Can patients with early-stage Parkinson's Disease improve scores on a functional reach test before and after exergame intervention training? Mendes and colleagues (2012) were interested in answering this question using Wii Fit as the intervention tool. I haven't see the entire paper yet but from the abstract it looks like some of the results are mixed. It appears that some of the cognitive demands of the game (attention, response inhibition, working memory) interfered and contributed to learning deficits; however, exergame trained patients were able to transfer exergame-related motor skills to a similar untrained task.
Mendes, F., Pompeu, J., Lobo, A., da Silva, K., Oliveira, T., Zomignani, A., & Piemonte, M. (2012). Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease – effect of motor and cognitive demands of games: a longitudinal, controlled clinical study Physiotherapy, 98 (3), 217-223 DOI: 10.1016/j.physio.2012.06.001
Mendes, F.A.D.S., Pompeu, J.E., Lobo, A.M., da Silva, K.G., Oliveira, T.D.P., Zomignani, A.P. & Piemonte, M.E.P. (2012). Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease – effect of motor and cognitive demands of games: a longitudinal, controlled clinical study, Physiotherapy, 98 (3) 223. DOI: 10.1016/j.physio.2012.06.001
Wednesday, October 24, 2012
Thursday, October 4, 2012
Can Kids Be Motivated to Move More? Zamzee Kids Moved 60% More! (Study)
I guess that answers the questions to whether or not a device and access to a new website could get kids to move more.
Now I've been a huge fan of HopeLab for almost 5 years since being introduced to Re-Mission through Ellen and Richard at GFH 2008 or 2009. Keeping up with their product development and trials for Zamzee has been great - even a little cloak and daggerish at times:)
As you've already read, kids who received the Zamzee accelerometer and had access to an innovative website, increased their moderate to vigorous physical activity (MVPA) 59% above the control group that only received the Zamzee.
Below is a picture I took at the 2011 GFH conference where they provided us an update on Zamzee's product development and trial early results.
Besides the great news about the increase in MVPA, and other biological markers - I think its great that the Zamzee group achieved CDC-recommended 60 min MVPA/day at a rate 4.5 times that of controls.
Points to Ponder (P2P)
- My only question is the statistic the use (3.1% ± 0.3% of days vs. 0.7% ± 0.4%; p < .0001) sounds quite low - should it be days and not percent (3.1 ± 0.3 days vs. 0.7 ± 0.4; p < .0001)?
Kudos to HopeLab, their partners, and all the participants for such encouraging results about how to improve the health of young people.
Click here to explore more of ExerGame Lab's archived posts involving research studies.
Abstract
Motivating Physical Activity in Tweens: The Zamzee Randomized Controlled Trial and Biomarker Study
Nicole Guthrie, Fred Dillon, Jana Haritatos, and Steve Cole
HopeLab Foundation, 1991 Broadway St. Suite 136, Redwood City CA 94063
This presentation will report results from the Zamzee Impact Trial – a randomized controlled trial of the Zamzee accelerometer /motivational website system in 448 11-14-year-old adolescents recruited from 6 urban, suburban, and rural US middle schools. Zamzee combines individualized feedback, progress monitoring and goal setting, tangible incentives, and intrinsic motivation features to promote long-term increase in physical activity as measured by a 3-axis accelerometer system with automated upload to a central database. In this study, control participants received Zamzee activity monitors that uploaded data but had no access to the motivational intervention website. 186 individuals enrolled in a biomarker sub-study involving pre- and post-study blood sampling. Primary outcomes were accelerometer-based measures of weekly moderate-to-vigorous physical activity (MVPA) assessed continuously over 6 months. Compared to controls, the Zamzee group showed an average 59% higher rate of MVPA (mean = 118 min/week ± SE 3 vs. 74 ± 5 for controls; p < .0001) throughout the 6-onth study, with no decrement in difference over time (no Group x Week interaction, p = .9415). These effects correspond to approximately 1,120 min MVPA and 8,800 kcal expended per participant over 6 months. The Zamzee group achieved CDC-recommended 60 min MVPA/day at a rate 4.5 times that of controls (3.1% ± 0.3% of days vs. 0.7% ± 0.4%; p < .0001). Within the biomarker sub-study, the Zamzee group showed more favorable pre- to post-study changes in LDL cholesterol (+0.3 ± 1.4 mg/dL vs. +5.1 ±1.6; p = .034), total cholesterol (+0.2 ± 1.5 mg/dL vs. +4.7 ± 1.7; p = .057), and, in protocol-adherent participants, HbA1c (-0.08% ± 0.03% vs. +0.08% ± 0.05%; p = .012). Non-significant effects were observed for CRP (-0.01 ± 0.06 mg/L vs. +0.53 ± 0.06; p = .322) and BMI (+0.34 ± 0.07 kg/m2 vs. +0.37 ±0.06; p = .781). The Zamzee activity meter/motivational website system can consistently increase MVPA over 6 months in middle school-aged children, with favorable effects on blood lipid and metabolic parameters.
