18 sportEX health (Oct 08)

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ISSUE 1 8 October 2008

formerly healthex specialist

DETAILS INSIDE

promoting

activity highlights

health for

n get connected to the latest technology n skills academy n TAke a seat n the energy project


contents October 2008 Issue 18 Publisher Tor Davies BSc (Hons) tor@sportex.net Editor JACKIE CRESSWELL jackie@sportex.net Art editor DEBBIE Asher debbie@sportex.net Advertising manager Paul Harris paul@sportex.net 020 8144 3391 Sales and marketing Lisa naji lisa@sportex.net 0845 652 1906 Subscriptions Sandra Greatorex subs@sportex.net 0845 652 1906 EDITORIAL advisors

Nick Cavill Dr Charlie Foster Martin Feaver Tessa Hicks Dawn Irwin Edward Poulter Liz Prosser Karan Thomas Dr Nick Webborn Sarah Wheatley Rebecca Weissbort

is published by Centor Publishing Ltd 88 Nelson Road Wimbledon, SW19 1HX Tel: 0845 652 1906 Fax: 0845 652 1907 www.sportex.net

Welcome

Welcome to the October issue of sportEX health which we have published earlier than usual this year due to our Major Moves 2008 conference - Using Technology to Promote Physical Activity which takes place later this month. The advances in technology have been swift and the public’s reaction to it has been equally speedy and innovative. Social networking sites have mushroomed, blogs are everywhere and mobile phones can now do just about everything apart from make the proverbial cuppa. However, health promotion is only just starting to explore how it can be used effectively to help people become healthier. Video games manufacturers have traditionally taken their fair share of the flack for the increasing sedentary behaviour and rising obesity levels among young. But they are now spotting many opportunities with a new breed of activity-based computer games which have become known as ‘exergames’. Up until recently, health promotion has not looked towards technology itself as a means of promoting physical activity, but the opportunities are enormous and in many cases very cost-effective. The articles in this issue offer a taster of what’s to come at the Major Moves event. So read on, and then book up to discover at the conference how you can really put these technologies into practice. Jackie Cresswell jackie@sportex.net 15

other Titles in the SportEX range

Inside

sportEX medicine ISSN 1471-8138 Written specifically for professionals p mo ting working in the field exro cellenc in of soft-tissue sports e injury and medici ne rehabilitation personal annual subscription £35, practice subscription £99 HIGHLIGH

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■ CORR ECT BICYL REDUCE THE RISK CLE SET-UP OF INJUR TO ■ HIP ROTA Y LOW BACK TION DEFIC ITS AND PAIN IN GOLF ■ USING ENHANCE GOAL SETTING REHABILITA TO ■ MOBI TION LITY WARM-UP: STRETCHIN G AND APPL SPORT & EXER ICATION IN CISE

sportEX dynamics ISSN 1744-93838 Written specifically for professionals working with a prom best opting wide variety of rac athletes and spoinrts tice sports people to care help them get the most out of their athletic performance personal annual subscription £30, practice subscription £55 HIGHLIGH

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■ WHAT IS PRACTICE?EVIDENCE-BASED AND WHY ■ ASSE APPLY SSMENT IT? OF THE ■ STRE HIP JOINT NGTH PRINCIPLES TRAINING – AND PRAC TICE

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DO INCR THE LOC EAS E ACT AL MOT ION: CON IVE TRA PLA NECT YGR TO KIDS VEL OUN : HI-T DS SET ECH SHE TING STA FFIE LD EXP NDA ERIE RDS: THE NCE

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Contents and research news 3 Policy 7 Skills academy 9 Take a seat 12 The Energy project 13 Major Moves 2008 14 Blog, Twitter or Facebook? A look at the latest news

Launch of a new government initiative Chair-based exercise for older adults Tips for getting girls more active

A look at this year’s exciting conference Using social networks and the web to promote physical activity

17 Exergames wireless wizardry cast 20 Cit’sanspell on health?

Techno-games to boost physical activity

The potential for using Bluetooth as a means of delivering health promotion

echnology and activity 23 Tpromotion

A look at technology used to promote activity

27 Resources

A guide to the latest resources

DISCLAIMER While every effort has been made to ensure that all information and data in this magazine is correct and compatible with national standards generally accepted at the time of publication, this magazine and any articles published in it are intended as general guidance and information for use by healthcare professionals only, and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. To the extent permissible by law, the publisher, editors and contributors to this magazine accept no liability to any person for any loss, injury or damage howsoever incurred (including by negligence) as a consequence, whether directly or indirectly, of the use by any person of any of the contents of the magazine. Copyright subsists in all material in the publication. Centor Publishing Limited consents to certain features contained in this magazine marked (*) being copied for personal use or information only (including distribution to appropriate patients) provided a full reference to the source is shown. No other unauthorised reproduction, transmission or storage in any electronic retrieval system is permitted of any material contained in this publication in any form. The publishers give no endorsement for and accept no liability (howsoever arising) in connection with the supply or use of any goods or services purchased as a result of any advertisement appearing in this magazine.

