Additional Exergames to Regular Tennis Training Improves Cognitive-Motor Functions of Children but May Temporarily Affect Tennis Technique: A Single-Blind Randomized Controlled Trial

Luka Šlosar, Eling D de Bruin, Eduardo Bodnariuc Fontes, Matej Plevnik, Rado Pisot, Bostjan Simunic, Uros Marusic, Luka Šlosar, Eling D de Bruin, Eduardo Bodnariuc Fontes, Matej Plevnik, Rado Pisot, Bostjan Simunic, Uros Marusic

Abstract

This study evaluated the effects of an exergame program (TennisVirtua-4, Playstation Kinect) combined with traditional tennis training on autonomic regulation, tennis technique, gross motor skills, clinical reaction time, and cognitive inhibitory control in children. Sixty-three children were randomized into four groups (1st - two exergame and two regular trainings sessions/week, 2nd - one exergame and one regular training sessions/week, 3rd - two regular trainings sessions/week, and 4th - one regular training session/week) and compared at baseline, 6-month immediately post intervention and at 1-year follow-up post intervention. At 6-month post intervention the combined exergame and regular training sessions revealed: higher breathing frequency, heart rate (all ps ≤ 0.001) and lower skin conductance levels (p = 0.001) during exergaming; additional benefits in the point of contact and kinetic chain elements of the tennis forehand and backhand technique (all ps ≤ 0.001); negative impact on the shot preparation and the follow-through elements (all ps ≤ 0.017); higher ball skills (as part of the gross motor skills) (p < 0.001); higher percentages of clinical reaction time improvement (1st -9.7% vs 3rd group -7.4% and 2nd -6.6% vs 4th group -4.4%, all ps ≤ 0.003) and cognitive inhibitory control improvement in both congruent (1st -20.5% vs 3rd group -18.4% and 2nd -11.5% vs 4th group -9.6%, all ps ≤ 0.05) and incongruent (1st group -19.1% vs 3rd group -12.5% and 2nd group -11.4% vs 4th group -6.5%, all ps ≤ 0.001) trials. The 1-year follow-up test showed no differences in the tennis technique, clinical reaction time and cognitive inhibitory control improvement between groups with the same number of trainings per week. The findings support exergaming as an additional training tool, aimed to improve important cognitive-motor tennis skills by adding dynamics to the standardized training process. Caution should be placed to planning this training, e.g., in a mesocycle, since exergaming might decrease the improvement of specific tennis technique parts of the trainees. (ClinicalTrials.gov; ID: NCT03946436).

Keywords: augmented and virtual reality; cognitive-motor learning; executive functions; teaching/learning strategies; tennis performance.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Šlosar, de Bruin, Fontes, Plevnik, Pisot, Simunic and Marusic.

Figures

FIGURE 1
FIGURE 1
CONSORT flow diagram of study recruitment.
FIGURE 2
FIGURE 2
Exergame interface screenshot.
FIGURE 3
FIGURE 3
Exergame intervention.
FIGURE 4
FIGURE 4
Clinical reaction time across time (percentages of improvement, averages, medians, first and third quartiles, minimum, and maximum values are shown). EG2 – group with 2 exergame and 2 regular tennis trainings/week; EG1 – group with 1 exergame and 1 regular tennis trainings/week; CG2 – group 2 regular tennis trainings/week; CG1 – group with 1 regular tennis training/week; BDC – baseline; POST – post intervention; FU – Follow-up after 1 year.
FIGURE 5
FIGURE 5
Simon task measurements on congruent trials (percentages of improvement, averages, medians, first and third quartiles, minimum, and maximum values are shown).EG2 – group with 2 exergame and 2 regular tennis trainings/week; EG1 – group with 1 exergame and 1 regular tennis trainings/week; CG2 – group 2 regular tennis trainings/week; CG1 – group with 1 regular tennis training/week; BDC – baseline; POST – post intervention; FU – Follow-up after 1 year.
FIGURE 6
FIGURE 6
Simon task measurements on incongruent trials (percentages of improvement, averages, medians, first and third quartiles, minimum, and maximum values are shown). EG2 – group with 2 exergame and 2 regular tennis trainings/week; EG1 – group with 1 exergame and 1 regular tennis trainings/week; CG2 – group 2 regular tennis trainings/week; CG1 – group with 1 regular tennis training/week; BDC – baseline; POST – post intervention; FU – Follow-up after 1 year.

References

    1. Albuquerque M. R., Gonzaga A. S., Greco P. J., Costa I. T. (2019). Association between inhibitory control and tactical performance of under-15 soccer players. J. Sport Psychol. 28 63–70.
    1. Barnett L. M., Hinkley T., Hesketh K., Okely A. D., Salmon J. (2012). Use of electronic games by young children and fundamental movement skills. Percept. Mot. Skills 114 1023–1034. 10.2466/10.13.PMS.114.3.1023-1034
    1. Bar-Or O. (1983). Pediatric Sports Medicine for the Practitioner: From Physiological Principles to Clinical Applications. New York: Springer-Verlag.
    1. Benzing V., Heinks T., Eggenberger N., Schmidt M. (2016). Acute cognitively engaging exergame-based physical activity enhances executive functions in adolescents. PLoS One 11:e0167501. 10.1371/journal.pone.0167501
    1. Benzing V., Schmidt M. (2017). Cognitively and physically demanding exergaming to improve executive functions of children with attention deficit hyperactively disorder: a randomised clinical trial. BMC Pediatr. 17:9.
    1. Best J. R. (2012). Exergaming immediately enhances children’s executive function. Dev. Psychol. 48 1501–1510. 10.1037/a0026648
    1. Biddiss E., Irwin J. (2010). Active video games to promote physical activity in children and youth: a systematic review. Arch. Pediatr. Adolesc. Med. 164 664–672. 10.1001/archpediatrics.2010.104
    1. Boucsein W. (2012). Electrodermal Activity, 2nd Edn. New York, NY: Springer.
    1. Bronner S., Pinsker R., Naik R., Noah J. A. (2016). Physiological and psychophysiological responses to an exer-game training protocol. J. Sci. Med. Sport 19 267–271. 10.1016/j.jsams.2015.03.003
    1. Cardona J. E. M., Cameirao M. S., Paulino T., Badia S. B. I., Rubio E. (2016). “Modulation of physiological responses and activity levels during exergame experiences,” in Proceedings of the 2016 8th International Conference on Games and Virtual Worlds for Serious Applications (VS-GAMES), Barcelona.
    1. Cohen J. (1988). Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Eribaum.
    1. Crespo M., Reid M. M., Miley D. (2004). Tennis: applied examples of a game-based teaching approach. J. Phys. Sport Educ. 17 27–30. 10.1080/08924562.2004.10591100
    1. National Research Council (1984). Development During Middle Childhood: The Years From Six to Twelve. Washington, DC: The National Academies Press.
    1. Diamond A. (2013). Executive functions. Annu. Rev. Psychol. 64 135–168. 10.1146/annurev-psych-113011-143750
    1. Dines J. S., Bedi A., Williams P. N., Dodson C. C., Ellenbecker T. S., Altchek D. W., et al. (2015). Tennis injuries: epidemiology, pathophysiology, and treatment. J. Am. Acad. Orthop. Surg. 23 181–189. 10.5435/JAAOS-D-13-00148
    1. Douris P. C., McDonald B., Vespi F., Kelley N. C., Herman L. (2012). Comparison between Nintendo Wii Fit aerobics and traditional aerobic exercise in sedentary young adults. J. Strength Cond. Res. 26 1052–1057. 10.1519/JSC.0b013e31822e5967
    1. Eckner J. T., Kutcher J. S., Broglio S. P., Richardson J. K. (2014). Effect of sport-related concussion on clinically measured simple reaction time. Br. J. Sports Med. 48 112–118.
    1. Eggenberger P., Wolf M., Schumann M., de Bruin E. D. (2016). Exergame and balance training modulate prefrontal brain activity during walking and enhance executive function in older adults. Front. Aging Neurosci. 8:66. 10.3389/fnagi.2016.00066
    1. Fernandez-Fernandez J., Ulbricht A., Ferrauti A. (2014). Fitness testing of tennis players: how valuable is it? Br. J. Sports Med. 48 (Suppl. 1), i22–i31. 10.1136/bjsports-2013-093152
    1. Flynn R. M., Richert R. A. (2018). Cognitive, not physical, engagement in video gaming influences executive functioning. J. Cogn. Dev. 19 1–20. 10.1080/15248372.2017.1419246
    1. Gao Z., Chen S., Pasco D., Pope Z. (2015). A meta-analysis of active video games on health outcomes among children and adolescents. Obes. Rev. 16 783–794. 10.1111/obr.12287
    1. Gao Z., Zeng N., Pope Z. C., Wang R., Yu F. (2019). Effects of exergaming on motor skill competence, perceived competence, and physical activity in preschool children. J. Sport Health Sci. 8 106–113. 10.1016/j.jshs.2018.12.001
    1. Girard O., Millet G. P. (2009). Physical determinants of tennis performance in competitive teenage players. J. Strength Cond. Res. 23 1867–1872. 10.1519/JSC.0b013e3181b3df89
    1. Grigore V., Mitrache G., Paunescu M., Predoiu R. (2014). The decision time, the simple and the discrimination reaction time in elite Romanian junior tennis players. Proc. Soc. Behav. Sci. 190 539–544.
    1. Jayanthi N., Dechert A., Durazo R., Dugas I., Luke A. (2011). Training and sports specialization risks in junior elite tennis players. J. Med. Sci. Tennis 16 14–20.
    1. Joronen K., Aikasalo M. H. S. A., Suivite R. N. A. (2016). Nonphysical effects of exergames on child and adolescent well-being: a comprehensive systematic review. Scand. J. Caring Sci. 31 449–461. 10.1111/scs.12393
    1. Knaepen K., Marušič U., Crea S., Guerrero C. D. R., Vitiello N., Pattyn N., et al. (2015). Psychophysiological response to cognitive workload during symmetrical, asymmetrical and dual-task walking. Hum. Mov. Sci. 40 248–263. 10.1016/j.humov.2015.01.001
    1. Kolman N. S., Kramer T., Elferink-Gemser M. T., Huijgen B. C. H., Visscher C. (2019). Technical and tactical skills related to performance levels in tennis: a systematic review. J. Sports Sci. 37 108–121. 10.1080/02640414.2018.1483699
    1. Lubans D. R., Morgan P. J., Cliff D. P., Barnett L. M., Okely A. D. (2010). Fundamental movement skills in children and adolescents: review of associated health benefits. Sports Med. 40 1019–1035. 10.2165/11536850-000000000-00000
    1. Magill R. A. (2011). Motor Learning: Concepts and Applications. Dubuque: MCGraw-Hill.
    1. Malcata R. M., Vandenbogaerde T. J., Hopkins W. G. (2014). Using athletes’ World rankings to assess countries’ performance. Int. J. Sports Physiol. Perform. 9 133–138. 10.1123/ijspp.2013-0014
    1. Martin-Niedecken A. L., Schättin A. (2020). Let the body’n’brain games begin: toward innovative training approaches in esports athletes. Front. Psychol. 11:138. 10.3389/fpsyg.2020.00138
    1. Masters R. S. W., Poolton J. M., Maxwell J. P., Raab M. (2008). Implicit motor learning and complex decision making in time-constrained environments. J. Mot. Behav. 40 71–79. 10.3200/JMBR.40.1.71-80
    1. Mat Rosly M., Mat Rosly H., Davis O. A. M. G., Husain R., Hasnan N. (2017). Exergaming for individuals with neurological disability: a systematic review. Disabil. Rehabil. 39 727–735. 10.3109/09638288.2016.1161086