Abstract
Motivating Physical Activity in Tweens: The Zamzee Randomized Controlled Trial and Biomarker Study
Nicole Guthrie, Fred Dillon, Jana Haritatos, and Steve Cole
HopeLab Foundation, 1991 Broadway St. Suite 136, Redwood City CA 94063
This presentation will report results from the Zamzee Impact Trial – a randomized controlled trial of the Zamzee accelerometer /motivational website system in 448 11-14-year-old adolescents recruited from 6 urban, suburban, and rural US middle schools. Zamzee combines individualized feedback, progress monitoring and goal setting, tangible incentives, and intrinsic motivation features to promote long-term increase in physical activity as measured by a 3-axis accelerometer system with automated upload to a central database. In this study, control participants received Zamzee activity monitors that uploaded data but had no access to the motivational intervention website. 186 individuals enrolled in a biomarker sub-study involving pre- and post-study blood sampling. Primary outcomes were accelerometer-based measures of weekly moderate-to-vigorous physical activity (MVPA) assessed continuously over 6 months. Compared to controls, the Zamzee group showed an average 59% higher rate of MVPA (mean = 118 min/week ± SE 3 vs. 74 ± 5 for controls; p < .0001) throughout the 6-onth study, with no decrement in difference over time (no Group x Week interaction, p = .9415). These effects correspond to approximately 1,120 min MVPA and 8,800 kcal expended per participant over 6 months. The Zamzee group achieved CDC-recommended 60 min MVPA/day at a rate 4.5 times that of controls (3.1% ± 0.3% of days vs. 0.7% ± 0.4%; p < .0001). Within the biomarker sub-study, the Zamzee group showed more favorable pre- to post-study changes in LDL cholesterol (+0.3 ± 1.4 mg/dL vs. +5.1 ±1.6; p = .034), total cholesterol (+0.2 ± 1.5 mg/dL vs. +4.7 ± 1.7; p = .057), and, in protocol-adherent participants, HbA1c (-0.08% ± 0.03% vs. +0.08% ± 0.05%; p = .012). Non-significant effects were observed for CRP (-0.01 ± 0.06 mg/L vs. +0.53 ± 0.06; p = .322) and BMI (+0.34 ± 0.07 kg/m2 vs. +0.37 ±0.06; p = .781). The Zamzee activity meter/motivational website system can consistently increase MVPA over 6 months in middle school-aged children, with favorable effects on blood lipid and metabolic parameters.
ClinicalTrials.gov Identifier: NCT01433679.
About HopeLab
HopeLab is a non-profit organization founded in 2001 by Board Chair Pam Omidyar. HopeLab harnesses the power and appeal of technology to improve the health of young people. HopeLab applies a research-based, customer-focused development model to create products that positively impact health behavior. HopeLab is part of the Omidyar Group philanthropic enterprises. For more information, please visit http://www.hopelab.org.
