Less lonely Alzheimer's patients using virtual reality

Staying connected is important for anyone, but especially for those with early staged of dementia and Alzheimer's disease, virtual reality may be one way to provide a close emotional connection in the absence of physical connection.  Especially during the pandemic, virtual reality could be one means to keep older family members connected to the rest of the family.  

As reported at SXSW, using virtual reality to recall memories and names, and places it might not reverse demential or Alzheimer's but it can slow the progression.

'We're moving to the era of prescription digital medicines'

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Virtual kayaking for stroke rehab

Stoke recovery patients were asked to play an exergame (Recovery Rapids) at home for three weeks and compared the results to patients who asked to do traditional therapy, and the results were similar.

"Motor practice: Participants agreed to play Recovery Rapids for a total of 15 hours (1·5 hours per day) on 10 treatment days over three weeks. This treatment schedule was designed to dose-match the duration of active motor practice provided in CI therapy (the same duration of active motor practice could be accomplished in half of the time because gaming treatment involves continuous practice without breaks for task set-up; automated feedback also occurs concurrently with game play). Participants could self-pace their game play (i.e., pause for short rests or begin another session later)."

Exercising with video games (exergames) improves quality of life in patients with heart failure

At the Heart Failure 2018 and the World Congress on Acute Heart Failure, researchers presented the second phase of their HF-Wii study examining the changes in Quality of Life (QoL).

Exercising with video games improves quality of life in patients with heart failure:

Professor Jaarsma said: "Patients in the exergame group had significantly higher quality of life after three months than those who received standard exercise advice. While there was no statistical difference in anxiety and depression, it was encouraging that playing the exergame did not increase anxiety."

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Wii Fit at home for balance and mobility in children with cerebral palsy

In this recent research article Balance and mobility training at home using Wii Fit in children with cerebral palsy: a feasibility study, authors used Wii Fit to see if it might be an option for patients with CP as an at-home device to improve mobility and balance.

At first glance playing Wii Fit seems to have been well received and safe to use at home. As I get a hold of the rest of the paper, I will update this post.







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Exergame to combat Alzheimer's Disease

Exergaming was used to combat Alzheimer's Disease in a study conducted by Union college researcher Cay Anderson-Hanley. 

Study details:
NIH funded
n=14 seniors from pool of 100
6 months regular exergaming/exercising
Mean age = 78 years
Control group
Group 1 = virtual cycle
Group 2 = play game while cycling

Results:
Improvements in both groups executive function including verbal memory and physical function

ExerGaming Points 2 Ponder (ExP2P)

• Were they using the Espresso Bikes?
• Did they use recumbent or traditional seated cycles?
• Was the program and tension standardized for the group, or individually based on fitness levels?

Summary

I am looking forward to reading the full article to dig deeper into these results. Cay has been publishing for a long time and it's good to see these articles getting good press too.

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Exergaming Research Update

I just spotted two articles that I haven't read yet and thought I'd share them here first before I review them in better detail.

One article was a review study that looked at active video games for patients with chronic pulmonary diseases - yes a very specific niche which in the end only had 6 articles included in the review.

The other article was a pilot study for patients with Parkinson's disease and the exergaming group did improve their walking gait speed after using Microsoft Kinect.

It's been a while since I've updated my list of studies but you can always check My Diiigo Group - Exergames which has a more up to date list of studies I find.

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Meta-Analysis of Exergaming on Physical Activity

Although not surprising, a meta-analysis of 11 RCT studies found that  playing exergames was one way to accumulate more physical activity for overweight individuals. Due to the differences in methodologies and inconsistent findings, no relationships were able to be established for patients with Type II diabetes. It does stand to reason that if you want more physical activity that can be done at home, exergaming might be one way to engage the target population and maybe others at home. What interventions need to focus on is the implementation at schools and community to be truly effective for long-lasting results or gateway to other physical activities.

ResultsOf 2845 records, 14 publications (11 studies) met the inclusion criteria. All included studies (ten experimental, cross-sectional laboratory studies and one RCT) were able to show increases in either VO2, EE, HR, or activity counts. However, effects of exergaming in terms of changes in these intensity parameters varied significantly between game modes and consoles as well as because of the vastly differing durations of exergame activity between studies. One of the included studies had a low risk of bias, and three had a high risk of bias; seven studies had an unclear risk of bias as the study description was insufficient. No studies were found investigating the changes in objectively measured PA intensity parameters in patients with type 2 diabetes.

