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Exergaming for Physical Activity: A Systematic Review

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Title: Exergaming for Physical Activity: A Systematic Review
Language: English
Authors: Jacob C. Davis, Lauren G. Killen (ORCID 0000-0003-0935-7594), J. Matt Green, Hunter S. Waldman (ORCID 0000-0001-5707-5642), Lee G. Renfroe
Source: Journal of American College Health. 2024 72(7):2090-2098.
Availability: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 9
Publication Date: 2024
Document Type: Journal Articles
Information Analyses
Descriptors: Physical Activities, Exercise, Young Adults, Video Games, Human Body, Exercise Physiology, Psychological Patterns, Attitudes
DOI: 10.1080/07448481.2022.2103377
ISSN: 0744-8481
1940-3208
Abstract: Objective: This review evaluates current literature on intensity selection, perceptual responses, activity enjoyment and adherence rates of exergaming. Methods: The literature search identified manuscripts that investigated exercise intensity, perceptual responses, or exercise adherence of exergaming in young adults. Results: Based on results of 29 studies, the current review suggest some exergaming activities have the potential to elicit moderate to vigorous exercise intensity and could potentially be substituted for traditional exercise. Additionally, exergame activities may aid in the start of exercise adherence by lowering the individual's perceived exertion when playing exergames. Exergaming not only has the potential to enhance enjoyment through an exercise objective but also through the distracting nature of video games. Conclusions: Exergaming shows potential to be substituted for traditional exercise and could offer a new, varied form of exercise for sedentary individuals. Future research should examine the influence of exergaming experience on intensity selection and adherence rates.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1438305
Database: ERIC
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  Value: <anid>AN0179435548;acl01oct.24;2024Sep06.05:51;v2.2.500</anid> <title id="AN0179435548-1">Exergaming for physical activity: A systematic review </title> <p>Objective: This review evaluates current literature on intensity selection, perceptual responses, activity enjoyment and adherence rates of exergaming. Methods: The literature search identified manuscripts that investigated exercise intensity, perceptual responses, or exercise adherence of exergaming in young adults. Results: Based on results of 29 studies, the current review suggest some exergaming activities have the potential to elicit moderate to vigorous exercise intensity and could potentially be substituted for traditional exercise. Additionally, exergame activities may aid in the start of exercise adherence by lowering the individual's perceived exertion when playing exergames. Exergaming not only has the potential to enhance enjoyment through an exercise objective but also through the distracting nature of video games. Conclusions: Exergaming shows potential to be substituted for traditional exercise and could offer a new, varied form of exercise for sedentary individuals. Future research should examine the influence of exergaming experience on intensity selection and adherence rates.</p> <p>Keywords: Exercise; exercise enjoyment; exergaming intensity; videogaming</p> <hd id="AN0179435548-2">Introduction</hd> <p>Despite known benefits of physical activity, roughly 25% of college-aged individuals remain inactive,[<reflink idref="bib1" id="ref1">1</reflink>] with greater than 50% of an average day spent sedentary.[<reflink idref="bib2" id="ref2">2</reflink>] A contributing factor of physical inactivity in a college-age population is video games, with 72% of men and 49% of women 30 years old and younger participating in gaming.[<reflink idref="bib3" id="ref3">3</reflink>] As the video game industry is expected to reach 20.28 billion dollars by 2020 with more than 2 billion video gamers worldwide,[<reflink idref="bib4" id="ref4">4</reflink>] it is beneficial to examine activities potentially influencing sedentary time and exercise engagement and adherence for this population. Provided a high engagement of gaming in this population, exergaming may effectively promote regular physical activity.</p> <p>A previous review suggested exergaming has shown potential in achieving adequate energy expenditure to reach the recommended amount of physical activity in a population 6–18 years old.[<reflink idref="bib5" id="ref5">5</reflink>] Although valuable information, that review focused solely on a youth population with a variety of exergaming modalities likely suitable only for a younger population. In addition to youth, Bryan et al[<reflink idref="bib6" id="ref6">6</reflink>] and Siegel et al[<reflink idref="bib7" id="ref7">7</reflink>] suggested adults 18–35 years of age can achieve the American College of Sports Medicine (ACSM) energy expenditure recommendation of 1000 kcal/week by engaging in exergaming 30 min/day, five times a week.[<reflink idref="bib8" id="ref8">8</reflink>] However, while previous exergaming studies allowed participants to exercise at a moderate intensity,[<reflink idref="bib6" id="ref9">6</reflink>],[<reflink idref="bib7" id="ref10">7</reflink>] research suggests some exergames only prompt light intensity based on energy expenditure values.[<reflink idref="bib9" id="ref11">9</reflink>]</p> <p>A common exergaming console used in both youth and adult populations is the Nintendo Wii. Barkley & Penko,[<reflink idref="bib10" id="ref12">10</reflink>] found Wii sports games such as boxing can elicit a significantly higher VO<subs>2</subs> in comparison to treadmill walking at 2.5 mph (15.4 ± 4.5 ml/kg/min vs. 10.4 ± 0.9 ml/kg/min); however, although VO<subs>2</subs> was higher, the difference was not significant when comparing boxing to a self-selected brisk walking pace (16.3 ± 4.8 ml/kg/min vs. 19.7 ± 4.2 ml/kg/min)[<reflink idref="bib11" id="ref13">11</reflink>] suggesting similar metabolic and physiological responses between the two activities. In addition to sport type exergaming activities, some modalities involve cardiovascular equipment (eg, treadmills, stationary bicycles, etc). Previous research found the use of an interactive cycling game resulted in a higher %VO<subs>2</subs> max vs. traditional stationary cycling at self-selected paces (78.8 ± 2.1% vs. 63.5 ± 3.1%) (34 ± 17% at 25% max power output and 18 ± 12% at 50% max power output).[<reflink idref="bib12" id="ref14">12</reflink>],[<reflink idref="bib13" id="ref15">13</reflink>]</p> <p>In addition to physiological benefits, exergaming has influenced perceptual measurements. When rating of perceived exertion (RPE) estimations were compared between interactive video cycling and traditional cycling sessions, they were not significantly different between trials despite the higher intensity selected during the gaming trial.[<reflink idref="bib13" id="ref16">13</reflink>],[<reflink idref="bib14" id="ref17">14</reflink>] In contrast, Barkley & Penko[<reflink idref="bib10" id="ref18">10</reflink>] reported the higher intensity Wii boxing activity resulted in a significantly higher RPE in comparison to treadmill walking. However, despite the higher RPE for boxing, participants liked it more than treadmill walking.[<reflink idref="bib10" id="ref19">10</reflink>] Therefore, it could be suggested that exergaming activity should not only result in similar or higher intensity selection to traditional activity, but also promote greater enjoyment. At least in some cases, it seems introduction of the gaming aspect alters the commonly anticipated coupling of RPE with acute intensity.[<reflink idref="bib10" id="ref20">10</reflink>] This disruption may be explained by the diversion associated with enjoyment and gaming. More work is needed for a definitive answer.</p> <p>The enhanced enjoyment associated with exergaming could potentially lead to increasing physical activity levels of inactive adults irrespective of altered physiological or perceptual responses. Further, it is reasonable that intensity for some participants during gaming reaches the minimum threshold typically associated with exercise prescriptions based on professional guidelines.[[<reflink idref="bib5" id="ref21">5</reflink>], [<reflink idref="bib7" id="ref22">7</reflink>]],[<reflink idref="bib11" id="ref23">11</reflink>] Further, it can be argued that lower intensity activity is preferable to sedentary activity making gaming an attractive option particularly if adherence is positively augmented. This systematic review critically reviewed the published, peer-reviewed literature to investigate intensity selection, perceptual responses, activity enjoyment and adherence rates. This review also provides methodological and future research recommendations to provide a better understanding to using exergaming as a modality for encouraging physical activity.</p> <hd id="AN0179435548-3">Methods</hd> <p>The search strategy for this review was to identify manuscripts that investigated exercise intensity selection, perceptual responses, and exercise adherence with the use of exergaming in a young adult population. EbscoHost, Google Scholar, Research Gate, PubMed, and Science Direct were the database search engines used to locate literature. The following keywords were used either independently or in a combination to search for literature "active," "energy expenditure," "enjoyment," "exercise," "exergame," "exergaming," "gaming," "gaming bike," "healthy benefits," "heart rate," "intensity," "oxygen consumption," "virtual cycling," "virtual reality," "videogames," "VO<subs>2,</subs>" "Xbox Kinect," "Wii." Review articles and editorials were excluded; however, they were used to identify additional existing literature.