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sportEX health 2008;18(Oct):2


news policy

news in brief n Local authorities are being invited to submit applications for £30 million worth of grants over the next three years to become healthy towns. Each town will be entitled to up to £5 million in a drive to reduce obesity. Plans include encouraging the creation of more cycle lanes, walk to work and school schemes, and healthy food. www.dh.gov.uk/obesity n Dumfries and Galloway has launched a three-year physical activity strategy to help get the people of the region more fit and active. The strategy sets out a three year action plan and has been produced jointly by Dumfries and Galloway Council and NHS. It includes working with people in the workplace, meeting with GPs to assist patients to become more active, taster sessions, working with disability groups and training volunteers within local communities. www.dumgal.gov.uk/ dumgal/documents.aspx?id=29534 n A green exercise project to help people with mental health problems has been set up by Wiltshire Wildlife Trust and the Wiltshire Primary Care Trust. Structured activities will be offered to people who are at a high risk of mental illness. The project will run for 18 months and will encourage people to work on conservation schemes outdoors. The project aims to focus on people from ethnic minorities and people from socially excluded groups. www.wiltshirewildlife.org/ n Three local authorities – South Tyneside, Manchester City and Hertfordshire County Council are involved in a pioneering partnership to improve local health. The Local Wellbeing Project is a threeyear scheme led by the Young Foundation, exploring how new approaches to local services can enhance happiness and wellbeing. www.youngfoundation.org.uk/work/ local_innovation/consortiums/ the_local_wellbeing_project

www.sportEX.net

Free swimming for the over 60s and under 16s, subsidised gym and fitness club membership for 16-22 year olds, and a target of helping at least one million people to get more active through sport, are some of the initiatives announced by the Government under the Olympics 2012 Legacy Action Plan. The announcements, which feature some of the pledges already made in the Government’s obesity strategy, include: n Encouraging local authorities to offer free swimming to over 60s in England through a new £140 million fund; using the fund as a “challenge fund” to also encourage local authorities to offer free swimming to under-16s and to rejuvenate and maintain pools. n Sport England is to be streamlined drastically with the abolition of its regional board structure aimed at saving £20m. Sport England has a target to reduce by 25% the “drop-off” in participation in five as yet unidentified sports after the school-leaving age of 16. n Working with the fitness industry to offer a ‘Fit for the Future’ incentive for 16-22 year olds. A £1 million commitment will fund a 12 month pilot, to be launched in April 2009 and end in March 2010, to be implemented by approved gyms. It will provide thousands of young people full access to facilities ranging from cycling, rowing, dance aerobics, resistance training and swimming, as well as a trained team of fitness professionals. This programme will subsequently be rolled out nationally.

A LASTING LEGACY n Unveiling the ‘Inspire Mark’, part of the 2012 ‘brand family’. This is the first time the International Olympic Committee has approved a noncommercial brand, which will be awarded to non-commercial projects and programmes that help to deliver the legacy ambitions for 2012 and beyond. n Committing to meeting a target of getting two million people more active by 2012 to be partly achieved through the new Sport England strategy to get one million people more active through sport. See Sport England’s new strategy. www.sportengland.org/index/news_ and_media/news_pr/sport_england_ strategy_2008-2011.htm n Introducing a £7 million programme of campaigns to encourage people to walk more each day – including a Schools Walking Challenge to encourage more children to walk to and outside school. n Investing £75 million in a targeted social marketing programme to support parents in changing children’s diet and increasing levels of physical activity. The Legacy Action Plan is available at www.culture.gov.uk/ reference_library/publications/5161. aspx

Welsh audit committee condemns fitness failure An audit committee has condemned the lack of progress of the Welsh Assembly’s physical activity strategy and has highlighted ‘a lack of effective leadership’ in efforts to make the people of Wales more active. The National Assembly of Wales Audit Committee pointed out that no one has yet been appointed to lead the assembly government’s flagship Climbing Higher strategy, published in 2003. The committee added in its report, Increasing physical activity in Wales, that the importance of physical activity was not being communicated clearly to those who

needed it most and an action plan was needed. Recommendations from the committee include: n The appointment of a physical activity champion n The definition of roles and responsibilities to deliver the physical activity agenda n Consider placing a statutory duty on local authorities in relation to physical activity provision n Instigate a public awareness campaign on exercise targets and how to achieve them. www.assemblywales.org

