Please citeGamercize

ARTICLE IN PRESSG ModelJSAMS-888; No. of Pages 5Journal of Science and Medicine in Sport xxx (2013) xxx xxx

Contents lists available at SciVerse ScienceDirect

Journal of Science and Medicine in Sport

j our na l ho me page: www.elsev ier .co

Original research

Active mA comp Kiand Xa

R.R. MellInstitute of Hum

a r t i c

Article history:Received 20 AReceived in reAccepted 18 MAvailable online xxx

Keywords:Video gamesExerciseChildHealthPhysical activiGirls

gnedtivity

betwal lab

Methods: We recruited 18 girls to participate in a peak VO2 test and to play Gamercize, Kinect RiverRush, XaviX J-Mat at three separate exergaming sessions. Linear regression equations of heart rate andpercentage of peak VO2 were calculated for each participant to determine the intensity of exergame play.Differences in intensity between the three exergames and time spent in the recommended moderate(heart rate at 55% peak VO2) and vigorous (heart rate at 75% peak VO2) intensity levels were analyzed.We calculated the coefcient of variation for the mean heart rate to determine the difference in variance

1. Introdu

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1440-2440/$ http://dx.doi.o this article in press as: Mellecker RR, McManus AM. Active video games and physical activity recommendations: A comparison of the Stepper, XBOX Kinect and XaviX J-Mat. J Sci Med Sport (2013), http://dx.doi.org/10.1016/j.jsams.2013.05.008

ty recommendations in heart rate values for the three exergames.Results: When playing Gamercize and Kinect the girls did not play at recommended moderate or vigorouslevels. Although the girls did not play at vigorous levels when playing XaviX J-Mat, our results showedthat when playing XaviX J-Mat they did play at moderate intensity levels. No signicant differences inthe coefcient of variation between the three exergames were apparent.Conclusions: If active gaming is to be used to increase physical activity levels then individual differencesin levels of exertion and specic activity recommendations need to be taken into consideration.

2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

ction

mes have become an attractive form of entertainmenturpassed television viewing as a preferred sedentaryice for children.1 Media usage reports indicate that chil-nding an average of 8 h playing sedentary video gamesd the time spent playing video games has been impli-tor in the rising prevalence of childhood obesity.3 Thean active component to this popular form of entertain-eated the optimal tool to halt declining physical activitygy expenditure,4,5 cardiovascular responses4,6 and spe-

outcomes79 have been assessed highlighting some of effects when engaging in active gaming activities.

promising, results are inconclusive as to whethers result in energy levels that are commensurate withtivity guidelines.10 To ensure children participate in

ding author.ress: robmel@hku.hk (R.R. Mellecker).

adequate amounts of physical activity for health it has been sug-gested that they engage in at least 60 min of moderate/vigorousintensity physical activity daily.11 A recent study investigating thedifferences in energy cost of 6 different active gaming systems sug-gests that children engage in active video game play at moderateto vigorous intensity levels that correspond to physical activityrecommendations for children.12 This study used general activ-ity guidelines and absolute intensities to determine whether theparticipants were meeting physical activity guidelines. Anchoringintensity to an absolute value does not account for differences incardiorespiratory tness between individuals, which may explainsome of the intensity level discrepancies between active gamingstudies. Cardiovascular effort during exercise or physical activityis commonly derived from predicted maximum heart rate valuesrather than individualized cardiovascular responses in relation topeak oxygen uptake. This may explain the differences noted incardiovascular effort between studies, since use of predictions ofmaximum heart rate, rather than values relative to an individualsaerobic tness are likely to reduce accuracy and lead to misrepre-sentation of physical effort.

see front matter 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.rg/10.1016/j.jsams.2013.05.008video games and physical activity recomarison of the Gamercize Stepper, XBOXviX J-Mat

ecker , A.M. McManusan Performance, University of Hong Kong, Hong Kong Special Administrative Region

l e i n f o

pril 2013vised form 9 May 2013ay 2013

a b s t r a c t

Objectives: The current study was desimine the association with physical acvariation in cardiovascular responsesDesign: We employed a cross-sectionm/locate / j sams

endations:nect

to evaluate the intensity levels of three exergames and deter- recommendations that correspond to specic outcomes. Theeen the three exergames was also examined.oratory design.