About Zamzee
Zamzee is a social enterprise on a mission to make it easier for tweens and families to be more physically active. The Zamzee meter and motivational website is the result of several years of research and design based on feedback from kids and families. The Zamzee meter is sold for $29.95; access to the Zamzee website is free of charge. Zamzee was established in 2010 by HopeLab, a nonprofit research organization that uses the power and appeal of technology to improve the health of kids. Initial research and development of Zamzee was conducted by HopeLab, with support from the Robert Wood Johnson Foundation. https://www.zamzee.com/
About HopeLab
HopeLab is a non-profit organization founded in 2001 by Board Chair Pam Omidyar. HopeLab harnesses the power and appeal of technology to improve the health of young people. HopeLab applies a research-based, customer-focused development model to create products that positively impact health behavior. HopeLab is part of the Omidyar Group philanthropic enterprises. For more information, please visit http://www.hopelab.org.
About Zamzee
Zamzee is a social enterprise on a mission to make it easier for tweens and families to be more physically active. The Zamzee meter and motivational website is the result of several years of research and design based on feedback from kids and families. The Zamzee meter is sold for $29.95; access to the Zamzee website is free of charge. Zamzee was established in 2010 by HopeLab, a nonprofit research organization that uses the power and appeal of technology to improve the health of kids. Initial research and development of Zamzee was conducted by HopeLab, with support from the Robert Wood Johnson Foundation. https://www.zamzee.com/
Wii Fit Improves Balance in Children with CP (Study)
Can a 3 week physio regiment improve balance, running speed and agility in children with Cerebral Palsy (CP)? The first question before the investigators should have asked is if 3 weeks is a typical regiment length that sees improvement in those areas? If so, then ask the question if Wii Fit can be used in place of the traditional modalities. According to their findings, these children did not see a significant improvement in RSA scales, but balance scores did improve significantly. (Photo credit via wn.com)
Jelsma J, Pronk M, Ferguson G, & Jelsma-Smit D (2012). The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Developmental neurorehabilitation PMID: 23030836
Exergaming Points to Ponder (P2P)
- Which games did they play in Wii Fit?
- Were there 2 separate groups or was it a multiple baseline-design?
- Although the changes may not have been statistically significant, were they clinical significant?
- Were the changes over time compared to a traditional treatment group?
- What assurances were there to mimic traditional tasks with the Wii Fit activities?
- Was the total amount of time in therapy exactly the same as a traditional 3-week regiment? During a typical treatment period of 3 weeks, what would typically be the level of improvment occurring in patients.
- Its interesting that they tested the children on running when for the most part there is no running feature in Wii Fit except for Free Run.
Click here to explore more of ExerGame Lab's archived posts involving research studies.
Wednesday, October 3, 2012
NFL & Xbox 60 Million Minutes to Better Health
Kinect for Xbox 360 and NFL PLAY 60 have teamed up to combat childhood obesity and inspire a healthier generation of kids. We're challenging kids of all ages across the nation to get their whole body in the game for 60 minutes every day.
You and your friends can help us reach our goal of inspiring 60 Million Minutes of active play this season. Pass the word along about the 60 Million Minutes Challenge today!
Exergaming Points to Ponder (P2P)
- I wonder if they'll take in points and minutes from PlayFit on Xbox Live?
- I think its great the NFL and Xbox are sponsoring this drive, but why aren't schools, states, provinces, and parents demanding more physical activity and PE in schools?
- How will this data be tracked? Via Facebook, self-report, activity monitors?
