Silence is golden: effect of encouragement in motivating the weak link in an online exercise video game

Enhancing Skills, Mood, and Performance in Overweight Handball Players: Exploring Individual vs. Collective Verbal Encouragement Strategies

This comparative study investigates the effectiveness of two teaching methods, individual verbal encouragement and collective verbal encouragement, in enhancing the technical-tactical skills and mood state of obese students during handball matches. This study employs a randomized controlled design and involves 28 overweight students (50% females), age: 17.4 ± 2.08 years and BMI: 26.8 ± 1.5 for females and 27.3 ± 2.1 for males. Technical-tactical skills are assessed through performance metrics (individual evaluation proposal by Gréhaigne) such as Ball Played (BP), Conquered Ball (CB), Lost Ball (LB), Shoots/Goals, Conservation index, and defensive index, while mood states are evaluated using pre- and post-tests (BRUMS Scale). Results reveal that individual verbal encouragement significantly enhances technical-tactical skills and positively influences the mood state of overweight students compared to collective verbal encouragement. Boys in Session 1 with VEI displayed a significantly higher number of ball plays (mean difference = 0.94 standard deviations, p = 0.004) and conquered balls (mean difference = 0.78 standard deviations, p = 0.006) compared to VEC. They also had a lower number of Lost Balls (mean difference = -0.62 standard deviations, p = 0.018) and a higher shooting efficiency (Shoots/Goals ratio, mean difference = 0.67 standard deviations; p = 0.013). Similar trends were observed in Session 2, with VEI, again, demonstrating advantages. Girls exhibited analogous improvements with VEI in both sessions. Notably, these performance enhancements coincided with positive emotional changes, with VEI leading to a greater decrease in depression and fatigue scores for both boys and girls. The study highlights the importance of tailoring teaching methods to the specific needs of overweight students in the context of handball, emphasizing the effectiveness of individualized verbal encouragement for skill development and emotional well-being. These findings offer practical implications for educators and coaches involved in physical education, advocating for personalized approaches to optimize learning experiences for overweight students in sports settings.

Effects of the Interactive Features of Virtual Partner on Individual Exercise Level and Exercise Perception

BACKGROUND

We designed an exercise system in which the user is accompanied by a virtual partner (VP) and tested bodyweight squat performance with different interactive VP features to explore the comprehensive impact of these VP features on the individual's exercise level (EL) and exercise perception.

METHODS

This experiment used three interactive features of VP, including body movement (BM), eye gaze (EG), and sports performance (SP), as independent variables, and the exercise level (EL), subjective exercise enjoyment, attitude toward the team formed with the VP, and local muscle fatigue degree of the exerciser as observational indicators. We designed a 2 (with or without VP's BM) × 2 (with or without VP's EG) × 2 (with or without VP's SP) within-participants factorial experiment. A total of 40 college students were invited to complete 320 groups of experiments.

RESULTS

(1) Regarding EL, the main effects of BM and SP were significant (p < 0.001). The pairwise interaction effects of the three independent variables on EL were all significant (p < 0.05). (2) Regarding exercise perception, the main effects of BM (p < 0.001) and EG (p < 0.001) on subjective exercise enjoyment were significant. The main effect of BM on the attitude toward the sports team formed with the VP was significant (p < 0.001). The interaction effect of BM and SP on the attitude toward the sports team formed with the VP was significant (p < 0.001). (3) Regarding the degree of local muscle fatigue, the main effects of BM, EG, and SP and their interaction effects were not significant (p > 0.05).

CONCLUSION

BM and EG from the VP elevate EL and exercise perception during squat exercises, while the VP with SP inhibited the EL and harmed exercise perception. The conclusions of this study can provide references to guide the interactive design of VP-accompanied exercise systems.

Feasibility and Acceptability of an Active Video Game-Based Physical Activity Support Group (Pink Warrior) for Survivors of Breast Cancer: Randomized Controlled Pilot Trial

BACKGROUND

Survivors of breast cancer with functional limitations have a 40% higher mortality rate than those without. Despite the known benefits of physical activity (PA), <40% of survivors of breast cancer meet the recommendations for PA. The combination of active video games (AVGs) and group-based PA counseling may hold potential for motivating PA adoption and improving physical function. However, this method has not been widely studied in survivors of breast cancer.

