One popular video game that uses some virtual reality technology is Wii Fit. The game allows the user to grasp handheld tools to manipulate images on a television screen as they exercise. Wii Fit games include yoga, tennis, and bowling. Three studies have explored the efficacy of Wii Fit games, including a 2011 study of women with systemic lupus erythematosus that showed users had some improvement in fatigue scores and body weight, Dr. Iversen noted.1 However, the effects of the game declined over time as people played it less frequently. Most Wii Fit users don’t achieve a vigorous energy expenditure level during their workouts, she added. She also recommended adding heart rate monitors to physical activity games.
There are new biosensor devices that use touch technology to allow people with physical disabilities to play video games or communicate more easily on their laptop computers, Dr. Iversen noted. This technology may be useful in the rheumatoid arthritis (RA) population, she said.
Online health behavior interventions are becoming more common. Most of these tools and programs focus on weight loss, and a number have been studied for efficacy. A report in the Journal of Medical Internet Research in 2013 looked at relevant literature on these online behavior interventions published between 2005 and 2012 and found 41 eligible reviews.2 Overall, the effects of these interventions were small, variable, and not sustainable, Dr. Iversen noted. Most of the users of online health behavior interventions were white, female, and well educated, she added.
Text Messaging
Text messaging is a promising area of growth, she said. In 2010, researchers at the Yale University School of Epidemiology and Public Health reported in Epidemiological Reviews that in eight of nine well-powered studies of text-based behavior interventions, there was evidence of success for behavioral change.3 Most of these text-based interventions focused on weight management in diabetes patients.
Text messaging has benefits and disadvantages, Dr. Iversen noted. It is widely used, low cost, and communication is instant. Texting does not require much technical expertise for use. It is applicable to many health conditions, and the patient may retrieve the text at his or her convenience, she noted. However, text messaging may marginalize people who have low literacy, don’t read English, don’t have mobile phones, or don’t have a text messaging feature. Mobile phones are often lost or broken, she noted.
Smartphone technology allows patients to interact with each other, sharing information about their health behaviors and encouraging each other to stick with a diet or exercise program, Dr. Iversen said. Patients may upload photos of a meal and ask their peers to comment on its dietary value, for example. “E-communities and social feedback is important,” she said. “Health and technology are more likely to be adopted when they have greater versatility.”
