Effect of the Nintendo Ring Fit Adventure Exergame on Running Completion Time and Psychological Factors among University Students Engaging in Distance Learning during the COVID-19 Pandemic: A Randomized Prospective Study (Preprint)

Physical and motivational effects of Exergames in healthy adults-A scoping review

Exergames have the potential to be used as physical-cognitive training tools. Although numerous studies investigated the physical and motivational effects of Exergaming, a comprehensive summary of training effects in healthy adults is still missing. This scoping review aims to identify available evidence and research gaps on absolute and relative effects of Exergame training on physical indicators (effectiveness) and motivation (attractiveness) compared to no or conventional training in healthy adults. A systematic literature search was performed in EBSCOhost, WoS CC, SURF, and Science Research for studies meeting the following criteria: a) randomized controlled trials with Exergames compared to conventional training and/ or no treatment; b) healthy adults (age: 18 to 64 years); c) Exergame training interventions; d) assessment of pre-post differences, primary outcomes: endurance, strength, flexibility, speed, balance, sensorimotor coordination, sports skills, player experience; secondary outcomes: adverse events, physical activity level, attitudes, and knowledge. Methodological quality of included studies was assessed using the PEDro Scale. Charted data were categorized according to the PICOS framework. Mean differences, 95% confidence intervals, and effect sizes (ES) were calculated for continuous outcomes. Evidence Maps were created to illustrate the estimated Risk of Bias, estimated effect, and sample sizes. Eighteen publications with 907 participants were included. The number of studies per outcome was low (2 to 9balance:). Studies on coordination and knowledge were lacking. No study analyzed the relative effects of speed training with Exergames. Absolute effects of Exergame training ranged from no to large effects. Significant ES were consistently found for skill training. Negative effects were found for individual parameters. Relative effects of Exergame training ranged from no to large effects (one exception). A moderate absolute effect favoring traditional training was found for skill training. The remaining results suggest that Exergaming elicited similar training effects compared to conventional training. A high variance of applied training, corresponding training parameters (FITT-VP), outcome measures, as well as methodological deficits and incomplete reporting were identified in included studies. Therefore, a lack of high-quality studies and reviews was identified. Future research should conduct high quality RCT studies analyzing the effectiveness and attractiveness in Exergames. In addition, more suitable, well-designed Exergames should be developed.

Effects of active video games on mental health among college students: a systematic review

BACKGROUND

Mental health significantly impacts college students' academic performance and overall happiness. Active video games (AVGs) have gained popularity among college students due to their ample entertainment, and there is growing interest in utilizing them to address mental health issues. However, there has not been a comprehensive summary and systematic review of research on the effects of AVGs on college students' mental health.

METHODS

As of October 18th, 2024, searches were conducted in six internationally renowned databases (PubMed, SCOPUS, Web of Science, CINAHL Plus, EBSCOhost, Cochrane Library). Inclusion and exclusion criteria were developed based on the PICOS principles. A systematic review was conducted following the PRISMA guidelines, and compliant studies using randomised controlled trial design (RCT) were included. The methodological quality of the included studies was evaluated using the PEDro scale.

RESULTS

A total of 3471 articles were retrieved, of which 17 met the criteria inclusion. The PEDro scores of the 17 studies ranged from four to nine. The results indicate that AVGs can effectively improve college students' poor mental health, such as stress, anxiety, and depression, as well as increase their happiness and psychological satisfaction. Moreover, AVGs have been shown to increase motivation for exercise, improve college students' attitudes toward other forms of exercise, and promote sustained physical activity. Additionally, AVGs have demonstrated efficacy in improving sleep quality.

CONCLUSION

Overall, AVGs can serve as an effective intervention to reduce dysphoria and promote positive psychological states among college students, thus improving mental health. Using the theory-based design of AVGs will further increase the effect. However, the effects of AVGs vary depending on their type and initial design purpose. Therefore, when using AVGs to improve college students' mental health, it is necessary to carefully consider the students' original state, select AVGs with rich game content that can provide at least moderate-intensity physical activity, and adopt the correct intervention strategy to achieve good results. AVG can potentially become a valuable tool for improving college students' mental health.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero , identifier: CRD42024510488.

Sensing In Exergames for Efficacy and Motion Quality: Scoping Review of Recent Publications

BACKGROUND

Many studies have shown a direct relationship between physical activity and health. It has also been shown that the average fitness level in Western societies is lower than recommended by the World Health Organization. One tool that can be used to increase physical activity for individual people is exergaming, that is, serious games that motivate players to do physical exercises.

OBJECTIVE

This scoping review of recent studies regarding exergame efficacy aims to evaluate which sensing modalities are used to assess exergame efficacy as well as motion quality. We also analyze how the collected motion sensing data is being leveraged with respect to exergame efficacy and motion quality assessment.

METHODS

We conducted 2 extensive and systematic searches of the ACM Digital Library and the PubMed database, as well as a single search of the IEEE Xplore database, all according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Overall, 343 studies were assessed for eligibility by the following criteria: The study should be peer-reviewed; the year of publication should be between 2015 and 2023; the study should be available in English or German; the study evaluates the efficacy of at least 1 exergame; sensor data is recorded during the study and is used for evaluation; and the study is sufficiently described to extract information on the exergames, sensors, metrics, and results.

