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      Home-Based Exergaming on Preschoolers’ Energy Expenditure, Cardiovascular Fitness, Body Mass Index and Cognitive Flexibility: A Randomized Controlled Trial

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          Abstract

          Purpose: The effects of exergaming-based physical activity (PA) interventions on preschoolers’ health outcomes and cognition remain largely unexplored. Therefore, we conducted a randomized controlled trial to discern the effectiveness of a home-based educational exergaming intervention on preschoolers’ energy expenditure, fitness, body mass index, and cognition. Methods: Participants were 32 preschoolers (16 girls; 59.4% Asian; M age = 4.72, SD = ±0.73) recruited from the Twin Cities area in Minnesota. During baseline testing, we measured preschooler’s daily energy expenditure (EE), cardiovascular fitness, body mass index, and cognitive flexibility using validated instruments. Participants were then randomly assigned to one of two conditions: (1) the exergaming intervention condition; or (2) control condition. The intervention program requested children participate in home-based educational exergaming using the LeapTV gaming console for at least 30 min/session 5 times/week. The control condition asked children to maintain regular PA patterns without any exergaming gameplay. Each condition lasted 12 weeks. We conducted identical outcome assessments for all children at baseline and post-intervention. Results: Analysis of covariance with repeated measures yielded significant time x group interaction effects for cognitive flexibility, Wilks’ Lambda = 0.81, F(1, 29) = 6.98, p = 0.01, η 2 = 0.19, suggesting children in the exergaming group demonstrated significantly greater increases in cognitive flexibility as compared to those in the control group over time. There were no significant differences for time x group changes between the two groups for EE, Wilks’ Lambda = 0.92, F(1, 29) = 2.29, p = 0.14, η 2 = 0.08; cardiovascular fitness, Wilks’ Lambda = 0.96, F(1, 29) = 1.07, p = 0.31, η 2 = 0.04; and BMI, Wilks’ Lambda = 0.99, F(1, 29) = 0.05, p = 0.82, η 2 = 0.01. However, our data did suggest a marginal effect of time for EE, Wilks’ Lambda = 0.89, F(1, 29) = 3.26, p = 0.08, η 2 = 0.08, indicating that children’s daily EE increased from baseline to post-intervention. Conclusions: Home-based educational exergaming may positively impact cognitive flexibility in preschoolers. Studies with larger sample sizes in multiple geographic locations are needed, with our study suggesting a longer intervention period might also be warranted.

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          The Dimensional Change Card Sort (DCCS): a method of assessing executive function in children.

          The dimensional change card sort (DCCS) is an easily administered and widely used measure of executive function that is suitable for use with participants across a wide range of ages. In the standard version, children are required to sort a series of bivalent test cards, first according to one dimension (e.g., color), and then according to the other (e.g., shape). Most 3-year-olds perseverate during the post-switch phase, exhibiting a pattern of inflexibility similar to that seen in patients with prefrontal cortical damage. By 5 years of age, most children switch when instructed to do so. Performance on the DCCS provides an index of the development of executive function, and it is impaired in children with disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism. We describe the protocol for the standard version (duration = 5 min) and the more challenging border version (duration = 5 min), which may be used with children as old as 7 years.
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            Exercise improves executive function and achievement and alters brain activation in overweight children: a randomized, controlled trial.

            This experiment tested the hypothesis that exercise would improve executive function. Sedentary, overweight 7- to 11-year-old children (N = 171, 56% girls, 61% Black, M ± SD age = 9.3 ± 1.0 years, body mass index [BMI] = 26 ± 4.6 kg/m², BMI z-score = 2.1 ± 0.4) were randomized to 13 ± 1.6 weeks of an exercise program (20 or 40 min/day), or a control condition. Blinded, standardized psychological evaluations (Cognitive Assessment System and Woodcock-Johnson Tests of Achievement III) assessed cognition and academic achievement. Functional MRI measured brain activity during executive function tasks. Intent to treat analysis revealed dose-response benefits of exercise on executive function and mathematics achievement. Preliminary evidence of increased bilateral prefrontal cortex activity and reduced bilateral posterior parietal cortex activity attributable to exercise was also observed. Consistent with results obtained in older adults, a specific improvement on executive function and brain activation changes attributable to exercise were observed. The cognitive and achievement results add evidence of dose-response and extend experimental evidence into childhood. This study provides information on an educational outcome. Besides its importance for maintaining weight and reducing health risks during a childhood obesity epidemic, physical activity may prove to be a simple, important method of enhancing aspects of children's mental functioning that are central to cognitive development. This information may persuade educators to implement vigorous physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
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              The Relationship between Physical Activity and Cognition in Children: A Meta-Analysis

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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                21 October 2019
                October 2019
                : 8
                : 10
                : 1745
                Affiliations
                [1 ]School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA
                [2 ]Department of Applied Human Sciences, University of Minnesota, Duluth, MN 55812, USA; junelee@ 123456d.umn.edu
                [3 ]Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, 110 Gifford Building, Fort Collins, CO 80523, USA; nanzeng@ 123456colostate.edu
                [4 ]School of Public Health, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA; popex157@ 123456umn.edu
                [5 ]Hangzhou Kindergarten Teacher College, Zhejiang Normal University, Hangzhou 310012, China; yingzh@ 123456zjnu.cn
                [6 ]School of Physical Education, Hunan Normal University, Changsha 410081, China; lixianxiong@ 123456hunnu.edu.cn
                Author notes
                [* ]Correspondence: gaoz@ 123456umn.edu
                Author information
                https://orcid.org/0000-0002-6037-0439
                https://orcid.org/0000-0002-8521-4619
                Article
                jcm-08-01745
                10.3390/jcm8101745
                6832462
                31640158
                dc588f90-094c-4330-90d7-0135306b4e17
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 28 August 2019
                : 18 October 2019
                Categories
                Article

                active video games,cognitive functions,early childhood,pediatric obesity,physical activity,health promotion

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