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Emerging Technology Applications to Promote Physical Activity and Health

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (15 October 2018) | Viewed by 143369

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Special Issue Editors

Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, TN 37996, USA
Interests: physical activity epidemiology; physical activity interventions; emerging technology applications; physical activity measurement
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Applied Human Sciences, The University of Minnesota at Duluth, Duluth, MN 55812, USA
Interests: psychological correlates of physical activity; technology-based physical activity promotion; motor skill enhancement
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As technology becomes an ever-more prevalent part of everyday life, and population-based physical activity programs seek new ways to increase life­long engagement with physical activity, these two ideas have become increasingly linked. This Special Issue attempts to offer a thorough and critical examination of emerging technolo­gies in physical activity and health promotion, considering technological interventions in different contexts (communities, clinics, schools, homes, etc.) among various populations, exploring the challenges of integ­rating technology into physical activity promotion, and offering solutions for its implementation. This Special Issue aims to occupy a broadly positive stance toward interactive technology initiatives and, while discussing some negative implications of an increased use of technology, offers practical recommendations for promoting physical activity through various emerging technologies, including, but not limited to: Active video games (exergaming); social media; mobile device apps; health wearables; mobile games, augmented reality games, global positioning and geographic information systems; and virtual reality. Offering a logical and clear critique of emerging technologies in physical activity and health promotion, this Special Issue will provide useful suggestions and practical implications for researchers, practitioners, and educators in the fields of public health, kinesiology, physical activity and health, and healthcare.

Prof. Dr. Zan Gao
Dr. Jung Eun Lee
Guest Editors

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Keywords

  • active video games
  • augmented reality games
  • exergaming
  • global positioning and geographic information systems
  • health wearables
  • mobile device apps
  • physical activity and health promotion
  • social media
  • virtual reality

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Published Papers (16 papers)

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Editorial

Jump to: Research, Review

10 pages, 215 KiB  
Editorial
Virtual Reality Exercise as a Coping Strategy for Health and Wellness Promotion in Older Adults during the COVID-19 Pandemic
by Zan Gao, Jung Eun Lee, Daniel J. McDonough and Callie Albers
J. Clin. Med. 2020, 9(6), 1986; https://doi.org/10.3390/jcm9061986 - 25 Jun 2020
Cited by 99 | Viewed by 19423
Abstract
The December 2019 COVID-19 outbreak in China has led to worldwide quarantine, as recommended by local governments and the World Health Organization. Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, [...] Read more.
The December 2019 COVID-19 outbreak in China has led to worldwide quarantine, as recommended by local governments and the World Health Organization. Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, including declines in motor ability and physical activity (PA) participation, increased obesity, impaired cognition, and various psychological disorders. Thus, given the secular increases in the older adult population, novel and effective intervention strategies are necessary to improve physical activity behaviors and health in this population. Virtual reality (VR)-integrated exercise is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. Therefore, the purpose of this editorial is to synthesize recent research examining the efficacy and effectiveness of VR exercise in the promotion of favorable health outcomes among the older adults. Results indicate the application of VR exercise to facilitate improved physical outcomes (e.g., enhanced motor ability, reduced obesity), cognition and psychological outcomes. VR exercise has also been observed to be an effective intervention strategy for fall prevention in this population. Future research should employ more rigorous research designs to allow for a more robust quantitative synthesis of the effect of VR exercise on the preceding outcomes to elucidate which type(s) of VR-based PA interventions are most effective in promoting improved health outcomes among older adults. Findings from this study will better inform the development of technology-savvy PA programs for wellness promotion in older adults who practice social distancing and exercise from home under the unprecedented global health crisis. Full article
14 pages, 263 KiB  
Editorial
Emerging Technology in Promoting Physical Activity and Health: Challenges and Opportunities
by Zan Gao and Jung Eun Lee
J. Clin. Med. 2019, 8(11), 1830; https://doi.org/10.3390/jcm8111830 - 1 Nov 2019
Cited by 59 | Viewed by 9015
Abstract
Sedentary behavior has been identified as one of the major causes of many chronic diseases such as cardiovascular disease, stroke, cancer, type 2 diabetes, and obesity [...] Full article