    1. McCaskey M. A., Schättin A., Martin-Niedecken A. L., de Bruin E. D. (2018). Making more of IT: enabling intensive motor cognitive rehabilitation exercises in geriatrics using information technology solutions. BioMed. Res. Int. 2018:4856146. 10.1155/2018/4856146
    1. McNarry M. A., Mackintosh K. A. (2016). Investigating the relative exercise intensity of exergames in prepubertal children. Games Health J. 3 135–140. 10.1089/g4h.2015.0094
    1. Medeiros P. D., Capistrano R., Zequinão M. A., Silva S. A. D., Beltrame T. S., Cardoso F. L. (2017). Exergames as a tool for the acquisition and development of motor skills and abilities: a systematic review. [Exergames como ferramenta de aquisiÇÃo e desenvolvimento de habilidades e capacidades motoras: uma revisÃo sistemÁtica]. Rev. Paulista Pediatr. 35 464–471. 10.1590/1984-0462/;2017;35;4;00013
    1. Medicine A. C. O. S. (n.d.). Exergaming. Available online at: (accessed June 11, 2020).
    1. Metzker M., Dreisbach G. (2011). Priming processes in the Simon task: more evidence from the lexical decision task for a third route in the Simon effect. J. Exp. Psychol. Hum. Percept. Perform. 37 892–902. 10.1037/a0021919
    1. Monteiro-Junior R. S., Vaghetti C. O. A., Nascimento O. J. M., Laks J., Deslandes A. C. (2016). Exergames neuroplastic hypothesis about cognitive improvement and biological effects on physical function of industrialized older persons. Neural Regen Res. 11 201–2014. 10.4103/1673-5374.177709
    1. Morton J. B., Harper S. N. (2007). What did Simon say? Revisiting the bilingual advantage. Dev. Sci. 10 719–726. 10.1111/j.1467-7687.2007.00623.x
    1. Mullane J. C., Corkum V. P., Klein R. M., McLaughlin E. (2009). Interference control in children with and without ADHD: a systematic review of Flanker and Simon task performance. Child Neuropsychol. 15 321–342. 10.1080/09297040802348028
    1. Myer G. D., Jayanthi N., Difiori J. P., Faigenbaum A. D., Kiefer A. W., Logerstedt D., et al. (2015). Sport specialization. Part I Sports Health Multidiscip. Approach 7 437–442. 10.1177/1941738115598747
    1. Ochi S., Kovacs M. S. (2016). “Periodization and recovery in the young tennis athlete,” in The Young Tennis Player, eds Colvin A., Gladstone J. (Cham: Springer; ), 87–104.
    1. O’Leary K. C., Pontifex M. B., Scudder M. R., Brown M. L., Hillman C. H. (2011). The effects of single bouts of aerobic exercise, exergaming, and videogame play on cognitive control. Clin. Neurophysiol. 122 1518–1525. 10.1016/j.clinph.2011.01.049
    1. Oliveira C. B., Pinto R. Z., Saraiva B. T. C., Tebar W. R., Delfino L. D., Franco M. R., et al. (2019). Effects of active video games on children and adolescents: a systematic review with meta-analysis. Scand. J. Med. Sci. Sports 30 4–12. 10.1111/sms.13539
    1. Pill S. (2017). Tennis coaching: applying the game sense approach. J. Phys. Sport Educ. 30 10–16. 10.1080/08924562.2016.1273807
    1. Pusenjak N., Grad A., Tusak M., Leskovsek M., Schwarzlin R. (2015). Can biofeedback training of psychophysiological responses enhance athtletes’ sport performance? A practitioner’s perspective. Phys. Sportsmed. 43 287–299. 10.1080/00913847.2015.1069169
    1. Reid M., Elliott B., Crespo M. (2013). Mechanics and learning practices associated with the tennis forehand: a review. J. Sports Sci. Med. 12 225–231.
