Energy cost of common activities in children and adolescents.

Journal of Physical Activity and Health. 2013 Jan;10(1):62-9.

Lyden K, Kozey Keadle S, Staudenmayer J, Freedson P, Alhassan S.
Dept of Kinesiology, University of Massachusetts-Amherst.

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Abstract

BACKGROUND: The Compendium of Energy Expenditures for Youth assigns MET values to a wide range of activities. However, only 35% of activity MET values were derived from energy cost data measured in youth; the remaining activities were estimated from adult values.

PURPOSE: To determine the energy cost of common activities performed by children and adolescents and compare these data to similar activities reported in the compendium.

METHODS: Thirty-two children (8-11 years old) and 28 adolescents (12-16 years) completed 4 locomotion activities on a treadmill (TRD) and 5 age-specific activities of daily living (ADL). Oxygen consumption was measured using a portable metabolic analyzer.

RESULTS: In children, measured METs were significantly lower than compendium METs for 3 activities [basketball, bike riding, and Wii tennis (1.1-3.5 METs lower)]. In adolescents, measured METs were significantly lower than compendium METs for 4 ADLs [basketball, bike riding, board games, and Wii tennis (0.3-2.5 METs lower)] and 3 TRDs [2.24 m·s-1, 1.56 m·s-1, and 1.34 m·s-1 (0.4-0.8 METs lower)].

CONCLUSION: The Compendium of Energy Expenditures for Youth is an invaluable resource to applied researchers. Inclusion of empirically derived data would improve the validity of the Compendium of Energy Expenditures for Youth.

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An investigation of the impact of regular use of the Wii Fit to improve motor and psychosocial outcomes in children with movement difficulties: a pilot study.

Child Care Health Dev. 2013 Jan 30. [Epub ahead of print]

Hammond J, Jones V, Hill EL, Green D, Male I.

Brighton & Sussex Medical School, University of Sussex, Brighton, East Sussex, UK.

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Abstract 

BACKGROUND: Children with Developmental Co-ordination Disorder (DCD) experience poor motor and psychosocial outcomes. Interventions are often limited within the healthcare system, and little is known about how technology might be used within schools or homes to promote the motor skills and/or psychosocial development of these children. This study aimed to evaluate whether short, regular school-based sessions of movement experience using a commercially available home video game console (Nintendo's Wii Fit) would lead to benefits in both motor and psychosocial domains in children with DCD.

METHODS: A randomized crossover controlled trial of children with movement difficulties/DCD was conducted. Children were randomly assigned to an intervention (n = 10) or comparison (n = 8) group. The intervention group spent 10 min thrice weekly for 1 month using Wii Fit during the lunch break, while the comparison group took part in their regular Jump Ahead programme. Pre- and post-intervention assessments considered motor proficiency, self-perceived ability and satisfaction and parental assessment of emotional and behavioural problems.

RESULTS: Significant gains were seen in motor proficiency, the child's perception of his/her motor ability and reported emotional well-being for many, but not all children.

CONCLUSIONS: This study provides preliminary evidence to support the use of the Wii Fit within therapeutic programmes for children with movement difficulties. This simple, popular intervention represents a plausible method to support children's motor and psychosocial development. It is not possible from our data to say which children are most likely to benefit from such a programme and particularly what the dose and duration should be. Further research is required to inform across these and other questions regarding the implementation of virtual reality technologies in therapeutic services for children with movement difficulties.

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Can balance in children with cerebral palsy improve through use of an activity promoting computer game?

Technology and Health Care

Volume 20, Number 6 / 2012; Pages -501-510

Authors: Nerrolyn Ramstrand, Frida Lygnegård

Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden

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Abstract
Introduction: This study aimed to evaluate if use of an activity promoting computer game, used in the home (Nintendo Wii Fit; Nintendo Co Ltd, Japan), could influence balance related outcome measures in children with cerebral palsy.

Method: Eighteen children with hemiplegic or diplegic cerebral palsy were recruited for the study. A randomised cross-over design was used with children tested at baseline, after five weeks of playing Wii Fit games and after five weeks without any intervention. Outcome measures of interest included: performance on the modified sensory organisation test, reactive balance test and rhythmic weight shift test.