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ARTICLE IN PRESSG ModelJSAMS-888; No. of Pages 52 R.R. Mellecker, A.M. McManus / Journal of Science and Medicine in Sport xxx (2013) xxx xxx

Differences in bodily movements required from various videogames result in varied intensity levels and energy expenditure.6

Body movements that incorporate all of the extremities producehigher intensity levels and elicit greater energy cost.10 Active videogames, whicontrol the extremitiesand Kinect in signicanusing MET cal activity whereas Ki

Unlike scontroller, pments to cto conventpauses whewith variouthe amountactivity.15

Active galternative engaging inwhether acommendatiindividual dsystems.16,1

We aimthree exergMat) and tVO2) and vels associatchanges, re(1) the threcal activity;to vigorous

In view vidual varigames,12 wbetween thbe signicaexergames.

2. Method

We chosedge that gibe a more scal activity Hong Kongment primagirls were awere exclusex specicweight andwas receivefor human e

The girlstime anthrowere assess0.1 cm withBody mass ausing elect410, Japan)and peak ox

determined using an incremental treadmill protocol. The girls start-ing walking at 3.0 km h1 and speed was increased every 4-minutesby 1.0 km h1 (4, 5, 6, km h1). Speed was increased to 8 km h1

for 1-min and once RER values of 0.90 were attained gradient wased eum.k VOions ate as eagemeteright-tion s. Calge. Tl 895as m

Linetageine ing tituatls rexergwithoaminowinactiv. At ttedsesshe 5-cularin toviderecesami

thre wereThe gere ns. Tet atdeo goviehis isenvire girlame

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to een thnect n thee heaO2 (v this article in press as: Mellecker RR, McManus AM. Active video game Stepper, XBOX Kinect and XaviX J-Mat. J Sci Med Sport (2013), http://d

ch include sensor-based technologies, allow the user togame with body movements, move freely and engage all

when playing. Physiologic responses of Dance CentralSports Boxing suggests that sensor based games resultt increases in energy expenditure above rest.13 When

values to equate these responses to generalized physi-recommendations14 Dance Central resulted in 2 METsnect Sports Boxing elicited a MET value of 4.ensor based systems that require an individual to use aerform an activity on a dance mat or use body move-ontrol the game, contingent systems are connectedional exercise equipment. Contingent systems (gamen activity ceases) provide the active video game players game choices. Preference or choice of game increases

of time and intensity that children engage in physical

aming (exergaming) is a promising physical activitygiven that children are encouraged to move whilst

an activity they enjoy. Limited evidence exists ontive gaming will increase activity levels that meet rec-ons commensurate with specic outcomes and theifferences in intensity levels between active gaming7

ed to determine differences in intensity between theame conditions (Gamercize, Kinect River Rush, XaviX J-he recommended moderate (heart rate at 55% peakigorous (heart rate at 75% peak VO2) intensity lev-ed with body composition and cardiorespiratory tnessspectively. Our hypothesis was two-fold. We expectede exergames would result in moderate levels of physi-

(2) the three exergames would not increase intensity levels.of the recent literature highlighting considerable indi-ations in physical effort when playing active videoe investigated the variation in cardiovascular responsese three exergames. We hypothesized that there wouldnt variation in intensity of play between the three

s

e to recruit girls for this investigation with the knowl-rls are less active than boys18 and that exergaming mayuitable physical activity alternative for meeting physi-recommendations in this subgroup of youth.19 Twenty

Chinese girls were recruited through a local govern-ry school and agreed to participate in this study. Twobsent during the maximal exercise testing protocol andded from the nal analysis. According to local age and

BMI cut-offs, 11 (61%) of the girls were considered over- 7 (39%) were normal weight. Written informed consentd by all the parents and the Institutional Review Boardthics granted ethical approval for this study.

