaming on adolescent girls' body composition and cardiovascular risk factors. METHODS This randomized controlled trial assigned 41 overweight and obese girls aged 14 to 18 years to group-based dance exergaming (36 h over 3 months) or to a self-directed care control condition. Body size and composition were measured by anthropometry, dual-energy X-ray absorptiometry [%fat and bone mineral density {BMD}] and magnetic resonance imaging. Cardiovascular risk factors included blood pressure, cholesterol, triglycerides, glucose and insulin. RESULTS Attrition was 5%. Using analysis of covariance controlling for baseline value, age and race, there were no significant condition differences. Per protocol (attended >75%), the intervention group significantly decreased abdominal subcutaneous adiposity and increased trunk and spine BMD (ps < 0.05). Per protocol (>2600 steps/session), the intervention group significantly decreased leg %fat and decreased abdominal subcutaneous and total adiposity (ps < 0.05). CONCLUSION Exergaming reduced body fat and increased BMD among those adolescent girls who adhered. Further research is required before exergaming is recommended in clinical settings.
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Affiliation(s)
- A. E. Staiano
- Pennington Biomedical Research Center, Baton Rouge, USA
| | - A. M. Marker
- Pennington Biomedical Research Center, Baton Rouge, USA
| | - R. A. Beyl
- Pennington Biomedical Research Center, Baton Rouge, USA
| | - D. S. Hsia
- Pennington Biomedical Research Center, Baton Rouge, USA
| | | | - R. L. Newton
- Pennington Biomedical Research Center, Baton Rouge, USA
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Adachi PJC, Willoughby T. The Link Between Playing Video Games and Positive Youth Outcomes. CHILD DEVELOPMENT PERSPECTIVES 2017. [DOI: 10.1111/cdep.12232] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Baranowski T. Exergaming: Hope for future physical activity? or blight on mankind? JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:44-46. [PMID: 30356568 PMCID: PMC6188910 DOI: 10.1016/j.jshs.2016.11.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 05/07/2023]
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Pasco D, Roure C, Kermarrec G, Pope Z, Gao Z. The effects of a bike active video game on players' physical activity and motivation. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:25-32. [PMID: 30356595 PMCID: PMC6188934 DOI: 10.1016/j.jshs.2016.11.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 07/16/2016] [Accepted: 09/10/2016] [Indexed: 05/07/2023]
Abstract
BACKGROUND Players may not acquire adequate levels of moderate-to-vigorous physical activity (MVPA) when playing commercial video games. This study's goal was to evaluate the effects of an exercise bike video game played by using a mobile application-based exergame that was designed exclusively to promote participants' MVPA, with additional attention paid to this game's ability to promote greater situational interest. METHODS An experimental design was used with 163 students (aged 20.31 ± 1.30, 18-26 years, 61.3% male), all of whom were randomly allocated into an experimental group and a control group. Physical activity (PA) levels were assessed with ActiGraph GT3X+ (ActiGraph Inc., Fort Walton Beach, FL, USA) accelerometers. The situational interest scale was used to evaluate students' situational interest in both groups. Multivariate analysis of variance was conducted to examine the differences between sedentary behavior, PA levels, and situational interest between groups. Regression analyses were also used, with the purpose being to evaluate the strength of the relationship between PA and situational interest. RESULTS Results revealed that the experimental group had higher degrees of sedentary behavior, light PA, total interest, instant enjoyment, exploration intention, attention demand, novelty, and challenge, whereas the control group received higher scores for MVPA (control 95.01% vs. experimental group 89.94%). Regression analysis indicated that instant enjoyment (β = 0.49, p < 0.01), exploration intention (β = 0.18, p < 0.05), and attention demand (β = 0.17, p < 0.05) were positive predictors for total interest, explaining 43% of its variance. CONCLUSION A newly designed mobile application-based exergame played via an exercise bike may enhance situational interest and provide a decent level of PA for players.
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Affiliation(s)
- Denis Pasco
- School of Education, The University of Bourgogne Franche-Comté, Besançon 25000, France
- Correspondence author.
| | - Cédric Roure
- Faculty of Movement Sciences, The Catholic University of Louvain, Louvain-La-Neuve B-1348, Belgium
| | - Gilles Kermarrec
- Faculty of Sport Science and Education, The University of Brittany-Loire, Brest 29200, France
| | - Zachary Pope
- School of Kinesiology, The University of Minnesota, Minneapolis, MN 55455, USA
| | - Zan Gao
- School of Kinesiology, The University of Minnesota, Minneapolis, MN 55455, USA
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Garde A, Umedaly A, Abulnaga SM, Robertson L, Junker A, Chanoine JP, Ansermino JM, Dumont GA. Assessment of a Mobile Game ("MobileKids Monster Manor") to Promote Physical Activity Among Children. Games Health J 2017; 4:149-58. [PMID: 26181809 DOI: 10.1089/g4h.2014.0095] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The majority of children in North America are not meeting current physical activity guidelines. The purpose of this study was to evaluate the impact of a mobile phone game ("MobileKids Monster Manor") as a tool to promote voluntary physical activity among children. MATERIALS AND METHODS The game integrates data from an accelerometer-based activity monitor (Tractivity(®); Kineteks Corp., Vancouver, BC, Canada) wirelessly connected to a phone and was developed with the involvement of a team of young advisors (KidsCan Initiative: Involving Youth as Ambassadors for Research). Fifty-four children 8-13 years old completed a week of baseline data collection by wearing an accelerometer but receiving no feedback about their activity levels. The 54 children were then sequentially assigned to two groups: One group played "MobileKids Monster Manor," and the other received daily activity feedback (steps and active minutes) via an online program. The physical activity (baseline and intervention weeks) was measured using the activity monitor and compared using two-way repeated-measures analysis of variance (intervention×time). RESULTS Forty-seven children with a body mass index (BMI) z-score of 0.35±1.18 successfully completed the study. Significant (P=0.01) increases in physical activity were observed during the intervention week in both the game and feedback groups (1191 and 796 steps/day, respectively). In the game group, greater physical activity was demonstrated in children with higher BMI z-score, showing 964 steps/day more per BMI z-score unit (P=0.03; 95 percent confidence interval of 98 to 1829). CONCLUSIONS Further investigation is required to confirm that our game design promotes physical activity.
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Affiliation(s)
- Ainara Garde
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Aryannah Umedaly
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - S Mazdak Abulnaga
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Leah Robertson
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Anne Junker
- 2 Clinical and Population Studies at the Child & Family Research Institute , Vancouver, British Columbia, Canada
| | - Jean Pierre Chanoine
- 3 Endocrinology and Diabetes Unit, Department of Pediatrics, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - J Mark Ansermino
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada .,4 Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
| | - Guy A Dumont
- 1 Electrical and Computer Engineering in Medicine Group, The University of British Columbia and BC Children's Hospital , Vancouver, British Columbia, Canada
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