OBJECTIVE

We aimed to determine the feasibility and acceptability of a group AVG-based multicomponent PA intervention and estimate its effect size and variability on PA and physical function in female survivors of breast cancer in a clinic setting.

METHODS

Female survivors of breast cancer (N=60) were recruited through the clinic and randomly assigned to the intervention group (12 weekly sessions) or the control group (existing support group). The intervention group received game-based pedometers and participated in weekly group AVG sessions, PA behavioral coaching, and survivorship navigation discussions. A participant manual with weekly reflection worksheets was provided to reinforce the coaching lessons and promote self-led PA. The control group received conventional pedometers and participated in an existing breast cancer support group. Feasibility was assessed by enrollment rate (≥50%), retention rate (≥80%), group attendance rate (75% attending ≥9 sessions [intervention group]), and the number of technological issues and adverse events. Acceptability was measured by participants' attitudes (from strongly disagree=1 to strongly agree=5) toward the use of AVGs and the overall program. The outcomes included PA (accelerometers) and physical function (Short Physical Performance Battery and gait speed). Analysis of covariance was used to determine differences in PA and physical function between the groups. The Cohen d and its 95% CI determined the effect size and variability, respectively. All the analyses followed the intention-to-treat principle.

RESULTS

Participants were an average of 57.4 (SD 10.5) years old, 70% (42/60) White, and 58% (35/60) off treatment. The enrollment rate was 55.9% (66/118). Despite substantial long-term hurricane-related disruptions, we achieved an 80% (48/60) retention. The intervention group's attendance rate was 78% (14/18), whereas the control group's attendance rate was 53% (9/17). Of the 26 game-based pedometers, 3 (12%) were damaged or lost. No study-related adverse events occurred. Acceptability items were highly rated. Steps (β=1621.64; P=.01; d=0.72), Short Physical Performance Battery (β=.47; P=.01; d=0.25), and gait speed (β=.12; P=.004; d=0.48) had a significant intervention effect.

CONCLUSIONS

The intervention was feasible and acceptable in this population despite the occurrence of a natural disaster. Pilot results indicate that group AVG sessions, PA coaching, and survivorship navigation produced moderate effects on PA and physical functioning. AVGs with PA counseling can potentially be used in existing breast cancer support groups to encourage PA and improve physical function.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02750241; https://clinicaltrials.gov/ct2/show/NCT02750241.

P-Curve Analysis of the Köhler Motivation Gain Effect in Exercise Settings: A Demonstration of a Novel Technique to Estimate Evidential Value Across Multiple Studies

BACKGROUND

Practitioners and researchers may not always be able to adequately evaluate the evidential value of findings from a series of independent studies. This is partially due to the possibility of inflated effect size estimates for these findings as a result of researcher manipulation or selective reporting of analyses (i.e., p-hacking). In light of the possible overestimation of effect sizes in the literature, the p-curve analysis has been proposed as a worthwhile tool that may help identify bias across a series of studies focused on a single effect. The p-curve analysis provides a measure of the evidential value in the published literature and might highlight p-hacking practices.

PURPOSE

Therefore, the purpose of this paper is to introduce the mechanics of the p-curve analysis to individuals researching phenomena in the psychosocial aspects of behavior and provide a substantive example of a p-curve analysis using findings from a series of studies examining a group dynamic motivation gain paradigm.

METHODS

We performed a p-curve analysis on a sample of 13 studies that examined the Köhler motivation gain effect in exercise settings as a means to instruct readers how to conduct such an analysis on their own.

RESULTS

The p-curve for studies examining the Köhler effect demonstrated evidential value and that this motivation effect is likely not a byproduct of p-hacking. The p-curve analysis is explained, as well as potential limitations of the analysis, interpretation of the results, and other uses where a p-curve analysis could be implemented.

Usage Metrics of Web-Based Interventions Evaluated in Randomized Controlled Trials: Systematic Review

Background

The evaluation of web-based interventions (defined as an intervention that can be downloaded or accessed on the internet through a web browser) in randomized controlled trials (RCTs) has increased over the past two decades. Little is known about how participants’ use of the intervention is measured, reported, and analyzed in these studies.

Objective

This study aimed to review the evaluation of web-based interventions in RCTs, assessing study characteristics and the methods used to record, and adjust for, intervention usage.

