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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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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Determining intensity levels for selected Wii Fit activities in college aged individuals.

By Joshua D. Grieser
Master of Science in Exercise and Sports Studies thesis
May 2010

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ABSTRACT
Introduction: Physical activity is important to the proper growth, development, and overall health of an individual. Current physical activity trends show declines in activity level throughout aging. To counteract inactivity many physical activity interventions have been implemented in different age groups and yet very little change in activity level has been seen. The Nintendo Wii® offers a popular technological intervention tool with its movement oriented game play. The physiological costs and intensity of the Nintendo Wii Fit® game have not been thoroughly researched, yet the Wii is being used as a physical activity tool in many arenas.


Purpose: The purpose of this study was to determine the intensity level of playing selected Nintendo Wii Fit® games using indirect calorimetry. Using the intensity information, it was determined if playing Wii Fit® (an exercise themed game) on the Nintendo Wii® video game console is an adequate activity for meeting the ACSM moderate physical activity guidelines threshold. Participants: Twenty-five participants, 5 males and 20 females, aged 22 ± 2 years (M ± SD) with little previous Wii experience were recruited for this study.

Method: Participants randomly completed two different Wii Fit activity sessions with two difficulty levels within the strength, endurance, and yoga categories. A resting metabolic rate and exercise VO2were measured on each participant with a TrueMax 2400 metabolic cart. Oxygen consumption was then converted into metabolic equivalents to estimate activity intensity level. SPSS18.0 (Chicago, IL, USA) was use for statistical analysis.

Results: Results indicated that VO2 of the selected Wii Fit activities was significantly higher than resting 2 VO levels. For example, the least intense activity was the Yoga Warrior activity, which had a mean intensity of 2.30 ± 0.42 METs and was still significantly higher than resting 2 VO levels, t (24) = 15.5, p < .001. The calculated MET values ranged from 3.28 ± 0.71 METs to 3.43 ± 0.60 METs for the strength activities, and ranged from 4.98 ± 1.22 METs to 5.73 ± 1.36 METs for the aerobic Basic Run exercises, indicating that the intensity levels of these activities met or exceeded the ACSM moderate intensity threshold of 3 METs. In contrast, the yoga exercises were significantly lower (from 2.30 ± 0.42 METs to 2.6749 ± .48 METs) than the recommended 3 METs, t (24) = -3.347, p= .003 for moderate intensity physical activity. Finally, the results showed that the medium difficulty level aerobic exercises (5.73 ± 1.36 METs) had significantly higher MET values than the easy aerobic exercises (4.98 ± 1.22 METs), t (24) = 5.00, p < .001.

Discussion: The findings of this study illustrate the potential of the Nintendo Wii Fit® game to be an adequate physical activity tool. Furthermore, these findings will allow for the further advancement of exercise themed video games to become satisfactory replacements for traditional physical activities in future interventions.

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Comparison Between Nintendo Wii Fit Aerobics and Traditional Aerobic Exercise in Sedentary Young Adults

Douris, PC, McDonald, B, Vespi, F, Kelley, NC, and Herman, L.
Journal of Strength and Conditioning Research
26(4): 1052–1057, 2012

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Abstract:


