Motivating Effects of Cooperative Exergame Play for Overweight and Obese Adolescents Can Exergaming Contribute to Improving Physical Activity Levels and Health Outcomes in Children? Comparative Effectiveness of a 12-Week Physical Activity Intervention for Overweight and Obese Youth: Exergaming with "Dance Dance Revolution". Two-Player Partnered Exergame for Obesity Prevention: Using Discrepancy in Players' Abilities as a Strategy to Motivate Physical Activity The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial. Active Video Gaming to Improve Balance in the Elderly Exergaming for Health Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. Feasibility of a telephone and web-based physical activity intervention for women shift workers Effects of a wobble board-based therapeutic exergaming system for balance training on dynamic postural stability and intrinsic motivation levels. Comparison of Acute Exercise Responses Between Conventional Video Gaming and Isometric Resistance Exergaming Impact of an active educational video game on children's motivation, science knowledge, and physical activity Controlled outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type II diabetes A pilot of a video game (DDR) to promote physical activity and decrease sedentary screen time. Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: an observational study Exergames for subsyndromal depression in older adults: a pilot study of a novel intervention. Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study Aerobic and Cognitive Exercise (ACE) Pilot Study for Older Adults: Executive Function Improves with Cognitive Challenge While Exergaming. The Relationship of Objectively Measured Physical Activity and Sedentary Behaviour with Gestational Weight Gain and Birth Weight Videogames and Health Improvement: A Literature Review of Randomized Controlled Trials. The effect of active video gaming on children's physical activity, behavior preferences and body composition. The contribution of lifestyle coaching of overweight patients in primary care to more autonomous motivation for physical activity and healthy dietary behaviour: results of a longitudinal study Effects of active video games on body composition: a randomized controlled trial.
Background : Exergames ( i.e. , video games that require gross motor activity ) may provide intrinsically motivating experiences that engage youth in sustained physical activity . Method : Thirty-one low-income 15– to 19-year-old overweight and obese African American adolescents were r and omly assigned to a competitive exergame ( n = 17 ) or a cooperative exergame ( n = 14 ) condition . Participants played a preassigned Wii Active exergame routine that took between 30 and 60 min each school day , and sessions occurred during lunch time or an after-school program over a 6 month period . Participation was voluntary , so students decided whether to come or not on a given day . Cooperative exergame players worked together with a peer to expend calories and earn points , while competitive exergame players competed individually against a peer to expend calories and earn points . Motivation was measured through surveys and interviews at the end of the intervention , and energy expenditure was measured by accelerometry during game play . Results : Compared with the competitive group , the cooperative players were significantly more intrinsically motivated to play ( p = .034 , partial eta-squared = 0.366 ) and more psychologically attracted to the design of the exergame ( p = .034 , partial eta-squared = 0.320 ) . Intrinsic motivation was significantly positively correlated with energy expenditure during game play : Individuals who were motivated by control/choice had higher energy expenditure ( p = .026 ) , and those who were more goal motivated ( p = .004 ) and more immersed in game play ( p = .024 ) had lower energy expenditure during game play . Conclusions : Cooperative exergame play produced higher intrinsic motivation to play the exergame than competitive exergame play did . Intrinsic motivation that came from a desire for control/choice was related to higher energy expenditure during game play . Cooperative exergame play holds promise as a method for engaging overweight and obese youth in physical activity Physical inactivity among children is a serious public health problem . It has been suggested that high levels of screen time are contributory factors that encourage sedentary lifestyles in young people . As physical inactivity and obesity levels continue to rise in young people , it has been proposed that new-generation active computer- and video-console games ( otherwise known as “ exergaming ” ) may offer the opportunity to contribute to young people 's energy expenditure during their free time . Although studies have produced some encouraging results regarding the energy costs involved in playing active video-console games , the energy costs of playing the authentic versions of activity-based video games are substantially larger , highlighting that active gaming is no substitute for real sports and activities . A small number of exergaming activities engage children in moderate-intensity activity , but most do not . Only 3 very small trials have considered the effects of exergaming on physical activity levels and /or other health outcomes in children . Evidence from these trials has been mixed ; positive trends for improvements in some health