Wii fitness games 'no health boost'

“Playing active video games won’t help you stay fit,” the Daily Mail has today reported.

In what will surely come as a blow to people who think tennis can be played from the sofa, researchers conducting a new study found that a selection of sporty, movement-based games for the popular Wii console did not make children any more active than traditional button-bashers like Super Mario Bros.

The games were tested in a 13-week trial that randomly gave children with an above-average weight ‘active’ video games controlled by moving around the room or games that did not require physical activity. After comparing activity levels between the two groups the researchers say that there was little difference, even though active video games have been shown to increase children’s physical activity levels in a laboratory setting.

In recent years, movement-based video games have been seen as a potential way to keep children healthy. Unfortunately, this research does not support the idea that we can prescribe a course of Dance Dance Revolution Hottest Party 3 to keep them active. That said, there were limitations to the study that mean that the results are not certain and need to be corroborated through larger trials.

Where did the story come from?

The study was carried out by researchers from the Baylor College of Medicine in the US and was funded by the US National Institutes of Health and US Department of Agriculture and Agricultural Research Service. It was published in the peer-reviewed medical journal Pediatrics.

The Daily Mail covered the research appropriately, although it did not report on any of the study’s limitations, including its small sample size or confounding factors that may have influenced the results.

What kind of research was this?

This was a randomised controlled trial that examined activity levels in children given a new Nintendo Wii console with either active or inactive video games. The Wii is a games system where players can play games either with traditional button-based controls or by using movement-sensing controllers that direct the action on screen. Some games also use a pressure-sensitive mat that can identify how people are standing or walking on it during activity-based games. The children were given a new video game to play at home, but were provided with no instructions on how much they were expected to play or which game they should play.

The researchers say that this approach mirrors more closely how children would use video games in a real-life setting, and may provide a more accurate indication of the actual impact of active video games than research carried out in a laboratory, where the type of game and intensity of activity can be monitored and controlled.

What did the research involve?

The researchers gave a new Wii video game console to 84 children between the ages of 9 and 12 years old with above-average body mass index (BMI). BMI is an estimate of body fat calculated using a person’s weight and height. The researchers randomised the children to either the active or inactive video game groups, and each child was allowed to select one video game from their assigned group at the start of the trial, and another video game from the same category seven weeks later.

The active game list featured:

• Active Life: Extreme Challenge 
• EA Sports Active
• Dance Dance Revolution Hottest Party 3
• Wii Fit Plus
• Wii Sports

The inactive game list featured:

• Disney Sing It: Pop Hits 
• Madden NFL 10
• Mario Kart Wii
• New Super Mario Bros 
• Super Mario Galaxy

Each child also wore a device called an accelerometer, which records movement and activity. Physical activity was monitored at weeks 1, 6, 7 and 12 over the course of the 13-week trial. In addition, the children and their parents kept a diary of game play, recording which game was played and for how long. Data were collected at the start of the study on child gender, age, ethnicity and the highest educational attainment in the house, and a questionnaire of parent perception of neighbourhood safety was conducted.

The researchers then used the accelerometer data to compare the average physical activity duration and level of children in the active video game group to the averages in the inactive video game group. They analysed the data while controlling for demographic factors as well as ‘neighbourhood safety’, which was taken to indicate how likely it would be for the child to play outside.

They also used the diaries of game play to determine which games were played in the two groups, and whether or not children in the inactive group played active games, and vice versa.

What were the basic results?

Of the 84 original participants, six did not complete the study (all six of these children were from the control group receiving the inactive games). The 78 remaining children had an average BMI that was higher than approximately 81% of their peers.

The researchers found no significant differences in the average amount of time spent engaged in sedentary, light physical activity or moderate/vigorous physical activity between the active game and inactive game groups. There was no evidence to suggest that neighbourhood safety, child BMI score, the number of total video games in the home, the number of active video games in the home, family income or education attainment influenced this finding.

Using the information provided by the game play diaries, the researchers found that some children in the inactive group obtained and played active video games. This was found to be true in the other group as well, with children in the active game group playing inactive games.

How did the researchers interpret the results?

The researchers conclude that “there is no reason to believe that simply acquiring an active video game under naturalistic circumstances provides a public health benefit to children”.

Conclusion

This was a small randomised controlled trial that indicates that there is little difference in activity levels between children given active video games and those given inactive games. While the results of this study appear to contradict those seen in previous studies carried out in more controlled environments, there are several limitations that should be kept in mind:

• There is no way to tell to what extent crossover between the video game groups distorted the results. The study did not prevent children in the active game group from playing inactive games, or vice versa. Therefore, their activity levels cannot be attributed solely to the group they were assigned to.
• The researchers assessed differences between groups, but did not report whether or not there were any significant differences within the groups over time. This means we do not know whether or not children who were given the Wii consoles were significantly more or less active after receiving the game. This may be important given that there was some crossover between the groups in the types of games played.
• The researchers say that their results indicate that merely giving children access to active video games does not produce a significant difference in activity compared with children given inactive games. They point out, however, that this study did not assess the impact of providing active games along with some instruction on the amount of time they should spend playing them.
• The researchers further say that it is not clear why there was no difference between the groups, and suggest that the children in the active game group may have compensated for any increased activity during playing the video games by decreasing their activity throughout the rest of the day.
• Some of the active games on the list, particularly those marketed as improving fitness, are targeted at a mature audience, and may not appeal to children.
• The study reported that many children had access to newer, more advanced consoles. This may have influenced the children’s behaviour, making them less likely to become enthusiastic about the older Wii console.

All in all, this was a small study that attempted to quantify differences in activity between children given two types of video games. This type of research in a natural setting can provide an indication of the impact of games in real life, and may be important in terms of providing an alternative view to that provided by game manufacturers.