RESULTS

We found 67 eligible studies, which we analyzed with regard to sensor usage for both efficacy evaluation and motion analysis. Overall, heart rate (HR) was the most commonly used vital sign to evaluate efficacy (n=52), while the Microsoft Kinect was the most commonly used exergame sensor (n=26). The results of the analysis show that the sensors used in the exergames and the sensors used in the evaluation are, in most cases, mutually exclusive, with motion quality rarely being considered as a metric.

CONCLUSIONS

The lack of motion quality assessment is identified as a problem both for the studies and the exergames themselves since incorrectly executed motions can reduce an exergame's effectiveness and increase the risk of injury. Here we propose how to use the same sensors both as input for the exergame and to assess motion quality by presenting recent developments in motion recognition and sensing.

Effect of Elastic Resistance on Exercise Intensity and User Satisfaction While Playing the Active Video Game BoxVR in Immersive Virtual Reality: Empirical Study

Background

One of the main contemporary forms of physical activity (PA) involves exercises and games in an immersive virtual reality (VR) environment, which allows the user to practice various forms of PA in a small space. Unfortunately, most of the currently available VR games and workout applications are mostly based on upper body movements, especially the arms, which do not guarantee sufficiently high exercise intensity and health benefits. Therefore, it is worth seeking solutions to help increase the exercise load during PA in VR.

Objective

The main aim of this study was to evaluate the effect of elastic arm resistance in the form of latex resistance bands of different elasticity levels on the intensity of students' PA while playing the BoxVR game. We further assessed the satisfaction of this form of exercise and its associations with PA intensity.

Methods

A total of 21 healthy and physically fit men (mean age 22.5, SD 2.0 years) were included in the study. The tests consisted of 3 10-minute games. One game was run with no load and the other two were run with 1.5-meter latex resistance bands (low and high resistance). The order of the tests was randomized and the participants rested for 20 minutes after each exercise. Exercise intensity was estimated using objective (heart rate monitoring) and subjective (Borg scale) methods. The Physical Activity Enjoyment Scale was used to assess satisfaction with the PA. The effect of elastic resistance on exercise intensity and user enjoyment was estimated using ANOVA for repeated measures.

Results

The ANOVA results indicated that incorporation of elastic resistance caused a significant change (F2,40=20.235, P<.001; η²p=0.503) in the intensity of PA in VR, which was low while playing without resistance and then increased to a moderate level with additional resistance. The use of elastic bands also changed participants' perceptions of the enjoyment of exercise in VR (F2,40=9.259, P<.001; η²p=0.316). The students rated their satisfaction with PA in VR on a 7-point scale highly and similarly when exercising without an upper limb load (mean 6.19, SD 0.61) and with slight elastic resistance (mean 6.17, SD 0.66), whereas their satisfaction declined significantly (mean 5.66, SD 0.94) when incorporating a higher load.

Conclusions

The intensity of PA among students playing the BoxVR game is at a relatively low level. With the added resistance of elastic bands attached to the upper limbs, the intensity of the exercise increased to a moderate level, as recommended for obtaining health benefits. Participants rated the enjoyment of PA in VR highly. The use of slight elastic resistance did not negatively affect satisfaction with the BoxVR game, although user satisfaction declined with a higher load. Further research should be undertaken to increase the effectiveness of exercise in VR so that regular users can enjoy the health benefits.

Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies

Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6-24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.

Acceptability of Physical Therapy Combined with Nintendo Ring Fit Adventure Exergame for Geriatric Hospitalized Patients

Geriatric hospitalized patients often experience complications associated with frailty and impaired functioning in activities of daily living. To enhance their functional independence, repetitive and continuous high-frequency exercises are necessary. However, conventional physical therapy (PT) can be monotonous and lead to reduced adherence. The introduction of Nintendo Ring Fit Adventure exergame (EG) as a complement to PT for geriatric inpatients has the potential to improve exercise enjoyment and acceptability. This study aimed to evaluate the acceptability of combining EG with PT for geriatric inpatients. A total of 30 geriatric inpatients were included in the study, receiving EG+PT on day 1 and PT only on day 2. The rate of perceived exertion (RPE) was assessed using the Borg scale, whereas enjoyment, motivation to continue, and perceived effectiveness were evaluated through a questionnaire after each exercise session and subsequently compared. The RPE for the lower extremities and the sense of enjoyment (P = 0.06) were found to be higher after the EG+PT session. The results suggest that combining PT with EG can enhance the enjoyment of exercise sessions and facilitate an increase in the intensity and frequency of exercise therapy. Incorporating EGs into geriatric PT holds promise as an effective strategy to improve patient engagement and adherence to exercise regimens. Further research is warranted to explore the long-term benefits and potential applications of EGs in geriatric rehabilitation settings.