Exergaming is becoming a popular recreational activity for young adults. The purpose was to compare the physiologic and psychological responses of college students playing Nintendo Wii Fit, an active video game console, vs. an equal duration of moderate-intensity brisk walking. Twenty-one healthy sedentary college-age students (mean age 23.2 ± 1.8 years) participated in a randomized, double cross-over study, which compared physiologic and psychological responses to 30 minutes of brisk walking exercise on a treadmill vs. 30 minutes playing Nintendo Wii Fit “Free Run” program. Physiologic parameters measured included heart rate, rate pressure product, respiratory rate, and rating of perceived exertion. Participants' positive well-being, psychological distress, and level of fatigue associated with each exercise modality were quantified using the Subjective Exercise Experience Scale. The mean maximum heart rate (HRmax) achieved when exercising with Wii Fit (142.4 ± 20.5 b·min−1) was significantly greater (p = 0.001) compared with exercising on the treadmill (123.2 ± 13.7 b·min−1). Rate pressure product was also significantly greater (p = 0.001) during exercise on the Wii Fit. Participants' rating of perceived exertion when playing Wii Fit (12.7 ± 3.0) was significantly greater (p = 0.014) when compared with brisk walking on the treadmill (10.1 ± 3.3). However, psychologically when playing Wii Fit, participants' positive well-being decreased significantly (p = 0.018) from preexercise to postexercise when compared with exercising on the treadmill. College students have the potential to surpass exercise intensities achieved when performing a conventional standard for moderate-intensity exercise when playing Nintendo Wii Fit “Free Run” with a self-selected intensity. We concluded that Nintendo Wii Fit “Free Run” may act as an alternative to traditional moderate-intensity aerobic exercise in fulfilling the American College of Sports Medicine requirements for physical activity.

© 2012 National Strength and Conditioning Association

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Activity-promoting gaming systems in exercise and rehabilitation

Matthew J. D. Taylor, PhD; Darren McCormick, BSc; Teshk Shawis, MBChB, FRCP; Rebecca Impson,
MSc; Murray Griffin, PhD

Journal of Rehabilitation Research & Development
Volume 48, Number 10, 2011 Pages 1171–1186

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Abstract—

Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation.


Key words: activity-promoting, Dance Dance Revolution,
exercise, falls, games, gaming systems, injury, Nintendo Wii,
rehabilitation, Sony EyeToy, Xbox Kinect.

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Feasibility and observed safety of interactive video games for physical rehabilitation in the intensive care unit: a case series

Journal of Critical Care
Available online 25 September 2011.
Michelle E. Kho PT, PhD, Abdulla Damluji MBChB, MPH , Jennifer M. Zanni PT, MSPT, ScD, Dale M. Needham MD, PhD^a

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Abstract 
Background 
Early rehabilitation in the intensive care unit (ICU) improves patients' physical function. Despite reports of using commercially available interactive video game systems for rehabilitation, there are few data evaluating feasibility and safety as part of routine in-patient rehabilitation, particularly in the ICU.

Methods
We conducted an observational study from September 1, 2009, to August 31, 2010, of adults admitted to a 16-bed medical ICU receiving video games as part of routine physical therapy (PT), evaluating use and indications and occurrence of 14 prospectively monitored safety events.

Results 
Of 410 patients receiving PT in the medical ICU, 22 (5% of all patients; male, 64%; median age, 52 years) had 42 PT treatments with video games (median [interquartile range] per patient, 1.0 [1.0-2.0]). Main indications for video game therapy included balance (52%) and endurance (45%), and the most common activities included boxing (38%), bowling (24%), and balance board (21%). Of 42 treatments, 69% occurred while standing and 45% while mechanically ventilated. During 35 hours of PT treatment, 0 safety events occurred (95% upper confidence limit for safety event rate, 8.4%).

Conclusions 
Novel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients.

Keywords: Rehabilitation; Critical care; Adults; Mechanical ventilation; Interactive video games Click here for more

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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Changes in physical activity and fitness after 3 months of home Wii Fit(TM) use

Journal of Strength & Conditioning Research:

25(11): 3191-3197, 

11 October 2011

Owens, SG, Garner III, JC, Loftin, JM, van Blerk, N, and Ermin, K.

