Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students.

BACKGROUND: Active video games are a new method for increasing physical activity (PA). Fully immersive virtual reality (VR) is a hardware device on which an active video game can run. Active (video games in) VR (AVR), might increase immersion, game engagement, and moderate-to-vigorous PA (MVPA), thereby yielding greater exercise-related benefits, e.g., cognitive performance. METHODS: We examined the induction of MVPA via an AVR and a sedentary VR (SVR) as well as the effects of VR play on cognitive performance, which was monitored using 2 different methods. Each of 29 sedentary college students attended three 20-min laboratory sessions (AVR, SVR, or control) in a randomized order; during the control session, they sat quietly doing nothing. A fully immersive headset was used for the 2 video game sessions. We monitored and computed participants' PA using hip-worn accelerometers (wGT3x-bt; ActiGraph, Pensacola, FL, USA) and a heart rate band (Polar H7; Polar, Kempele, Finland). After each session, the participants completed a mnemonic similarity test (MST) to measure recognition memory. They also filled out a motion sickness questionnaire and an abbreviated game experience questionnaire. RESULTS: The AVR session induced a significantly greater heart rate and more time spent in MVPA than did either of the other 2 sessions regardless of the PA monitoring method. AVR elicited greater game experience questionnaire-assessed sensory and imaginative immersion, challenge, and positive affect than did SVR. The mnemonic similarity test recognition score was marginally higher post-AVR session than it was post-SVR session. CONCLUSION: AVR elicited MVPA without a significant increase in motion sickness and induced a better game experience and better borderline cognitive performance than did SVR.

Comparison of Inhibitory Control After Acute Bouts of Exergaming Between Children with Obesity and Their Normal-Weight Peers.

Objective: The benefits of exergaming on executive function in children have been increasingly reported; however, weight-dependent effects of exergames on executive function, and inhibitory control in particular, remain poorly understood. We examined performance on an inhibitory control task at baseline and following acute bouts of exergaming in children who varied in weight status. Materials and Methods: Forty 8-12-year-old children with obesity (n = 20) and normal weight (n = 20) performed neutral, congruent, and incongruent conditions of a Victoria Stroop Test (VST) before and after exergames through an Xbox One in an elementary classroom. We measured time spent in moderate-to vigorous-intensity activity through ActiGraph accelerometers and recorded gameplay time. Results: At baseline, children with obesity relative to their normal-weight peers had significantly longer reaction times (P = 0.011), resulting in significantly longer completion time (P = 0.005) during incongruent trials requiring greater inhibitory control, and therefore had higher interference scores (P = 0.024). However, following acute bouts of exergames, children with obesity compared with their normal-weight counterparts significantly decreased completion time (P = 0.013), made fewer errors (P = 0.012) during incongruent trials, and subsequently had reduced interference effects (P = 0.037). Children with obesity and normal-weight children spent similar time (minutes) (7.8 vs. 8.6, P = 0.725) in moderate-to vigorous-intensity activity during similar gameplay time (8.7 vs. 10.5, P = 0.819). Conclusion: Our results suggest that greater, acute cognitive gains occur in children with obesity relative to normal-weight children following similar intensity and duration of exergames, which may be due to reduced inhibitory control capacity at baseline in childhood obesity.

The impact of narratives and active video games on long-term moderate-to-vigorous physical activity: A randomized controlled trial protocol.

BACKGROUND: Although physical activity (PA) has been shown in helping prevent and treat obesity, current PA interventions are still not effective in ameliorating the obesity epidemic. Additional forms of PA need to be investigated to improve PA engagement and outcomes. We hypothesize that pairing a narrative (i.e., story) with an active video game (AVG), a less traditional form of PA, will increase participant engagement in PA. This paper presents the rationale, implementation, and pilot results of a study assessing the effect of narrative's impact on PA and a series of other health outcomes. OBJECTIVE: This paper presents the rationale, implementation, and pilot results of a study assessing the effect of narrative's impact on PA and a series of other health outcomes. METHODS/DESIGN: The Active Video Game Study is a six-month randomized controlled single-blind trial projected to include 210 participants. The intervention strategy will pair a narrative to an active video game (AVG). Participants will be randomized into 3 groups: condition A [Narrative + AVG], condition B [AVG Only], and condition C [Control]. Participants will undergo three in-person data collection visits over the course of six months. Inclusion criteria are that children are between the ages of 8-12 and have a BMI ≥ 85%. The primary outcome is change in moderate to vigorous physical activity (MVPA). Secondary outcome measures include change in BMI percentile, fasting insulin and glucose, lipid panel, C-reactive protein, and cognitive function. A pilot trial of n = 6 was conducted to help develop procedures and address problems that could arise in the main trial. DISCUSSION: Successful completion of this study will provide the empirical basis for novel intervention and design strategies to enhance the impact of AVGs on long-term MVPA.

Correction: The Effect of Narrative on Physical Activity via Immersion During Active Video Game Play in Children: Mediation Analysis.