Results: No significant difference was observed between testing occasions for any of the balance measures investigated (p > 0.05).

Conclusion: Our results suggest that use of a Nintendo Wii balance board and Wii Fit software for a minimum of thirty minutes per day in the patient's own home, over a five week period, is not effective as a balance training tool in children with cerebral palsy.

Keywords:  Balance, postural stability, interactive games, Nintendo Wii, cerebral palsy, children

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Wii-habilitation as balance therapy for children with acquired brain injury.

Authors: Tatla SK, Radomski A, Cheung J, Maron M, Jarus T.

Developmental Neurorehabilation. 2012 Dec 11. [Epub ahead of print]

Acute Rehabilitation Team, Sunny Hill Health Centre for Children, 3644 Slocan Avenue , Vancouver, BC V5M 3E8 , Canada.

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Abstract
Purpose: To evaluate the effectiveness of the Nintendo Wii compared to traditional balance therapy in improving balance, motivation, and functional ability in children undergoing acute rehabilitation after brain injury.
Methods: A non-concurrent, randomized multiple baseline single-subject research design was used with three participants. Data were analyzed by visual inspection of trend lines.
Results: Daily Wii balance training was equally motivating to traditional balance therapy for two participants and more motivating for one participant. While improvements in dynamic balance were observed, the results for static balance remain inconclusive. All participants demonstrated improvements in functional ability.
Conclusion: Wii balance therapy is a safe, feasible, and motivating intervention for children undergoing acute rehabilitation after an acquired brain injury. Further research to examine the effectiveness of Wii balance therapy in this population is warranted.

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The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy.

Dev Neurorehabil. 2012 Oct 3.

Jelsma J, Pronk M, Ferguson G, Jelsma-Smit D.

 Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town , South Africa.

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Abstract 
Objective: To study the impact of training using the Nintendo Wii Fit in 14 children with spastic hemiplegic cerebral palsy.

Methods: A single-subject single blinded design with multiple subjects and baselines was utilised. Interactive video gaming (IVG) in lieu of regular physiotherapy was given for 3 weeks. Outcome measures included modified balance and running speed and agility (RSA) scales of the Bruininks-Oserestky test of Motor Performance 2 and the timed up and down stairs (TUDS).

Results: Balances score improved significantly (F(2, 26) = 9.8286, p = 0.001). Changes over time in the RSA (F(2, 26) = 0.86198, p = 0.434) and the TUDS (F(2, 26) = 1.3862, p = 0.268) were not significant. Ten children preferred the intervention to conventional physiotherapy.

Conclusion: Most children preferred the IVG but as the effect did not carry over into function, IVG should not be used in place of conventional therapy and further research is needed into its use as an adjunct to therapy.

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Potential of the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy in a developing country: a pilot study.

Physiotherapy. 2012 Sep;98(3):238-42. Epub 2012 Jul 23.
Gordon C, Roopchand-Martin S, Gregg A.

Source:Section of Physical Therapy, University of the West Indies, Kingston, Jamaica.

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Abstract
OBJECTIVES:
To explore the possibility of using the Nintendo Wii™ as a rehabilitation tool for children with cerebral palsy (CP) in a developing country, and determine whether there is potential for an impact on their gross motor function.

DESIGN:
Pilot study with a pre-post-test design.

SETTING:
Sir John Golding Rehabilitation Center, Jamaica, West Indies.

PARTICIPANTS:
Seven children, aged 6 to 12years, with dyskinetic CP were recruited for the study. One child dropped out at week 4.

INTERVENTION:
Training with the Nintendo Wii was conducted twice weekly for 6weeks. The games used were Wii Sports Boxing, Baseball and Tennis.

MAIN OUTCOME MEASURES:
Percentage attendance over the 6-week period, percentage of sessions for which the full duration of training was completed, and changes in gross motor function using the Gross Motor Function Measure (GMFM).

RESULTS:
All six participants who completed the study had 100% attendance, and all were able to complete the full 45minutes of training at every session. Those who were wheelchair bound participated in two games, whilst those who were ambulant played three games. The mean GMFM score increased from 62.83 [standard deviation (SD) 24.86] to 70.17 (SD 23.67).

