Summary+of+P.E.

A couple of papers discussed the motivational factors of the video games in relation to P.E. specifically, and those have been included as well. One paper specifically studied whether or not students preferred to exercise with a video game, and that was included as well in the motivation section.
 * __Inclusion Criteria__** There were no quantitative research papers studying the affordances of video games in a physical education setting. Thus, research papers on the exercise affordances of active video games such as Dance Dance Revolution or EyeToy were considered as well. In addition, papers and articles including strong testimonials, such as from school districts or studies involving a number of schools, were included. A couple of papers contained testimonials from individuals or from a teacher from a single school, but those were considered too weak to include in the paper.

**__Research Summary__** To date, little quantitative research has been done to test the affordances of active video games (exergames) such as Dance Dance Revolution or Wii Fit for Physical Education in schools.

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===================== __**Testimonials**__ There does however exist real-life testimonials of such games being used in school successfully.

The West Virginia school system in particular was able to incorporate Dance Dance Revolution (DDR) into its physical education curriculum to great effect in 2004 (O'Hanlon, 2008). It began as an at-home clinical study of 50 overweight children in which the results were very positive, including "better arterial response to increased blood flow, an increase in aerobic capacity, and no weight gain" for the physical affordances as well as the participants being "more willing to try new activities and invite friends over to play, and were more confident in participating in physical education classes" for the motivational affordances. West Virginia's department of education then decided to implement DDR in 20 middle schools as a pilot program to gauge student interest and acceptance. When those programs produced positive results as well, the state mandated that all middle and junior high schools integrate DDR into their P.E. programs and that all the state's gym teachers be trained in using DDR, with plans to expand into elementary and high school as well ( look into whether or not that has happened yet ). Some schools also allow children to play before and after school as a supplemental activity as well as incorporating it into school dances ( look into if this is still going on ).

Schools in the UK as well have begun introducing exergames into their P.E. curriculum. Five schools in Worcestershire, England have used Wii Sports, which includes virtual bowling, baseball, and tennis, to successfully attract children to P.E. who normally skipped that class. Increased heart rates observed in the children playing the games showed that the games did indeed provide proper exercise. (Hawkins, 2009) ( additional result under Motivation )

Studies have been done in Australia as well on the affordances of exergames in physical education. The Wii was introduced into a number of schools in Brisbane, Queensland for the study and found many positive results. As with results from other studies, it was observed that the games requiring physical input was able to promote exercise. (Souter, 2008) ( additional results under Motivation and Additional Benefits )

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===================== While little research has been done on the educational affordances of exergames, more studies have been done on whether or not exergames can provide the same amount of physical activity as traditional forms of exercise.
 * __Exergames vs. Traditional Exercise__**

A 2008 preliminary study in Auckland, New Zealand consisted of a 12-week intervention where 20 children aged 10-14 either played exergames or were part of the control group and didn't play exergames. Physical activity was measured using an accelerometer for quantitative data and questionnaires for qualitative data. The results suggested that children who played exergames were more physically active while playing fewer video games overall and also had decreased waist circumferences. So, this study found that, at least in the short term, children's activity level may be increased by using exergames. A follow up study involving 330 children was later conducted in 2009 that measured additional values such as body mass index (BMI), percent body fat, waist circumference, and cardio-respiratory fitness (Maddison, Foley, Mhurchu, Jull, Jiang, Prapavessis, Rodgers, Hoorn, Hohepa, & Schaaf, 2009), but the results of that study have not yet been published as of the time of this paper. (Mhurchu, Maddison, Jiang, Jull, Prapavessis, & Rodgers, 2008)

In a 2008 study, 19 male college students played a 30-minute Dance Dance Revolution (DDR) gaming session while their heart rates, ratings of perceived exertion, respiratory exchange rates, oxygen consumption, and total steps were recorded. Of the 19 participants, 12 were experienced DDR players (regularly and consistently played on the highest difficulty level) and 7 were inexperienced players (could consistently maintain play at the lowest difficulty levels). The purpose of the study was to determine whether the player's experience with the game had an effect on their energy expenditure during the 30-minute session, and to determine whether both experienced and inexperienced players could meet the minimal daily recommended levels of physical activity and energy expenditure. The results of the study found that experienced players showed higher levels of intensity and energy expenditure compared to inexperienced players. Experienced players also met or exceeded the American College of Sports Medicine (ACSM) recommendations for moderate-intensity activity, whereas inexperienced players were only able to achieve levels of very light intensity activity. This implies that as the player continues playing and improves, he or she may experience higher daily levels of physical activity and fitness in the same amount of time. In addition, higher levels of enjoyment from playing DDR versus other traditional forms of exercise may make it easier for players to maintain consistent and regular daily play sessions. (Sell, Lillie, Taylor, & 2008)