attended one session in our laboratory during whichpometric measures and peak oxygen uptake (peak VO2)ed. Stature was measured barefoot with an accuracy of

a xed stadiometer (Invicta 2007246, Leicester, UK).nd body fat were determined with an accuracy of 0.1 kgronic scales (Tanita Body Composition Analyzer, TBF-. Following a 10-min seated resting period, submaximalygen uptake, as well as cardiovascular responses were

increasmaxim

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Mevariabductedbetweand Kiences iand thpeak V physical activity recommendations: A comparison of the.org/10.1016/j.jsams.2013.05.008

very minute by 2% until the child reached volitional

2 was determined when two of the following threewere reached: (i) a respiratory exchange ratio >1.0, (ii)>85% of age predicted maximum and (iii) the partici-xhausted and refused to carry on despite strong verbalent.20 We utilized a Medgraphics Ultima indirect. Data were collected breath-by-breath and integratedbreath average. Prior to each test gases of known con-were used to calibrate the oxygen and carbon dioxideibration of the volume sensor was performed using a 3-he children wore a pediatric sized Hans Rudolph mask0), which was assessed for proper t and leakage. Heartonitored continuously from heart rate telemetry (Polarar regression equations of percentage of peak HR versus

of peak VO2 were calculated for each participant tothe level of exergame play at 55% and 75% of peak VO2.he baseline assessment session the girls were given timee to the three active gaming systems. Although none ofported having any prior experience playing any of theames, habituation (ability to operate the controller andut disruption to the game or physical activity) to theg systems was completed within 15-min.g the initial baseline assessments, the girls attendede gaming sessions on separate days in the primarythe beginning of each active gaming session the girls

with a Polar heart rate monitor (Polar E600). Heart rateed continuously for 5-min and the average heart ratemin of active game play was used determine the car-

effort for each session. We asked the girls to sit quietly ensure heart rates were at resting levels prior to theo gaming sessions. Due to limited time period durings and to reduce the burden on the school the activeng sessions were limited to 5-min each.e exergames used in this study are commercial systems,

available and affordable to the girls at the time of theirls were allowed to play freely on the three exergamesot given any feedback during the 5-min exergamingo maintain consistency all of the XBOX video games

beginner level. We also allowed the girls to chooseame from a variety of E-rated adventure video games

and Surfs Up) when playing on the Gamercize Stepper common practice when playing with this system in aonment. When exergaming using the Gamercize Step-s stepped and played on contingent mode, which ceases

play when stepping stops. The Kinect XBOX system is ad active video game system, which requires body move-ntrol the game. We choose the Kinect River Rush videopliment the adventure video games used when playingize Stepper. We set the Kinect system to single playerd the girls choose the River Rush adventure. The girls

and dodged ninjas at their chosen pace when playinghan Challenge on the XaviX J-Mat, which comprises ofrt and a mat.nd standard deviations were computed for all key

within group only repeated measures ANOVA was con-xamine whether there were differences in heart ratee three exergame conditions: Gamercize, XaviX J-MatRiver Rush. We used paired t-tests to determine differ-

heart rate achieved whilst playing the three exergamesrt rate values at 55% peak VO2 (moderate) and at 75%igorous), which were obtained during the exercise test.

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ARTICLE IN PRESSG ModelJSAMS-888; No. of Pages 5R.R. Mellecker, A.M. McManus / Journal of Science and Medicine in Sport xxx (2013) xxx xxx 3

Table 1Descriptive characteristics of the girls.

N = 18 Mean SD Range

Age (y) 8.5 0.2 8.08.9Stature (cm) 133.4 5.6 122.5142.1Body mass (kg) 34.3 6.4 25.348.5BMI (kg m2) 19.2 2.7 1424Waist circumference (cm) 63.9 6.9 52.575.5%Fat 35.6 5.0 2545

To determine the variance in heart rate values between Gamer-cize, Kinect and XaviX J-Mat, we calculated the coefcient ofvariation (CV) for the heart rate elicited whilst playing all threeexergames. We performed a between subject One Way ANOVA todetermine the difference in variance in heart rate values for thethree exergames.

3. Results

Descriptive characteristics of the girls are noted in Table 1.Means and standard deviations for resting, submaximal and maxi-mal heart rate, as well as peak VO2 are shown in Table 2.

A within-subjects repeated measures ANOVA revealed sig-nicant differences in heart rate response during the differentexergames (F(2, 30) = 16.088, p < 0.001). Post hoc Bonferroni testsrevealed signicant differences between the Gamercize heart rateand Kinect River Rush (Gamercize HR: 138 14 beats min1; KinectRiver Rush HR: 124 14 beats min1). Heart rate responses werealso signicantly higher for XaviX J-Mat (148 16 beats min1),compared with playing Kinect River Rush (124 14 beats min1).