Here is Dr.Bill Crouse's message from his blog:
Sometimes my work at Microsoft takes an interesting turn. The other day my colleagues in our Interactive Entertainment Business asked if I would help them promote a campaign to fight childhood obesity. The physician in me jumped at the opportunity. After all, according to the Centers for Disease Control, about one third of all children and teens in the United States now fall into the category of being overweight or obese. That is triple the number since I first started practicing medicine in the early 1980’s. And the consequences of so many young people being fat at an early age cannot be ignored. Overweight children are very likely to be overweight adults. With that comes a range of chronic illnesses and disabilities like high blood pressure, type 2 diabetes, joint problems, increased risk of stroke and heart disease, and even increased risk for some kinds of cancer.
Today we are kicking off a campaign called the Xbox 360 “60 Million Minutes Challenge”. The objective is to get 1 million kids to pledge that they will play at least 60 minutes each day between now and Super Bowl Sunday on February 3rd. The campaign joins a wider effort initiated by the National Football League called NFL Play 60.Of course the idea is to get kids more active no matter how they play, but getting in the game with Xbox 360 and Kinect is one such way. If you’ve ever watched kids (and adults) playing with Xbox 360 using Kinect you know what I mean. Kinect for Xbox 360 features controller-free gaming where you use your whole body to play and offers a natural and interactive way for kids to get off the couch - kicking, jumping, and running in place.The official spokesperson for the NFL Play 60 campaign and our 60 Million Minutes Challenge is the greatest receiver in football history, Jerry Rice. Rice says, “To reverse the trend of childhood obesity, we need to continue to educate kids and parents about the importance of 60 minutes of daily activity. That's what's great about Kinect for Xbox 360. It gets kids off the couch and gets their whole body in the game. Being a healthy kid can lead to being a healthy adult."
Created in the spirit of NFL PLAY 60, which encourages kids to get 60 minutes of physical activity daily, the Kinect for Xbox 360 “60 Million Minutes Challenge” is a season-long nationwide movement. From now through Super Bowl XLVII, kids and families can pledge to PLAY 60 at www.Xbox60MillionMinutes.com or online on the Xbox Live dashboard. Those who register their pledge on LIVE can enter for a chance to win NFLShop.com gift cards. On Oct. 9, 2012, the “60 Million Minutes Challenge” Facebook tab will go live and those who pledge via Facebook will have a chance to win a personalized “Social Autograph” on their Facebook wall from a host of current and former NFL stars.
You can learn more about the 60 Million Minutes challenge and what both Jerry Rice and I have to say about the benefits of getting kids active by following this link.
Bill Crounse, MD Senior Director, Worldwide Health
CardioDefender Smartphone-based ECG
Imagine being able to monitor ECGs in realtime on your physician's phone. That's what this device offers and is just the start of medical informatics integration.
Education Implications
CardioDefender Smartphone-based ECG, a 21st Century Holter Monitor:
Everist Genomics, an Ann Arbor, Michigan company, is set to release its CardioDefender diagnostic system, a smartphone ECG that can provide continuous readings throughout the day that can help detect arrhythmias that may be hard to spot in an office visit.
The system uses a wrist watch-like device to collect data from electrodes and transmit it wirelessly via Bluetooth to a smartphone that can then share it with clinicians monitoring the patient. CardioDefender, that recently won both FDA approval and EU’s CE Mark, can activate an alarm to rapidly notify a physician of any particularly unwelcome graph via an email, page, or other electronic means.
Read More
Click here to explore more of ExerGame Lab's archived posts involving research studies.
Education Implications
- I would love to see more monitoring systems for schools to track daily physical activity as well as intensity across heart rate zones, calories burned, calories consumed, workout plans and emotion/psychological levels.
- Its funny that we put more emphasis into tracking daily attendance (do you know of students who have perfect attendance?), Math/History/English/Science grades (Common Core) than we do about physical fitness, physical activity, nutrition, stress and emotional levels. When is this going to change?
CardioDefender Smartphone-based ECG, a 21st Century Holter Monitor:
Everist Genomics, an Ann Arbor, Michigan company, is set to release its CardioDefender diagnostic system, a smartphone ECG that can provide continuous readings throughout the day that can help detect arrhythmias that may be hard to spot in an office visit.