CONCLUSION:
The Nintendo Wii has the potential for use as a rehabilitation tool in the management of children with CP. Clinical trials should be conducted in this area to determine whether this could be an effective tool for improving gross motor function.

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Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Can exergames increase physical activity?

Posted by John Ferrara on June 7, 2012

Earlier this year, a study published in the journal Pediatrics found that five games that are marketed with the promise of increasing players' physical fitness produced no actual difference in activity. 78 kids between 9 and 12 were given Wii consoles, and then one group was given a couple of exergames while a control group was given "inactive" games like Madden and Mario Kart. The kids wore devices to measure their physical activity, and they kept logs of when they played.

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To be certain, the study was performed by a very accomplished group of researchers. The lead author, Tom Baranowski of Baylor College, is one of the most widely published researchers of health games. And this was a very well-designed study, printed in the foremost journal on children's health. Nevertheless, the study should not be read to mean that games can't affect physical activity and can't have a positive impact on public health. That's because it didn't account for the most influential factor in a health game's impact -- its design.

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Impact of an Active Video Game on Healthy Children's Physical Activity

Tom Baranowski, Dina Abdelsamad, Janice Baranowski, Teresia Margareta O'Connor, Debbe Thompson, Anthony Barnett, Ester Cerin and Tzu-An Chen
Pediatrics;
Originally published online February 27, 2012;

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Abstract


OBJECTIVE: This naturalistic study tests whether children receiving a new (to them) active video game spontaneously engage in more physical activity than those receiving an inactive video game, and whether
the effect would be greater among children in unsafe neighbourhoods, who might not be allowed to play outside.

METHODS: Participants were children 9 to 12 years of age, with a BMI .50th percentile, but ,99th percentile; none of these children a medical condition that would preclude physical activity or playing video
games. A randomized clinical trial assigned children to receiving 2 active or 2 inactive video games, the peripherals necessary to run the games, and a Wii console. Physical activity was monitored by using accelerometers for 5 weeks over the course of a 13-week experiment. Neighbourhood safety was assessed with a 12 item validated questionnaire.

RESULTS: There was no evidence that children receiving the active video games were more active in general, or at any time, than children receiving the inactive video games. The outcomes were not moderated
by parent perceived neighborhood safety, child BMI z score, or other demographic characteristics.

CONCLUSIONS: These results provide no reason to believe that simply acquiring an active video game under naturalistic circumstances provides a public health benefit to children.

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Postural activity and motion sickness during video game play in children and adults

EXPERIMENTAL BRAIN RESEARCH

Volume 217, Number 2 (2012), 299-309,
Chih-Hui Chang, Wu-Wen Pan, Li-Ya Tseng and Thomas A. Stoffregen

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Abstract Research has confirmed that console video games give rise to motion sickness in many adults. During exposure to console video games, there are differences in postural activity (movement of the head and torso) between participants who later experience motion sickness and those who do not, confirming a prediction of the postural instability theory of motion sickness. Previous research has not addressed relations between video games, movement and motion sickness in children. We evaluated the nauseogenic properties of a commercially available console video game in both adults and 10-year-old children. Individuals played the game for up to 50 min and were instructed to discontinue immediately if they experienced any symptoms of motion sickness, however mild. During game play, we monitored movement of the head and torso. Motion sickness was reported by 67% of adults and by 56% of children; these rates did not differ. As a group, children moved more than adults. Across age groups, the positional variability of the head and torso increased over time during game play. In addition, we found differences in movement between participants who later reported motion sickness and those who did not. Some of these differences were general across age groups but we also found significant differences between the movement of adults and children who later reported motion sickness. The results confirm that console video games can induce motion sickness in children and demonstrate that changes in postural activity precede the onset of subjective symptoms of motion sickness in children.

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The energy expenditure of an activity-promoting video game compared to sedentary video games and TV watching

Journal of Pediatric Endocrinology and Metabolism. Volume 24, Issue 9-10, Pages 689–695
Naim Mitre, Randal C. Foster, Lorraine Lanningham-Foster & James A. Levine

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Abstract

Background: In the present study we investigated the effect of television watching and the use of activity-promoting video games on energy expenditure in obese and lean children.