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===================== **__Motivation__** Like in other areas of school, video games have been found to provide motivation for students to attend P.E. and exercise who might otherwise not. The University of Cumbria in England conducted a study of 50 children aged 11 and 12. The children were asked to use exercise equipment while playing video games, and could only actually play the game while maintaining movement on the machine, for if they stopped, the game would pause. The results showed that 90% of the children enjoyed that combination and that "the games reduce the boredom of exercise ". (Hawkins, 2009)   The study in Brisbane, Queensland observed a number of factors that motivated students to participate. For instance, students who were unskilled in or were reluctant to participate in other physical activities or other social events were able to comfortably play the Wii with a group and be successful at the games. That success then lead to increased self-confidence and some students were even motivated to try real sports after playing the Wii games. (Souter, 2008)   A study at the University at Buffalo had overweight and non-overweight children exercise in a variety of different ways involving Dance Dance Revolution. The children could either play the game using the interactive dance pad, play it using just a handheld controller, dance along with a video, or dance listening to music. Their results showed that the children were more motivated to play DDR with the interactive dance pad over the other options due to the interactive nature of the game. That motivation also did not depend on the child's gender, or weight-status. (Epstein, Beecher, Graf, & Roemmich, 2007)

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 * __Additional Benefits (not P.E. related)__** There are additional benefits to incorporating exergames in schools. ( are this and the asthma part related to P.E.? )    A California Department of Education study found that doing 10 minutes of rhythmic exercise before a standardized test allowed students to perform up to 25% better than students who received 20 minutes of tutoring (O'Hanlon, 2008 - link to original article is broken ).    Also, an article by the National Institute for Health Care Management Foundation found that "breaks for physical activity during the school day can help children to be more focused and better able to learn" (O'Hanlon, 2008 - link to original article is broken ).    The study in Brisbane, Queensland also observed improvements in the social interactions of the students who participated. As stated above ( Motivation section ), students were more open to play the Wii games as a group even though they were initially reluctant or self-conscious about their abilities. Additionally, some students, who were typically disengaged or had low self-confidence, were observed assisting others in games they were experienced in. The Wii was able to provide a greater number of communication opportunities than other activities the students were exposed to. (Souter, 2008)

Dance Dance Revolution and EyeToy does seem to have many affordances for physical education. The students find it fun so it motivates them to participate. Importantly, it attracts students who may be hesitant participate in traditional P.E. or who skip the class entirely for whatever reasons. The testimonials state that such students are willing to attend class if games such as DDR are used. The games also provide a valid workout for the students to they are a suitable alternative for traditional exercise. Unfortunately, there are not enough articles and papers for a well supported, conclusive pattern.
 * __Patterns__**

A study in Auckland, New Zealand involved a six month intervention where 330 overweight children aged 10-14 years either played exergames or had no intervention (control). Body mass index (BMI), percent body fat, waist circumference, cardio-respiratory fitness, and physical activity levels were measured. The children that were part of the intervention group played exergames instead of traditional non-active games, while the control group continued to play traditional active games. The study concluded in early 2010 but as of now, the results have not yet been published. The final results of this study will be very interesting to examine. (Maddison, Foley, Mhurchu, Jull, Jiang, Prapavessis, Rodgers, Hoorn, Hohepa, & Schaaf, 2009)
 * __Future Directions__**

The future certainly looks promising as new active video game technologies such as Kinect for the Xbox360 and Playstation Move are introducing new ways for players to get physically involved while playing games.

Kinect may be of high interest as it is able to accurately track the player's movement using a sophisticated camera system. Zumba Fitness, a game that directly combines the Zumba workout with the Kinect has already been released, and looks to be a prime candidate for further exergame research.

__**Initial Notes**__ __** anecdotal evidence(?) from places that have used DDR, Wii, and other exergames and got good results **__ I didn't find many papers with definitive quant/qual analysis on "traditional PE" vs. "PE with exergames" but did find a couple papers/articles with testamony from places that used exergames and got positive results.


