Video game creators have a new controller -- you.
The phenomenon started four years ago when Nintendo released the Wii console, which uses hand controllers and your movement to control the game. This winter has seen others invade the market, with the Playstation Move and the Xbox Kinect.
Wii Fit, released in 2008, introduced the idea that fitness and video games could coexist. Now the studies have started trickling in -- and the news is not as promising.
"Nearly all of these research studies have a similar conclusion," said Dale Wagner, health professor at Utah State University, in an e-mail interview. "The interactive video games increase heart rate and energy expenditure compared to sedentary computer games. However, the increase in heart rate with these games corresponds to only light to moderate intensity."
Wagner said the studies show that the games on average raised the heart rate between 40 percent to 60 percent. The American College of Sports Medicine noted that moderate-intensity workouts need to be over 60 percent -- meaning that these video games fall short of moderate intensity.
"It's not as good an exercise as I think people were hoping it was going to be," said Justin Mingo, personal trainer for Gold's Gym. "They are looking for an excuse to play the games, hoping that it will be an excuse for not exercising. (They're) trying to appease (their) conscience of being active."
Mingo said the video games were designed for the exertion level of a child, well below what an adult requires.
"If (interactive gaming) were to substitute (for) time spent playing a stationary-type game, then anything is better than nothing. But nothing is better than the real activity, getting out and playing real sports or really running, or going to the gym and taking a real aerobics class," Mingo said.
There are positives to the new video game styles -- such as in rehabilitation.
The University Orthopedic Center in Salt Lake City has been using the Nintendo Wii as a form of therapy for two years.
"We saw the potential to combine exercise and physical therapy and the fun of playing a video game," said Patty Trela, physical therapist at the center, which is affiliated with the University of Utah.
"Usually when we have patients in here, we do stretching and weightlifting. It's pretty boring, especially for those people who really don't like exercising. So this gives us a way to make exercise fun."
The video games are used in physical therapy to address balance issues and build muscle strength. Trela uses the Wii with patients who are rehabbing lower- and upper-extremity injuries and surgeries.
"I know other facilities use them for neurological disorders," Trela said, "because it's a video game so it also works with the mental aspects of problem solving and with decision making."
With the Wii Fit, the board the user steps on measures balance. Some people might put more pressure on one leg or more pressure on the front toes or on the heel -- balance issues that need to be corrected. Wii Fit calculates the percentage of balance on its force plate.
Trela can show the patient visually what's wrong so they can self-correct.
"The one thing I like is that the Wii ... it can detect changes in body movements and body-positioning orientations - kind of a three-dimensional picture," Trela said. "We really don't have that in any of the tools in the clinic."
Several games incorporate aerobics and Pilates, with sensors giving feedback on the maneuvers.
The aerobic component is the one that comes closest to mirroring the actual activity in terms of intensity and outcome, Mingo said.
Aerobics require only a small space to exercise and don't have a large calorie burn -- just like in the game.
Trela said users can ratchet up the work by adding weight vests.
"Just adding some resistance with weights around your trunk makes the balance exercises more challenging, the aerobic challenges more challenging," Trela said.
While leading a group fitness class with several dozen people, Mingo has the ability to read a person's face. He can see when a participant is struggling and can talk him/her through the exercises.
A virtual trainer doesn't have that ability -- and that can affect the training, he said.
"For most people, it's essential," Mingo said. "Whether it's in the form of personal trainer or in an aerobics class with a good instructor who is paying attention to his class, that aspect of being in front of a live person -- nothing beats real feedback to motivate."
Also, nothing beats the interaction and socializing that takes place in a gym or when playing sports, he said.
"It's not just about physical activity," Mingo said. "It's about the whole big picture with interaction with people."
Going from zero
Mingo said fitness video games won't be beneficial to most fit people, if they are substituting the games for the real activity. But they might enjoy the video games as a way to maintain some activity on a scheduled rest day.
In regard to sedentary users or children, jumping on the Wii board might be what it takes to motivate them toward a healthier lifestyle.
"I think there are some positive health/fitness aspects to interactive video games, and interactive gaming may serve as a transition for getting sedentary individuals to participate in real physical activity," Wagner said.
"However, the games are not intense or vigorous enough to take the place of the real activity and are not likely to improve the cardiorespiratory fitness of most healthy young adults."