Improved Executive Functioning from Wii Active Exergame Play
1. Improved Executive Functioning from Wii Active Exergame Play Amanda E. Staiano, Anisha Abraham, & Sandra L. Calvert Games for Health 2010 May 27, 2010 Children’s Digital Media Center Department of Psychology, Georgetown University Funded by Robert Wood Johnson Foundation Health Games Research
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4. 1998 Rise of Adult Obesity (Obesity = *BMI 30, or about 30 lbs. overweight for 5’4” person) 2007 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% BRFSS, Behavioral Risk Factor Surveillance System, http: //www.cdc.gov/brfss/ Staiano, Abraham, & Calvert, 2010 Georgetown University
5. Rise of Pediatric Obesity Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Examination Surveys II (ages 6–11) and III (ages 12–17), and National Health and Nutrition Examination Surveys I, II and III, and 1999–2006. Staiano, Abraham, & Calvert, 2010 Georgetown University
6. Rise of Pediatric Obesity The National Survey of Children's Health. Childhood Obesity Action Network. State Obesity Profiles, 2008. National Initiative for Children's Healthcare Quality, Child Policy Research Center, and Child and Adolescent Health Measurement Initiative. Retrieved 5/9/09 from http://www.nschdata.org:80/Content/ObesityReportCards.aspx. Staiano, Abraham, & Calvert, 2010 Georgetown University
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12. Study 1 Social Exergame Play for Caloric Expenditure among Adolescents Staiano, Abraham, & Calvert, 2010 Georgetown University
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16. Stimulus: Nintendo Wii Sports Tennis Staiano, Abraham, & Calvert, 2010 Georgetown University
23. Caloric Expenditure: By Condition Linear regression predicting caloric expenditure by condition. Variable B SE B β ________ Gender -6.59 2.15 -0.19** Age -1.45 0.64 -0.15* Solitary Condition -6.72 2.49 -0.19** Control Condition -20.12 2.58 -0.58*** Weight 0.64 0.09 0.65*** BMI Percentile -0.09 0.06 -0.14 Waist-to-Hip Ratio 3.75 18.36 0.01 R 2 0.76 _____________________________________________________________________ Values are expressed as coefficient. *** = p < .001, ** = p < .01, * = p < .05. For Gender, 0 = Male, 1 = Female. F (7,66) = 30.373, p = .000, r 2 = .763 (adjusted r 2 = .738). Condition was dummy-coded so that Solitary = 1, Control = 1, and Social = 0. Staiano, Abraham, & Calvert, 2010 Georgetown University
24. Caloric Expenditure & METs (by condition) Staiano, Abraham, & Calvert, 2010 Georgetown University Social Solitary Control Condition (kCal) 62.93 54.83 37.69 Condition (METs) 2.017 1.788 1.262
25. Caloric Expenditure: Tennis Court Play vs. Exergame Play = tennis court play is significantly different than treatment, p < .05. Staiano, Abraham, & Calvert, 2010 Georgetown University
26. Enjoyment of exergame play Note . 2 (1, N = 47) = 4.968, p = .026 Staiano, Abraham, & Calvert, 2010 Georgetown University Enjoy Do Not Enjoy Males 18 4 Females 25 0
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31. Study 2 Social Exergame Play for Improved Executive Functioning among Adolescents Staiano, Abraham, & Calvert, 2010 Georgetown University
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37. Stimulus: EA Active for Nintendo Wii Staiano, Abraham, & Calvert, 2010 Georgetown University
Definitions: Obesity: Having a very high amount of body fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher. Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters. Source of the data: The data shown in these maps were collected through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Each year, state health departments use standard procedures to collect data through a series of monthly telephone interviews with U.S. adults. Prevalence estimates generated for the maps may vary slightly from those generated for the states by BRFSS (http://aps.nccd.cdc.gov/brfss) as slightly different analytic methods are used. Particularly high obesity rates for low-income and for African American Obesity leads to cardiovascular disease and hypertension, type 2 diabetes, sleep apnea, discrimination, etc Youth Risk Behavior Surveillance: Only about 1/3 of adolescents meet minimal PA recommendations (60 min or more most days of week), now recs are 60 min daily; worse for females and for AAs Video Games: Lenhart 2008 Pew Internet –99% of boys & 94% of girls play video games
Particularly for low-income and for African American Obesity leads to cardiovascular disease and hypertension, type 2 diabetes, sleep apnea, discrimination, etc Youth Risk Behavior Surveillance: Only about 1/3 of adolescents meet minimal PA recommendations (60 min or more most days of week), now recs are 60 min daily; worse for females and for AAs Video Games: Lenhart 2008 Pew Internet –99% of boys & 94% of girls play video games Approximately 13 million U.S. children and adolescents are obese, with a body mass index at or above the 95 th percentile. Obesity is a major risk factor for many serious health conditions, including type 2 diabetes, stroke, heart disease, high blood pressure and certain cancers. During the past 40 years, obesity rates for children age 6 to 11 nearly tripled—from 5% to 14%—and more than tripled for adolescents age 12 to 19—from 5% to 17.1%. Obese adolescents have an 80% chance of becoming obese adults. An estimated 61% of obese young people already have at least one additional health risk factor such as high blood pressure or high cholesterol. Childhood obesity health expenses are estimated at $14 billion annually. Good nutrition and physical activity can help prevent obesity, but opportunities for healthy choices may be limited. Wealthy communities have three times as many supermarkets as poor areas, increasing their access to fruits, vegetables, and a wider selection of healthy foods. Poorer areas also often have less access to places to be physically active. Almost 30% of U.S. children do not exercise three or more times a week. More than 75% of high school students do not eat the recommended servings of fruits and vegetables each day. Sources: Ogden, et al. JAMA , 295 (13): 1549-1555 and JAMA , 288 (14): 1728-1732. CDC, Morbidity and Mortality Weekly Report 54, no.8: 203. Pediatrics 103, no.6: 1175-1172. CDC, Preventing Obesity and Chronic Diseases through Good Nutrition and Physical Activity. Interagency Forum on Child and Family Statistics America's Children; Key National Indicators of Well-Being, 2007.