    1. Reuter E. M., Vieluf S., Koutsandreou F., Hubner L., Budde H., Godde B., et al. (2019). A non-linear relationship between selective attention and associated ERP markers across the lifespan. Front. Psychol. 10:30. 10.3389/fpsyg.2019.00030
    1. Schättin A., Arner R., Gennaro F., de Bruin E. D. (2016). Adaptations of prefrontal brain activity, executive functions, and gait in healthy elderly following exergame and balance training: a randomized-controlled study. Front. Aging Neurosci. 8:278. 10.3389/fnagi.2016.00278
    1. Shim J., Carlton L. G., Chow J. W., Chae W. S. (2005). The use of anticipatory visual cues by highly skilled tennis players. J. Mot. Behav. 3 164–175. 10.3200/JMBR.37.2.164-175
    1. Šlosar L., Simunic B., Pišot R., Marusic U. (2018). Validation of a Tennis Rating Score to evaluate the technical level of children tennis players. J. Sports Sci. 37 100–107. 10.1080/02640414.2018.1483184
    1. Staiano A. E., Abraham A. A., Calvert S. L. (2012). Competitive versus cooperative exergame play for African American adolescents’ executive function skills: short term effects in a long-term training intervention. Dev. Psychol. 48 337–342. 10.1037/a0026938
    1. Sun H. (2013). Impact of exergames on physical activity and motivation in elementary school students: a follow-up study. J. Sport Health Sci. 2 138–145. 10.1016/j.jshs.2013.02.003
    1. Taddei F., Bultrini A., Spinelli D., Di Russo F. (2012). Neural correlates of attentional and executive processing in middle-age fencers. Med. Sci. Sports Exerc. 44 1057–1066. 10.1249/MSS.0b013e31824529c2
    1. The United States Tennis Association [USTA] (2009). Coaching Tennis Technical and Tactical Skills. Champaign, IL: Human Kinetics Europe Ltd.
    1. Ulbricht A., Fernandez-Fernandez J., Mendez-Villanueva A., Ferrauti A. (2016). Impact of fitness characteristics on tennis performance in elite junior tennis players. J. Strength Cond. Res. 30 989–998. 10.1519/jsc.0000000000001267
    1. Ulrich D. A. (2000). Test of Gross Motor Development. Austin: Pro-Ed.
    1. Vernadakis N., Papastergiou M., Zetou E., Antoniou P. (2015). The impact of an exergame-based intervention on children’s fundamental motor skills. Comput. Educ. 59 196–205. 10.1016/j.compedu.2015.01.001
    1. Vestberg T., Gustafson R., Maurex L., Ingvar M., Petrovic P. (2012). Executive functions predict the success of top-soccer players. PLoS One 7:e34731. 10.1371/journal.pone.0034731
    1. Vestberg T., Reinebo G., Maurex L., Ingvar M., Petrovic P. (2017). Core executive functions are associated with success in young elite soccer players. PLoS One 12:e0170845. 10.1371/journal.pone.0170845
    1. Viana P. B., Vancini R. L., Vieira C. A., Gentil P., Campos M. H., Andrade M. S., et al. (2018). Profiling exercise intensity during the exergame Hollywood workout on xbox 360 kinect. PeerJ 6:e5574. 10.7717/peerj.5574
    1. Wang C. H., Chang C. C., Liang Y. M., Shih C. M., Chiu W. S., Tseng P., et al. (2013). Open vs. closed skill sports and the modulation of inhibitory control. PLoS One 8:e55773. 10.1371/journal.pone.0055773
    1. Wilkinson R. T., Allison S. (1989). Age and simple reaction time: decade differences for 5,325 subjects. J. Gerontol. 44 29–35.
    1. Young H., Benton D. (2015). We should be using nonlinear indices when relating heart-rate dynamics to cognition and mood. Sci. Rep. 5:16619. 10.1038/srep16619

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner