Authors Study description Sample Key findings Exergames Chin A Paw et al., 2008 [36 ] Comparison of home-based DDR and multiplayer DDR sessions with a 12-week RCT. 16 children with low fitness between 9 and 12 years old (mean 10.6
) from 4 primary schools. 29 recruited, 27 randomly assigned, 11 dropped out. Multiplayer group played more (901 min) than home-based (376 min). Children reported finding game boring after a while. Epstein et al., 2007 [37 ] Comparison study of activity levels and reinforcement value in active dance and bicycle games. 35 (18 M, 17 F) overweight (18) and nonoverweight (17) children aged 8 to 12 (10.8
). Active dance game is more reinforcing than dancing alone or while watching video. No difference found across 3 bicycle conditions. Graf et al., 2009 [38 ] Comparison EE rates playing AVG (DDR, Wii) in relation to treadmill walking (2.62, 4.2, and 5.7 km/h). 23 (14 M, 9 F) healthy children aged 10 to 13 (11.9
) with a mean BMI of 19.1
. EE increased 2- to 3-fold with AVG play and walking compared to watching TV. 2-fold increase in EE with bowing and DDR. Graves et al., 2007 [39 ] Determine EE with a cross section of 4 games. 11 (6 M, 5 F) children between 13 and 15 years (14.6
, BMI 21.2
) EE was 51% greater during VG play. Highest EE with Wii Tennis. EE greater for M versus F. Graves et al., 2008 [40 ] Comparison of EE in upper limbs versus total body movement with sedentary and active gaming. 13 youths (6 F, 7 M) between 11 and 17 years (15.1
) with a mean BMI of 22.0
Wii Boxing resulted in highest HR, EE, and nondominant upper limb activity. Haddock et al., 2009 [41 ] Determine EE when riding stationary bike with and without a video game. 20 children (13 M, 7F) at risk for or overweight between 7 and 14 years old. EE higher cycling with video game than without. No sig. difference in average perceived exertion. Lanningham-Foster et al., 2006 [42 ] Comparison of EE during sedentary gaming, watching TV, AVG play, and treadmill walking. 25 children (12 M, 13 F) aged 8 to 12 years (9.7
). 15 lean and 10 (5 M, 5 F) with mild obesity EE increased by 108 ± 40% with EyeToy and by 172 ± 68% with DDR. Maddison et al., 2007 [43 ] Comparison of EE and physical activity during sedentary gaming and AVG play. 21 children (11 M, 10 F) between 10 and 14 years old (12.4
) with a mean BMI of 20.3
Step counts increased 122 to 1288 during AVG play from sedentary play. Maddison et al., 2009 [30 ] Overview of the eGAME study. 2-arm parallel RCT to be carried. Determine effects of AVG on BMI, physical activity, cardiorespiratory fitness, waist circumference, and body composition. 330 overweight children between the ages of 10 and 14 years. Phase 1: All children enjoyed AVGs. Phase 2: EE sig. greater in AVGs compared to rest and sedentary gaming conditions. Madsen et al., 2007 [44 ] Pre-/post-6-mth noncomparative trial. Determine if overweight would use DDR for exercise, reasons fuse, correlate use with BMI. 30 (18F, 12 M) obese (BMI 38.3
) participants aged 9 to 18 (13.0
). Few used DDR regularly. Lack association between DDR use and change in BMI. Maloney et al., 2008 [45 , 46 ] 28-wk comparison of home-based DDR intervention focusing on physical activity and enjoyment. 60 children (30 M, 30 F) with a mean age of 7.5
DDR use highest in wk 1. Mean play duration 89 min/d. Use decreased to half prescribed level by study end. Sig. reduction in sedentary screen time in DDR group. McDougall and Duncan, 2008 [47 ] Mixed-methods, noncomparative design of 1 wk of lunchtime AVG play. 12 children (7 F, 5 M) aged 8–11 years Mean play duration of 24 min/d. Game play resulted in 10% of recommended steps daily and 11 min sustained moderate-to-vigorous phys. activity. Mellecker and McManus, 2008 [48 ] Comparison study of EE and HR while seated and during AVG play. 18 children (11 M, 7 F) aged 6–12 years (9.6
) EE above rest sig. higher for 2 AVGs compared with seated gaming. HR sig. higher during bowling and J-Mat compared to rest. Mellecker et al., 2009 [49 ] Evaluation of newly developed walking media station for feasibility of ambulatory screen time. 29 (17M, 12 F) healthy children between 6 and 13 years old Steady gait walking achieved in less than 1 min. No increase in EE when computer game added to walking. Murphy et al., 2009 [50 ] Determine whether DDR is effective in improving endothelial dysfunction in overweight. Randomly assigned to 12 wks of aerobic exercise using DDR or to a nonexercising delayed-treatment control group. 35 (17 F, 18 M) overweight children aged 7–12 years (10.21) with EDF. Sig. improvements in FMD, exercise time, MAP, weight, and peak VO2 compared with delayed-treatment group. 13 intervention participants achieved normal endothelial function. Ni Mhurchu et al., 2008 [51 ] Pilot 12-wk RCT to evaluate effect of AVG on phys. activity levels. Intervention received AVG upgrade package. Control received upgrade package at study end. 20 (8 F, 12 M) children aged 10–14 years (12
