improved executive functioning from wii active exergame play

Improved Executive Functioning from Wii Active Exergame Play

Amanda E. Staiano, Anisha Abraham, & Sandra L. Calvert

Games for Health 2010May 27, 2010

Children’s Digital Media CenterDepartment of Psychology, Georgetown UniversityFunded by Robert Wood Johnson Foundation Health

Games Research

1

Outline

• Study 1: Social Exergame Play for Caloric Expenditure among Adolescents

• Study 2: Improved Executive Functioning from

Wii Active Exergame Play

3Staiano, Abraham, & Calvert, 2010 Georgetown University

1998

Rise of Adult Obesity(Obesity = *BMI 30, or about 30 lbs. overweight for 5’4” person)

2007

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

BRFSS, Behavioral Risk Factor Surveillance System, http: //www.cdc.gov/brfss/


Rise of Pediatric Obesity

Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Examination Surveys II (ages 6–11) and III (ages 12–17), and National Health and Nutrition Examination Surveys I, II and III, and 1999–2006.


Rise of Pediatric Obesity

6

The National Survey of Children's Health. Childhood Obesity Action Network. State Obesity Profiles, 2008. National Initiative for Children's Healthcare Quality, Child Policy Research Center, and Child and Adolescent Health Measurement Initiative. Retrieved 5/9/09 from http://www.nschdata.org:80/Content/ObesityReportCards.aspx.

Staiano, Abraham, & Calvert, 2010 Georgetown University

Consequences of Pediatric Obesity

• Physiological– Cardiovascular risk factors, type 2 diabetes,

asthma, sleep apnea (McGinnis, Gootman, & Kraak, 2006)

• Psychosocial– Social discrimination, low self-esteem (Eisenberg, Neumarck-

Sztainer, & Story, 2003)

• Cognitive– Missed school days, poorer academic achievement

(Staiano, 2010)Division of Nutrition, Physical Activity and Obesity, CDC, 2009


Low Physical Activity RatesYouth are not meeting

physical activity recommendations

Eaton, Kann, & Kinchen, et al., 2006

Adolescents Not Exercising 5 or More Days per Week

All

Male

Female

White

Black

Hispanic

40

50

60

70

80

Per

cent

age


High Gaming RatesYouth spend 36 minutes daily

playing on video game consoles

Rideout, Foehr, & Roberts, 20109Staiano, Abraham, & Calvert, 2010

Georgetown University

• Exergames burn calories – Similar to walking at 3 miles per hour, skipping, or jumping (Staiano & Calvert, 2010;

Maddison et al., 2007)

• Exergames meet requirements for aerobic fitness (Unnithan, Houser, & Fernhall, 2006; Tan et al., 2002)

• Exergames are engaging (Warburton et al., 2007)

• Wii Sports: Youth expend more energy when playing boxing, tennis, and bowling than when playing sedentary video game (Graves et al., 2007)

– Males expend more energy than females, particularly in Wii tennis

Exergames for Caloric Loss


Limitations in Current Research

• Small sample sizes• Only target athletic youth• Short-term exposure• Little comparison to sports activities• Only solitary game play


Study 1

Social Exergame Play for Caloric Expenditure

among Adolescents


Research Questions

1. How does playing a videogame alone (solitary) versus playing a videogame with a partner (social) affect energy expenditure?

2. How does energy expenditure during exergame play compare to actual sport play?

3. How does enjoyment of playing the Wii game differ by gender?


Hypotheses

H1: Exergame play will burn more calories than a sedentary activity

H2: Social group will burn more calories than solitary group

H3: Tennis court play will burn more calories than exergame play

H4: Boys will enjoy exergame more than girls


Methodology

• 74 low-income African American 12- to 18-year-old adolescents – Mean BMI percentile = 69.28 (SD = 28.06)– Proportion overweight/obese = 41.89%– Mean Age = 14.45 years (SD = 1.67)

• Setting: Campus of Georgetown University


Stimulus:Nintendo Wii Sports Tennis


Solitary Condition


Social Condition


Control Condition


Treatment

• 10 min of tennis skills test on tennis court

• 30 min of solitary or social exergame play or 30 min of sedentary computer activity


Measures

• Weight, BMI percentile, waist-to-hip ratio

• Actical physical activity monitor

• Self-reported enjoyment of exergame play


Results


Linear regression predicting caloric expenditure by condition.

Variable B SE B β________ Gender -6.59 2.15 -0.19**

Age -1.45 0.64 -0.15* Solitary Condition -6.72 2.49 -0.19**

Control Condition -20.12 2.58 -0.58***

Weight 0.64 0.09 0.65***

BMI Percentile -0.09 0.06 -0.14

Waist-to-Hip Ratio 3.75 18.36 0.01 R2 0.76

_____________________________________________________________________Values are expressed as coefficient. *** = p < .001, ** = p < .01, * = p < .05. For Gender, 0 = Male, 1 = Female. F(7,66) = 30.373, p = .000, r2 = .763 (adjusted r2 = .738). Condition was dummy-coded so that Solitary = 1, Control = 1, and

Social = 0.