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news in brief n The latest health profiles for every local authority and region across England have been published by the Department of Health and the Association of Public Health Observatories (APHO). The APHO along with the DH have also published a companion, ‘Health inequalities intervention tool’ that enables every English local authority to model the effect of four high impact interventions on their life expectancy gaps. The health profiles are available online at www.healthprofiles.info The Health Inequalities Intervention tool is at: www.lho.org.uk/HEALTH_ INEQUALITIES/Health_Inequalities_ Tool.aspx n The Department of Health has announced that parents will now be automatically informed about their children’s weight, unless they specify that they do not want to know, as part of the National Child Measurement Programme. Parents whose children are deemed to be unhealthy will be sent information about healthy eating and exercise and details of support services. Families may still refuse to allow their children to be weighed but schools and Primary Care Trusts will be told to encourage full participation. Previously, if parents wanted the information from the National Child Measurement Programme they had to ask for it. http://nds.coi.gov.uk/Content/Detail. asp?ReleaseID=375803&NewsAr eaID=2 n Paris marks the first anniversary of free public bicycles on its streets. Since the introduction of the bikes, cycle traffic has increased by 70% and the bikes are used for 120,000 trips a day each one averaging 22 minutes. On the negative side, however, there has been a jump in cycle deaths and injuries. The bikes, which are free for the first 30 minutes and are available from 1,200 docking zones, have proven more vulnerable than expected to thefts and vandalism. www.velib.paris.fr/

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WOMEN UNFIT AND FEELING EXCLUDED

Sport, a new independent body set up to examine how to combat the low participation in sport by women. www. wsff.org.uk/ n The Fitness Industry Association is working with the WSFF on a new programme to get more young women, aged 16-24, active in London. A three month pilot, that could spread to other major cities across the UK, ‘Sweat In the City’ will see participants given free membership to health clubs and leisure centres. The programme will cover the costs of group sessions for participating clubs and centres. www.fia. org.uk/activity-programs/fia-wsff-16-24. html

Four out of five women are facing a fitness crisis, warns a report from the Women’s Sport and Fitness Foundation. The report, Women in Sport Audit, states that 80% of women are doing too little exercise and the perception of exercise as being masculine prevents more from changing their habits. In a bid to address the problem, the government has announced the setting up of the Commission on the Future of Women’s

First cycling city named Bristol has been named the country’s first ‘cycling city’ as the Department of Transport announced a £100 million investment to turn one city and 11 towns into centres of urban cycling. Bristol City Council, in partnership with neighbouring South Gloucestershire council, won the bid which will provide Britain’s first ‘Paris style’ on-street bike rental network, the offer of free bikes to people in deprived communities, state of the art shower and locker facilities in the city centre,

dedicated commuter cycle ways linking the suburbs and the centre, and an expansion in training for schoolchildren. Bristol receives a grant of £11.4m, which will be matched with the same amount by each of two councils over the next 30 months. Eleven towns will receive awards ranging from £600,000 to £4.8million to become cycling demonstration towns. http://nds.coi.gov.uk/environment/dft/

Workplace health pilots started A pilot to test a new workplace approach to supporting the health and wellbeing of staff working in the NHS has started across three areas of England, involving 10 NHS trusts. Throughout the pilot, staff will receive on-line and off-line information on a wide range of health and wellbeing issues. The programme will also involve a healthy eating initiative that will encourage busy staff to make good choices for themselves followed by a strength and resilience programme

to help staff identify and manage pressures in the workplace and everyday life. At the end of the first year, staff will be able to reassess themselves to see what improvements they have made. If there is still work to do, they will be able to undertake two additional lifestyle management programmes. http://nds.coi.gov.uk/environment/dh/

sportEX health 2008;18(Oct):3-4


news research

research in brief n Being physically fit could hold back the advance of Alzheimer’s disease, US researchers have suggested. The study looked at 121 people aged over 60, around half of them in the early stages of the disease. Those with Alzheimer’s who were less fit had four times more signs of brain shrinkage than those who were fit. Neurology 2008;71:210-216 n Despite media and health campaigns aiming to raise awareness of healthy weight, increasing numbers of overweight people fail to recognise that their weight is a cause for concern, according to researchers. The study used data from household surveys of two representative samples in Great Britain, which showed that in 1999, 81% of overweight participants correctly identified themselves as overweight compared with 75% in 2007. British Medical Journal 2008;337:494 n A study by the Children’s National Medical Centre in Washington claims that the peer groups with which teenage girls identify determine if they control their weight. The survey of 236 girls aged between 13 and 18 found that those identifying with athletic peers were least concerned about their own weight. Journal of Youth and Adolescence 2008 online first www.springerlink.com/ content/0047-2891 n A study that investigated the relationships between exercise aids available at home, physical activity and perceived neighbourhood safety found that exercise aids were significantly related to physical activity in adolescent girls but not boys. Researchers concluded that girls living in neighbourhoods which their parents perceived to be less safe may benefit from having exercise equipment they can use at home. Medicine and Science in Sports and Exercise 2008;40(7):1244-1248