Research

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9 pages, 219 KiB  
Article
Examining Young Children’s Physical Activity and Sedentary Behaviors in an Exergaming Program Using Accelerometry
by Minghui Quan, Zachary Pope and Zan Gao
J. Clin. Med. 2018, 7(10), 302; https://doi.org/10.3390/jcm7100302 - 25 Sep 2018
Cited by 19 | Viewed by 3663
Abstract
Exergaming has been observed to be a viable supplemental approach in promoting physical activity (PA) among children. However, whether sex differences in PA and sedentary behaviors exist during exergaming is inconsistent. Thus, this study aimed to quantify, via accelerometry, young children’s PA and [...] Read more.
Exergaming has been observed to be a viable supplemental approach in promoting physical activity (PA) among children. However, whether sex differences in PA and sedentary behaviors exist during exergaming is inconsistent. Thus, this study aimed to quantify, via accelerometry, young children’s PA and sedentary behaviors during exergaming as well as examine sex differences in these PA and sedentary behaviors during gameplay. In total, 121 first- and second-grade children (mean age = 6.89 ± 0.9 years; 73 girls) were included in the analysis. Children were a part of a large 18-week parent study. Children wore ActiGraph GT1M accelerometers during exergaming play, with four measurements purposively selected from the 28 total exergaming sessions to capture children’s PA and sedentary behaviors during exergaming play. Outcome variables included mean percentages of time spent in moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary behavior during each exergaming session. One-way ANOVA was performed to determine whether there were differences in the percentage of time engaged in MVPA, LPA, and sedentary behavior during exergaming by sex. Accelerometry data indicated that children’s mean percentage of exergaming time spent in MVPA, LPA, and sedentary behavior were 19.9%, 32.9%, and 47.2%, respectively. However, no sex differences were present. Observations in this study indicated that boys and girls have similar PA levels during exergaming and suggests that features inherent to exergaming may assist in PA promotion among both sexes. Full article
8 pages, 699 KiB  
Article
The Effect of Gamification through a Virtual Reality on Preoperative Anxiety in Pediatric Patients Undergoing General Anesthesia: A Prospective, Randomized, and Controlled Trial
by Jung-Hee Ryu, Jin-Woo Park, Francis Sahngun Nahm, Young-Tae Jeon, Ah-Young Oh, Hak Jong Lee, Jin-Hee Kim and Sung-Hee Han
J. Clin. Med. 2018, 7(9), 284; https://doi.org/10.3390/jcm7090284 - 17 Sep 2018
Cited by 92 | Viewed by 10572
Abstract
The use of gamification in healthcare has been gaining popularity. This prospective, randomized, clinical trial was designed to evaluate whether gamification of the preoperative process—via virtual reality (VR) gaming that provides a vivid, immersive and realistic experience—could reduce preoperative anxiety in children. Seventy [...] Read more.
The use of gamification in healthcare has been gaining popularity. This prospective, randomized, clinical trial was designed to evaluate whether gamification of the preoperative process—via virtual reality (VR) gaming that provides a vivid, immersive and realistic experience—could reduce preoperative anxiety in children. Seventy children scheduled for elective surgery under general anesthesia were randomly divided into either the control or gamification group. Children in the control group received conventional education regarding the preoperative process, whereas those in the gamification group played a 5 min VR game experiencing the preoperative experience. Preoperative anxiety, induction compliance checklist (ICC), and procedural behavior rating scale (PBRS) were measured. Sixty-nine children were included in the final analysis (control group = 35, gamification = 34). Preoperative anxiety (28.3 [23.3–36.7] vs. 46.7 [31.7–51.7]; p < 0.001) and intraoperative compliance measured using ICC (p = 0.038) were lower in the gamification group than in the control group. However, PBRS (p = 0.092) and parent/guardian satisfaction (p = 0.268) were comparable between the two groups. VR experience of the preoperative process could reduce preoperative anxiety and improve compliance during anesthetic induction in children undergoing elective surgery and general anesthesia. Full article
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15 pages, 1517 KiB  
Article
Application and Validation of Activity Monitors’ Epoch Lengths and Placement Sites for Physical Activity Assessment in Exergaming
by Jungyun Hwang, Austin Michael Fernandez and Amy Shirong Lu
J. Clin. Med. 2018, 7(9), 268; https://doi.org/10.3390/jcm7090268 - 11 Sep 2018
Cited by 28 | Viewed by 6355
Abstract
