Effectiveness of exergame on physical fitness of overweight adolescents: a clinical trial

Authors

DOI:

https://doi.org/10.62827/fb.v25i2.3b54

Keywords:

Adolescent; overweight; pediatric obesity; respiratory function test; cardiorespiratory fitness.

Abstract

Objective: To verify the effects of physical exercise using a gamified exergame on pulmonary function and cardiorespiratory fitness of adolescents with overweight in their school environment. Methods: This controlled clinical trial was conducted in two schools. Adolescents aged 10-16 years with overweight or obesity were eligible. Control group received physical education classes and orientations provided by school. Intervention group performed physical exercise using the exergame associated with gamification in school, with four adolescents per group, three times per week during eight consecutive weeks. For gamification, the performance was scored every week, generating a weekly classification and a final at the end of the study. Cardiorespiratory fitness was assessed indirectly using the maximal oxygen consumption (VO2max) from the 20-meter shuttle run test. Pulmonary function was assessed using manovacuometry and spirometry. Results: Intervention and control groups were composed of 36 and 27 adolescents, respectively. Adolescents that performed the exergame presented lower forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) and higher FEV1/FVC ratio than the control group. Intervention group increased FEV1 (p = 0.041) and maximal expiratory pressure (PEmax) (p = 0.009), decreased body mass index (BMI) (p < 0.001), and improved VO2max (p = 0.007), compared to baseline. Control group increased FEV1 (p = 0.021), FVC (p = 0.014), and FEV1/FVC ratio (p = 0.033) and decreased BMI (p < 0.001), compared to baseline. Conclusion: Exergame improved pulmonary function, and intragroup analysis showed the gamified exergame improved pulmonary function, nutritional status, and cardiorespiratory fitness.

Author Biographies

  • Tatianne Moura Estrela Gusmão, UNIFACISA/IMIP

    Fisioterapeuta formada pela Universidade Estadual da Paraíba (UEPB). Mestre em Saúde Pública pelo Programa de Pós-Graduação de Mestrado em Saúde Pública da Universidade Estadual da Paraíba (UEPB). Doutora em Saúde Integral pelo Programa de Pós-Graduação em Saúde Materno Infantil do IMIP, PE. Professora do Centro universitário Unifacisa e Fisioterapeuta Concursada da Fundação PBSAÚDE no Hospital de Trauma de Campina Grande, PB, Brasil 

  • Carla Campos Muniz Medeiros, UEPB

    Médica formada pela Universidade Estadual de Pernambuco, mestre em Saúde da Criança e do Adolescente pela Universidade Estadual de Campinas e doutora em Saúde da Criança e do Adolescente pela Universidade Estadual de Campinas. Atualmente é professora Doutora Associada da Universidade Estadual da Paraíba (UEPB), PB, Brasil 

  • Francisco Renato Silva Ferreira, UNILEÃO

    Mestre em Ensino em Saúde pelo Centro Universitário Dr. Leão Sampaio (MePESa/UNILEÃO). Especialista em Docência do Ensino Superior pela Faculdades Integradas de Patos (FIP). Especialista em Educação Especial e Treinamento Desportivo pela Faculdade Dom Alberto (DOM ALBERTO). Especialista em Educação Especial/ Educação Inclusiva/ Altas Habilidades pela Faculdade de Venda Nova do Imigrante (FAVENI). Especialista em Personal Trainer e Educação Física Escolar pela Faculdade de Venda Nova do Imigrante (FAVENI). Especialista em Gestão Escolar pela Faculdade de Venda Nova do Imigrante (FAVENI). Especialista em Psicopedagogia Institucional e Clínica pelo Centro Universitário Faveni (UNIFAVENI). Graduação Bacharelado em Educação Física pelo Centro de Ensino Superior de Piracanjuba EIRELI (FACULDADE DE PIRACANJUBA -FAP). Graduação-Licenciatura em Educação Física pelo Centro Universitário Doutor Leão Sampaio (UNILEÃO). Graduação Licenciatura em Pedagogia pelo Centro Universitário Faveni (UNIFAVENI). Atualmente é Diretor Administrativo da Rede Municipal de Educação de Juazeiro do Norte, CE (SEDUC/JN). Experiência profissional com formação e capacitação na área de Educação Adaptada e Inclusiva, com ênfase em Atividades Adaptadas através da integração de grupos especiais de Pessoas com Deficiência. Conselheiro no Conselho Municipal de Educação de Juazeiro do Norte (CME/JN). Pesquisador do Laboratório Interdisciplinar de Estudos e Extensão da Educação Inclusiva e Violência (LIEVI/UNILEÃO). Pesquisador Voluntário do Grupo de Pesquisa sobre Contemporaneidade, Subjetividade e Novas Epistemologias (G-PENSE/UPE), Recife, PE, Brasil 

