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daily requirements for physical activity [26]. An additional challenge is that some
children and adolescents may lose interest in playing exergames over time [28].
Currently issues of motivation and sustained interest in exergame play are still under
investigation and need to be assessed over longer periods of time. Another possible
challenge with using this technology is the limited or restricted access to active video
game play. These restrictions may result from the concern of children becoming
addicted to active video game play which has the potential to negatively affect
behavior and academic performance.
Fig. 1. The Integration Framework of On-screen and Off-screen Physical Activity (Activity
monitoring technologies photos are adapted from [32] [33] [34])
Physical activity tracking technologies have been suggested as another method to
increase individuals' motivation to exercise. These technologies are an effective
means of increasing individuals' self-awareness through self-monitoring and goal
setting. However, there is still concern about individuals losing motivation and
interest over time, especially when goals associated with this technology are not
achieved. An additional concern is that due to the variety of these technologies
currently available, individuals may become confused about which is most
appropriate for them. Inaccurate selection of an appropriate physical activity
monitoring technology may result in a person giving up use of this technology.
Our previous work in this area has suggested the best solution involves the
integration of active video game technology with physical activity tracking
technology [29], [30], [31] to increase both on-screen exercise and off-screen
exercise. The framework illustrated in Fig. 1 shows the two possible ways of
exercising. Children are able to exercise in front of screens while playing exergames.
In addition, their off-screen time exercising is also recorded by activity tracking
devices and then this activity provides game rewards that are transferred through
Bluetooth or Wi-Fi to the game software. Based on physical activity levels, the
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