Article

# Anxiolytic Effects of a Single Session of the Exergame Zumba ® Fitness on Healthy Young Women

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## Abstract

Objective: Exergames appear to be a promising tool to increase energy expenditure and physical fitness. However, less is known about the effect of a single session of an exergame on anxiety state. Thus, the aim of this study was to evaluate the effects of a single session of the exergame Zumba(®) Fitness (Xbox 360 Kinect(®)) on the anxiety state of healthy young women. Materials and methods: Forty healthy young women (22.9 ± 3.7 years; 62.43 ± 8.75 kg; 1.64 ± 0.06 m; 23.05 ± 2.75 kg/m(2); [Formula: see text]O2max of 41.23 ± 10.61 mL/kg/min) performed ∼20 minutes of the exergame Zumba Fitness using the Xbox 360 Kinect. The state anxiety (State Anxiety Inventory) and level of enjoyment (Physical Activity Enjoyment Scale) were evaluated before and after intervention. Rating perceived exertion (Borg scale) and heart rate (HR) were also tracked and collected. Results: A single exergame session significantly reduced the state anxiety of the participants (P = 0.0230, effect size = 0.62, CI 0.34-0.90). However, no statistically significant correlation was found between enjoyment and absolute (r = -0.10, P = 0.5345) or relative change in state anxiety (r = -0.17, P = 0.2869). A moderate positive correlation was found between enjoyment and performance in the exergame Zumba Fitness (r = 0.59, P = 0.0001). The mean HR during exergames was 137 ± 19 bpm (∼70% of predicted HRmax). Conclusions: The exergame Zumba Fitness seems to be a useful tool to reduce state anxiety in a nonclinical sample of healthy women.

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... The exergames allow to perform physical activity while playing a game. Traditionally, exergames are characterized by exercises that simulate traditional continuous exercises of moderate intensity (for example, walking, running, cycling and calisthenics exercises) [22][23][24], sports (for example, basketball, bowling, yoga, tennis, table tennis, baseball, swimming, ping-pong, boxing and beach volleyball) [22,23,[25][26][27][28], dance [25,29,30] and resistance exercise [31]. ...
... The exergames allow to perform physical activity while playing a game. Traditionally, exergames are characterized by exercises that simulate traditional continuous exercises of moderate intensity (for example, walking, running, cycling and calisthenics exercises) [22][23][24], sports (for example, basketball, bowling, yoga, tennis, table tennis, baseball, swimming, ping-pong, boxing and beach volleyball) [22,23,[25][26][27][28], dance [25,29,30] and resistance exercise [31]. ...
... Previous studies showed that exergames can be a useful tool to improve anxiety levels [25,30] and balance in older people [32], can be a feasible tool for neurological patients [33] and fibromyalgia patients [34]. Previous studies investigated the effects of exergames on physiological variables, such as heart rate, oxygen uptake and caloric expenditure [24,26,35] and reported similar responses to traditional exercise modes. ...
Article
Low sleep quality is associated with many health problems. Although physical exercise is a nonpharmacological tool that positively impacts sleep quality, there are many barriers (lack of energy, lack of motivation, lack of skills, lack of resources, and fear of injury) for people to adopt an active lifestyle. Exergames are an alternative way of physical exercise that are funnier and more attractive than traditional forms of physical exercise and, therefore, has the potential to increase adherence to a physical exercise program. Given that previous studies showed that exergames presents similar physiological and psychological outcomes to traditional forms of exercise, we aimed to discuss in this narrative review potentials applications, limitations and perspectives of using exergames to improve sleep quality.
... However, to the best of our knowledge, there is no study comparing the acute effects of single vs. multiplayer modes on state anxiety levels. Viana et al. (2017) showed that a single session of the exergame Zumba ® Fitness in the Xbox 360 Kinect ® of moderate intensity in the single-player mode decreased the state anxiety level [18]. Recently, Morais et al. (2021) compared state anxiety levels between a dance exergame session and a traditional aerobic exercise [19]. ...
... However, to the best of our knowledge, there is no study comparing the acute effects of single vs. multiplayer modes on state anxiety levels. Viana et al. (2017) showed that a single session of the exergame Zumba ® Fitness in the Xbox 360 Kinect ® of moderate intensity in the single-player mode decreased the state anxiety level [18]. Recently, Morais et al. (2021) compared state anxiety levels between a dance exergame session and a traditional aerobic exercise [19]. ...
... One possible explanation for the current study results may be related to the light intensity of the exergame session evoked by the single and multiplayer modes. Previous studies demonstrated that moderate-intensity physical exercise provides a reduction in anxiety levels [29][30][31][32][33]. Viana et al. (2017) and Morais et al. (2021) evaluated the effects of a single session of the exergame Zumba Fitness ® performed at moderate intensity on the state anxiety level in healthy young women and found a significant reduction after the session. In addition to moderate-intensity exercise, the authors attributed the anxiolytic effect to the participants' high enjoyment levels. ...
Article
Full-text available
This study compared the exergame beach volleyball’s acute effects on state anxiety level in single vs. multiplayer mode in adult men. Sixty adult men (age: 21.98 [4.58] years, body mass: 75.40 [15.70] kg, height: 1.77 [0.09] m, and body mass index: 24.19 [5.44] kg/m2; data are expressed as median [interquartile range]) were assigned to play exergame of beach volleyball in single- or multiplayer mode for approximately 30 min using the Xbox 360 Kinect®. The state anxiety level was evaluated before and after the intervention. There was no significant difference in the state anxiety levels after an exergame session between the single and multiplayer modes (p-value = 0.407, effect size (rB) = −0.12, defined as small). Furthermore, there was no significant difference in the state anxiety levels before and after an exergame session in single-player mode (p-value = 0.516, effect size (d) = 0.14, defined as trivial) and multiplayer mode (p-value = 0.053, rB = 0.43, defined as medium). In conclusion, state anxiety level after exergame beach volleyball did not differ between the single and multiplayer modes in adult men.
... Despite advances in the knowledge on the physiological effects of exergames [12,16,17], evidence on the effects of exergames on anxiety disorders has been controversial [13,[18][19][20]. A recent meta-analysis showed that although exergames provided a significant reduction in anxiety in different clinical populations, the reduction was not greater than that of no exercise [19]. ...
... According to the authors, there is great heterogeneity among studies, which could explain the lack of difference in the effects of exergame participation and no exercise [19]. For example, Viana et al. [20] evaluated the effects of a single dance exergame session (~ 20 min) at moderate intensity on state anxiety in 40 healthy young adult women. The authors found a significant decrease in state anxiety after the dance exergame session. ...
... Some studies have reported that exergames provide a moderate level of physical activity and that mean heart rate ranges from 64 to 76% of maximal heart rate (HRmax) [13,17,20,21], which corresponds to the recommendations of the American College of Sports Medicine for developing and maintaining cardiorespiratory fitness in apparently healthy adults [22]. Although there are many different exergaming modalities (e.g., cycling, walking, running, climbing stairs, balance training, rowing, swimming, baseball, ping-pong, tennis, boxing, canoeing, stretching exercises, bowling, golf, resistance exercises, yoga, and dancing) [19,23,24], little is known about the effects of exergame-based physical exercise on anxiety level compared to non-exergame traditional physical exercise, such as calisthenics exercise. ...
Article
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This study compared the acute effects of an exergame-based calisthenics (EXG) session versus a traditional calisthenics (TC) session on state anxiety levels in healthy adult men, and compared the mean heart rate, number of repetitions performed, enjoyment, and affective valence reported by the participants between sessions. Methods: Thirty-six young adult men performed two 30-minute sessions of physical exercise in random order (EXG and TC). The same exercise protocol was used for each session; however, the TC session was guided by an exercise science professional. State anxiety was assessed before and immediately after each session. Heart rate was monitored during the sessions. Enjoyment and affective valence were assessed immediately after the sessions. In addition, the number of repetitions performed was recorded. Results: There was no significant interaction between sessions (EXG vs. TC) and time (pre vs. post-session) (p=0.102), no significant effect of session (p=0.587), and no significant effect of time (p=0.121). Participants presented a higher mean heart rate (+3.5%, p=0.020) and number of repetitions performed (+43.7%, p<0.001) in the TC session compared with the EXG session. There was no difference in enjoyment (p=0.804) and affective (p=0.195) valence between the EXG and TC sessions. Conclusion: The EXG and TC sessions did not reduce state anxiety levels. Nor did they increase enjoyment or affective valence in healthy young adult men. However, the TC session evoked a higher mean heart rate and higher training volume than the EXG session.
... The number of participants ranged from 27 [109] to 337 [85,111] in RCT studies and from 1 [123] to 40 [120] in quasiexperimental studies. The two cross-sectional/correlational studies included 3915 [82] and 133 participants [124], respectively. ...
... Nine studies reported improvement after playing a COTS game compared to an eye movement desensitization and reprocessing (EMDR) therapy alone [113], watching a film [117], surfing the web [114], anxiolytic medication [102], physiotherapy alone [105], passive video game distraction [123], and not playing a game [103,109,112]. Furthermore, in two studies that did not include a control group, exergames diminished anxiety in only one session [120] and in a more extended program including a total of 30 sessions [122]. Another study compared the efficacy of an exergame and a CVG played in virtual reality; anxiety reduction was more significant in the case of the exergame [119]. ...
... Concerning anxiety, studies that emerged from this systematic review reported better improvement after playing a COTS game compared with not playing the game [103,109,112], surfing the web [114], watching a film [117], a passive video game distraction [123], EMDR therapy [113], anxiolytic medication [102], or physiotherapy alone [105]. Furthermore, two studies found a significant decrease in anxiety after a single exergame session [120] and after an exercise program with the same video game genre [122]. ...
Article
... The number of participants ranged from 27 [109] to 337 [85,111] in RCT studies and from 1 [123] to 40 [120] in quasiexperimental studies. The two cross-sectional/correlational studies included 3915 [82] and 133 participants [124], respectively. ...
... Nine studies reported improvement after playing a COTS game compared to an eye movement desensitization and reprocessing (EMDR) therapy alone [113], watching a film [117], surfing the web [114], anxiolytic medication [102], physiotherapy alone [105], passive video game distraction [123], and not playing a game [103,109,112]. Furthermore, in two studies that did not include a control group, exergames diminished anxiety in only one session [120] and in a more extended program including a total of 30 sessions [122]. Another study compared the efficacy of an exergame and a CVG played in virtual reality; anxiety reduction was more significant in the case of the exergame [119]. ...
... Concerning anxiety, studies that emerged from this systematic review reported better improvement after playing a COTS game compared with not playing the game [103,109,112], surfing the web [114], watching a film [117], a passive video game distraction [123], EMDR therapy [113], anxiolytic medication [102], or physiotherapy alone [105]. Furthermore, two studies found a significant decrease in anxiety after a single exergame session [120] and after an exercise program with the same video game genre [122]. ...
Article
... ping-pong, volleyball, beach volleyball, and boxing), dancing (Neves et al., 2015;Unnithan, Houser, & Fernhall, 2006;Viana et al., 2017), and weight-bearing exercises (Moreira, Rodacki, Costa, Pitta, & Bento, 2020;Viana et al., 2018;Viana, Gentil, Andrade, Vancini, & de Lira, 2019). Consoles that enable this experience are Sony's PlayStation Move ® , Microsoft's Xbox Kinect ® and Nintendo's Wii ® Wiemeyer et al., 2015). ...