Original Article: PDF Only

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Abstract 
The purpose of this study was to examine changes in physical activity and fitness variables in members of 8 volunteer families after 3 months of home use of the Wii Fit(TM) interactive video game. Pre and postintervention measurements were obtained from 21 subjects relative to physical activity (5 days of accelerometry), aerobic fitness (graded treadmill test), muscular fitness (push-ups), flexibility (sit-and-reach test), balance (composite equilibrium score), and body composition (body mass index and % body fat). Use characteristics of the Wii Fit(TM) device were also determined. A series of 2 (age group) x 2 (time) repeated measures analyses of variance were conducted to assess changes over time and between adults and children. Three months of home Wii Fit(TM) use revealed no significant age group x time interactions or main effects of group or time for daily physical activity, muscular fitness, flexibility, balance, or body composition. An age group x time interaction (p = 0.04) was observed in peak [latin capital V with dot above]O2 (ml[middle dot]kg-1[middle dot]min-1) with children displaying a significant (p = 0.03) increase after 3 months of Wii Fit(TM) use, whereas adults showed no significant (p = 0.50) change. Daily Wii Fit(TM) use per household declined by 82% (p < 0.01) from 21.5 +/- 9.0 min[middle dot]d-1 during the first 6 weeks to 3.9 +/- 4.0 min[middle dot]d-1 during the second 6 weeks. Most measures of health-related fitness in this exploratory study remained unchanged after 3 months of home use of the popular Wii Fit(TM) whole-body movement interactive video game. Modest daily Wii Fit(TM) use may have provided insufficient stimulus for fitness changes. 


 (C) 2011 National Strength and Conditioning Association 


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METs in Adults While Playing Active Video Games: A Metabolic Chamber Study

Medicine & Science in Sports & Exercise: June 2010 - Volume 42 - Issue 6 - pp 1149-1153 MIYACHI, MOTOHIKO; YAMAMOTO, KENTA; OHKAWARA, KAZUNORI; TANAKA, SHIGEHO +/- Click for more/less

Abstract Purpose: Active video game systems controlled through arm gestures and motions (Nintendo Wii Sports) and video games controlled through force plate (Wii Fit Plus) are becoming increasingly popular. This study was performed to determine the energy expenditure (EE) during Wii Fit Plus and Wii Sports game activities. Methods: Twelve adult men and women performed all the activities of Wii Sports (five activities: golf, bowling, tennis, baseball, and boxing) and Wii Fit Plus (63 activities classified as yoga, resistance, balance, and aerobic exercises). Each activity was continued for at least 8 min to obtain a steady-state EE. Because EE was assessed in an open-circuit indirect metabolic chamber consisting of an airtight room (20,000 or 15,000 L), subjects were freed of apparatus to collect expired gas while playing the games. MET value was calculated from resting EE and steady-state EE during activity. Results: The mean MET values of all 68 activities were distributed over a wide range from 1.3 METs (Lotus Focus) to 5.6 METs (single-arm stand). The mean MET values in yoga, balance, resistance, and aerobic exercise of Wii Fit Plus and Wii Sports were 2.1, 2.0, 3.2, 3.4, and 3.0 METs, respectively. Forty-six activities (67%) were classified as light intensity (<3 METs), and 22 activities (33%) were classified as moderate intensity (3.0-6.0 METs). There were no vigorous-intensity activities (>6.0 METs). Conclusions: Time spent playing one-third of the activities supplied by motion- and gesture-controlled video games can count toward the daily amount of exercise required according to the guidelines provided by the American College of Sports Medicine and the American Heart Association, which focus on 30 min of moderate-intensity daily physical activity 5 d·wk−1. Click for more details

Incorporating Gaming Technology into Athletic Injury Rehabilitation

Athletic Training & Sports Health Care March/April 2009 - Volume 1 · Issue 2: 79-84

David A. Middlemas, EdD, ATC; Jeffrey Basilicato, ATC; Michael Prybicien, MA, ATC; Joseph Savoia, MS, ATC; Jenna Biodoglio

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ABSTRACT
Rehabilitation of athletes presents challenges relating to proprioceptive training, reacquisition of sport-related skills, and maintaining the patient’s interest. Incorporation of video gaming technology into the rehabilitation process has been reported in physical therapy, stroke rehabilitation, geriatric exercise, and physical education. Reported feedback indicates that the technology is well received by patients. The purpose of this article is to present video gaming technology, such as the Nintendo Wii, as an alternative tool for clinicians to use in rehabilitation. We present examples of the use of video game activities from the Wii Sports software package in injury rehabilitation. The sport activities selected require patients to simulate athletic motions and skills while competing in the selected activity. In addition, examples of use of gaming activities with traditional balance and proprioceptive equipment are presented.