  • José Figueroa Natal, IMIP

    Bacharelato em Matemática pela Universidade Federal de Pernambuco, mestre em em Estatística pela Washington University e em Análise de Sistemas e Aplicações pelo Instituto de Pesquisas Espaciais, Doutor em Saúde Materno Infantil pelo Programa de Pós Graduação em Saúde Materno Infantil do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP-PE).  Atualmente é Professor de Bioestatística do IMIP, Recife, PE, Brasil 

  • Danielle Franklin de Carvalho, UEPB

    Farmacêutica com habilitação em Análises Clínicas (UEPB), Mestre em Saúde Coletiva (UEPB) e Doutora em Saúde da Criança e do Adolescente da Universidade Federal de Pernambuco (UFPE). Professora Associada e Coordenadora do Programa de Pós-Graduação em Saúde Pública da Universidade Estadual da Paraíba (UEPB), João Pessoa, PB, Brasil 

  • Thacira Dantas Almeida Ramos, IMIP/UNIFACISA

    Médica formada pela Universidade Federal de Campina Grande, Mestre em Saúde Pública pela Universidade Estadual da Paraíba e Doutora em Saúde Integral pelo Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), atualmente é Professora e Preceptora em Cirurgia do Centro Universitário UNIFACISA de Campina Grande, PB e da Universidade Federal de Campina Grande (UFCG), Campina Grande, PB, Brasil 

  • João Guilherme Bezerra Alves, IMIP/UNIFACISA

    Médico Formado pela Universidade Federal de Pernambuco (UFPE), Residência Médica em Pediatra pelo Instituto Materno Infantil Prof. Fernando Figueira (IMIP), Mestrado em Pediatria pela UFPE e Doutorado em Medicina. Coordenador do programa de Pós-Graduação do IMIP, Recife, PE, Brasil

References

World Health Organization. Report of the commission on ending childhood obesity. Geneva: World Health Organization; 2016.

NCD Risk Factor Collaboration. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;6736:1-16.

World Health Organization. Guidelines on Physical Activity, Sedentary Behaviour. Geneva: World Health Organization; 2019

Forno E, Han YY, Mullen J, Celedón JC. Overweight, Obesity, and Lung Function in Children and Adults—A Meta-analysis. J Allergy Clin Immunol Pract. 2017;6:570-581.e10.

Bokov P, Delclaux C. The impact of obesity on respiratory function. Rev Mal Respir. 2019;36:1057-1063.

Fretzayas A, Moustaki M, Loukou I, Douros K. Is obesity related to the lung function of non-asthmatic children? World J Clin Pediatr. 2018;7:67-74.

Forno E, Weiner DJ, Mullen J, et al. Obesity and airway dysanapsis in children with and without asthma. Am J Respir Crit Care Med. 2017;195:314-323.

Köchli S, Endes K, Bartenstein T, et al. Lung function, obesity and physical fitness in young children: The Examin Youth study. Respir Med. 2019;159:105813.