... Most studies involving exergames have investigated their effects on behavioral, cognitive, psychological and physical outcomes (Benzing & Schmidt, 2018;. There is evidence that exergame interventions are able to improve physical activity levels (Fogel, Miltenberger, Graves, & Koehler, 2010), the performance of daily activities (Neumann, Meidert, Barber a-Guillem, Poveda-Puente, & Becker, 2018;Zangirolami-Raimundo et al., 2019), muscle strength in older adults (Htut, Hiengkaew, Jalayondeja, & Vongsirinavarat, 2018), heart rate Neves et al., 2015;Rodrigues et al., 2015;Viana et al., 2017Viana et al., , 2018, oxygen consumption Rodrigues et al., 2015;Viana et al., 2018), and energy expenditure in various populations Rodrigues et al., 2015;Viana et al., 2018;Wu et al., 2015), improvements in body composition in children (Staiano, Abraham, & Calvert, 2013), postural balance (Jorgensen, Laessoe, Hendriksen, Nielsen, & Aagaard, 2013), cognitive function in older adults (Maillot, Perrot, & Hartley, 2012), and anxiety disorders in different populations (Viana & de Lira, 2020;Viana et al., 2017). Therefore, although access to exergames may be more limited than access to traditional video games, the benefits of this type of video games must be taken into account during the COVID-19 outbreak due to its strong motivational ability. ...
... Most studies involving exergames have investigated their effects on behavioral, cognitive, psychological and physical outcomes (Benzing & Schmidt, 2018;. There is evidence that exergame interventions are able to improve physical activity levels (Fogel, Miltenberger, Graves, & Koehler, 2010), the performance of daily activities (Neumann, Meidert, Barber a-Guillem, Poveda-Puente, & Becker, 2018;Zangirolami-Raimundo et al., 2019), muscle strength in older adults (Htut, Hiengkaew, Jalayondeja, & Vongsirinavarat, 2018), heart rate Neves et al., 2015;Rodrigues et al., 2015;Viana et al., 2017Viana et al., , 2018, oxygen consumption Rodrigues et al., 2015;Viana et al., 2018), and energy expenditure in various populations Rodrigues et al., 2015;Viana et al., 2018;Wu et al., 2015), improvements in body composition in children (Staiano, Abraham, & Calvert, 2013), postural balance (Jorgensen, Laessoe, Hendriksen, Nielsen, & Aagaard, 2013), cognitive function in older adults (Maillot, Perrot, & Hartley, 2012), and anxiety disorders in different populations (Viana & de Lira, 2020;Viana et al., 2017). Therefore, although access to exergames may be more limited than access to traditional video games, the benefits of this type of video games must be taken into account during the COVID-19 outbreak due to its strong motivational ability. ...
Article
Full-text available
Although significant increases in gaming may not always be beneficial, exergames (a new generation of video games also known as exergaming or active video games) appear as an alternative, feasible, attractive, and safe way to perform physical exercise for most clinical and nonclinical populations. Therefore, it is important to recognize that exergames can be considered a useful tool for coping with the COVID-19 outbreak and the recommended social distancing period.
... 29 Moreover, it has already been demonstrated that a single session of a dance exergame reduced anxiety levels in young adult women. 22 Taking all the points already mentioned together, this article offers a critical appraisal of the opportunities and challenges of exergames as a coping strategy for preventing and treating anxiety disorders in a home-based environment during the COVID-19 quarantine period. ...
... Although there is some heterogeneity among studies, these can mostly be explained by differences in methods employed. 31, 32 Exergames comprise many different modalities (walking, running, climbing stairs, cycling, rowing, swimming, baseball, ping-pong, tennis, balance training, frisbee, boxing, canoeing, stretching exercises, bowling, golf, resistance exercises, yoga, dancing, etc.) [21][22][23]26,30 and are based on the idea of integrating physical activity and exercise with appealing digital games. 33 We believe that some modalities may be better than others at reducing anxiety levels, especially those classified as being of moderate intensity. ...
... 7,8 In this context, a single session (20 minutes) of the exergame Zumba Fitness performed at moderate intensity seems to significantly reduce state anxiety levels in healthy young women. 22 Also, an 8-week (2 days per week, 60 minutes per session) exergames intervention (dance steps, postural control, coordination, and walk training) seems to provide superior effects on anxiety levels in patients with fibromyalgia, compared with a nonexercise control group. 31 In addition, participants enrolled in a dance-based exergaming intervention 32 appear to report a higher perceived competence in performing regular exercise, and exergames seem to provide a positive effect on overall psychological adjustment in obese adolescents. ...
Article
Full-text available
The COVID-19 outbreak has led to wide-scale self-isolation, as a result of the quarantine period recommended by the World Health Organization. Consequently, people's mental health, including their anxiety levels, may be becoming impaired. To cope with the situation, the exergame appears to be an enjoyable easy-to-use tool for reducing social isolation, as well as an interesting mode of home-based exercise for tackling anxiety disorders and sedentary behavior. This article critically appraises the opportunities and challenges exergames present for the prevention and treatment of anxiety disorders in a home-based environment during the COVID-19 quarantine period.
... Thus, exergames appear as an interesting alternative to increase motivation and self-efficacy, which are important aspects for people to remain physically active. 27 Additionally, as exergames require ample body movements, 28 several studies have shown that an exergame is capable of increasing physical activity levels, 17 performance in daily activity, 29,30 HR, 23,[31][32][33][34][35] oxygen consumption, 23,31,[34][35][36] and energy expenditure in different populations, [23][24]31,[34][35]37 as well as reducing anxiety levels in young adult women. 32 However, there are currently many different approaches to performing exergames and there is still no consensus as to whether exergames are able to reduce anxiety levels, 32,38 as well as whether exergames provide greater reductions on anxiety levels when added to traditional forms of clinical interventions (eg, psychotherapy, drugs). ...
... 27 Additionally, as exergames require ample body movements, 28 several studies have shown that an exergame is capable of increasing physical activity levels, 17 performance in daily activity, 29,30 HR, 23,[31][32][33][34][35] oxygen consumption, 23,31,[34][35][36] and energy expenditure in different populations, [23][24]31,[34][35]37 as well as reducing anxiety levels in young adult women. 32 However, there are currently many different approaches to performing exergames and there is still no consensus as to whether exergames are able to reduce anxiety levels, 32,38 as well as whether exergames provide greater reductions on anxiety levels when added to traditional forms of clinical interventions (eg, psychotherapy, drugs). In this sense, the elucidation of this topic may provide important practical information regarding the use of exergames to manage anxiety levels. ...
... 27 Additionally, as exergames require ample body movements, 28 several studies have shown that an exergame is capable of increasing physical activity levels, 17 performance in daily activity, 29,30 HR, 23,[31][32][33][34][35] oxygen consumption, 23,31,[34][35][36] and energy expenditure in different populations, [23][24]31,[34][35]37 as well as reducing anxiety levels in young adult women. 32 However, there are currently many different approaches to performing exergames and there is still no consensus as to whether exergames are able to reduce anxiety levels, 32,38 as well as whether exergames provide greater reductions on anxiety levels when added to traditional forms of clinical interventions (eg, psychotherapy, drugs). In this sense, the elucidation of this topic may provide important practical information regarding the use of exergames to manage anxiety levels. ...
Article
Full-text available
There are currently many different approaches to performing exergames and there is still no consensus as to whether exergames are able to reduce anxiety levels, as well as whether exergames provide greater reductions on anxiety levels when added to traditional forms of clinical interventions. Therefore, the aim of the present systematic review and meta‐analysis was to access data from studies that evaluated the effects of exergames on anxiety levels in humans. PubMed, Scopus and Cochrane databases were searched up to 22 February 2019. Inclusion criteria were acute and chronic (short‐term and long‐term interventions) studies which evaluated the effects of exergames in anxiety levels as primary or secondary aim. Of the 1342 studies found, 17 and 10 were included in qualitative analyses and meta‐analyses, respectively. The within‐group analysis found that exergames (standardized mean difference [SMD]:‐0.57 [95% Confidence interval (CI):‐0.86 to ‐0.28], p<0.001) and usual care (SMD:‐0.21 [95%CI:‐0.34 to ‐0.08], p=0.002) resulted in significant improvements on anxiety levels. However, the between‐group meta‐analysis on the effects of control interventions versus exergames (SMD:0.02 [95%CI:‐0.55 to 0.60], p=0.939) found no significant difference between groups in anxiety levels reductions. There was also no significant difference (SMD:‐0.04 [95%CI:‐0.32 to 0.25], p=0.805) between usual care versus exergames plus usual care interventions in anxiety levels reductions. Although exergames demonstrated within‐group improvements in anxiety levels across different clinical populations, it was not greater than the effects from non‐exercise interventions. Also, given the paucity of studies, small sample sizes, different research designs, and different population investigated, the existing evidence is insufficient to support the advantages of usual care supplemented by exergame intervention over usual care standalone in anxiety levels reduction.
... Findings from decades of research on the relationship between video gaming frequency and emotional well-being have been inconsistent and even contradictory. While some studies have found a negative correlation between video gaming and emotional well-being Lo, Wang, & Fang, 2005;Madrigal-Pana, Gómez-Figueroa, & Moncada-Jiménez, 2018;Maras et al., 2015;Mikuška & Vazsonyi, 2018;Rehbein et al., 2010;Tortolero et al., 2014;Twenge & Campbell, 2019), a growing body of research has shown that video gaming is associated with higher levels of emotional well-being (Johannes, Vuorre, & Przybylski, 2021;Jones, Scholes, Johnson, Katsikitis, & Carras, 2014;Kühn, Berna, Lüdtke, Gallinat, & Moritz, 2018;Orben & Przybylski, 2019;Viana et al., 2017). Although these mixed findings may be due, in part, to the vastly different or suboptimal methodologies used to examine this relationship (Johannes et al., 2021;Odgers & Jensen, 2020) or potential third variables in numerous studies (Ophir, Lipshits-Braziler, & Rosenberg, 2020;Pallavicini, Ferrari, & Mantovani, 2018), we suggest that another significant contributor to the mixed literature is the insufficient consideration of contextual factors that may affect this relationship. ...
... Considering the well-established psychological benefits of physical exercise (Zhang & Chen, 2019), exergames may likewise be highly beneficial for psychological health. Indeed, research on exergames has consistently revealed associations between higher frequency of playing exergames and better emotional outcomes, such as fewer depressive symptoms, reduced anxiety, and greater positive affect across different age groups (Viana et al., 2017;Zheng, Li, Salmon, & Theng, 2020). Thus, instead of taking time away from players to engage in physical exercise, exergames can actually serve as a fun source of exercise and motivate people to keep physically fit. ...
