Objective: Although current evidence supports the use of virtual reality (VR) in the treatment of mental disorders, it is unknown whether VR exercise would be beneficial to mental health. This review synthesized literature concerning the effect of VR exercise on anxiety and depression among various populations. Methods: Ten electronic databases were searched for studies on this topic from January 2000 through October 2017. Studies were eligible if the article: (1) was peer-reviewed; (2) was published in English; and (3) used quantitative measures in assessing anxiety- and depression-related outcomes. Results: A total of five empirical studies met the eligibility criteria. These studies included two randomized clinical trials, one control trial, and two cross-sectional studies. Four studies reported significant improvements in anxiety- and depression-related measures following VR exercise, including reduced tiredness and tension, in addition to increased energy and enjoyment. Nonetheless, one study failed to support the effectiveness of VR exercise over traditional exercise alone on depressive symptoms. Conclusions: Findings favor VR exercise in alleviating anxiety and depression symptomology. However, existing evidence is insufficient to support the advantages of VR exercise as a standalone treatment over traditional therapy in the alleviation of anxiety and depression given the paucity of studies, small sample sizes, and lack of high-quality research designs. Future studies may build upon these limitations to discern the optimal manner by which to employ VR exercise in clinical settings.

The December 2019 COVID-19 outbreak in China has led to worldwide quarantine, as recommended by local governments and the World Health Organization. Particularly affected are older adults (i.e., those aged ≥ 65 years) who are at elevated risk for various adverse health outcomes, including declines in motor ability and physical activity (PA) participation, increased obesity, impaired cognition, and various psychological disorders. Thus, given the secular increases in the older adult population, novel and effective intervention strategies are necessary to improve physical activity behaviors and health in this population. Virtual reality (VR)-integrated exercise is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. Therefore, the purpose of this editorial is to synthesize recent research examining the efficacy and effectiveness of VR exercise in the promotion of favorable health outcomes among the older adults. Results indicate the application of VR exercise to facilitate improved physical outcomes (e.g., enhanced motor ability, reduced obesity), cognition and psychological outcomes. VR exercise has also been observed to be an effective intervention strategy for fall prevention in this population. Future research should employ more rigorous research designs to allow for a more robust quantitative synthesis of the effect of VR exercise on the preceding outcomes to elucidate which type(s) of VR-based PA interventions are most effective in promoting improved health outcomes among older adults. Findings from this study will better inform the development of technology-savvy PA programs for wellness promotion in older adults who practice social distancing and exercise from home under the unprecedented global health crisis.

Sedentary behavior has been identified as one of the major causes of many chronic diseases such as cardiovascular disease, stroke, cancer, type 2 diabetes, and obesity

Purpose: The effects of exergaming-based physical activity (PA) interventions on preschoolers’ health outcomes and cognition remain largely unexplored. Therefore, we conducted a randomized controlled trial to discern the effectiveness of a home-based educational exergaming intervention on preschoolers’ energy expenditure, fitness, body mass index, and cognition. Methods: Participants were 32 preschoolers (16 girls; 59.4% Asian; M_age = 4.72, SD = ±0.73) recruited from the Twin Cities area in Minnesota. During baseline testing, we measured preschooler’s daily energy expenditure (EE), cardiovascular fitness, body mass index, and cognitive flexibility using validated instruments. Participants were then randomly assigned to one of two conditions: (1) the exergaming intervention condition; or (2) control condition. The intervention program requested children participate in home-based educational exergaming using the LeapTV gaming console for at least 30 min/session 5 times/week. The control condition asked children to maintain regular PA patterns without any exergaming gameplay. Each condition lasted 12 weeks. We conducted identical outcome assessments for all children at baseline and post-intervention. Results: Analysis of covariance with repeated measures yielded significant time x group interaction effects for cognitive flexibility, Wilks’ Lambda = 0.81, F(1, 29) = 6.98, p = 0.01, η² = 0.19, suggesting children in the exergaming group demonstrated significantly greater increases in cognitive flexibility as compared to those in the control group over time. There were no significant differences for time x group changes between the two groups for EE, Wilks’ Lambda = 0.92, F(1, 29) = 2.29, p = 0.14, η² = 0.08; cardiovascular fitness, Wilks’ Lambda = 0.96, F(1, 29) = 1.07, p = 0.31, η² = 0.04; and BMI, Wilks’ Lambda = 0.99, F(1, 29) = 0.05, p = 0.82, η² = 0.01. However, our data did suggest a marginal effect of time for EE, Wilks’ Lambda = 0.89, F(1, 29) = 3.26, p = 0.08, η² = 0.08, indicating that children’s daily EE increased from baseline to post-intervention. Conclusions: Home-based educational exergaming may positively impact cognitive flexibility in preschoolers. Studies with larger sample sizes in multiple geographic locations are needed, with our study suggesting a longer intervention period might also be warranted.