We assessed the agreement of two ActiGraph activity monitors (wGT3X vs. GT9X) placed at the hip and the wrist and determined an appropriate epoch length for physical activity levels in an exergaming setting. Forty-seven young adults played a 30-min exergame while wearing wGT3X [...] Read more.
We assessed the agreement of two ActiGraph activity monitors (wGT3X vs. GT9X) placed at the hip and the wrist and determined an appropriate epoch length for physical activity levels in an exergaming setting. Forty-seven young adults played a 30-min exergame while wearing wGT3X and GT9X on both hip and wrist placement sites and a heart rate sensor below the chest. Intraclass correlation coefficient indicated that intermonitor agreement in steps and activity counts was excellent on the hip and good on the wrist. Bland-Altman plots indicated good intermonitor agreement in the steps and activity counts on both placement sites but a significant intermonitor difference was detected in steps on the wrist. Time spent in sedentary and physical activity intensity levels varied across six epoch lengths and depended on the placement sites, whereas time spent from a 1-s epoch of the hip-worn monitors most accurately matched the relative exercise intensity by heart rate. Hip placement site was associated with better step-counting accuracy for both activity monitors and more valid estimation of physical activity levels. A 1-s epoch was the most appropriate epoch length to detect short bursts of intense physical activity and may be the best choice for data processing and analysis in exergaming studies examining intermittent physical activities. Full article
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11 pages, 368 KiB  
Article
Impact of Exergaming on Children’s Motor Skill Competence and Health-Related Fitness: A Quasi-Experimental Study
by Sunyue Ye, Jung Eun Lee, David F. Stodden and Zan Gao
J. Clin. Med. 2018, 7(9), 261; https://doi.org/10.3390/jcm7090261 - 7 Sep 2018
Cited by 33 | Viewed by 6396
Abstract
This study was designed to examine the effectiveness of a combined exergaming and physical education (PE) program on children’s motor skill competence (MSC) and health-related fitness (HRF) as compared to traditional PE. A total of 261 second- and third-grade children (127 boys; 8.25 [...] Read more.
This study was designed to examine the effectiveness of a combined exergaming and physical education (PE) program on children’s motor skill competence (MSC) and health-related fitness (HRF) as compared to traditional PE. A total of 261 second- and third-grade children (127 boys; 8.25 ± 0.66 years for male; 8.29 ± 0.74 years for female; 73.6% non-Hispanic white) participated in the nine-month study from 2012 to 2013. Children were assigned to one of the two groups: (a) intervention group (125 min of alternating PE and exergaming weekly); and (b) comparison group (125-min weekly PE). MSC was assessed via product scores in two locomotor and two object control skills. HRF included the cardiorespiratory fitness, musculoskeletal fitness, and body mass index (BMI). A multivariate analysis of variance (MANOVA) was performed to analyze the effect of the combined exergaming–PE program on children’s MSC and HRF. There were significant group by time interaction effects for BMI, p < 0.01, η2 = 0.20; musculoskeletal fitness, p < 0.01, η2 = 0.13; and object control skills (the comparison group demonstrating greater improvement), p = 0.01, η2 = 0.03. The findings suggest that the combined exergaming program can have a positive effect on children’s BMI and musculoskeletal fitness, indicating that exergaming can be an alternative school-based program to supplement traditional PE. Full article
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12 pages, 521 KiB  
Article
Association between Air Quality and Sedentary Time in 3270 Chinese Adults: Application of a Novel Technology for Posture Determination
by Yiqun Ma, Bing Yuan, Shuhui Fan, Yizhou Luo and Xu Wen
J. Clin. Med. 2018, 7(9), 257; https://doi.org/10.3390/jcm7090257 - 6 Sep 2018
Cited by 9 | Viewed by 3563
Abstract
This study investigated the association between ambient air quality and sedentary time in Chinese adults. The participants were 3270 Chinese users (2021 men and 1249 women) of wrist-worn activity trackers. The data of participants’ daily activities were collected from July 2015 to October [...] Read more.