Article
Full-text available
The appeal of video gaming has undoubtedly withstood the test of time. In view of its increasing popularity, lay people and researchers alike have taken an interest in the psychological consequences of video gaming. However, there seems to be a paradox associated with the effect of video gaming on gamers' well-being—namely, while most video game players cite “fun” as their motivation to play video games, video games continue to hold a notorious reputation among some researchers for being detrimental to mental health and emotional well-being as measured by indicators such as happiness, perceived stress, anxiety, and depressive symptoms. We suggest that a significant contributor to the mixed literature is the oversight of contextual factors that may moderate this relationship. The current review highlights five important contextual factors that should be considered when studying the associations between the frequency of video gaming and well-being. Specifically, we suggest that unless the social context (who), type (what), motivation (why), time and day (when), and amount (how much) of video gaming activities are adequately considered, examinations of well-being outcomes in relation to video gaming will remain incomplete.
... Many previous studies have shown that the most common exergames elicit a physical exercise intensity corresponding from light to moderate [29][30][31][32][33] . For example, 29 investigated the responses of heart rate and oxygen uptake during an exergame session. ...
... 32 and 34 investigated the acute effects of the exergame Zumba Fitness on anxiety in women. The authors found that this exergame had an anxiolytic effect and attributed this effect to the moderate intensity of physical exercise evoked by the exergame session. ...
Article
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During the COVID-19 pandemic, factors related to the isolation and quarantine period increased psychobiological distress in the general population around the world, increasing anxiety, emotional stress, and depression, as well as worsening of the quality of sleep. Seeking alternatives to provide support for the implementation of some interventions for well-being and health under pandemic conditions, exergames (active video games) seem to be a feasible alternative to keep people physically active and to positively impact sleep health. In this overview article, we discussed the feasibility of exergames as an option to cope with sleep disorders and improve sleep quality during the COVID-19 outbreak through increasing physical exercise and physical fitness levels.
... Finally, the current sample attended, on average, OULA® 1.22 times per week during the intervention period. It is possible that the attendance frequency was not high enough to alleviate anxious symptoms, albeit, Viana et al. (2017) found a significant decrease in state anxiety in healthy women after a single session of the exergame Zumba. One difference between the current study and Viana et al.'s (2017) study is that the latter recruited healthy women, whereas we included women with a DSM-5 diagnosis of major depressive or persistent depressive disorder, and depression is known to complicate treating anxiety (Ballenger, 2000). ...
... One difference between the current study and Viana et al.'s (2017) study is that the latter recruited healthy women, whereas we included women with a DSM-5 diagnosis of major depressive or persistent depressive disorder, and depression is known to complicate treating anxiety (Ballenger, 2000). Moreover, Viana et al. (2017) investigated the dance exergame Zumba, a type of gaming exercise that involves Latin dancing, while OULA® in the current study was attended via online or in person. Also, state anxiety was measured pre-and post-single session of the exergame Zumba, and we collected anxiety severity over time. ...
Article
The primary purpose of this pilot study was to evaluate OULA®, a dance fitness program with a strong emphasis on processing emotions through dance, as an intervention for depression in women diagnosed with major or persistent depressive disorders. 53 women were eligible for participation. Women attended OULA® for 12 weeks and then abstained from OULA® during week 13. For the primary outcome, depression severity was measured using the Hamilton Depression Rating Scale (HAM-D), and secondary outcomes were measured using the Beck Anxiety Index (BAI) and the Subjective Happiness Scale (SHS). After the abstinence week, women were offered 3-months of optional additional OULA®. HAM-D, BAI and SHS scores were collected at weeks 2, 4, 5-14 and at the end of the 3-month optional OULA® phase. Results from linear mixed effects repeated models show that during the 12-week intervention period and at week 26, HAM-D scores significantly decrease each week compared to baseline. Further, BAI scores significantly decrease starting at week 5 and through the end of the intervention period and at week 26. Moreover, SHS scores increased significantly for four of the weeks during the intervention period and at week 26. The results from this study suggest that OULA® may be a useful intervention for decreasing depression and anxiety severity in women with depression but may not be helpful for improving subjective happiness.
... Physical training with exergames has been suggested as an alternative exercise routine due to the enjoyment of individuals while exercising, leading to an increase of acute energy expenditure 1 and improvement on the aerobic fitness 2,3 , balance 4 and muscle strength of the lower limbs 5 . The energy expenditure is increased with exergame compared to sedentary condition and the intensity of an exergame session -measured with heart rate (HR) and rating of perceived exertion (RPE) -is moderate in young women 6 ; however, higher intensities (i.e., internal and external load) during the exergame training session may play a key role in the success of physiological enhancements. ...
... This study aimed to check whether performing exergames with and without an additional external load induces to different internal load demand in young women. The moderate exercise intensity was characterized by RPE and HR measurements, agreeing with previous study 6 . However, using an external load did not change the internal load in both games, although such approach can be a promising way of manipulating exercise intensity, as the local RPE was greater with an additional load than without a load in the "Just Dance" game. ...
Article
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... In addition, the musical factor adds to the sense of fun, enjoyment, and camaraderie (Terry, Karageorghis, Curran, Martin, & Parsons-Smith, 2020). Not surprisingly, Zumba exercises decrease anxiety and depression (Batista, Maia, de-Souza, 65 Lins, & de-Souza, 2021;Herdianti, Rasjad, & Widayanti, 2019;Norouzi et al., 2020;Viana et al., 2017), as well as improves the QoL (Cugusi et al., 2016;Domene, Moir, Pummell, Knox, & Easton, 2016) in different female populations. Moreover, it has been documented that Zumba provides muscular and sensorimotor stimulation, therefore improving functional performance such as lower limb muscular strength (Barene, Holtermann, Oseland, 70 Brekke, & Krustrup, 2016;Krishnan et al., 2015). ...
Article
We aimed to investigate 12-week-Zumba training effects on physical and psychological parameters, and quality of life (QoL) in postmenopausal women. Forty-two postmenopausal women were randomly allocated to a control group or a Zumba group (ZG). Postural balance, lower limb strength, mood level, and QoL were assessed before and after the 12-week-Zumba training. The ZG showed significantly better balance performances under all conditions such as on firm and foam surfaces with opened and closed eyes as well as improvements in limb strength, mood and QoL compared to their baselines. Thereby, 12-week-Zumba training was effective in improving postural balance, limb strength, mood and, QoL in postmenopausal women.
... Since we need quick results considering the post-pandemic context, the use of strategies like replacing non-active video games with active video games (exergames) (Ni Mhurchu et al., 2008) is potentially promising for encouraging and promoting the necessary behavior changes. Indeed, exergames can also be an interesting strategy for reducing sedentary behavior and have the benefit of improving mental health Viana et al., 2017;Viana & de Lira, 2020;Viana et al., 2021). ...
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... In 2007, Nintendo used Wii Fit (Nintendo Co, Ltd) in the rehabilitation of patients with Parkinson disease and stroke [12,13]. In addition, some research indicated that exergames demonstrated a positive effect on sleep quality shown by the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) score and mood disorders shown by the 5-item Brief Symptom Rating Scale (BSRS-5) score [14,15], whereas other studies found that exergaming could alleviate the symptoms of chronic low back pain [8]. Despite the existence of studies on the effect of exergaming on health maintenance or psychological improvement, it is still necessary to conduct extensive investigations on the changes or improvements of physical fitness among students after performing exergames. ...
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Background: The COVID-19 outbreak has not only changed the lifestyles of people globally but has also resulted in other challenges, such as the requirement of self-isolation and distance learning. Moreover, people are unable to venture out to exercise, leading to reduced movement, and therefore, the demand for exercise at home has increased. Objective: We intended to investigate the relationships between a Nintendo Ring Fit Adventure (RFA) intervention and improvements in running time, cardiac force index (CFI), sleep quality (Chinese version of the Pittsburgh Sleep Quality Index score), and mood disorders (5-item Brief Symptom Rating Scale score). Methods: This was a randomized prospective study and included 80 students who were required to complete a 1600-meter outdoor run before and after the intervention, the completion times of which were recorded in seconds. They were also required to fill out a lifestyle questionnaire. During the study, 40 participants (16 males and 24 females, with an average age of 23.75 years) were assigned to the RFA group and were required to exercise for 30 minutes 3 times per week (in the adventure mode) over 4 weeks. The exercise intensity was set according to the instructions given by the virtual coach during the first game. The remaining 40 participants (30 males and 10 females, with an average age of 22.65 years) were assigned to the control group and maintained their regular habits during the study period. Results: The study was completed by 80 participants aged 20 to 36 years (mean 23.20, SD 2.96 years). The results showed that the running time in the RFA group was significantly reduced. After 4 weeks of physical training, it took females in the RFA group 19.79 seconds (P=.03) and males 22.56 seconds (P=.03) less than the baseline to complete the 1600-meter run. In contrast, there were no significant differences in the performance of the control group in the run before and after the fourth week of intervention. In terms of mood disorders, the average score of the RFA group increased from 1.81 to 3.31 for males (difference=1.50, P=.04) and from 3.17 to 4.54 for females (difference=1.38, P=.06). In addition, no significant differences between the RFA and control groups were observed for the CFI peak acceleration (CFIPA)_walk, CFIPA_run, or sleep quality. Conclusions: RFA could either maintain or improve an individual's physical fitness, thereby providing a good solution for people involved in distance learning or those who have not exercised for an extended period. Trial registration: ClinicalTrials.gov NCT05227040; https://clinicaltrials.gov/ct2/show/NCT05227040.
... Due to its motivating and interactive features, it has been stated that exergames might increase commitment to exercise [46][47][48][49]. Exergames, which mimic cycling, dancing, running, walking, playing a sport modality, and resistance training, have become commercially available [50][51][52][53][54][55][56]. Nowadays, exergames have been used in various rehabilitation programs for cerebral palsy, Parkinson's disease, stroke, obesity, or sarcopenia [57]. ...
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Muscle architectural parameters play a crucial role in the rate of force development, strength, and sports performance. On the other hand, deteriorated muscle architectural parameters are associated with injuries, sarcopenia, mortality, falls, and fragility. With the development of technology, exergames have emerged as a complementary tool for physical therapy programs. The PRISMA 2020 statement was followed during the systematic review and meta-analysis. CENTRAL, CINAHL, PROQUEST, PubMed, and OpenGrey databases were searched last time on 22 September 2021. In total, five controlled trials were included in the systematic review. Twelve weeks of virtual dance exercise (Dance Central game for Xbox 360®) showed a medium effect on the improvement of hamstrings (g = 0.55, 95% CI (−0.03, 1.14), I2 = 0%) and the quadriceps femoris muscle cross-sectional area (g = 0.58, 95% CI (0.1, 1.00), I2 = 0%) in community-dwelling older women. Additionally, a four-week virtual balance-training program (the ProKin System) led to significant increments in the cross-sectional areas of individual paraspinal muscles (14.55–46.81%). However, previously investigated exergame programs did not show any medium or large effects on the architectural parameters of the medial gastrocnemius muscle in community-dwelling older women. Distinct exergame programs can be used as a complementary therapy for different prevention and rehabilitation programs.
... Other studies have shown that exergames are as effective as conventional balance training exercises [14,228]. Moreover, the benefits of playing exergames include, but not limited to, improving the quality of life [247], reducing state anxiety [267], as well as improvements in the number of steps taken, standing balance, gait speed, and mobility [82]. ...
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... Studies have shown that exergames have a positive effect on improving mood disorders (Byrne and Kim, 2019). Healthy young women performing a 20-min exergame Zumba fitness training at moderate intensity can reduce the level of anxiety (Viana et al., 2017). ...