</p> <p>A total of 66 articles were identified for this review. For this review, at least one of the following criteria had to be mentioned: energy expenditure, heart rate, RPE, enjoyment, or adherence with exergaming being involved. A total of 36 studies were excluded from this review due to: lack of physiological responses, focus on cognitive responses, were systematic reviews, or focused on rehabilitation variables without any physiological responses. Following omission of articles due to exclusionary criteria, a total of 29 studies with a variety of exergaming activities focusing on physiological and perceptual responses remained and were included in this review. A summary of published exergaming studies that examine the impact on physical activity is listed in Table 1.</p> <p>Table 1. Summary of exergaming studies.</p> <p> <ephtml> <table><thead><tr><td>Author</td><td>Participants</td><td>EG activity</td><td>Main findings</td></tr></thead><tbody valign="top"><tr><td>Barkley et al<xref ref-type="bibr" rid="bibr10">10</xref></td><td char="."><italic>n</italic> = 12, males: age 35.7 ± 13.3 yrs; females: age 27.3 ± 10.9 yrs</td><td>Wii Boxing</td><td char=".">Wii Boxing had sig.↑ avg HR (121 ± 12 bpm), VO<sub>2</sub> (15.4 ± 4.5 ml/kg/min), RPE (13.3 ± 1.7) and liking (9.1 ± 1.0 cm; used visual analog scale) vs. treadmill walking at 2.5 mph. Wii Boxing elicited a mod. Intensity (4.2 ± 0.9 METs).</td></tr><tr><td>Barry et al<xref ref-type="bibr" rid="bibr15">15</xref></td><td char="."><italic>n</italic> = 50, age 33.8 ± 12.7 yrs</td><td>Xbox 360 Kinect</td><td>Acute RPE was sig. ↓ in the Kinect™ group. Exergaming elicited mod. to vig. levels of exercise.</td></tr><tr><td>Barry et al<xref ref-type="bibr" rid="bibr16">16</xref></td><td char="."><italic>n</italic> = 19, age 23 ± 3 yrs</td><td>Xbox 360 Kinect Reflex Ridge</td><td>Exergames elicited mod. levels of intensity based on %Hrmax and %VO<sub>2</sub> max, but achieved vig. intensity based on METs.</td></tr><tr><td>Bryan et al<xref ref-type="bibr" rid="bibr6">6</xref></td><td char="."><italic>n</italic> = 117, Age 22.7 ± 2.3 yrs</td><td>Golds Gym, Biggest Loser, Just Dance, Your shape</td><td char=".">Avg. HR for all games was 125 ± 20 bpm and the average EE was 6.7 ± 2.1 kcal/min, suggesting a mod. intensity was achieved.</td></tr><tr><td>Debska et al<xref ref-type="bibr" rid="bibr17">17</xref></td><td char="."><italic>n</italic> = 61, Omni Treadmill Group: female n = 6, age 28.3 ± 11.6 yrs, male n= 30, age 25.6 ± 8.2 yrs. Icaros Pro Group: females n =4, age 32.0 ± 13.0 yrs, males n = 21 age 24.71 ± 8.65 yrs</td><td>Omni treadmill</td><td char=".">Avg. enjoyment and % HR max were significantly ↑ for Omni treadmill (enjoyment 5.74 ± 0.86; 76.8% HRmax) than the Icaros Pro flight simulator (enjoyment 5.60 ± 0.88; 62.5% HRmax).</td></tr><tr><td>Devereaux et al<xref ref-type="bibr" rid="bibr18">18</xref></td><td char="."><italic>n</italic> = 12, Age: males: 21.4 ± 1.14 yrs; females: 22.1 ± 1.35 yrs</td><td>Wii Fit Plus</td><td>With matched intensity, acute RPE for Nintendo Wii (9.57) was ↓ than cycle ergometer (10.85), and treadmill (10.43). Session RPE was sig. ↓ for Nintendo Wii (9.50), and treadmill (9.92) vs. cycle ergometer (11.08).</td></tr><tr><td>Douris et al<xref ref-type="bibr" rid="bibr19">19</xref></td><td char="."><italic>n</italic> = 21, Age 23.2 ± 1.8 yrs</td><td>Wii Fit Run</td><td char=".">Mean HR max for Wii Fit (142 ± 20 bpm) was sig. ↑ than brisk treadmill walking (123 ± 14 bpm). There is potential to reach mod. intensity. Wii Fit RPE (12.7 ± 3.0) was sig. ↑ compared to brisk treadmill walking (10.1 ± 3.3).</td></tr><tr><td>Duncan<xref ref-type="bibr" rid="bibr20">20</xref></td><td char="."><italic>n</italic> = 30, Age 21.3 ± 2.4 yrs</td><td>Gamercize Power Stepper and Wii Just Dance</td><td char=".">Just Dance elicited EE of 37.8 ± 21 kcals/10-minutes with Gamercize Power Stepping achieving 56.2 ± 14.5 kcals/10-minutes, both considered a mod. intensity. Females enjoyed playing Wii sig. more than males.</td></tr><tr><td>Graves et al<xref ref-type="bibr" rid="bibr21">21</xref></td><td char=".">Adolescents: <italic>n</italic> = 14, 15.8 ± 1.3 yrs; Young adults: n = 15, 28.2 ± 4.6 yrs; Older adults: n = 13, 57.6 ± 6.7 yrs</td><td>Wii Fit (Yoga, Muscle Conditioning, Balance, Aerobics)</td><td char=".">Mod. intensity was achieved with an avg. MET value of 3.6 ± 0.8 METs and an avg. of 51% of age predicted max HR. Enjoyment was sig. ↑ for Wii Aerobics vs. treadmill walking/jogging.</td></tr><tr><td>Howe et al<xref ref-type="bibr" rid="bibr22">22</xref></td><td char="."><italic>n</italic> = 53, Ages 21.8 ± 1.9 yrs</td><td>Kinect Football, Dance Central 2, Reflex Ridge, Zumba Fitness</td><td char=".">Kinect Sports football elicited 3.8 ± 0.1 METs, Dance Central 2 (6.1 ± 0.2 MET), Reflex Ridge (7.0 ± 0.3 MET) and Zumba Fitness (7.4 ± 0.3 METs). These exergames elicited mod. to vig. levels of intensity.</td></tr><tr><td>Kraft et al<xref ref-type="bibr" rid="bibr14">14</xref></td><td char="."><italic>n</italic> = 37, Ages men: 23.15 ± 8.12 yrs; women: 20.59 ± 2.18 yrs</td><td>Gaming bike, Dance Dance Revolution</td><td char=".">Gaming Bike (GB) avg. HR, and min. at THR was sig. ↑ (57% HRR and 22.5 ± 11.1 min) than DDR (37% HRR and 11.2 ± 11.9 min) or CE (42% HRR and 14.2 ± 12.6 min). Acute RPE for GB (4.2 ± 1.5) and CE (3.8 ± 1.2) was sig. ↑ than DDR (2.7 ± 1.3). Session RPE was sig.↑ for GB (4.6 ± 1.7) and CE (4.1 ± 1.6) than DDR (2.8 ± 1.5).</td></tr><tr><td>Leatherdale et al<xref ref-type="bibr" rid="bibr23">23</xref></td><td char="."><italic>n</italic> = 51, Age 18.9 ± 0.9 yrs</td><td>Wii Tennis</td><td char=".">Wii Tennis elicited a MET value of 5.4 ± 2.6, suggesting a mod. intensity.</td></tr><tr><td>Miyachi et al<xref ref-type="bibr" rid="bibr24">24</xref></td><td char="."><italic>n</italic> = 12, Age 34.0 ± 6.0 yrs</td><td>Wii Fit Plus Balance and Resistance Exercises, Yoga and Aerobic Exercises, and Wii Sports</td><td char=".">The exergames Wii Fit Plus Resistance (3.2 ± 1.2 METs), Aerobic Exercise (3.4 ± 0.9), and Wii Sports Boxing (4.2 ± 0.9), tennis (3.0 ± 0.8), and Baseball (3.0 ± 0.7 METs) achieved mod. intensity based on MET values; however, Golf (2.0 ± 0.3 METs) and Bowling (2.7 ± 0.6 METs) only achieved a light intensity.</td></tr><tr><td>Noah et al<xref ref-type="bibr" rid="bibr25">25</xref></td><td char="."><italic>n</italic> = 12, Age 27.2 ± 11.3 yrs</td><td>Dance Dance Revolution</td><td>DDR elicited vig. intensity at 8 METs. Subjects reported that DDR is fun, and that the competitive nature of playing with others is enjoyable.</td></tr><tr><td>O'Donovan et al<xref ref-type="bibr" rid="bibr9">9</xref></td><td char="."><italic>n</italic> = 14, Age 21.0 ± 3.0 yrs</td><td>Xbox Kinect/ Wii Boxing</td><td char=".">All gaming conditions elicited a moderate intensity based on MET values 4.51 ± 1.21 − 3.14 ± 1.03.</td></tr><tr><td>O'Donovan and Hussey<xref ref-type="bibr" rid="bibr26">26</xref></td><td char="."><italic>n</italic> = 28, Age males: 23.0 ± 1.0 yrs; females: 22.0 ± 3.0 yrs</td><td>Wii Sports Boxing, Tennis, and Baseball or Wii Boxing and Wii Fit Free Jogging</td><td char=".">Mean %HRmax and METs for Wii Fit Free Jogging (71 ± 13 %HRmax, 5.9 ± 1.8 METs); Wii Boxing (58 ± 13 %HRmax, 3.2 ± 1.1 METs); Wii Baseball (42 ± 6 %HRmax, 2.0 ± 0.5 METs); and Wii Tennis (42 ± 7 %HRmax, 2.0 ± 0.4 METs).</td></tr><tr><td>Perusek et al<xref ref-type="bibr" rid="bibr27">27</xref></td><td><italic>n</italic> = 29, Age 25.6 yrs</td><td>Heavy bag boxing/Wii Boxing</td><td char=".">Bag boxing elicited a sig. ↑ HR (156 ± 17 bpm vs. 138 ± 23 bpm) and RPE (13.8 ± 1.6 vs. 11.4 ± 2.0) vs. Wii boxing. However, EE was not sig. different between the two (bag, 8.0 ± 2.8 kcal/min; Wii, 7.1 ± 2.3 kcal/min).</td></tr><tr><td>Roopchand-Martin et al<xref ref-type="bibr" rid="bibr28">28</xref></td><td char="."><italic>n</italic> = 24, Age 20.63 ± 1.5 yrs</td><td>Just Dance 4</td><td char=".">100% adherence rate was achieved for a six-week program. Nine (37.5%) participants continued to engage in this form of exercise at least 3-days per week over the 3-month post intervention follow-up period.</td></tr><tr><td>Roure et al<xref ref-type="bibr" rid="bibr12">12</xref></td><td char="."><italic>n</italic> = 60, Age 20.8 ± 1.3 yrs</td><td>Exergame cycling (Greedy Rabbit)</td><td char=".">Exergame cycling ↑ cadence (103.8 ± 7.10 rpms vs. 84.1 ± 12.1rpms), %VO<sub>2</sub> max (78.8 ± 2.1% vs. 63.5 ± 3.1%), and %HR max (89.2 ± 1.3% vs. 78.0 ± 2.0%) vs. traditional cycling. Cycling intensity elicited vig. intensity. Exergame group reported ↑ scores for instant enjoyment and attention demand.</td></tr><tr><td>Samendinger et al<xref ref-type="bibr" rid="bibr29">29</xref></td><td char="."><italic>n</italic> = 85, Age 44.9 ± 9.5 yrs</td><td>Cycle ergometer with virtual partner</td><td>Wattage selection was not sig. diff when comparing cycling intensity selection between 75%-90% HRmax with another rider (coactive group), cycling with performance dependent on virtual partner (conjunctive group), or cycling alone (control group). Self-efficacy and enjoyment were sig. related to effort in the more intense interval sessions.