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

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