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The COVID-19 pandemic and its related public health restrictions are having an increasingly serious impact on mental health, and measures need to be taken to curb this trend. The positive relationship between physical exercise and mental health has been well established, but during the COVID-19 pandemic, with various restrictions, the space and facilities for physical exercise are limited. This article explores the relationship between physical exercise and mental health during the COVID-19 pandemic based on the latest research findings published in 2019-2021. We offer a novel model that consists of three central arguments. First, physical exercises during COVID-19, especially supervised exercises, are conducive to enhancing happiness and improving mental health. Second, physical exercise reduces people’s anxiety, sadness and depression during the COVID-19 pandemic. Third, the maintenance and improvement of mental health are related to the intensity and frequency of physical exercise. Intensive and frequent physical exercise are conducive to maintaining mental health. Finally, this article proposes important directions for future research.
... Viana et al [62] found that playing an exergame (even for only 1 session) seemed to be a useful method for reducing state anxiety in healthy women. However, this is also not supported by our study on an iVR exergame. ...
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Background In recent years, there has been an increase in the number of students with depression, anxiety, and perceived stress. A solution that has been increasingly used for improving health and well-being is exergaming. The effects and acceptability of exergames have been studied widely but mostly with older adults. The feasibility and usability of exergames among university students, especially those of immersive virtual reality (iVR) exergames, remain unexplored. Objective This study aimed to explore the feasibility of a 6-week iVR exergame–based intervention in reducing anxiety, depression, and perceived stress among university students and to examine the usability and acceptability of such games. Methods A total of 31 university students were recruited to participate in a 6-week study in which they needed to play a boxing-style iVR exergame called FitXR (FitXR Limited) twice per week (30 minutes per session). Their anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory-II), and perceived stress (Perceived Stress Scale) levels were measured before and after intervention. Results A total of 15 participants completed the 6-week study. Our results suggested that participants’ mean depression scores decreased significantly from 8.33 (SD 5.98) to 5.40 (SD 5.14) after the intervention (P=.01). In addition, most participants (14/15, 93%) believed that the iVR exergame has good usability. Furthermore, most participants (14/15, 93%) were satisfied with the iVR gameplay experience and would play the iVR exergame again in the future. Of the 15 participants, 11 (73%) would recommend the iVR exergame to their friends. Conclusions The results gained from this study show that the iVR exergame has good usability, is highly acceptable, and has the potential to reduce depression levels among university students.
... 22,23 And exergame is one of the alternatives to facilitate active physical activity. 24,25 In this study, we employed a participatory design (PD) approach to help students with visual impairments engage in the design and testing of exergames, and to explore factors that may modulate self-efficacy in terms of psychological emotion, physical activity, and social interactivity. Such approaches may be useful for the design of athletic, health management, and social behavior programs for people with visual disabilities. ...
Article
Objective: To explore changes in task/scheduling self-efficacy in children with visual impairments after playing exergames, using the participatory design (PD) method to guide students with visual impairments to engage in the design and test of exergames. Materials and Methods: A pre-/post-test was used with two experimental groups (nine high school students with visual impairments aged 18-21, nine junior high school students with visual impairments aged 14-17). Data were analyzed by an independent-/paired-sample t-test to assess changes in task/scheduling self-efficacy of different groups after gameplay. Data of three dimensions (psychological emotion, physical activity, and social interaction) were collected through texts, participative observations, live notetaking, and video recordings. These dimensions provide opportunities for children with visual impairments to improve their self-efficacy. Results: Exergames helped children with visual impairments to improve their task and scheduling self-efficacy. It confirmed that exergames can be useful to promote their psychological emotion, enhance levels of positive physical activity, and increase social opportunities to improve self-efficacy. Conclusion: Participants of various ages who engaged in exergames reported an improvement in both task and scheduling self-efficacy in terms of psychological emotion, physical activity, and social interaction. The PD approach may be useful in the design of products for people with visual impairments and may ultimately be helpful in supporting the social and physical needs of people with disabilities.
... Although there are several types of exergames, the most common exergames simulate traditional moderate-intensity continuous exercises (e.g., walking, running, and cycling), 21,22 sports modalities (e.g., basketball, bowling, yoga, tennis, table tennis, baseball, swimming, ping-pong, and boxing), 23 and dancing. [23][24][25] More recently, exergames that mimic resistance training exercises have been made commercially available. 26 In these exergames, visual and auditory stimuli are combined with different types of equipment (e.g., balance boards, step mats, dance mats, dumbbells, cameras, and other types of sensors and inputs) that allow users to move to play. ...
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This systematic review and meta‐analysis examined studies on the chronic effects of exergames on muscle strength in humans. PubMed, Scopus, CENTRAL, Web of Science, SciELO, Biblioteca Virtual em Saúde, and Google Scholar were searched, and manual searches of the reference lists of included studies and hand‐searches on Physiotherapy Evidence Database and ResearchGate were conducted from inception to August 10, 2020. Randomized and non‐randomized exergame intervention studies with or without a non‐exercise group and/or a “usual care intervention group” (any other intervention that did not incorporate exergames), which evaluated muscle strength through direct measurements, were included. Forty‐seven and 25 studies were included in the qualitative review and meta‐analysis, respectively. The between‐groups meta‐analyses showed no significant differences between exergames and non‐exercise control groups for handgrip strength in heathy/unhealthy middle‐aged/older adults or knee extension maximum voluntary isometric contraction (MVIC) in healthy older adults. However, exergames provided a greater increase in handgrip strength, knee flexion MVIC, and elbow extension MVIC, but not knee extension MVIC or elbow flexion MVIC, in individuals with different health statuses when compared to usual care interventions. Also, there was a greater increase in handgrip strength in children with hemiplegic cerebral palsy favouring usual care plus exergames compared to usual care interventions. These results suggest that exergames may improve upper and lower limb muscle strength in individuals with different heath statuses compared to usual care interventions, but not muscle strength in middle age/older adults after accounting for random error. Also, exergames appear to be a useful tool for improving handgrip strength in children with hemiplegic cerebral palsy when added to usual care. However, as the exergame interventions were applied in different populations and there currently are many different approaches to perform exergames, future randomized controlled trials with high methodological quality and large sample sizes are needed to provide more compelling evidence in favour of a specific exergame protocol, or to elucidate exergame protocol design principles that appear to strongly influence outcomes.
... mood disorders. Its benefits are already established in the literature, and regular physical exercise is an important tool for the treatment of mental disorders (31)(32)(33)(34). ...
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... In the context of the positive adaptations associated with the practice of physical exercise (Pascoe et al., 2020), in a wide literature review showed that physical exercise is a promising factor to mental health promotion. In general, it is well-established positive physiological/psychological effects associated with physical exercise practice because could to improve mood state and ameliorate/ prevent anxiety and depressive symptoms and disorders (Pascoe et al., 2020;Shaphe and Chahal, 2020;Chen et al., 2018;Viana et al., 2017;Stanton et al., 2012;Hale et al., 2002), mood state (Pascoe et al., 2020;Jaggers et al., 2015) and sleep and life quality (Alley et al., 2015). ...
... Interestingly, previous studies have reported that an increased involvement of the body while playing video games on desktop displays leads to more intense emotional and affective responses by the player [69,70]. Furthermore, recent preliminary studies have reported that exergames-ones that are considered a combination of video gaming and physical exercise requiring physical effort from the player in order to play the game [71][72][73]-are able to elicit positive emotions among older adults [71], inducing higher positive emotions than traditional exercise [74], and are able to reduce state anxiety in a nonclinical sample of healthy women [75]. ...
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Background In the last few years, the introduction of immersive technologies, especially virtual reality, into the gaming market has dramatically altered the traditional concept of video games. Given the unique features of virtual reality in terms of interaction and its ability to completely immerse the individual into the game, this technology should increase the propensity for video games to effectively elicit positive emotions and decrease negative emotions and anxiety in the players. However, to date, few studies have investigated the ability of virtual reality games to induce positive emotions, and the possible effect of this new type of video game in diminishing negative emotions and anxiety has not yet been tested. Furthermore, given the critical role of body movement in individuals’ well-being and in emotional responses to video games, it seems critical to investigate how body involvement can be exploited to modulate the psychological benefits of virtual reality games in terms of enhancing players’ positive emotions and decreasing negative emotions and anxiety. Objective This within-subjects study aimed to explore the ability of commercial virtual reality games to induce positive emotions and diminish negative emotions and state anxiety of the players, investigating the effects of the level of body involvement requested by the game (ie, high vs low). MethodsA total of 36 young adults played a low body-involvement (ie, Fruit Ninja VR) and a high body-involvement (ie, Audioshield) video game in virtual reality. The Visual Analogue Scale (VAS) and the State-Trait Anxiety Inventory, Form-Y1 (STAI-Y1) were used to assess positive and negative emotions and state anxiety. ResultsResults of the generalized linear model (GLM) for repeated-measures multivariate analysis of variance (MANOVA) revealed a statistically significant increase in the intensity of happiness (P
... Other studies have shown that exergames are as effective as conventional balance training exercises. 16,17 Moreover, the benefits of playing exergames include, but not limited to, improving the quality of life, 18 reducing state anxiety, 19 as well as improvements in the number of steps taken, standing balance, gait speed, and mobility. 20 Given the recent emergence of immersive VR technology, 10 which frequently uses head-mounted displays (HMDs), there is limited and only preliminary research on immersive VR exergames. ...
