Assessment of Voluntary Exercise Behavior and Active Video Gaming Among Adolescent and Young Adult Patients During Hematopoietic Stem Cell Transplantation

To evaluate the 6-minute walking distance (6MWD) for healthy Caucasian children and adolescents of a population-based sample from the age of 3 to 18 years. Two hundred and eighty boys and 248 girls completed a modified test, using a measuring wheel as incentive device. Median 6MWD increased from the age of 3 to 11 years in boys and girls alike and increased further with increasing age in boys (from 667.3 m to 727.6 m), whereas it essentially plateaued in girls (655.8 m to 660.9 m). After adjusting for age, height (P = .001 in boys and P < .001 in girls) remained independently correlated with the 6MWD. In the best fitting and most efficient linear and quadratic regression models, the variables age and height explained about 49% of the variability of the 6MWD in boys and 50% in girls. This modified 6-minute walk test (6MWT) proved to be safe, easy to perform, and highly acceptable to children. It provides a simple and inexpensive means to measure functional exercise capacity in children, even of young age, and might be of value when conducting comparable studies.

To compare energy expenditure rates in children playing the physically active video games, Dance Dance Revolution (DDR) and Nintendo's Wii Sports in relation to treadmill walking. Energy expenditure, heart rate, step rate, and perceived exertion were measured in 14 boys and 9 girls (ages 10-13 years; BMI at 3-98th percentile for age and gender) while watching television at rest, playing DDR at 2 skill levels, playing Wii bowling and boxing, and walking at 2.6, 4.2, and 5.7 km/h. Arterial elasticity was measured at rest and immediately after gaming. Compared with watching television, energy expenditure while gaming or walking increased 2- to 3-fold. Similarly, high rates of energy expenditure, heart rate, and perceived exertion were elicited from playing Wii boxing, DDR level 2, or walking at 5.7 km/h. This occurred despite variations in step rate among activities, reflecting greater use of upper body during Wii play (lowest step rate) than during walking (highest step rate) or DDR play. Wii bowling and beginner level DDR elicited a 2-fold increase in energy expenditure compared to television watching. Large-artery elasticity declined immediately after both DDR and Wii. The change was inversely related to the increment in energy expenditure above rest achieved during the activity. Energy expenditure during active video game play is comparable to moderate-intensity walking. Thus, for children who spend considerable time playing electronic screen games for entertainment, physically active games seem to be a safe, fun, and valuable means of promoting energy expenditure.

As computer game playing is a popular activity among adolescents, a questionnaire study was undertaken with 387 adolescents (12-16 years of age) to establish their "dependence" using a scale adapted from the DSM-III-R criteria for pathological gambling. Analysis indicated that one in five adolescents were currently "dependent" upon computer games. Boys played significantly more regularly than girls and were more likely to be classified as "dependent." The earlier children began playing computer games it appeared the more likely they were to be playing at "dependent" levels. These and other results are discussed in relation to research on other gaming dependencies.