The future of activity-promoting video games in clinical practice: Is it the ultimate exercise test in prepubertal children?

Paediatric exercise testing laboratories should accommodate subjects of various sizes and ages. To this day, games and conventional treadmill exercise tests have not been carried out in pre-pubertal children. Children cannot easily adapt to the treadmill or cycle ergometer. We therefore aim to the use of video games as a form of exercise tests in pre-pubertal children. Twenty healthy children (10 girls and 10 boys, aged 5-11 years old) were enrolled in the study. The physical examination, 12-lead electrocardiography and echocardiography were performed. The heart rate and respiratory rate were measured with systolic blood pressures. Treadmill exercise testing was performed, and electrocardiographic changes were studied during both the treadmill exercise test with Bruce protocol and an activity-promoting video game (Nintendo Wii Boxing), in different time periods. Exercises were stopped at the target heart rate.The mean duration of exercise was 15 minutes in both the Bruce protocol and the activity-promoting video game. Although the data of healthy children (including heart rate and blood pressure responses to exercise) were consistent with the results from several countries using the Bruce protocol, the mean maximal heart rates for all groups were slightly lower than those obtained with the video game. The data obtained from this new exercise test may be used to determine the diagnosis and activation of cardiovascular disease in pre-pubertal children. It can be used as an exercise test especially in young children who are unable to use the treadmill or cycle ergometer