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A Kinect-based system for physical rehabilitation: A pilot study for young adults with motor disabilities.

Research in Developmental Disabilities. 2011 Jul 22. Chang YJ, Chen SF, Huang JD. Department of Electronic Engineering, Chung Yuan Christian University, Chung-Li, Taiwan
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Abstract This study assessed the possibility of rehabilitating two young adults with motor impairments using a Kinect-based system in a public school setting. This study was carried out according to an ABAB sequence in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their motivation for physical rehabilitation, thus improving exercise performance during the intervention phases. Practical and developmental implications of the findings are discussed. Highlights ► To reduce staff intervention and enhance students’ motivation, interest, and perseverance to engage in physical rehabilitation, a Kinect-based system was employed with success. ► Single subject research design was used with two young adults who were diagnosed with motor disability. ► Data showed that the participants improve exercise performance during the intervention phases. Click here for more

The effects of single bouts of aerobic exercise, exergaming, and videogame play on cognitive control.

Clinical Neurophysiology. 2011 Aug;122(8):1518-25. Kevin C. O’Leary, Matthew B. Pontifex, Mark R. Scudder, Michael L. Brown, Charles H. Hillman Department of Kinesiology & Community Health, 317 Louise Freer Hall, 906 South Goodwin Avenue, University of Illinois, Urbana, IL 61801, USA

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Abstract Objective The effects of single bouts of aerobic exercise, exergaming, and action videogame play on event-related brain potentials (ERPs) and task performance indices of cognitive control were investigated using a modified flanker task that manipulated demands of attentional inhibition. Methods Participants completed four counterbalanced sessions of 20min of activity intervention (i.e., seated rest, seated videogame play, and treadmill-based and exergame-based aerobic exercise at 60% HRmax) followed by cognitive testing once heart rate (HR) returned to within 10% of pre-activity levels. Results Results indicated decreased RT interference following treadmill exercise relative to seated rest and videogame play. P3 amplitude was increased following treadmill exercise relative to rest, suggesting an increased allocation of attentional resources during stimulus engagement. The seated videogame and exergame conditions did not differ from any other condition. Conclusions The findings indicate that single bouts of treadmill exercise may improve cognitive control through an increase in the allocation of attentional resources and greater interference control during cognitively demanding tasks. However, similar benefits may not be derived following short bouts of aerobic exergaming or seated videogame participation. Significance Although exergames may increase physical activity participation, they may not exert the same benefits to brain and cognition as more traditional physical activity behaviors. Click here for more

Effects of an Interactive Video Game (Nintendo Wii™) on Older Women with Mild Cognitive Impairment

THERAPEUTIC RECREATION JOURNAL Vol,. XLIV, No. 4 • 271-287 • 2010

Elizabeth H. Weybright, CTRS
John Dattilo
Frank R. Rusch

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Abstract
Older adults with a cognitive impairment in residential care settings are often found
to be inactive throughout the day. Participation in video games holds promise for these
individuals; however, effects of video games played by older adults have not been studied
consistently and the few studies conducted have yielded mixed results. The purpose of
this study was to examine effects of an interactive video game (Nintendo Wii'" bowling)
on attention to task and positive affect of older adult women with mild cognitive impairment. A single-subject, multiple baseline design comparing a television viewing phase
and an interactive video game phase was conducted using observational measures. Results
indicated that both participants attended to task more and demonstrated higher levels of
positive affect while engaged in the interactive video game as compared to baseline. The
low-impact activity of the Nintendo Wii" bowling program may provide the appropriate amount of physical and mental challenge and stimulation for older adults with mild
cognitive impairments.

KEYWORDS: Interactive video game, mild cognitive impairment, older adult,
recreation

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Potential Benefits of Nintendo Wii Fit Among People with Multiple Sclerosis A Longitudinal Pilot Study

International Journal of MS Care. 2011;13:21–3

Matthew Plow, PhD; Marcia Finlayson, PhD, OT(C), OTR/L

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Abstract

We examined the potential of Nintendo Wii Fit (Nintendo Co, Ltd, Kyoto, Japan) to increase physical activity (PA) behavior and health among people with multiple sclerosis (MS). The study consisted
of a repeated-measures design with a baseline control period and involved 30 people with MS who
had the ability to walk 25 feet with or without a cane (26 individuals were included in the analyses).
Nintendo Wii was set up in the homes of participants, who were prescribed a Wii Fit exercise program lasting 14 weeks, 3 days a week. The Physical Activity and Disability Survey, Modified Fatigue
Impact Scale, and 36-item Short Form Health Status Survey were administered three times before
participants gained access to Wii Fit (control period, at 2-week intervals), and three times after they
received Wii Fit (posttest 1: immediately after; posttest 2: 7 weeks after; posttest 3: 14 weeks after).
Mobility, balance, strength, and weight were assessed at the first pretest, immediately prior to obtaining access to Wii Fit, and 7 weeks after obtaining access to Wii Fit. Results from the questionnaires
indicated that PA significantly improved at week 7, but at week 14, PA levels declined relative to week
7 and the difference was no longer significant compared with the control period. Physical assessments
indicated that balance and strength significantly improved at week 7. One adverse event was reported
(repetitive knee injury). Physical assessments indicated that people with MS may be able to improve
their fitness levels by using Wii Fit. Future studies should incorporate behavior change strategies to
promote long-term use of Wii Fit, and explore whether individuals with more severe symptoms of MS
can safely use Wii Fit.

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Using Wii Fit to reduce fatigue among African American women with systemic lupus erythematosus: A pilot study

Lupus. 2011 Jun 23

Yuen H, Holthaus K, Kamen DL, Sword D, Breland HL.

University of Alabama at Birmingham, USA.

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Abstract

Fatigue and physical deconditioning are common, difficult to treat conditions among patients with systemic lupus erythematosus (SLE). The aim of this pilot study was to evaluate the effectiveness of a home-based exercise program using the Wii Fit system in patients with SLE. Fifteen sedentary African American women with SLE experiencing moderate to severe fatigue participated in a home exercise program using the Wii Fit 3 days a week for 30 minutes each for 10 weeks. A one-group pretest-post test design was used to evaluate the effectiveness of this program. Primary outcome measure was severity of fatigue. Secondary outcome measures were body weight, waist circumference, fatigue-related symptoms of distress, activity level, and physical fitness. At the completion of the 10-week Wii Fit exercise program, participants perceived fatigue severity as measured by the Fatigue Severity Scale to be significantly decreased (p= 0.002), and body weight and waist circumference were significantly reduced (pp= 0.01). In addition, anxiety level, as measured by Hospital Anxiety and Depression Scale, and overall intensity of total pain experience, as measured by Short-form of the McGill Pain Questionnaire, were also significantly reduced (p < 0.05). Findings provide preliminary evidence that the Wii Fit motivates this population to exercise, which leads to alleviation of fatigue and reduced body weight, waist circumference, anxiety level, and overall intensity of total pain experience.

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The cardiovascular and metabolic responses to Wii Fit video game playing in middle-aged and older adults Dec 2010

The Journal of Sports Medicine and Physical Fitness
2010 December;50(4):436-42 
Guderian B. 1, Borreson L. A. 1, Sletten L. E. 1, Cable K. 1, Stecker T. P. 1, Probst M. A. 1, Dalleck L. C. 2