This study investigated the association between ambient air quality and sedentary time in Chinese adults. The participants were 3270 Chinese users (2021 men and 1249 women) of wrist-worn activity trackers. The data of participants’ daily activities were collected from July 2015 to October 2015. A novel algorithm based on raw accelerometer data was employed to determine sedentary time. Personal data, including sex, age, weight and height, were self-reported by the participants. Data of air quality, ambient temperature and weather were collected from the data released by the China National Environmental Monitoring Centre and the China Central Meteorological Observatory and matched in accordance with the Global Positioning System and time information. Multilevel regression analyses were conducted to investigate the association between air quality and sedentary time and adjusted for gender, age, region, body mass index, weather, temperature, weekday/weekend and monitored wake time per day. Better air quality index levels and lower concentrations of fine particulate matter were significantly associated with approximately 20 and 45 min reduction in sedentary time, respectively. Poor air quality appears to be an independent factor associated with prolonged sedentary time in Chinese adults. Full article
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17 pages, 4251 KiB  
Article
Safety and Lack of Negative Effects of Wearable Augmented-Reality Social Communication Aid for Children and Adults with Autism
by Ned T. Sahin, Neha U. Keshav, Joseph P. Salisbury and Arshya Vahabzadeh
J. Clin. Med. 2018, 7(8), 188; https://doi.org/10.3390/jcm7080188 - 30 Jul 2018
Cited by 44 | Viewed by 8742
Abstract
There is a growing interest in the use of augmented reality (AR) to assist children and adults with autism spectrum disorders (ASD); however, little investigation has been conducted into the safety of AR devices, such as smartglasses. The objective of this report was [...] Read more.
There is a growing interest in the use of augmented reality (AR) to assist children and adults with autism spectrum disorders (ASD); however, little investigation has been conducted into the safety of AR devices, such as smartglasses. The objective of this report was to assess the safety and potential negative effects of the Empowered Brain system, a novel AR smartglasses-based social communication aid for people with ASD. The version of the Empowered Brain in this report utilized Google Glass (Google, Mountain View, CA, USA) as its hardware platform. A sequential series of 18 children and adults, aged 4.4 to 21.5 years (mean 12.2 years), with clinically diagnosed ASD of varying severity used the system. Users and caregivers were interviewed about the perceived negative effects and design concerns. Most users were able to wear and use the Empowered Brain (n = 16/18, 89%), with most of them reporting no negative effects (n = 14/16, 87.5%). Caregivers observed no negative effects in users (n = 16/16, 100%). Most users (77.8%) and caregivers (88.9%) had no design concerns. This report found no major negative effects in using an AR smartglasses-based social communication aid across a wide age and severity range of people with ASD. Further research is needed to explore longer-term effects of using AR smartglasses in this population. Full article
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11 pages, 228 KiB  
Article
Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening
by Hee Yun Lee, Mi Hwa Lee, Zan Gao and Karim Sadak
J. Clin. Med. 2018, 7(8), 181; https://doi.org/10.3390/jcm7080181 - 24 Jul 2018
Cited by 20 | Viewed by 5130
Abstract
Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia [...] Read more.
Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations. Full article
10 pages, 374 KiB  
Article
Technology-Enhanced Classroom Activity Breaks Impacting Children’s Physical Activity and Fitness
by Heidi Buchele Harris and Weiyun Chen
J. Clin. Med. 2018, 7(7), 165; https://doi.org/10.3390/jcm7070165 - 29 Jun 2018
Cited by 16 | Viewed by 5726
Abstract
Background: This study examined the effects of a 4-week technology-enhanced physical activity (PA) interventions on students’ real-time daily PA and aerobic fitness levels. Methods: 116 fifth-graders were assigned to one intervention group (n = 31) participating in daily physical activity engaging the [...] Read more.
Background: This study examined the effects of a 4-week technology-enhanced physical activity (PA) interventions on students’ real-time daily PA and aerobic fitness levels. Methods: 116 fifth-graders were assigned to one intervention group (n = 31) participating in daily physical activity engaging the brain with Fitbit Challenge (PAEB-C), another intervention group (n = 29) wearing Fitbits only (Fitbit-O) daily, five days per week, or the comparison group (n = 56). Four-week real-time PA data were collected from the intervention students via Fitbase. Three groups were pre- and post-tested aerobic fitness. Results: The PAEB-C students showed significantly higher steps and minutes of being very active and fairly active (F = 7.999, p = 0.014, ŋ = 0.121; F = 5.667, p = 0.021, ŋ = 0.089; F = 10.572, p = 0.002, ŋ = 0.154) and lower minutes of being sedentary daily (F = 4.639, p = 0.035, ŋ = 0.074) than the Fitbit-O group. Both Fitbit groups exhibited significantly greater increases in aerobic fitness scores than the comparison group over time (F = 21.946, p = 0.001, ŋ = 0.303). Boys were more physically active and fit than girls. Conclusions: Technology-enhanced PA intervention was effective for improving real-time PA and aerobic fitness. Full article