Abstract
Background
The majority of patients with overweight and type 2 diabetes show insufficient levels of daily physical activity (PA) and usually are among the least likely to engage in or adhere to any form of generic PA. Active video games (exergames) may be a solution to motivate these individuals to overcome their sedentary lifestyle.
Objectives
This systematic review was conducted to review the current evidence for the effectiveness of exergaming in overweight and type 2 diabetes mellitus and thus to evaluate the suitability of these games to be used as tools for exercise promotion that meet current PA guidelines.
Methods
We searched electronic bibliographic databases (PubMed, Embase, Web of Science, OpenGrey, and the Cochrane Central Register of Controlled Trials) up to March 2015. Randomized controlled trials (RCT) and cross-sectional studies published in English in a peer-reviewed journal and analyzing the effects of exergames on objectively measured intensity parameters of PA in overweight (body mass index [BMI] ≥25 kg/m2) adults (mean age ≥18 years) with and without type 2 diabetes were included. Study selection, data extraction, and quality assessment were performed independently by two review authors. Primary outcomes included changes in oxygen uptake (VO2), energy expenditure (EE), heart rate (HR), or activity counts. Secondary outcomes were enjoyment of treatment, exercise adherence, ratings of perceived exertion (RPE), changes in body composition, and changes in blood parameters (serum glucose, long-term blood glucose, blood cholesterol, triglycerides, or serum lactate).
Results
Of 2845 records, 14 publications (11 studies) met the inclusion criteria. All included studies (ten experimental, cross-sectional laboratory studies and one RCT) were able to show increases in either VO2, EE, HR, or activity counts. However, effects of exergaming in terms of changes in these intensity parameters varied significantly between game modes and consoles as well as because of the vastly differing durations of exergame activity between studies. One of the included studies had a low risk of bias, and three had a high risk of bias; seven studies had an unclear risk of bias as the study description was insufficient. No studies were found investigating the changes in objectively measured PA intensity parameters in patients with type 2 diabetes.
Conclusion
This review suggests that exergames are able to increase PA among overweight individuals. However, the inconsistent results and the overall poor or moderate methodological quality do not permit judgment on whether exergames are suitable to meet PA guidelines in this target group. The lack of research regarding the effects of exergames in type 2 diabetes indicates a great need for future research.

Effects of Exergaming on Physical Activity in Overweight Individuals


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Active gaming benefits brain health #exergaming

There have been some mixed results about the effectiveness of basic brain training games and their impact on cognitive function. In general, we tend to see some low to moderate gains in certain brain processes, but they tend to be short lived and typically specific to the type of testing or assessment used.

In this meta-analysis of RCT, the authors found that across the 17 included studies, exergames were found to improve executive function, attentional processing and visuospatial skills in older people and people with neurocognitive deficits.

Let's get playing!

Abstract
Physically-active video games (‘exergames’) have recently gained popularity for leisure and entertainment purposes. Using exergames to combine physical activity and cognitively-demanding tasks may offer a novel strategy to improve cognitive functioning. Therefore, this systematic review and meta-analysis was performed to establish effects of exergames on overall cognition and specific cognitive domains in clinical and non-clinical populations. We identified 17 eligible RCTs with cognitive outcome data for 926 participants. Random-effects meta-analyses found exergames significantly improved global cognition (g = 0.436, 95% CI = 0.18–0.69, p = 0.001). Significant effects still existed when excluding waitlist-only controlled studies, and when comparing to physical activity interventions. Furthermore, benefits of exergames where observed for both healthy older adults and clinical populations with conditions associated with neurocognitive impairments (all p < 0.05). Domain-specific analyses found exergames improved executive functions, attentional processing and visuospatial skills. The findings present the first meta-analytic evidence for effects of exergames on cognition. Future research must establish which patient/treatment factors influence efficacy of exergames, and explore neurobiological mechanisms of action.

Link:  Study suggests active gaming benefits brain health | Alzheimer's Research UK:

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Can Cycle Exergaming increase Brain Function in Seniors? (Study)

Can cycle exergaming increase brain function in seniors with diabetes? German researchers wanted to know if exergaming was as effective at increasing BDNF levels as a regular cycle ergometer.

Findings

• Similar heart rates but lactate threshold levels were higher in the cycle group.
• BDNF and VEGF were increased to similar levels post-exercise.