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Abstract
AIM: The purpose of this study was (a) to assess the cardiovascular and metabolic responses to Wii Fit video games and (b) to determine if Wii Fit video games meet the American College of Sports Medicine guidelines for improving and maintaining cardiorespiratory fitness.
METHODS: Twenty men and women (mean±SD age, height, and weight: = 58.1±8.8 years, 172.1±10.5 cm, 87.1±22.8 kg, respectively) completed a 20-min Wii Fit testing session consisting of six separate aerobic and balance games. Cardiovascular and metabolic data were collected via a portable calorimetric measurement system.
RESULTS: Mean relative exercise intensity was 43.4±16.7% of heart rate reserve. Absolute exercise intensity in metabolic equivalents (METS) was 3.5±0.96. Total net energy expenditure for the Wii Fit video game playing session was 116.2±40.9 kcal/session.
CONCLUSION: Results indicate that playing Wii Fit video games is a feasible alternative to more traditional aerobic exercise modalities for middle-aged and older adults that fulfills the American College of Sports Medicine guidelines for improving and maintaining cardiorespiratory fitness.

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Metabolic responses to wii fit™ video games : March 2011

Journal of Strength and Conditioning Research. 2011 Mar;25(3):689-93.
Metabolic responses to wii fit™ video games at different game levels.
Worley JR, Rogers SN, Kraemer RR.

Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, Louisiana


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From Pubmed

Abstract

-The Wii Fit™ is a form of interactive gaming designed to elicit health and fitness benefits to replace sedentary gaming.
This study was designed to determine the effectiveness of Wii Fit™ fitness games. The purpose of the study was to determine the %&OV0312;O2max and energy expenditure from different Wii Fit™ games at different levels including the step and hula games. Eight healthy young women completed a preliminary trial to determine &OV0312;O2max and later played the Wii Fit™ during 2 separate counterbalanced trials. During each session, subjects played levels of Wii Fit™ games for 10 minutes each level. One session involved beginning and intermediate hula, and the other session involved beginning and intermediate steps. The &OV0312;O2 was measured continuously via metabolic cart, and rating of perceived exertion (RPE) was assessed at the end of each game level. The lowest %&OV0312;O2max, kcal·min, and RPE occurred during the beginning step game and the highest values occurred during the intermediate hula game. Respiratory exchange ratio was significantly higher in the intermediate hula than beginning hula game but was not significantly different between step game levels. The intermediate hula and step games produced the greatest energy expenditure with an equivalent effect of a walking speed of >5.63 km·h (>3.5 miles·h). This is the first study to determine the percentage of &OV0312;O2max and caloric expenditure elicited by different Wii Fit™ video games at different game levels in adults. Findings suggest that the Wii Fit™ can be used as an effective activity for promoting physical health in this population.

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Only lower limb controlled interactive computer gaming enables an effective increase in energy expenditure.

Now published: Link
EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY Volume 111, Number 7, 1465-1472

Previously:
Eur J Appl Physiol. 2010 Dec 17. [Epub ahead of print]

Jordan M, Donne B, Fletcher D.

Department of Physiology, Trinity College, Dublin 2, Ireland, jordanm1@tcd.ie.

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Abstract
Limited research documents if new and existing interactive computer gaming "exergaming" increase energy expenditure and cardio-respiratory costs comparable to common exercise modalities. To address this, healthy male volunteers (n = 15) completed six by 12-min test elements: PlayStation2 (PS2(hand)), Nintendo Wii boxing, walk at 5.6 km h(-1), cycle at 120 W, playing an adapted lower limb controlled PS2 (PS2(limb)) and run at 9.6 km h(-1). In addition, they played PS2(limb) for 30 min and performed an incremental treadmill test to exhaustion. Data were analysed using repeated measures ANOVA with post hoc Tukey tests, P < 0.05 inferred significance. PS2(limb) increased energy expenditure (EE) and post-exercise blood lactate (BLa) significantly higher (P < 0.001) than PS2(hand), Wii gaming or walking at 5.6 km h(-1) (EE: 30.3 ± 4.9 vs. 4.7 ± 1.1, 22.0 ± 6.1 and 17.9 ± 1.9 kJ h(-1) kg(-1); BLa: 2.4 ± 1.5 vs. 1.0 ± 0.3, 1.8 ± 0.8 and 0.9 ± 0.2 mmol L(-1)), playing the PS2(limb) raised mean EE over six times greater than PS2(hand). Mean fat and carbohydrate oxidation rates during the 9- to 12-min period playing the PS2(limb) were five and ten times greater than PS2(hand) (0.25 ± 0.10 vs. 0.05 ± 0.10, 1.69 ± 0.52 vs. 0.15 ± 0.14 g min(-1), respectively). PS2(limb) met ACSM guidelines for cardiovascular fitness; however, current Wii technology failed. In conclusion, gaming interactive technology must be adapted or designed to include the lower limbs in order to provide a significant exercise stimulus.

