Despite the proven health benefits of regular aerobic exercise, physical inactivity remains a major public health concern, because it is a chief cause of morbidity and contributor to premature mortality in the U.S.A. (10). Participating in physical activity is regarded as a lifestyle choice that can profoundly and positively influence health and longevity (16). The American College of Sports Medicine (ACSM) recommends engaging in moderate-intensity aerobic physical activity for a minimum of 30 minutes for 5 days each week or vigorous-intensity aerobic physical activity for 20 minutes on 3 days each week to promote and maintain health (1,10). According to 2007 data from the Centers for Disease Control and Prevention, less than half of U.S. adults (49.1%) met physical activity recommendations put forth by the ACSM (10). College-age young adults are one population, in particular, experiencing the most rapid decline in physical activity participation, in part because of the perception that exercise is not enjoyable and a lack of time to devote toward exercise (21). Decline in physical activity begins in high school and by college, data compiled reveal that nearly 35% of persons between the ages of 18 and 24 years are physically inactive. An additional 27% do participate in some leisure time activity but fail to meet current physical activity recommendations (15,22). A key barrier to participation for sedentary individuals and those who do not meet ACSM requirements for physical activity is inconvenience and lack of time for exercise, and the perception that exercise is not an enjoyable activity. The popularization of video games has contributed greatly to a decline in physical activity and has increased the time devoted to sedentary behaviors. However, video gaming is now perceived by many as being an enjoyable pastime, the innovation of active gaming may inspire pursuit of physical fitness in those previously sedentary (6). Active video games or exergaming require interactive physical activity by the user (8).
Miyachi et al. (14) have postulated that previous research investigating active video games may have underestimated energy expenditure because of the restrictive nature of indirect calorimeters used to make such measurements. Miyachi et al. (14) using an open-circuit metabolic chamber to allow for free, whole-body movement, found 46 activities on Wii Fit Plus and Wii Sports (Nintendo Inc., Kyoto, Japan) to be of light intensity (<3 METs), 22 activities to be of moderate intensity (3.0–6.0 METs), and no activities to be of vigorous intensity (>6 METs). They concluded that one-third of Wii Fit Plus and Wii Sports activities could contribute to daily moderate-intensity physical activity requirements outlined by ACSM.
Previous studies have investigated energy expenditure playing active vs. sedentary video games. Graves et al. (6) compared Nintendo Wii Sports against sedentary XBox 360 (Microsoft Co., Redmond, WA) and concluded that playing Wii Sports resulted in greater energy expenditure, although not as much as actually playing the sport and, therefore, the intensity was unable to replace a regular exercise routine. They also concluded in another study that the heart rate elicited during Fit aerobics fell below the recommended intensity for maintaining cardiorespiratory health (7). Lanningham-Foster et al. (12) found that both adults and children had significantly higher energy expenditure while playing Nintendo Wii Boxing and that activity-promoting video games have the potential to increase energy expenditure in children and adults. Guderian et al. (9) investigated Wii Fit video gaming in middle-aged and older adults. They concluded that playing Wii Fit is a feasible exercise modality as compared with traditional aerobic physical activity in fulfilling ACSM guidelines for cardiorespiratory fitness. However, they did not perform a direct comparison to traditional aerobic physical activity as part of their research design. Siegel et al. (20) compared the energy expenditure of 30 minutes of continuous video exergaming where the subjects were allowed access to 3 different games during a 30-minute exercise session. They concluded that the caloric expenditure was within ACSM recommendations. Graf et al. (8) concluded that active video games were comparable with treadmill walking for increasing energy expenditure in children.