outcomes in the intervention groups were noted in 2 trials . No adequately powered r and omized , controlled trial has been published to date , and no trial has assessed the long-term impact of exergaming on children 's health . We now need high- quality r and omized , controlled trials to evaluate the effectiveness and sustainability of exergaming  , as well as its clinical relevance ; until such studies take place , we should remain cautious about its ability to positively affect children 's health OBJECTIVE Experts recommend that children engage in 60 minutes of daily moderate to vigorous PA ( PA ) , but few meet these goals . Exergames like " Dance Dance Revolution " ( DDR ) ( Konami of America , Redwood City , CA ) have the potential to provide PA . We sought to determine if DDR would boost PA among overweight or obese children . SUBJECTS AND METHODS Children over the 85th percentile for body mass index ( BMI ) and between 9 and 17 years old were r and omly assigned to receive DDR+pedometers ( treatment group ) or pedometers only ( comparison group ) .  PA levels were tracked for 12 weeks by self-report , pedometer , and accelerometer data . RESULTS Sixty-five families completed the study . The average  BMI percentile of the participant was over 96 percent . Despite r and omization , participants in the treatment ( DDR )  group were more often male , older , and heavier than participants in the comparison group . Self-reported frequency of moderate to vigorous PA increased significantly from baseline to 12 weeks for the treatment group and declined for the comparison group . Accelerometer results indicated a significant decline in moderate activity over time for the comparison group . However , there were no significant between-group differences based on the accelerometer or pedometer data . CONCLUSION Based on self-report measures , DDR may have increased PA levels in obese and overweight children . However , we are led to question the validity of these results because analyses based on objective measures do not confirm them . Accelerometer results indicate that although DDR did not boost PA , it may have helped to slow the decline in moderate to vigorous PA over time Background :  Physical inactivity  is associated with obesity and type 2 diabetes . A key obstacle to physical activity is lack of motivation . Although some interactive exercise games ( i.e. , exergames — video games that require physical exertion in order to play ) motivate players to exercise more , few games take advantage of group dynamics to motivate players ' duration of exercise . In a test of the Kohler motivation gain effect , this study varied the ability level of a virtually presented partner in an interactive exergame that focused on abdominal strength to identify effects on a subject 's ( S ' ) persistence with the task . Method : Male ( n = 63 ) and female ( n = 72 ) undergraduate students were r and omly assigned to one of four conditions ( individual control or low- , moderate- , or high- partner discrepancy ) in a conditions x gender factorial design and tested on a series of isometric abdominal exercises using PlayStation 2 EyeToy : Kinetic software . They performed the first series of five exercises alone ( trial block 1 ) , and after a rest period , those in the partner conditions performed remaining trials ( trial block 2 ) with a same-sex virtually presented partner whom they could observe during their performance , while those in the individual control condition performed the remaining trials alone . In the partner conditions , the partner 's performance was manipulated to be always better than the S 's , the exact difference depending on the discrepancy condition . The partnered tasks were conjunctive ; that is , success in the game depended on the performance of the weaker team member . Persistence , the outcome measure for this study , consisted of the total number of seconds the S held the exercise position . Results : Using planned orthogonal contrasts on difference scores between blocks 1 and 2 , results showed that persistence was significantly ( p < .001 ) greater in all experimental conditions with a virtually presented partner ( M = 33.59 s ) than in the individual control condition ( M = −49.04 s ) . Subjects demonstrated more persistence in the moderate-discrepancy condition ( M = 51.36 s ) than in the low-discrepancy condition ( M = 22.52 s ) or the high-discrepancy condition ( M = 26.89 s ) . A significant quadratic trend confirmed the expected inverted-U function relating partner discrepancy and persistence ( p = .025 ) . Although Ss persisted longer and had higher heart rate in partnered conditions , they did not perceive their exertion to be any higher than those in the individual condition . Conclusions : Virtually presented partners who are moderately more capable than participants are the most effective at improving persistence in exergame tasks BACKGROUND Exergames are a well-known type of game based on a virtual avatar 's body movements . This hightech approach promotes an active lifestyle . OBJECTIVES The aim of this r and omized controlled trial was to evaluate the effects of exergames on pain , disease activity , functional capacity and quality of life in patients with ankylosing spondylitis ( AS ) . MATERIAL AND METHODS The study involved 60 patients , who were r and omized into either the exergame group ( EG ) or the control group ( CG ) . The