Energy Expenditure and Enjoyment During Active Video Gaming Using an Adapted Wii Fit Balance Board in Adults with Physical Disabilities: Observational Study

BACKGROUND Individuals with physical disabilities have fewer opportunities to participate in enjoyable physical activity. One option for increasing physical activity is playing active video games (AVGs); however, many AVGs are inaccessible or offer limited play options. OBJECTIVE This study aimed to examine energy expenditure and enjoyment in adults with mobility impairment during AVG play using off-the-shelf (OTS) and adapted versions of the Wii Fit balance board (Nintendo). METHODS During visit 1, participants completed a functional assessment and the familiarization period. During visit 2, metabolic data were collected during a 20-minute baseline and four 10-minute bouts of Wii Fit Plus game play, with two bouts on each of the boards. During the resting period, participants completed the Physical Activity Enjoyment Scale (PACES). Statistical analyses were computed using SPSS software. Data were analyzed separately for individuals who were able to play while standing on both boards (StdStd); those who could not play while standing on the OTS board, but were able to play while standing on the adapted board (aStd); and those who could only play while sitting on the adapted board (aSit). RESULTS Data were collected for 58 participants (StdStd, n=17; aStd, n=10; aSit, n=31). The sample included 31 men and 27 women with a mean age of 41.21 (SD 12.70) years. Energy expenditure (metabolic equivalent [MET]) during game play was significantly greater than that during rest for all players. Only 17 participants (StdStd group) were able to play using the OTS board. During game play on the adapted board, the average MET values for the two game sets were 2.261 (SD 0.718) kcal/kg/hour and 2.233 (SD 0.751) kcal/kg/hour for the aSit group, 3.151 (SD 1.034) and 2.990 (SD 1.121) for the aStd group, and 2.732 (SD 0.655) and 2.777 (SD 0.803) for the StdStd group. For game play on the adapted board, self-reported ratings of perceived exertion on a 0-10 scale suggested greater exercise intensity levels, with median scores ranging from moderate (3) to very hard (7). The PACES scores indicated that all players enjoyed using the adapted board, with a median score of 4 on a 5-point scale. CONCLUSIONS The adapted Wii Fit balance board provided an opportunity for individuals with mobility impairments, including wheelchair users, to engage in AVG. All participants were able to utilize the adapted controller and enjoyed the AVG activity. Although the average MET values achieved during AVG represented light-intensity exercise (<3 METs), 16% of sitting participants and 41% of standing participants achieved moderate-intensity exercise (3-6 METs) in at least one of the games. Factors not accounted for, which may have influenced the intensity of exercise, include game selection, limited familiarization period, and discomfort wearing the COSMED portable metabolic system for measurement of oxygen consumption. Accessible AVG controllers offer an innovative approach to overcome various barriers to participation in physical activity. The next steps include assessment of an AVG intervention using an adapted board gaming controller on health and fitness outcomes. CLINICALTRIAL ClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by Webcite at http://www.webcitation.org/75fc0mN39).

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Perspectives on Active Video Gaming as a New Frontier in Accessible Physical Activity for Youth With Physical Disabilities

Physical Therapy ◽

10.2522/ptj.20140258 ◽

2016 ◽

Vol 96 (4) ◽

pp. 521-532 ◽

Cited By ~ 13

Author(s):

Jennifer L. Rowland ◽

Laurie A. Malone ◽

Cali M. Fidopiastis ◽

Sangeetha Padalabalanarayanan ◽

Mohanraj Thirumalai ◽

...

Keyword(s):