 * //(O'Hanlon 2008)// was entirely about the West Virginia school system incorporating Dance Dance Revolution and seeing positive results. It started off with an at-home clinical study of 50 kids, and when those saw good results, the department of education implemented it as a pilot program in 20 middle school and got similarly good results. The state then integrated DDR into the P.E. programs of all its middle and junior high schools and planned to expansions into elementary and highs schools. There are also benefits that go beyond fitness, such as "A study by the California Department of Education found that students who did just 10 minutes of rhythmic aerobics before a standardized test performed up to 25 percent better on the test than students who received 20 minutes of test-specific tutoring" (from middle of page 2). From the end of page 2 into page 3 (in the "BYTESIZE" section), has another interesting finding, with a Nintendo-created game for asthma sufferers. It "removed the stigmas of the conditions and helped reinforce and boost communicationabout them. It increased the social support for the kids.", and that psychological boost translated into physical benefits. The "Getting FIT" section was also very interesting, with more examples of incorporating games into classrooms (not just P.E. classes). The rest of the paper from the botton of page 3 to the end talked about more benefits of games in school.
 * //(Maldonado 2010)// was mainly an overview of the Wii and how it can be used in different kinds of classes. Only the first 1.5 pages are related to P.E. It includes some testimonies from schools (England and U.S.) that have used the Wii in P.E. "The school has found that children averse to rigorous play activity become engaged in the physical activity necessary to play the Wii games." Childrens heart rates were monitored while they played, and seeing an increase in hearts rates showed that Wii games can provide a valid workout. Another benefit is that "competition via these games not only provides physical movement but also encourages good sportsmanship and teamwork."
 * //(Trout & Zamora 2005)// is about DDR but it's mostly just presenting ideas on how to implement it in classrooms. Page 2 has some short testimonies (just a couple of quotes) from places and people who have used DDR. The authors talks briefly about "using DDR as a tool to help them understand rhythm and tempo; to promote teamwork, cooperation, fair play; and even to enhance creative dance choreography." They also state that as of 2005 (date this article was published), "no empirical studies have been published regarding the use of DDR in physical education."
 * //(Yang, Smith, & Graham 2008)// was mainly a survey of current exergames and how they could be healthy. There are two testimonies at the top of page 2 where two people described how they lost weight playing DDR. Immediately after that is a short paragraph of school systems (West Virginia included) that have incorporated nontraditional forms of exercise (like DDR and EyeToy). The middle of page 4 discusses ways to study exergames, with a section specifically about DDR.

__** focusing more on if exergames are comparable to traditional forms of exercise (in terms of energy expenditure and other exercise measures) **__ Some of the papers compared exergames and traditional exercise methods to see if exergames could be suitable substitutes. These papers said that exergames can have similar health benefits in terms of physical exercies compared to traditional forms of exercise.


 * //(Maddison, Foley, Mhurchu, Jull, Jiang, Prapavessis, Rodgers, Hoorn, Hohepa, & Schaaf 2009)// compared a number of different values for quantitative analysis (body mass index (BMI), percent body fat, waist circumference, cardio-respiratory fitness, and physical activity levels) and also used surveys. They found that "overall, the energy expenditure associated with playing these active video games is similar in intensity to traditional physical activities such as walking, jogging, and cycling, approximately 3–6 Metabolic Equivalents (METS), which are multiples of resting metabolic rate." I ended up skimming most of the article because it was technical (in terms of physical exercise values), but I treid looking for the final results but couldn't actually find them...
 * //(Mhurchu, Maddison, Jiang, Jull, Prapavessis, & Rodgers 2008)// measured the effects of exergames over a 12-week intervention period. It used an Actigraph accelerometer to measure quantitative data ("motion in the vertical plane, with movement outside of 'normal' motion being filtered electronically") and a Physical Activity Questionnaire ("a validated self-report seven-day recall physical activity measure, consisting of nine items that are used to calculate summary activity scores"). The children played DDR and EyeToy games. The findings "suggest that, at least in the short-term, active video games may be an effective means to increase children's overall physical activity levels."
 * //(Sell, Lillie, & Taylor 2008)// tested college students to determine whether playing experience influences energy expenditure during a single DDR exercise session as well as whether experienced and inexperienced DDR players are able to meet the minimal recommendations for daily physical activity and energy expenditure through playing DDR. The results showed that participants with greater DDR experience had greater energy expenditure and playing intensity relative to inexperienced participants. Experienced players met or exceeded the current recommendations for moderate-intensity physical activity. I also ended up skimming most of this article because it went into a lot of technical details (in terms of physical data).

__**focused on motivation of students (exergames vs. traditional exercise methods) **__ Just this one paper of whether children would be more motivated to play exergames than traditional exercise.
 * //(Epstein, Beecher, Graf, & Roemmich 2007)// "tested the reinforcing value and activity levels of interactive dance and bicycle race games in 18 overweight and 17 nonoverweight 8- to 12-year-old youth." The experim ent compared overweight and nonoverweight children on whether they preferred playing DDR with a dance pad versus: playing it with a constroller, dancing while watching a video, or dancing while listening to music. There was also a bicycling game tested. The results showed no difference in the bicycling game but did show that the children preferred to dance with the pad.

