[ad_1]
Participants
A posteriori power analysis was performed using G*Power (version 3.1.9.7; Frans Faul, University of Kiel, Germany) [37]. Based on a moderate correlation between repeated measurements (r = 0.5) and a partial eta squared (η2p) of 0.29 (converted to effect size f of 0.639), the sample size of 30 participants promoted a statistical power of ≥ 95%.
The participants were recruited through social media (Instagram® and WhatsApp®), direct contact, and announcements on institutional websites. Thirty-four healthy adult women participated in the study (a convenience sample) (Table 1). The inclusion criteria were (i) female sex and (ii) aged between 18 and 40 years. The exclusion criteria were (i) contraindications to physical activity (assessed using the Physical Activity Readiness Questionnaire); (ii) diagnosis of mood and/or anxiety disorders; (iii) use of stimulants (e.g., psychotropic drugs); and (iv) being in the menstrual period.
Four participants were excluded from the study because they had an illness with repercussions on mood. The participants were not clinically diagnosed with anxiety, depression, and/or other mental disorders according to a self-report made by each participant. The literature show that anxiety symptoms do not only appear in people with anxiety and can also affect non-clinical populations, impairing quality of life and daily activities, such as work performance, relationships, and schoolwork. In this sense, strategies for managing these symptoms are desirable. Furthermore, although the effect of exercise on anxiety is well established, a large part of the population is physically inactive. Therefore, exercise programs considered more fun such as exergame should be investigated.
In this study, we evaluated only young adult women because the literature showed that anxiety is more prevalent in this population than in men [1]. Informed consent was obtained from all participants included in this study. All experimental procedures were approved by the Research Ethics Committee of the Federal University of Goiás (approval number: 01970818.8.0000.5083) and followed the principles outlined in the Declaration of Helsinki. The flow diagram of the study is presented in Fig. 1.
Diagram flow of the study
Study design
This was an experimental within-participants study composed of three visits. At the first visit, the participants were submitted to anamnesis, anxiety trait assessment, anthropometric assessment, cardiorespiratory fitness assessment, and randomization of subsequent visits. In addition, all participants were familiarized with a match of the exergame beach volleyball for approximately six minutes. At the second and third visits, the participants played a session of the exergame beach volleyball in singleplayer mode (intervention) or remained seated (control session) for 30 min, and the order depended on randomization. During and at the end of each match, heart rate (HR) and rating of perceived exertion (RPE) were measured to characterize the session exercise intensity. State anxiety and affectivity level were assessed before and after the exergame and control sessions. Furthermore, enjoyment and future engagement possibility were evaluated only after the exergame session. In order to avoid bias, the scales and questionnaires were applied by an experienced researcher with these tools. During data collection, the researcher did not express facial or behavioral reactions to the participants’ responses.
Experimental procedures
Anamnesis and anthropometric assessment
The anamnesis was performed through the Physical Activity Readiness Questionnaire (PAR-Q). The PAR-Q contains seven questions to evaluate the general health condition of the participants and whether they were fit to perform exercise. If a participant answered “yes” to one or more questions, the participant was excluded from the study [38]. Body mass was measured using a digital balance (Omron, HN-289, USA) to the nearest 0.1 kg, and body height was measured using a wall stadiometer (Caumaq, Brazil) to the nearest 0.1 cm. Thereafter, body mass index was calculated by dividing body mass by body height squared (kg/m²).
Cardiorespiratory fitness assessment
Cardiorespiratory fitness of the participants was assessed through the Ebbeling test, performed on a motorized treadmill (ATL, Inbramed, Brazil). This test was chosen because of its easy application, low cost and provides a valid and time-efficient method for estimating maximum oxygen uptake (r² = 0.92) [39]. The Ebbeling protocol is composed of two four-minute stages [39]. During the first four minutes of the protocol, participants walked or ran at a 0% slope with a speed corresponding to an HR range from 50 to 70% of the maximal HR (HRmax) predicted for age. Finally, for the last four minutes of the protocol, the treadmill slope increased to 5% while the speed remained the same [39]. Thereafter, HR was measured at the end of the protocol. After the protocol, the predicted maximal oxygen uptake (\(\dot{V}{O}_{2}max\)) was estimated through the equation below:
\(\dot{V}{O}_{2}max = 15.1 + 21.8\,(speed) – 0.327\,(HR) – 0.263\)
\(\,(speed \times age) + 0.00504\,(HR \times age) + 5.98 \times sex.\)
Where, speed was expressed in miles per hour, HR in beats per minute (bpm), age in years and sex was 0 for women or 1 for men.