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COVID-19 is a thorny challenge of global public health. To curb the rapid spread of the epidemic, the World Health Organization recommends a series of public health measures including “social distance” and “different levels of lockdown”. However, these restrictive measures have completely changed people’s lifestyles. Although these measures are conducive to controlling the pandemic, people usually lack adequate physical activity during the lockdown period. Staying indoors for a long period may easily lead to negative emotions such as depression and anxiety. Therefore, restrictive public health measures may have a detrimental impact on people’s mental health. Physical activity is considered an effective strategy to improve physical and mental health during the pandemic. Thus, it is an important and urgent public health issue to promote physical activity during COVID-19. With the recent implementation of public health restrictions in Taiwan, various online fitness courses have become new choices. In addition, “exergame” which combines physical activity and electronic games is also increasing popularity, with smart display technologies (such as augmented reality, virtual reality, etc.) to provide a brand-new immersive experience while exercising. Exergame is a new way to maintain physical activity has become a new trend, but there are some limitations and challenges. Therefore, it will be a new challenge to maintain physical and mental health with these emerging technologies under the pandemic. COVID-19 的大流行反映出全球公共衛生的艱困。為了避免疫情快速擴散，在世界衛生組織建 議實施的一系列公共衛生措施中，除了將疑似感染者隔離之外，各國政府也藉由實施“社交距離” 和“不同層級的警戒封鎖”，以遏制 COVID-19 的傳播。而一系列的限制措施大幅改變了民眾的生 活型態。雖然各項措施有益於控制疫情，但是在封鎖警戒期間，民眾除了缺乏足夠的身體活動 (physical activity)，長時間處在室內環境對於心理層面也容易帶來憂鬱、焦慮等負向情緒，這也使 COVID-19 疫情除了對身體健康造成影響之外，限制性的公共衛生措施可能進而影響到民眾的心理 健康。身體活動被視為在疫情期間可以增進身體與心理健康的重要策略。因此在 COVID-19 期間促 進身體活動是重要且迫切的公共衛生政策。因此，如何在疫情肆虐下讓民眾維持足夠的身體活動量， 並增加持續健康行為的動機，進而改善其生理與心理健康，成為非常重要的課題。然而，近期在臺 灣實施相關限制措施下，民眾的身體活動習慣受到了極大的改變。各式各樣的線上運動課程成為民 眾的運動新選擇。在疫情期間，居家運動成為新的運動型態。此外，結合身體活動與電子遊戲的「運 動遊戲」也大受歡迎，搭配智慧顯示科技 (如:擴增實境、虛擬實境等技術) 提供全新型態的運動 體驗。透過新型態的方式維持身體活動已成為新趨勢，然而也存在著部分限制與挑戰。如何更有效 地利用新興科技輔助滿足身體活動的需求、維持身心健康，也將會是疫情下的新挑戰。
Article
Background and aim The effects of physical activity and exercise on gaming disorder severity in individuals with gaming disorder are unknown. The present study aimed to address the empirical gap in the current literature by comparing the effects of virtual reality-based training (VRT) and aerobic training (AT) exercise programs on gaming disorder severity, physical activity, physical fitness, and anxiety versus control group. Materials and methods Forty-four young male adults (18–28 years) with gaming disorder and a sedentary lifestyle were included in the study. The primary outcomes of the study were changes in gaming disorder severity and physical activity, and secondary outcomes included changes in physical fitness and anxiety levels. The participants were randomly assigned to VRT (n = 15), AT (n = 14) and control (n = 15) groups. Training sessions were performed at 50–70% of the maximal heart rate. Exercise programs consisted of 6 weeks of training 3 times a week for 30 min. Results There was a decrease in the severity of gaming disorder as well as an increase in the level of physical activity in the VRT and AT exercise groups compared to the control group. In addition, a reduction was observed in the gaming time and sedentary time in both exercise groups versus control group. VRT group experienced greater improvements in physical fitness parameters than the AT group. Conclusion VRT and AT were effective in reducing gaming time and the severity of gaming disorder in individuals with gaming disorder. The therapeutic effects of VRT and AT can be used for reducing the severity of gaming disorder.
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Anxiety, depression, and stress are the most common psychological concerns among the population of society. The desirable changes in mental health are obtained through therapeutic diagnosis i.e., physical exercise practice and physical activity participation which are having a great potential as a prevention and treatment for these psychological issues. The purpose of the study was to systematically review the evidences for the effect of an exercise program on psychological variables i.e., anxiety, depression, and stress. For this purpose 198 research articles were reviewed from the available resources i.e. Research Gate, Pub Med, Google Scholar, Springer, Scopus, Web of Science and sample of 38 research articles were selected for the study as per the inclusion criteria. This study was given an idea that exercise interventions were beneficial in reducing the anxiety, depression, and stress. Further, research literature evidently reported that exercise in detention environments improves mental health. Findings of the study were concluded that low to high intensive exercise practices, physical activities and participation in recreational games brought the significant improvement in psychological variables i.e., anxiety, depression, and stress respectively in place of the alternative of drugs and other clinical treatment methods.
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Introdução. Nos últimos anos, novas tecnologias como os jogos ativos de videogame foram incorporadas no âmbito da reabilitação. Os jogos de dança promovem a interação direta com o próprio jogo estimulando a atividade física de forma lúdica e vêm se mostrando promissores na terapêutica neurológica. Método. Foi realizada uma busca não sistemática nas bases de dados PubMed (National Library of Medicine National Institutes of Healf), BVS (Biblioteca Virtual em Saúde) e Google Scholar para pesquisa de estudos em português e inglês. Resultados. Os jogos de dança somam os benefícios proporcionados pela prática da dança com as vantagens favorecidas pelo uso de videogames. Com esta pesquisa pôde-se encontrar melhorias físicas, cognitivo-motoras e psicossociais em indivíduos com disfunções neurológicas como sequelas de Acidente vascular cerebral (AVC), doença de Parkinson, Esclerose Múltipla e Doença de Huntington. Conclusão. Os jogos de dança são ferramentas divertidas e prazerosas que proporcionam benefícios em diversos componentes físicos e psicossociais como a neuroplasticidade, cognição, marcha, equilíbrio, sintomas depressivos e de ansiedade em indivíduos com doenças neurológicas. Mais estudos são necessários para maiores esclarecimentos sobre essa temática.
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Background: Anxiety disorders affect many people around the world and women are more affected than men. Physical exercise might be an important nonpharmacological tool to ameliorate these disorders. The aim of this study was to compare state anxiety level and enjoyment between a dance exergame session and a traditional aerobic exercise. Methods: Twenty healthy young women completed 3 visits, on separate days. At the first visit, participants performed a graded exercise testing and familiarization procedures. In other two visits, participants completed two exercise sessions (dance exergame and traditional aerobic exercise), with similar intensities and duration. Each session lasted approximately 45 minutes. State anxiety level was evaluated before, immediately post- and 10 minutes post sessions. Enjoyment was evaluated immediately post sessions. Results: There was a significant interaction between session and time (p<0.001), a main effect of time (p=0.007) but no significant main effect of session (p=0.057) on state anxiety level. State anxiety level immediately post (p<0.001) and 10 minutes post-session (p<0.001) were significantly lower than pre-dance exergame session. There were no significant changes between pre-, immediately post and 10 minutes post-traditional aerobic exercise session (p>0.05). State anxiety level at immediately post dance exergame session was significantly lower than immediately post traditional aerobic exercise session (p=0.026). Dance exergame session was significantly more enjoyable than traditional aerobic exercise session (p<0.0001). Conclusions: Dance exergames might be used as a tool to reduce anxiety level in young women.
Article
The purpose of this article is to validate the correlations between the heart rate (HR) and rating of perceived exertion (RPE) during exergaming boxing in sitting and standing positions. Thirty healthy adults, whose mean age was 25.10 and standard deviation (SD) 2.95 years, were recruited to play 10 minutes of exergaming boxing in sitting and standing positions. HR measurements were obtained at rest and during gameplay. RPE was assessed using Borg's modified (1–10) and original (6–20) scales. A paired-sample t -test, bivariate Pearson's, and Spearman's rho correlations were used to analyze the results. Mean HR was significantly higher while exergaming in standing position (130.79 SD23.18 bpm) as compared to sitting position (116.46 SD19.08 bpm) ( p $\leq 0.05$ ). There was a significant correlation between HR and RPE values while playing boxing exergaming in the standing position. A regression model that can be fitted into an equation to predict HR from reported RPE was derived from the significant values of Pearson's correlations. However, HR and RPE values did not significantly correlate with each other during exergaming boxing in the sitting position. The formula extracted from the linear regression models provides reliable predictions in estimating HR from the reported RPE while exergaming boxing in the standing position.
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First reported in Dec 2019, the on-going COVID-19 pandemic has become a public health emergency of international concern (PHEIC). The isolation and quarantine during the COVID-19 pandemic limited the physical and social activities of the population, which contributed to the increased prevalence of mental disorder. Depression and anxiety are the most common mental illnesses conferring a serious impact on individuals' life quality. This review summarizes the mental health consequences of COVID-19, especially for depression and anxiety. Exercise as an intervention for anxiety and depression has been demonstrated in both of the animal studies and human clinical trials. The underlying mechanism including the regulation on the production of brain-derived neurotrophic factor (BDNF), D-β-hydroxybutyrate, synaptic transmission, hypothalamic pituitary adrenal (HPA) axis, tryptophan hydroxylase, GSK3β/β-catenin pathway, neuroinflammation, oxidative stress and PGC-1α1-PPAR axis. In addition, we summarized the exercise strategies to fight against anxiety and depression according to the information from American College of Sports Medicine (ACSM), World Health Organization and recent literatures about physical exercise during COVID-19.
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Exergames appear to have great potential in releasing anxiety and two ubiquitous elements of exergames are competition and cooperation. However, less is known about effects of competition and cooperation in exergames on anxiety state. Thus, the aim of this study was to examine and compare possible anxiolytic impacts of the two game modes in male university students. Twenty-four healthy male students were recruited and randomly assigned to competitive exergame, cooperative exergame or control conditions. All participants’ state anxiety, trait anxiety or skin conductance were accessed before and after the interventions. During the experiment, the competition and cooperation groups played the exergame in different modes respectively, while the control group was asked to do traditional exercises. Results showed that cooperative exergame significantly improved the state anxiety as well as the physiological behavior. No significant changes of self-report anxiety or physiological response occurred in the competition and control group. Exergames, especially played cooperatively, can be an effective tool for anxiety management.
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The COVID-19 pandemic has created an unprecedented worldwide public health concern. Characterised by rapid and high frequency human-to-human transmission, the World Health Organisation has recommended implementation of public health measures, including isolation of all suspected infectious individuals for a 14-day quarantine period, while governments have introduced "social distancing" and "lock-downs" of varying severity to curtail COVID-19 spread. Recent COVID-19 research further suggests there are major sleep problems and psychological disorders (e.g., stress, anxiety, depression) associated with the reduction of movement and activities, as well as the reduced social interaction. There have been no studies examining the effect of physical activity at home during such periods of isolation. However, based previous research, potential tactics to overcome these negative effects include home-based exercise, exergaming, dancing to music, and participation in yoga. Adults should accumulate at least 150 min of moderate-intensity and at least 75 min of vigorous-intensity of activity divided in 5 to 7 sessions per week. This training volume could be reduced by 30% for children and adolescents that could be replaced by recess or active play in and around the home. Additionally, exercises should be adapted to the fitness level of the participant and a progressive model of intensity and training volume should be utilised and monitored by telephone applications and wearable sensors. Keywords. COVID-19; Quarantine; Psychology; Sleep; Physical activity.
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Objective To critically review developments over the first fifty years of research (1967–2017) on (a) how people feel when they participate in exercise and physical activity, and (b) the implications of these responses for their willingness to become and remain active. Design Non-systematic narrative review. Method Representative sources were selected through a combination of computer searches and cross-referencing. Results For over three decades, exercise psychology exhibited a fixation on the idea that exercise and physical activity make people feel better. This notion, however, seemed to contrast with evidence that most adults in industrialized countries exhibit low levels of activity. In the last two decades, a critical examination and overhaul of the methodological platform resulted in the delineation of a dose-response pattern that encompasses positive as well as negative affective responses, and revealed marked interindividual differences. An emerging literature is aimed at refining and testing integrative dual-process models that can offer specific predictions about the behaviors that may result from the interaction of automatic processes (theorized to be heavily influenced by past affective experiences) and deliberative processes (such as cognitive appraisals). Conclusions Affective responses to exercise and physical activity are more complex than the long-popularized "feel-better" effect, encompassing both pleasant and unpleasant experiences and exhibiting marked interindividual variation. The potential of affective experiences to influence subsequent behavior offers an opportunity for an expanded theoretical perspective in exercise psychology.