This study evaluated the effects of exergaming on college students’ energy expenditure (EE), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), rating of perceived exertion (RPE), and enjoyment compared to traditional treadmill exercise, and sex differences. Sixty college students (30 female; $\overline{\mathrm{X}}$ _age = 23.6 ± 4.1 years) completed three 20-min exercise sessions on Xbox 360 Kinect Just Dance (Microsoft, Redmond, WA, USA), Xbox 360 Kinect Reflex Ridge (Microsoft, Redmond, WA, USA), and treadmill walking. Their EE and PA were assessed by ActiGraph accelerometers (ActiGraph Co.; Pensacola, FL, USA); RPE every four min; enjoyment via an established scale. Significant exercise-type by sex interaction effects were observed for RPE (p < 0.01): females reported significantly lower RPE during exergaming sessions but significantly higher RPE during treadmill walking. Results revealed significant main effects for all outcomes between exercise sessions (all p < 0.01): treadmill walking resulted in significantly higher metabolic equivalents (METs), MVPA, and EE (p < 0 .01), yet lower LPA (p < 0.01), compared to the two exergaming sessions. Participants’ RPE was significantly higher during treadmill walking than during exergaming sessions, with exergaming eliciting significantly higher enjoyment (all p < 0.01). College students find exergaming more enjoyable and report lower RPE compared to traditional treadmill exercise, though not yet matching the moderate physiological intensity level.

Background: Quality physical education (PE) lessons tap on the four focal areas: curriculum, instruction, policies and environment (National Association for Sport and Physical Education 2013 National Association for Sport and Physical Education. 2013. Quality Physical Education NASPE Resource Brief.. Reston, VA : American Alliance for Health, Physical Education, Recreation and Dance. [Google Scholar] . Quality Physical Education NASPE Resource Brief. Reston, VA: American Alliance for Health, Physical Education, Recreation and Dance). One of the approaches to enhance the quality of PE is to use digital technologies, such as the iPad and mobile applications (apps), in the classes to facilitate teachers’ instruction and students’ learning process. Although literature discussing strategies and different types of apps employed in PE classes is available, studies investigating their effectiveness on students’ physical activity (PA) level and their PA-related beliefs are scarce. The national guidelines state that students meet the recommended moderate-to-vigorous PA (MVPA) levels in PE, as children are not sufficiently active in PE classes. Recently, more PE teachers are integrating apps in their classes and, therefore, it is essential to examine whether app-integrated PE is effective in promoting children’s PA and PA-related psychosocial beliefs such as enjoyment and self-efficacy. Purpose: The study examined the short-term (two-week) effects of mobile app-integrated PE classes on children’s PA and their psychosocial beliefs. Methods: A total of 157 fourth and fifth grade children from two elementary schools in the Midwestern U.S. participated in this study in 2016. Four PE classes from one school (n = 77) served as the app-integrated group, while three classes from the comparison school (n = 80) participated as the traditional PE group. Three PE sessions were measured for both schools at baseline and post-test to examine children’s differences in PA levels and psychosocial beliefs. In the app-integrated lessons, teachers used the iPad and mobile apps to instruct during the post-test sessions. Children’s percentages of time spent in sedentary behavior, light PA, and MVPA during PE classes were measured via ActiGraph GTX3+ accelerometers. A battery of validated questionnaires were used to assess the children’s PA-related psychosocial beliefs (i.e. self-efficacy, outcome expectancy, social support, and enjoyment) in PE. Results: The changes in children’s PA were significantly different between the app-integrated and comparison groups in sedentary behavior (F (1,154) = 110.6, p < 0.001, η² = 0.42), light PA (F (1,154) = 97.7, p < 0.01, η² = 0.39), and MVPA (F (1,154) = 31.4, p < .01, η² = 0.17). Children in both groups demonstrated a decrease in their MVPA; however, the decrease in the app-integrated group was significantly greater than that of the comparison group (−1.6%). There were no significant differences in changes of all beliefs between the two groups. Conclusions: The short-term (two-week) app-integrated PE classes was ineffective in reducing children’s sedentary behavior and improving light PA, MVPA, and PA-related beliefs. Teachers are recommended to align the use of iPad and apps with the PE learning goals: selection of apps and pedagogy of app use need to be carefully thought out to prevent compromising children’s PA for the sake of efficient management or emphasis on other learning domains.