title: Exergaming (XBOX Kinect™) versus traditional gym-based exercise for postural control, flow and technology acceptance in healthy adults: a randomised controlled trial.
abstract: BACKGROUND
  The use of exergaming is a potential alternative to traditional methods of balance training, which can be repetitive and somewhat monotonous. The purpose of this study was to assess the effects of exergaming using XBOX Kinect™ versus traditional gym-based exercise with no virtual stimuli (TGB) on postural control, technology acceptance, flow experience and exercise intensity, in young healthy adults.
  
  
  METHODS
  Fifty healthy active adults (age: 33.8 ± 12.7 years, height: 172.9 ± 11.9 cm, weight: 75 ± 15.8 kg) were recruited; 44 completed both baseline and post-intervention data collection. Participants were randomised (blind card) allocation to one of two groups: (1) received balance training using the XBOX Kinect™ and (2) performed traditional gym-based exercise. Exercises were matched for intensity, duration and movement patterns across groups. All participants completed three, 30-minute, exercise sessions a week for four weeks. Postural sway was measured using a Kistler™ Force platform during unipedal standing. Mean heart rate (HR) and rate of perceived exertion (RPE) were collected during each exercise session to determine and verify that intensity of exercise was matched between groups. Technology acceptance was measured with the Unified Theory of Acceptance and Use of Technology (UTAUT) and flow experience with the Flow State Scale (FSS).
  
  
  RESULTS
  Heart rate was matched between groups and BORG RPE was significantly lower in the Kinect™ group. There were significant between-group differences in postural sway in the medial-lateral direction and CoP. There were also significant differences in technology acceptance between groups for performance expectancy, social influence and behavioral intention, with higher values in the Kinect exercise group. The flow state scale showed significant differences between the groups on several dimensions, with higher values in the Kinect exercise group.
  
  
  CONCLUSIONS
  Objective physiological demand of exercise (HR) was matched across groups, but the exergaming group perceived it as being less demanding and of lower intensity. This suggests that exergaming may offer an alternative method of rehabilitation exercise through improved concordance. Balance training in healthy adults using the Kinect is both accepted and intrinsically motivating.
  
  
  BACKGROUND
  Retrospectively registered on 27th July 2016. Trial number NCT02851017.
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Barry
authors.affiliation: School of Social Science, Business and Law, Teesside University, Middlesbrough, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: van Schaik
authors.affiliation: Health and Social Care Institute, Teesside University, Middlesbrough, UK.
authors.forename: Alasdair
authors.initials: A
authors.lastname: MacSween
authors.affiliation: Health and Social Care Institute, Teesside University, Middlesbrough, UK.
authors.forename: John
authors.initials: J
authors.lastname: Dixon
authors.affiliation: Health and Social Care Institute, Teesside University, Middlesbrough, UK.
authors.forename: Denis
authors.initials: D
authors.lastname: Martin
keywords: Balance; Exergaming; Flow state experience; Heart rate; Postural control; Technology experience