Exergaming Versus Gym-based Exercise for Postural Control, Flow and Technology Acceptance

Exergaming (XBOX Kinect™) Versus Traditional Gym-based Exercise for Postural Control, Flow and Technology Acceptance in Healthy Adults: a Randomised Controlled Trial

Balance training is an important component of physical fitness, however due to the mundane and often repetitive nature of balance training alone this is often forgotten about and as a result people may be more susceptible to postural control instabilities. A potential solution to the mundane aspect of balance training is the use of exergaming (interactive exercise and gaming combined) through the use of commercial gaming systems such as the Nintendo Wii, Dance Dance Revolution (DDR) and more recently the XBOX Kinect. The aim of the investigation was to assess the XBOX Kinect versus traditional balance training on postural control, flow and technology acceptance.

Exergaming - exercise with the use of an interactive computer-generated environment - is increasingly used in physical rehabilitation. Benefits have been reported in a range of clinical populations (people with neurological problems children with cerebral palsy and learning difficulties, Parkinson' disease, multiple sclerosis and older people. Balance training is an important focus of such rehabilitation. Previous literature regarding the effects of exergaming as a method of balance-training has mainly been conducted using the Nintendo Wii™ and the Wii™ fit where people must stand on a balance board to play the games. Although literature has shown that traditional balance training alone is effective in improving balance in a range of populations, studies comparing exergaming with "traditional" balance exercises (SEBT, trampolines and wobble boards) have shown mixed results from both exergaming and traditional balance training groups improving in postural control outcomes to greater improvement in the exergaming group over traditional balance exercise. A potential reason for the differentiation if results could be due to different movements required in the "traditional" balance exercises rather than there being something inherently different about exercising in a virtual environment. There is also a dearth of randomized controlled trials (RCT) in this area so the evidence base is limited. Furthermore, few have studied the important psychological aspect of exergaming, in particular acceptance and flow experience. The aim of this study was to assess the effects of exergaming using the XBOX Kinect™ system, versus, traditional gym-based exercise, with no virtual stimuli (TGB) on: (1) postural control, (2) technology acceptance (3) flow experience and (4) exercise intensity in young healthy adults. Matching of intensity of exercise, in the two groups, was assessed objectively, by Heart Rate and subjectively by Borg RPE during all exercise sessions. To our knowledge this is the first paper to compare the effects of exergaming against matched traditional exercises where the movement patterns, intensity and physiological demand was matched and assessed across groups.

Inclusion Criteria:

• Male or female,
• Aged 18-50 years,
• Physically active (three or more moderate-vigorous physical activity sessions per week), free from injury (no musculoskeletal injuries or neurological conditions)
• Able to take part in four weeks of exercise.

Exclusion Criteria:

• Unable to give informed consent and/or to comprehend and write English,
• Current (or history of) any medical condition or injury which would contraindicate participation,
• Allergy to alcohol wipes and/or adhesive tape
• Previous experience of using the XBOX Kinect™.