Lowers self-esteem, hinders academic and social functioning, persists into adulthood Abnormal glucose tolerance; population-based sample, 70% of obese children had at least 1 CVD risk factor while 39% had 2 or more Asthma is a disease of the lungs in which the airways become blocked or narrowed causing breathing difficulty. Studies have identified an association between childhood obesity and asthma.41, 42 Hepatic steatosis is the fatty degeneration of the liver caused by a high concentration of liver enzymes. Weight reduction causes liver enzymes to normalize.39 Sleep apnea is a less common complication of obesity for children and adolescents. Sleep apnea is a sleep-associated breathing disorder defined as the cessation of breathing during sleep that lasts for at least 10 seconds. Sleep apnea is characterized by loud snoring and labored breathing. During sleep apnea, oxygen levels in the blood can fall dramatically. One study estimated that sleep apnea occurs in about 7% of obese children.43 Type 2 diabetes is increasingly being reported among children and adolescents who are obese.44 While diabetes and glucose intolerance, a precursor of diabetes, are common health effects of adult obesity, only in recent years has Type 2 diabetes begun to emerge as a health-related problem among children and adolescents.45 Onset of diabetes in children and adolescents can result in advanced complications such as CVD and kidney failure.45
Youth Risk Behavioral Surveillance 2005 67% don’t attend P.E. daily; only 54.2% attended P.E. 1 or more days in an average week Lowers self-esteem, hinders academic and social functioning, persists into adulthood Abnormal glucose tolerance; population-based sample, 70% of obese children had at least 1 CVD risk factor while 39% had 2 or more Asthma is a disease of the lungs in which the airways become blocked or narrowed causing breathing difficulty. Studies have identified an association between childhood obesity and asthma.41, 42 Hepatic steatosis is the fatty degeneration of the liver caused by a high concentration of liver enzymes. Weight reduction causes liver enzymes to normalize.39 Sleep apnea is a less common complication of obesity for children and adolescents. Sleep apnea is a sleep-associated breathing disorder defined as the cessation of breathing during sleep that lasts for at least 10 seconds. Sleep apnea is characterized by loud snoring and labored breathing. During sleep apnea, oxygen levels in the blood can fall dramatically. One study estimated that sleep apnea occurs in about 7% of obese children.43 Type 2 diabetes is increasingly being reported among children and adolescents who are obese.44 While diabetes and glucose intolerance, a precursor of diabetes, are common health effects of adult obesity, only in recent years has Type 2 diabetes begun to emerge as a health-related problem among children and adolescents.45 Onset of diabetes in children and adolescents can result in advanced complications such as CVD and kidney failure.45
Youth spend 49 minutes daily playing videogames
Maddison: increase EE between 129-400% from baseline Graves: boxing, tennis, bowling > sedentary; boys > girls
The D-KEFS assesses the performance of the frontal system of the brain which control executive control skills. The test employs a game-like structure that encourages optimal performance without providing right/wrong feedback that may frustrate adolescent test-takers. In particular, the Design Fluency sub-test measures response inhibition and cognitive flexibility by having the participant connect dots to design as many novel shapes as quickly as possible. The Trail-Making sub-test assesses temporal sequencing and mental flexibility including visual scanning, number and letter sequencing, and motor speed. D-KEFS has shown adequate reliability and validity. Test-retest reliabilities range from .62 to .80 depending on age groups and particular sub-test. Validity has been shown through adequate intercorrelations of measures within individual D-KEFS tests and correlations with D-KEFS tests and other cognitive tests including the Wisconsin Card Sorting Test. Homack, S., Lee, D., & Riccio, C.A. (2005). Test review: Delis-Kaplan executive function system. J Clin Exp Neuropsychol, 27(5): 599-609. Design Fluency = This test measures ability to generate novel designs as quickly as possible, response inhibition, and cognitive flexibility. The test is composed of three conditions. In each, the child is presented rows of boxes each containing dots that the examinee must connect, with four lines only, to make different designs. Conditions are 1. Draw as many designs as possible; 2. Connect only unfilled dots, leaving filled dots blank; and 3. Alternate connections between filled and unfilled dots. Trail Making = An adaptation of the traditional Trail Making Test used to measure temporal sequencing and mental flexibility, this test consists of 5 conditions instead of 2 including a number-letter switching condition. The test allows the examiner to tease out more fundamental processes including visual scanning, number and letter sequencing, and motor speed Bender Gestalt is a test of visual spatial skills and fine motor skills. The Bender Gestalt Test is used to evaluate visual maturity, visual motor integration skills, style of responding, reaction to frustration, ability to correct mistakes, planning and organizational skills, and motivation. Copying figures requires fine motor skills, the ability to discriminate between visual stimuli, the capacity to integrate visual skills with motor skills, and the ability to shift attention from the original design to what is being drawn. BG scale (reliability = 0.91; White, 2004). White, R.F., Campbell, R., Echeverria, D., Knox, S.S., & Janulewicz, P. (2004). Assessment of neuropsychological trajectories in longitudinal population-based studies of chidren. J Epidemiol Community Health, 63(Suppl): i15-i26.