Exergame and control session
The console used in this study was the Xbox 360 (Microsoft®, USA). Xbox has a movement sensor, Kinect® (Microsoft, USA). This sensor allows players to interact with videogames without the necessity of remote control. The exergame Kinect Sports® included six modalities of sports (i.e., beach volleyball, soccer, track and field, bowling, boxing, and table tennis). In the current study, participants played beach volleyball, because several muscles are recruited to maintain a player’s performance during match [40]. This exergame is inherently competitive with a possible win or lose outcome. Each visit was performed within an interval of 24–72 h (wash-out period). The participants were instructed to visit the laboratory wearing appropriate clothes to perform physical exercise, to refrain from eating two hours before exercising, and to abstain from caffeine, alcohol, and strenuous physical activity on the day of the experiment. The temperature in the laboratory ranged from 21 to 23 °C. Each participant was supervised by an experienced researcher. Furthermore, conversation was minimized during all data collection periods, and the presence of people was restricted only to researchers and the participant involved in the study. During the control session, the participants remained seated for 30 min. The participants were not allowed to read, study, listen to music, or use their smartphones during the sessions. The exergame session lasted approximately 30 min and the number of sets was variable according to participants to reach the same time of control session.
State-trait anxiety assessment
Anxiety of the participants was assessed through the state component from the State-Trait Anxiety Inventory (STAI), an instrument already translated and validated for Brazilian Portuguese [5, 41]. Briefly, the STAI is a 40-item self-reported assessment scale made up of two 20-item anxiety subscales (state and trait). The state subscale describes an individual’s feelings at a particular time, whereas the trait subscale describes an individual’s usual feelings. Each item of the STAI is given a score of 1 to 4. Overall scores can range from a minimum of 20 to a maximum of 80. A score equal to or lower than 30 indicates a low level of state anxiety, a score ranging from 31 to 49 indicates an intermediate level of state anxiety, and a score higher than or equal to 50 indicates a high level of state anxiety [41]. The STAI was answered by participants inside a sound-attenuated room. The STAI was chosen because of its easy application and low cost.
Physical exercise intensity assessment
Physical exercise intensity was monitored by measuring participants’ HR and RPE. HR was monitored using an HR monitor (H10, Polar, Finland). The HRmax was estimated using the following age-predicted HRmax equation: HRmax = 208 − 0.7 × age [42]. RPE was monitored using the Borg Scale (6–20) [43]. The classification of the exercise intensity followed the criterion adopted by the ACSM [34].
Enjoyment assessment
Enjoyment was assessed through the Physical Activity Enjoyment Scale, a scale translated and validated for Brazilian Portuguese [44]. This scale has 18 items, and each item has two opposite poles that are separated by a 7-point Likert scale (1 = “I like”; 7 = “I hate”; 4 = “neutral”). Scores range from a minimum of 18 (no enjoyment at all) to a maximum of 126 (highest enjoyment level). The scale was applied only after the exergame session [44].
Future engagement and affectivity assessment
Affectivity was assessed through the feeling scale [44]. This scale ranges from − 5 to + 5 (-5 = very bad, -3 = poorly, -1 = reasonably bad, 0 = neutral, 1 = reasonably well, 3 = well, and 5 = very well). This scale was applied before and after the exergame and control session [44]. Future engagement was assessed after sessions through a scale adapted by Focht et al. [45]. The scale ranges from 0 to 100%, in which verbal anchors are provided at points 0%, 50% and 100%, where 0% means no intention, 50% means moderate intention, and 100% means strong intention. These tools were already used in previous studies [33, 45,46,47,48,49].
Statistical analysis
The Shapiro‒Wilk test was used to test data normality. As the state anxiety and affectivity data did not present a normal distribution, the Friedman test was used to evaluate state anxiety level and affectivity level between times (pre-exergame session, post-exergame session, pre-control session, and post-control session). When necessary, Conover’s post hoc test was used to identify the differences between times. Kendall’s W was used as the effect size for the Friedman test. Kendall’s W values were classified according to Cohen’s d as “trivial” (< 0.10), “small” (0.10 ≤ to < 0.30), “medium” (0.30 ≤ to < 0.50), and “large” (≥ 0.5) [50]. The variables age, body mass, body mass index, future engagement possibility, RPE, number of matches, and game time presented a non-normal distribution. However, body height, trait anxiety, \( \dot{V}\)O2max, enjoyment level, mean HR, percentage of HRmax, number of wins, state anxiety after exergame, and state anxiety before and after the control session presented normal distributions. Parametric data are presented as the mean ± standard deviation, and non-parametric data are presented as the median and interquartile range (IQR). All data were analyzed through Jeffrey’s Amazing Statistics Program (JASP, version 0.16.4, University of Amsterdam, Netherlands). The level of significance assumed was α < 0.05.
[ad_2]
Source link
