Last minute preparations are for the festive season are frantically being made and Santa Claus is loading his sleigh high with presents. There is a fair chance that at least some of them will contain an ExerGame or two. There have been a lot of ExerGaming products recently launched on the market and they have prompted a spate of letter writing to Mr Claus c/o North Pole.
Overwhelmed by the number of letters that they have received, Santa’s little helpers have turned to the folks from The ExerGaming Network (TEN) for some advice on the various types of ExerGaming currently available. According to these knowledgeable folks there are 5 different types of ExerGames and therefore plenty to keep you going for a long time to come. Santa’s reindeer team have great fun running around from roof to roof and helping him deliver all his presents. It is the same with ExerGaming – it is so engaging and such fun that you hardly noticing you are exercising!
Part of the Quest of writing this blog has involved me “getting in touch” with my creative side. I have ventured into a range of varied experiences with a variety of new forms of art, media and technology. Often these have been a catalyst for novel ideas for ways to tackle some of the social and health problems of society in the 21st century. If you were to ask me what my guiding design principle was it would be:
Make if Fun and Make it Easy
So I have to hand to these guys in managing to successfully make taking the stairs fun.
If you go down to the shopping mall today you might be in for a big surprise! How about a few steps of Machine Dance (Dance Dance Revolution) between purchases? Well coming to a shopping centre near you (in Scotland) is a roadshow for the latest health promotion campaign being run by the Scottish health promotion agency.
There is currently a debate raging on both sides of the Atlantic as to the future provision of healthcare treatment and whether or not it should be public or private or some combination of the two. By in large the debate is in fact about “sick service” i.e. a service for when you are sick and what is missing is any consideration of a genuine “health service” that has prevention (rather than cure) as its primary aim.
With regard to a treatment (cure) service I am still waiting for a national debate to take place here in the UK as to what treatments (say treatments A,B&C) are part of the system and guaranteed to everybody no matter where you live, thereby ending the current post-code lottery. Those treatments (say treatments X,Y&Z) which are deemed/agreed to be unaffordable by the system will require alternative arrangements if you wish to access them.
All this however is going to become somewhat academic if current trends in the prevalence of so called “lifestyle” diseases as they will ultimately overwhelm the current “sick service” in whatever form it takes. Clearly there is a need for the right form of long-term incentives for both the public and health care providers to invest in preventative measures.
It was somewhat ironic that in the Sunday Times last week not only was there coverage of the debate entitled “USA versus the NHS” but on the previous page there was an article lambasting local government councils for failing to support businesses through the recession and instead spending money on “Nanny State Jobs“.
When you get in to the body of the piece you see that the examples given of these so called “nanny state jobs” are all in one way or other connected with trying to get people to become physically active and to eat more healthily. You can’t have it both ways. People have to wake up and take responsibility and realize that good health is going to cost money for prevention and/or cure. Whilst prevention requires significant upfront investment, it is going to be cheaper and more importantly sustainable in the long-term.
A recent article published in Time Magazine tends to give the impression that exercise or “working out” won’t result in weight loss. It has created a bit of a stir and has been rebuffed by a press release from the American College of Sports Medicine. There is a substantial body of evidence to support the importance of exercise in the expenditure side of the energy balance side of the equation and it has recently be reviewed by the said ACSM in a position paper.
In contrast there is no denying the real life experiences of a significant number of people who started working out with a view to loosing weight with little or no success. So what is the problem? In my view it is part due to the gap between theory and practice and the desire for “quick fix” solutions.
The health benefits of exercise began to be widely promoted in the late 1980’s in response to increasing prevalence of heart disease, hence the concept of intense “cardio” exercise and the mantra of “20 minutes intense exercise three times per week”. Then in the 1990’s along came the obesity epidemic and the focus shifted from exercise intensity to energy expenditure and a new mantra of “30 minutes physical activity most days”. Unfortunately these messages have “stuck” and become widely popularized however they are in fact minimum recommendations and not a license for “all you can eat”.
It is worth reflecting at this point how unrecognizable our modern lifestyles would be to rest of human history. Life in the developed world is almost as sedentary as it can get. Our 24/7 lifestyles feature a ready availability of abundant refined, calorie dense food, temperature control, artificial lighting, psychological stress, sleep-deprivation etc. etc. and we are pushing ourselves to the limit and beyond.
Thus whilst research indicates that in theory we should aim for a daily 500 calorie deficit in order to loose weight all the time we are fighting against ourselves. Even the very term “workout” is overloaded with negative connotations. It is no wonder as the author of the Time Magazine article points out that people feel the need to “reward” their efforts with a calorie laden treat.
Trying to achieve a 500 calorie deficit against a starting point of a daily energy intake of 1500-2000 calories doesn’t leave any room for error and it is therefore critical to have a healthy and nutritious calorie-controlled diet.
