Game On!

by Biray Alsac, MS on Feb 02, 2009

Ex Rx

How to incorporate video games into a client’s workout.

With the commercial successes of Nintendo® Wii and Dance, Dance Revolution® video games, the merging of gaming with exercise has proved a winning combination.

While exergames (part exercise, part video game) appeal to both video gamers and those looking for alternatives to traditional exercise, they also target unfit, sedentary and often “hard-to-reach” individuals. Schools are integrating exergames into their physical education programs, community centers are dedicating rooms specifically for game play, and fitness clubs are adding gaming equipment in their facilities. And now personal trainers are exploring ways they can enhance their services using video games.

Although more individuals are engaging in exergames at home or in gaming centers, exergames should not be considered stand-alone, “plug-and-play” fitness programs. Nor should they act as a replacement for traditional exercises. Coupling game play with professional expertise and motivation is simply another way for trainers to enhance a workout. Read on to learn how you can design effective exergaming programs and successfully coach your next game-savvy client.

All Exergames Are Not Created Equal

Over the past decade, studies have shown that game play is comparable in intensity to physical activities such as walking or jogging (Maddison et al. 2007); increases exercise adherence (Warburton et al. 2007); and develops and maintains physical fitness (Unnithan et al. 2006). “When you pool data from a number of [exergaming] studies, a picture begins to emerge,” says exercise physiologist, Alasdair Thin, PhD, who researches the health-enhancing potential of exergames at Heriot-Watt University in Edinburgh, Scotland. However, in calculating the metabolic equivalent (MET) values for different forms of game play, Thin is quickly discovering that even exergames are not all created equal. “Some games are a lot more intense than others,” he suggests.

To select the appropriate game for your clients, you need to know the types of exergames that exist, as well as their strengths and limitations.

Dance-Based Games. These games simulate dance activities and require players to move their hands and/or feet to a set pattern that scrolls on the screen, matching a rhythm or the beat of a song. Participants stand on a “dance pad” in front of a monitor or TV screen and step, stomp or hop to directional cues (i.e., up, back, right and left). Dance-based games improve cardiovascular endurance (Tan et al. 2002), and extended game play may improve muscular endurance in the leg muscles, while challenging coordination and balance. These games may not appeal to the uncoordinated or to those who do not enjoy dance-related activities.

Exergames: Dance Dance Revolution (DDR), Wii Helix, Motivatrix

Simulation Sports. Simulated sports play allows players to participate virtually in sports like tennis, bowling, boxing and baseball. While this doesn’t replace real-life sports play, it can introduce players to new sports or refine the skills of a budding athlete. Coupling the game with bat simulators and racquets or wearing a pair of boxing gloves during game play enhances the effects of the game. Games with balance boards give the thrill of snowboarding or skateboarding. Virtual sporting games can improve cardiovascular endurance (Mellecker & McManus 2008) and (depending on the game) may encourage muscular endurance, balance and flexibility. However, these games can also reinforce movements that may not translate successfully to real sports.

Exergames: Nintendo Wii, Wii Fit, XaviX®, CYBEX Trazer®

Virtual Cycling. Players on virtual bicycles (upright or recumbent) control on-screen action via handlebars and pedal speed. The players take charge of their game strategy through their own body movements (the faster they pedal, the faster their characters move, etc.). Some game bikes allow multiplayer game mode, while others are equipped with feedback monitors that display pedal speed and heart rate. Virtual cycling games may improve muscular strength and endurance in leg muscles, as well as enhance cardiovascular fitness (Warburton et al. 2007; Fitzgerald et al. 2004). This activity is accessible with only a limited number of racing video games available on the Sony PlayStation®, PlayStation 2, GameCube and Xbox® consoles.

Exergames: Cateye Fitness, GameBike®, Expresso Fitness, Dog Fighter Bike, Game Cycle (an upper-body ergometer bike)

Martial Arts Games. Martial arts simulators are designed to teach strategy and precision. Sometimes these are taught in a virtual environment, encouraging players to mimic and replicate punching and kicking moves. Other times they require players to interact with a piece of equipment, such as a tower that can be punched, kicked or slapped with feet or hands. Martial arts simulators develop cardiovascular strength and endurance (Thin 2007). They may also enhance muscular strength and endurance and improve coordination and reaction times.

Exergames: EyeToy®: Kinetic (and Kinetic 2: Combat), Makoto Sports Arena, Jackie Chan’s PowerBoxing

Gamercize®. Gamercize is a fitness machine in the form of a cycle, stepper or rower. It acts as an interface between the player and the video game. If a player doesn’t remain active (or move with enough intensity), then game play ceases. Gamercize improves cardiovascular endurance and balance (when played while standing). However, a player’s physical exertion does not have a direct impact on game play; for example, a character won’t move any faster or more slowly in response to the player’s speed on the machine.

