Elsevier

Physiotherapy

Volume 98, Issue 3, September 2012, Pages 205-210
Physiotherapy

Active video games as a form of exercise and the effect of gaming experience: a preliminary study in healthy young adults

https://doi.org/10.1016/j.physio.2012.05.001Get rights and content

Abstract

Objectives

To examine the energy expenditure and heart rate response while playing active video games, and the effect of gaming experience on energy expenditure.

Design

Cross-sectional study.

Participants and interventions

Twenty-eight healthy participants (18 male, age 19 to 27 years) played either Wii Sports Boxing, Tennis and Baseball, or Wii Sports Boxing and Wii Fit Free Jogging.

Main outcome measures

Percentage maximal heart rate (%HRmax) and metabolic equivalents (METs) were measured during 15 minutes of rest and during each game.

Results

Mean %HRmax and METs while playing each of the four games were as follows: Wii Fit Free Jogging 71% [standard deviation (SD) 13%], 5.9 (SD 1.8); Wii Sports Boxing 58% (SD 13%), 3.2 (SD 1.1); Wii Sports Baseball 42% (SD 6%), 2.0 (SD 0.5); and Wii Sports Tennis 42% (SD 7%), 2.0 (SD 0.4). Subjects with gaming experience achieved a lower heart rate playing Wii Sports Tennis compared with subjects without gaming experience.

Conclusions

Wii Sports Boxing, Tennis and Baseball are light-intensity activities, and Wii Fit Free Jogging is a moderate-intensity activity. Experience of gaming may affect the exercise intensity of games requiring controller skill.

Introduction

Physical activity is a major factor in the prevention and treatment of obesity, cardiovascular disease and other morbidities [1]. It is recommended that adults should participate in at least 30 minutes of moderate activity at least 5 days per week [1]. For healthy young adults, moderate-intensity exercise is that which results in an energy expenditure of 4.8 to 7.1 metabolic equivalents (METs), or a maximal heart rate (%HRmax) of 64% to 76% [1]. Examples of moderate activity for young adults include walking for exercise, dancing or mowing the lawn [2].

Activity levels have been shown to decline below recommended levels in early adulthood [3]. Watching television and playing computer and video games are thought to contribute to sedentary behaviour in adults [4]. However, video games appeal to young adults [5] and their use is increasing [6].

With the development of active video games (AVGs), computer gaming has the potential to become a more active pastime [7]. An AVG, or interactive game, is defined as electronic media that allows players to actively interface with the game by physical manipulation of equipment [8]. One such AVG console is the WiiTM (Nintendo Co Ltd., Tokyo, Japan). The Wii is primarily operated through a handheld wireless controller (Wii Remote™). Players simulate movements with this controller, and the on-screen character moves in the same way. This allows players to move freely while controlling characters as they engage in activities such as swinging a racket.

Theoretically, if the exercise intensity reached while playing the Wii is moderate, such participation may contribute to the achievement of physical activity guidelines [1]. Furthermore, the visual and auditory stimulation from these games may provide augmented feedback which can be an effective addition to exercise therapy [9].

A number of studies have investigated the exercise intensity associated with playing the Wii [5], [10], [11], [12], [13], [14], [15], [16]. Wii Sports is the most common Wii game as it is provided with the console when purchased. Several simulations can be played on Wii Sports, including baseball, golf and bowling, all which result in energy expenditure of just below 3 METs; these are generally considered to be light-intensity games [13], [14], [16]. Although studies have consistently shown that Wii Sports Boxing (hereinafter known as ‘Boxing’) is the most active of the Wii Sports simulations, there is uncertainty about whether or not it can be considered a moderate-intensity activity. Some studies found that Boxing required a higher or comparable energy expenditure to brisk walking [11], [12], [17], while others [13], [14] reported it as a light-intensity activity. Differences in methodologies may explain the variations between studies. The study populations varied from children [14] to adults [16], and some studies used electronic devices to estimate energy expenditure [13] while others used indirect calorimetry [14].

AVGs that require whole body movement are likely to be more metabolically demanding than AVGs that only require upper body movement [19]. Wii FitTM is a game designed to incorporate lower limb movement. Many Wii Fit games are played using a pressure sensitive platform (Wii Balance Board™). On-screen characters can be controlled by players shifting their body weight while standing on this platform. However, it is not capable of supporting the weight of a human landing on it with momentum, and therefore it is not used to play Wii Fit Jogging. Players’ movements for jogging simulations are detected through the Wii Remote, which is placed in the player's pocket while they jog.