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17 pages, 698 KiB  
Article
Effectiveness of Combined Smartwatch and Social Media Intervention on Breast Cancer Survivor Health Outcomes: A 10-Week Pilot Randomized Trial
by Zachary C. Pope, Nan Zeng, Rui Zhang, Hee Yun Lee and Zan Gao
J. Clin. Med. 2018, 7(6), 140; https://doi.org/10.3390/jcm7060140 - 7 Jun 2018
Cited by 64 | Viewed by 6707
Abstract
Physical activity (PA) among breast cancer survivors (BCS) can improve this population’s health and quality of life (QoL). This study evaluated the effectiveness of a combined smartwatch- and social media-based health education intervention on BCS’s health outcomes. Thirty BCS ( X ¯ age [...] Read more.
Physical activity (PA) among breast cancer survivors (BCS) can improve this population’s health and quality of life (QoL). This study evaluated the effectiveness of a combined smartwatch- and social media-based health education intervention on BCS’s health outcomes. Thirty BCS ( X ¯ age = 52.6 ± 9.3 years; X ¯ Wt = 80.2 ± 19.6 kg) participated in this 10-week, 2-arm randomized trial, with BCS randomized into: (1) experimental group (n = 16): received Polar M400 smartwatches for daily PA tracking and joined a Facebook group wherein Social Cognitive Theory-related PA tips were provided twice weekly; and (2) comparison group (n = 14): only joined separate, but content-identical Facebook group. Outcomes included PA, physiological, psychosocial, and QoL variables. Specifically, PA and energy expenditure (EE) was assessed by ActiGraph GT3X+ accelerometers while physiological, psychosocial, and QoL were examined via validated instruments at baseline and post-intervention. No baseline group differences were observed for any variable. Ten BCS dropped out of the study (experimental: 4; comparison: 6). Compared to completers, dropouts differed significantly on several outcomes. Thus, a per-protocol analysis was performed, revealing significant group differences for changes in social support (t = −2.1, p = 0.05) and barriers (t = −2.2, p = 0.04). Interestingly, the comparison group demonstrated improvements for both variables while the intervention group demonstrated slightly decreased social support and no change in barriers. Notably, both groups demonstrated similarly increased daily light PA, moderate-to-vigorous PA, EE, and steps of 7.7 min, 5.1 min, 25.1 kcals, and 339 steps, respectively, over time. Despite extensive user training, several experimental BCS found the Polar M400 use difficult—possibly decreasing intervention adherence. Future interventions should utilize simpler smartwatches to promote PA among middle-aged clinical/non-clinical populations. Full article
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8 pages, 236 KiB  
Article
Preschoolers’ Technology-Assessed Physical Activity and Cognitive Function: A Cross-Sectional Study
by Minghui Quan, Hanbin Zhang, Jiayi Zhang, Tang Zhou, Jinming Zhang, Guanggao Zhao, Hui Fang, Shunli Sun, Ru Wang and Peijie Chen
J. Clin. Med. 2018, 7(5), 108; https://doi.org/10.3390/jcm7050108 - 8 May 2018
Cited by 18 | Viewed by 5455
Abstract
Early childhood is a critical period for development of cognitive function, but research on the association between physical activity and cognitive function in preschool children is limited and inconclusive. This study aimed to examine the association between technology-assessed physical activity and cognitive function [...] Read more.
Early childhood is a critical period for development of cognitive function, but research on the association between physical activity and cognitive function in preschool children is limited and inconclusive. This study aimed to examine the association between technology-assessed physical activity and cognitive function in preschool children. A cross-sectional analysis of baseline data from the Physical Activity and Cognitive Development Study was conducted in Shanghai, China. Physical activity was measured with accelerometers for 7 consecutive days, and cognitive functions were assessed using the Chinese version of Wechsler Young Children Scale of Intelligence (C-WYCSI). Linear regression analyses were used to assess the association between physical activity and cognitive function. A total of 260 preschool children (boys, 144; girls, 116; mean age: 57.2 ± 5.4 months) were included in analyses for this study. After adjusting for confounding factors, we found that Verbal Intelligence Quotient, Performance Intelligence Quotient, and Full Intelligence Quotient were significantly correlated with light physical activity, not moderate to vigorous physical activity, in boys. Standardized coefficients were 0.211, 0.218, and 0.242 (all p < 0.05) in three different models, respectively. However, the correlation between physical activity and cognitive functions were not significant in girls (p > 0.05). These findings suggest that cognitive function is apparently associated with light physical activity in boys. Further studies are required to clarify the sex-specific effect on physical activity and cognitive functions. Full article