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The training effects of contemporary aerobics programmes (hi lo, dance aerobics, step aerobics, aqua aerobics etc.) have been frequently investigated. However, we found no recent paper which reviewed aerobic programmes with regard to their training effectiveness, characteristics of the subjects involved, variables of interest and experimental design. In this paper we summarise the findings of more than 40 studies published in the 2000-2011 period that investigated the training effects of different forms of contemporary aerobics. In this review, the studies are grouped according to their characteristics (sample of subjects, variables of interest, study design, effects, etc.). Around 80% of the investigations dealt with females, with adults being most commonly observed. In the majority of investigations, the authors studied different variables at the same time (morphological anthropometric, motor, cardiovascular, biochemical indices, etc.). In recent studies a trend toward a psychological status examination is evident. In most instances positive training effects on motor-endurance and varsity of physiological variables are declared throughout a training period of 8 to 12 weeks. However, the positive changes in anaerobic endurance are not evidenced. Knowing the tendency of the overall increase of certain psychological disorders in population (including depression) there are indications that future, potentially highly interesting studies will deal with the psychological status of adults and older subjects.
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The purpose of this study is to investigate associations between physical activity (PA), depression, and anxiety among adolescents in Ireland. Adolescents (N = 481; 281 male, 200 female) aged 15.1 ± 1.7y self-reported PA level, depression, and anxiety. Approximately 21% of adolescents were high trait anxious, and ∼37% reported scores indicating probable depression. Anxiety and depressive symptoms were higher for low PA (60 min/d, 0-2 d/wk) compared to moderate (60 min/d, 3-4 d/wk) and high (60 min/d, 5-7 d/wk) PA. After adjustment for relevant covariates, reduced odds of depression were 30% and 56% for moderate and high PA, respectively; reduced odds of high trait anxiety were 46% and 47% for moderate and high PA, respectively. These findings support the need for adolescents to engage in moderate PA, with potential for increased benefits with increased PA. To conclude, moderate and high PA are inversely associated with anxiety and depressive symptoms, and risk of depression and high trait anxiety in adolescents.
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Objectives: Evidence suggests that symptoms of depression and anxiety predict lower exercise behaviour and, inversely, that less exercise predicts higher symptomatology. The present longitudinal study examined this reciprocal association in adults with type 2 diabetes mellitus. We predicted that symptoms of anxiety or depression would intensify over time as a consequence of lower exercise frequency and, similarly, that exercise frequency would decrease as a consequence of greater symptoms of anxiety or depression. Methods: We studied 1691 adults with type 2 diabetes who provided baseline measures in 2011 and 2 subsequent annual assessments (Follow-up 1 and Follow-up 2). Symptoms of depression and anxiety were measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. A single item assessed exercise frequency in the past month (in days). Results: Separate 3-wave cross-lagged path models for symptoms of anxiety and depression tested the reciprocal associations. Contrary to our hypotheses, the reciprocal associations were not supported and, by extension, the predicted secondary associations were not tested. In sum, only depressive symptoms negatively predicted subsequent exercise frequency (Follow-up 1 and Follow-up 2). Conclusions: Symptoms of depression were prospectively associated with lower exercise frequency, which is consistent with evidence from population-based studies that identify depressive symptoms as a barrier to exercise participation.
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Anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and separation anxiety disorder, are the most prevalent mental disorders and are associated with immense health care costs and a high burden of disease. According to large population-based surveys, up to 33.7% of the population are affected by an anxiety disorder during their lifetime. Substantial underrecognition and undertreatment of these disorders have been demonstrated. There is no evidence that the prevalence rates of anxiety disorders have changed in the past years. In cross-cultural comparisons, prevalence rates are highly variable. It is more likely that this heterogeneity is due to differences in methodology than to cultural influences. Anxiety disorders follow a chronic course; however, there is a natural decrease in prevalence rates with older age. Anxiety disorders are highly comorbid with other anxiety disorders and other mental disorders.
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[Purpose] This study evaluated the acute cardiovascular responses during a session of Zumba® Fitness in a virtual reality environment. [Subjects] Eighteen healthy volunteers were recruited. [Methods] The following cardiovascular variables: heart rate, systolic blood pressure, diastolic blood pressure, and double product were assessed before and after the practice of virtual Zumba®, which was performed as a continuous sequence of five choreographed movements lasting for 22 min. The game Zumba Fitness Core®, with the Kinect-based virtual reality system for the XBOX 360, was used to create the virtual environment. Comparisons were made among mean delta values (delta=post-Zumba® minus pre-Zumba® values) for systolic and diastolic blood pressure, heart rate, and double product using Student’s t-test for paired samples. [Results] After a single session, a significant increase was noted in all the analyzed parameters (Systolic blood pressure=18%; Diastolic blood pressure=13%; Heart rate=67%; and Double product=97%). [Conclusion] The results support the feasibility of the use of Zumba Fitness Core® with the Kinect-based virtual reality system for the XBOX 360 in physical activity programs and further favor its indication for this purpose. © 2015 The Society of Physical Therapy Science. Published by IPEC Inc.
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[Purpose] This investigation evaluated the acute cardiovascular responses that occur while playing virtual games (aerobic and balance) emulated by Nintendo Wii®. [Subjects] Nineteen healthy male volunteers were recruited. [Methods] The ergospirometric variables of maximum oxygen consumption, metabolic equivalents, and heart rate were obtained during the aerobic (Obstacle Course, Hula Hoop, and Free Run) and balance (Soccer Heading, Penguin Slide, and Table Tilt) games of Wii Fit Plus® software. To access and analyze the ergospirometric information, a VO2000 analyzer was used. Normalized data (using maximum oxygen consumption and heart rate) were analyzed using repeated measures analysis of variance and Scheffe’s test. [Results] Significant differences were found among the balance and aerobic games in all variables analyzed. In addition, the Wii exercises performed were considered to be of light (balance games) and moderate (aerobic games) intensity in accordance with American College Sports Medicine exercise stratification. [Conclusion] Physical activity in a virtual environment emulated by Nintendo Wii® can change acute cardiovascular responses, primarily when Wii aerobic games are performed. These results support the use of the Nintendo Wii® in physical activity programs. © 2015 The Society of Physical Therapy Science. Published by IPEC Inc.
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Although Zumba® is practiced by millions of people worldwide, there is a paucity of research about its potential benefits. The objective of this study was to investigate the effects of Zumba® on physiological and psychological outcomes in healthy women. Cardiovascular fitness, body composition, physical self-perception and psychological well-being were assessed before and immediately after 8 weeks of Zumba® performed three times weekly (Zumba group, n = 22, age: 26.6±5.4 years old; height: 165.8±7.1cm) or no intervention (control group, n = 22, age: 27.9±6.0 years old; height: 164.7±6.2cm). All variables were analyzed by a two-way (group x time) analysis of variance with repeated measures, and a Bonferroni post-hoc test. Pearson correlation coefficient assessed the relationship between changes in anthropometric, physiological and psychological variables. Zumba® provided significant positive changes in maximal aerobic fitness (+3.6%), self-perception of physical strength (+16.3%) and muscular development (+18.6%), greater autonomy (+8.0%) and purpose in life (+4.4%). No significant changes were observed in the control group. In addition, some psychological changes were significantly correlated to body fat at baseline, and changes in fitness. These results highlight that Zumba® is beneficial to improve fitness and well-being in healthy women, but does not change body composition.
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One prominent and well-cited meta-analysis published nearly 25 years ago reported that an acute or single bout of exercise reduced state anxiety by approximately ¼ standard deviation. We conducted a meta-analysis of randomized controlled trials (RCTs) published after that meta-analysis for updating our understanding of the acute effects of exercise on state anxiety. We searched PubMed, EBSCOHost, Medline, PsycINFO, ERIC, and ScienceDirect for RCTs of acute exercise and state anxiety as an outcome. There were 36 RCTs that met inclusion criteria and yielded data for effect size (ES) generation (Cohen's d). An overall ES was calculated using a random effects model and expressed as Hedge's g. The weighted mean ES was small (Hedge's g = 0.16, standard error (SE) = 0.06), but statistically significant (P < 0.05), and indicated that a single bout of exercise resulted in an improvement in state anxiety compared with control. The overall ES was heterogeneous and post hoc, exploratory analyses using both random- and fixed-effects models identified several variables as moderators including sample age, sex and health status, baseline activity levels, exercise intensity, modality and control condition, randomization, overall study quality, and the anxiety measure (P < 0.05). The cumulative evidence from high quality studies indicates that acute bouts of exercise can yield a small reduction in state anxiety. The research is still plagued by floor effects associated with recruiting persons with normal or lower levels of state anxiety, and this should be overcome in subsequent trials. © 2015 Wiley Periodicals, Inc.
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The physical capabilities are reduced in individuals with neuromotor damage. The balance and motor skills are aff ected by diseases in the nervous system. Virtual reality (VR) has been used to balance recovery and motor function these individuals, but its eff ectiveness is not fully known. The aim of this study was to identify and analyze studies that investigated the eff ectiveness of virtual technology in the rehabilitation of the body balance and motor skills of individuals with neuromotor defi cits. We included clinical trials and / or randomized controlled trials published in English and Portuguese between 2001 and 2011, wich used with VR exercises as therapy for individuals of both genders, aged 45 years or more with neurological disorders. The following databases were consulted: Medline, BVS, SciELO and PEDro. Studies found in the references were also considered for further reviews. The PEDro scale was used to evaluate the scientifi c quality of articles. Studies with a minimum of 6 points on this scale were included and analyzed, totalling of seven studies. The mean eff ect size for the virtual rehabilitation body balance (0.50 ± 0.35) and motor skills (0.52 ± 0.34) were better to other interventions (0.17 ± 0.16 and 0.25 ± 0.22 respectively). VR proved to be eff ective in the rehabilitation of the body balance and motor skills of individuals with neuromotor defi cits although the amount of evidence is still limited. Despite the positive eff ect shown the method should still be used with care and also studied in subjects with other conditions. Keywords: Rehabilitation; Physical exercise; Virtual technology
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The purpose of this study was assess the effect of a training session with Nintendo Wii® on the hemodynamic responses of healthy women not involved in regular physical exercise. Twenty-five healthy unfit women aged 28 ± 6 years played for 10 minutes the game Free Run (Wii Fit Plus). The resting heart rate (RHR), systolic and diastolic blood pressures (SBP and DBP), and double (rate-pressure) product (DP) were measured before and after activity. The HR during the activity (exercise heart rate, EHR) was measured every minute. A statistically significant difference was observed between the RHR (75 ± 9 bpm) and the mean EHR (176 ± 15 bpm) (P < 0.001). The EHR remained in the target zone for aerobic exercise until the fifth minute of activity, which coincided with the upper limit of the aerobic zone (80% heart rate reserve (HRR) + RHR) from the sixth to tenth minute. The initial (110 ± 8 mmHg) and final (145 ± 17 mmHg) SBP (P < 0.01) were significantly different, as were the initial (71 ± 8 mmHg) and final (79 ± 9 mmHg) DBP (P < 0.01). A statistically significant difference was observed between the pre- (8.233 ± 1.141 bpm-mmHg) and post-activity (25.590 ± 4.117 bpm-mmHg) DP (P < 0.01). Physical exercise while playing Free Run sufficed to trigger acute hemodynamic changes in healthy women who were not engaged in regular physical exercise.
