It might not surprise you that video games are big business, but you may find it interesting to learn that the 2009 video game sales in the U.S alone totaled more $19.5bn which actually beats the GNP (the economic performance of a country) of about 90 of the 192 independent nations of the world! The popularity of screen media based devices that have a system of rewarding, or incentivizing the participant, through competitive and interactive plots and designed for recreational use hardly escapes notice wherever you find yourself today in the U.S and indeed most of the developed and developing world.
Do video games have any positive effects on our health? Can video games be useful in improving health outcomes? “Most research related to video games and health has focused on their potential for harm. Ample violence is portrayed in video games, even when they are not labeled as such, and exposure to violent video games has been linked to aggressive cognitions, aggressive behaviors, desensitization to violence, and decreases in pro-social behavior. Research further suggests that active participation with violent video games may increase aggression more than equivalent time passively exposed to movie violence.” A team of researchers led by Dr B.A Primack at the University of Pittsburgh, set out to address some of these questions and published their findings in the June 2012 issue of the American Journal of Preventive Medicine, reviewed in this commentary.
Play is fun and instinctive across many life forms and it captured the attention of the ancient philosopher, Plato who stated in 400 BCE “You can discover more about a person in an hour of play than in a year of conversation”. Certainly, Plato had no ideas about the remarkable vivid imagery seen on many platforms and real-life simulation of combat scenes obtainable today or even the extreme and sad story from a couple’s obsession with raising a virtual child in an online video game, during 12hr long online game sessions that eventually blurred their perception of reality and cost them the death of their own living child from starvation in South Korea in 2010.
The researchers combed through six premium medical literature databases and with proper scientific scrutiny chose 38 studies for analysis from an initial pool of >1400 studies. Only the studies that met the high pedigree of testing known as RCT and lent information to the question, whether video games may be useful in improving health outcomes were reviewed. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. There is still a need for higher quality research in this regard; for example, two thirds (66%) of studies had short follow-up periods of <12 weeks, longer follow-up periods of participants give a clearer sense of what the long term effects of the intervention applied would be and generally a better sense of its applicability to the vast majority of the public. More so only 11% of the selected studies enhanced the scientific rigor applied further by blinding researchers during the test period and making themselves unaware which participant was getting what intervention and vice-versa to avoid biased observations.
Far from making this out as a eulogy on video games, we need to remember also that video gaming demands substantial screen time that has been associated with inactivity and the development of obesity. As a pediatrician this has been a recurring area of concern. The playing of video games also has been linked to adolescent risk-taking in traffic, poor school performance,video game addiction,unfavorable changes in hemodynamic parameters, seizures, motion sickness, and physical injuries related to repetitive strain.The American Academy of Pediatrics recommends that children get no more than 2hours of educational content screen time daily, this includes both TV and video gaming time.
The typical gamer today in the US is actually not always the gawky pre-adolescent and 10th grader holed away for hours in his chosen corner of our good planet as one might be quick to assume is the case. The researchers showed that long-held stereotypes do not apply here and the average game player is 34 years old; 40% of players are female, and 26% are aged >50 years. In 2009, 67% of U.S. households owned either a console or a personal computer (PC) used to run entertainment software or both. Therefore, video game playing is now a phenomenon woven into the fabric of American life. This didn't escape the attention of policy makers who in West Virginia made substantial investments in the active video game “Dance Dance Revolution” in all of its 765 public schools to increase physical activity, despite a lack of comparative effectiveness data.
There are clearly gains to be made with these gaming consoles just as there are ills inherent with abuse, their visibility and impact on everyday life hopefully will foster more quality research from the medical community to guide us all. Plato’s surmise of the potential benefits of a hour of play sounds to me like a good spot to begin, game on!