Exercise is associated with improving psychological mood states (2,4,11,13,19). Previous training status appears to be a significant factor in the acute psychological effects of exercise (4). Research has demonstrated that young sedentary adults have negative shifts in psychological mood states when compared with active young adults especially at higher exercise intensities (2,4,5). Ekkekakis et al. (4) also state that negative psychological states are related to increasing exercise intensity. Previous training states and exercise intensity are important variables associated with the acute psychological effects of exercise
The previous research has provided evidence for video games as an exercise modality that can provide the recommended intensity for cardiorespiratory fitness. However, they have not performed a direct comparison to traditional aerobic physical activity in sedentary young adults and investigated the psychological responses to video exergaming. Because video gaming is now perceived by many as being an enjoyable pastime (6), we hypothesized that playing the Wii Fit will provide superior psychological responses in comparison to traditional treadmill exercise. We also hypothesized that both exercise modalities will provide similar physiological responses. The primary purpose of this investigation was to compare the physiological and psychological responses of Nintendo Wii Fit with performing a universal standard for moderate-intensity physical activity (30 minutes of brisk walking). Based on this comparison of exercise intensities achieved, it can then be determined if using Nintendo Wii Fit can be incorporated into a daily physical activity routine as a suitable alternative to conventional brisk walking for sedentary young adults.
Experimental Approach to the Problem
A repeated-measures design was used to investigate the physiological and psychological responses of 30 minutes of brisk walking exercise on a treadmill vs. 30 minutes of playing Nintendo Wii Fit “Free Run.” The subjects participated in the 2 conditions that were randomly assigned and separated by 1 week. The testing order was counterbalanced. The brisk walk consisted of walking on a treadmill set at 3.5 miles per hour for 30 minutes. The Nintendo Wii Fit condition comprised a 30-minute “Free Run” program. The design of this study allowed for a direct comparison between the 2 modes of aerobic exercise. The dependent variables of heart rate, rate pressure product (RPP), ventilation rate, rating of perceived exertion (RPE), and the Subjective Exercise Experience Scale (SEES) were measured to investigate the differences between these 2 forms of aerobic exercise. The physiologic variables of heart rate, RPP, ventilation rate, and RPE will provide information concerning exercise intensity. The SEES was designed to measure the psychological responses to exercise (13). McAuley et al. (13) have demonstrated convergent and discriminant validity for the SEES. The SEES has been previously used to measure the acute psychological responses to exercise (2,13). The results of this study can be used to establish the feasibility of video exergaming as an alternative to traditional aerobic exercise for sedentary young adults.
The experimental procedures of the study were approved by the New York Institute of Technology Institutional Review Board. All subjects signed an informed consent form approved by the New York Institute of Technology Institutional Review Board before participation in the study. Twenty-one healthy subjects, 9 men, and 12 women (mean age 23.2 ± 1.8 years), took part in this study. Subject characteristics are presented in Table 1. Subjects were recruited from the New York Institute of Technology community. They were average full-time college-age students. The subjects were screened for inclusion and exclusion criteria by a health questionnaire that was approved the New York Institute of Technology Institutional Review Board. The inclusion criteria were (a) age range: 18–25 years; (b) subjects who were deemed healthy to exercise according to the Physical Activity Readiness Questionnaire (PAR-Q); (c) subjects who did not engage in regular exercise; and (d) subjects who had a body mass index (BMI) of ≤30 kg·m−2. The exclusion criteria were as follows: (a) subjects who do not fit the inclusion criteria; (b) cardiopulmonary conditions including asthma within the last 6 months; (c) major musculoskeletal injuries over the last 6 months; (d) other health issues that would interfere with a subject's safety during exercise; and (e) a response of “yes” to any of the questions on the PAR-Q resulted in exclusion of the participant. The PAR-Q, a 7-item questionnaire to determine if engaging in exercise is hazardous to an individual's health, was used before exercise testing as a basis for participant exclusionary criteria (1,18).