Exergaming Points to Ponder - ExP2P

• Which gaming platform did they use?
• Was it one of the cycle exergames or exergame bikes?
• Did they have social connections to others including in other locations?
• Were there gamification features like leaderboards, and points and challenges across the individuals?

Effects of Cycling and Exergaming on Neurotrophic Factors in Elderly Type 2 DM

Patients with type 2 diabetes mellitus (T2DM) are at increased risk of developing neurodegenerative diseases. There is growing evidence that repeated exercise-induced transient increases in neurotrophic factors can augment neurogenesis and neuroplasticity. This pilot study compares the effects of 30-min submaximal cycling with those of exergaming (combining exercise and video gaming) at the same duration and same rating of perceived exertion (BORG RPE: 14-15) on serum neurotrophic factors in 8 elderly non-insulin-dependent T2DM patients (71±4 years) (2×2 crossover design). Brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF)-1 levels were quantified using enzyme-linked immunosorbent assay (ELISA) kits. Heart rates were almost equal during cycling and exergaming, while lactate values were significantly higher during cycling (cycling versus exergaming: 3.7±1.1 versus 2.5±1.2 mmol/l, p<0.05). BDNF and VEGF levels were increased significantly post-cycling (+20%,+14%, p<0.05). No other significant pre-post changes were evident. This study demonstrates that acute exercise can increase neurotrophic factors (BDNF, VEGF) in elderly T2DM patients, depending on exercise mode.

Journal link

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Can Playing Xbox Kinect Exergame Improve Mood States? RCT (Study)

I spotted this RCT trial from Taiwan that studied how much enjoyment university students had while playing the exergame Your Shape: Fitness Evolved for Xbox 360.

Sample: 337 participants (168 intervention group, 167 control group)

Population: Mean age 20 years

Methods: RCT, 2 sessions over 2 weeks, 30 minutes per session

Measurements: vigor, happiness, and stress

Results:
Intervention group had higher levels of vigor from the start to the end of the study.

Exergaming Points 2 Ponder (ExP2P)

• After playing YourShape: Fitness Evolved I still hold PS2 EyeToy Kinectic as the top of the whole body exergaming genre. Although it is a step up from the YourSelf Fitness (Wii), it still doesn't compare to actually seeing you actually moving and interacting with virtual objects (and without VR headsets). 
• I wonder if they (Sony) own the actual patent for that feature?
• I wonder if we will ever see ourselves instead of an avatar?

To examine how playing exergames impacts the mood states of university students and staff, and whether such an impact depends on gender and players' previous exercise time. This study was designed as a randomized controlled trial. It enrolled 337 participants and randomly assigned them to an intervention group (n = 168) or a control group (n = 167). A 2-week exergame program was designed for the participants in the intervention group. They were required to play exergames for 30 consecutive minutes each week for 2 weeks and respond to the items measuring vigor, happiness, and perceived stress. All measures were administered before and after the study. Repeated measures analysis of variances were conducted. Playing exergames enhanced vigor and happiness for participants in the intervention group. This group exhibited more positive change in vigor and happiness than the control group. This effect of playing exergames was not moderated by gender, age, occupation (student or staff), or previous exercise time. Playing exergames may induce positive mood states among university students and staff.

Impact of Playing Exergames on Mood States: A Randomized Controlled Trial

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Exergaming (Fitness Video Games) can increase Physical Activity

This story pick-up from Science Daily is from Tuomas Kari's dissertation recently defended and released online from the University of Jyväskylä.   Much of what was summarized in his work has also been my findings in that exergames need to be fun, enjoyable, sociable and skill (competence) building in order to continue doing. You just can't hammer users into doing something for the health benefits alone; rather, "games could present the potential health benefits of playing to the player."

Digital gaming has generally been perceived to increase individuals’ sedentary time. According to a new dissertation, gaming can also act as a medium to promote health. Exergaming is a form of digital gaming that combines games with physical activity: the game requires physical activity from the player in order to play the game, and the outcome of the game is partly determined by that physical activity. Examples of such games are console-based dance games and different mobile exergames, such as Zombies Run and Pokémon GO.

Images 1, 2, 3

Pokemon Go - Simple game or health intervention?

After reviewing a couple of research studies on the latest exergaming craze - Pokemon Go

(Summer 2016), it was interesting to see this study released in the British Medical Journal regarding the health impact of playing.