Exergames: Gamercize is compatible with any console and works with any game.

Creating a Game Plan

Every exergame is designed to give each player a unique gaming experience. Therefore, designing an exergame-based workout program requires a slightly different approach than structuring a conventional workout. While it may seem intuitive to develop a client’s program around a specific game or set of games, trainers will achieve more success if they start by designing around the client’s gaming experience. Below is a four-phase process to help fitness professionals discover the best training design for a particular client.

Phase 1: Introduction. Explain each game to the client. For instance, explain that DDR is a dancing game or that one can play tennis on the Wii. Avoid full disclosure, but give an idea of the games available.

Phase 2: Familiarization. Allow the client to explore each exergame at her own pace. Schedule a series of “open play” sessions and observe which games the client gravitates toward and which ones she plays hardly at all. Let her discover the challenges and attractions to each game. Are her movements intuitive and balanced? Is she getting tired quickly or giving up too soon? This will be helpful in assessing the client’s strengths and weaknesses.

Phase 3: Structure. As the client develops the skills needed for successful game play, provide structured challenges to enhance gaming outcomes and improve the player’s deficiencies. An exergame circuit is one way to combine a variety of games into a balanced session. Circuits can be platform specific (such as Wii-only games), outcome-specific (cardio-intense games) or game-specific (i.e., various drills using DDR).

Phase 4: Complementary Activities. Complement the client’s workouts with other activities. For instance, if a client is always engaged in cardio-intensive games, begin introducing strength training exercises. For someone who enjoys playing DDR, integrate drills that counter and encourage multiple-planar movements. For a fan of balance boards, try some drills on the BOSU® Balance Trainer.

Game (Not) Over

Exergames are fun first, fitness later. While playing, clients are not necessarily thinking about heart rate zones and calories burned. They are focused on making it to the next level and beating their highest score. When personal trainers design programs that integrate exergames, it is important to keep this spirit of gaming alive during the workout.

“People of all ages enjoy [exergaming] because it is inherently fun and usually the game does not feel like a typical, structured workout with a definite beginning, middle and end,” says Stephen Yang, MS, assistant professor at the State University of New York College at Cortland in the physical education department. Yang studies the physiological, psychological and social effects of playing exergames. “If the nature of the activity is not enjoyable, it is unlikely that the client will continue with it,” he believes.

Exergames will never replace or replicate the experience of having a live, in-person interaction with a personal trainer. However, as more games enter the market, they will feature more prominently in the fitness arena. Personal trainers who choose to complement their conventional training programs with exergames will provide an alternative for incoming DDR freshmen and will have the opportunity to transition future Wii graduates into other activities.


Anders, M. 2007. Human joysticks: Could a video game be the secret to making our kids more fit and less fat? Ace Fitness Matters, 13 (5), 7–9.

Fitzgerald, S.G., et al. 2004. The GAME (Cycle) exercise system: Comparison with standard ergometry. Journal of Spinal Cord Medicine, 27 (5), 453–59.

Maddison, R., et al. 2007. Energy expended playing video console games: An opportunity to increase children’s physical activity? Pediatric Exercise Science, 19 (3), 334–43.

Mellecker, R., & McManus, A. 2008. Energy expenditure and cardiovascular responses to seated and active gaming in children. Archives of Pediatrics & Adolescent Medicine, 162 (9), 886–91.

Sell, K., Lillie, T., & Taylor, J. 2008. Energy expenditure during physically interactive video game playing in male college students with different playing experience. Journal of American College Health, 56 (5), 505–12.

Tan, B., et al. 2002. Aerobic demands of the dance simulation game. International Journal of Sports Medicine, 23 (2), 125–29.

Thin, A.G., et al. 2007. Evaluation of physical exertion required to play the body movement controlled EyeToy Kinetic video game. School of Life Sciences, Heriot-Watt University, Edinburgh, Scotland.

Unnithan, V.B., Houser, W., & Fernhall, B. 2006. Evaluation of the energy cost of playing a dance simulation video game in overweight and non-overweight children and adolescents. International Journal of Sports Medicine, 27 (10), 804–809.

Warburton, D.E.R., et al. 2007. The health benefits of interactive video game exercise. Applied Physiology, Nutrition, and Metabolism, 32 (4), 655–63.

IDEA Fitness Journal, Volume 6, Issue 2

© 2009 by IDEA Health & Fitness Inc. All rights reserved. Reproduction without permission is strictly prohibited.

About the Author

Biray Alsac, MS

Biray Alsac, MS IDEA Author/Presenter

Biray Alsac, MS, is the owner of FITTmaxx Institute, a consulting company for health organizations and fitness/wellness professionals interested in learning how to integrate Web-based tools and intera...