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A Systematic Review

Elaine Biddiss, PhD, MASc, BAS; Jennifer Irwin, BEng

Arch Pediatr Adolesc Med. 2010;164(7):664-672. doi:10.1001/archpediatrics.2010.104

Objectives  To systematically review levels of metabolic expenditure and changes in activity patterns associated with active video game (AVG) play in children and to provide directions for future research efforts.

Data Sources  A review of the English-language literature (January 1, 1998, to January 1, 2010) via ISI Web of Knowledge, PubMed, and Scholars Portal using the following keywords: video game, exergame, physical activity, fitness, exercise, energy metabolism, energy expenditure, heart rate, disability, injury, musculoskeletal, enjoyment, adherence, and motivation.

Study Selection  Only studies involving youth (21 years) and reporting measures of energy expenditure, activity patterns, physiological risks and benefits, and enjoyment and motivation associated with mainstream AVGs were included. Eighteen studies met the inclusion criteria. Articles were reviewed and data were extracted and synthesized by 2 independent reviewers.

Main Outcome Exposures  Energy expenditure during AVG play compared with rest (12 studies) and activity associated with AVG exposure (6 studies).

Main Outcome Measures  Percentage increase in energy expenditure and heart rate (from rest).

Results  Activity levels during AVG play were highly variable, with mean (SD) percentage increases of 222% (100%) in energy expenditure and 64% (20%) in heart rate. Energy expenditure was significantly lower for games played primarily through upper body movements compared with those that engaged the lower body (difference, –148%; 95% confidence interval, –231% to –66%; P = .001).

Conclusions  The AVGs enable light to moderate physical activity. Limited evidence is available to draw conclusions on the long-term efficacy of AVGs for physical activity promotion.

Author Affiliations: Bloorview Research Institute, Bloorview Kids Rehab (Dr Biddiss), and Institute of Biomaterials and Biomedical Engineering, University of Toronto (Ms Irwin), Toronto, Ontario, Canada.

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