Methods

A systematic review of the literature was undertaken to identify all published reports of RCTs that involved a web-based intervention. A random sample of 100 published trials was selected for detailed data extraction. Information on trial characteristics was extracted, including whether web usage data were recorded, and if so, the methods used to gather these data and whether these data were used to inform efficacy analyses.

Results

A PubMed search identified 812 trials of web-based interventions published up to the end of 2017 and demonstrated a growing trend over time. Of the 100 studies reviewed, 90 studies collected web usage data, but more than half (49/90, 54%) of these studies did not state the method used for recording web usage. Only four studies attempted to check on the reliability of their web usage data collection methods. A total of 39% (35/90) studies reported patterns or levels of web intervention use, of which 21% (19/90) studies adjusted for intervention use in their outcome analysis, but only two of these used appropriate statistical methods.

Conclusions

Trialists frequently report a measure of web-based intervention usage but do not always report the collection method or provide enough detail on their analysis of web usage. Appropriate statistical methods to account for intervention use are rarely used and are not well reported even in the very few trials in which they are used. The number of trialists who attempt to check on the reliability of their web usage collection methods is extremely low.

Intergroup Competition in Exergames: Further Tests of the Köhler Effect

OBJECTIVE

We examined how competing with a software-generated partner (SGP) against another human/virtual partner team, in an exercise video game (exergame), affects individual motivation as measured by effort.

MATERIALS AND METHODS

Participants (n = 90; 49 female; Mage = 19.93 ± 1.48) were randomly assigned to one of three conditions: individual control (IC); conjunctive partner, no competition (PNC); or conjunctive partner, with competition (PWC). Participants performed the first series of exercises alone. After resting, those in the partnered conditions performed the remaining trials with a same-sex SGP. Those in the PWC condition were told that they and their virtual partner would be competing against another human-virtual partner team.

RESULTS

A significant motivation gain was observed in both partnered conditions compared to control (P < 0.001), but the partnered groups did not differ significantly. However, participants in the PWC condition enjoyed the task significantly (P < 0.05) more than those in the PNC and IC conditions and the PWC participants identified more with the SGP as a teammate than the PNC participants.

CONCLUSIONS

Altogether, intergroup competition with an SGP may be an enjoyable way to enhance motivation and performance while exercising.

Peer-Based Social Media Features in Behavior Change Interventions: Systematic Review

Background

Incorporating social media features into digital behavior change interventions (DBCIs) has the potential to contribute positively to their success. However, the lack of clear design principles to describe and guide the use of these features in behavioral interventions limits cross-study comparisons of their uses and effects.

Objective

The aim of this study was to provide a systematic review of DBCIs targeting modifiable behavioral risk factors that have included social media features as part of their intervention infrastructure. A taxonomy of social media features is presented to inform the development, description, and evaluation of behavioral interventions.

Methods

Search terms were used in 8 databases to identify DBCIs that incorporated social media features and targeted tobacco smoking, diet and nutrition, physical activities, or alcohol consumption. The screening and review process was performed by 2 independent researchers.

Results

A total of 5264 articles were screened, and 143 articles describing a total of 134 studies were retained for full review. The majority of studies (70%) reported positive outcomes, followed by 28% finding no effects with regard to their respective objectives and hypothesis, and 2% of the studies found that their interventions had negative outcomes. Few studies reported on the association between the inclusion of social media features and intervention effect. A taxonomy of social media features used in behavioral interventions has been presented with 36 social media features organized under 7 high-level categories. The taxonomy has been used to guide the analysis of this review.

Conclusions

Although social media features are commonly included in DBCIs, there is an acute lack of information with respect to their effect on outcomes and a lack of clear guidance to inform the selection process based on the features’ suitability for the different behaviors. The proposed taxonomy along with the set of recommendations included in this review will support future research aimed at isolating and reporting the effects of social media features on DBCIs, cross-study comparisons, and evaluations.

The Psychological Effects of Playing Exergames: A Systematic Review

Successful exergames should lead players not only to achieve enough level of energy expenditure but also to engage in the play itself. The aim of this study is to review studies that explored the psychological effects of playing exergames, from the viewpoint of player engagement. Peer-reviewed journal articles in English collected via database search (Science Direct, Web of Science, ACM Digital Library) from 2011 to 2015 were considered, and 45 experimental studies were selected out of 911 studies. The results show that a variety of psychological effects of engagement including enjoyment, immersion, and flow were measured in the exergame studies. In addition, physiological variables (e.g., energy expenditure), feedback modality (e.g., auditory and tactile), and play modes (e.g., solitary or group play mode) are related to psychological effects of playing exergames. Finally, salient methodological issues (e.g., validated measurement, sample size calculation) in the studies are identified and discussed.

Simulated Partners and Collaborative Exercise (SPACE) to boost motivation for astronauts: study protocol

Background

Astronauts may have difficulty adhering to exercise regimens at vigorous intensity levels during long space missions. Vigorous exercise is important for aerobic and musculoskeletal health during space missions and afterwards. A key impediment to maintaining vigorous exercise is motivation. Finding ways to motivate astronauts to exercise at levels necessary to mitigate reductions in musculoskeletal health and aerobic capacity have not been explored. The focus of Simulated Partners and Collaborative Exercise (SPACE) is to use recently documented motivation gains in task groups to heighten the exercise experience for participants, similar in age and fitness to astronauts, for vigorous exercise over a 6-month exercise regimen. A secondary focus is to determine the most effective features in simulated exercise partners for enhancing enjoyment, self-efficacy, and social connectedness. The aims of the project are to (1) Create software-generated (SG) exercise partners and interface software with a cycle ergometer; (2) Pilot test design features of SG partners within a video exercise game (exergame), and (3) Test whether exercising with an SG partner over 24-week time period, compared to exercising alone, leads to greater work effort, aerobic capacity, muscle strength, exercise adherence, and enhanced psychological parameters.

Methods/Design

This study was approved by the Institutional Review Board (IRB). Chronic exercisers, between the ages 30 and 62, were asked to exercise on a cycle ergometer 6 days per week for 24 weeks using a routine consisting of alternating between moderate-intensity continuous and high-intensity interval sessions. Participants were assigned to one of three conditions: no partner (control), always faster SG partner, or SG partner who was not always faster. Participants were told they could vary cycle ergometer output to increase or decrease intensity during the sessions. Mean change in cycle ergometer power (watts) from the initial continuous and 4 min. interval sessions was the primary dependent variable reflecting work effort. Measures of physiological, strength, and psychological parameters were also taken.

Discussion

This paper describes the rationale, development, and methods of the SPACE exergame. We believe this will be a viable intervention that can be disseminated for astronaut use and adapted for use by other populations.

Development of a Web Exercise Video for Patients With Shoulder Problems

The purpose of this study was to develop a Web video designed to promote regular shoulder joint exercise on a continuous basis among patients with shoulder joint disease. This is a methodological research. A shoulder joint exercise video was developed through the five stages of the ADDIE model: analysis, design, development, implementation, and evaluation. The video demonstrates exercises that stretch and strengthen the joints and muscles of the shoulders. Stretching exercises include the pendulum, forward elevation, outer rotation, crossover arm stretch, inner rotation, and the sleeper; strengthening exercises include dumbbell exercises, a chair exercise, wall push-ups, and rowing. This Web exercise video can be used as an educational resource for preventing shoulder joint diseases by middle-aged and elderly people and those seeking to restore shoulder joint function damaged by shoulder joint diseases.

Enhancing Aerobic Exercise with a Novel Virtual Exercise Buddy Based on the Köhler Effect

OBJECTIVE

Research on active videogames (AVGs) has demonstrated the motivation-boosting power of the Köhler effect (a motivating force for "weak links" in groups based on group principles of upward social comparison and indispensability) with software-generated partners (SGPs), but the effect has yet to be examined over time. We tested the viability of the Köhler effect in an AVG with an SGP over 12 exercise sessions using a cycle ergometer and whether a fatiguing partner (FP) could further boost the effect.

MATERIALS AND METHODS

A repeated-measures design was used to assess mean changes in exercise persistence over time. Participants were randomly assigned to one of three game conditions: AVG alone (individual-control [IC]), AVG with a consistently superior partner (CSP), or AVG with a superior partner who showed signs of fatigue (FP). Assessments were conducted on 82 participants (42 college students and 40 adults from the community) in a laboratory over 12 experimental sessions. The main outcome measure was exercise persistence (minutes of gameplay cycling at 75% HRmax).

RESULTS

Data yielded significant improvements in exercise duration for men in the FP condition when compared with men in the IC condition (Mdiff = 12:32 minutes, SEdiff = 4:54). Women showed no change in exercise persistence over time and no condition differences.