</td></tr><tr><td>Schneekloth and Brown<xref ref-type="bibr" rid="bibr30">30</xref></td><td char="."><italic>n</italic> = 8, Age 33.0 ± 3.0 yrs</td><td>Zumba class/Kinect Zumba</td><td char=".">Traditional Zumba class resulted in ↓ sedentary time (3.3 ± 0.8 min vs. 7.8 ± 3.2 min) and ↑ vigorous intensity (22.0 ± 12.0 vs. 14.2 ± 12.8 minutes) vs. Kinect Zumba.</td></tr><tr><td>Sell et al<xref ref-type="bibr" rid="bibr31">31</xref></td><td char="."><italic>n</italic> = 19, Age 21.8 ± 3.5 yrs</td><td>Dance Dance Revolution</td><td char=".">Experienced players achieved a mod. intensity (47.7 ± 8.4 %VO<sub>2</sub>R) vs. a light intensity for inexperienced players (18.0 ± 4.2 %VO<sub>2</sub>R).</td></tr><tr><td>Siegel et al<xref ref-type="bibr" rid="bibr7">7</xref></td><td char="."><italic>n</italic> = 13, Age 26.6 ± 5.7 yrs</td><td char=".">3-Kick (Lighted pads), Bike connected to racing game (Disney's Cars Piston Cup Race, and Jackie Chan Studio Fitness Power Boxing)</td><td char=".">3-Kick resulted in a similar VO<sub>2</sub> (17.47 ± 4.79 ml/kg/min) to the bike game (15.60 ± 4.30 ml/kg/min) but was sig. ↑ to boxing (12.41 ± 4.36 ml/kg/min). HR values of 3-Kick (166 ± 14 bpm), boxing game (161 ± 14 bpm), and the bike game (159 ± 17 bpm) suggest participants achieved 60% or better of one's HRR.</td></tr><tr><td>Tan et al<xref ref-type="bibr" rid="bibr32">32</xref></td><td char="."><italic>n</italic> = 40, Age 17.5 ± 0.7 yrs</td><td>Dance Dance Revolution</td><td char=".">The dance intensity met minimum ACSM guidelines for cardiorespiratory fitness with the results showing mean HR (137 ± 22 bpm), mean VO<sub>2</sub> (24.6 ± 4.7 ml/kg/min) during the dance simulation game. The reported HR values correspond with 53% on one's HRR and 44% of VO<sub>2</sub>R, achieving a mod. intensity.</td></tr><tr><td>Warburton et al<xref ref-type="bibr" rid="bibr13">13</xref></td><td char="."><italic>n</italic> = 14, Age 25.9 ± 5.6 yrs</td><td>Interactive video game cycling</td><td char=".">During interactive video game exercise, V0<sub>2</sub> was sig. ↑ at 25% of max power output (34 ± 17%) and 50% of max power output (18% ± 12%) compared to traditional stationary cycling. Despite sig. ↑ intensity, there was no sig. difference in RPE between conditions.</td></tr><tr><td>Willems et al<xref ref-type="bibr" rid="bibr11">11</xref></td><td char="."><italic>n</italic> = 10, Age 21.0 ± 1.0 yrs</td><td>Nintendo Wii Sports Tennis, Baseball, and Boxing.</td><td char=".">Nintendo Wii Boxing vs. brisk walking were similar for V0<sub>2</sub> (16.3 ± 4.8 ml/kg/min vs. 19.7 ± 4.2 ml/kg/min), and HR (115 ± 19 bpm vs. 116 ± 15 bpm).</td></tr><tr><td>Worley et al<xref ref-type="bibr" rid="bibr33">33</xref></td><td char="."><italic>n</italic> = 8, Age 21.88 ± 2.20 yrs</td><td>Wii Fit Games (Hula/Step)</td><td>%VO<sub>2</sub> max during intermediate level Wii Step Aerobics and Wii Hula were sig.↑ than beginner; however, it failed to meet mod. intensity level recommendations.</td></tr><tr><td>Wu et al<xref ref-type="bibr" rid="bibr34">34</xref></td><td char="."><italic>n</italic> = 17, Age 22.0 ± 2.9 yrs</td><td>Xbox Kinect (Boxing, Soccer, Tennis, Track and Field, Ping Pong, Beach Volleyball, and Bowling</td><td char=".">Boxing (6.84 ± 1.9 METs) and soccer (6.2 ± 1.7 METs) elicited vigorous intensity. Beach Volleyball (5.7 ± 1.8 METs), track and field (5.0 ± 1.5 METs) and ping-pong (4.0 ± 1.6 METs) elicited mod. intensity. Bowling reached light intensity (2.6 ± 0.8 METs). Males had higher EE among all Exergames due to previous gaming experience and enjoyment.</td></tr><tr><td>Zeng et al<xref ref-type="bibr" rid="bibr35">35</xref></td><td char="."><italic>n</italic> = 12, Age 25.01 ± 4.74 yrs</td><td>VR Cycling vs, Traditional Cycling</td><td char=".">VR cycling achieved 65–85% of age predicted max HR when cycling against a virtual opponent. Sig. ↑ RPE was found during traditional cycling vs. VR-based cycling, despite similar workload. Sig. ↑ enjoyment during the VR-cycling vs. traditional cycling.</td></tr></tbody></table> </ephtml> </p> <hd id="AN0179435548-4">Discussion</hd> <p>Exergaming as an appropriate form of exercise is a novel idea, that could potentially be substituted for traditional exercise with a variety of modalities available. Participating in exergaming can be completed with a variety of gaming consoles or gaming equipment such as bicycles or dance floor pads that are used throughout the activity. Moreover, virtual reality (VR) is an exergaming option in which the individual wears a headset enabling them to see an alternative space in which they complete the activity. In addition to the variety of consoles there exists an array of activities allowing participation involving upper body, lower body, or full body movements. With the variety of modalities, there is the potential to not only achieve an intensity to meet physical activity recommendations, but to also have a positive influence on one's perceptual response and activity enjoyment that could plausibly impact adherence.</p> <p>Therefore, the purpose of this review was to examine the peer-reviewed literature that analyzed intensity selection, perceptual responses, activity enjoyment and adherence rates, while also using this information to provide future research recommendations for a better understanding to using exergaming in place of traditional exercise.</p> <hd id="AN0179435548-5">Physiological responses</hd> <p></p> <hd id="AN0179435548-6">Upper body</hd> <p>Exergaming consoles offer a variety of activities, with several games focusing on upper body movements such as tennis, baseball, golf, and boxing. For the Wii, beach volleyball (5.73 ± 1.8 METs) and ping-pong (4.05 ± 1.59 METs) both elicited a moderate intensity, whereas bowling (2.61 ± 0.77 METs) only achieved a light intensity based on MET values.[<reflink idref="bib34" id="ref24">34</reflink>] When comparing intensities between genders, Wu et al[<reflink idref="bib34" id="ref25">34</reflink>] reported males to have a consistently higher energy expenditure among all exergames and suggested the difference could be explained by exergaming experience and participation enjoyment. Therefore, while substituting traditional exercise for one of these upper body Wii sport games should be used with caution, it is also important to note exergaming would still be preferred over being sedentary.</p> <p>When examining tennis exergaming, equivocal results have been reported when determining if playing intensity is appropriate to be considered a moderate to vigorous exercise according to the ACSM[<reflink idref="bib8" id="ref26">8</reflink>] physical activity recommendations. Previous research found participants had an average MET value of 5.4 ± 2.6[<reflink idref="bib23" id="ref27">23</reflink>] and 3.0 ± 0.8[<reflink idref="bib24" id="ref28">24</reflink>] when playing Wii tennis, suggesting it is an appropriate moderate intensity activity. However, O'Donovan and Hussey[<reflink idref="bib26" id="ref29">26</reflink>] suggest Wii tennis is considered a very light intensity activity based on heart rate with the activity only achieving 42% of one's estimated max heart rate. A potential explanation of the differences could be in the skill level of the participant with O'Donovan and Hussey[<reflink idref="bib26" id="ref30">26</reflink>] reported more skilled individuals sustained lower heart rates due to more efficient controller skill. Additionally, Leatherdale et al[<reflink idref="bib23" id="ref31">23</reflink>] results are based on energy expenditure estimations from the SenseWear armband in which it has been suggested to overestimate with upper body activities[<reflink idref="bib36" id="ref32">36</reflink>]; whereas, percentage of individuals' heart rates represent a relative value.</p> <p>Boxing is another upper body exergame activity that could potentially offer a greater intensity selection by the exerciser due to the nature of muscle involvement in the game with completing punches. The Wii has shown to elicit a moderate intensity when playing Wii boxing suggesting it could be an appropriate activity to achieve physical activity recommendations.[<reflink idref="bib10" id="ref33">10</reflink>],[<reflink idref="bib24" id="ref34">24</reflink>],[<reflink idref="bib26" id="ref35">26</reflink>],[<reflink idref="bib27" id="ref36">27</reflink>] Specifically, when Wii boxing was compared to heavy bag boxing, energy expenditure (EE) was not significantly different between the two (heavy bag 8.0 kcal/min vs. Wii 7.1 kcal/min) despite a significantly higher heart rate (HR) for the heavy bag (156 ± 18 bpm vs. 138 ± 24 bpm).[<reflink idref="bib27" id="ref37">27</reflink>] These findings not only suggest that Wii boxing could provide similar EE as its' real-life counterpart, but also that the activity elicits an intensity that can be classified as moderate intensity based off the percent of one's max heart rate and achieved MET levels. Similar to Perusek et al[<reflink idref="bib27" id="ref38">27</reflink>] and Miyachi et al,[<reflink idref="bib24" id="ref39">24</reflink>] Barkley and Penko[<reflink idref="bib10" id="ref40">10</reflink>] also suggest one can achieve a moderate intensity using Wii boxing based on METs, despite reporting a lower MET value (5.6 ± 1.6 METs and 4.2 ± 0.9 METS vs. 4.4 ± 1.3 METs). The difference in the findings could potentially be explained by the difficulty of the level with participants completing the least difficult level[<reflink idref="bib10" id="ref41">10</reflink>] vs. participants encouraged to simulate heavy bag boxing.