Rationale, design and methods for a randomised and controlled trial of the impact of virtual reality games on motor competence, physical activity, and mental health in children with developmental coordination disorder.

This is the final version of the article. Available from BioMed Central via the DOI in this record.BACKGROUND: A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR) game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder. METHODS: This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (≤ 15th percentile) will be recruited and randomised to a balanced ordering of 'no active electronic games' and 'active electronic games'. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentary behaviour will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. A sample of 30 will provide a power of > 0.9 for detecting a 5 point difference in motor coordination on the MABC-2 TIS scale (mean 17, sd = 5). DISCUSSION: This is the first trial to examine the impact of new virtual reality games on motor coordination in children with developmental coordination disorder. The findings will provide critical information to understand whether these electronic games can be used to have a positive impact on the physical and mental health of these children. Given the importance of adequate motor coordination, physical activity and mental health in childhood, this project can inform interventions which could have a profound impact on the long term health of this group of children. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000400965.This randomised and controlled trial is funded by the National Health and Medical Research Council (NHMRC) of Australia through project grant #533526. Professor Leon Straker and Doctor Anne Smith are supported by fellowships awarded from the NHMRC. No funding or other input to the study has been received from any electronic game design, manufacture or supply company

Wheelchair-based game design for older adults

Few leisure activities are accessible to institutionalized older adults using wheelchairs; in consequence, they experience lower levels of perceived health than able-bodied peers. Video games have been shown to be an engaging leisure activity for older adults. In our work, we address the design of wheelchair-accessible motion-based games. We present KINECTWheels, a toolkit designed to integrate wheelchair movements into motion-based games, and Cupcake Heaven, a wheelchair-based video game designed for older adults using wheelchairs. Results of two studies show that KINECTWheels can be applied to make motion-based games wheelchair-accessible, and that wheelchair-based games engage older adults. Through the application of the wheelchair as an enabling technology in play, our work has the potential of encouraging older adults to develop a positive relationship with their wheelchair. Copyright 2013 ACM

Rationale, design and methods for a randomised and controlled trial to investigate whether home access to electronic games decreases children's physical activity

Background. Many children are reported to have insufficient physical activity (PA) placing them at greater risk of poor health outcomes. Participating in sedentary activities such as playing electronic games is widely believed to contribute to less PA. However there is no experimental evidence that playing electronic games reduces PA. There is also no evidence regarding the effect of different types of electronic games (traditional sedentary electronic games versus new active input electronic games) on PA. Further, there is a poor understanding about how characteristics of children may moderate the impact of electronic game access on PA and about what leisure activities are displaced when children play electronic games. Given that many children play electronic games, a better understanding of the effect of electronic game use on PA is critical to inform child health policy and intervention. Methods. This randomised and controlled trial will examine whether PA is decreased by access to electronic games and whether any effect is dependent on the type of game input or the child's characteristics. Children aged 1012 years (N = 72, 36 females) will be recruited and randomised to a balanced ordering of 'no electronic games', 'traditional' electronic games and 'active' electronic games. Each child will participate in each condition for 8 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is PA, assessed by Actical accelerometers worn for 7 days on the wrist and hip. Energy expenditure will be assessed by the doubly labelled water technique and motor coordination, adiposity, self-confidence, attitudes to technology and PA and leisure activities will also be assessed. A sample of 72 will provide a power of > 0.9 for detecting a 15 mins difference in PA (sd = 30 mins). Discussion. This is the first such trial and will provide critical information to understand whether access to electronic games affects children's PA. Given the vital importance of adequate PA to a healthy start to life and establishing patterns which may track into adulthood, this project can inform interventions which could have a profound impact on the long term health of children. Trial registration. This trial is registered in the Australia and New Zealand Clinical Trials Registry (ACTRN 12609000279224)

To remove or to replace traditional electronic games? A crossover randomised controlled trial on the impact of removing or replacing home access to electronic games on physical activity and sedentary behaviour in children aged 10-12 years.