Ye S, Pope ZC, Lee JE, Gao Z. Effects of school-based exergaming on urban children’s physical activity and cardiorespiratory fitness: A quasi-experimental study. Int J Environ Res Public Health. 2019;16:4080.

Zeng N, Gao Z. Exergaming and obesity in youth: Current perspectives. Int J Gen Med. 2016;9:275-284.

Goldfield GS, Kenny GP, Hadjiyannakis S, et al. Video game playing is independently associated with blood pressure and lipids in overweight and obese adolescents. PLoS One. 2011;6:e26643.

Lamboglia CMGF, Silva VTBL Da, Vasconcelos Filho JE De, et al. Exergaming as a strategic tool in the fight against childhood obesity: a systematic review. J Obes. 2013;2013:438364.

Benzing V, Schmidt M. Exergaming for Children and Adolescents: Strengths, Weaknesses, Opportunities and Threats. J Clin Med. 2018;7:422.

Gao Z. Fight fire with fire? Promoting physical activity and health through active video games. J Sport Heal Sci. 2017;6:1-3.

Gao Z, Chen S, Pasco D, Pope Z. A meta-analysis of active video games on health outcomes among children and adolescents. Obes Rev. 2015;16:783-794.

De Oliveira RG, Guedes DP. Physical activity, sedentary behavior, cardiorespiratory fitness and metabolic syndrome in adolescents: Systematic review and meta-analysis of observational evidence. PLoS One. 2016;11:e0168503.

Graf DL, Pratt LV, Hester CN, Short KR. playing active video games increases energy expenditure in children. Pediatrics. 2009;124:534-540.

Lisón JF, Bruñó-Soler A, Torró I, et al. Changes in physical fitness of a home-based physical exercise program in childhood obesity: A quasi-experimental uncontrolled study. J Child Heal Care. 2017;21:153-161.

de Onis M, et al. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660-667.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-191.

ABEP – Associação Brasileira de Empresas de Pesquisa. CCEB: Critério de Classificação Econômica Brasil. https://www.abep.org/criterio-brasil (Last accessed mai 19, 2020).

Hong TK, Trang NH, van der Ploeg HP, et al. Validity and reliability of a physical activity questionnaire for Vietnamese adolescents. Int J Behav Nutr Phys Act. 2012;9:93.

Matsudo S, Araújo T, Matsudo V, et al. Questionário Internacional de Atividade Física (Ipaq): Estupo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fis Saúde. 2001;6(2):5-18.

Kuba VM, Leone C, Damiani D. Is waist-to-height ratio a useful indicator of cardio-metabolic risk in 6-10-year-old children? BMC Pediatr. 2013;13:91.

Tomkinson GR, Lang JJ, Tremblay MS, et al. International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries. Br J Sports Med. 2017;51:1545-1554.

Quinart S, Mougin F, Nicolet-guénat M, et al. Evaluation of cardiorespiratory fitness using three field tests in obese adolescents: validity, sensitivity and prediction of peak VO2. J Sci Med Sport. 2013:17:521-522.

Léger LA, Mercier D, Gadoury C, Lambert J. The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci. 1988;6:93-101.

Souza RB. Pressões respiratórias estáticas máximas. J Bras Pneumol. 2002;28:S155-S165.

Domènech-Clar R, López-Andreu JA, Compte-Torrero L, et al. Maximal static respiratory pressures in children and adolescents. Pediatr Pulmonol. 2003;35:126-132.

Pereira CAC. Espirometria. J Bras Pneumol. 2002;28:45-51.

Biddiss E, Irwin J. Active video games to promote physical activity in children and youth. Arch Pediatr Adolesc Med. 2010;164:664-672.

Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol. 2001;37:153-156.

Machado FA, Denadai BS. Validade das equações preditivas da frequência cardíaca máxima para crianças e adolescentes. Arq Bras Cardiol. 2011;97:136-140.

