Exercise as it relates to Disease/The impact of Active video games on children's physical activity during recess

This page is a critique of the journal article titled The impact of a school-based active video game play intervention on children’s physical activity during recess Duncan M, Staples V. The impact of a school-based active video game play intervention on children's physical activity during recess. Human Movement. 2010 Jun 1;11(1):95-9 What is the background to this research? The World Health Organisation defines physical activity as any bodily movement which requires energy expenditure and also states that physical inactivity is one of the top risk factors for global mortalityWorld Health Organisation, Physical Activity, [2017], available from: http://www.who.int/topics/physical_activity/en/. The recommended physical activity guidelines for children ages 5-12 years is shown below Australian Government; Department of Health, Australia’s Physical Activity and Sedentary Behaviour Guidelines [2014], available from: http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines. Guideline Recommendation Physical Activity At least 60 minutes every day Intensity Moderate-vigorous Strengthening At least 3 days per week Electronic use No more than two hours a day Sitting (sedentary time) Break up long periods as often as possible Specifically, in Australia only one third of children and one in ten young people met the Australian guidelines for physical activity, placing them at higher risk of having poorer physical, mental and social outcomesAustralian Government; Department of Health, Research and Statistics, [2014], Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-active-evidence.htm. Playing video games has previously contributed to sedentary time and has been shown to be related to a higher weight status in childrenVandewater EA, Shim MS, Caplovitz AG. Linking obesity and activity level with children's television and video game use. Journal of adolescence. 2004 Feb 29;27(1):71-85. Active video games are electronic games which encourage movement and physical activity in the participation of the gameFoley L, Maddison R. Use of active video games to increase physical activity in children: a (virtual) reality?. Pediatric exercise science. 2010 Feb;22(1):7-20. By doing so, this incorporates the preferred pass time of the child into their completion of the recommended daily physical activity. While many studies have observed the effect of active video games on energy expenditure in comparison with sedentary time Biddiss E, Irwin J. Active video games to promote physical activity in children and youth: a systematic review. Archives of pediatrics & adolescent medicine. 2010 Jul 5;164(7):664-72, this study aimed to observe the effect of active video games on physical activity in comparison with traditional school recess activities. Where is the research from? This research was conducted with children from 2 different schools in central England. The research team was based out of Coventry University and the University of Derby in the United Kingdom. As this study was not observing Australian participants, some demographic differences are evident, however the physical activity guidelines and statistics above are Australian. What kind of research was this? This research is a clinical trial, specifically a randomised controlled trial in which participants are randomly selected in to the treatment group or the control group. This type of methodology is considered the gold standard procedure for clinical trials. What did the research involve? 15 children from 2 primary schools aged 10-11 years were randomly allocated to join a 6 week physical activity program which utilised active video games as the only source of exercise during recess. Another 15 children aged 10-11 years from the same schools were allocated to a control group which participated in traditional recess physical activity. The children who were allocated to the treatment group would participate in 30 minute active video game play sessions twice a week for 6 weeks in replacement of their usual recess activity. Three different video games from the Nintendo Wii were rotated during each session to avoid children becoming bored. The children’s physical activity was observed at three intervals during the study by measuring their step count (pedometry) and their heart rate which was later interpreted into intensity. During the study, the researchers ensured that the children were all of similar demographics and that they understood the games well enough to sufficiently participate in the exercise. This methodology, while it was randomised and controlled, had several limitations which may have affected the overall results. No eligibility criteria were put into place to ensure that both groups were of similar demographics. This meant that certain characteristics of the children, such as mobility status, developmental progression and baseline sedentary behaviour were not analysed prior to the study. Also the children and assessors were not blinded to the intervention allocation and therefore a placebo or bias effect may have been evident. While a control group was utilised, the traditional recess activities in which the control children participated in were not defined or listed at any time during the study. This meant that some of the control children may have been participating in high intensity physical activity while others may have been completely sedentary the whole time. This also means that the level of physical activity which the control children reached may have been limited by weather and equipment limitations which were not stated. These limitations thereby reduce the reliability and validity of the research conclusions. What were the basic results? The researchers found that during the first week of the treatment, the children participating in the active game play showed an increased number of step/min. However, during the final week of the treatment, the children who participated in their normal recess activity were taking more steps during their play time. They also observed that in regards to heart rate, the children who participated in the active game play spent less time in moderate to vigorous physical activity throughout the entire study than those who didn’t. Outcome measure Active video game play Traditional play Steps/min in week 1 28.9 27 Steps/min in week 6 19.3 25.1 High intensity exercise week 1 15.9% 23.1% High intensity exercise week 6 12.1% 25.2% What conclusions can we take from this research? While many studies have previously shown that active video games increased energy expenditure and heart rate in children when compared to sedentary time, this study went one step further to examine the optimal school activity for children . The authors concluded that active video games only increased physical activity during the first week of a 6 week program. For the rest of the program, the authors concluded that traditional recess activities were more beneficial in terms of steps taken and heart rate increases. The authors finally state that although there is an acute effect on baseline physical activity, over long periods of time, children are more likely to reach physical activity guidelines when participating in traditional recess activities. Practical advice While this study did show that children who participated in traditional recess activities were more “active” than those who played active video games over a longer period of time, many limitations make this conclusion unreliable and possibly invalid. Many previous studies have shown that participating in active video games is more beneficial than complete sedentary time Barnett A, Cerin E, Baranowski T. Active video games for youth: a systematic review. Journal of Physical Activity and Health. 2011 Jul;8(5):724-37. However, the argument that active video games are more beneficial that traditional school play time is still in need of further reliable research. Further information/resources Australian government, Department of Health; Australian Physical Activity and Sedentary Behaviour Guidelines http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines/$File/FS-Children-5-12-Years.PDF Australian Government, Department of Health; Tips and Ideas for physical activity promotion http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines/$File/Tips&Ideas-Children-5-12years.PDF Australian Sports Commission; Yulunga Traditional Indigenous Games https://www.sportingschools.gov.au/resources-and-pd/schools/yulunga Sleep Health Foundation: Technology and Sleep https://www.sleephealthfoundation.org.au/pdfs/TechnologyandSleep-0416.pdf American Heart Association: 8 Best Active Video Games for Kids https://halleheartchildrensmuseum.org/8-best-active-video-games-kids/ References