11 pages, 231 KiB  
Article
Reliability of Using Motion Sensors to Measure Children’s Physical Activity Levels in Exergaming
by Nan Zeng, Xingyuan Gao, Yuanlong Liu, Jung Eun Lee and Zan Gao
J. Clin. Med. 2018, 7(5), 100; https://doi.org/10.3390/jcm7050100 - 2 May 2018
Cited by 13 | Viewed by 4893
Abstract
Objectives: This study examined the reliability of two objective measurement tools in assessing children’s physical activity (PA) levels in an exergaming setting. Methods: A total of 377 children (190 girls, Mage = 8.39, SD = 1.55) attended the 30-min exergaming class every [...] Read more.
Objectives: This study examined the reliability of two objective measurement tools in assessing children’s physical activity (PA) levels in an exergaming setting. Methods: A total of 377 children (190 girls, Mage = 8.39, SD = 1.55) attended the 30-min exergaming class every other day for 18 weeks. Children’s PA levels were concurrently measured by NL-1000 pedometer and ActiGraph GT3X accelerometer, while children’s steps per min and time engaged in sedentary, light, and moderate-to-vigorous PA were estimated, respectively. Results: The results of intraclass correlation coefficient (ICC) indicated a low degree of reliability (single measures ICC = 0.03) in accelerometers. ANOVA did detect a possible learning effect for 27 classes (p < 0.01), and the single measures ICC was 0.20 for pedometers. Moreover, there was no significant positive relationship between steps per min and time spent in moderate-to-vigorous physical activity (MVPA). Finally, only 1.3% variance was explained by pedometer as a predictor using Hierarchical Linear Modeling to further explore the relationship between pedometer and accelerometer data. Conclusions: The NL-1000 pedometers and ActiGraph GT3X accelerometers have low reliability in assessing elementary school children’s PA levels during exergaming. More research is warranted in determining the reliable and accurate measurement information regarding the use of modern devices in exergaming setting. Full article
10 pages, 212 KiB  
Article
Cross-Sectional Associations of Environmental Perception with Leisure-Time Physical Activity and Screen Time among Older Adults
by Ming-Chun Hsueh, Chien-Yu Lin, Pin-Hsuan Huang, Jong-Hwan Park and Yung Liao
J. Clin. Med. 2018, 7(3), 56; https://doi.org/10.3390/jcm7030056 - 13 Mar 2018
Cited by 11 | Viewed by 4783
Abstract
This study investigated associations of perceived environmental factors with leisure-time physical activity (LTPA) and screen time (ST) among older adults. A cross-sectional study was conducted by administering computer-assisted telephone interviews to 1028 older Taiwanese adults in November 2016. Data on personal factors, perceived [...] Read more.
This study investigated associations of perceived environmental factors with leisure-time physical activity (LTPA) and screen time (ST) among older adults. A cross-sectional study was conducted by administering computer-assisted telephone interviews to 1028 older Taiwanese adults in November 2016. Data on personal factors, perceived environmental factors, LTPA, and ST were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine associations of environmental perception with LTPA and ST by using logistic regression analyses. The results showed that after adjusting for potential confounders, older adults who perceived their neighborhood with good access to shops (AS) and to public transportation (AT) were more likely to have sufficient LTPA (AS: OR = 1.64, 95% CI: 1.16–2.32; AT: OR = 1.43; 95% CI, 1.00–2.03) and less likely to have excessive ST (AS: OR = 0.70; 95% CI: 0.50–0.97; AT: OR = 0.64; 95% CI: 0.46–0.90). Different perceived environmental factors were also associated with LTPA and ST, respectively. This study highlights environment perception as a crucial factor for LTPA and ST. These findings suggest that policy makers and physical activity intervention designers should develop both common and individual environmental strategies to improve and increase awareness of the neighborhood environment to promote LTPA and reduce ST among older adults. Full article