[This corrects the article DOI: 10.2196/17994.].

The Effect of Narrative on Physical Activity via Immersion During Active Video Game Play in Children: Mediation Analysis.

BACKGROUND: Active video games (AVGs) can increase physical activity (PA) and help produce higher physiological expenditure. Animated narrative videos (NVs) possess unique immersive and motivational properties. When added to AVGs, they have been found to increase moderate-to-vigorous physical activity (MVPA) as opposed to the original no video condition. However, there is no evidence of whether that was due to the NV or the addition of an animated video to an AVG. OBJECTIVE: This study aimed to investigate the differential effect of adding an NV versus a nonnarrative video (NNV) to an AVG on PA parameters and physiological responses and to explore the mediating role of immersion. METHODS: A total of 22 children aged 8 to 12 years were randomly assigned to the NV or NNV condition. They were instructed to play an AVG (on Xbox Kinect) for as long as they wanted. We used accelerometers to estimate the time spent (in minutes) in MVPA. Heart rate (HR) and rate of perceived exertion (RPE) were measured before, during, and after the AVG play session. The participants then reported their experience of narrative immersion via a questionnaire. RESULTS: The NV group had significantly higher narrative immersion (mean 3.50, SD 0.55 vs mean 2.91, SD 0.59; P=.03) and MVPA (mean 19.46, SD 13.31 vs mean 7.85, SD 5.83; P=.02) than the NNV group. Narrative immersion was positively correlated with MVPA (r=0.52; P=.01) and average HR during AVG (r=0.43; P=.05). Mediation analysis indicated that narrative immersion mediated the effect of NV (NV vs NNV) on MVPA (direct effect: beta=7.51; P=.01). The indirect effect was that NV was positively correlated with the mediator variable narrative immersion (beta=.59; P=.03), which was itself marginally associated with MVPA (beta=6.95; P=.09); when narrative immersion was included in the model, the regression coefficient was attenuated. CONCLUSIONS: AVG with added narratives elicits more narrative immersion, resulting in more minutes in MVPA. Narrative immersion served as a mediator between NV and MVPA via its elicitation of an elevated HR without increasing RPE. The inclusion of immersive narratives in AVG could be helpful for inducing MVPA, to enhance AVG engagement without additional exertion.

Exploring Energy Expenditure and Body Movement of Exergaming in Children of Different Weight Status.

PURPOSE: This study examined differences in energy expenditure and bodily movement among children of different weight status during exergames that varied in mode and intensity. METHODS: Fifty-seven 8- to 12-year-old children including overweight/obesity (n = 28) and normal weight (n = 29) played three 10-minute interval Xbox One exergames (Fruit Ninja, Kung-Fu, and Shape Up) categorized based on predominantly upper-, whole-, or lower-limb movement, respectively. The authors measured bodily movement through accelerometry and obtained energy expenditure and metabolic equivalent (MET) via indirect calorimetry. RESULTS: Energy expended during gameplay was the highest in Shape Up (P < .01) and higher in Kung-Fu than Fruit Ninja (P < .01). Absolute energy expenditure was significantly higher in overweight/obese children (P < .01), but not when controlling for body mass across 3 exergames (P > .05). Based on the MET cut-points, overweight/obese children spent more time at light intensity (<3 METs) for Fruit Ninja (P < .05) and Shape Up (P < .01), but less time at vigorous intensity (≥6 METs) for Kung-Fu (P < .01) and Shape Up (P < .01). Lower-limb movements during Shape Up were less in overweight/obese children (P = .03). CONCLUSION: Although children in both groups expended similar energy relative to their body mass during gameplay, overweight/obese children spent more time at light intensity but less time at vigorous intensity with fewer movements especially while playing a lower limb-controlled exergame.

Application and Validation of Activity Monitors' Epoch Lengths and Placement Sites for Physical Activity Assessment in Exergaming.

We assessed the agreement of two ActiGraph activity monitors (wGT3X vs. GT9X) placed at the hip and the wrist and determined an appropriate epoch length for physical activity levels in an exergaming setting. Forty-seven young adults played a 30-min exergame while wearing wGT3X and GT9X on both hip and wrist placement sites and a heart rate sensor below the chest. Intraclass correlation coefficient indicated that intermonitor agreement in steps and activity counts was excellent on the hip and good on the wrist. Bland-Altman plots indicated good intermonitor agreement in the steps and activity counts on both placement sites but a significant intermonitor difference was detected in steps on the wrist. Time spent in sedentary and physical activity intensity levels varied across six epoch lengths and depended on the placement sites, whereas time spent from a 1-s epoch of the hip-worn monitors most accurately matched the relative exercise intensity by heart rate. Hip placement site was associated with better step-counting accuracy for both activity monitors and more valid estimation of physical activity levels. A 1-s epoch was the most appropriate epoch length to detect short bursts of intense physical activity and may be the best choice for data processing and analysis in exergaming studies examining intermittent physical activities.