Wilcox RR. Introduction to Robust Estimation and Hypothesis Testing. 4th ed. Elsevier (Academic Press), 2017.

Schulz KF, Altman DG, Moher D, Fergusson D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11:32.

Arena R, Cahalin LP. Evaluation of cardiorespiratory fitness and respiratory muscle function in the obese population. Prog Cardiovasc Dis. 2014;56:457-464.

Brown T, Moore TH, Hooper L, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2019;7:CD001871.

Hamilton K, Hatzis D, Kavanagh DJ, White KM. Exploring parents’ beliefs about their young child’s physical activity and screen time behaviours. J Child Fam Stud. 2015;24:2638-2652.

Farias EDS, Gonçalves EM, Morcillo AM, et al. Effects of programmed physical activity on body composition in post-pubertal schoolchildren. J Pediatr (Rio J). 2015;91:122-129.

Staiano AE, Marker AM, Beyl RA, et al. A randomized controlled trial of dance exergaming for exercise training in overweight and obese adolescent girls. Pediatr Obes. 2017;12:120-128.

Staiano AE, Beyl RA, Guan W, et al. Home-Based Exergaming among Children with Overweight and Obesity. Pediatr Obes. 2018;13:724-733.

Ameryoun A, Sanaeinasab H, Saffari M, Koenig HG. Impact of game-based health promotion programs on body mass index in overweight/obese children and adolescents: a systematic review and meta-analysis of randomized controlled trials. Child Obes. 2018;14:67-80.

Hernández-Jiménez C, Sarabia R, Paz-Zulueta M, et al. Impact of active video games on body mass index in children and adolescents: Systematic review and meta-analysis evaluating the quality of primary studies. Int J Environ Res Public Health. 2019;16:2424.

Zguira MS, Slimani M, Bragazzi NL, et al. Effect of an 8-week individualized training program on blood biomarkers, adipokines and endothelial function in obese young adolescents with and without metabolic syndrome. Int J Environ Res Public Health. 2019;16:751.

Polechoński J, Dȩbska M, Dȩbski PG. Exergaming can be a health-related aerobic physical activity. Biomed Res Int. 2019;2019:1890527.

Thivel D, Ring-Dimitriou S, Weghuber D, et al. Muscle strength and fitness in pediatric obesity: A systematic review from the European Childhood Obesity Group. Obes Facts. 2016;9:52-63.

Mintjens S, Menting MD, Daams JG, et al. Cardiorespiratory fitness in childhood and adolescence affects future cardiovascular risk factors: a systematic review of longitudinal studies. Sport Med. 2018;48:2577-2605.

Schmidt MD, Magnussen CG, Rees E, et al. Childhood fitness reduces the long-term cardiometabolic risks associated with childhood obesity. Int J Obes. 2016;40:1134-1140.

Riiser K, Løndal K, Ommundsen Y, et al. The outcomes of a 12-week internet intervention aimed at improving fitness and health-related quality of life in overweight adolescents: the young & active controlled trial. PLoS One. 2014;9:e114732.

Riiser K, Løndal K, Ommundsen Y, et al. Targeting and tailoring an intervention for adolescents who are overweight: some ethical concerns. Nurs Ethics. 2015;22:237-247.

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Published

2024-06-27

Issue

Vol. 25 No. 2 (2024): Fisioterapia Brasil v25n2

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Artigos originais

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Copyright (c) 2024 Tatianne Moura Estrela Gusmão, Carla Campos Muniz Medeiros, Francisco Renato Silva Ferreira, José Figueroa Natal, Danielle Franklin de Carvalho, Thacira Dantas Almeida Ramos, João Guilherme Bezerra Alves (Autor)

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How to Cite

Effectiveness of exergame on physical fitness of overweight adolescents: a clinical trial. (2024). Fisioterapia Brasil, 25(2), 1285-1300. https://doi.org/10.62827/fb.v25i2.3b54