Methods: Energy expenditure and physical activity were measured while participants were watching television, playing a video game on a traditional sedentary video game console, and while playing the same video game on an activity-promoting video game console.

Results: Energy expenditure was significantly greater than television watching and playing video games on a sedentary video game console when children played the video game on the activity-promoting console. When examining movement with accelerometry, children moved significantly more when playing the video game on the Nintendo Wii console.

Conclusion: Activity-promoting video games have shown to increase movement, and be an important tool to raise energy expenditure by 50% when compared to sedentary activities of daily living.

Keywords children, energy expenditure, obesity, physical activity, television, video-games

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A Comparison of the Energy Cost of 6 Forms of Exergaming

Arch Pediatr Adolesc Med. 2011;165(7):597-602.

Bruce W. Bailey, PhD; Kyle McInnis, ScD

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Objective 
To determine the relative effect of interactive digital exercise that features player movement (ie, exergames) on energy expenditure among children of various body mass indexes (BMIs; calculated as weight in kilograms divided by height in meters squared).

Design Comparison study.
Setting GoKids Boston, a youth fitness research and training center located at University of Massachusetts, Boston.

Participants 
Thirty-nine boys and girls (mean [SD] age, 11.5 [2.0] years) recruited from local schools and after-school programs.

Main Exposure
Six forms of exergaming as well as treadmill walking.

Main Outcome Measures 
In addition to treadmill walking at 3 miles per hour (to convert miles to kilometers, multiply by 1.6), energy expenditure of the following exergames were examined: Dance Dance Revolution, LightSpace (Bug Invasion), Nintendo Wii (Boxing), Cybex Trazer (Goalie Wars), Sportwall, and Xavix (J-Mat). Energy expenditure was measured using the CosMed K4B2 portable metabolic cart.

Results
All forms of interactive gaming evaluated in our study increased energy expenditure above rest, with no between-group differences among normal (BMI < 85th percentile) and "at-risk" or overweight (BMI 85th percentile) children (P .05). Walking at 3 miles per hour resulted in a mean (SD) metabolic equivalent task value of 4.9 (0.7), whereas the intensity of exergaming resulted in mean (SD) metabolic equivalent task values of 4.2 (1.6) for Wii, 5.4 (1.8) for Dance Dance Revolution, 6.4 (1.6) for LightSpace, 7.0 (1.8) for Xavix, 5.9 (1.5) for Cybex Trazer, and 7.1 (1.7) for Sportwall. Enjoyment of the games was generally high but was highest for children with BMIs in the highest percentiles.

Conclusion 
All games used in our study elevated energy expenditure to moderate or vigorous intensity. Exergaming has the potential to increase physical activity and have a favorable influence on energy balance, and may be a viable alternative to traditional fitness activities for children of various BMI levels.

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Exploring children's movement characteristics during virtual reality video game play.

Hum Mov Sci. 2010 Aug 17.

Levac D, Pierrynowski MR, Canestraro M, Gurr L, Leonard L, Neeley C.

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Abstract
There is increasing interest in the use of commercially-available virtual reality video gaming systems within pediatric rehabilitation, yet little is known about the movement characteristics of game play. This study describes quantity and quality of movement during Nintendo Wii and Wii Fit game play, explores differences in these movement characteristics between games and between novice and experienced players, and investigates whether motivation to succeed at the game impacts movement characteristics. Thirty-eight children (aged 7-12) with and without previous game experience played Wii (boxing and tennis) and Wii Fit (ski slalom and soccer heading) games. Force plate data provided center of pressure displacement (quantity) and processed pelvis motion indicated smoothness of pelvic movement (quality). Children rated their motivation to succeed at each game. Movement quantity and quality differed between games (p<.001). Children with previous experience playing Wii Fit games demonstrated greater movement quantity during Wii Fit game play (p<.001); quality of movement did not differ between groups. Motivation to succeed did not influence the relationship between experience and outcomes. Findings enhance clinical understanding of this technology and inform the development of research questions to explore its potential to improve movement skills in children with motor impairments. Link to Pubmed