Background: Sedentary activities such as video gaming are independently associated with obesity. Active video games, in which players physically interact with images on screen, may help increase physical activity and improve body composition. Objective: The aim of this study was to evaluate the effect of active video games over a 6-mo period on weight, body composition, physical activity, and physical fitness. Design: We conducted a 2-arm, parallel, randomized controlled trial in Auckland, New Zealand. A total of 322 overweight and obese children aged 10-14 y, who were current users of sedentary video games, were randomly assigned at a 1:1 ratio to receive either an active video game upgrade package (intervention, n = 160) or to have no change (control group, n = 162). The primary outcome was the change from baseline in body mass index (BMI; in kg/m 2 ). Secondary outcomes were changes in percentage body fat, physical activity, cardiorespiratory fitness, video game play, and food snacking. Results: At 24 wk, the treatment effect on BMI (20.24; 95% CI: 20.44, 20.05; P = 0.02) favored the intervention group. The change (6SE) in BMI from baseline increased in the control group (0.34 6 0.08) but remained the same in the intervention group (0.09 6 0.08). There was also evidence of a reduction in body fat in the intervention group (20.83%; 95% CI: 21.54%, 20.12%; P = 0.02). The change in daily time spent playing active video games at 24 wk increased (10.03 min; 95% CI: 6.26, 13.81 min; P , 0.0001) with the intervention accompanied by a reduction in the change in daily time spent playing nonactive video games (29.39 min; 95% CI: 219.38, 0.59 min; P = 0.06). Conclusion: An active video game intervention has a small but definite effect on BMI and body composition in overweight and obese children. This trial was registered in the Australian New Zealand Clinical Trials Registry at http://www.anzctr.org.au/ as ACTRN12607000632493.Am J Clin Nutr 2011;94:156-63.

The primary objective of this pilot study was to evaluate the effect of active video games on children's physical activity levels.Twenty children (mean ± SD age = 12 ± 1.5 years; 40% female) were randomised to receive either an active video game upgrade package or to a control group (no intervention). Effects on physical activity over the 12-week intervention period were measured using objective (Actigraph accelerometer) and subjective (Physical Activity Questionnaire for Children [PAQ-C]) measures. An activity log was used to estimate time spent playing active and non-active video games.Children in the intervention group spent less mean time over the total 12-week intervention period playing all video games compared to those in the control group (54 versus 98 minutes/day [difference = -44 minutes/day, 95% CI [-92, 2]], p = 0.06). Average time spent in all physical activities measured with an accelerometer was higher in the active video game intervention group compared to the control group (difference at 6 weeks = 194 counts/min, p = 0.04, and at 12 weeks = 48 counts/min, p = 0.06).This preliminary study suggests that playing active video games on a regular basis may have positive effects on children's overall physical activity levels. Further research is needed to confirm if playing these games over a longer period of time could also have positive effects on children's body weight and body mass index. Trial Registration Number: ACTRN012606000018516

This study sought to quantify the energy expenditure and physical activity associated with playing the "new generation" active and nonactive console-based video games in 21 children ages 10-14 years. Energy expenditure (kcal) derived from oxygen consumption (VO2) was continuously assessed while children played nonactive and active console video games. Physical activity was assessed continuously using the Actigraph accelerometer. Significant (p < .001) increases from baseline were found for energy expenditure (129-400%), heart rate (43-84%), and activity counts (122-1288 versus 0-23) when playing the active console video games. Playing active console video games over short periods of time is similar in intensity to light to moderate traditional physical activities such as walking, skipping, and jogging.

Objective To examine the effect of a 6‐week prehabilitation exercise training program on presurgical quadriceps strength for patients undergoing total knee arthroplasty (TKA). Design Two‐arm, parallel, randomized, controlled pilot trial. Setting Private exercise space in a research facility. Participants Twenty‐two patients scheduled for primary TKA. Methods Participants completed a series of baseline questionnaires (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Short Form 36, and Arthritis Self‐efficacy Scale) and functional testing (isometric quadriceps strength assessment, flat‐surface walk test, and stair ascent‐descent test). The participants were randomized to a lower‐body strength training program or to a nonspecific upper‐body strength training program. The participants exercised 3 times per week for 6 weeks before TKA. Postintervention assessment occurred immediately before TKA, with follow‐up assessments at 6 and 12 weeks after surgery. Outcomes The primary outcome was isometric quadriceps strength. Secondary outcomes were mobility, pain, self‐reported function, health‐related quality of life, and arthritis self‐efficacy. Results There was no significant treatment condition–by‐time effect on quadriceps strength, but the effect size was large (F3,18 = 0.89, P = .47, η2 = 0.13). Similar findings were shown for walking speed (F3,18 = 1.47, P = .26, η2 = 0.20). There was a significant treatment‐by‐time effect for the Short Form 36 mental component score (F3,18 = 0.41, P = .02, η2 = 0.41), with differences emerging before surgery but not at either postoperative assessment. For all other secondary outcome measures, the treatment‐by‐time effect was nonsignificant and small. Conclusion The intervention elicited clinically meaningful increases in quadriceps strength, walking speed, and mental health immediately before TKA. It did not impart lasting benefits to patients in the 12 weeks after surgery. Analysis of the results suggests that quadriceps strength may not drive functional improvements after surgery. These findings need to be replicated in larger trials before clinical recommendations are made about including strength training prehabilitation in everyday practice.

Exercise can have a positive effect on cigarette cravings and TWS. However, the most effective exercise intensity to reduce cravings and the underlying mechanisms associated with this effect remain unclear.