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In this meta-analysis, we evaluated the effectiveness of dance movement therapy (DMT) and the therapeutic use of dance for the treatment of health-related psychological problems. Research in the field of DMT is growing, and 17 years have passed since the last and only general meta-analysis on DMT (Ritter & Low, 1996) was conducted. This study examines the current state of knowledge regarding the effectiveness of DMT and dance from 23 primary trials (N = 1078) on the variables of quality of life, body image, well-being, and clinical outcomes, with sub-analysis of depression, anxiety, and interpersonal competence. Results suggest that DMT and dance are effective for increasing quality of life and decreasing clinical symptoms such as depression and anxiety. Positive effects were also found on the increase of subjective well-being, positive mood, affect, and body image. Effects for interpersonal competence were encouraging, but due to the heterogenity of the data remained inconclusive. Methodological shortcomings of many primary studies limit these encouraging results and, therefore, further investigations to strengthen and expand upon evidence-based research in DMT are necessary. Implications of the findings for health care, research, and practice are discussed.
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Background: Older adults show increased risk of falling and major risk factors include impaired lower extremity muscle strength and postural balance. However, the potential positive effect of biofeedback-based Nintendo Wii training on muscle strength and postural balance in older adults is unknown. Methods: This randomized controlled trial examined postural balance and muscle strength in community-dwelling older adults (75±6 years) pre- and post-10 weeks of biofeedback-based Nintendo Wii training (WII, n = 28) or daily use of ethylene vinyl acetate copolymer insoles (controls [CON], n = 30). Primary end points were maximal muscle strength (maximal voluntary contraction) and center of pressure velocity moment during bilateral static stance. Results: Intention-to-treat analysis with adjustment for age, sex, and baseline level showed that the WII group had higher maximal voluntary contraction strength (18%) than the control group at follow up (between-group difference = 269 N, 95% CI = 122; 416, and p = .001). In contrast, the center of pressure velocity moment did not differ (1%) between WII and CON at follow-up (between-group difference = 0.23 mm(2)/s, 95% CI = -4.1; 4.6, and p = .92). For secondary end points, pre-to-post changes favoring the WII group were evident in the rate of force development (p = .03), Timed Up and Go test (p = .01), short Falls Efficacy Scale-International (p = .03), and 30-second repeated Chair Stand Test (p = .01). Finally, participants rated the Wii training highly motivating at 5 and 10 weeks into the intervention. Conclusions: Biofeedback-based Wii training led to marked improvements in maximal leg muscle strength (maximal voluntary contraction; rate of force development) and overall functional performance in community-dwelling older adults. Unexpectedly, static bilateral postural balance remained unaltered with Wii training. The high level of participant motivation suggests that biofeedback-based Wii exercise may ensure a high degree of compliance to home- and/or community-based training in community-dwelling older adults.
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Two studies examined the reliability and validity of the Physical Activity Enjoyment Scale (PACES). In Study 1, each of 37 undergraduates rode an exercise bicycle under control and external focus conditions. As predicted, Ss reported enjoying the exercise more, as measured by the PACES, in the external focus condition. Moreover, there was a significant negative correlation in the control condition between Ss PACES scores and their scores on a measure of boredom proneness. In Study 2, each of 37 undergraduates rode an exercise bicycle and jogged on a minitrampoline in separate sessions; each then chose one of these activities for their 3rd session. As predicted, there was a significant relationship between Ss PACES ratings (completed after each activity) and their choices of activity. Test–retest reliability was high for jogging and moderate for bicycling. The PACES had high internal consistency in both studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The purpose of the present study was to assess the potential of exergame training based on physically simulated sport play as a mode of physical activity that could have cognitive benefits for older adults. If exergame play has the cognitive benefits of conventional physical activity and also has the intrinsic attractiveness of video games, then it might be a very effective way to induce desirable lifestyle changes in older adults. To examine this issue, the authors developed an active video game training program using a pretest-training-posttest design comparing an experimental group (24 × 1 hr of training) with a control group without treatment. Participants completed a battery of neuropsychological tests, assessing executive control, visuospatial functions, and processing speed, to measure the cognitive impact of the program. They were also given a battery of functional fitness tests to measure the physical impact of the program. The trainees improved significantly in measures of game performance. They also improved significantly more than the control participants in measures of physical function and cognitive measures of executive control and processing speed, but not on visuospatial measures. It was encouraging to observe that, engagement in physically simulated sport games yielded benefits to cognitive and physical skills that are directly involved in functional abilities older adults need in everyday living (e.g., Hultsch, Hertzog, Small, & Dixon, 1999). (PsycINFO Database Record (c) 2012 APA, all rights reserved).
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Epidemiological studies show that anxiety disorders are highly prevalent and an important cause of functional impairment; they constitute the most frequent menial disorders in the community. Phobias are the most common with the highest rates for simple phobia and agoraphobia. Panic disorder (PD) and obsessive-compulsive disorder (OCD) are less frequent (2% lifetime prevalence), and there are discordant results for social phobia (SP) (2%-16%) and generalized anxiety disorder (GAD) (3%-30%). These studies underline the importance of an accurate definition of disorders using unambiguous diagnostic and assessment criteria. The boundaries between anxiety disorders are often ill defined and cases may vary widely according to the definition applied. Simple phobia, agoraphobia, and GAD are more common in vmrnen, while there is no gender différence for SP, PD, and OCD, Anxiety disorders are more common in separated, divorced, and widowed subjects; their prevalence is highest in subjects aged 25 to 44 years and lowest in subjects aged >65 years. The age of onset of the different types of anxiety disorders varies widely: phobic disorders begin early in life, whereas PD occurs in young adulthood. Clinical - rather than epidemiological - studies have examined risk factors such as life events, childhood experiences, and familial factors. Anxiety disorders have a chronic and persistent course, and are frequently comorbid with other anxiety disorders, depressive disorders, and substance abuse. Anxiety disorders most frequently precede depressive disorders or substance abuse, Comorbid diagnoses may influence risk factors like functional impairment and quality of life. It remains unclear whether certain anxiety disorders (eg, PD) are risk factors for suicide. The comorbidity of anxiety disorders has important implications for assessment and treatment and the risk factors should be explored. The etiology, natural history, and outcome of these disorders need to be further addressed in epidemiological studies.
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To determine the relative effect of interactive digital exercise that features player movement (ie, exergames) on energy expenditure among children of various body mass indexes (BMIs; calculated as weight in kilograms divided by height in meters squared). Comparison study. GoKids Boston, a youth fitness research and training center located at University of Massachusetts, Boston. Thirty-nine boys and girls (mean [SD] age, 11.5 [2.0] years) recruited from local schools and after-school programs. Six forms of exergaming as well as treadmill walking. In addition to treadmill walking at 3 miles per hour (to convert miles to kilometers, multiply by 1.6), energy expenditure of the following exergames were examined: Dance Dance Revolution, LightSpace (Bug Invasion), Nintendo Wii (Boxing), Cybex Trazer (Goalie Wars), Sportwall, and Xavix (J-Mat). Energy expenditure was measured using the CosMed K4B2 portable metabolic cart. All forms of interactive gaming evaluated in our study increased energy expenditure above rest, with no between-group differences among normal (BMI < 85th percentile) and "at-risk" or overweight (BMI ≥ 85th percentile) children (P ≥ .05). Walking at 3 miles per hour resulted in a mean (SD) metabolic equivalent task value of 4.9 (0.7), whereas the intensity of exergaming resulted in mean (SD) metabolic equivalent task values of 4.2 (1.6) for Wii, 5.4 (1.8) for Dance Dance Revolution, 6.4 (1.6) for LightSpace, 7.0 (1.8) for Xavix, 5.9 (1.5) for Cybex Trazer, and 7.1 (1.7) for Sportwall. Enjoyment of the games was generally high but was highest for children with BMIs in the highest percentiles. All games used in our study elevated energy expenditure to moderate or vigorous intensity. Exergaming has the potential to increase physical activity and have a favorable influence on energy balance, and may be a viable alternative to traditional fitness activities for children of various BMI levels.
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Acute aerobic exercise is associated with a reduction in state anxiety and an improvement in subjective well-being. The objective of the present study was to contrast the effects of aerobic exercise at self-selected intensity versus prescribed intensity on state anxiety and subjective well-being (negative affect, positive well-being and fatigue) in patients with depressive and/or anxiety disorders. In addition, the potential impact of heart rate feedback was assessed. Nineteen men and 29 women performed three test conditions on a bicycle ergometer during 20 minutes: two tests at self-selected intensity; one with and another without heart rate feedback, and a third test at the prescribed intensity of 50% of the maximal heart rate reserve according to Karvonen. Tests were executed in random order. State anxiety and subjective well-being were evaluated using the state anxiety inventory and the subjective exercise experiences scale. After 20 minutes cycling, patients showed significantly decreased state anxiety and negative affect in the three conditions. The magnitude of the reduction did not differ significantly between the three conditions. Only cycling at self-selected intensity enhanced positive well-being. Cycling at 50% of the maximal heart rate reserve decreased fatigue, whereas cycling at self-selected intensity increased fatigue. The response in state anxiety and negative affect was unaffected by the type of aerobic exercise. Self-selected intensity influenced exercise-induced changes in positive well-being and fatigue in a positive and negative way, respectively.
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The relationship between exercise and anxiety has been extensively examined over the last 15 years. Three separate meta-analysis were conducted to quantitatively review the exercise-anxiety literature for state anxiety, trait anxiety and psychophysiological correlates of anxiety. Such a procedure allows tendencies of the research to be characterised. The results substantiate the claim that exercise is associated with reductions in anxiety, but only for aerobic forms of exercise. These effects were generally independent of both subject (i.e. age and health status) and descriptive characteristics. Numerous design characteristics were different, but these differences were not uniform across the 3 meta-analyses. For state anxiety, exercise was associated with reduced anxiety, but had effects similar to other known anxiety-reducing treatments (e.g. relaxation). The trait anxiety meta-analysis revealed that random assignment was important for achieving larger effects when compared to the use of intact groups. Training programmes also need to exceed 10 weeks before significant changes in trait anxiety occur. For psychophysiological correlates, cardiovascular measures of anxiety (e.g. blood pressure, heart rate) yielded significantly smaller effects than did other measures (e.g. EMG, EEG). The only variable that was significant across all 3 meta-analyses was exercise duration. Exercise of at least 21 minutes seems necessary to achieve reductions in state and trait anxiety, but there were variables confounding this relationship. As such, it remains to be seen what the minimum duration is necessary for anxiety reduction. Although exercise offers therapeutic benefits for reducing anxiety without the dangers or costs of drug therapy or psychotherapy, it remains to be determined precisely why exercise is associated with reductions in anxiety. Since several mechanisms may be operating simultaneously, future research should be designed with the idea of testing interactions between these mechanisms.
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We have validated a Portuguese version of the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) tests by obtaining profiles for three Brazilian samples: 270 university students, 117 panic patients and 30 depressed patients. The mean BDI scores were higher for depressed patients (25.2 +/- 12.6), intermediate for anxious patients (15.8 +/- 10.3) and lower for students (8.5 +/- 7.0). Mean STAI scores for anxious (52.8 +/- 11.4) and depressed patients (56.4 +/- 10.5) were higher than for the student sample (40.7 +/- 8.6). BDI and STAI scores were correlated significantly in all samples. The internal consistency of the Portuguese version of BDI is in agreement with the literature (0.81 for students and 0.88 for depressed patients). The present data demonstrate that the psychometric properties of the Portuguese versions of the BDI and STAI are comparable to the original English language versions of these questionnaires, thereby indicating their use in clinical situations.