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Lessons learned: Staff perceptions of the Nintendo Wii as a health promotion tool within an aged-care and disability service.

Health promotion journal of Australia, 2010 Dec;21(3):189-95.

Higgins HC, Horton JK, Hodgkinson BC, Muggleton SB.

Blue Care, Milton, Queensland.

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Abstract
Issue addressed: Enhancing opportunities for all older people to be physically and mentally active is an imperative in our ageing society. Lessons learned from the use of the Nintendo Wii within Queensland agedcare and disability services were assembled through eliciting staff perceptions regarding the usefulness of Wii technology within their centres.

Methods: Telephone interviews were conducted with direct care staff in 53 centres that had been using the Wii technology for at least three months. Content analysis of interview data identified the major response patterns raised by staff.

Results: Staff noted that Wii activities were easy to master for more able clients and that there was minimal risk to clients. Staff reported that these activities provided health promoting physical benefits (mobility, range of motion, dexterity, coordination, distraction from pain) and psychosocial gains (social engagement, self-esteem, mastery, ability to pacify challenging behaviours) and were a useful adjunct to other care practices within these aged-care and disabilities services.

Conclusions: Staff believed that Wii activities provided purposeful and meaningful opportunities to promote wellbeing for aged and disabled clients within an aged-care and disability service. However, Wii activities were less successful with clients who had significant cognitive and/or physical disabilities.

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Energy expenditure in adults with cerebral palsy playing Wii Sports.

Hurkmans HL, van den Berg-Emons RJ, Stam HJ.

Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC–University Medical Center, Rotterdam, The Netherlands

Arch Phys Med Rehabil. 2010 Oct;91(10):1577-81.

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Abstract
OBJECTIVE: To determine energy expenditure of adults with bilateral spastic cerebral palsy while playing Wii Sports tennis and boxing.

DESIGN: Cross-sectional study.

SETTING: University medical center.

PARTICIPANTS: Five men and 3 women with bilateral spastic cerebral palsy and ambulatory ability (Gross Motor Function Classification System level I or II) participated. The mean participant age ± SD was 36±7 years. Exclusion criteria were comorbidities that affected daily physical activity and fitness, contraindications to exercise, or inability to understand study instructions owing to cognitive disorders or language barriers.

INTERVENTION: Participants played Wii Sports tennis and boxing, each for 15 minutes in random order.

MAIN OUTCOME MEASURE: By using a portable gas analyzer, we assessed energy expenditure by oxygen uptake (Vo(2)) while sitting and during Wii Sports game play. Energy expenditure is expressed in metabolic equivalents (METs), which were calculated as Vo(2) during Wii Sports play divided by Vo(2) during sitting.

RESULTS: Mean ± SD energy expenditure during Wii Sports game play was 4.5±1.1METs for tennis and 5.0±1.1METs for boxing (P=.024). All participants attained energy expenditures greater than 3METs, and 2 participants attained energy expenditures greater than 6METs while playing Wii Sports tennis or boxing.

CONCLUSIONS: Both Wii Sports tennis and boxing seem to provide at least moderate-intensity exercise in adults with bilateral spastic cerebral palsy (GMFCS level I or II). These games, therefore, may be useful as treatment to promote more active and healthful lifestyles in these patients. Further research is needed to determine the energy expenditures of other physically disabled patient groups while playing active video games, and to determine the effectiveness of these games in improving health and daily activity levels.

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