Review

Jump to: Editorial, Research

12 pages, 6378 KiB  
Review
Exergaming for Children and Adolescents: Strengths, Weaknesses, Opportunities and Threats
by Valentin Benzing and Mirko Schmidt
J. Clin. Med. 2018, 7(11), 422; https://doi.org/10.3390/jcm7110422 - 8 Nov 2018
Cited by 138 | Viewed by 16578
Abstract
Exergaming, or active video gaming, has become an emerging trend in fitness, education and health sectors. It is defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). Since [...] Read more.
Exergaming, or active video gaming, has become an emerging trend in fitness, education and health sectors. It is defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). Since exergaming is becoming more popular, claims have been made on the usefulness of exergaming. It has, for example, been entitled as being “the future of fitness” by the American College of Sports Medicine, promoting PA and health in children and adolescents. However, research also suggests that long-term engagement in exergaming is difficult to achieve, and there is a noticeable reservation towards exergaming by parents, teachers and caregivers. To provide an overview and to outline the future directions of exergaming, the aim of this review was to critically illustrate the strengths, weaknesses, opportunities and threats of exergaming to promote PA and health in children and youth. The available evidence indicates that exergaming has the potential to improve health via an increase in PA. However, it seems that this potential is frequently underexploited, and further developments such as customized exergames are needed. Full article
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13 pages, 582 KiB  
Review
Virtual Reality Exercise for Anxiety and Depression: A Preliminary Review of Current Research in an Emerging Field
by Nan Zeng, Zachary Pope, Jung Eun Lee and Zan Gao
J. Clin. Med. 2018, 7(3), 42; https://doi.org/10.3390/jcm7030042 - 4 Mar 2018
Cited by 148 | Viewed by 24579
Abstract
Objective: Although current evidence supports the use of virtual reality (VR) in the treatment of mental disorders, it is unknown whether VR exercise would be beneficial to mental health. This review synthesized literature concerning the effect of VR exercise on anxiety and depression [...] Read more.
Objective: Although current evidence supports the use of virtual reality (VR) in the treatment of mental disorders, it is unknown whether VR exercise would be beneficial to mental health. This review synthesized literature concerning the effect of VR exercise on anxiety and depression among various populations. Methods: Ten electronic databases were searched for studies on this topic from January 2000 through October 2017. Studies were eligible if the article: (1) was peer-reviewed; (2) was published in English; and (3) used quantitative measures in assessing anxiety- and depression-related outcomes. Results: A total of five empirical studies met the eligibility criteria. These studies included two randomized clinical trials, one control trial, and two cross-sectional studies. Four studies reported significant improvements in anxiety- and depression-related measures following VR exercise, including reduced tiredness and tension, in addition to increased energy and enjoyment. Nonetheless, one study failed to support the effectiveness of VR exercise over traditional exercise alone on depressive symptoms. Conclusions: Findings favor VR exercise in alleviating anxiety and depression symptomology. However, existing evidence is insufficient to support the advantages of VR exercise as a standalone treatment over traditional therapy in the alleviation of anxiety and depression given the paucity of studies, small sample sizes, and lack of high-quality research designs. Future studies may build upon these limitations to discern the optimal manner by which to employ VR exercise in clinical settings. Full article
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