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The goal of this clinical trial is to learn how effective a combined therapy of computer-based game and also high-intensity interval training (HIIT) physical exercise to improve the clinical symptoms, executive function and neuroplasticity in teenagers with Internet Gaming Disorder (IGD). Executive function refers to the brain's ability to manage tasks such as planning, problem-solving, and decision-making. BDNF is a protein crucial for brain health and development. Neuroplasticity is the brain's ability to change and adapt throughout life. High-intensity interval training involves short bursts of intense exercise followed by periods of rest or recovery. The main questions it aims to answer are:
Researchers will compare the improvement before and after the therapies.
Participants will:
This is a study protocol of a clinical study to examine the effectiveness of computer-based game and high-intensity interval training towards improvement of clinical symptoms, executive function and neuroplasticity in adolescents with Internet Gaming Disorder (IGD).
According to calculations, our study will aim for a minimum of 44 participants using purposive sampling. Participants will drop-out of the study if they missed >10% participation (>3 sessions out of 35 total sessions). Analysis of the effectiveness of both interventions (computer-based game and HIIT exercise) on improvement of clinical symptoms of Internet Gaming Disorder will be done using McNemar test. Meanwhile, analysis of the effectiveness of both interventions towards executive function and neuroplasticity will be done using paired-T tests. Significance levels will be set at 0.05 for analysis. All data will be analyzed using IBM SPSS v. 26.0.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Combined Intervention Group | Experimental | This group will experience both computer-based game therapy and also high-intensity interval training for 7 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Computer-Based Game Therapy | Behavioral | Computer-based game intervention will be done three times a week, every morning before school lessons begin or during break time. Researchers will give a brief explanation of the rules on how to play the game before the intervention begins. In the game, participants will act as a fruit truck delivery driver and will have to sort out fruit delivery to different houses according to the instructions of the game. For example, the instruction starts with delivering a yellow-colored banana to a house with a red-colored roof, or delivering a purple-colored grape to a house with a blue-colored roof. Participants will first have to finish a minimum of three tutorial rounds reaching ≥75% correct delivery. Instructions will be divided into four stages; visual stimulus, auditory stimulus, visual stimulus with an obstacle, auditory stimulus with an obstacle. Each round will last for 2 minutes. Total time needed to complete a single computer-based intervention session is around 30-45 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Symptoms | Clinical Symptoms of Internet Gaming Disorder evaluated with Ten-Item Internet Gaming Disorder Test (IGDT-10) questionnaire | Baseline (T0), 4th week of intervention (T1), 7th week of intervention (T2) |
| Executive Function | Executive Function assessed with Behavior Rating Inventory of Executive Function (BRIEF) questionnaire | Baseline (T0), 4th week of intervention (T1), 7th week of intervention (T2) |
| Neuroplasticity | Neuroplasticity measured with serum brain-derived neurotrophic factor (BDNF) levels | Baseline (T0), 4th week of intervention (T1), 7th week of intervention (T2) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eva Suryani, dr., Sp.KJ. | Contact | +6281574877329 | eva.suryanipramudhita@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Eva Suryani, dr., Sp.KJ. | Doctoral Program, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital | Jakarta | DKI Jakarta | Indonesia |
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| ID | Term |
|---|---|
| D000082424 | Internet Addiction Disorder |
| ID | Term |
|---|---|
| D000088942 | Technology Addiction |
| D016739 | Behavior, Addictive |
| D003192 | Compulsive Behavior |
| D007175 | Impulsive Behavior |
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| ID | Term |
|---|---|
| D000072696 | High-Intensity Interval Training |
| ID | Term |
|---|---|
| D064797 | Physical Conditioning, Human |
| D015444 | Exercise |
| D009043 | Motor Activity |
| D009068 | Movement |
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One group pre and post-test design
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| High-Intensity Interval Training | Behavioral | HIIT will be done two times a week during physical education hours (in the school's sports field) led by the school's physical education teacher and also certified physical trainers who have undergone training supervised by a sports medicine physician. Before the start of each HIIT session, participants will have their pulse rate assessed with a pulse oximetry and then undergo warm-up for 5 minutes. The duration of each HIIT session will be continuously extended starting at around 4 minutes (1 tabata block/8 moves) during the first week to 8 minutes (2 tabata block/16 moves) during the final week. A single tabata block moveset incorporates 8 total moves; squat jump, push up, high skipping, burpees, isometric front plank, multi jumps on bench, mountain climber in hand plank and lateral sprint (5m). Each move will be done for 20 seconds, followed by a 10 second rest. Pulse rate will be assessed again after the HIIT session and then participants will undergo cooling down and relaxation. |
|
| D001519 |
| Behavior |
| D009142 |
| Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |