The Gamification of Exercise for Children

Posted October 20, 2016 by Josh Grant

Children Walking With Smartphones
Can smartphone games like "Pokemon Go" help combat childhood obesity?

In 2014, the obesity rate for children and teenagers between ages 2 and 19 in the United States increased to 17.2 percentExternal Link, up from 13.9 percent in 1999. While various organizations and agencies are working to help children lead healthy lifestyles, there has been another trend in recent years that has come into play: gamification.

Gamification turns any activity into a game, creating rewards and incentives to motivate people who would not participate in something otherwise. It’s most commonly used in online marketing and is catching on in the outside world as well. For exercise, gamification can mean adding physical activity to video games. However, it remains to be seen whether this system is sustainable and leads to long-term lifestyle changes like exercising and eating healthy, which are key to avoiding obesity and other health concerns.

One of the most recent entries in the gamification genre is “Pokemon Go,” which was released in the U.S. in early July. The game is played on smartphones and motivates users to walk around in the real world, with parental supervision for children, in order to reach in-game milestones. For instance, players can unlock new characters by walking various distances (1, 5 or 10 kilometers) to hatch digital eggs and conquer monsters. The mechanics of the game are very similar an earlier one called “Ingress.” Although the storyline and incentives were different, it still rewards players for walking to different locations.

“’Pokemon Go’ rewards walking and is helping kids be more active,” said Robert Ziltzer, MD, FACP, FAAP, from the Scottsdale Weight Loss Center. “Plus, going too fast while biking or driving doesn’t help players, so walking is best and the game presents rewards for activity without the use of food.”

Parents often reward good behavior with treats, so the idea of replacing food as an incentive is particularly important to helping create healthy eating habits. Many healthcare providers and organizations encourage parents to create non-food rewards, which help reinforce good nutrition and good behavior. 

The idea of non-food “gamification” of physical activity is not new. In fact, for centuries, “real world” versions feature some level of non-food reward. Games like Tag and Capture the Flag as well as sports like soccer and baseball are all forms of exercising that include healthy competition and fun as their primary rewards. Other incentives that can replace food are t-shirts for participating in races or events, or buttons and pins for recreational activities.

But because video games are typically a sedentary activity, rewards have to be created to encourage activity. One benefit of games like “Pokemon Go” is it can distract children from the fact that they’re exercising, which they might resist otherwise.

“Many kids don’t even realize they’re exercising while they’re playing the game,” said Kristine Cieslak, MD, Chief Medical Officer of the Infant Welfare Society of Chicago. “It’s similar to the Wii; it’s not a video game where children can be sedentary. As providers, we have to be aware of these trends to see whether this generation is drawn to this model of interactivity and play.”

Concerns for Sustainability and Injury
The Wii comparison may be an apt one. The video game console was a sensation when it was first released, leading to imitators that sought to adopt the exercise-for-play model. The PlayStation Move and Xbox Kinect both relied on motion-tracking technology to allow players to control on-screen avatars through movement. However, the popularity of all three waned as developers struggled to keep its users playing and moving. 

“Pokemon Go” is struggling with a similar issue. At its peak in July, the game had approximately 45 million daily active users; that number dropped to 30 million in mid-AugustExternal Link. Some of the decline may be due to the back-to-school season and the weather starting to change. However, as a game, it has to stay current to keep engaging children and adults alike.

“Unless ‘Pokemon Go’ is constantly updated with new features, it’s not going to last,” said Maia Noeder, PhD, a child psychologist at Nemours/Alfred I. duPont Hospital for Children. “Parents can make it part of a schedule of positive, healthy activities, but we can’t rely on it in the long run.”

Nor should we. Parental involvement can go a long way toward ensuring that children don’t rely too much on “Pokemon Go,” or any video game, for exercise. Moms, dads and other caregivers can also limit video game play time so that the game never becomes “something children feel like they have to do instead of enjoying it,” something Noeder herself felt after playing for a few weeks.

Without sustainability, it’s difficult to determine what kind of benefits gamification could have on children’s fitness, and as with other games, there could even be risks. Because “Pokemon Go” relies on players walking around in the real world while looking at a smartphone, they might not be aware of potential dangers.

“Walking on uneven surfaces while looking at your phone can be dangerous. The risks include venturing into dangerous neighborhoods, into streets, and off steep cliffs,” said Ziltzer.

Even with supervision by parents, new bells and whistles from the maker, and new games that encourage physical exercise, gamification is not an all-encompassing solution for encouraging to exercise. The key is to ensure that children start to enjoy each activity for itself so they’ll want to participate regardless of the presence of a video game, which would lead to a healthier lifestyle overall. Playing just for the fun of it is, perhaps, why tag is still so popular after all.

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