CONCLUSION

Exercising in an AVG with a superior SGP, who shows signs of fatigue over time, improved exercise persistence for men but not for women under present experimental conditions.

The Use of Behavior Change Techniques and Theory in Technologies for Cardiovascular Disease Prevention and Treatment in Adults: A Comprehensive Review

This review examined the use of health behavior change techniques and theory in technology-enabled interventions targeting risk factors and indicators for cardiovascular disease (CVD) prevention and treatment. Articles targeting physical activity, weight loss, smoking cessation and management of hypertension, lipids and blood glucose were sourced from PubMed (November 2010-2015) and coded for use of 1) technology, 2) health behavior change techniques (using the CALO-RE taxonomy), and 3) health behavior theories. Of the 984 articles reviewed, 304 were relevant (240=intervention, 64=review). Twenty-two different technologies were used (M=1.45, SD=+/-0.719). The most frequently used behavior change techniques were self-monitoring and feedback on performance (M=5.4, SD=+/-2.9). Half (52%) of the intervention studies named a theory/model - most frequently Social Cognitive Theory, the Trans-theoretical Model, and the Theory of Planned Behavior/Reasoned Action. To optimize technology-enabled interventions targeting CVD risk factors, integrated behavior change theories that incorporate a variety of evidence-based health behavior change techniques are needed.

Better Together: Outcomes of Cooperation Versus Competition in Social Exergaming

Children and adolescents most often play active videogames, or exergames, in a social environment. Social play may enhance the potential benefits of an exergaming experience, much like group exercise and team sports are observed to improve physical activity-related outcomes above those of solitary exercise. Two ubiquitous elements of exergames are cooperation and competition. Previous literature suggests that cooperative and competitive aspects of exergames may affect physiological and psychosocial changes. Competitive play has been found to increase energy expenditure and aggression in short bouts of exergaming. Cooperative exergaming has been found to increase motivation, promote continued play, enhance self-efficacy, and increase pro-social behaviors. In one study, a cooperative exergaming condition also resulted in significant weight loss for overweight and obese adolescents. Individual player differences such as individual preferences, competitiveness, weight status, age, gender, and ethnicity may moderate effects. Although the current volume of literature on competition and cooperation in exergaming is small, social exergames hold promise as an engaging alternative to traditional physical activity interventions and may promote a broad range of positive outcomes for children and adolescents. Principles of cooperation and competition are applicable for developers of health-promoting games. Future research is needed to further understand the mechanisms of how competition and cooperation in social exergaming impact physiological and psychosocial outcomes.

Cyber Buddy Is Better than No Buddy: A Test of the Köhler Motivation Effect in Exergames

OBJECTIVE

Although exergames are popular, few people take advantage of the potential of group dynamics to motivate play (and achieve associated health benefits). One motivation gain phenomenon has shown promise for motivating greater effort in partnered exergames: The Köhler effect (working at a task with a more capable partner where one's performance is indispensable to the group). This article examines whether a Köhler effect can be demonstrated in an exergame by exercising with a moderately superior humanoid, software-generated partner.

MATERIALS AND METHODS

Male and female (n=120; mean age, 19.41 years) college students completed a series of plank exercises using "CyBuddy Exercise," a program developed specifically for this study. In a lab in an academic building, participants completed the exercises individually and, after a rest, were randomly assigned to complete the same exercises again, but with a "live" human partner (HP) presented virtually, a nearly-human-like, humanoid partner (NHP), a hardly human-like, software-generated partner (HHP), or a no-partner control condition (IC), with equal numbers in each group (i.e., n=30). Exercise persistence, perceived exertion, self-efficacy beliefs, enjoyment, and intentions to exercise were recorded and analyzed.

RESULTS

A 4×2 analysis of variance on the (Block 2 - Block 1) difference scores showed that a significant Köhler motivation gain was observed in all partner conditions (compared with IC), but persistence was significantly greater with HPs than with either NHP or HHP humanoid partners (P<0.05). By the conclusion of the study, there were no significant differences among the partnered conditions in perceived exertion, self-efficacy, enjoyment, or future intentions to exercise.

CONCLUSIONS

These results suggest that a software-generated partner can elicit the Kőhler motivation gain in exergames, but not as strongly as a partner who is thought to be human.