This is the final version of the article. Available from BMJ Publishing Group via the DOI in this record.OBJECTIVE: To evaluate the impact of (1) the removal of home access to traditional electronic games or (2) their replacement with active input electronic games, on daily physical activity and sedentary behaviour in children aged 10-12 years. DESIGN: Crossover randomised controlled trial, over 6 months. SETTING: Family homes in metropolitan Perth, Australia from 2007 to 2010. PARTICIPANTS: 10-year-old to 12-year-old children were recruited through school and community media. From 210 children who were eligible, 74 met inclusion criteria, 8 withdrew and 10 had insufficient primary outcome measures, leaving 56 children (29 female) for analysis. INTERVENTION: A counterbalanced randomised order of three conditions sustained for 8 weeks each: no home access to electronic games, home access to traditional electronic games and home access to active input electronic games. MAIN OUTCOME MEASURES: Primary outcome was accelerometer assessed moderate/vigorous physical activity (MVPA). Secondary outcomes included sedentary time and diary assessed physical activity and sedentary behaviours. RESULTS: Daily MVPA across the whole week was not significantly different between conditions. However, compared with home access to traditional electronic games, removal of all electronic games resulted in a significant increase in MVPA (mean 3.8 min/day, 95% CI 1.5 to 6.1) and a decrease in sedentary time (4.7 min/day, 0.0 to 9.5) in the after-school period. Similarly, replacing traditional games with active input games resulted in a significant increase in MVPA (3.2 min/day, 0.9 to 5.5) and a decrease in sedentary time (6.2 min/day, 1.4 to 11.4) in the after-school period. Diary reports supported an increase in physical activity and a decrease in screen-based sedentary behaviours with both interventions. CONCLUSIONS: Removal of sedentary electronic games from the child's home and replacing these with active electronic games both resulted in small, objectively measured improvements in after-school activity and sedentary time. Parents can be advised that replacing sedentary electronic games with active electronic games is likely to have the same effect as removing all electronic games. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry (ACTRN 12609000279224).The study was funded by a National Health and Medical Research Council of Australia project grant (533526). The funding body had no influence on the analysis and reporting of the study. LMS had financial support from an NHMRC senior research fellowship (1019980) for the submitted work

Active video games: An opportunity for enhanced learning and positive health effects?

Active video games are an emerging genre of electronic games that provide engaging exercise experiences by combining physical exertion with interactive game play. As such they have attracted increased interest from health promotion professionals to reduce sedentary behavior, increase physical activity, and improve health outcomes such as body composition. However their potential for enhancing the educational experience has not been extensively explored. This paper provides a brief overview of active video game research to date and outlines opportunities for future research. Specifically, we highlight the need to develop a conceptual framework to better understand the determinants, mediators, moderators, and consequences of active video gaming and integrate learning and health outcomes. We propose that active video games can be a key part of a wider “digital” supportive environment where education and health researchers and professionals work with, rather than against, video game technologies to promote learning and health

Human-centred design methods : developing scenarios for robot assisted play informed by user panels and field trials

Original article can be found at: http://www.sciencedirect.com/ Copyright ElsevierThis article describes the user-centred development of play scenarios for robot assisted play, as part of the multidisciplinary IROMEC1 project that develops a novel robotic toy for children with special needs. The project investigates how robotic toys can become social mediators, encouraging children with special needs to discover a range of play styles, from solitary to collaborative play (with peers, carers/teachers, parents, etc.). This article explains the developmental process of constructing relevant play scenarios for children with different special needs. Results are presented from consultation with panel of experts (therapists, teachers, parents) who advised on the play needs for the various target user groups and who helped investigate how robotic toys could be used as a play tool to assist in the children’s development. Examples from experimental investigations are provided which have informed the development of scenarios throughout the design process. We conclude by pointing out the potential benefit of this work to a variety of research projects and applications involving human–robot interactions.Peer reviewe

Virtual Reality Games for Motor Rehabilitation

This paper presents a fuzzy logic based method to track user satisfaction without the need for devices to monitor users physiological conditions. User satisfaction is the key to any product’s acceptance; computer applications and video games provide a unique opportunity to provide a tailored environment for each user to better suit their needs. We have implemented a non-adaptive fuzzy logic model of emotion, based on the emotional component of the Fuzzy Logic Adaptive Model of Emotion (FLAME) proposed by El-Nasr, to estimate player emotion in UnrealTournament 2004. In this paper we describe the implementation of this system and present the results of one of several play tests. Our research contradicts the current literature that suggests physiological measurements are needed. We show that it is possible to use a software only method to estimate user emotion