Children are becoming more inactive and are spending a significant proportion of their time participating in screen-time sedentary behaviours. New generation active video games may provide an opportunity to convert traditional sedentary screen-time into active screen-time. The aims of this thesis were to: 1) determine the metabolic costs of different activities; 2) determine whether experience and fitness influence the metabolic costs of active video games; and 3) determine children's enjoyment of active video games. Accordingly, this thesis is presented as two papers. Twenty-six boys' (11.4 ± 0.8 yr) participated in the study. Each performed sedentary activities (resting, watching television and sedentary gaming), active video games (Nintendo® Wii Bowling, Boxing, Tennis, Skiing and Step Aerobics), traditional physical activities (walking and running) and a maximal fitness test. During all activities oxygen uptake and heart rate were measured and energy expenditure (EE) calculated. The active video games resulted in a significantly higher EE compared to rest (63-190%, p<0.05). No significant differences in EE were found between the most active video games (Wii Boxing and Wii Step) and walking. The intensities of the active video games were low (≤ 3 METSmeas). There was no evidence to suggest that gaming experience or aerobic fitness influenced EE during active video game play. Using the same sample, the aim was to determine the participants' enjoyment of active video games sedentary activities and physical activities. Participants' enjoyment was measured using the Physical Activity Enjoyment Scale immediately after the activities. The percentages of children that enjoyed each activity were: walking (39%), television (58%), running (60%), PS3 (73%), Wii Boxing (88%), Wii Tennis (77%), Wii Fit (75%) and Wii Bowling (89%). The active video games were the most enjoyable activities irrespective of participants' weight status, fitness and experience. The metabolic costs of active video games suggest that they may be suitable for future interventions which are aimed at decreasing time spent in sedentary behaviour. However, as they are low intensity activities, active video game play time should not be accumulated as part of the 60-minutes of daily moderate to vigorous physical activity that is currently recommended for children.

Interactive stationary bikes provide positive affective experiences and physiological benefits; however research has been limited to adults within laboratory settings. Using a randomized, controlled trial design (RCT), this study sought to examine usage of GameBikes (GB) compared to traditional stationary bikes (TSB) among families in the home-setting including the theory of planned behaviour (TPB) to understand motivation for use. Parents completed questionnaires after having a ten minute trial with the bike (T1) and then again after six weeks (T2). Usage was tracked by all family members and belief elicitation was performed with GB families following the trial. Repeated measures (RM) ANOVA for frequency of use yielded a large time effect (F5,34 = 3.15, p < .05; η2 = .32); post-hoc analysis illustrated decrease by TSB (t18 = 3.77, p < .01; d = .89) and GB (t20 = 1.02, p = .32; d = .32). Parents in the GB group increased the proportion of those meeting Health Canada’s Physical Activity guidelines by 33.3% compared to 8.34% for TSB (h = .51). RM ANOVA for affective attitude (AA) of parents yielded large time and intervention effects (F1,22 = 32.73, p < .01, η2 = .60; F1,22 = 8.54, p = .01, η2 = .60 respectively). GB (t11 = 6.08, p < .01, d = 1.67) and TSB (t11 = 3.27, p < .01, d = .88) lowered across time; GB experienced higher levels of AA at T1 (t25 = 2.69, p < .01, d = 1.55) and T2 (t22 = 2.58, p < .05, d = 1.39). Elicited beliefs were primarily affective- and control-based and concerned the equipment and sizing for children. From this study, it is noted that usage decreases less rapidly with the GB than with TSB. Also, differences in AA between groups highlight the importance of AA in PA interventions. This study provides support for the use of interactive video games to augment current PA initiatives with larger scale trials.

Introduction: The theoretical part of the thesis summarizes findings from foreign literature on virtual reality and its use in rehabilitation, as well as the possibility of the benefits of active video games as part of balance training, specifically gaming console Nintendo Wii. The practical part is a pilot study to evaluate the effect of balance training in patients with cerebral palsy using this gaming console. Methods: The study included five patients with cerebral palsy, three in the form of spastic hemiparesis, two in the form of spastic triparesis. Patients were aged 8-18 years. Therapy took place on the Nintendo Wii, selecting five games from cd/dvd Wii Fit Plus. Patients underwent a total of 8 treatments with a frequency of once a week. One therapy lasted 20-30 minutes, according to success in individual games. The effect of therapy was evaluated using the Balance Master, specifically through tests Weight / Bearing squat (weight distribution of the lower limbs), mCTSIB (modified test balance sensory interaction) Limits of Stability (CoG sway to the borders of support base), Rhytmic Weight Shift (fast active transfer of CoG), Walk Across, Tandem walk and Step/Quick Turn (walking with a turn). For statistical evaluation and comparison of the results before and after treatment was used...