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      Assessment of Active Video Gaming Using Adapted Controllers by Individuals With Physical Disabilities: A Protocol

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          Abstract

          Background

          Individuals with disabilities are typically more sedentary and less fit compared to their peers without disabilities. Furthermore, engaging in physical activity can be extremely challenging due to physical impairments associated with disability and fewer opportunities to participate. One option for increasing physical activity is playing active video games (AVG), a category of video games that requires much more body movement for successful play than conventional push-button or joystick actions. However, many current AVGs are inaccessible or offer limited play options for individuals who are unable to stand, have balance issues, poor motor control, or cannot use their lower body to perform game activities. Making AVGs accessible to people with disabilities offers an innovative approach to overcoming various barriers to participation in physical activity.

          Objective

          Our aim was to compare the effect of off-the-shelf and adapted game controllers on quality of game play, enjoyment, and energy expenditure during active video gaming in persons with physical disabilities, specifically those with mobility impairments (ie, unable to stand, balance issues, poor motor control, unable to use lower extremity for gameplay). The gaming controllers to be evaluated include off-the-shelf and adapted versions of the Wii Fit balance board and gaming mat.

          Methods

          Participants (10-60 years old) came to the laboratory a total of three times. During the first visit, participants completed a functional assessment and became familiar with the equipment and games to be played. For the functional assessment, participants performed 18 functional movement tasks from the International Classification of Functioning, Disability, and Health. They also answered a series of questions from the Patient Reported Outcomes Measurement Information System and Quality of Life in Neurological Conditions measurement tools, to provide a personal perspective regarding their own functional ability. For Visit 2, metabolic data were collected during an initial 20-minute baseline, followed by 40 minutes of game play. The controller (balance board or gaming mat) played was randomly selected. A set of games was played for 10 minutes, followed by 5 minutes of rest, and then another set of games was played for 10 minutes, followed by rest. Quality of game play was observed and documented for each set. During rest, the participant completed questions regarding enjoyment. Following the same procedures, the participant then played the two sets of games using the other version (off-the-shelf or adapted) of the controller. The entire procedure was repeated during Visit 3 with the controller that was not played.

          Results

          Enrollment began in February 2016 and ended in September 2016. Study results will be reported in late 2017.

          Conclusions

          We hypothesized that the adapted versions of the Wii Fit balance board and gaming mat would produce greater quality of game play, enjoyment, and energy expenditure in persons with mobility impairments compared to off-the-shelf versions.

          Trial Registration

          ClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by WebCite at http://www.webcitation.org/6qpPszPJ7)

          Related collections

          Most cited references39

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          Physical activity participation among persons with disabilities: barriers and facilitators.

          The purpose of this study was to identify various barriers and facilitators associated with participation in fitness and recreation programs/facilities among persons with disabilities. Focus groups were conducted in ten regions across the United States in 2001 to 2002 with four types of participants: (1) consumers with disabilities, (2) architects, (3) fitness and recreation professionals, and (4) city planners and park district managers. Sessions were tape-recorded and content analyzed; focus group facilitators took notes of identified barriers and facilitators to access. Content analysis of tape recordings revealed 178 barriers and 130 facilitators. The following themes were identified: (1) barriers and facilitators related to the built and natural environment; (2) economic issues; (3) emotional and psychological barriers; (4) equipment barriers; (5) barriers related to the use and interpretation of guidelines, codes, regulations, and laws; (6) information-related barriers; (7) professional knowledge, education, and training issues; (8) perceptions and attitudes of persons who are not disabled, including professionals; (9) policies and procedures both at the facility and community level; and (10) availability of resources. The degree of participation in physical activity among people with disabilities is affected by a multifactorial set of barriers and facilitators that are unique to this population. Future research should utilize this information to develop intervention strategies that have a greater likelihood of success.
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            Energy expenditure of sedentary screen time compared with active screen time for children.

            We examined the effect of activity-enhancing screen devices on children's energy expenditure compared with performing the same activities while seated. Our hypothesis was that energy expenditure would be significantly greater when children played activity-promoting video games, compared with sedentary video games. Energy expenditure was measured for 25 children aged 8 to 12 years, 15 of whom were lean, while they were watching television seated, playing a traditional video game seated, watching television while walking on a treadmill at 1.5 miles per hour, and playing activity-promoting video games. Watching television and playing video games while seated increased energy expenditure by 20 +/- 13% and 22 +/- 12% above resting values, respectively. When subjects were walking on the treadmill and watching television, energy expenditure increased by 138 +/- 40% over resting values. For the activity-promoting video games, energy expenditure increased by 108 +/- 40% with the EyeToy (Sony Computer Entertainment) and by 172 +/- 68% with Dance Dance Revolution Ultramix 2 (Konami Digital Entertainment). Energy expenditure more than doubles when sedentary screen time is converted to active screen time. Such interventions might be considered for obesity prevention and treatment.
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              Measuring Enjoyment of Physical Activity in Children: Validation of the Physical Activity Enjoyment Scale.

              This study sought to determine the reliability and validity of the Physical Activity Enjoyment Scale (PACES) in elementary school children. The sample consisted of 564 3rd grade students (M age = 8.72 +/- .54; 268 male, 296 female) surveyed at the beginning of the fall semester. Results indicated that the PACES displayed good internal consistency and item-total correlations. Confirmatory factor analyses supported a unidimensional factor structure. Scores on the PACES were significantly correlated with task goal orientation (r = .65, p < .01), athletic competence (r = .23, p < .01), physical appearance (r = .20, p < .01), and self-reported physical activity (r = .16, p < .01). However, results of invariance analysis suggested the factor structure is variant across sex. The present findings suggest support for the validity of the PACES as a valid measure of enjoyment of physical activity in children; nevertheless, further research examining the invariance of the factor structure across sex is warranted.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                June 2017
                16 June 2017
                : 6
                : 6
                : e116
                Affiliations
                [1] 1University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative Birmingham, ALUnited States
                Author notes
                Corresponding Author: Laurie A Malone lamalone@ 123456uab.edu
                Author information
                http://orcid.org/0000-0001-9426-6325
                http://orcid.org/0000-0002-8567-9571
                http://orcid.org/0000-0002-4826-0827
                http://orcid.org/0000-0001-9768-3829
                Article
                v6i6e116
                10.2196/resprot.7621
                5493786
                28623186
                f04dc1d0-bda8-410a-a04c-2ec7a2ef8867
                ©Laurie A Malone, Sangeetha Padalabalanarayanan, Justin McCroskey, Mohanraj Thirumalai. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 16.06.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 1 March 2017
                : 21 March 2017
                : 4 April 2017
                : 5 April 2017
                Categories
                Protocol
                Protocol

                video games,exercise,physical activity,disability,energy expenditure,enjoyment

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