If we were to wind back the clock in time and double our daily energy expenditure to 3500-4000 calories per day and become significantly more physically active, then the energy intake side of the equation would become much less of a problem. Indeed, the notion that significantly greater amounts of exercise are need in order to ensure a consistent negative energy balance is supported by a recent ACSM position paper that concludes that greater than 250 minutes exercise per week are needed to effectively promote weight loss.
So the bottom line is that you need to find forms of physical activity that you find enjoyable and that you are able to perform for significantly longer periods of time than for traditional “workouts”. If the activity it in itself rewarding then you won’t need to indulge yourself with calories afterwards. Games are inherently motivating and rewarding. So game-based approaches to exercise (i.e. ExerGames) might have significant potential to make you thin.
This prototype game from my ISAGA 2009 interactive session was focused on a game intended to help people to quit smoking. It required an additional piece of hardware in the form of a portable sensor that could interface with a mobile phone which could measure the “air quality” of the smoker’s breath. (In fact a handheld carbon monoxide meter is routinely used as a easy measure of cigarette usage in a cessation counseling setting).
Regular breath measurements would be taken over time and the data uploaded to a server via a mobile data network. A particular breath reading would be indicative of a certain level of cigarette consumption and can be expressed in terms of number of minutes of life lost (or in case of a reduction) “gained” or added to the player’s life expectancy. It might even be possible to relate it to people around the smoker (e.g. children) who maybe affected by passive smoking.
The game play would be arranged in forms of leagues with the aim of achieving the highest number of minutes gained. Further consideration as to the nature of the process of quitting smoking lead to the idea that the teams would be comprised of individuals at different stages/length of experience in the cessation process and that it was possible to score points by means of offering tips and advice to other “players”. It would also be possible to score points by recruiting new “players” to the game and also by developing a form of “buddy” system whereby a fraction of the points earned by any recruit would also contribute to the score of the person recruiting them.
At this point I have to apologize for the lack of updates from the Games from Health conference. A severe network connectivity problem was an obstacle that I just could not overcome. Furthermore, a lack of sleep on my return journey coupled with jet-lag resulted in a lack of clarity of thought for several days. Having said that, I am now beginning to feel somewhat more normal now. Just one small issue – I am off to Lisbon, Portugal tomorrow morning to see if health promotion researchers have anything to say about smart applications of technology to promote positive behavior change – I will keep you posted.
Overall, I found the Games for Health conference quietly reassuring. There was not the excitement and novelty that I experienced last year, but instead a real willingness to ask questions and to seek answers. In addition, there was a real sense that whatever “ExerGaming” is and for that matter whatever “Games for Health” are, they are much bigger phenomena than they first seemed. In fact it appears that we know even less about them than was first apparent, but at least now people are beginning to ask searching questions and are beginning to undertake significant exploration. To me this would suggest a growing maturity of the field and bodes well for the future.
Yesterday’s Games Accessibility was a truly inspiring workshop yesterday and it is encouraging to hear that an ever increasing range of tools (software and hardware) are now available to help make games accessible. The benefits of making games accessible are far ranging from improving motor coordination through to socialization.
I was rather nervous about my own session and it was both somewhat “techie” and I was worried that I might be out of my depth and also that it included several live demos. I am happy (and relieved) to report that it went without a hitch. I will post a few pictures from the event as soon as I receive them.
Early start this morning in order to keep a date for some exercise. The warm up was a conventional 2 mile run with a short sharp hill at the end with a few puddles to avoid along the way. The gym at Sunny, Cortland had just taken delivery of a couple of Virtual Reality (VR) Cycling bikes (Espresso) so I just had to give one a try out. Indeed it was rather a fitting warm up to the Games for Health 2009 conference as I was about to catch a plane to Boston later in the morning.
After adjusting the bike to fit my frame, it was time to choose a course. A 5 mile mountain climb was selected on which to challenge my (real) training partner.
Off we went. It took a short while to get used to the gear changes (one button press to go up a gear another to go down). As the course was a mountain climb it was important to anticipate the changes in gradient and adjust the gears accordingly. The graphical rendering of the road wasn’t perhaps as good as it could be therefore you had to keep an eye on the course profile in order to clearly see the gradient changes coming.
I managed to keep a steady 95-100 rpm going in order to maximize my efficiency. My power output averaged 200-210 W and my heart rate was between 150-160 bpm. Only when it got really steep did I my legs start to burn. Rarely was I aware of my breathing. I completed the course in 20 minutes and I can honestly say that the engaging and immersive nature (including the steering to avoid other races and the precipitous edge of the road) of the game meant that I was almost completely distracted from the stress that was being placed on my body.
Overall it was a great ExerGaming experience and one I look forward to repeating soon.