The system uses a wrist watch-like device to collect data from electrodes and transmit it wirelessly via Bluetooth to a smartphone that can then share it with clinicians monitoring the patient. CardioDefender, that recently won both FDA approval and EU’s CE Mark, can activate an alarm to rapidly notify a physician of any particularly unwelcome graph via an email, page, or other electronic means.
Read More
Click here to explore more of ExerGame Lab's archived posts involving research studies.
Tuesday, October 2, 2012
80 Minutes A Week! Dutch Adolescents Like to Exergame (Study)
Just days after reporting on a study done in Montreal (25% of Youth Exergame! Do You? (Study)) our Games for Health colleague Dr. Monique Simons and her team are reporting on the prevalence of exergaming in Dutch adolescents. they found that on average, adolescents played about 80 (+/- 136) minutes a week of exergames which is lower than the figures I collected a few years ago (25 mintues/day); but its still great to see all these figures from different countries. I love this final line from the abstract "According to the adolescents, active gaming mainly replaces sedentary screen time such as TV viewing, internet and non-active gaming. Parental opinions concurred with this appraisal." Now this is what we've been looking for in terms of exergames displacing traditional sedentary activities.
Exergaming Points to Ponder (P2P)
- Will the displacement of sedentary activities continue as games become more complex and exhausting?
- Will enjoyment and skill development in exergames translate to better self-efficacy and lead to trying and maintaining of other fitness activities - Exergame Gateway Effect?
- The actual sample size was relatively small for a national sample of regular exergamers (n=65) it'd be interesting to see what games they play regularly because we all know there are so many different games that elicit different intensities.
Simons, M, Bernaards, C.M., & Slinger, J.D. (2012). Active gaming in Dutch adolescents: a descriptive study International Journal of Behavioral Nutrition and Physical Activity, 9 (118) DOI: 10.1186/1479-5868-9-118
Yang, S.P., Treece, J.L, Miklas, C, & Graham, G (2009). Physical activity, sedentary, and exergaming time in a PEP school Research Quarterly for Exercise and Sport , 80 (1(Supplement))
Erin K. O’Loughlin,, Erika N. Dugas, Catherine M. Sabiston, & Jennifer L. O’Loughlin (2012). Prevalence and Correlates of Exergaming in Youth Pediatrics : doi: 10.1542/peds.2012-0391
Click here to explore more of ExerGame Lab's archived posts involving research studies.
Background
Adequate levels of physical activity are part of a healthy lifestyle and in this way linked to better health outcomes. For children and adolescents, the physical activity guideline recommends at least 60 minutes of moderate-to-vigorous physical activity every day. However, many adolescents are not physically active enough and they spend a lot of their time on sedentary activities (such as video games). A new generation of video games that require body movements to play them, so-called "active games", could serve to increase physical activity in adolescents. The activity level while playing these games is comparable to light-to-moderate intensity physical activity. The current study aims to increase our understanding of 1) the demographic characteristics of adolescents who play active games regularly (3 1 hour per week) and non-regularly (>= 1 hour per week), 2) time spent on active games, 3) the contribution of active games to daily physical activity and 4) the type and amount of activities being replaced by active gaming.
Yang, S.P., Treece, J.L, Miklas, C, & Graham, G (2009). Physical activity, sedentary, and exergaming time in a PEP school Research Quarterly for Exercise and Sport , 80 (1(Supplement))
Erin K. O’Loughlin,, Erika N. Dugas, Catherine M. Sabiston, & Jennifer L. O’Loughlin (2012). Prevalence and Correlates of Exergaming in Youth Pediatrics : doi: 10.1542/peds.2012-0391
Click here to explore more of ExerGame Lab's archived posts involving research studies.