The subjects were required to attend 1 initial day and 2 days of testing. During the initial day, subjects were screened for inclusion and exclusion criteria, signed the consent form, and were familiarized with the training and testing protocols. Subjects were advised to avoid caffeine, alcohol, heavy exertion, and maintain normal hydration 24 hours before testing. Subjects were tested at the same time of the day. Subjects were randomly assigned testing sample A or B. The testing order was counterbalanced. On day 1 of the study, participants were randomly divided into 2 groups, labeled “sample A” and “sample B.” Sample A participated first in the treadmill condition, comprising brisk walking on a treadmill set at 3.5 miles per hour for 30 minutes. Sample B participated first in the Nintendo Wii Fit condition, comprising the 30-minute “Free Run” program. On the second day of the study, sample A performed the Nintendo Wii Fit condition and sample B performed the treadmill condition. The exercise conditions were separated by 1 week. Baseline measurements of physiologic parameters were taken before beginning each modality of exercise and included height, weight, heart rate, blood pressure, and respiratory rate. All physiological measurements were measured manually with standard laboratory equipment including a standing blood pressure cuff (Standby; WA Baum, Copiaque, NY, USA), a stethoscope (3M Littman; Littman, St. Paul, MN, USA), a digital body weight scale, stopwatch, and measuring tape. The SEES is a scale that measures a global psychological response to exercise. The scale contains 3 categories: positive well-being, psychological distress, and fatigue (13). The scale was completed before and immediately after each exercise condition.
The Nintendo Wii Fit (Model No. RVL-001; Nintendo), which has an active video game console and detects movements in 3 dimensions, was used for the video exergaming modality. The subjects were instructed to use the Wii Fit as they would in their own home. They were not given a set pace. They were instructed they could walk, jog, run, or any combination throughout the duration of the 30 minutes. Therefore, they exercised at a self-selected pace. A standard treadmill (Quinton Q4500 Stress Test Monitor; Quinton, Bothell, WA, USA) was used for the traditional aerobic exercise condition, which was set at 3.5 miles per hour for 30 minutes. Subjects described their perception of exercise intensity, throughout both exercise-testing conditions, by using the RPE scale. The RPE scale is numerical, ranging from 6 to 20, where 6 indicates “no exertion at all” and 20 indicates “maximal exertion” (3). During each exercise condition, measurements were obtained at 5-minute intervals for heart rate, blood pressure, and RPE. At the conclusion of each exercise condition, measurements of heart rate, blood pressure, respiratory rate, RPE and SEES were recorded and used for subsequent data analysis.
Statistical analyses were performed using SPSS (Windows version 15.0; SPSS, Chicago, IL, USA) using a repeated-measures design. The independent variables were the Nintendo Wii Fit and the treadmill exercise at 3.5 mph. The dependent variables were heart rate, RPP, ventilation rate, RPE, and the SEES. Paired t-tests were performed on each dependent variable to compare the 2 exercise conditions. The magnitudes of the difference between the 2 exercise conditions were calculated by the effect size (ES) (17). The magnitude of the difference was considered as small (0.2–0.5), medium (0.5–0.8), and large (>.0.8). A priori sample size calculations revealed that at least 15 subjects were required to detect observed differences at a power of 80%. Statistical significance for this study was set at p ≤ 0.05.
The means and SDs of the physiological and psychological responses after the 2 exercise conditions are presented in Table 2. As demonstrated in Table 2, significant differences were noted between exercise conditions on paired t-tests for heart rate, RPP, RPE, and positive well-being. Heart rate and RPP were significant even when correcting with Bonferroni's adjustment to reduce the chance of making a type I error. There were no significant differences between groups for ventilation rate, psychological distress, and fatigue. The mean maximum heart rate (HRmax) achieved when exercising using the Wii Fit was 142.4 b·min−1, which was 15% higher and significantly different (p = 0.001, ES = 1.10) than mean HRmax achieved when exercising on the treadmill (123.2 b·min−1). The ES calculated represents a large ES for heart rate. The maximum heart rates for each subject attained during the exercise conditions are illustrated in Figure 1. The RPP, calculated by the highest positive product of systolic blood pressure and heart rate achieved by each participant, is a marker of the oxygen requirements of the heart. The mean RPP when playing Wii Fit was 18% higher and significantly different (p = 0.001, ES = 0.90) compared with treadmill brisk walking. The ES calculated represents a large ES for RPP.
Participants' RPE, based on the Borg Scale, when playing Wii Fit was 20% higher and significantly different (p = 0.014, ES = 0.83) compared with brisk walking on the treadmill. The ES calculated represents a large ES for RPE. Participants' mean perceived exercise intensity using the Wii Fit was “somewhat hard” and ranged, on average, from “light” to “hard.” The mean RPE when brisk walking on the treadmill was “light” and ranged from “extremely light” to “somewhat hard.”