EG patients engaged in exergaming , and CG patients did not engage in any exercises . The exergaming sessions were performed five times a week for eight weeks ( 40 sessions in total ) . The patients were assessed before and after the eight-week program on a visual analog scale ( VAS ) , the Bath Ankylosing Spondylitis Functional Index ( BASFI ) , the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) and the Ankylosing Spondylitis Quality of Life ( ASQOL ) question naire . RESULTS A statistically significant improvement was observed in VAS , BASFI , BASDAI and ASQoL scores in the EG group after completion of the exercise program ( p < 0.05 ) . CONCLUSIONS This study is a first step in investigating the possibilities of using an exergame platform to help patients with spondyloarthropathies to adopt a more physically active lifestyle . The results of this study suggest that exergames increase physical activity and decrease the pain scores in AS patients and also could , therefore , be feasible and safe The combination of active video gaming and exercise ( exergaming ) is suggested to improve elderly people 's balance , thereby decreasing fall risk . Exergaming has been shown to increase motivation during exercise therapy , due to the enjoyable and challenging nature , which could support long-term adherence for exercising balance . However , scarce evidence is available of the direct effects of exergaming on postural control . Therefore , the aim of the study was to assess the effect of a six-week videogame-based exercise program aim ed at improving balance in elderly people .  Task performance and postural control were examined using an interrupted time series design . Results of multilevel analyses showed that performance on the dot task improved within the first two weeks of training . Postural control improved during the intervention . After the intervention period task performance and balance were better than before the intervention . Results of this study show that healthy elderly can benefit from a videogame-based exercise program to improve balance and that all subjects were highly motivated to exercise balance because they found gaming challenging and enjoyable Objective . To evaluate the efficacy and feasibility of a multifaceted , community-based weight intervention program for children using exergaming technology ( activity-promoting video gaming ) .  Design and Methods . This is a prospect i ve observational pilot study . Forty-eight children , between the ages of 8 and 16 years , who are overweight or obese , enrolled in Exergaming for Health , a multidisciplinary weight management program , which used active video gaming . Primary outcome measures were change in body mass index ( BMI ) z scores . Results . Most children ( n = 40 , 83 % ) completed the program and participated in outcome evaluations . The average BMI change was −0.48 kg/m2 ( SD = 0.93 ) , P < .002 ( BMI z-score change was −0.072 , SD = 0.14 , P < .0001 ) . The average Global Self-Worth score improved , screen time and soda intake reduced , and exercise hours per week increased . Conclusions . The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates . A larger r and omized controlled trial is needed to confirm these results BACKGROUND Underst and ing the inter-relationships between lifestyle factors in youth is important with respect to the development of effective promotional programmes for healthy eating and active living . The present study aim ed to explore the associations of dietary habits ( DH ) with physical activity ( PA ) and screen time ( ST )  among Saudi adolescents aged between 15 and 19 years of age relative to gender . METHODS Data were obtained from the Arab Teens Lifestyle Study , a school-based multicentre lifestyle study conducted in 2009/2010 in three major cities in Saudi Arabia . A multistage stratified cluster r and om sampling technique was used . The number of participants with complete data for  DH  and  PA  was 2886 and the respective number for DH and ST was 2822 . Assessment included weight , height , body mass index , total daily ST ( television viewing , video/computer games and Internet use ) , PA and DH using self-reported question naires . RESULTS Females were significantly more sedentary and less active than males ( P < 0.001 ) . Two-way analysis of covariance , controlling for age , showed significant ( P < 0.05 ) gender by PA and gender by ST interactions for several DH . Logistic regression analyses revealed significant associations of higher PA with a higher consumption of fruit , vegetables , milk , French fries/potato chips and energy drinks , whereas higher ST was significantly associated with a higher consumption of sugar-sweetened drinks , fast foods , cake/doughnuts and energy drinks . CONCLUSIONS Healthful dietary habits were associated mostly with  PA  , whereas sedentary behaviours , independent of PA , negatively impacted upon eating behaviours . The low PA levels and high sedentary levels of Saudi females represent a great concern . The results reported in the present study have important implication s for both youth public health policies and intervention programmes INTRODUCTION Shift work ( an occupation requiring work between 2200 and 0500H ) comprises approximately 20 % of the workforce in Europe and North America [ 1 ] . This is likely to increase , with many shift workers ( SWs ) in emergency services , retail , hospitality , healthcare , transportation and manufacturing [ 2 ] . SWs are at increased risk for negative health outcomes , including cancer and other chronic diseases [ 3 , 4 ] . Biological changes from poor lifestyle habits related to shift work ( e.g. low physical activity ( PA ) , poor nutrition , obesity ) are thought to contribute to this risk ; these factors are also amenable to lifestyle intervention [ 5 ] . PA in particular , reduces cancer risk [ 6 ] , and has many positive physical and psychological benefits [ 7 ] . It is a simple , cost-effective strategy that may be implemented by individual workers or within workplaces to mitigate risk . Unfortunately , SWs are unlikely to engage in regular PA [ 8 ] . In Canada , only 15.9 % of SWsmeet the PA guidelines and have lower levels of aerobic fitness than those of day workers [ 9 ] . Few behavioural interventions improving health outcomes in SWs have been published [ 10 ] . In a targeted PA intervention , nurses r and omised to 4 months of supervised PA  improved aerobic fitness , muscular strength , fatigue and musculoskeletal symptoms . However , authors reported low adherence and large loss to follow-up , perhaps due to the supervised scheduled sessions [ 11 , 12 ] . Sustained behaviour change is a challenge and requires targeted efforts to encourage individuals to reach an adequate dose of PA to change health outcomes [ 13 ] . Due to irregular schedules and time constraints , SWs may be less likely to adhere to a traditional supervised PA intervention with face-to-face behavioural support [ 12 ] . Women SWs cite work schedule interference and lack of time as PA barriers and report scheduling flexibility as the most important in PA [ 14 ] . This highlights the need for a creative and innovative programming to promote PA in SWs . Distance-based interventions , in which individuals exercise independent of study staff or participants , may include telephone counselling and website or smart phone app-based technology . These interventions are highly flexible and may help overcome barriers related to timing and scheduling that are important for SWs . In a review of telephone-based PA interventions , 14 of 17 found evidence for behaviour change [ 15 ] . These may be a way to implement scalable , individuallytailored interventions in SWs . The primary objective of this study was to test the feasibility of a distance-based PA intervention in women SWs . Feasibility studies are important for establishing effective processes and underst and ing re sources required before attempting a r and omised controlled trial ( RCT ) , in order to put forward interventions that are most likely to be efficacious [ 16 ] . As this work was funded by a grant to examine the role of lifestyle in reducing breast cancer risk in SWs , only women were included . A secondary objective was to conduct a preliminary evaluation of intervention efficacy , to estimate effect size for future studies STUDY DESIGN R and omized controlled trial . OBJECTIVES To compare the effects of wobble board exercises with and without feedback provided through integrating the wobble board movement into a computer game system , by comparing changes in postural stability and motivation . BACKGROUND Therapeutic exergaming systems may offer a solution to poor adherence to postural control exercise regimes by improving motivation levels during exercise performance . METHODS Twenty-two healthy adults , r and omly assigned to an exergaming group ( n = 11 ) and a control group ( n = 11 ) , completed 12 exercise sessions .  Dynamic postural stability was quantified at baseline and follow-up using the star excursion balance test and the dynamic postural stability index during a jump-l and ing task . Intrinsic motivation was measured at baseline using the Self-Motivation Inventory and at follow-up using the Intrinsic Motivation Inventory . RESULTS Star excursion balance test scores showed a statistically significant ( P<.008 ) improvement in the posteromedial and posterolateral direction for both groups . No within-group change for the dynamic postural stability index or between-group difference for star excursion balance test or dynamic postural stability index scores were observed . The " interest and enjoyment " category of the Intrinsic Motivation Inventory showed significantly higher scores ( P<.001 ) in the exergaming group at follow-up , which was 1 of the 5 Intrinsic Motivation Inventory categories evaluated . CONCLUSIONS The findings suggest that exercising with the therapeutic exergaming system showed similar improvements in dynamic postural stability and showed a greater level of interest and enjoyment when compared to a group doing similar balance training without the game system . LEVEL OF EVIDENCE Therapy , level 2b Bonetti , AJ , Drury , DG , Danoff , JV , and Miller , TA . Comparison of acute exercise responses between conventional video gaming and isometric resistance exergaming . J Strength Cond Res 24(7 ) : 1799 - 1803 , 2010-Exergaming is a relatively new type of entertainment that couples physical activity and video gaming . To date , research that has focused on the physiologic responses to exergaming has been focused exclusively on aerobic-type activities . The purpose of this project was to describe the acute exercise responses ( i.e. , oxygen uptake [ & OV0312;O2 ] , heart rate , and rate of perceived exertion [ RPE ] ) to exergaming using full-body isometric