). Had to own PlayStation 2 to be eligible Phys. activity sig. higher in intervention group. Reduction in weight and waist circumference in intervention group at wk 12. Penko and Barkley, 2010 [52 ] Evaluation of physiologic cost, RRV, and liking. AVG play versus sedentary video game. 24 (12 M, 12 F) children (11 Lean, 13 obese) aged 8 to 12 years. Mean HR, VO2 , and liking sig. greater for AVG play than all other conditions. Ridley and Olds, 2001 [53 ] Description of EE and child behavior while visiting game centres. 134 children from observed. 10 (5 M, 5 F) children aged 10–12 years (12.5
) evaluated. Gross energy cost ranged from 7.6 to 2.5 ml kg-1 min-1 . Sit et al., 2010 [54 ] Examining preferences and PA levels during interactive or online games. 70 (35 F, 35 M) overweight (20) and nonoverweight (50) children aged 9 to 12. Split game time between interactive (52%) and online (48%). Sig. more moderate-to-vigorous PA with interactive than online. Boys and nonoverweight expended more energy during interactive games than girls and overweight. Straker and Abbott, 2007 [55 ] Comparison of cardiovascular response and EE during TV watching, sedentary gaming, and AVG play. 20 healthy children (12 M, 8 F) aged 9–12 years AVG play increased EE by 224% and HR by 59% from rest. AVG play exertion levels were equivalent to activities of moderate intensity. Unnithan et al., 2006 [56 ] Comparison of energy costs of playing DDR between overweight and nonoverweight kids. 22 children (10 with mild obesity; 12 with normal weight) between 11 and 17 years old. No sig. difference in HR or energy costs associated with DDR. Average VO2 with DDR sig. higher in overweight than nonoverweight. Educational Video Games Baranowski et al., 2011 [57 –59 ] 2-group RCT evaluation of Diab and Nanoswarm play in intervention group versus control playing website games. 133 children (45% F, 58% M) between 10 and 12 years old (42.5% 10 years old). BMI percentile initially 50th–95th. Playing Diab and Nanoswarm increased daily fruit consumption by 0.67 servings but not water intake, moderate-to-vigorous physical activity, or body composition. Baranowski et al., 2003 [60 ] 2 group RCT (30 min/wk, 8 wks) to prevent obesity. The Fun, Food and Fitness! project. 35 African-American girls aged 8 years (8.3
intervention; 8.4
control) and their parents/guardians. Intervention group consumed 232 less kcal; greater water, fruit, juice, and veg. consumption; fewer sweetened drinks consumed. Baranowski et al., 2003 [61 , 62 ] 5 wk 2 group RCT with pre/post test to increase fruit, juice and veg intake among healthy children via Squire's Quest! 26 elementary schools with 1578 (803 F) 4th-grade students (872 9 year olds). 1.0 fruit, juice, and veg. servings more in intervention group than control. Moore et al., 2009 [2 ] Effectiveness of Color My Pyramid and Blast-Off Game on physical activity and nutrition knowledge over 3 month period (pre/post test). 126 4th-5th (9–11 years old) grade students (46 M, 80 F). Increase in activity time from pretest to posttest and decrease in systolic BP for both groups. No sig. differences in BMI. Munguba et al., 2008 [63 ] Evaluation of an occupational therapy education nutrition education intvn using 2 interactive games (1 video game, 1 board game). 200 public school children between 8 and 10 years old (95 M, 105 F). Both games promoted learning of nutritional concepts. Pempek and Calvert, 2009 [64 ] Examination of how advergames affect consumption of healthier and less healthy snacks. 30 (15 M, 15 F) low-income African-American school children between 9 and 10 years old from 5 elementary schools Group playing healthier version of the game chose and ate more healthy snacks than less healthy game group. D. R. Southard and B. H. Southard, 2006 [65 ] Prelim. results of 4-wk RCT using MetaKenkoh to promote phys. activity and healthier food choice. 120 children (63% M) aged 9–11 years old. Of which 13.6% are at risk for overweight, 25.9% are overweight. Underweight and normal weight in intervention group showed increase in activity. Thompson et al., 2009 [66 ] 9 wk 2-group RCT evaluating Boy Scout 5-a-Day Badge on fruit, juice, and veg. consumption. With online knowledge games. 473 boy scouts (42 troops) aged 10–14 years. Sig. increases in fruit juice consumption, fruit juice availability at home, and veg. consumption self-efficacy in the intervention group. Turnin et al., 2001 [67 ] 2-group RCT evaluation of knowledge games nutritional knowledge and improving eating habits. 1876 7–12-year-old 3rd-5th graders (52.5% F) from 16 schools. Intervention group sig. better nutritional knowledge and dietary intake compared with control.