Results

• NSD in physical activity (steps) PG players vs non-PG players in 6 week trial
• SD in steps taken in early weeks

Discussion

• As in many exergaming studies, the short-term always bodes well for the interaction and physical activity, however the long term effects are always (almost) weaker and sometimes NSD.

 (via Techcrunch)

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Kinect Powers Evaluation of Kids with Duchennes

Finding ways for children to become eligible for clinical trials requires them to be able to walk for six minutes. In using Kinect to track upperbody movements, researchers have proved at Nationwide Hospital that gaming technology can be used to chart upperbody function for children with Duchennes. [Via Medgadget]

Study in journal Muscle & Nerve: Reliability and validity of ACTIVE-seated: An outcome in dystrophinopathy

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Related articles

• Human Factors in Speed-Based Exergames - CHI14 Study
• Can children with DCD improve balance with Wii Fit? #exergame study
• Fitness & Rehabilitation ATHENE #Exergaming Wins 2nd Place at FIBO

Human Factors in Speed-Based Exergames - CHI14 Study

Human Factors of Speed-based Exergame Controllers

Exergame controllers are intended to add fun to monotonous exercise. However, studies on exergame controllers mostly focus on designing new controllers and exploring specific application domains without analyzing human factors, such as performance, comfort, and effort. In this paper, we examine the characteristics of a speed-based exergame controller that bear on human factors related to body movement and exercise. Users performed tasks such as changing and maintaining exercise speed for avatar control while their performance was measured. The exergame controller follows Fitts’ law, but requires longer movement time than a gamepad and Wiimote. As well, resistance force and target speed affect performance. User experience data confirm that the comfort and mental effort are adequate as practical game controllers. The paper concludes with discussion on applying our findings to practical exergame design.

#CHI2014 Honourable Mention Award! Taiwoo Park et al. http://t.co/fGJBcPEooW

Human Factors of Speed-based Exergame Controllers
— CHI2014 (@chi2014) February 25, 2014

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Seniors enjoy playing #exergames at moderate intensity levels [Study]

Wii Tennis Player B side (Photo credit: Mesq)

This descriptive study examined healthy older adults who played one session of 15 minutes of Wii Tennis #exergaming. The participants were able to achieve 64% of their predicted heart rate maximum with 86% of them enjoying the experience. These findings are consistent with the many number of other studies that have evaluated seniors playing exergames, especially when played in a care facility like assisted-living.

Exergaming Points 2 Ponder (ExP2P)

• It would be great to see results of studies where older adults are paired with children, teens or college students who play together and engage in physical activities requiring more than minimal levels of intensity.
• Although the included photo was not from this study, it would be great to see their reaction to such a setup where it is closer to the actual physical sport of tennis. In fact, I'd love to play this setup and I'm thinking of a way to accomplish this for my kids.
• As with many studies, would the findings have been changed if they were given a familiarization period?
• How long would they play if given an undefined time period to play?

Fachko MJ, Xiao C, Bowles KH, Robinson KM, & Libonati JR (2013). Cardiovascular effects and enjoyment of exercise gaming in older adults. Journal of Gerontological Nursing, 39 (12), 43-54 PMID: 23855328

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CHI 2014 #Exergaming Papers

Here are some of the papers that involve exergames, exergaming, or exertion games and interfaces for the upcoming CHI 2014 Conference in Toronto, Canada (April 26 - May 1, 2014).

Effects of Balancing for Physical Abilities on Player Performance, Experience and Self-Esteem in Exergames

Kathrin M Gerling-Interaction Lab, University of Saskatchewan, Saskatoon, Canada

Matthew Miller-University of Saskatchewan, Saskatoon, Canada

Regan L Mandryk-University of Saskatchewan, Saskatoon, Canada

Max V Birk-University of Saskatchewan, Saskatoon, Canada

Jan D Smeddinck-Digital Media Research Group, University of Bremen, Bremen, Germany

  
• Game balancing can help players with different skill levels play multiplayer games together; however, little is known about how the balancing approach affects performance, experience, and self-esteem–especially when differences in player strength result from given abilities, rather than learned skill. We explore three balancing approaches in a dance game and show that the explicit approach commonly used in commercial games reduces self-esteem and feelings of relatedness in dyads, whereas hidden balancing improves self-esteem and reduces score differential without affecting game outcome. We apply our results in a second study with dyads where one player had a mobility disability and used a wheelchair. By making motion-based games accessible for people with different physical abilities, and by enabling people with mobility disabilities to compete on a par with able-bodied peers, we show how to provide empowering experiences through enjoyable games that have the potential to increase physical activity and self-esteem.

