Playing self-paced video games requires the same energy expenditure but is more enjoyable and less effortful than standard of care activities

The purpose of this study was to determine if a custom self-paced video game promoted intense training without compromising movement symmetry, while being perceived as less effortful and more enjoyable than a comparable standard of care activity. Fifteen participants (38–72 years old) in the chronic phase post-stroke participated in this study. They played a custom self-paced stepping video game (VSTEP) and a comparable standard of care stepping activity (SOC). Data collected for each activity included, stepping frequency and accuracy, kinematics, exercise intensity, perceived effort, and enjoyment. There were no significant differences in repetitions or exercise intensity between conditions. The difference of the maximum side step length between the unaffected and affected lower extremity (LE) was significant in SOC, but not in the VSTEP condition. Maximum marching height of the affected limb and symmetry of marching was significantly greater for VSTEP compared to SOC. Perceived effort was statistically significantly lower and enjoyment was statistically significantly higher for VSTEP compared to SOC. In conclusion, playing custom self-paced video games required the same energy expenditure but was more enjoyable, promoted movement symmetry and was less effortful than SOC.