Development of an exergame to deliver a sustained dose of high-intensity training: Lessons learned in a formative pilot randomized trial

Background: Sport science can play a critical role in reducing health inequalities. The inverse relationship between life-expectancy, cardiorespiratory fitness and socioeconomic status could be addressed by performing high-intensity training (HIT), delivered in a class salient and accessible approach. Commercially available exergames have shown encouraging compliance rates but are primarily designed for entertainment purposes rather than focussing on health-related outcomes. A serious game tailored towards delivering an exercise stimulus, whilst reducing the aversive protocols associated with HIT, could be beneficial to engage and improve health outcomes in socially deprived males. Objective: The aims were to develop an exergame capable of delivering HIT and evaluate the effect on selected health outcomes in men recruited in regions of socioeconomic deprivation. Methods: We conducted an exploratory trial in our target population and participants were allocated to intervention (n = 14) or control groups (n = 10) by third-party minimisation. The intervention was a 6-week training program consisting of 3 sessions of exergaming per week. The sessions involved a structured warm-up then brief intermittent repetitions in the form of boxing rounds (10, 20 and 30-sec) against their peers with a work/rest ratio of 0.25. Results: Retention to the intervention was 87%. Over the duration of the intervention, session attendance was 68%, repetition mean and peak heart rates (% of maximal) and session ratings of perceived exertion (arbitrary units) were 86.3±5.4%, 89.9±6.1% and 7.5±2.2AU, respectively. The effect of the intervention, when compared to the control, was a likely small beneficial improvement in predicted VO2max (3.0; 90% confidence limits ± 2.6%). Effects on body mass, waist circumference and blood pressure were either trivial or unclear. Conclusions: Over the 6-week intervention, the exergame delivered a consistent and sustained dose of HIT, with some beneficial effects on aerobic fitness in the target population.