Our results show that when playing Gamercize and Kinectthe girls did not play at the recommended moderate (p = 0.033,p < 0.001) or vigorous levels (ps < 0.001). Although the girls didnot play at vigorous levels when playing XaviX J-Mat (p < 0.001),

Table 2Exercise test physiological data.

N = 18 Mean SD

Seated HR (beats min1) 92 10Maximum HR (beats min1) 199 5.0Peak VO2 (ml kg min1) 41.6 4.5HR at 4 km h1 (beats min1) 120 11HR at 5 km h1 (beats min1) 129 13HR at 6 km h1 (beats min1) 142 14HR at 8 km h1 (beats min1) 163 11Heart rate (beats min1) 55% Peak VO2 146 10Heart rate (beats min1) 75% Peak VO2 171 6

our results showed that when playing XaviX J-Mat they did playat moderate intensity levels (p = 0.642). No signicant differenceswere apparent between the heart rate at 55% peak VO2 and XaviXJ-Mat, however, signicant differences were noted between XaviXJ-Mat and heart rate at 75% peak VO2 (ps < 0.001).

Fig. 1 illustrates the individual heart rate responses for the girlswhen playing each of the three exergames. The CV for Gamercizeis 8.9%, Kinect 11.3% and XaviX J-Mat 11.4%. Results from the OneWay ANOVA showed that there were no signicant differences inthe CV between the three exergames (p = 0.477).

4. Discussion

When comparing the three exergame conditions, we foundXaviX J-Mat play was equivalent to moderate intensity levels, levelscommensurate with body composition changes.17 Although heartrates were elevated above resting and sitting heart rates, most ofthe girls did not step and game using Gamercize or play the KinectRiver Rush at moderate intensity levels.17 Our results do not concurwith the proposal that the physiological response between games isan artifact of body movement.10 The XaviX J-Mat requires full body80

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Fig. 1. Scatterplot illustrating cardiovascular responses for the three exergam physical activity recommendations: A comparison of the.org/10.1016/j.jsams.2013.05.008

HR 55 %Peak VO2

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es and heart rate at 55% and 75% peak VO2.

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ARTICLE IN PRESSG ModelJSAMS-888; No. of Pages 54 R.R. Mellecker, A.M. McManus / Journal of Science and Medicine in Sport xxx (2013) xxx xxx

movement including jumping, stamping, and performing kneelingto standing actions whereas some video games require the user toonly use the upper body or simply ick a wrist to control the videogame.6 On the other hand, the heart rate responses were 124 and148 bpm foThe XaviX J-upper and lmovementsplaying thethat correspgest that inmovements

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number of participants. In an attempt to provide some resemblanceto free play in a home environment we allowed the girls to choosetheir video game when video gaming and stepping on the Gamer-cize Stepper. The active gaming sessions were limited to 5-min.

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r the Kinect River Rush and XaviX J-Mat, respectively.Mat and Kinect River Rush both required the girls to useower extremities to play and both video games required

such as jumping, kneeling and lateral movements. Yet, Kinect River Rush did not result in heart rate responsesond with moderate intensity levels. These ndings sug-tensity levels vary between games but specic body

alone may not explain the variance.omparing the energy cost of various active games itt differences in intensity level may also be subject to thee played.12,21 The XaviX Jackie Chan Challenge allowstravel through the streets of Hong Kong whilst follow-ic Hong Kong actor, Jackie Chan. The journey through

and the connection with Jackie Chan may have beenfor the girls in this study. Relatedness or connectionf or a character22 facilitates motivation to play and per-continue playing.23 The XaviX Jackie Chan Challengerovided some sense of cultural connectivity whereasiver Rush and the video games chosen when steppingaming on the Gamercize Stepper did not include char-had cultural relevance or a personalized connection.f relatedness on intensity of play is of interest givenctive games do not elicit intensity levels sufcient tomendations10,24 and the possibility that relatednessong-term play.