[<reflink idref="bib27" id="ref42">27</reflink>] In addition to Wii boxing, the Jackie Chan Studio Boxing resulted in similar intensities to Barkley and Penko[<reflink idref="bib10" id="ref43">10</reflink>] (12.4 ± 4.4 ml/kg/min vs. 15.4 ± 4.5 ml/kg/min) by not only including traditional boxing punches, but also incorporating kickboxing moves with the difficulty of moves increasing throughout the game.[<reflink idref="bib7" id="ref44">7</reflink>] However, it should be noted the Xbox Kinect boxing was also found to elicit vigorous intensities at 6.84 ± 1.87 METs, an intensity that has not been reported with Wii boxing.[<reflink idref="bib34" id="ref45">34</reflink>] The variety of studies featuring Wii boxing and other boxing exergames show the potential for one to achieve moderate-vigorous intensity, especially when the game difficulty is greater than a beginner or difficulty is increased throughout the game with various moves.[<reflink idref="bib7" id="ref46">7</reflink>]</p> <p>Similar to tennis, Wii baseball isolates upper body movement to complete the game through batting and throwing the ball. Research findings were equivocal with intensity only achieving a light intensity based on percent of one's heart rate max (42 ± 7% HRmax)[<reflink idref="bib9" id="ref47">9</reflink>]; whereas, Miyachi et al[<reflink idref="bib24" id="ref48">24</reflink>] reported a moderate intensity achieved in baseball (3.0 ± 0.7 METs); however, it should be noted this study's participants had not completed physical activity in the past year. While previous research indicates one can achieve a moderate intensity MET level when completing exergaming boxing and tennis, only a light intensity is achieved with golf (2.0 ± 0.3 METs) and bowling (2.7 ± 0.6 METs).[<reflink idref="bib24" id="ref49">24</reflink>] Therefore, while upper body exergaming activities have the potential to meet moderate intensity recommendations, one should be cautious about game selection as some activities have more continuous movement resulting in greater intensities and energy expenditures.</p> <hd id="AN0179435548-7">Lower body</hd> <p>In addition to upper body activities, there are a variety of lower body activities that one can use to meet physical activity recommendations. Activities such as Dance Dance Revolution (DDR), Wii fit step aerobics and Wii running primarily involve lower body muscles, potentially leading to greater intensity achievements. DDR is a unique exergame that uses a floor dance pad for participants to follow foot movements projected on the screen that is choreographed to music. When examining exercise intensity while engaging in DDR results contradicted one another in that a light intensity was achieved based on heart rate reserve achievement (37% HRR)[<reflink idref="bib14" id="ref50">14</reflink>]; whereas moderate[<reflink idref="bib31" id="ref51">31</reflink>],[<reflink idref="bib32" id="ref52">32</reflink>] and vigorous intensity[<reflink idref="bib25" id="ref53">25</reflink>] achievement is suggested in similar studies. The lower physiological response is potentially explained by experience level with Tan et al[<reflink idref="bib32" id="ref54">32</reflink>] suggesting inexperienced players selected the lighter intensity that incorporates fewer steps and more rest periods in comparison to experienced individuals being able to successfully complete the advanced levels that incorporate more continuous playing time ultimately leading to a higher intensity achievement.[<reflink idref="bib25" id="ref55">25</reflink>],[<reflink idref="bib31" id="ref56">31</reflink>],[<reflink idref="bib32" id="ref57">32</reflink>] While moderate intensity DDR achievements have been based on relative measures of HRR[<reflink idref="bib32" id="ref58">32</reflink>] and VO<subs>2</subs>R,[<reflink idref="bib31" id="ref59">31</reflink>] the vigorous intensity was determined from MET achievement.[<reflink idref="bib25" id="ref60">25</reflink>] Therefore, while it is suggested experienced DDR users can achieve a moderate exercise intensity, individual fitness levels should be considered before determining if it can be substituted as vigorous exercise. Although DDR may not achieve recommended intensities for beginners, it should not be discouraged as a beneficial activity due to a pre-determined intensity not being met.</p> <p>Similar to using the DDR floor pad, the Wii Fit user stands on a small board that allows the user to play a variety of games, using predominantly lower body muscles to complete the activity, standing or stepping on the gaming board to complete aerobic activities such as step, running or walking. When examining intensity selection of Wii Fit Aerobics in young adults, a moderate intensity was achieved with an average MET value of 3.6 ± 0.8 and an average HR of 51% of age predicted max HR.[<reflink idref="bib21" id="ref61">21</reflink>] Additionally, despite the %VO<subs>2</subs> max during the intermediate level of Wii step aerobics and Wii hula being higher than the beginner level, it failed to meet moderate intensity recommendations with the highest average %VO<subs>2</subs> max only reaching 39.4% VO<subs>2</subs> max.[<reflink idref="bib33" id="ref62">33</reflink>] As seen with other exergame activities, the interval nature of some Wii Fit activities could explain why heart rate or VO<subs>2</subs> did not reach the recommended intensity level for physical activity as one may see in a more continuous exercise such as walking or running.[<reflink idref="bib21" id="ref63">21</reflink>],[<reflink idref="bib33" id="ref64">33</reflink>]</p> <p>When participating in continuous exergaming such as walking or running using the Wii Fit board, there is the potential to achieve a moderate intensity.[<reflink idref="bib19" id="ref65">19</reflink>] Exercising at a self-selected intensity, young physically active participants achieved a greater intensity when using the Wii Fit free run vs. a moderate intensity brisk walk of 3.5 mph with HR (142 ± 21 bpm vs. 123 ± 14 bpm) responses throughout the 30 minute session.[<reflink idref="bib19" id="ref66">19</reflink>] Similar to walking in place, Duncan and Dick[<reflink idref="bib20" id="ref67">20</reflink>] found the Gamercize Power Stepper, a traditional video game that requires the user to maintain a stepping cadence to continue play, to be appropriate moderate intensity physical activity and used to replace sedentary games. The Wii Fit and Gamercize Power Stepper have shown these consoles can elicit moderate intensity when exercising and increases HR and EE effectively, and possibly substituted for moderate intensity exercise for ≥ 10 minutes for one to achieve physical activity recommendations.</p> <p>Exergame cycling is another form of exercise that shows potential to elicit an appropriate intensity for it to be an appropriate substitution for traditional stationary cycling. Exergame cycling combines the physical exertion of a traditional cycle ergometer with an interactive video game that provides a mental engagement component. Roure et al[<reflink idref="bib12" id="ref68">12</reflink>] suggested that having an engaging objective during exercise resulted in a higher cadence (103.8 ± 7.10 rpm vs. 84.1 ± 12.1 rpm), %V0<subs>2</subs> max (78.8 ± 2.1% vs. 63.5 ± 3.1%), and %HR max (89.2 ± 1.3% vs. 78.0 ± 2.0%) vs. traditional cycling. Additionally, other exergame cycling studies have shown when using the Sony EyeToy camera and playing ATV Off-Road Fury 2 with a cycle ergometer not only achieved a moderate intensity, but also showed significantly higher heart rates with exergame cycling in comparison to self-selected cycling (144 ± 22 bpm, 57% HRR vs. 126 ± 20 bpm, 42% HRR).[<reflink idref="bib14" id="ref69">14</reflink>] Additionally, Warburton et al[<reflink idref="bib13" id="ref70">13</reflink>] found similar results to Kraft et al[<reflink idref="bib14" id="ref71">14</reflink>] with participants achieving higher HR and oxygen consumption while exergaming in comparison to traditional stationary cycling despite matched workloads of 25% and 50% maximal power output with a suggested explanation of upper body involvement when playing the exergame. Similarly, when using a traditional cycle ergometer and playing Disney's Cars Piston Cup Race, after around 10 minutes, the average HR was 159 ± 17bpm, suggesting this activity achieved approximately ≥ 60% of one's HRR.[<reflink idref="bib7" id="ref72">7</reflink>] In addition to exergame cycling objectives as collecting objects, another cycling game would include racing other opponents.</p> <p>When using cycling exergaming with virtual reality opponents Samendinger et al,[<reflink idref="bib29" id="ref73">29</reflink>] found no significant difference in wattage selection when comparing cycling intensity selection between 75%-90% max HR independently with another rider (Coactive group), cycling with performance dependent on virtual partner (Conjunctive Group), or cycling alone (control group). However, Zeng et al[<reflink idref="bib35" id="ref74">35</reflink>] found VR cycling achieved a self-selected intensity of 65–85% of age predicted max HR when participants cycled against virtual opponents in a cycling game, suggesting VR cycling can achieve similar intensities of traditional cycling. These contradicting findings could suggest immersion in the game such as pedaling to participate when cycling opponents are involved could potentially impact selection of moderate-vigorous exercise intensities.