muscle resistance and to determine whether these responses are different during single- versus opponent-based play . Male subjects ( n = 32 ) were r and omly and equally divided into either an experimental ( EXP ) or control ( CON ) group . Acute exercise responses ( & OV0312;O2 , heart rate , and RPE ) were measured in all subjects during both solo- and opponent-based video game play . Subjects in the EXP group played using a controller that relied on full-body isometric muscle resistance to manipulate the on-screen character , whereas CON subjects used a conventional h and held controller . During solo play , the EXP group exhibited significantly higher values for & OV0312;O2 ( 9.60 ±0.50 mL/kg/min ) and energy expenditure ( 3.50 ± 0.14 kcal/min ) than the CON group ( & OV0312;O2 5.05 ± 0.16 mL/kg/min ; energy expenditure 1.92 ± 0.07 kcal/min ) . These changes occurred with no significant differences in RPE or heart rate between the groups . These results suggest that whole-body isometric exergaming results in greater energy expenditure than conventional video gaming , with no increase in perceived exertion during play . This could have important implication s regarding long-term energy expenditure in gamers Background Active educational video games ( AVGs ) appear to have a positive effect on elementary school students ' motivation leading to enhanced learning outcomes . The purpose of this study was to identify the effectiveness of an AVG on elementary school students ' science knowledge learning , physical activity ( PA ) level , and interest-based motivation . Methods In this r and omized controlled study , 53 elementary school students were assigned to an experimental condition or a comparison condition . The experimental condition provided an AVG learning environment , whereas the comparison condition was based on sedentary educational video games . Results The results of repeated measures analysis of variance ( ANOVA ) on the knowledge test showed that students in both groups performed better on the post-test than they did on the pre-test ( p < 0.001 , η2 = 0.486 ) , and their post-test scores did not differ significantly . The experimental condition provided a more active environment since the students ' average heart rates ( HRs ) were in the Target-Heart-Rate-Zone ( HR = 134 bpm ) , which was significantly higher than the average HR ( 103 bpm ) from the comparison condition ( t = 7.212 , p < 0.001 ) . Students in the experimental condition perceived a higher level of situational interest than their counterparts in the comparison group ( p < 0.01 , and η2 = 0.301 ) . Conclusion These results suggest that AVGs benefit children more in terms of PA and motivation  than traditional video games by providing an enjoyable learning experience and sufficient PA OBJECTIVE : To conduct a r and omised trial of a physical activity ( PA ) intervention , The First Step Program ( FSP ) for adults with type II diabetes . DESIGN : A 16-week intervention study and 24-week follow-up assessment . PARTICIPANTS : A total of 47 overweight/obese , sedentary individuals ( age=52.7±5.2 y ; BMI = 33.3±5.6 kg/m2 ) recruited through a diabetes education centre . MEASUREMENTS : Primary outcome :  daily PA assessed by pedometer ( steps/day ) . Secondary outcomes : anthropometric measures ( weight , BMI , waist girth , hip girth ) ; indicators of cardiovascular health ( resting heart rate and blood pressure ) ; glycemic control ( fasting glucose , insulin , HbA1c , glucose concentration 120 min postglucose load ) ; plasma lipid status ( total cholesterol , HDL cholesterol , LDL cholesterol , and triglycerides ) . RESULTS : Relative to the CONTROL group , FSP participants increased  their PA > 3000 steps/day ( approximately 30 min/day ) during the intervention ( P<0.0001 ) . Waist and hip girth decreased ( approximately 2–3 cm ) , but did not differ significantly between groups . Significant changes did not emerge for any of the other variables . CONCLUSIONS : The FSP is a practical intervention that elicits an immediate and profound change in walking behaviour . Such change is an important ‘ first step ’ towards increasing the volume and /or intensity of PA necessary to improve long-term health outcomes in this largely sedentary and overweight or obese population . Relapse by 24 weeks indicates that other strategies such as booster sessions are needed to maintain lifestyle change . Further research must determine realistic and responsive health outcomes for this population that are achievable through practical , real-world programming OBJECTIVE We examined the feasibility of Dance Dance Revolution ( DDR ) , a dance video game , in participants ' homes , to increase physical activity ( PA ) and to decrease sedentary screen time ( SST ) . METHODS AND PROCEDURES Sixty children ( 7.5 + /- 0.5 years ) were r and omized in a 2:1 ratio to DDR or to wait-list control ( 10-week delay ) . DDR use was logged , PA was measured objective ly by accelerometry . SST was self-reported at weeks 0 and 10 . At week 28 , after both groups had access to DDR , accelerometry and SST were repeated . RESULTS Mean use of DDR was 89 + /- 82 ( range 0 - 660 min ) min per week ( mpw ) . The DDR group showed increased vigorous PA and a reduction in light PA ; the control group showed no increase in moderate and /or vigorous PA ( MVPA ) although they also had a reduction in light PA . Differences between the groups were