**__References (with information for Appendix)__**

**content area** = PE for all (if a paper describes multiple games in multiple areas, I focused only on the PE sections)
 * **Epstein, L. H., Beecher, M. D., Graf, J. L., Roemmich, J. N. (2007). Choice of Interactive Dance and Bicycle Games in Overweight and Nonoverweight Youth. //Annals of Behavioral Medicine//, 33(2), 124-131.**
 * games: Dance Dance Revolution and Freekstyle (bicycle game)
 * sample: 18 overweight and 17 nonoverweight 8- to 12-year-old children
 * length: 2 hours total (two 1-hour sessions)
 * outcome: participants chose the interactive way to play DDR (with dance pad) over all the other choices
 * location: US (University at Buffalo)
 * link: [] ,
 * **Hawkins, D. (2009). Using Game Equipment to Teach. //Curriculum Review//, 48(6), 9-10.**
 * games: Wii Sports,
 * sample: 50 kids ages 11 and 12 (study), 5 schools in Worcestershire, England (testimonial)
 * length: n/a
 * outcome: 90% of the participants enjoyed combining exercise with video games (study with 50 kids), the 5 schools incorporated the Wii successfully (kids were interested and they were getting valid exercise)
 * location: UK ( University of Cumbria ) (Worcestershire )
 * link: [|http://findarticles.com/p/articles/mi_7516/is_200902/ai_n32315789/]
 * **Maddison, R., Foley, L., Mhurchu, C. N., Jull, A., Jiang, Y., Prapavessis, H., Rodgers, A., Hoorn, S. V., Hohepa, M., Schaaf, D. (2009). Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study.** //**BMC Public Health**//**, 9(1).** ( study completed in early 2010 but results not yet published as far as I could find... so put in Future Directions section )
 * games: EyeToy games
 * sample: 330 children aged 10–14 years
 * length: 6 months
 * outcome: results not yet published
 * location: Auckland, New Zealand
 * link: []
 * **Mhurchu, C. N., Maddison, R., Jiang, Y., Jull, A., Prapavessis, H., Rodgers, A. (2008). Couch potatoes to jumping beans: A pilot study of the effect of active video games on physical activity in children. //International Journal of Behavioral Nutrition and Physical Activity//, 5(1).**
 * games: EyeToy games and Dance Dance Revolution(?)
 * sample: 20 children (mean ± SD age = 12 ± 1.5 years; 40% female)
 * length: 12 weeks
 * outcome: suggested that children who played exergames were more physically active while playing fewer video games overall and also had decreased waist circumferences. So, this study found that, at least in the short term, children's activity level may be increased by using exergames
 * location: Auckland, New Zealand
 * link: []
 * **O'Hanlon, C. (2007). Gaming :: Eat Breakfast, Drink Milk, Play Xbox. //T.H.E. Journal//, 34(4), 34-39.**
 * games: Dance Dance Revolution
 * sample: elementary to high school, all students
 * length: n/a
 * outcome: the West Virginia school were able to successfully incorporate DDR into their P.E. curriculum
 * location: West Virginia
 * link: []
 * **Sell, K., Lillie, T., Taylor, J. (2008). Energy Expenditure During Physically Interactive Video Game Playing in Male College Students With Different Playing Experience. //Journal of American College Health//, 56(5), 505-512.**
 * games: Dance Dance Revolution
 * sample: 19 male college students—12 experienced Dance Dance Revolution (DDR) players and 7 inexperienced players
 * length: one 30-minute DDR session
 * outcome: experienced players showed higher levels of intensity and energy expenditure compared to inexperienced players. Experienced players also met or exceeded the American College of Sports Medicine (ACSM) recommendations for moderate-intensity activity, whereas inexperienced players were only able to achieve levels of very light intensity activity
 * location: US
 * link: [] (full text: [])
 * **Souter, J. (2008). Nintendo Wii as an inclusive learning tool. //Disability Support Services Unit Online Newsletter//, 7(3).**
 * games: Wii games
 * sample: special schools, a hospital school and mainstream schools with either a special education program or a population of students with special needs
 * length: n/a
 * outcome: numerous positive results, including: the games promoted exercise, reluctant or self-conscious students were more inclined to participate (when they would have not participated in traditional P.E.), success led to increased confidence, some students became motivated to try real sports
 * location: Brisbane (Australia)
 * link: []