[<reflink idref="bib35" id="ref75">35</reflink>] In addition to exergame cycling being an effective mode of exercise to achieve appropriate intensities, participants using the Omni-treadmill with VR games were found to elicit a vigorous intensity of 76.8% of one's max HR.[<reflink idref="bib17" id="ref76">17</reflink>] Therefore, cycling and treadmill exergaming have the potential to not only offer a unique exercise experience but also to achieve appropriate intensity levels for health benefits.[<reflink idref="bib17" id="ref77">17</reflink>],[<reflink idref="bib29" id="ref78">29</reflink>],[<reflink idref="bib35" id="ref79">35</reflink>]</p> <hd id="AN0179435548-8">Full body</hd> <p>In addition to the possibility of upper and lower body exergaming being substituted for traditional exercise, full body exergames may have a greater potential to be a substitute for traditional exercise by having greater muscle mass involvement. Specifically, the Xbox Kinect offers various games that involve full body movement that simulates sport performance. Research suggests the track and field game offers a variety of events such as discus throwing, running, and jumping which achieves a moderate intensity based on MET values when analyzed as one activity (4.98 ± 1.48).[<reflink idref="bib34" id="ref80">34</reflink>] As seen with the track and field events, Howe et al[<reflink idref="bib22" id="ref81">22</reflink>] found Kinect Sports football also achieved a moderate intensity based on METs (3.8 ± 0.1), suggesting the possibility of substituting Kinect games for traditional exercise. In addition to moderate intensity, the Kinect could result in vigorous intensity criteria (7.0 ± 0.3 METs) with an obstacle dodging type game, Reflex Ridge.[<reflink idref="bib22" id="ref82">22</reflink>] While there is a limited amount of research involving the Kinect, full body activities offer a modality to achieve moderate-vigorous intensities which would benefit cardiovascular fitness.[<reflink idref="bib22" id="ref83">22</reflink>],[<reflink idref="bib34" id="ref84">34</reflink>] Furthermore, a variety of dance exergames offers an alternative intervention which could substitute for traditional exercise.</p> <p>Dance based activities, incorporating full body movements have demonstrated potential in achieving ideal appropriate intensities for achieving ACSM physical activity guidelines. Specifically, when compared to brisk treadmill walking the exergame, Just Dance elicited a similar moderate intensity energy expenditure of 37.8 ± 21 kcals vs. 48.5 ± 10.1 kcals with exercise periods of 10 minutes.[<reflink idref="bib20" id="ref85">20</reflink>] Not only can dance exergames result in a moderate intensity,[<reflink idref="bib20" id="ref86">20</reflink>] but also a vigorous intensity as found with Dance Central 2 resulting in a MET value of 6.0 ± 0.2 following a 6–10 minute play period.[<reflink idref="bib22" id="ref87">22</reflink>] Therefore, it could be suggested when completed for recommended durations, Just Dance 4 and Dance Central 2 would be appropriate activities to achieve a moderate-vigorous intensity.[<reflink idref="bib20" id="ref88">20</reflink>],[<reflink idref="bib22" id="ref89">22</reflink>]</p> <p>VR Zumba is similar to previously listed dance exergames in that using the Kinect, one could achieve both moderate and vigorous intensities while playing.[<reflink idref="bib22" id="ref90">22</reflink>],[<reflink idref="bib30" id="ref91">30</reflink>] Although it could be substituted for traditional exercise modalities, it is important to note that when comparing VR to human instructor led Zumba, traditional Zumba resulted in less sedentary time (3.3 ± 0.8 min vs. 7.8 ± 3.2 min) and longer physical activity at a higher vigorous intensity (22 ± 12.0 mins vs. 14 ± 12.8 mins) than the VR Zumba.[<reflink idref="bib30" id="ref92">30</reflink>]</p> <p>While a variety of exergames involving upper, lower, and full body movement show the potential to achieve a moderate-vigorous intensity (Table 2), recommendations to use exergaming as a substitute for traditional exercise should be approached with caution, but not discouraged. With previous exergame intensity based on MET values it should be noted that appropriate intensity would be influenced by one's fitness level. In addition to one's fitness level, exergaming experience and perception could also influence intensity achievement with less experience typically resulting in starting at lower game levels that involved more intermittent vs. continuous movement. While full body exergames are more likely to achieve a moderate-vigorous intensity, other games could be used to initiate exercise in sedentary individuals.</p> <p>Table 2. Intensity achievement, perception, and enjoyment/adherence of exergaming activities.</p> <p> <ephtml> <table><thead><tr><td>Exergame activity</td><td>Intensity achievement</td></tr></thead><tbody valign="top"><tr><td char=".">3-Kick (Lighted pads)</td><td>Moderate<xref ref-type="bibr" rid="bibr7">7</xref></td></tr><tr><td>Biggest Loser</td><td>Moderate<xref ref-type="bibr" rid="bibr6">6</xref></td></tr><tr><td>Dance Central 2</td><td>Vigorous<xref ref-type="bibr" rid="bibr22">22</xref></td></tr><tr><td>Dance Dance Revolution</td><td>Light<xref ref-type="bibr" rid="bibr14">14</xref>,<xref ref-type="bibr" rid="bibr31">31</xref> Moderate<xref ref-type="bibr" rid="bibr31">31</xref>,<xref ref-type="bibr" rid="bibr32">32</xref> Vigorous<xref ref-type="bibr" rid="bibr25">25</xref></td></tr><tr><td>Disney's Cars Piston Cup Race</td><td>Moderate<xref ref-type="bibr" rid="bibr7">7</xref></td></tr><tr><td>Exergame cycling (Greedy Rabbit)</td><td>Vigorous<xref ref-type="bibr" rid="bibr12">12</xref></td></tr><tr><td>Gamercize Power Stepper</td><td>Moderate<xref ref-type="bibr" rid="bibr20">20</xref></td></tr><tr><td>Gaming bike</td><td>Light<xref ref-type="bibr" rid="bibr14">14</xref></td></tr><tr><td>Golds Gym</td><td>Moderate<xref ref-type="bibr" rid="bibr6">6</xref></td></tr><tr><td>Jackie Chan Studio Fitness Power Boxing</td><td>Moderate<xref ref-type="bibr" rid="bibr7">7</xref></td></tr><tr><td>Just Dance</td><td>Moderate<xref ref-type="bibr" rid="bibr6">6</xref>,<xref ref-type="bibr" rid="bibr28">28</xref></td></tr><tr><td>Omni treadmill</td><td>Vigorous<xref ref-type="bibr" rid="bibr17">17</xref></td></tr><tr><td>VR Cycling</td><td>Vigorous<xref ref-type="bibr" rid="bibr35">35</xref></td></tr><tr><td>Wii Baseball</td><td>Light<xref ref-type="bibr" rid="bibr26">26</xref> Moderate<xref ref-type="bibr" rid="bibr24">24</xref></td></tr><tr><td>Wii Bowling</td><td>Light<xref ref-type="bibr" rid="bibr24">24</xref></td></tr><tr><td>Wii Boxing</td><td char=".">Moderate[<xref ref-type="bibr" rid="bibr9">9-10</xref>, <xref ref-type="bibr" rid="bibr11">11</xref>],<xref ref-type="bibr" rid="bibr24">24</xref>,<xref ref-type="bibr" rid="bibr26">26</xref>,<xref ref-type="bibr" rid="bibr27">27</xref></td></tr><tr><td>Wii Fit Free Run</td><td>Vigorous<xref ref-type="bibr" rid="bibr26">26</xref></td></tr><tr><td>Wii Fit Run</td><td>Moderate<xref ref-type="bibr" rid="bibr19">19</xref></td></tr><tr><td>Wii Fit (Yoga, Muscle Conditioning, Balance, Aerobics)</td><td>Moderate<xref ref-type="bibr" rid="bibr21">21</xref>,<xref ref-type="bibr" rid="bibr24">24</xref></td></tr><tr><td>Wii Golf</td><td>Light<xref ref-type="bibr" rid="bibr24">24</xref></td></tr><tr><td>Wii Hula</td><td>Light<xref ref-type="bibr" rid="bibr33">33</xref></td></tr><tr><td>Wii Just Dance</td><td>Moderate<xref ref-type="bibr" rid="bibr20">20</xref></td></tr><tr><td>Wii Step Aerobics</td><td>Light<xref ref-type="bibr" rid="bibr33">33</xref></td></tr><tr><td>Wii Tennis</td><td>Light<xref ref-type="bibr" rid="bibr26">26</xref> Moderate<xref ref-type="bibr" rid="bibr23">23</xref>,<xref ref-type="bibr" rid="bibr24">24</xref></td></tr><tr><td>Xbox 360 Kinect</td><td>Moderate-Vigorous<xref ref-type="bibr" rid="bibr9">9</xref></td></tr><tr><td>Xbox Kinect Beach Volleyball</td><td>Moderate<xref ref-type="bibr" rid="bibr34">34</xref></td></tr><tr><td>Xbox Kinect Bowling</td><td>Light<xref ref-type="bibr" rid="bibr34">34</xref></td></tr><tr><td>Xbox Kinect Boxing</td><td>Vigorous<xref ref-type="bibr" rid="bibr34">34</xref></td></tr><tr><td>Xbox Kinect Ping Pong</td><td>Moderate<xref ref-type="bibr" rid="bibr34">34</xref></td></tr><tr><td>Xbox Kinect Reflex Ridge</td><td>Moderate-Vigorous<xref ref-type="bibr" rid="bibr22">22</xref></td></tr><tr><td>Xbox Kinect Soccer</td><td>Vigorous<xref ref-type="bibr" rid="bibr34">34</xref></td></tr><tr><td>Xbox Kinect Sports Football</td><td>Moderate<xref ref-type="bibr" rid="bibr22">22</xref></td></tr><tr><td>Xbox Kinect Track and Field</td><td>Moderate<xref ref-type="bibr" rid="bibr34">34</xref></td></tr><tr><td>Your Shape</td><td>Moderate<xref ref-type="bibr" rid="bibr6">6</xref></td></tr><tr><td>Zumba Fitness</td><td>Vigorous<xref ref-type="bibr" rid="bibr22">22</xref></td></tr><tr><td>Exergame activity</td><td>Perception</td></tr><tr><td>Gaming bike</td><td>RPE not sig. diff between matched intensities of exergame and traditional exercise<xref ref-type="bibr" rid="bibr13">13</xref> Mean and Session RPE were not sig. diff. between gaming bike and traditional ergometer despite ↑ HR in gaming session<xref ref-type="bibr" rid="bibr14">14</xref></td></tr><tr><td>VR Cycling</td><td>Exergame: ↓ acute RPE<xref ref-type="bibr" rid="bibr35">35</xref></td></tr><tr><td>Wii Boxing</td><td>↓ RPE with Wii Boxing vs. heavy bag boxing despite similar energy