Promoting Daily Physical Activity by Means of Mobile Gaming: A Review of the State of the Art

Abstract

Objectives:

To review mobile games and gaming applications that claim to improve physical activity behavior in daily life.

Search Methods:

We searched PubMed, Web of Science, and the ACM Digital Library and performed a manual search of relevant journals and reference lists. Studies that reported on a mobile game that requires players to perform physical activity in daily life and where the game has specific goals, rules, and feedback mechanisms were included. This excludes non-mobile exergames. Theoretical foundations, game characteristics, and evaluation methodologies were assessed.

Results:

In total, 797 articles were identified through the search, of which 11 articles were included. The reviewed studies show that there is limited theoretical foundation for the game development, and most studies used goal setting as a motivation strategy to engage people in playing the game. There was a large variety in game characteristics found, although the majority of the studies used metaphors or avatars to visualize activity, whereas feedback was mostly provided in relation to the goal. Rewards and competition were the most commonly incorporated game elements. The evaluations were focused on feasibility, and clinical evidence is lacking with only two randomized controlled studies found.

Conclusions:

This review provides a first overview of mobile gaming applications to promote daily life physical activity and shows this as a new research area with demonstration of its acceptability and feasibility among the users. Clinical effectiveness and the added value of gaming in changing daily activity behavior have by far not yet been established.

Get full access to this article

View all access options for this article.

References

Kohl

, Craig

, Lambert

, et al. The pandemic of physical inactivity: Global action for public health. Lancet, 2012; 380:294–305.

Lee

, Shiroma

, Lobelo

, et al. Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet, 2012; 380:219–229.

Sjöström

, Oja

, Hagströmer

, et al. Health-enhancing physical activity across European Union countries: The Eurobarometer study. J Public Health, 2006; 14:291–300.

Hillsdon

, Foster

, Thorogood

. Interventions for promoting physical activity. Cochrane Database Syst Rev, 2005; (1):CD003180.

Conn

, Hafdahl

, Mehr

. Interventions to increase physical activity among healthy adults: Meta-analysis of outcomes. Am J Public Health, 2011; 101:751–758.

Prochaska

, diClemente

. Toward a comprehensive model of change. Appl Clinical Psychol, 1986; 13:3–27.

Fanning

, Mullen

, McAuley

. Increasing physical activity with mobile devices: A meta-analysis. J Med Internet Res, 2012; 14:e161.

Free

, Phillips

, Galli

, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: A systematic review. PLoS Med, 2013; 10:e1001362.

van Weering

, Vollenbroek-Hutten

, Hermens

. Do personalized feedback messages about activity patterns stimulate patients with chronic low back pain to change their activity behavior on a short term notice?. Appl Psychophysiol Biofeedback, 2012; 37:81–89.

10.

Evering

RMH

. Ambulatory feedback at daily physical activity patterns—A treatment for the chronic fatigue syndrome in the home environment? [PhD thesis Number 30]. Enschede, The Netherlands: Roessingh Research and Development; 2013.

11.

Tabak

, op den Akker

, Hermens

. Motivational cues as real-time feedback for changing daily activity behavior of patients with COPD. Patient Educ Couns, 2014; 94:372–378.

12.

Tabak

, Vollenbroek-Hutten

MMR

, Van der Valk

PDLPM

, et al. A telerehabilitation intervention for patients with COPD: A randomized controlled pilot trial. Clin Rehabil, 2014; 28:582–591.

13.

Huis in 't Veld

, Kosterink

, Barbe

, et al. Relation between patient satisfaction, compliance and the clinical benefit of a teletreatment application for chronic pain. J Telemed Telecare, 2010; 16:322–328.

14.

Lange

, Flynn

, Rizzo

. Game-based telerehabilitation. Eur J Phys Rehabil Med, 2009; 45:143–151.

15.

Taylor

, McCormick

, Shawis

, et al. Activity-promoting gaming systems in exercise and rehabilitation. J Rehabil Res Dev, 2011; 48:1171–1186.

16.

Harjumaa

, Segerståhl

, Oinas-Kukkonen

. Understanding persuasive software functionality in practice: A field trial of polar FT60. Presented at the 4th International Conference on Persuasive Technology (Persuasive '09), Claremont, CA, April 26–29, 2009.

17.

Consolvo

, Everitt

, Smith

, Landay

. Design requirements for technologies that encourage physical activity. Presented at the SIGCHI Conference on Human Factors in Computing Systems (CHI '06), Montréal, QC, Canada, April 22–27, 2006.

18.

McGonigal

. Reality Is Broken: Why Games Make Us Better and How They Can Change the World. New York: Penguin Press; 2011.

19.

Reeves

, Read

. Total Engagement: Using Games and Virtual Worlds to Change the Way People Work and Business Compete. Boston: Harvard Business School Press; 2009.

20.

Dunwell

, de Freitas

, Jarvis

. Four-dimensional consideration of feedback in serious games. In: de Freitas

, Maharg

, eds. Digital Games and Learning. London: Continuum Publishing; 2011: pp. 42–62.

21.

Rogers

. Client-Centered Therapy: Its Current Practice, Implications and Theory. London: Constable; 1951.

22.

DeChant

, Tohme

, Mun

, et al. Health systems evaluation of telemedicine: A staged approach. Telemed J, 1996; 2:303–312.

23.

Ahtinen

, Huuskonen

, Häkkilä

. Let's all get up and walk to the North Pole: Design and evaluation of a mobile wellness application. In: Proceedings of the 6th Nordic Conference on Human-Computer Interaction: Extending Boundaries (NordiCHI '10). Reykjavik, Iceland: ACM; 2010: pp. 3–12.

24.

Bielik

, Tomlein

, Krátky

, et al. Move2Play: An innovative approach to encouraging people to be more physically active. Presented at the 2nd ACM SIGHIT International Health Informatics Symposium (IHI '12), Miami, FL, January 28–30, 2012.

25.

Fujiki

, Kazakos

, Puri

, et al. NEAT-o-games: Blending physical activity and fun in the daily routine. ACM Comput Entertain, 2008; 6:21.

26.

Jensen

, Krishnasamy

, Selvadurai

. Studying PH.A.N.T.O.M. in the wild: A pervasive persuasive game for daily physical activity. Presented at OzCHI 2010, Brisbane, Australia, November 22–26, 2010.

27.

Lin

, Mamykina

, Lindtner

, et al. Fish'n’Steps: Encouraging physical activity with an interactive computer game. Presented at UbiComp 2006: The Eighth International Conference on Ubiquitous Computing, Newport Beach, Orange County, CA, September 17–21, 2006.

28.

Munson

, Consolvo

. Exploring goal-setting, rewards, self-monitoring, and sharing to motivate physical activity. Presented at the 6th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth), San Diego, CA, May 21–24, 2012.

29.

Rodríguez

, Roa

, Morán

, Nava-Muñoz

. CAMMInA: A mobile ambient information system to motivate elders to exercise. Pers Ubiquit Comput, 2013; 17:1127–1134.

30.

Stanley

, Pinelle

, Bandurka

, et al. Integrating cumulative context into computer games. Presented at FuturePlay 2008, Toronto, ON, Canada, November 3–5, 2008.

31.

Walsh

, Golbeck

. StepCity: A preliminary investigation of a personal informatics-based social game on behavior change. In: CHI '14 Extended Abstracts on Human Factors in Computing Systems. Toronto: ACM; 2014: pp. 2371–2376.

32.

, Shehan Poole

, Miller

, et al. Designing pervasive health games for sustainability, adaptability and sociability. Presented at the International Conference on the Foundations of Digital Games (FDG '12), Raleigh, NC, May 29–June 1, 2012.

33.

Zuckerman

, Gal-Oz

. Deconstructing gamification: Evaluating the effectiveness of continuous measurement, virtual rewards, and social comparison for promoting physical activity. Pers Ubiquit Comput, 2014; 18:1705–1719.

34.

Sallis

, Owen

, Fisher

. Ecological models of health behavior. In: Glanz

, Rimer

, Viswanath

, eds. Health Behavior and Health Education: Theory, Research, and Practice, 4th ed. San Francisco, Jossey-Bass; 2008: pp. 465–486.

35.

Fogg

. A behavior model for persuasive design. In: Proceedings of the 4th International Conference on Persuasive Technology. Claremont, CA: ACM; 2009: pp. 1–7.

36.

Locke

, Latham

. Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. Am Psychol, 2002; 57:705–717.

37.

Festinger

. A theory of social comparison processes. Hum Relat, 1954; 108:117–140.

38.

Shegog

. Application of behavioral theory in computer game design for health behavior change. In: Cannon-Bowers

, Bowers

, eds. Serious Game Design and Development. New York: IGI Global; 2010; pp. 196–232.

39.

Noar

, Benac

, Harris

. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull, 2007; 133:673–693.

40.

Baranowski

, Buday

, Thompson

, et al. Developing games for health behavior change: Getting started. Games Health J, 2013; 2:183–190.

41.

Achterkamp

, Dekker-Van Weering

MGH

, Evering

RMH

, et al. Strategies to improve adherence to coaching systems in telemedicine: Development of personas for providing tailored feedback. Manuscript submitted for publication, Informatics for Health and Social Care, 2015.

42.

Consolvo

, Klasnja

, McDonald

, Landay

. Goal-setting considerations for persuasive technologies that encourage physical activity. In: Proceedings of the 4th International Conference on Persuasive Technology. Claremont, CA: ACM; 2009: pp. 1–8.

43.

Albaina

, Visser

, van der Mast

CAPG

, Vastenburg

. Flowie: A persuasive virtual coach to motivate elderly individuals to walk. Presented at Pervasive Health2009, London, United Kingdom, April 1–3, 2009.

44.

Consolvo

, McDonald

, Toscos

, et al. Activity sensing in the wild: A field trial of UbiFit garden. Paper presented at CHI 2008, Florence, Italy, April 5–10, 2008.

45.

McMahon

, Vankipuram

, Fleury

. Mobile computer application for promoting physical activity. J Gerontol Nurs, 2013; 39:15–20.

46.

Fan

, Forlizzi

, Dey

. Considerations for technology that support physical activity by older adults. In: Proceedings of the 14th International ACM SIGACCESS Conference on Computers and Accessibility. Boulder, CO: ACM; 2012: pp. 33–40.

47.

Anderson

, Maitland

, Sherwood

, et al. Shakra: Tracking and sharing daily activity levels with unaugmented mobile phones. Mob Netw Appl, 2007; 12:185–199.

48.

Consolvo

, Everitt

, Smith

, Landay

. Design requirements for technologies that encourage physical activity. Presented at the SIGCHI Conference on Human Factors in Computing Systems (CHI 2006), April 24–27, 2006.

49.

Zombies Run!

2015. zombiesrungame.com (accessed July 20, 2015).