Using the SEES, it was found that participants' positive well-being (a summation of scores for “great,” “positive,” “strong” and “terrific”) when playing Wii Fit decreased from preexercise to postexercise (−0.48 ± 3.12). However, when brisk walking on the treadmill, mean positive well-being increased from preexercise to postexercise (1.43 ± 3.17). There was a significant difference (p = 0.018, ES = 0.61) between the 2 exercise conditions regarding positive well-being. The ES calculated represents a medium ES for positive well-being. Psychological distress (a summation of scores for “awful,” “crummy,” “discouraged” and “miserable”) decreased when playing Nintendo Wii Fit (−0.48 ± 1.97) as did mean psychological distress when brisk walking on the treadmill (−0.76 ± 1.89); however, there was a significant difference between the exercise conditions. Feelings of fatigue (a summation of scores for “drained,” “exhausted,” “fatigue,” and “tired”) increased comparably after both exercise conditions.
This investigation compared the physiological and psychological responses of 30 minutes of playing Nintendo Wii Fit to 30 minutes of brisk walking in sedentary college-age adults. The results of this study discovered Wii Fit to be superior to brisk walking on a treadmill in regards to elevating heart rate, RPP, and RPE and to be inferior for improving positive well-being. On average, the maximum heart rate produced while playing Wii Fit was greater than the maximum heart rate elicited from treadmill brisk walking exercise when each exercise was performed for an equal duration of time. Playing Wii Fit also demanded greater oxygen requirements for the heart as demonstrated by the higher RPP evoked when exercising with Wii Fit as compared with treadmill brisk walking. Rate pressure product has not been previously investigated as a result of video exergaming. Accordingly, participants of our study perceived their exertion to be greater when playing Wii Fit. However, positive well-being according to the SEES questionnaire was significantly decreased after the Wii Fit exercise probably because of the greater physiological demands of the exercise. American College of Sports Medicine guidelines list walking at 3.5 mph as moderate intensity (10). Miyachi et al. (14) also categorized the Wii Fit aerobics as moderate intensity. However, in our direct comparison, there was significant difference between the 2 based on physiological data and participant perception. Our results demonstrate that playing the Wii Fit can be used as a physical activity that can meet ACSM requirements for exercise intensity.
The physiologic findings from this study were comparable with other similar studies (6–9,14,20). Our results are in agreement with Graf et al. (8) who compared in children brisk treadmill walking at 3.5 mph vs. Nintendo Wii Sports and Dance Dance Revolution (Konami Digital Entertainment, Redwood City, CA, USA). They concluded that energy expenditure, heart rate, and perceived exertion were similar or even higher than moderate-intensity walking. Siegel et al. (20) also investigated the effects of active video gaming in a similar-age population and concluded that a 30-minute session is within ACSM recommendations for daily activity. Their mean heart rate attained was 162.82 ± 10.78 and their RPE reported was 14.0 ± 2.04. This was higher than our 142.4 ± 20.5 for heart rate and 12.7 ± 3.0 for RPE. However, their subjects were considered overweight with a BMI of 26.5 ± 4.5 vs. our BMI of 23.7 ± 3.7.The subjects in our study were sedentary while the information concerning the exercise habits was not available for the study by Siegel et al. The overall results were similar between the 2 studies except that we also compared exercise gaming with a traditional aerobic exercise. Our results also compare with the findings of Guderian et al (9), who investigated Wii Fit exercise in middle-aged and older adults and concluded that it fulfills the ACSM guidelines for improving cardiorespiratory health. However, they did not provide a direct comparison to a traditional exercise modality as was performed in this study. Lanningham-Foster et al. (12) state that although active video games have the potential to increase energy expenditure, they concluded that there is a need to evaluate them as a substitute for real sports or free play. Our study has provided a direct comparison between video gaming and traditional exercise. Graves et al. (7) performed a comparison similar to our study between Wii Fit and traditional aerobic exercise in adolescents, young adults, and older adults. They reported mean heart rate values of 94.5 ± 10.1 for the Wii Fit vs. 108.3 ± 11.4 for brisk treadmill walk in young adults. They concluded that the heart rate for the Wii Fit fell below the minimum ACSM recommendations. However, their exercise protocol used was only 10 minutes, which is also below ACSM recommendations for exercise duration. They also did not provide any information on whether their subjects were active or sedentary.
