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Diabetes Patients Face Exergame Risks

Over Exertion Presents Dangers

Diabetes Patients Face Exergame Risks

By John Salak –

Online exercise games (exergames), the ones that are designed to get people up and moving, have been around for well over a decade and are growing in popularity—all with good reason. Many exergames are great at promoting physical activity, particularly in people who otherwise might be too sedentary.

However, for the almost two million people suffering from type 1 diabetes, these activity-promoting options may be doing more harm than good, according to researchers out of Britain and Portugal. The warning is particularly surprising because exercise is believed to be a central component for reducing the risk of developing high blood pressure, heart disease, nerve damage and vision loss that comes with type 1 diabetes.

The study by Staffordshire University and Federal University of Vale do Sao Francisco stressed that exercise is still important to offset these risks. Its concerns rest strictly with exergames because they can change people’s perceptions of how fatigued they are, which is potentially harmful to those with the condition.

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas makes little or no insulin, restricting the body’s ability to generate energy. This disease, which impacts up to two million people in the U.S. compared to type 2 diabetes, found in almost 40 million Americans, is caused by genetics and some viruses, reports the Centers For Disease Control & Prevention. There is no known cure for type 1 diabetes, although there are treatments, like exercise, that help keep its impact at bay.

“Type-1 diabetes patients need to control their blood glucose regularly, both before and after exercise, to prevent complications. As part of this, it is important to regulate the intensity of exercise, whether real or virtual,” noted Dr. Pooya Soltani, senior lecturer at Staffordshire University. 

“While this has proven to be effective for traditional exercise, we wanted to investigate whether this scale can also be used when exercising with video games,” Soltani explained.

The research team assessed the correlations between physiological measurements of exercise intensity, including metabolic equivalent (MET), oxygen consumption and heart rate in both real and virtual sessions. The trial consisted of type 1 diabetes patients performing two 30-minute sessions of moderate-intensity exercise, which involved either running or playing the Kinect Adventures! video game. The rate of perceived exertion (RPE) was measured on the 6— 20 point Borg scale after the sessions.

The results revealed a significant difference in the accuracy of perceived exertion. 

“The RPE and MET values were strongly correlated in real exercise but were moderately correlated during the virtual exercise session. Other metabolic and physiological variables were mostly low and lacked statistical significance during the virtual exercise,” reported the study’s co-author Jorge Luiz de Brito Gomes of Federal University. 

“This highlights that it is crucial to exercise caution when extending use of the 6—20 point RPE scale to other types of exercise, especially virtual sessions, as they may not accurately reflect the physiological and metabolic intensity of the exercise,” he added. 

Ultimately, the research team supported the use of exergames but underscored the importance of using measurement tools that more accurately reflect a patient’s exertion.

“Active video games and virtual reality are recent exercise trends that can provide motivation to participants and might increase their adherence to physical activity. Light to vigorous-intensity exergaming sessions may also benefit people with type-1 diabetes,” Soltani added. “But our research shows that the current 6—20 RPE scale needs to be updated so that everyone can safely benefit from using immersive games.”

Until then, he advised healthcare professionals who use exergames to use caution when measuring physical activity.”





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