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Exergaming may be an important option to support an active lifestyle, especially during pandemics.
Our objectives were (1) to explore whether change in exergaming status (stopped, started or sustained exergaming, or never exergamed) from before to during the COVID-19 pandemic was related to changes in walking, moderate-to-vigorous physical activity (MVPA) or meeting MVPA guidelines and (2) to describe changes among past-year exergamers in minutes per week exergaming from before to during the pandemic.
A total of 681 participants (mean age 33.6; SD 0.5 years; n=280, 41% male) from the 22-year Nicotine Dependence in Teens (NDIT) study provided data on walking, MVPA, and exergaming before (2017 to 2020) and during (2021) the COVID-19 pandemic. Physical activity (PA) change scores were described by change in exergaming status.
We found that 62.4% (n=425) of the 681 participants never exergamed, 8.2% (n=56) started exergaming during the pandemic, 19.7% (n=134) stopped exergaming, and 9.7% (n=66) sustained exergaming. Declines were observed in all 3 PA indicators in all 4 exergaming groups. The more salient findings were that (1) participants who started exergaming during COVID-19 reported the highest MVPA levels before and during the pandemic and declined the least (mean –35 minutes/week), (2) sustained exergamers reported the lowest MVPA levels during the pandemic (median 66 minutes/week) and declined the most in MVPA (mean change of –92 minutes/week) and in meeting MVPA guidelines (–23.6%). During the pandemic, starting exergamers reported 85 minutes of exergaming per week and sustained exergamers increased exergaming by a median 60 minutes per week.
Although starting and sustaining exergaming did not appear to help exergamers maintain prepandemic PA levels, exergaming can contribute a substantial proportion of total PA in young adults and may still represent a useful option to promote PA during pandemics.
Many studies conducted early on during the COVID-19 pandemic suggest widespread decreases in physical activity (PA) related to public health lockdowns and restrictions [
A review on PA during COVID-19 suggested that “positive technology” (defined as a “scientific and applied approach to the use of technology for improving the quality of our personal experience”) [
Exergaming (or active video gaming), one form of positive technology that engages users in PA, can be played using gaming consoles, mobile devices, virtual reality, personal computers, and specific types of exercise equipment (eg, stationary bikes and treadmills with interactive screens) [
Before the COVID-19 pandemic, the prevalence of weekly exergaming among adolescents and young adults ranged from 18% to 43% in Canada [
The objectives of this study were to (1) explore whether a change in exergaming status (stopped, started or sustained exergaming, or never exergamed) from before to during the COVID-19 pandemic related to changes in walking, minutes of moderate-to-vigorous physical activity (MVPA), and meeting MVPA guidelines. We were particularly interested in ascertaining whether starting to exergame or sustaining exergaming were associated with maintaining pre–COVID-19 PA levels of walking, MVPA, or meeting MVPA guidelines. We also aimed to (2) describe changes in minutes of exergaming per week among past-year exergamers from before to during the COVID-19 pandemic.
Data were drawn from the Nicotine Dependence in Teens (NDIT) study [
The study procedures were approved by the Montreal Department of Public Health Ethics Review Committee (2007–2384), the McGill University Faculty of Medicine Institutional Review Board (2017–6895), and the Ethics Research Committee of the Centre de Recherche du Centre Hospitalier de l’Université de Montréal (2021-9385, 20.278-YP). Parental consent was obtained at NDIT inception. Participants could legally provide consent in the post–high school data collections because they had all attained the age of 18 years.
Data on number of minutes per week walking, moderate physical activity, and vigorous physical activity were collected using the short form of the International Physical Activity Questionnaire (IPAQ-SF) [
Number of MVPA minutes per week was calculated by adding the number of moderate PA minutes per week and number of vigorous PA minutes per week.
Participants were categorized as meeting MVPA guidelines (yes or no) if they had engaged in MVPA for ≥150 minutes per week [
Using data from cycles 23 and 24, participants were categorized into 4 groups based on their exergaming behavior over time using the following item: “In the past 12 months, how often did you exergame using consoles, or using your cellphone and/or a mobile app?” Response choices included never, less than once a month, 1 to 3 times a month, 1 to 6 times per week, and every day. In both cycles 23 and 24, participants were categorized as exergamers if they chose any response option other than “never.” The four groups included (1) never-exergamers (ie, participants who did not report exergaming in cycles 23 or 24); (2) stopping exergamers (ie, participants who reported exergaming in cycle 23 but not in cycle 24); (3) starting exergamers (ie, participants who reported exergaming in cycle 24 but not in cycle 23); and (4) sustaining exergamers (ie, participants who exergamed in both cycles 23 and 24).
Items measuring the number of minutes exergaming per week were modeled on the IPAQ-SF [
Usual intensity of exergaming was measured by the following question: “What was your usual physical effort during play?” Response choices included light, moderate, and vigorous.
Sociodemographic characteristics included age, sex, whether the participant was university educated (yes or no), whether their mother was university educated (yes or no), and whether they were French speaking (yes or no), were born in Canada (yes or no), had an annual household income <CAN $50,000 (US $36,966; yes or no), lived alone (yes or no), lived with children (yes or no), and were employed (yes or no).
Descriptive statistics were used to compare sociodemographic and PA-related characteristics (ie, walking, MVPA, and exergaming) of participants retained in the analytic sample (ie, those who provided data in cycles 23 and 24) versus not retained (ie, those who provided data in cycle 23 but not cycle 24). Based on skewness and kurtosis, walking, MVPA, and exergaming minutes per week were not normally distributed. Therefore, the median (IQR) is reported for these variables. The proportion of participants that met MVPA guidelines is reported as a percentage.
Change scores were computed by subtracting number of minutes per week for each PA indicator (including exergaming) in cycle 23 from minutes per week in cycle 24. Because the distributions for the change scores were relatively normal in each of the 4 groups defined by exergaming status as well as in the sample overall, we report mean (SD) change scores. We report the median (IQR) for the change in minutes exergaming per week because the data were not normally distributed. Data were analyzed using SPSS (version 20.0; IBM Corp).
The mean age of the 681 participants retained for analysis was 33.6 (SD 0.5) years in cycle 24; 41% (n=280) were male, 95% (n=647) were born in Canada, 33% (n=225) were French speaking, 21% (n=143) had an annual household income of <CAN $50,000 (US $36,966), 15% (n=102) lived alone, 51% (n=347) lived with children, 83% (n=565) reported being employed, and 36% (n=245) met MVPA guidelines. The median (IQR) minutes per week during COVID-19 was 120 (45-240) for walking and 80 (0-240) for MVPA. Participants who exergamed during COVID-19 (n=122) reported a median (IQR) of 80 (9-240) minutes of exergaming per week.
Of 681 participants retained for analysis, 425 (62.4%) were never-exergamers, 56 (8.2%) started exergaming in cycle 24 (during the pandemic), 134 (19.7%) stopped exergaming in cycle 24, and 66 (9.7%) sustained exergaming. Among the 200 exergamers in cycle 23, 66 (33%) sustained exergaming in cycle 24, and 134 (67%) stopped exergaming.
The data suggest declines over time in all 3 PA indicators in the sample overall (
Characteristics of participants retained and not retained for analysis from the Nicotine Dependence in Teens study (Montreal, Quebec, 2017-2021). Data were drawn from cycle 23a.
Characteristicsb | Total (n=799) | Retained in cycle 24 (n=681) | Not retained in cycle 24 (n=118) |
Age (years), mean (SD) | 30.6 (1.0) | 30.5 (1.0) | 31.0 (1.1) |
Male, n (%) | 351 (43.9) | 280 (41.1) | 71 (60.2) |
Born in Canada, n (%) | 799 (93.7) | 642 (94.3) | 107 (90.7) |
Mother is university educated, n (%) | 332 (46.2) | 283 (45.6) | 49 (50) |
French speaking, n (%) | 245 (30.7) | 199 (29.2) | 46 (39) |
Walking (minutes/week), median (IQR) | 175(60-350) | 175 (60-350) | 200 (70-420) |
MVPAc (minutes/week), median (IQR) | 135 (0-330) | 135 (0-303) | 180 (20-450) |
Met MVPA guidelines, n (%) | 387 (49.5) | 326 (48.9) | 61 (53) |
Exergaming (minutes/week), median (IQR)c | 0 (0-0) | 0 (0-0) | 0 (0-83) |
aTotals may differ due to missing data.
bIncludes only past-year exergamers.
cMVPA: moderate-to-vigorous physical activity.
Number of minutes walking per week, number of minutes engaged in moderate-to-vigorous physical activity per week, and percentage of participants who met moderate-to-vigorous physical activity guidelines from before to during the COVID-19 pandemic in 4 groups defined by consistency in exergaming behavior over time (Nicotine Dependence in Teens study, Montreal, Canada, 2017-2021)a.
|
Before COVID-19 (cycle 23b) | During COVID-19 (cycle 24c) | Change between cycles 23 and 24 | ||||
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|||||||
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Overall (n=681) | 175 (60-350) | 120 (45-240) | –58 (310)d | |||
|
Never exergamed (n=424) | 175 (60-315) | 120 (45-240) | –48 (298)d | |||
|
Started exergaming (n=56) | 163 (90-420) | 195 (40-420) | –38 (372)d | |||
|
Stopped exergaming (n=134) | 178 (88-420) | 120 (60-210) | –97 (279)d | |||
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Sustained exergaming (n=66) | 140 (30-258) | 90 (40-188) | –56 (380)d | |||
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Overall (n=681) | 130 (0-310) | 80 (0-240) | –49 (342)d | |||
|
Never exergamed (n=424) | 120 (0-300) | 80 (0-240) | –41 (336)d | |||
|
Started exergaming (n=56) | 210 (40-420) | 90 (4-394) | –35 (395)d | |||
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Stopped exergaming (n=134) | 180 (41-360) | 80 (0-275) | –58 (306)d | |||
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Sustained exergaming (n=66) | 180 (0-360) | 66 (0-221) | –92 (405)d | |||
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Overall (n=681) | 326 (48.3) | 245 (36) | –12.3f | |||
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Never exergamed (n=424) | 186 (44.8) | 155 (36.6) | –8.2f | |||
|
Started exergaming (n=56) | 31 (57.1) | 21 (37.5) | –19.6f | |||
|
Stopped exergaming (n=134) | 74 (55.6) | 48 (35.8) | –19.8f | |||
|
Sustained exergaming (n=66) | 35 (55.4) | 21 (31.8) | –23.6f |
aTotals may differ due to missing data.
bData were collected from January 2017 to March 2020 (mean age 30.6 years).
cData were collected from December 2020 to June 2021 (mean age 33.6 years).
dThese values are the mean (SD), since the change scores were normally distributed.
eMVPA: moderate-to-vigorous physical activity.
fThese values represent the absolute decline in percentage.
Among the 4 groups defined by exergaming status, patterns of interest in walking from before to during COVID-19 (
Patterns of interest in MVPA in the 4 exergaming status groups (
Compared to the other 3 groups, a higher proportion of participants who started to exergame during the COVID-19 pandemic met MVPA guidelines both before and during the COVID-19 pandemic. Although the proportion of sustained exergamers that met MVPA guidelines was similar to the other 2 exergaming groups before COVID-19, this group reported the lowest proportion during COVID-19 and the largest decline over time (–23.6%). The proportion of participants that met MVPA guidelines was lowest among never-exergamers before COVID-19 (186/424, 44.8%), and this group had the lowest decline over time (–8.2%).
Number of minutes per week engaged in exergaming before and during the COVID-19 pandemic in groups defined by consistency in exergaming behavior over time (Nicotine Dependence in Teens study, Montreal, Quebec, 2017-2021).
|
Exergaming (minutes/week), median (IQR) | ||
|
Before COVID-19 (cycle 23a) | During COVID-19 (cycle 24b) | Change between cycles 23 and 24 |
Started exergaming (n=56) | 0 (0 to 0) | 85 (0 to 240) | 85 (0 to 240) |
Stopped exergaming (n=134) | 0 (0 to 0)c | 0 (0 to 0) | 0 (0 to 0) |
Sustained exergaming (n=66) | 0 (0 to 63)c | 68 (14 to 229) | 60 (–4 to 188) |
aData were collected from January 2017 to March 2020 (mean age 30.6 years).
bData were collected from December 2020 to June 2021 (mean age 33.6 years).
cParticipants who reported past-year exergaming but 0 minutes exergaming in the past 30 days were assigned a score of 0 minutes exergaming per week.
Overall, the percentage of participants meeting MVPA guidelines, the number of minutes walked, and the number of minutes engaged in MVPA per week declined from before to during the pandemic regardless of exergaming status [
Never-exergamers reported declines of 48 minutes per week in walking and 41 minutes per week in MVPA from before to during the COVID-19 pandemic. Of the 4 exergaming groups studied, never-exergamers reported the lowest levels of MVPA and were least likely to meet MVPA guidelines before the pandemic. The relatively minor changes in PA in this group during COVID-19 may reflect a general disinterest in PA (so that closure of gyms and recreational centers during the pandemic made little difference to their PA levels). It is possible that level of motivation for PA remained low among these individuals during the pandemic, such that they did not benefit from any increases in time available for PA due to containment measures. It is also possible that this group had established (lower) PA levels and patterns that they were content with and that they felt little need to explore different ways of building PA into their routines, regardless of the pandemic context.
Among the 4 groups defined by exergaming status, those who stopped exergaming declined the most in walking (–97 minutes/week) from before to during the COVID-19 pandemic. Although stopping exergaming in this group was possibly related to COVID-19, the middle to early 30s is often a turbulent time during the life course marked by numerous important transitions as people complete their education, enter the workforce, and begin their own families [
Of the 4 exergaming groups, sustained exergamers reported the lowest levels of walking both before and during the pandemic and the lowest levels of MVPA during the pandemic. Previous research suggests that although exergamers do not necessarily have higher PA levels than never-exergamers and may not be interested in traditional PA, they do understand the importance of movement and turn to exergaming for their PA [
Sustained exergamers reported a median of 68 minutes per week of exergaming, an important contribution to overall PA. Exergaming is not usually dependent on fitness or recreational facilities outside the home; therefore, this group may not have been overly affected by pandemic-related lockdowns. While the change in walking levels among sustained exergamers was not as marked as among those who stopped exergaming, their decline in MVPA was substantial (–92 minutes per week). It is possible that sustained exergamers participated in other modes of PA before the pandemic that were not replaced during the pandemic. Minutes exergaming per week among sustained exergamers did increase (as also reported in the Ellis et al study), but this was not enough to replace MVPA lost in other PA modes.
Of the 4 exergaming groups, those who started exergaming during the pandemic reported the highest MVPA levels before the pandemic (210 minutes/week) and the smallest decrease in MVPA (–35 minutes/week) during the pandemic. This group may have started using exergaming to compensate for activities they could no longer participate in during COVID-19. In addition to compensating for the loss of PA during the pandemic, video games may have helped with the loss of social interactions, which might have been a particularly salient loss in this group [
More research is needed to examine fluctuations in exergaming behaviors over time, especially during such challenging times as COVID-19. Qualitative research may help identify reasons for stopping, starting, or continuing to exergame during pandemics. This study did not identify types of exergaming engaged in, who participants exergamed with, or the context (ie, indoors or outdoors) in which they exergamed. These areas could be important avenues to explore to better inform recommendations for starting exergaming or for maintaining previous levels of exergaming during pandemics, as well as in general.
Limitations of this study include that self-report IPAQ-SF data are subject to overreporting, although Lee et al [
Although it may support PA at home during periods of confinement, starting or sustaining exergaming did not appear to be enough to maintain prepandemic PA levels in this population-based sample of young adults. However, the data suggest that exergaming can contribute a substantial proportion of total PA in young adults and may still represent a useful option to promote PA during pandemics.
International Physical Activity Questionnaire–Short Form
moderate-to-vigorous physical activity
Nicotine Dependence in Teens
physical activity
World Health Organization
The Nicotine Dependence in Teens study was supported by the Canadian Cancer Society (grants 010271, 017435, and 704031) and the Canadian Institutes of Health Research (grant 451832). RHO holds a Sciences and Humanities Research Council of Canada (SSHRC) Canada Graduate Scholarships—Doctoral Program (CGS-D) (#767-2022-0015). The funders were not involved in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
EKO is the first author of the manuscript and conducted all analyses and data verifications. EKO, CMS, RHO, MB, MPS, and JLO drafted and revised the manuscript. JLO designed and acquired the funding for the Nicotine Dependence in Teens study, and JLO, MPS, and MB acquired the funding for the COVID-19 data collection. All authors contributed to the interpretation of results and read and approved the final manuscript. EKO holds a postdoctoral salary award from the Fonds de Recherche du Québec-Santé (FRQ-S). CS holds a Canada Research Chair in physical activity and mental health. MPS holds a J2 Salary award from the FRQ-S. JLO held a Canada Research Chair in the Early Determinants of Adult Chronic Disease from 2004 to 2021.
None declared.