not observed . The DDR group also reported a decrease in SST of -1.2 + /- 3.7 h per week ( hpw ) ( P < 0.05 ) , whereas the controls reported an increase of + 3.0 + /- 7.7 hpw ( nonsignificant ) . The difference in SST between the groups was significant , with less SST in the DDR group . Between weeks 10 and 28 , numeric reductions in SST were reported in both groups . In the DDR group , SST at week 28 ( 8.8 + /- 6.0 hpw ) was lower than baseline ( 10.5 + /- 5.5 hpw ; P < 0.03 ) . DISCUSSION This pilot study suggests that DDR reduces SST and may facilitate slight increases in vigorous PA . Further study is needed to better characterize children and context s in which DDR may promote a healthy lifestyle Background Physical activity ( PA ) interventions design ed to prevent prenatal complications have focused on increasing moderate PA yielding conflicting results . Minimal attention has focused on the evaluation of sleep , sedentary behavior ( SB ) , light activity or total daily PA during pregnancy . The purpose of this prospect i ve , longitudinal study was to 1 ) objective ly quantify and compare habitual PA and SB during the 2nd and 3rd trimester ; and 2 ) evaluate differences in activity patterns for women meeting prenatal PA guidelines versus those that did not . Methods Forty-six participants wore 2 PA monitors ( SenseWear ® Mini and activPAL ™ ) during week 18 and week 35 of pregnancy . We compared differences in sleep duration , postural allocation , daily steps , and PA between the 2nd and 3rd trimester and for women who met and did not meet PA guidelines . Results During the 2nd trimester , 30 % of the women ’s day ( 24-hours ) was total sleep ; 52 % SB ; 13 % light ; 3 % moderate ; and 0 % vigorous PA . Light ( P = 0.05 ) , vigorous ( P = 0.02 ) , and moderate-vigorous PA ( MET-minutes ; P = 0.02 ) , decreased with a trend in increased SB ( P = 0.07 ) . Activity of other intensities and sleep duration did not significantly change . Only 39 % and 37 % of participants slept between 7–9 hours/night at week 18 and 35 , respectively . Forty-six percent ( n = 21 ) and 28 % ( n = 13 ) of participants met prenatal PA guidelines during the 2nd and 3rd trimester , respectively . At week 18 , no differences in total sleep , SB , or light PA existed for women who met PA guidelines versus those who did not ; total PA was significantly greater for women who met guidelines . At week 35 , women that met PA guidelines had significantly less SB ( P < 0.005 ) than women who did not . Conclusions This study demonstrates that pregnant women spend the majority of their day in SB . Significant reductions in total activity across pregnancy may be attributed , in part to shifts in light PA and increased SB . Based on the lifestyle of our sample , regardless of meeting PA guidelines in mid-pregnancy , no significant difference exists in time spent in SB , however meeting PA recommendations in late pregnancy may reduce SB . Future interventions should target reducing SB by increasing light and moderate PA beyond volitional exercise OBJECTIVES Subsyndromal depression ( SSD ) is several times more common than major depression in older adults and is associated with significant negative health outcomes . Physical activity can improve depression , but adherence is often poor . The authors assessed the feasibility , acceptability , and short-term efficacy and safety of a novel intervention using exergames ( entertaining video games that combine game play with exercise ) for SSD in older adults . METHODS Community-dwelling older adults ( N = 19 , aged 63 - 94 years ) with SSD participated in a 12-week pilot study  ( with follow-up at 20 - 24 weeks ) of Nintendo 's Wii sports , with three 35-minute sessions a week . RESULTS Eight-six percent of enrolled participants completed the 12-week intervention . There was a significant improvement in depressive symptoms , mental health-related quality of life ( QoL ) , and cognitive performance but not physical health-related QoL. There were no major adverse events , and improvement in depression was maintained at follow-up . CONCLUSIONS The findings provide preliminary indication of the benefits of exergames in seniors with SSD . R and omized controlled trials of exergames for late-life SSD are warranted Background Childhood obesity has reached epidemic proportions in developed countries . Sedentary screen-based activities such as video gaming are thought to displace active behaviors and are independently associated with obesity . Active video games , where players physically interact with images onscreen , may have utility as a novel intervention to increase physical activity and improve body composition in children . The aim of the Electronic Games to Aid Motivation to Exercise ( eGAME ) study is to determine the effects of an active video game intervention over 6 months on : body mass index ( BMI ) , percent body fat , waist circumference , cardio-respiratory fitness , and physical activity levels in overweight children . Methods / Design Three hundred and thirty participants aged 10–14 years will be r and omized to receive either an  active video game up grade package  or to a control group ( no intervention ) .  