Active Video Games and Physical Activity in Overweight Children and Adolescents Systematic Review João do Carmo, Ricardo Gonçalves, Rui Batalau Centro de Investigação em Desporto e Ed. Física Instituto Superior Manuel Teixeira Gomes Portimão Faculdade de Educação Física e Desporto Universidade Lusófona de Humanidade e Tecnologias Lisboa joaolfcarmo@gmail.com António L. Palmeira Faculdade de Educação Física e Desporto Universidade Lusófona de Humanidade e Tecnologias Lisboa Centro Interdisciplinar de Estudo da Performance Humana – Faculdade de Motricidade Humana, Universidade Técnica de Lisboa Lisboa antonio.palmeira@ulusofona.pt Abstract - Introduction: A new generation of videogames, also called Active Video Games (AVG), may contribute to increase youth Physical Activity (PA) levels. This systematic review aims to provide a synthesis of the current knowledge regarding physical activity promotion in overweight children and adolescents through AVG play. Methods: We conducted a search strategy in PubMed on 25 th January 2012, using the following key-words based on PICO (Population, Intervention, Control and Outcome) model: Child*, Adolescen*, Teenager, Youth, Obes*, Overweight, Active Video Games, Exergam*, Video gam*, Exertainment, New generation computer game, Physical Activity, Fitness, Exercise, Motor activit*, Energy expenditure. The search was limited to English-language papers in peer-reviewed journals, published between 1 st January 2008 and 31 st December 2011. Results: We found 124 articles in which eight were extracted, based on inclusion and exclusion criteria (two experimental trials and six observational studies). Conclusion: AVG use increases PA from light to moderate intensity. Nevertheless, most of these studies where developed in laboratorial context. In overweight children and adolescent the use of home-based AVG may be an opportunity to increase PA, developing motor skills and overcoming physical inactivity barriers. Keywords: Systematic Review; Physical Activity; Active Video Games; Adolescent; Children; Overweight. I. INTRODUCTION Youth overweight is in our days a health problem, with special focus on developed countries [1]. This fact has been attributed to the reduction of PA and energy intake increase [2]. The raise of obesity levels in children and adolescent is associated with the appearance of cardiovascular diseases and psychological problems in short term. It seems that obese children and youth are more likely to be obese adults [3]. There is strong evidence that regular physical activity is related to health benefits in youth. Children and adolescent must accumulate at least 60 minutes of moderate to vigorous PA in most of the days of the week [4]. Despite these recommendations, children are spending a lot of time in sedentary activities. A recent meta-analysis showed that children spend 2-4 hours a day watching TV [5]. The European Association for the Study of Obesity (EASO) refers that screen time is related to the children’s weight increase [6]. Children and adolescents are also exposed to another sedentary activity: video games. However, with the development of technology, a new generation of video games has emerged. These video games, also named as “active video games” (AVG), are based on matching motion technology, tracking the body movement replicating it in a real time game character, also raising physical exertion [7]. Normally, overweight children have low self esteem levels when performing some physical activities [8], so the use of this AVG can be a opportunity for overcoming this barriers [9]. A recent meta-analysis showed that exergaming provides light to moderate PA among its users [10]. Although the use of this technology promotes more energy expenditure then sedentary video games, more interventions are needed to evaluate the influence of AVG in engaging long term PA [11]. This systematic review aims to provide a synthesis of the current knowledge regarding physical activity promotion in overweight children and adolescents through the use of AVG. Furthermore our goal is to provide future directions to take in future investigations, helping the design of new programs for obesity fight. II. METHODS A. Data sources and search strategies We conducted a research strategy in which one author searched in PubMed data base, on 25 th January 2012, using terms according to the PICO model [12], with the help of this question: “Can active video games improve PA in overweight children and adolescents?” (Table 1). Alternative terms were defined to the keywords and placed in the research strategies, to reduce bias in results. All terms were determined after examining literature. The search terms were used independently and were later grouped using AND and OR terms: [(child* OR adolescen* OR teenager OR youth) AND (obes* OR overweight)] AND (active vídeo games OR exergam* OR video gam* OR exertainment OR new