Background
Adequate levels of physical activity are part of a healthy lifestyle and in this way linked to better health outcomes. For children and adolescents, the physical activity guideline recommends at least 60 minutes of moderate-to-vigorous physical activity every day. However, many adolescents are not physically active enough and they spend a lot of their time on sedentary activities (such as video games). A new generation of video games that require body movements to play them, so-called "active games", could serve to increase physical activity in adolescents. The activity level while playing these games is comparable to light-to-moderate intensity physical activity. The current study aims to increase our understanding of 1) the demographic characteristics of adolescents who play active games regularly (3 1 hour per week) and non-regularly (>= 1 hour per week), 2) time spent on active games, 3) the contribution of active games to daily physical activity and 4) the type and amount of activities being replaced by active gaming.
Methods
A cross-sectional survey was conducted in a Dutch internet panel, questioning adolescents in conjunction with one of their parents. A random sample of 320 households (with stratification on gender of the parent and the adolescent, the age of the adolescent and the region of the household) was selected that owned a console or application for active video games and that had a child aged 12 through 16 years. 201 child--parent couples (63% response) completed an internet survey with questions about demographics, physical activity and sedentary behaviour, and gaming behaviour. The questionnaire also contained questions designed to assess whether and how active gaming replaces other activities. Besides descriptive analyses, independent t-test, Pearson's chi-square and Mann--Whitney test (when data were not normally distributed) were used for comparisons between regular and non-regular active gamers.
A cross-sectional survey was conducted in a Dutch internet panel, questioning adolescents in conjunction with one of their parents. A random sample of 320 households (with stratification on gender of the parent and the adolescent, the age of the adolescent and the region of the household) was selected that owned a console or application for active video games and that had a child aged 12 through 16 years. 201 child--parent couples (63% response) completed an internet survey with questions about demographics, physical activity and sedentary behaviour, and gaming behaviour. The questionnaire also contained questions designed to assess whether and how active gaming replaces other activities. Besides descriptive analyses, independent t-test, Pearson's chi-square and Mann--Whitney test (when data were not normally distributed) were used for comparisons between regular and non-regular active gamers.
Results
Eleven percent of the adolescents with an active game in their household never used the game. There were no significant differences in gender, education level (of adolescent and parent), ethnicity and sedentary behaviour between regular (n = 65) and non-regular active gamers (n = 114). Adolescents' (regular and non-regular active gamers) meantime spent on active gaming was 80 (+/- 136) minutes a week; this potentially amounts to 11% of total physical activity. When time spent on active gaming was included in the calculation of the percentage of adolescents that met the physical activity guideline, the percentage increased significantly (p < 0.05) from 67 to 73%. According to the adolescents, active gaming mainly replaces sedentary screen time such as TV viewing, internet and non-active gaming. Parental opinions concurred with this appraisal.
Eleven percent of the adolescents with an active game in their household never used the game. There were no significant differences in gender, education level (of adolescent and parent), ethnicity and sedentary behaviour between regular (n = 65) and non-regular active gamers (n = 114). Adolescents' (regular and non-regular active gamers) meantime spent on active gaming was 80 (+/- 136) minutes a week; this potentially amounts to 11% of total physical activity. When time spent on active gaming was included in the calculation of the percentage of adolescents that met the physical activity guideline, the percentage increased significantly (p < 0.05) from 67 to 73%. According to the adolescents, active gaming mainly replaces sedentary screen time such as TV viewing, internet and non-active gaming. Parental opinions concurred with this appraisal.
Conclusions
The results of this study confirm the idea that active gaming may contribute to an active lifestyle in adolescents, primarily because it potentially contributes substantially to time spent on physical activity. Secondly, active gamers indicate that they spent time on active games which they would have spent otherwise on less active activities.
The results of this study confirm the idea that active gaming may contribute to an active lifestyle in adolescents, primarily because it potentially contributes substantially to time spent on physical activity. Secondly, active gamers indicate that they spent time on active games which they would have spent otherwise on less active activities.
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