Effectiveness of two different exergaming systems in addition to conventional treatment for physical therapy in patients with multiple sclerosis: A study protocol for a multicenter, assessor-blind, 24-week, randomized controlled trial

Objectives

The main aim is to evaluate and compare the effectiveness of two specific exergaming systems in addition to conventional treatment on improving physical functional capacity, balance, muscle strength, spasticity in lower limbs, and quality of life in patients with multiple sclerosis. The secondary aim is to compare the effectiveness of each exergaming system to isolated conventional treatment.

Design

A multicenter, assessor-blind, 24-week, randomized controlled trial.

Methods

39 patients diagnosed with multiple sclerosis will be allocated to three groups. A control group will perform a conventional treatment based on daily routine activities and/or combined training, whereas the experimental groups will be randomly divided to develop an active videogame-based exercise program through Nintendo Ring Fit Adventure© or Nintendo Wii Fit©, in addition to the conventional treatment. Study outcomes will be assessed at baseline and at 12 and 24 weeks. One-way ANOVA or Kruskal-Wallis tests will be used to analyze differences between groups at baseline and mixed ANOVA for differences between-within groups over time.

Discussion

The findings from this evidence-based trial, which includes both Nintendo© active videogames, could potentially establish exergame training as a valuable and reliable therapeutic tool for neurorehabilitation. It is essential to consider the customization, specifically in our case, on each multiple sclerosis condition, and ensure patients' adherence to the treatment.

Effects of digital sleep interventions on sleep and psychological health during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

Various digital sleep interventions have been implemented to address sleep and psychological complications during the coronavirus disease 2019 (COVID-19) pandemic. However, the characteristics and effectiveness of digital sleep interventions on sleep and psychological outcomes for people with sleep problems during the COVID-19 pandemic are unknown.

METHODS

The protocol of this systematic review and meta-analysis was registered on PROSPERO (ID: CRD42022325662), seven databases were searched from December 2019 to June 2023. Reference lists from digital sleep reviews were also identified and selected. Two reviewers independently screened eligible articles and extracted data. Quality appraisal was undertaken by two independent reviewers using the Cochrane Risk-of-Bias Tools. Data synthesis was conducted using fixed- or random-effects model based on the results of the heterogeneity test.

RESULTS

A total of 20 studies were identified, including nine randomised controlled trials (RCTs) and 11 non-RCTs, involving 3860 participants. Meta-analyses showed that digital sleep interventions significantly improve sleep quality, insomnia, and depression during the COVID-19 pandemic. Subgroup analysis showed that interventions of more than four weeks, healthcare workers as participants, and relaxation therapies may have the advantage of improving sleep quality. Most non-RCTs supported the efficacy of digital sleep interventions on sleep and psychological health.

CONCLUSION

Digital sleep interventions during the COVID-19 pandemic had significant effectiveness in improving sleep and psychological outcomes for people with sleep problems. More structured and personalised digital sleep interventions should be designed, and other diverse digital technologies could be used to improve sleep and psychological disorders.

G Tolerance Prediction Model Using Mobile Device-Measured Cardiac Force Index for Military Aircrew: Observational Study

BACKGROUND

During flight, G force compels blood to stay in leg muscles and reduces blood flow to the heart. Cardiovascular responses activated by the autonomic nerve system and strengthened by anti-G straining maneuvers can alleviate the challenges faced during G loading. To our knowledge, no definite cardiac information measured using a mobile health device exists for analyzing G tolerance. However, our previous study developed the cardiac force index (CFI) for analyzing the G tolerance of military aircrew.

OBJECTIVE

This study used the CFI to verify participants' cardiac performance when walking and obtained a formula for predicting an individual's G tolerance during centrifuge training.

METHODS

Participants from an air force aircrew undertook high-G training from January 2020 to December 2022. Their heart rate (HR) in beats per minute and activity level per second were recorded using the wearable BioHarness 3.0 device. The CFI was computed using the following formula: weight × activity / HR during resting or walking. Relaxed G tolerance (RGT) and straining G tolerance (SGT) were assessed at a slowly increasing rate of G loading (0.1 G/s) during training. Other demographic factors were included in the multivariate regression to generate a model for predicting G tolerance from the CFI.

RESULTS

A total of 213 eligible trainees from a military aircrew were recruited. The average age was 25.61 (SD 3.66) years, and 13.1% (28/213) of the participants were women. The mean resting CFI and walking CFI (WCFI) were 0.016 (SD 0.001) and 0.141 (SD 0.037) kg × G/beats per minute, respectively. The models for predicting RGT and SGT were as follows: RGT = 0.066 × age + 0.043 × (WCFI × 100) - 0.037 × height + 0.015 × systolic blood pressure - 0.010 × HR + 7.724 and SGT = 0.103 × (WCFI × 100) - 0.069 × height + 0.018 × systolic blood pressure + 15.899. Thus, the WCFI is a positive factor for predicting the RGT and SGT before centrifuge training.

CONCLUSIONS

The WCFI is a vital component of the formula for estimating G tolerance prior to training. The WCFI can be used to monitor physiological conditions against G stress.