expenditure<xref ref-type="bibr" rid="bibr14">14</xref> ↑ RPE and HR values with Wii Boxing vs. treadmill walking<xref ref-type="bibr" rid="bibr14">14</xref></td></tr><tr><td>Wii Fit Plus</td><td>Acute and session RPE were sig. ↓ for exergaming vs. traditional exercise with matched intensities<xref ref-type="bibr" rid="bibr18">18</xref></td></tr><tr><td>Wii Fit Run</td><td>↑ HR and RPE values with exergaming vs. traditional exercise modalities<xref ref-type="bibr" rid="bibr19">19</xref></td></tr><tr><td>Xbox 360 Kinect</td><td>Acute RPE was ↓ for exergaming vs. traditional exercise with matched intensities<xref ref-type="bibr" rid="bibr15">15</xref></td></tr><tr><td>Xbox Kinect Reflex Ridge</td><td>Acute RPE was ↓ for exergaming vs. traditional exercise with matched intensities<xref ref-type="bibr" rid="bibr15">15</xref>,<xref ref-type="bibr" rid="bibr22">22</xref></td></tr><tr><td>Exergame activity</td><td>Enjoyment/Adherence</td></tr><tr><td>Dance Dance Revolution</td><td>↑ enjoyment with exergame<xref ref-type="bibr" rid="bibr14">14</xref> Potential to improve adherence with exergaming<xref ref-type="bibr" rid="bibr14">14</xref></td></tr><tr><td>Exergame cycling (Greedy Rabbit)</td><td>↑ enjoyment, attention, and interest with exergame vs. traditional cycling<xref ref-type="bibr" rid="bibr12">12</xref></td></tr><tr><td>Gamercize Power Stepper</td><td>Suggest females enjoyed Wii exercise more than males with previous experience influencing enjoyment<xref ref-type="bibr" rid="bibr20">20</xref></td></tr><tr><td>Gaming bike</td><td>↑ enjoyment with exergame<xref ref-type="bibr" rid="bibr14">14</xref> Potential to improve adherence with exergaming<xref ref-type="bibr" rid="bibr14">14</xref></td></tr><tr><td>Just Dance</td><td char=".">100% adherence rate for 6-week training program with sedentary females<xref ref-type="bibr" rid="bibr28">28</xref></td></tr><tr><td>Omni treadmill</td><td>↑ enjoyment levels on VR treadmill<xref ref-type="bibr" rid="bibr17">17</xref></td></tr><tr><td>VR Cycling</td><td>↑ enjoyment with exergame<xref ref-type="bibr" rid="bibr35">35</xref></td></tr><tr><td>Wii Fit (Yoga, Muscle Conditioning, Balance, Aerobics)</td><td>↑ enjoyment with Wii balance and aerobics vs. treadmill walking and jogging<xref ref-type="bibr" rid="bibr21">21</xref></td></tr><tr><td>Wii Just Dance</td><td>Suggest females enjoyed Wii exercise more than males with previous experience influencing enjoyment<xref ref-type="bibr" rid="bibr20">20</xref></td></tr></tbody></table> </ephtml> </p> <hd id="AN0179435548-9">Perceptual</hd> <p>RPE is commonly used to subjectively assess feelings of exercise intensity. When using this measure, external cues such as settings and events have the potential to alter one's perceptual response with previous research reporting lower scores when focus was on external environmental cues vs. internal cardiorespiratory cues.[<reflink idref="bib37" id="ref93">37</reflink>] Exergaming has the potential to alter perception (RPE) by diverting one's attention away from how they feel during exercise and focus more on the exergame activity.[<reflink idref="bib14" id="ref94">14</reflink>] Therefore, it could be suggested that using exergaming may lead an individual to perceive exercise as less intense vs. traditional exercise (Table 2).[<reflink idref="bib14" id="ref95">14</reflink>],[<reflink idref="bib35" id="ref96">35</reflink>] More work is needed to definitively answer questions surrounding these concepts.</p> <p>When comparing exergaming of identical modalities to traditional exercise, research suggests exergaming results in lower acute RPE values despite a similar workload.[<reflink idref="bib35" id="ref97">35</reflink>] Zeng et al[<reflink idref="bib35" id="ref98">35</reflink>] speculated an immersive exergame experience, such as requiring pedaling to participate in the game, could alter one's perception due to enjoyment of playing. Similarly, mean RPE and Session RPE were not significantly different when comparing a gaming bike to a traditional cycle ergometer even though mean heart rate and minutes above a target heart rate were higher during the gaming bike session (vs. traditional cycling).[<reflink idref="bib14" id="ref99">14</reflink>] Not only have lower RPE values been found in cycling, but also in simulated boxing.[<reflink idref="bib27" id="ref100">27</reflink>] Wii boxing has shown to have similar energy cost as heavy bag boxing, achieving moderate intensity exercise but at a lower RPE.[<reflink idref="bib27" id="ref101">27</reflink>] Therefore, it is suggested exergaming could be substituted for a similar exercise modality and alter one's perception, leading to selecting a greater exercise intensity.[<reflink idref="bib14" id="ref102">14</reflink>],[<reflink idref="bib27" id="ref103">27</reflink>],[<reflink idref="bib35" id="ref104">35</reflink>]</p> <p>When exercise intensities were matched, acute RPE[<reflink idref="bib15" id="ref105">15</reflink>],[<reflink idref="bib18" id="ref106">18</reflink>] and session RPE values[<reflink idref="bib18" id="ref107">18</reflink>] were found to be lower for exergaming vs. traditional exercise modalities. While the modality of exercise could potentially impact one's perception (RPE) of exercise, authors suggested exergaming may be a more appealing and desirable form of exercise, particularly if they are a novice exerciser.[<reflink idref="bib18" id="ref108">18</reflink>] However, opposing findings are reported when comparing treadmill walking to Wii boxing[<reflink idref="bib10" id="ref109">10</reflink>] and Wii Fit[<reflink idref="bib19" id="ref110">19</reflink>] with higher heart rates and RPE values in exergaming vs. traditional exercise modalities. A potential explanation for these findings could be the exergaming intensity resulted in an appropriate RPE response vs. previous results seen with matching intensities. Despite the greater intensity and perception, Barkley et al[<reflink idref="bib10" id="ref111">10</reflink>] report a greater enjoyment with exergaming vs. traditional treadmill walking. This suggests exergaming immersion could enhance exercise enjoyment potentially improving exercise adherence in comparison to traditional exercise modalities.[<reflink idref="bib38" id="ref112">38</reflink>]</p> <hd id="AN0179435548-10">Enjoyment/adherence</hd> <p>The differences in exergaming RPEs (vs. traditional exercise) are likely explained by the enjoyment of exergaming. Exergaming offers a unique approach to exercise by incorporating gaming objectives that are not seen in traditional exercise. Previous research suggests incorporating a gaming objective such as a maze or racing during exergaming, not only achieves a higher intensity selection but also results in greater enjoyment.[<reflink idref="bib12" id="ref113">12</reflink>],[<reflink idref="bib14" id="ref114">14</reflink>],[<reflink idref="bib35" id="ref115">35</reflink>] In addition to increased enjoyment, Roure et al[<reflink idref="bib12" id="ref116">12</reflink>] reported greater interest and attention to the activity when participants completed a cycling exergame vs. traditional cycling. Exergaming not only has the potential to enhance enjoyment through an exercise objective but also through external cues in the environment.</p> <p>Robertson and Nobel[<reflink idref="bib37" id="ref117">37</reflink>] suggest when external cues are present, an individual would focus on the environment rather than internal cardiorespiratory cues and thus, reduce one's perception. Specifically, Debska et al[<reflink idref="bib17" id="ref118">17</reflink>] reported not only high intensity levels based on one's heart rate max, but also high enjoyment levels while exercising on a VR treadmill suggesting visual aids have the potential to alter one's perception of the activity. Furthermore, 92% stated they would be more likely to participate in regular physical activity if this type of equipment were readily available. Despite the achievement of high intensity (76.8% HRmax), only 44% believed this VR activity could replace traditional exercise, suggesting a VR activity could aid as a distraction during exercise. Despite not achieving moderate-vigorous intensity levels, Graves et al[<reflink idref="bib21" id="ref119">21</reflink>] reported greater enjoyment with Wii balance and aerobics in comparison to treadmill walking and jogging. While lower intensity exergames may not achieve recommended intensity levels, they could be beneficial in encouraging exercise adherence.[<reflink idref="bib21" id="ref120">21</reflink>]</p> <p>With reported differences in RPE and enjoyment with exergaming vs. traditional exercise, there is the potential to improve exercise adherence specifically in a younger population.[<reflink idref="bib14" id="ref121">14</reflink>] Exergame activities may aid in the start of chronic exercise participation by decreasing conscious awareness of exertion and increasing enjoyment, potentially enhancing exercise adherence.[<reflink idref="bib14" id="ref122">14</reflink>] Although exergaming has been suggested to enhance exercise adherence, Duncan et al[<reflink idref="bib20" id="ref123">20</reflink>] suggested females enjoyed Wii exercise more than males and exergaming enjoyment could be impacted by previous gaming experience. Specifically, Roopchand-Martin et al[<reflink idref="bib28" id="ref124">28</reflink>] found a 100% adherence rate for a six-week training program using Just Dance 4 with sedentary female college students, suggesting a high enjoyment level. While a high adherence rate was reported during the study, only of 37.5% of participants continued exercising three months post-intervention. Although a decrease in adherence was expected, it could be partially explained by time constraints due to students in the final examination period and participants completing the game outside of one's home.