Discussion An overview of the eGAME study is presented , providing an example of a large , pragmatic r and omized controlled trial in a community setting . Reflection is offered on key issues encountered during the course of the study . In particular , investigation into the feasibility of the proposed intervention , as well as robust testing of proposed study procedures is a critical step prior to implementation of a large-scale trial . Trial registration Australian New Zeal and Clinical Trials Registry Dementia cases are increasing worldwide ; thus , investigators seek to identify interventions that might prevent or ameliorate cognitive decline in later life . Extensive research confirms the benefits of physical exercise for brain health , yet only a fraction of older adults exercise regularly . Interactive mental and physical exercise , as in aerobic exergaming , not only motivates , but has also been found to yield cognitive benefit above and beyond traditional exercise . This pilot study sought to investigate whether greater cognitive challenge while exergaming would yield differential outcomes in executive function and generalize to everyday functioning . Sixty-four community based older adults ( mean age=82 ) were r and omly assigned to pedal a stationary bike , while interactively engaging on-screen with : ( 1 ) a low cognitive dem and task ( bike tour ) , or ( 2 ) a high cognitive dem and task ( video game ) .  Executive function ( indices from Trails , Stroop and Digit Span ) was assessed before and after a single-bout and 3-month exercise intervention . Significant group × time interactions were found after a single-bout ( Color Trails ) and after 3 months of exergaming ( Stroop ; among 20 adherents ) . Those in the high cognitive dem and group performed better than those in the low cognitive dose condition . Everyday function improved across both exercise conditions . Pilot data indicate that for older adults , cognitive benefit while exergaming increased concomitantly with higher doses of interactive mental challenge Objective . To evaluate the relationship of physical activity ( PA ) and sedentary behaviour with  gestational weight gain ( GWG ) and birth weight . Design . Combined data from two prospect i ve studies : ( 1 ) nulliparous pregnant women without BMI restrictions and ( 2 ) overweight and obese pregnant women at risk for gestational diabetes . Methods . Daily PA and sedentary behaviour were measured with an accelerometer around 15 and at 32–35 weeks of gestation . The association between time spent in moderate-to-vigorous PA ( MVPA ) and in  sedentary activities  with GWG and birth weight was determined . Main outcome measures were GWG between 15 and 32 weeks of gestation , average GWG per week , and birth weight . Results . We studied 111 women . Early in pregnancy , 32 % of women spent ≥30 minutes/day in at least moderate PA versus 12 % in late pregnancy . No significant associations were found between time spent in MVPA or sedentary behaviour with GWG or birth weight . Conclusions . We found no relation  between MVPA and sedentary behaviour with GWG or birth weight . The small percentage of women meeting the recommended levels of PA indicates the need to inform and support pregnant women to maintain regular PA , as there seems to be no adverse effect on birth weight and maintaining PA increases overall health OBJECTIVE There are potential benefits of playing videogames for health improvement such as increasing knowledge about health-related issues by playing educational games and fighting a sedentary lifestyle by playing exergames . The number of systematic review articles about " videogames " and " health improvement " is limited . Therefore , the purpose of this study is to review those r and omized controlled trials ( RCTs ) with the topic of " videogames " and " health improvement . " MATERIAL S AND METHODS Several electronic data bases were search ed for RCTs testing  videogames on health outcomes that were published in English between January 2000 and April 2012 . RESULTS Forty-five articles met the eligibility criteria and were categorized into five groups : ( 1 ) videogames and patient pain and stress reduction ( nine articles ) , ( 2 ) videogames and  patient behavioral change  ( 19 articles ) , ( 3 ) videogames and patient rehabilitation  ( eight articles ) , ( 4 ) videogames as diagnostic tools ( three articles ) , and ( 5 ) videogames and cognitive ability ( six articles ) . CONCLUSIONS Most of the articles have shown promising results in using videogames within various fields of healthcare . Although exergames are the most prominent choice regarding health improvement , videogames have the potential to be used as a pain management tool , diagnostic tool , or educational tool . They also can be used as a facilitator in physical rehabilitation or cognitive loss prevention . More RCTs are needed to fully uncover the benefits of using videogames for improving patients ' health Active video game interventions typically provide children a single game that may become unappealing . A peripheral device ( jOG ) encourages step-powered gaming on multiple games . This trial evaluated the effect of jOG on children 's objective ly measured PA , body fat and self-reported behaviors . 