There are four choices of jogging simulations on the Wii Fit Plus game. Basic Jogging and Jogging Plus are computer-paced games, 2P Wii Jogging allows two players’ on-screen characters to jog through the same virtual landscape simultaneously, and Free Jogging is paced by the player and lasts a set time of either 10 or 20 minutes. Wii Fit Free Jogging is unique among Wii simulations in that it has both the desired qualities of being continuous for a minimum of 10 minutes, and necessitates whole body movement.

To the authors’ knowledge, three studies have examined the energy expenditure associated with playing Wii Fit games [5], [10], [16], but none of them used Wii Fit Free Jogging. Miyachi et al. reported energy expenditure of 5.1 METs and 4.0 METs during Wii Fit Plus Basic Jogging and Jogging Plus, respectively, in healthy adults aged 25 to 44 years [16]. As such, these games were considered to be moderate-intensity activities in this population [16]. These jogging games were paced by a computer-generated guide.

Graves et al. [5] and Guderian et al. [10] examined the energy expenditure associated with playing Wii Fit games; however, they grouped different simulations together and did not report the energy expenditure for individual simulations. The combined mean energy expenditure for playing six Wii Fit games among middle-aged and older adults was 3.5 METs [10]. Similarly, the combined mean energy expenditure for playing Wii Fit Hula Hoop, step aerobics and jogging games among young adults was 3.6 METs [5]. Another limitation of these studies was that the trial versions of the games were used, which are shorter and require a lower level of skill than the full versions.

It is not clear whether gaming experience is related to energy expenditure when playing AVGs. Sell et al. found that players with gaming experience expended more energy when playing AVGs compared with those without gaming experience [18]. However, some researchers believe that experienced players may adapt their movement patterns while playing to conserve energy [19].

Video games can be played at different levels, either by selection or progress. A methodological difficulty arises when comparing energy expenditure across computer game levels, as these levels can lead to the playing experience being inherently different. A game that is paced by the player from the beginning is therefore preferable when comparing experienced gamers with inexperienced gamers. Research has shown that when children had the opportunity to modify the intensity of an AVG, they accrued more physical activity [8]. No studies examining the exercise intensity reached by adults playing the Wii have investigated the possible effect of gaming experience on energy expenditure.

This study aimed to examine the energy expenditure and heart rate response while playing four Wii simulations, and to compare these results with moderate-intensity exercise guidelines [1]. In addition, the effect of gaming experience on energy expenditure while playing AVGs of different energy requirements was examined.

Section snippets

Recruitment and design

Twenty-eight young non-smoking adults (mean age 22 years, 18 male) were recruited through posters on university notice boards. Those with a history of cardiac or respiratory disease, musculoskeletal injury, low back pain in the previous 3 months, taking prescribed medication other than the oral contraceptive pill, and pregnant women were excluded from participation. All testing took place in the exercise laboratory of the Trinity Centre for Health Sciences, Dublin. Written informed consent was

Results

There were no significant differences in anthropometric variables between sexes, groups and level of gaming experience. Data were therefore pooled for sex and gaming experience (Table 1). Five participants in each group (all male) were considered to be experienced gamers.

Data were normally distributed, with the exception of kilojoules expended when playing Baseball and Tennis. A common outlier was found for these variables. Laboratory notes recorded during testing reported that the participant

Discussion

For any exercise prescription, the FITT principles apply, whereby there is a need to determine the frequency, intensity, time and type of exercise. It is not possible to prescribe AVGs without knowledge of their exercise intensity. For AVGs to contribute towards an individual's daily recommended activity, they must require appropriate HRs or levels of energy expenditure [1].

Energy expenditure and HR while playing Wii Sports simulations were comparable with those obtained in previous studies,

Conclusions

To the authors’ knowledge, this is the first study to examine the energy requirements of a self-paced Wii game without transition periods. It is also the first study to investigate whether gaming experience affects energy expenditure while playing Wii games.

The results of this study can guide the clinical use of the Wii, and inform its prescription. The Wii may be useful to encourage sedentary adults who enjoy playing video games to become more active. Tennis and Baseball were classed as

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