Active Video Games and Health Indicators in Children and Youth: A Systematic Review

Abstract

BackgroundActive video games (AVGs) have gained interest as a way to increase physical activity in children and youth. The effect of AVGs on acute energy expenditure (EE) has previously been reported; however, the influence of AVGs on other health-related lifestyle indicators remains unclear.ObjectiveThis systematic review aimed to explain the relationship between AVGs and nine health and behavioural indicators in the pediatric population (aged 0–17 years).Data sourcesOnline databases (MEDLINE, EMBASE, psycINFO, SPORTDiscus and Cochrane Central Database) and personal libraries were searched and content experts were consulted for additional material.Data selectionIncluded articles were required to have a measure of AVG and at least one relevant health or behaviour indicator: EE (both habitual and acute), adherence and appeal (i.e., participation and enjoyment), opportunity cost (both time and financial considerations, and adverse events), adiposity, cardiometabolic health, energy intake, adaptation (effects of continued play), learning and rehabilitation, and video game evolution (i.e., sustainability of AVG technology).Results51 unique studies, represented in 52 articles were included in the review. Data were available from 1992 participants, aged 3–17 years, from 8 countries, and published from 2006–2012. Overall, AVGs are associated with acute increases in EE, but effects on habitual physical activity are not clear. Further, AVGs show promise when used for learning and rehabilitation within special populations. Evidence related to other indicators was limited and inconclusive.ConclusionsControlled studies show that AVGs acutely increase light- to moderate-intensity physical activity; however, the findings about if or how AVG lead to increases in habitual physical activity or decreases in sedentary behaviour are less clear. Although AVGs may elicit some health benefits in special populations, there is not sufficient evidence to recommend AVGs as a means of increasing daily physical activity.

Physical Wellness Among Gaming Adults: Cross-Sectional Study (Preprint)

“…Another limitation of this study was the small sample size, which hindered the statistical power of the analysis. Reviews on gaming health literature by LeBlanc et al [25] and Kharrazi et al [6] have identified low sample size as a consistent issue that arises in this field of research. Comparable studies by Ballard et al [7] and Weaver et al [9] also had limited sample size with 116 and 562 participants respectively.…”

How Effective Are Active Videogames Among the Young and the Old? Adding Meta-analyses to Two Recent Systematic Reviews

“…Previous empirical studies and systematic reviews have primarily relied on P values. 8,9,16 Effect sizes, however, are more appropriate for intervention evaluation. 17,18 Although the flaws of null-hypothesis significance testing have been discussed …”

“…The conclusion of Larsen et al 9 is that more research is necessary to study the effects of active videogames for the elderly. Another recent systematic review 8 concluded that active videogames result in acute energy expenditure, but that it is not clear if active videogames result in longer-term health benefits. The preliminary estimates provided by the present meta-analytic procedures suggest that active videogames do indeed lead to improvements in children's BMI and in functional balance in the elderly.…”

“…Recently, a new generation of digital gaming systems, which require physical exertion to play the game, has become commercially available. These games are denoted as ''active videogames'' 8 or ''exergames'' 9 (e.g., ''Dance Dance RevolutionÔ'' [Konami Digital Entertainment, El Segundo, CA] and ''Wii Sports ResortÔ'' [Nintendo, Kyoto, Japan]). Several studies have shown that active videogames can have beneficial effects on physical activity and related health outcomes.…”

“…21 No meta-analysis, however, has assessed whether active videogames can result in increased long-term physical activity, which is more important from a public health perspective than one-time physical exertion. 8 Also, no published metaanalysis has focused on direct health outcomes, such as body mass index (BMI).…”