“Healthifying” Exergames: Improving Health Outcomes through Intentional Priming-- Paper

• Frank X ChenComputer Science Department, Stanford University, Palo Alto, United StatesAbby C KingSchool of Medicine, Stanford University, Palo Alto, United StatesEric B HeklerSchool of Nutrition and Health Promotion, Arizona State University, Phoenix, United States

---

• Exergames, video game systems that require exertion and interaction, have been rising in popularity in the past years. However, research on popular exergames shows mixed health benefits, potentially due to minimal energy expenditure and decreasing use over time. This paper presents a 2x2 experimental study (N = 44), using a popular exergame, where we vary the framing of intention (i.e., “Gameplay” or “Exercise”) and feedback (i.e., “Health” or “No health”) to explore their single and interactive impacts on perceived exertion, objectively measured energy expenditure, affect, and duration of usage in a single session. Our study showed that participants primed with exercise used the system significantly longer than those primed with game play (M = 49.2 ±2.0 min versus M = 39.3 ±2.0 min). We discuss our results and possible design implications based on our single-session experiment. We conclude with a discussion on the potential impact of focusing on “healthifying” exergames—highlighting an exergames’ dual purpose as both a game and exercise—as opposed to gamifying health behaviors.
• Exergaming,Priming,Persuasive Technology,Fitness

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Related articles

• Blue Goji #Exergame System Adds New Games (iPad)
• Oculus Rift + Leap Motion = Shark Punch + Game of Thrones #Exergaming VR
• Go Dance with Sega's Free Mobile App #Exergaming
• Pavigym 3.0 #Exergaming Fitness Center
• Can Wii Fit exergaming help children with migraines? [Study]

Can children with DCD improve balance with Wii Fit? #exergame study

Can exergaming with Wii Fit improve balance in children with Developmental Coordination Disorder? Researchers in Belgium found that when compared to children with no balance coordination issues, 28 children were able to improve balance measures over a six-week intervention using Wii Fit games for 30-minute sessions three times per week. After playing each of the available 18 games twice, children were then allowed to play any of the games besides the pre-test/post-test slalom game. Pre-post tests results (Wii Fit Slalom, MABC2, BOT2) revealed improved measures of balance for the exergame intervention group compared to the control group (typical development). The intervention was also enjoyed by almost all of the participants (see ExP2P for more details).

Can Wii Fit exergaming help children with migraines? [Study]

Can exergaming help children who have migraines without aura (MoA)? According to a recent study from a group of Italian authors published in Neuropsychiatric Disease and Treatment, playing the exergame Wii Fit over three months can improve measures of balance, coordination, motor tasks in children. Over 12 weeks, children (mean age: 9.13±1.94 years) played games that focused on antero-posterior (snowboarding); medio-lateral (skiing, penguin game, and soccer); and multidirectional weight shifting (bubble game and hula hoop) movements three times per week each for 30 minute sessions. Its good to read that participants were able to choose (autonomy) from 18 different games which likely increased levels of motivation and enjoyment (self-determination theory - SDT). Other games listed include: ski-jump, segway circuit, obstacle course, and skate boarding,ski-slalom, table tilt, snowboard slalom, Tilt City, and Rhythm.

Exergaming Points 2 Ponder (ExP2P)

• In the introduction, the authors stated that since many children with migraines suffer from "...emotional dysfunction, absenteeism from school, and poor academic performance, as well as issues relating to poor cognitive function, and sleep habits"... it would have been nice to see some of these measures tested in the study.
• It appears that the control group used was a non-active group and many studies are now using active controls to better compare any group effects. 
• It would be interesting to see what impact other exergames that include more hand-eye coordination (Kinect Brain & Body Connection, EyeToy) as opposed to foot-eye/balance coordination (Wii Fit).
• I would also wonder what more intense levels of physical activity (with a rhythm game like Dance Central or Just Dance) would do for cognitive function and mood in this population.

Concluding Thoughts

I love and have used a similar version of the following phrase in terms of using games for therapy "video game interventions can increase patient enjoyment and engagement, which may enhance compliance." What remains to be seen in many exergame studies are long term "lasting" effects. Unfortunately most children (and adults too) play games for a short amount of time and then end up switching games so we definitely see a novelty effect (or reactivity). I wonder how we could design experiments that are less dependent on a particular game and more focused on overall health or performance outcomes.  

