title: Importance of Patient Culture and Exergaming Design for Clinical Populations: A Case Series on Exercise Adherence in Soldiers with Depression.
abstract: OBJECTIVE
  Exercise is an effective intervention for depressed individuals, but adherence is often poor. Exergaming may be useful for stimulating motivation and adherence with physical activity. This study piloted the use of the Nintendo(®) "Wii™ Fit" (Nintendo of America, Inc., Redwood City, CA) as part of cognitive behavioral treatment (CBT) for soldiers.
  
  
  METHODS
  Male soldiers with depression (N=3) were treated in a military treatment facility using a case-controlled research design. Patients were loaned a "Wii Fit" during five of 10 CBT treatment sessions and asked to exercise at least 20 minutes/day.
  
  
  RESULTS
  Rates of compliance and minutes of exercise were no different during the periods with and without the "Wii Fit." All three patients reported a reduction in depression severity following treatment.
  
  
  CONCLUSIONS
  This study provides important lessons learned for future studies of exergaming for patients with depression. Exergaming software is typically not designed for clinical populations, and certain characteristics of the game may decrease the likelihood of use. Researchers should consider the characteristics of various available exergaming platforms and select one that represents a clinical and cultural fit for their patient population.
authors.affiliation: National Center for Telehealth & Technology , Joint Base Lewis-McChord, Washington.
authors.forename: Greg M
authors.initials: GM
authors.lastname: Reger
authors.affiliation: National Center for Telehealth & Technology , Joint Base Lewis-McChord, Washington.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Holloway
authors.affiliation: National Center for Telehealth & Technology , Joint Base Lewis-McChord, Washington.
authors.forename: Joe
authors.initials: J
authors.lastname: Edwards
authors.affiliation: National Center for Telehealth & Technology , Joint Base Lewis-McChord, Washington.
authors.forename: Amanda
authors.initials: A
authors.lastname: Edwards-Stewart