42 of 58 eligible children ( 8 - 10 y ) r and omly assigned to an intervention ( jOG ) or control ( CON ) completed the trial . Intervention children received two jOG devices for home use . Analyses of covariance compared the intervention effect at 6 and 12 weeks from baseline . No differences were found between groups for counts per minute ( CPM ; primary outcome ) at 6 and 12 weeks ( p > .05 ) . Active video gaming increased ( adjusted change 0.95 ( 95 % CI 0.25 , 1.65 ) h·d⁻¹ , p < .01 ) and sedentary video gaming decreased ( -0.34 ( -1.24 , 0.56 ) h·d⁻¹ , p > .05 ) at 6 weeks relative to CON . No body fat changes were observed between groups . Targeted changes in video game use did not positively affect PA . Larger trials are needed to verify the impact of active video games on children 's PA and health Background Combined lifestyle interventions ( CLIs ) have been advocated as an effective instrument in efforts to reduce overweight and obesity . The odds of maintaining higher levels of  physical activity ( PA ) and healthier dietary behaviour improve when people are more intrinsically motivated to change their behaviour . To promote the shift towards more autonomous types of motivation , facilitator led CLIs have been developed including lifestyle coaching as key element . The present study examined the shift in types of motivation to increase  PA  and  healthy dieting  among participants of a primary care CLI , and the contribution of lifestyle coaching to potential changes in motivational quality . Methods This prospect i ve cohort study included participants of 29 general practice s in the Netherl and s that implemented a CLI named ‘ BeweegKuur ’ .  Question naires including items on demographics , lifestyle coaching and motivation were sent at baseline and after 4 months . Aspects of motivation were assessed with the  Behavioural Regulation and Exercise Question naire ( BREQ-2 ) and the  Regulation of Eating Behaviour Question  naire ( REBS ) . We performed a drop out analysis to identify selective drop-out . Changes in motivation were analysed with t-tests and effect size interpretations ( Cohen ’s d ) , and multivariate regression analysis was used to identify predictors of motivational change . Results For physical activity , changes in motivational regulation were fully in line with the tenets of Self Determination Theory and Motivational Interviewing : participants made a shift towards a more autonomous type of motivation ( i.e. controlled types of motivation decreased and autonomous types increased ) . Moreover , an autonomy supportive coaching style was generally found to predict a larger shift in autonomous types of motivation . For healthy dietary behaviour , however , except for a small decrease in external motivation , no favourable changes in different types of motivation were observed . The relation between coaching and motivation appeared to be influenced by the presence of physical activity guidance in the programme . Conclusions Motivation of participants of a real life primary care CLI had changed towards a more autonomous motivation after 4 months of intervention . Autonomy-supportive lifestyle coaching contributed to this change with respect to physical activity . Lifestyle coaching for healthy diet requires thorough knowledge about the problem of unhealthy dieting and solid coaching skills BACKGROUND Sedentary activities such as video gaming are independently associated with obesity .  Active video games , in which players physically interact with images on screen , may help increase physical activity and improve body composition . OBJECTIVE The aim of this study was to evaluate the effect of active video games over a 6-mo period on weight , body composition , physical activity , and physical fitness . DESIGN We conducted a 2-arm , parallel , r and omized controlled trial in Auckl and , New Zeal and . A total of 322 overweight and obese children aged 10 - 14 y , who were current users of sedentary video games , were r and omly assigned at a 1:1 ratio to receive either an active video game up grade package ( intervention , n = 160 ) or to have no change ( control group , n = 162 ) . The primary outcome was the change from baseline in body mass index ( BMI ; in kg/m(2 ) ) . Secondary outcomes were changes in percentage body fat , physical activity , cardiorespiratory fitness , video game play , and food snacking . RESULTS At 24 wk , the treatment effect on BMI ( -0.24 ; 95 % CI : -0.44 , -0.05 ; P = 0.02 ) favored the intervention group . The change ( ±SE ) in BMI from baseline increased in the control group ( 0.34 ± 0.08 ) but remained the same in the intervention group ( 0.09 ± 0.08 ) . There was also evidence of a reduction in body fat in the intervention group ( -0.83 % ; 95 % CI : -1.54 % , -0.12 % ; P = 0.02 ) . The change in daily time spent playing active video games at 24 wk increased ( 10.03 min ; 95 % CI : 6.26 , 13.81 min ; P < 0.0001 ) with the intervention accompanied by a reduction in the change in daily time spent playing nonactive video games ( -9.39 min ; 95 % CI : -19.38 , 0.59 min ; P = 0.06 ) . CONCLUSION An active video game intervention has a small but definite effect on BMI and body composition in overweight and obese children . This trial was registered in the Australian New Zeal and Clinical Trials Registry at http://www.anzctr.org.au/ as ACTRN12607000632493
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 duration s of exergame activity between studies .
Conclusion This review suggests that exergames are able to increase PA among overweight individuals .
However , the inconsistent results and the overall poor or moderate method ological quality do not permit judgment on whether exergames are suitable to meet PA guidelines in this target group .
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 .