Fun and exergames: Not just for kids anymore

Video game workouts work pretty well, but the initial cost can be substantial.

Doctors often say that the best form of physical activity is the one that you'll do consistently. If you're still searching for an effective routine that's actually fun, or want a high-tech take on fitness, consider active-play video games, also called exergames. No longer just for youngsters, exergames such as Nintendo's Wii Fitness and Xbox's Kinect Sports are catching on with middle-aged and older adults as an enjoyable way to get moving.

Although not as ubiquitous as just-sit-there video games, exergames offer diverse activities and benefits from playing. Depending on the system, you can choose from muscle-strengthening workouts, balance and stretching games, aerobic exercises and dancing, martial arts, and simulated recreational activities such as golf, skiing, ping-pong, and bowling.

The study of exergames in relation to fitness and health is still in its infancy. But interest is building. In 2011, the American Heart Association (AHA) convened a panel to begin examining how active-play video games might affect health.

A workout like walking

What we know so far from limited research and anecdotes from people who play exergames is that they are far from boot camp when it comes to intensity (see sidebar). They deliver, at best, a moderate workout. Measurements of energy expenditure and heart rate taken after exergaming were much lower than those taken after treadmill jogging (Journal of Physical Activity and Health, May 2010). Because exergaming isn't a vigorously intense activity, it won't help you lose weight or train for a marathon.

Still, many exergames meet the AHA's criteria for "moderate-intensity daily activity." And the rigor of most exergames can be adjusted to your current fitness level. Most exergames can motivate couch potatoes to overcome their inertia because beginner-level activities are not a giant leap from leisure behavior.

Fun, motivation, and money

Exergames are fun, but adults are more likely to consistently play games that include clear instructions, use realistic equipment, and deliver feedback on progress and performance.

If fun alone isn't a sufficient motivator, improvements in balance, muscle tone, and coordination that people report from exergaming are additional incentives to keep playing. And, when played with a group, exergames can generate encouragement and social support that improve a player's psychological state. Finally, early research suggests that exergames may boost mental as well as physical functioning in older adults.

Some fitness and senior centers are now incorporating exergaming into their facilities. For a home system, you'll probably spend about $250 for the basics — console, accessories such as handheld controls or balance board, and software.

Some better than none

"You can become more fit with relatively simple activities, so these games have a lot of potential," says Dr. JoAnne Foody, director of the Cardiovascular Wellness Service at Harvard-affiliated Brigham and Women's Hospital. But Dr. Foody suggests a check-in with your doctor before starting any new physical activity — even something as seemingly tame as an exergame.

With such sparse evidence, it's too early to tell what role exergames will play in health and fitness, especially in people with heart disease or at risk for it. If you experiment with exergaming, don't let it supplant your participation in "real" sports and recreational activities. In terms of energy expended and pure enjoyment, the real things are bound to be more healthful and rewarding than electronic simulations.

Readers, do you have experience, good or otherwise, with exergames? Please tell us about it at heart_letter@hms.harvard.edu.