in this study were given a variety of video games to when stepping and video gaming on the Gamercize

tonomy (choice of many different games) increase exer-ty, with girls more motivated by choice than boys.15

as proven to be successful in promoting the amount ofildren are physically active25 but when comparing Wiiwith traditional versions of sport, intensity was greaterren engaged in traditional sports.25 Our results are con-

previous ndings.25 Most of the girls in our studych moderate intensity levels associated with specichen stepping and gaming on the Gamercize Steppering the autonomy to choose their game. When consid-sign of exergames it has been suggested that developerssoftware interface with corresponding equipment to

the system offers a holistic experience for the end video games coupled with the Gamercize Stepper mayvideo game experience that is disconnected with the

which results in a subsequent decrease in the level ofen stepping and gaming.

vidualized exercise test allowed us to examine the intra-ifferences in cardiorespiratory effort and determine aned assessment of whether the girls were meeting phys-

recommendations for specic health outcomes.15,16

o signicant difference in variation between the threebut the range of cardiovascular responses within eachsts that intensity of play differs widely between indi-n when playing with the same exergame system. Of thet participated in the study, 10 of the girls played XaviX,ed on the Gamercize Stepper and 1 girl played Kinect

levels of intensity. None of the girls played any of theat vigorous intensity levels.h promising our results are not without limitations. Weed our data and matched the cardiovascular responsese gaming to individual heart rate responses when exer-ak VO2 to address issues related to body compositionespiratory tness. However, we were not able to address

in variables such as weight status due to the limited

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rief, short bouts of intermittent activity are characteris-nt patterns for this age group and this population.27 Ine 5-min play bouts mimic the short duration intervals,inherent in the design of active games. Future effortsnd the physiological responses to active game playstems (boredom, intensity level variations) are obliga-p the type of game constant, we offered games that wereontent and video games that possessed an adventurehe time of this study, the XaviX Jackie Chan Challengeect River Rush were the only games in this genre fors and for this reason the girls did not have game choice

ng on these systems. Furthermore, the autonomy tonot increase intensity levels when stepping and playings on the Gamercize Stepper.

ion

ings suggest that not all active gaming systems resultevels commensurate with physical activity guidelinesty levels when playing active video games is variable.ivity recommendations and health outcomes need toto consideration to ensure that specic goals are pre-

met when implementing active gaming interventions. individual differences in levels of exertion when active

need of further investigation.

plications

aming is to be used to increase physical activity lev-c activity recommendations related to health outcomes

taken into consideration. that children meet recommended levels of intensityurate with specic health outcomes active game inter-may need to consider the active gaming console beingd.nal techniques to address intra-individual variation inlevels need to be addressed when implementing actives a physical activity alternative.

gements

extremely grateful to the participants and the primaryssisting us with this research study. We would also likeedge the generosity of Databridge Services Limited.

DA, Ebel BE, Rivara FP et al. Television, video, and computer gamehildren under 11 years of age. J Pediatr 2004; 145(5):652656.J, Foehr UG, Roberts DF. Generation M2: Media in the Lives of 818 year

Park, CA, Henry J Kaiser Foundation, 2010.er EA, Shim MS, Caplovitz AG. Linking obesity and activity level with

television and video game use. J Adolesc 2004; 27(1):7185. RR, McManus AM. Energy expenditure and cardiovascular responses

and active gaming in children. Arch Pediatr Adolesc Med 2008;6891.choeld G, Kilding AE. Energy expended by boys playing active videoci Sports Med 2011; 14(2):130134.

Ridgers ND, Stratton G. The contribution of upper limb and total bodyt to adolescents energy expenditure whilst playing Nintendo Wii. Euriol 2008; 104(4):617623.ratt LV, Hester CN et al. Playing active video games increases energyre in children. Pediatrics 2009; 124(2):534540., Carson L, Neal W et al. Effects of an exercise intervention using Danceolution on endothelial function and other risk factors in overweightnt J Pediatr Otorhinolaryngol 2009; 4(4):205214.

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Please cite s andGamercize x.doi

ARTICLE IN PRESSG ModelJSAMS-888; No. of Pages 5R.R. Mellecker, A.M. McManus / Journal of Science and Medicine in Sport xxx (2013) xxx xxx 5

9. Primack BA, Carroll MV, McNamara M et al. Role of video games in improv-ing health-related outcomes: a systematic review. Am J Prev Med 2012;42(6):630638.