Article
To examine and compare the energy expenditure (EE) and intensity of Xbox 360 Kinect exergames in healthy young adults. Seventeen young adults (22.0±2.9 years; 7 men) were enrolled and asked to complete 6 exergames using Xbox 360 Kinect. Oxygen consumption (VO2) and heart rate (HR) were measured throughout each exergame, and metabolic equivalents (METs) and EE were calculated from VO2. Boxing (6.8±1.9 METs) and soccer (6.2±1.7 METs) provided vigorous intensity of physical activity, which was significantly greater than track and field, ping-pong, and bowling (5.0±1.5, 4.0±1.6, and 2.6±0.8 METs, respectively; all p < .01). Beach volleyball (5.7±1.8 METs) was greater than ping-pong and bowling (both p < .01). EE exhibited a similar pattern. These results remained after adjusting for participants' previous exergaming experience and resting HR. Kinect Sports from Xbox 360 Kinect is capable of providing a moderate-to-vigorous level of physical activity in young healthy adults. These exergames may be used as an alternative mode of exercise to promote physical activity participation in this population. Future research that evaluates the feasibility of using exergames as an alternative mode of exercise in other populations is warranted.
Article
ABSTRACT: Objective: analyze the responses of heart rate and blood pressure during and after a session of active videogames (AVG’s). Methodological procedure: eight male subjects (age: 21 ± 1.6 years, weight: 71.0 ± 4.2, height: 1.77 ± 4 cm; % fat mass: 23 ± 5.78). The session: 72 minutes with AVG Xbox 360º Kinect ® in 4 different games (Dance Central 3 and Kinect Sports: boxing, volleyball and table tennis). Results: the responses of heart rate and blood pressure in VGA’s shows that the games are able to alter the cardiovascular responses. Conclusion: through FCmáx, VGA’s are able to reach levels of moderate intensity.
Article
Unlabelled: Overweight and obese youth, who face increased risk of medical complications including heart disease and type II diabetes, can benefit from sustainable physical activity interventions that result in weight loss. Objective: This study examined whether a 20-week exergame (i.e., videogame that requires gross motor activity) intervention can produce weight loss and improve psychosocial outcomes for 54 overweight and obese African-American adolescents. Design and methods: Participants were recruited from a public high school and randomly assigned to competitive exergame, cooperative exergame, or control conditions. All exergame participants were encouraged to play the Nintendo Wii Active game for 30-60 min per school day in a lunch-time or after-school program. Cooperative exergame participants worked with a peer to expend calories and earn points together, whereas competitive exergame participants competed against a peer. Control participants continued regular daily activities. Outcome measures included changes in weight, peer support, self-efficacy, and self-esteem, measured at baseline, and at ∼10 and 20 weeks. Results: Growth curve analysis revealed that cooperative exergame players lost significantly more weight (mean = 1.65 kg; s.d. = 4.52) than the control group, which did not lose weight. The competitive exergame players did not differ significantly from the other conditions. Cooperative exergame players also significantly increased in self-efficacy compared to the control group, and both exergame conditions significantly increased in peer support more than the control group. Conclusion: Exergames, especially played cooperatively, can be an effective technological tool for weight loss among youth.
Article
To determine the safety and feasibility of using Nintendo Wii Fit exergames to improve balance in older adults. Seven older adults aged 84 (5) years with impaired balance (Berg Balance Scale [BBS] score < 52 points) were recruited from 4 continuing care retirement communities to participate in a single group pre- and postevaluation of Wii Fit exergames. Participants received individualized instructions (at least 5 home visits) on playing 4 exergames (basic step, soccer heading, ski slalom, and table tilt) and were asked to play these games in their homes at least 30 minutes 3 times per week for 3 months and received weekly telephone follow-up. They also completed a paper log of their exergame play and rated their enjoyment immediately after each session. Participants completed the BBS, 4-Meter Timed Walk test, and the Physical Activity Enjoyment Scale at baseline and 3 months. Semistructured interviews were conducted at the 3-month evaluation. Participants safely and independently played a mean of 50 sessions, median session duration of 31 minutes. Two of the games were modified to ensure participants' safety. Participants rated high enjoyment immediately after exergame play and expressed experiencing improved balance with daily activities and desire to play exergames with their grandchildren. Berg Balance Scores increased from 49 (2.1) to 53 (1.8) points (P = .017). Walking speed increased from 1.04 (0.2) to 1.33 (0.84) m/s (P = .018). Use of Wii Fit for limited supervised balance training in the home was safe and feasible for a selected sample of older adults. Further research is needed to determine clinical efficacy in a larger, diverse sample and ascertain whether Wii Fit exergames can be integrated into physical therapy practice to promote health in older adults.
Article
There is a general belief that physical activity and exercise have positive effects on mood and anxiety and a great number of studies describe an association of physical activity and general well-being, mood and anxiety. In line, intervention studies describe an anxiolytic and antidepressive activity of exercise in healthy subjects and patients. However, the majority of published studies have substantial methodological shortcomings. The aim of this paper is to critically review the currently available literature with respect to (1) the association of physical activity, exercise and the prevalence and incidence of depression and anxiety disorders and (2) the potential therapeutic activity of exercise training in patients with depression or anxiety disorders. Although the association of physical activity and the prevalence of mental disorders, including depression and anxiety disorders have been repeatedly described, only few studies examined the association of physical activity and mental disorders prospectively. Reduced incidence rates of depression and (some) anxiety disorders in exercising subjects raise the question whether exercise may be used in the prevention of some mental disorders. Besides case series and small uncontrolled studies, recent well controlled studies suggest that exercise training may be clinically effective, at least in major depression and panic disorder. Although, the evidence for positive effects of exercise and exercise training on depression and anxiety is growing, the clinical use, at least as an adjunct to established treatment approaches like psychotherapy or pharmacotherapy, is still at the beginning. Further studies on the clinical effects of exercise, interaction with standard treatment approaches and details on the optimal type, intensity, frequency and duration may further support the clinical administration in patients. Furthermore, there is a lack of knowledge on how to best deal with depression and anxiety related symptoms which hinder patients to participate and benefit from exercise training.
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There is a great demand for perceptual effort ratings in order to better understand man at work. Such ratings are important complements to behavioral and physiological measurements of physical performance and work capacity. This is true for both theoretical analysis and application in medicine, human factors, and sports. Perceptual estimates, obtained by psychophysical ratio-scaling methods, are valid when describing general perceptual variation, but category methods are more useful in several applied situations when differences between individuals are described. A presentation is made of ratio-scaling methods, category methods, especially the Borg Scale for ratings of perceived exertion, and a new method that combines the category method with ratio properties. Some of the advantages and disadvantages of the different methods are discussed in both theoretical-psychophysical and psychophysiological frames of reference.
Article
An attempt was made to determine if state anxiety responses following acute exercise are influenced by the intensity of exercise. Fifteen adults (5 female, 10 male) completed 20 minute sessions of bicycle ergometer exercise on separate days at intensities equal to 40, 60, or 70% VO2peak. Expired gas spirometry was employed to determine peak oxygen consumption and to control the workload during the submaximal protocols. State anxiety (STAI-Y1) was assessed prior to and following each exercise session, and 5, 60 and 120 minutes post-exercise. Repeated measures ANOVA revealed that state anxiety decreased (p < 0.05) following each exercise condition. Post hoc analysis indicated that state anxiety was significantly (p < 0.05) reduced at all post-exercise assessments in the 40 and 60% VO2peak conditions. State anxiety was elevated by 3.4 units at 5 minutes following exercise at 70% VO2peak, but decreased (p < 0.05) below baseline at 60 and 120 minutes post-exercise to a degree not different from the other exercise conditions. Further analysis indicated the increase in anxiety 5 minutes following 70% VO2peak exercise was significant only in subjects with low baseline state anxiety values, whereas it was unchanged in subjects with higher baseline values. In conclusion, 20-minute sessions of cycle ergometer exercise at intensities ranging from light to heavy were equally effective in reducing state anxiety in young, healthy adults. However, this reduction is delayed somewhat following exercise at a high intensity (i.e., 70% VO2peak).
Article
The active transports of sodium and chloride ions, between the vacuole and environmental solutions, were measured in the giant coenocyte of the marine alga Halicystis ovalis. Ion fluxes, determined isotopically, of individual single cells were measured by the short-circuit technique of Ussing and Zerahn (1951). Concentric pipettes were used to replace the vacuole sap with sep water and to short-circuit the vacuole potential difference to zero. The mean net efflux of sodium represented 39.2%, S. D. = 5.4, and the mean net influx of chloride 57.6%, S. D. = 5.3, of the current flowing through a short-circuited cell. Therefore a summation of the current carried by the two net active fluxes can account for the total short-circuit current. Micro-electrode penetration of the protoplasm of the cell indicated that the potential difference of the protoplasm was identical with the vacuole potential; that the total potential difference develops at the outer membrane. A theory is presented which evaluates the effect of these transport systems on the total potential difference and on the osmotic stability of the cell relative to its environment.
Article
The study of quality of life has increased in importance in the area of mental disorders during the last decade. The aim of the present study was to investigate the effect of specific anxiety disorders on specific quality of life indicators in the common population. More than 2000 individuals between 18 and 65 years old were studied by means of structured interviews. The results showed that social phobia and panic disorder within the past year and lifetime, and generalized anxiety disorder within the past year, had an independent effect on quality of life when controlling for a number of sociodemographic variables, somatic health, and other DSM-III-R Axis I mental disorders. Specific phobias and obsessive compulsive disorder had only a small effect, and agoraphobia showed no effect. The effect was strongest for self-realization and contact with friends, but anxiety disorders also influenced subjective well-being, social support, negative life events, contact with family of origin, and neighborhood quality.
Article
Research has focused on defining which types of family interactions promote development of anxiety. Control has emerged as an important construct in anxious families. Central to conceptualizing the relationship between family functioning, control beliefs, and anxiety is establishing a sequential relationship among these variable, which may entail mediating or moderating relationships, or relationships that change over the course of development. The current study investigated whether control acts as a moderator or a mediator between perceived family environment and anxiety in your adults. An undergraduate sample (N=364) completed the family assessment device (FAD), anxiety control questionnaire (ACQ), Beck anxiety inventory (BAI), and a demographic questionnaire. Structural equation modeling (SEM) was used to test both moderating and mediating models. No moderating effects were found. Sense of control mediated the relation between aspects of family functioning and anxiety. Theoretical implications and suggestions for future research are discussed.
Vigilância de fatores de Risco para doenças crônicas por inquérito telefônico
• Brazil
• Vigitel
Brazil. VIGITEL 2014: Vigilância de fatores de Risco para doenças crônicas por inquérito telefônico [Internet]. Brasília: Ministério da Saúde. 2015. www.ans.gov.br/images/stories/ Materiais_para_pesquisa/Materiais_por_assunto/2015_ vigitel.pdf (accessed June 20, 2017).
Grand Central Life & Style
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