Esposito M, Ruberto M, Gimigliano F, Marotta R, Gallai B, Parisi L, Lavano SM, Roccella M, & Carotenuto M (2013). Effectiveness and safety of Nintendo Wii Fit Plus™ training in children with migraine without aura: a preliminary study. Neuropsychiatric disease and treatment, 9, 1803-10 PMID: 24453490

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

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

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

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

Esposito M., Ruberto M., Gimigliano F., Marotta R., Gallai B., Parisi L., Lavano S.M., Roccella M. & Carotenuto M. Effectiveness and safety of Nintendo Wii Fit Plus training in children with migraine without aura: a preliminary study, Neuropsychiatric Disease and Treatment, 1803. DOI: 10.2147/NDT.S53853

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CDC finds 63% of teens play #exergames

Having researchers add the category of active video games / exergames to the list of activities on the Compendium of Physical Activities and the current inclusion in the NYPANS survey are great steps into letting more people to understand their potential. I worry however that they have not considered other categories of exergaming or game platforms besides the ones listed.

Brener ND, Eaton DK, Kann LK, McManus TS, Lee SM, Scanlon KS, Fulton JE, & O'Toole TP (2013). Behaviors Related to Physical Activity and Nutrition Among U.S. High School Students. The Journal of adolescent health : official publication of the Society for Adolescent Medicine PMID: 23796969

Behaviors Related to Physical Activity and Nutrition Among U.S. High School Students

Abstract

National data related to physical activity (PA) and nutrition among adolescents are needed to help develop effective obesity prevention programs. The 2010 National Youth Physical Activity and Nutrition Study (NYPANS) was conducted to provide nationally representative data on behaviors and behavioral correlates related to healthy eating and PA.

NYPANS used a three-stage cluster sample design to obtain data representative of public- and private-school students in grades 9 through 12 in the United States (n = 11,429). Students completed an anonymous, self-administered questionnaire in their classrooms during a regular class period. Trained data collectors directly measured the students' height and weight at school using a standard protocol.

Analyses revealed that 19.0% of students were obese and 17.8% were overweight. Students participated in a range of physical activities during the 12 months before the survey; prevalence ranged from 5.0% for ice hockey to 83.9% for walking. In addition, 52.5% of students enjoyed the physical education classes they took at school. During the 7 days before the survey, 74.8% of students ate at least one meal or snack from a fast food restaurant, with black students more likely than white and Hispanic students to have done so. Forty-one percent of students always or most of the time have a TV on while eating dinner at home.

These and other NYPANS results can be used to develop obesity prevention programs that address specific behaviors and behavioral correlates, and target subgroups in which behaviors and behavioral correlates related to obesity are most prevalent.

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Wii Fit to improve balance in elderly (#Exergame Study)

Feasibility of Wii Fit training to improve clinical measures of balance in older adults

Kathleen A Bieryla and Neil M Dold

Numerous interventions have been proposed to improve balance in older adults with varying degrees of success. A novel approach may be to use an off-the-shelf video game system utilizing real-time force feedback to train older adults. The purpose of this study is to investigate the feasibility of using Nintendo’s Wii Fit for training to improve clinical measures of balance in older adults and to retain the improvements after a period of time.

Methods

Twelve healthy older adults (aged >70 years) were randomly divided into two groups. The experimental group completed training using Nintendo’s Wii Fit game three times a week for 3 weeks while the control group continued with normal activities. Four clinical measures of balance were assessed before training, 1 week after training, and 1 month after training: Berg Balance Scale (BBS), Fullerton Advanced Balance (FAB) scale, Functional Reach (FR), and Timed Up and Go (TUG). Friedman two-way analysis of variance by ranks was conducted on the control and experimental group to determine if training using the Wii Balance Board with Wii Fit had an influence on clinical measures of balance.

Results

Nine older adults completed the study (experimental group n = 4, control group n = 5). The experimental group significantly increased their BBS after training while the control group did not. There was no significant change for either group with FAB, FR, and TUG.

Conclusion

Balance training with Nintendo’s Wii Fit may be a novel way for older adults to improve balance as measured by the BBS.

Bieryla K.A. & Dold N.M. (2013). Feasibility of Wii Fit training to improve clinical measures of balance in older adults., Clinical interventions in aging, PMID: 23836967
 

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