10. Peng W, Lin JH, Crouse J. Is playing exergames really exercising? A meta-analysisof energy expenditure in active video games. Cyberpsychology, Behaviour andSocial Networking 2011; 14(11):681688.

11. Dept of Health US, Human Services Physical activity guidelines for Ameri-cans. ODPHP Publication No. U0036, 2008. Available at: http://www.health.gov/paguidelines/pdf/paguide.pdf. Accessed (20.12.12).

12. Bailey BW, McInnis K. Energy cost of exergaming: a comparison of the energycost of 6 forms of exergaming. Arch Pediatr Adolesc Med 2011; 165(7):597602.

13. Smallwood SR, Morris MM, Fallows SJ et al. Physiologic responses and energyexpenditure of Kinect active video game play in schoolchildren. Arch PediatrAdolesc Med 2012; 166(11):10051009.

14. Pate RR, Pratt M, Blair SN et al. Physical activity and public health. A recommen-dation from the Centers for Disease Control and Prevention and the AmericanCollege of Sports Medicine. JAMA 1995; 273(5):402407.

15. Feda DM, Lambiase MJ, McCarthy TF et al. Effect of increasing the choice of activeoptions on childrens physically active play. J Sci Med Sport 2012; 15(4):334340.

16. Armstrong N, Tomkinson G, Ekelund U. Aerobic tness and its relationship tosport, exercise training and habitual physical activity during youth. Br J SportsMed 2011; 45(11):849858.

17. Gutin B, Barbeau P, Owens S et al. Effects of exercise intensity on cardiovasculartness, total body composition, and visceral adiposity of obese adolescents. AmJ Clin Nutr 2002; 75(5):818826.

18. Trost SG, Pate RR, Sallis JF et al. Age and gender differences in objectively mea-sured physical activity in youth. Med Sci Sports Exerc 2002; 34(2):350355.

19. OLoughlin EK, Dugas EN, Sabiston CM et al. Prevalence and correlates ofexergaming in youth. Pediatrics 2012; 130(5):806814.

20. Yu CCW, McManus AM, Sung RYT et al. Cardiopulmonary exercise testing inchildren. Hong Kong J Pediatr 2010; 15:3547.

21. Lyons EJ, Tate DF, Ward DS et al. Energy expenditure and enjoyment dur-ing video game play: differences by game type. Med Sci Sports Exerc 2011;43(10):19871993.

22. Ryan RM, Deci EL. On happiness and human potentials: a review of research onhedonic and eudaimonic well-being. Annu Rev Psychol 2001; 52:141166.

23. Ryan RM, Rigby SC, Przybylski A. The motivational pull of video games: a self-determination theory approach. Motiv Emotion 2006; 30(4):344361.

24. Biddiss E, Irwin J. Active video games to promote physical activity in childrenand youth: a systematic review. Arch Pediatr Adolesc Med 2010; 164(7):664672.

25. Roemmich JN, Lambiase MJ, McCarthy TF et al. Autonomy supportive environ-ments and mastery as basic factors to motivate physical activity in children: acontrolled laboratory study. Int J Behav Nutr Phys Act 2012; 9:16.

26. Sinclair J, Hingston P, Masek M. Considerations for the design of exergamesGRAPHITE, 2007. p. 289296. Available at: https://blog.itu.dk/MOSP-F2010/les/2010/04/sinclair07.pdf. Accessed 19.02.13.

27. McManus AM, Chu EYW, Yu CCW et al. How children move: activitypattern characteristics in lean and obese Chinese children. J Obes 2011.http://dx.doi.org/10.1155/2011/679328. this article in press as: Mellecker RR, McManus AM. Active video game Stepper, XBOX Kinect and XaviX J-Mat. J Sci Med Sport (2013), http://d physical activity recommendations: A comparison of the.org/10.1016/j.jsams.2013.05.008

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Active video games and physical activity recommendations: A comparison of the Gamercize Stepper, XBOX Kinect and XaviX J-Mat1 Introduction2 Methods3 Results4 Discussion5 ConclusionPractical implicationsAcknowledgementsReferences