[<reflink idref="bib28" id="ref125">28</reflink>] Therefore, a variety of exergaming modalities and locations may need to be considered to enhance one's experience and improve adherence rates. Furthermore, if exergaming is perceived as more enjoyable, then there is the potential to improve exercise adherence. Future research should examine one's gaming experience with a variety of modalities to determine intensity achievement and adherence rates.</p> <hd id="AN0179435548-11">Summary</hd> <p>The main findings of this review show exergaming has the potential to elicit moderate.[<reflink idref="bib6" id="ref126">6</reflink>],[<reflink idref="bib7" id="ref127">7</reflink>],[[<reflink idref="bib15" id="ref128">15</reflink>], [<reflink idref="bib17" id="ref129">17</reflink>]],[<reflink idref="bib21" id="ref130">21</reflink>],[<reflink idref="bib24" id="ref131">24</reflink>],[<reflink idref="bib34" id="ref132">34</reflink>] and vigorous.[<reflink idref="bib12" id="ref133">12</reflink>],[<reflink idref="bib16" id="ref134">16</reflink>],[<reflink idref="bib22" id="ref135">22</reflink>],[<reflink idref="bib34" id="ref136">34</reflink>] exercise intensities and could potentially be substituted for traditional exercise. While not all exergame activities met recommended intensity levels, they are still preferred to being sedentary. Additionally, exergaming has shown to alter perception with lower acute and session RPE values when comparing exergaming to traditional exercise of a matched intensity or resulting in higher intensity selection when RPE values are similar. These findings suggest participants find exergaming more enjoyable and therefore might improve exercise adherence rates. Future research should examine the influence of exergaming experience on intensity selection and adherence rates. In conclusion, exergaming has the potential to be substituted for traditional exercise and could offer a unique exercise modality for sedentary individuals, potentially leading to improving one's physical activity levels.</p> <hd id="AN0179435548-12">Conflict of interest disclosure</hd> <p>The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of United States and received approval from the Institutional Review Board of the Universtiy of North Alabama.</p> <ref id="AN0179435548-13"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Keating XD, Guan J, Piñero JC, Bridges DM. A meta-analysis of college students' physical activity behaviors. J Am Coll Health. 2005; 54 (2): 116 – 126. doi: 10.3200/JACH.54.2.116-126.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">2</bibl> <bibtext> Matthews CE, Chen KY, Freedson PS, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008; 167 (7): 875 – 881. doi: 10.1093/aje/kwm390.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref3" type="bt">3</bibl> <bibtext> Brown A. Younger men play video games, but so do a diverse group of other Americans. Pew Research Center; 2017. https://<ulink href="http://www.pewresearch.org/fact-tank/2017/09/11/younger-men-play-video-games-but-so-do-a-diverse-group-of-other-americans/">www.pewresearch.org/fact-tank/2017/09/11/younger-men-play-video-games-but-so-do-a-diverse-group-of-other-americans/</ulink></bibtext> </blist> <blist> <bibl id="bib4" idref="ref4" type="bt">4</bibl> <bibtext> Tower AP, Noble CH. Exploring and extending a collective open business model. AMS Rev. 2017; 7 (3–4): 170 – 182. doi: 10.1007/s13162-017-0105-8.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref5" type="bt">5</bibl> <bibtext> Barnett A, Cerin E, Baranowski T. Active video games for youth: a systematic review. J Phys Act Health. 2011; 8 (5): 724 – 737. doi: 10.1123/jpah.8.5.724.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref6" type="bt">6</bibl> <bibtext> Bryan LH, Jarvis S, Nicholas RK, et al. Measurement of energy expenditure while playing exergames at a self-selected intensity. Open Sport Sci J. 2012; 5 : 1.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref7" type="bt">7</bibl> <bibtext> Siegel SR, Haddock BL, Dubois AM, Wilkin LD. Active video/arcade games (exergaming) and energy expenditure in college students. Int J Exerc Sci. 2009; 2 (3): 165.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref8" type="bt">8</bibl> <bibtext> Liguori G. Medicine ACoS. ACSM's Guidelines for Exercise Testing and Prescription. Philadelphia, PA : Lippincott Williams & Wilkins; 2020.</bibtext> </blist> <blist> <bibl id="bib9" idref="ref11" type="bt">9</bibl> <bibtext> O'Donovan C, Hirsch E, Holohan E, McBride I, McManus R, Hussey J. Energy expended playing Xbox Kinect and Wii games: a preliminary study comparing single and multiplayer modes. Physiotherapy 2012; 98 (3): 224 – 229. doi: 10.1016/j.physio.2012.05.010.</bibtext> </blist> <blist> <bibtext> Barkley JE, Penko A. Physiologic responses, perceived exertion, and hedonics of playing a physical interactive video game relative to a sedentary alternative and treadmill walking in adults. J Exerc Physiol Online. 2009; 12 (3): 12 – 23.</bibtext> </blist> <blist> <bibtext> Willems ME, Bond TS. Comparison of physiological and metabolic responses to playing Nintendo Wii Sports and brisk treadmill walking. J Hum Kinetics. 2009; 22 (2009): 43 – 49. doi: 10.2478/v10078-009-0022-5.</bibtext> </blist> <blist> <bibtext> Roure C, Pasco D, Benoît N, Deldicque L. Impact of a design-based bike exergame on young adults' physical activity metrics and situational interest. Res Q Exerc Sport. 2020; 91 (2): 309 – 315. doi: 10.1080/02701367.2019.1665621.</bibtext> </blist> <blist> <bibtext> Warburton DER, Sarkany D, Johnson M, et al. Metabolic requirements of interactive video game cycling. Med Sci Sports Exerc. 2009; 41 (4): 920 – 926. doi: 10.1249/MSS.0b013e31819012bd.</bibtext> </blist> <blist> <bibtext> Kraft JA, Russell WD, Bowman TA, Selsor CW, III, Foster GD. Heart rate and perceived exertion during self-selected intensities for exergaming compared to traditional exercise in college-age participants. J Strength Cond Res. 2011; 25 (6): 1736 – 1742. doi: 10.1519/JSC.0b013e3181e06f13.</bibtext> </blist> <blist> <bibtext> Barry G, Van Schaik P, MacSween A, Dixon J, Martin D. Exergaming (XBOX Kinect™) versus traditional gym-based exercise for postural control, flow and technology acceptance in healthy adults: a randomised controlled trial. BMC Sports Sci, Med Rehab. 2016; 8 (1): 1 – 11.</bibtext> </blist> <blist> <bibtext> Barry G, Tough D, Sheerin P, Mattinson O, Dawe R, Board E. Assessing the physiological cost of active videogames (Xbox Kinect) versus sedentary videogames in young healthy males. Games Health J. 2016; 5 (1): 68 – 74. doi: 10.1089/g4h.2015.0036.</bibtext> </blist> <blist> <bibtext> Dębska M, Polechoński J, Mynarski A, Polechoński P. Enjoyment and intensity of physical activity in immersive virtual reality performed on innovative training devices in compliance with recommendations for health. Int J Environ Res Public Health. 2019; 16 (19): 3673. doi: 10.3390/ijerph16193673.</bibtext> </blist> <blist> <bibtext> Devereaux J. Comparison of rates of perceived exertion between active video games and traditional exercise. Int Sport Med J. 2012; 13 (3): 133 – 140.</bibtext> </blist> <blist> <bibtext> Douris PC, McDonald B, Vespi F, Kelley NC, Herman L. Comparison between Nintendo Wii Fit aerobics and traditional aerobic exercise in sedentary young adults. J Strength Cond Res. 2012; 26 (4): 1052 – 1057. doi: 10.1519/JSC.0b013e31822e5967.</bibtext> </blist> <blist> <bibtext> Duncan MJ, Dick S. Energy expenditure and enjoyment of exergaming: a comparison of the Nintendo Wii and the gamercize power stepper in young adults. Med Sport. 2012; 16 (3): 92 – 98. doi: 10.5604/17342260.1011386.</bibtext> </blist> <blist> <bibtext> Graves LE, Ridgers ND, Williams K, Stratton G, Atkinson G, Cable NT. The physiological cost and enjoyment of Wii Fit in adolescents, young adults, and older adults. J Phys Act Health. 2010; 7 (3): 393 – 401. doi: 10.1123/jpah.7.3.393.</bibtext> </blist> <blist> <bibtext> Howe CA, Barr MW, Winner BC, Kimble JR, White JB. The physical activity energy cost of the latest active video games in young adults. J Phys Act Health. 2015; 12 (2): 171 – 177. doi: 10.1123/jpah.2013-0023.</bibtext> </blist> <blist> <bibtext> Leatherdale ST, Woodruff SJ, Manske SR. Energy expenditure while playing active and inactive video games. Am J Health Behav. 2010; 34 (1): 31 – 35.</bibtext> </blist> <blist> <bibtext> Miyachi M, Yamamoto K, Ohkawara K, Tanaka S. METs in adults while playing active video games: a metabolic chamber study. Med Sci Sports Exerc. 2010; 42 (6): 1149 – 1153. doi: 10.1249/MSS.0b013e3181c51c78.</bibtext> </blist> <blist> <bibtext> Noah JA, Spierer DK, Tachibana A, Bronner S. Vigorous energy expenditure with a dance exer-game. J Exerc Physiol Online. 2011; 14 (4): 13 – 28.</bibtext> </blist> <blist> <bibtext> O'Donovan C, Hussey J. Active video games as a form of exercise and the effect of gaming experience: a preliminary study in healthy young adults. Physiotherapy 2012; 98 (3): 205 – 210. doi: 10.1016/j.physio.2012.05.001.