Exergaming as a Strategic Tool in the Fight against Childhood Obesity: A Systematic Review

Table 1

Summary of the findings of the selected studies with regard to body composition, energy expenditure, and physical activity levels of children and adolescents.

Author and year	Study objective	Study population	Methodology	Variables	Results
Graves et al., 2008 [14].	Compare the energy expenditure when playing sedentary and new-generation active computer games.	11 adolescents aging 13–15 years.	Four types of games were played: 1 sedentary (XBOX 360) and 3 active (Wii Sports), 15 min each.	Height, body mass, BMI, and energy expenditure.	Energy expenditure was greater when gaming than at rest (𝑃<0.001). Active gaming expended significantly more energy than sedentary gaming (𝑃<𝟎.𝟎𝟎𝟏).
Ni Mhurchu et al., 2008 [15].	Analyze effect of exergaming on anthropometric profile and level of physical activity.	20 children aging 10–14 years.	The intervention group (𝑛=10) played active games; the control group (𝑛=10) played sedentary games. Study duration: 12 weeks.	Height, body mass, physical activity questionnaire for children (PAQ-C), accelerometer, and waist circumference.	Compared to the controls, children in the intervention group were physically more active (𝑃<0.05), played fewer sedentary games, and had reduced waist circumference (𝑃<𝟎.𝟎𝟓).
Mellecker and McManus, 2008 [16].	Evaluate energy cost and cardiovascular response to active gaming and sedentary gaming.	18 children aging 6–12 years.	Intervention: 5 min familiarization, 5 min resting, 5 min playing while seated (bowling), 5 min exergaming (XaviX Bowling), 5 min resting, and 5 min exergaming (XaviX J-Mat Jackie’s Action Run).	BMI, energy cost (rest versus sedentary gaming versus exergaming), and heart rate.	Exergaming required greater energy expenditure than sedentary gaming (𝑃<𝟎.𝟎𝟎𝟏).
Maloney et al., 2008 [17].	Evaluate the ability of DDR to increase physical activity and decrease sedentary screen time.	60 children aging 7-8 years.	Intervention group (𝑛=40) played DDR compared to wait-list control group (𝑛=20). Study duration: 28 weeks.	BMI, heart rate, blood pressure, and level of physical activity (accelerometer).	The groups did not differ significantly with regard to physical activity, but sedentary screen time decreased in the intervention group (𝑃<𝟎.𝟎𝟓).
Graf et al., 2009 [18].	Evaluate energy expenditure for two exergames (DDR and Wii Sports) in relation to treadmill walking.	23 children aging 10–13 years.	During 4 weeks (2 visits per week), the participants played DDR (1st visit) and played Wii and walked (2nd visit).	Height, body mass, body fat, IMC, energy expenditure, heart rate, accelerometer, blood pressure, and arterial elasticity.	Exergaming increased energy expenditure equivalent to moderate-intensity walking.
Haddock et al., 2009 [19].	Compare energy expenditure of stationary cycling connected to a video game and stationary cycling alone.	23 children aging 7–14 years with BMI ≤ the 85th percentile.	Following familiarization, the participants used the bicycle for 20 min with or without the video game connected.	Height, body mass, BMI, heart rate, oxygen consumption, and energy expenditure.	The energy expenditure was greater when riding the bike + video game than when riding the bike by itself (𝑃<0.01); no significant difference in the rating of perceived exertion was observed (𝑃>0.05); level of exertion was classified as moderate intensity.
Bailey and McInnis, 2011 [20].	Evaluate relative effect of exergaming on body composition and energy expenditure in different BMI ranges.	39 children aging 9–13 years.	Participants played 6 types of exergames.	BMI, energy expenditure at rest and during exercise, and, body composition (% fat, fat mass, and fat-free mass).	The evaluated exergames elevated energy expenditure to moderate or vigorous intensity (𝑃<𝟎.𝟎𝟓) and represent a good alternative for children in different BMI ranges.
Maddison et al., 2011 [21].	Evaluate effects of active video games on body composition, physical activity, and fitness.	322 children aging 10–14 years.	Intervention group (𝑛=160) played active games; control group (𝑛=162) played sedentary games. Study duration: evaluation after 12 and 24 weeks of intervention.	Height, body mass, bioelectrical impedance, and shuttle run (V̇O2 max).	Small but significant differences were observed between the groups with regard to BMI (𝑃=𝟎.𝟎𝟐) and body composition, for % fat (𝑃=𝟎.𝟎𝟐) and fat mass (𝑃=𝟎.𝟎𝟎𝟓), in overweight and obese children.
Shayne et al., 2012 [22].	Compare the effects of exergaming and traditional physical education on physical activity.	Four boys.	The children had regular physical education classes (sports and fitness challenges) and exergaming classes with six types of equipment.	Percentage of session engaged in physical activity, and percentage of session with opportunity for physical activity.	The percentage of physical activity was significantly greater for exergaming. So was the percentage of physical activity engaged in when given the opportunity.

BMI: body mass index; PAQ-C: physical activity questionnaire for children; DDR: Dance Dance Revolution; and V̇O₂ max: maximal oxygen uptake.