Physical Activity ◽

Lower Extremity ◽

Sedentary Behavior ◽

Physical Disabilities ◽

Video Gaming ◽

Lower Extremity Function ◽

Pediatric Rehabilitation ◽

New Frontier ◽

Active Video Gaming ◽

Active Video

This perspective article explores the utility of active video gaming as a means of reducing sedentary behavior and increasing physical activity among youth with physical disabilities and limitations in lower extremity function who typically are excluded from mainstream exercise options. Youth with physical disabilities are disproportionately affected by health problems that result from sedentary behavior, lack of physical activity, and low fitness levels. Physical, programmatic, and attitudinal barriers have a synergistic and compounded impact on youths' ability to participate in physical activity. A recent health and wellness task force recommendation from the American Physical Therapy Association's Section on Pediatrics supports analyzing individualized health behaviors and preferences that are designed to improve fitness, physical activity, and participation in pediatric rehabilitation. This recommendation represents an opportunity to explore nontraditional options to maximize effectiveness and sustainability of pediatric rehabilitation techniques for youth with disabilities who could best benefit from customized programming. One new frontier in promoting physical activity and addressing common physical activity barriers for youth with physical disabilities is active video games (AVGs), which have received growing attention as a promising strategy for promoting health and fitness in children with and without disabilities. The purpose of this article is to discuss the potential for AVGs as an accessible option to increase physical activity participation for youth with physical disabilities and limitations in lower extremity function. A conceptual model on the use of AVGs to increase physical activity participation for youth with physical disabilities is introduced, and future research potential is discussed, including a development project for game controller adaptations within the Rehabilitation Engineering Research Center on Interactive Exercise Technologies and Exercise Physiology for People With Disabilities (RERC RecTech) at the University of Alabama at Birmingham (UAB)/Lakeshore Foundation Research Collaborative.

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Active Video Gaming Using an Adapted Gaming Mat in Youth and Adults with Physical Disabilities: Observational Study (Preprint)

10.2196/preprints.30672 ◽

2021 ◽

Author(s):

Laurie A. Malone ◽

Ganisher K. Davlyatov ◽

Sangeetha Padalabalanarayanan ◽

Mohanraj Thirumalai

Keyword(s):

Physical Activity ◽

Energy Expenditure ◽

Leisure Time ◽

Video Gaming ◽

Game Play ◽

Mobility Impairments ◽

Active Video Gaming ◽

Active Video ◽

Play Experience

BACKGROUND A common leisure-time activity amongst youth and adults in the United States is video game play. Playing video games is typically a sedentary endeavor, however, to encourage an increased level of physical activity in an engaging and enjoyable way active video gaming has become popular. Unfortunately, accessibility of gaming controllers is often an issue for persons with disabilities. To address this issue, a commercial off-the-shelf (OTS) gaming mat was adapted to facilitate use by individuals with mobility impairments. OBJECTIVE To examine energy expenditure, enjoyment, and game play experience in youth and adults with mobility impairment during active video gaming (AVG) using OTS and adapted versions of a gaming mat. METHODS The study used an observational design. During visit 1, physical function was assessed, and participants were given a familiarization period with the gaming system. For visit 2, based on observation during the physical function tests and discussion with the participant, it was decided whether the participant would play in a standing or seated position. For standing game play the mat was placed on the floor and for seated play the mat was placed on a height- and tilt-adjustable tabletop. Metabolic data were collected during a 20-minute baseline and four 10-minute bouts of Wii Fit Plus game play, two bouts on each of the mats (adapted, OTS). During gameplay, research staff observed and rated participants’ ability to use the game controller (mat) and quality of gameplay. At the end of each game set, participants reported their rating of perceived exertion on a scale from 0-10. During rest participants completed the Physical Activity Enjoyment Scale (PACES). Participants also answered additional questions regarding usability of the system with each controller (adapted mat, OTS mat). Statistical analyses were computed using Stata 16. Linear mixed-effects maximum likelihood regression was performed, separately for individuals who were able to play standing and for those who played seated. RESULTS A convenience sample of 78 individuals with mobility impairments between the ages of 12 and 60 years (mean 39.6, SD 15.8) participated in the study. Of the sample, 48 participants played the video games in a seated position, while 30 played the games standing. Energy expenditure and heart rate tended to be higher in the OTS mat condition for seated players, while values were similar for both conditions among standing players. However, seated participants reported greater game play experience and both groups exhibited a higher quality of game play during the adapted mat condition. CONCLUSIONS Active video gaming using an adapted gaming mat provided an enjoyable exercise activity for individuals with mobility impairments. Use of the adapted controller provides a means by which this population can engage in light to moderate intensity active video gaming, thereby reducing sedentary leisure time. CLINICALTRIAL ClinicalTrial: ClinicalTrials.gov Identifier: NCT02994199

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