</bibtext> </blist> <blist> <bibtext> Perusek K, Sparks K, Little K, Motley M, Patterson S, Wieand J. A comparison of energy expenditure during "Wii Boxing" versus heavy bag boxing in young adults. Games Health J. 2014; 3 (1): 21 – 24. doi: 10.1089/g4h.2013.0059.</bibtext> </blist> <blist> <bibtext> Roopchand-Martin S, Nelson G, Gordon C, Sing SY. A pilot study using the XBOX Kinect for exercise conditioning in sedentary female university students. Technol Health Care. 2015; 23 (3): 275 – 283. doi: 10.3233/THC-150899.</bibtext> </blist> <blist> <bibtext> Samendinger S, Hill CR, Kerr NL, et al. Group dynamics motivation to increase exercise intensity with a virtual partner. J Sport Health Sci. 2019; 8 (3): 289 – 297. doi: 10.1016/j.jshs.2018.08.003.</bibtext> </blist> <blist> <bibtext> Schneekloth B, Brown GA. Comparison of physical activity during Zumba with a human or video game instructor. Int J Exerc Sci. 2018; 11 (4): 1019.</bibtext> </blist> <blist> <bibtext> Sell K, Lillie T, Taylor J. Energy expenditure during physically interactive video game playing in male college students with different playing experience. J Am Coll Health. 2008; 56 (5): 505 – 512. doi: 10.3200/JACH.56.5.505-512.</bibtext> </blist> <blist> <bibtext> Tan B, Aziz AR, Chua K, Teh KC. Aerobic demands of the dance simulation game. Int J Sports Med. 2002; 23 (2): 125 – 129. doi: 10.1055/s-2002-20132.</bibtext> </blist> <blist> <bibtext> Worley JR, Rogers SN, Kraemer RR. Metabolic responses to Wii Fit™ video games at different game levels. J Strength Cond Res. 2011; 25 (3): 689 – 693. doi: 10.1519/JSC.0b013e318207eae9.</bibtext> </blist> <blist> <bibtext> Wu PT, Wu WL, Chu IH. Energy expenditure and intensity in healthy young adults during exergaming. Am J Hlth Behav. 2015; 39 (4): 556 – 561. doi: 10.5993/AJHB.39.4.12.</bibtext> </blist> <blist> <bibtext> Zeng N, Pope Z, Gao Z. Acute effect of virtual reality exercise bike games on college students' physiological and psychological outcomes. Cyberpsychol Behav Soc Netw. 2017; 20 (7): 453 – 457. doi: 10.1089/cyber.2017.0042.</bibtext> </blist> <blist> <bibtext> Killen L, Coons J, Barry V. Validation of a physical activity monitor as an estimation of energy expenditure during a circuit-style workout with females who are overweight or obese. Arch Sports Med. 2017; 1 (2): 58 – 64.</bibtext> </blist> <blist> <bibtext> Robertson R, Noble B. Perception of physical exertion: methods, mediators, and applications. Exerc Sport Sci Rev. 1997; 25 : 407 – 452.</bibtext> </blist> <blist> <bibtext> McGloin R, Embacher K. " Just like riding a bike": a model matching approach to predicting the enjoyment of a cycling exergame experience. Media Psychol. 2018; 21 (3): 486 – 505. doi: 10.1080/15213269.2017.1311269.</bibtext> </blist> </ref> <aug> <p>By Jacob C. Davis; Lauren G. Killen; J. Matt Green; Hunter S. Waldman and Lee G. Renfroe</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref12"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref13"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref14"></nolink> <nolink nlid="nl4" bibid="bib13" firstref="ref15"></nolink> <nolink nlid="nl5" bibid="bib14" firstref="ref17"></nolink> <nolink nlid="nl6" bibid="bib34" firstref="ref24"></nolink> <nolink nlid="nl7" bibid="bib23" firstref="ref27"></nolink> <nolink nlid="nl8" bibid="bib24" firstref="ref28"></nolink> <nolink nlid="nl9" bibid="bib26" firstref="ref29"></nolink> <nolink nlid="nl10" bibid="bib36" firstref="ref32"></nolink> <nolink nlid="nl11" bibid="bib27" firstref="ref36"></nolink> <nolink nlid="nl12" bibid="bib31" firstref="ref51"></nolink> <nolink nlid="nl13" bibid="bib32" firstref="ref52"></nolink> <nolink nlid="nl14" bibid="bib25" firstref="ref53"></nolink> <nolink nlid="nl15" bibid="bib21" firstref="ref61"></nolink> <nolink nlid="nl16" bibid="bib33" firstref="ref62"></nolink> <nolink nlid="nl17" bibid="bib19" firstref="ref65"></nolink> <nolink nlid="nl18" bibid="bib20" firstref="ref67"></nolink> <nolink nlid="nl19" bibid="bib29" firstref="ref73"></nolink> <nolink nlid="nl20" bibid="bib35" firstref="ref74"></nolink> <nolink nlid="nl21" bibid="bib17" firstref="ref76"></nolink> <nolink nlid="nl22" bibid="bib22" firstref="ref81"></nolink> <nolink nlid="nl23" bibid="bib30" firstref="ref91"></nolink> <nolink nlid="nl24" bibid="bib37" firstref="ref93"></nolink> <nolink nlid="nl25" bibid="bib15" firstref="ref105"></nolink> <nolink nlid="nl26" bibid="bib18" firstref="ref106"></nolink> <nolink nlid="nl27" bibid="bib38" firstref="ref112"></nolink> <nolink nlid="nl28" bibid="bib28" firstref="ref124"></nolink> <nolink nlid="nl29" bibid="bib16" firstref="ref134"></nolink>
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  Data: Exergaming for Physical Activity: A Systematic Review
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  Data: <searchLink fieldCode="AR" term="%22Jacob+C%2E+Davis%22">Jacob C. Davis</searchLink><br /><searchLink fieldCode="AR" term="%22Lauren+G%2E+Killen%22">Lauren G. Killen</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-0935-7594">0000-0003-0935-7594</externalLink>)<br /><searchLink fieldCode="AR" term="%22J%2E+Matt+Green%22">J. Matt Green</searchLink><br /><searchLink fieldCode="AR" term="%22Hunter+S%2E+Waldman%22">Hunter S. Waldman</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-5707-5642">0000-0001-5707-5642</externalLink>)<br /><searchLink fieldCode="AR" term="%22Lee+G%2E+Renfroe%22">Lee G. Renfroe</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. 2024 72(7):2090-2098.
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  Data: Taylor & Francis. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Data: 9
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  Data: Journal Articles<br />Information Analyses
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  Label: Descriptors
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  Data: <searchLink fieldCode="DE" term="%22Physical+Activities%22">Physical Activities</searchLink><br /><searchLink fieldCode="DE" term="%22Exercise%22">Exercise</searchLink><br /><searchLink fieldCode="DE" term="%22Young+Adults%22">Young Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Video+Games%22">Video Games</searchLink><br /><searchLink fieldCode="DE" term="%22Human+Body%22">Human Body</searchLink><br /><searchLink fieldCode="DE" term="%22Exercise+Physiology%22">Exercise Physiology</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Attitudes%22">Attitudes</searchLink>
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  Data: 10.1080/07448481.2022.2103377
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  Data: 0744-8481<br />1940-3208
– Name: Abstract
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  Data: Objective: This review evaluates current literature on intensity selection, perceptual responses, activity enjoyment and adherence rates of exergaming. Methods: The literature search identified manuscripts that investigated exercise intensity, perceptual responses, or exercise adherence of exergaming in young adults. Results: Based on results of 29 studies, the current review suggest some exergaming activities have the potential to elicit moderate to vigorous exercise intensity and could potentially be substituted for traditional exercise. Additionally, exergame activities may aid in the start of exercise adherence by lowering the individual's perceived exertion when playing exergames. Exergaming not only has the potential to enhance enjoyment through an exercise objective but also through the distracting nature of video games. Conclusions: Exergaming shows potential to be substituted for traditional exercise and could offer a new, varied form of exercise for sedentary individuals. Future research should examine the influence of exergaming experience on intensity selection and adherence rates.
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  Data: 2024
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  Data: EJ1438305
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        Value: 10.1080/07448481.2022.2103377
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      – Text: English
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      Pagination:
        PageCount: 9
        StartPage: 2090
    Subjects:
      – SubjectFull: Physical Activities
        Type: general
      – SubjectFull: Exercise
        Type: general
      – SubjectFull: Young Adults
        Type: general
      – SubjectFull: Video Games
        Type: general
      – SubjectFull: Human Body
        Type: general
      – SubjectFull: Exercise Physiology
        Type: general
      – SubjectFull: Psychological Patterns
        Type: general
      – SubjectFull: Attitudes
        Type: general
    Titles:
      – TitleFull: Exergaming for Physical Activity: A Systematic Review
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      – PersonEntity:
          Name:
            NameFull: Jacob C. Davis
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            NameFull: Lauren G. Killen
      – PersonEntity:
          Name:
            NameFull: J. Matt Green
      – PersonEntity:
          Name:
            NameFull: Hunter S. Waldman
      – PersonEntity:
          Name:
            NameFull: Lee G. Renfroe
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 0744-8481
            – Type: issn-electronic
              Value: 1940-3208
          Numbering:
            – Type: volume
              Value: 72
            – Type: issue
              Value: 7
          Titles:
            – TitleFull: Journal of American College Health
              Type: main
ResultId 1