One reason for lack of participation in physical activity is the perception that exercise is not an enjoyable activity. To gauge subjective feelings toward playing Nintendo Wii Fit and treadmill brisk walking, each participant was surveyed pre- and postexercise using the SEES scale that measures a global psychological response to exercise. Previous research has shown that physical activity has the ability to improve mood and psychological responses (2,4,11,13,19). To the author's knowledge, there is a lack of research performed on the psychological benefits of video exergaming. Based on this concept that physical activity improves mood, we originally hypothesized that playing Wii Fit would provide superior psychological responses in comparison to traditional treadmill exercise. However, based on responses to the mood scale administered, participants' subjective feelings of positive well-being decreased from pre- to postexercise when playing Wii Fit and increased when brisk walking on the treadmill. These finding are in agreement with Ekkekakis et al. (4) who concluded that increasing intensity reduces positive psychological responses especially in low-fit individuals. Research has demonstrated that sedentary subjects will not respond the same psychologically as trained or fit subjects to acute bouts of aerobic exercise (2,4,5,19). One explanation for the less favorable subjective response from participants playing Wii Fit may be because of the greater physiological intensity they attained during their self-selected pace. Focht et al. (5) state that the participants' sedentary status and their perception of the demands of the exercise session may contribute to negative psychological states after exercise. The participants in this study were individuals who do not regularly exercise and, therefore, may perceive having to exercise harder in a negative manner. Although there was a difference on positive well-being between the 2 types of exercise, psychological distress decreased similarly from pre- to postexercise for both Wii Fit and treadmill brisk walking. A decrease in psychological distress can be viewed as a favorable response to acute exercise. Perception of fatigue also increased equally from pre- to postexercise for both modalities of exercise.
This study only tested the Nintendo Wii Fit “Free Run” program. The results of this study, therefore, cannot be applied to all Nintendo Wii Fit exercise programs. Testing was only conducted in 1 session per exercise modality, limiting our ability to draw conclusions on long-term effects and benefits. The long-term physiological responses and compliance to video exergaming should be investigated, because it is usually performed alone eliminating the social aspect of exercise. The potential for the Hawthorne effect to have taken place existed, because participants were asked to exercise in an environment where they were constantly being monitored and evaluated. This may have altered the way in which participants exercised and may not be an accurate reflection of how participants would use this equipment in their own homes. Future studies should also evaluate the physiologic and psychological responses of high-fit young adults as they may differ from our sedentary population.
This study has shown that when playing Nintendo Wii Fit “Free Run” with a self-selected intensity, college students have the potential to surpass exercise intensities achieved when performing a conventional standard for moderate-intensity exercise, brisk walking on a treadmill. Novice practitioners and sedentary individuals should be aware that the intensity of exercise that they may attain at their self-selected pace might result in negative psychological responses after exercise. Based on these results, it can be concluded that Nintendo Wii Fit “Free Run” may act as an alternative to traditional moderate-intensity aerobic exercise in fulfilling ACSM requirements for physical activity.
College-age young adults are experiencing the most rapid decline in physical activity participation when compared with other age groups. Health professionals must be aware of all new exercise programs that will increase physical activity in this population. The emergence of exergaming has created a new trend in exercise. The Nintendo Wii Fit is advertised as a way to exercise in the comforts of your own home. The intensity that can be attained is sufficient for fulfilling the ACSM requirements for physical activity. Our results support the use of the Nintendo Wii Fit as another option to traditional exercise in improving and maintaining the aerobic fitness of sedentary college-age adults.
We did not receive any funding for this study. The results of this current study do not constitute endorsement of any of the products by the authors or the National Strength and Conditioning Association.
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Keywords:Copyright © 2012 by the National Strength & Conditioning Association.
exergaming; moderate-intensity exercise; wellness