Caloric Expenditure: By Condition


Caloric Expenditure & METs (by condition)

Social Solitary Control

Condition (kCal) 62.93 54.83 37.69

Condition (METs) 2.017 1.788 1.262

Staiano, Abraham, & Calvert, 2010 Georgetown University 24

Caloric Expenditure: Tennis Court Play vs. Exergame Play

= tennis court play is significantly different than treatment, p < .05. 25Staiano, Abraham, & Calvert, 2010

Georgetown University

Enjoyment of exergame play

Enjoy Do Not Enjoy

Males 18 4

Females 25 0

Note. 2(1, N = 47) = 4.968, p = .026


Summary of Results

As expected: Social expended more calories than solitary. Both expended more calories than control.

Also, males, younger, and heavier weight individuals burned more calories.


Summary of Results

• Social exergame play was comparable to tennis court play

• Solitary play and control condition burned significantly fewer calories than during tennis court play.


Summary of Results

• 100% of girls and 82% of boys enjoyed playing the exergame


Implications of Findings

• Social exergame play is a more physically active option than solitary gameplay

• Exergames may be a viable supplemental physical activity, particularly for low-income adolescents

• Incorporating enjoyable physical activities in schools and homes may encourage energy expenditure and potentially improve health for at-risk youth


Study 2

Social Exergame Play for Improved Executive

Functioning among Adolescents


Research Question

Exergames produce caloric expenditure that may promote physical health,

but can they also promote cognitive health?


Activity Improved Cognition

• Executive function hypothesis (Davis et al., 2007)

• Aerobic Activity– Enhanced executive control skills (Etnier et al., 2006;

Hertzog et al., 2008; Hillman et al., 2009)

– Enhanced attention and concentration (Budde et al., 2008)


Video Games Improved Cognition

• Attention (Green & Bavelier, 2003)

– Capacities: Task-switching– Visual Spatial Skills: Useful field of view, spatial

and temporal resolution, attentional blink paradigm, alerting and orienting

• Retention (Pivec, 2008)


Hypothesis

Participants who play an exergame will improve more in executive functioning and visual spatial skills than those in a sedentary control group.


Methodology

• 50 (34 female) low-income African American 14- to 19-year-old overweight and obese adolescents – Mean BMI = 33.27 (SD = 6.38)– Mean BMI percentile = 94.76 (SD = 5.51)– Mean Age = 16.8 years (SD = 1.14)

• Setting: Inner-city public high school


Stimulus:EA Active for Nintendo Wii


Game Play Exposure

• Baseline cognitive assessment

• Two 15 minute sessions of Wii Active play

– Immediate cognitive assessment following each 15 minute session of game play


Cognitive Measures

• Delis-Kaplan Executive Function Scale (DKEFS)– Design Fluency– Trail-Making Test

• Bender Gestalt visual spatial skills test


Results


Executive Functioning (DKEFS)


Executive Functioning (DKEFS)• Repeated measures ANOVA at baseline and week 6

• All participants improved over time– F (1, 45) = 11.073, p = .002

• Wii players improved more than control – F (1, 45) = 4.502, p = .039

• Wii players increased on average 11.26% vs. 3.34% for control group


Visual Spatial Skills (Bender Gestalt)


Visual Spatial Skills (Bender Gestalt)

• Repeated measures ANOVA at baseline and week 6

• Wii players improved more than control F (1, 48) = 5.014, p = .030

• Wii players increased average of 9.45% vs. 5.44% for the control group


Summary of Results

• Wii Active players significantly improved scores on executive functioning and visual spatial skills more than the sedentary control group did


Implications of Findings• Only 15 minutes of exergame play produces short-

term improved cognitive outcomes

• The physical activity component and video game component may enhance cognitive outcomes from exergames

• Exergames could be integrated within the school day (PE; Recess) to produce short-term gains in cognitive performance


Future Work

• Analysis of the full 8 month Wii Active exergame intervention– Game enjoyment– Physical health change (BMI, caloric expenditure)– Cognitive change (memory, attention,

concentration)– Socio-emotional change (self-efficacy, motivation,

self-esteem, attitude towards physical activity)


Conclusion• Exergames produce physiological and

cognitive benefits for at-risk adolescents• Social exergame play produces caloric expenditure

similar to low to moderate intensity physical activity and matches actual sport play

• Social exergame play produces short-term cognitive gains in executive function skills and visual spatial skills

Exergames may be a tool to promote physical and cognitive health


Acknowledgements


improved executive functioning from wii active exergame play

Technology

wii active exergame

improved executive functioning

social exergame

georgetown university

calvert games

anisha abraham

adolescents study

rise of adult obesity