www.sportEX.net

The comfortably well-off, white, and middleaged are the most likely to participate in sporting activities, reveals a 10 year study. The study also shows that the gap between rich and poor, and black and white, appears to have widened, rather than narrowed in a decade, as overall participation in sports has actually increased. The findings are based on data from several of the annual Health Surveys for England between 1997 and 2006. These draw on a nationally representative sample of households. The entire sample comprised 61,000 adults, just under half of whom (27,217) were men. In 2006, men were around 10% more likely, and women around 20% more likely to participate regularly in sports compared with the figures for 1997.

Who takes part in sport? The increase is mainly attributable to gym and fitness activities, with both sexes, around 20%, more likely to participate in them than they were in 1997. The proportion of regular female runners/joggers also doubled to 4% over the decade. British Journal of Sports Medicine 2008 online first (25 July) http://bjsm.bmj.com/onlinefirst.dtl

Exercise referral schemes not very effective A systematic review and metaanalysis of research relating to exercise referral schemes has shown that although such schemes result in a statistically significant increase in the proportion of sedentary people becoming moderately active, the absolute risk reduction was small. The researchers found that 17 sedentary people needed to be referred for one to become moderately active. They added the schemes were not likely to be an efficient use of resources. The reseachers highlight

guidance from the National Institute of Clinical Excellence which states that schemes should only be recommended if they are part of a controlled research study. The researchers point out that a National Exercise Referral Scheme is being rolled out throughout Wales in three phases, and is being evaluated in a randomised controlled trial. British Journal of Sports Medicine online first (31 July) http://bjsm.bmj. com/onlinefirst.dtl

Formula for weight loss Women who want to lose weight and keep it off need to exercise for almost an hour, five days a week, according to US researchers. The study found that 55 minutes of exercise, five days a week and continuing a calorie controlled diet was the best formula for losing weight, and researchers found that the regime has to be stuck to rigidly for two years for the benefits to be maintained. The study involved more than 200 women who were overweight and obese over a four year period – they were told to eat between 1,200 and 1,500 calories a day and split into four different exercise programmes, varying the intensity and amount of exercise carried out. After six months women in all four groups had lost up to 10% of their body weight but most could not keep this going. The women who did maintain the 10% loss were those who reported doing more exercise – on average 275 minutes a week. Archives of Internal Medicine 2008;168(14):1550-1559

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We know where you live Where you live influences the type of activity you take part in, reveals a year long study from researchers in Holland. The researchers asked almost 5,000 men and women how much exercise they did of different kinds, including walking, cycling and gardening. It found that those living in the countryside spent more time gardening but cycled less and spent

an hour less walking each week then urban inhabitants. Researchers found no difference in the amount of time spent on jogging or other sports and concluded that those living in rural areas did no more or less exercise than those from the city. BMC Public Health 2008;8:206 www.biomedcentral. com/1471-2458/8/206

Time - main barrier to exercise

Technological interventions merge into health and fitness

A research survey of what prevents blue collar and white collar workers from taking part in workplace physical activity programmes found time was the main barrier for both groups of workers. White collar workers cited scheduling and work conflicts as impeding them from taking part, and blue collar workers stated that shift working and long hours prevented their participation. White collar workers were motivated by weight loss and appearance while blue collars worker wanted to maintain their health. Physical Activity and Health 2008;5(3):418-429

A number of studies at the American College of Sports Medicine’s 55th annual meeting highlighted how technology is starting to have an impact on health and fitness. One showed how sending e-mail messages about the benefits of exercise and positive images of healthy people exercising helped people keep active. A second study showed how a three-month telephone counselling programme conducted on pregnant and post partum women motivated them to exercise. A research team also showed how a step and glucose meter combined in a mobile phone can help those with diabetes. www.acsm.org/AM/Template. cfm?Section=ACSM_News_ Releases&TEMPLATE=/ CM/ContentDisplay. cfm&CONTENTID=10116

child’s BMI may be misleading Using a child’s body mass index (BMI) as a measure of the success of exercise targets may be misleading, according to experts. UK researchers could find no difference in BMI between those exercising regularly and those missing healthy exercise targets and suggests that blood testing might be the only way to measure exercise benefits. The study, carried out at Peninsula Medical school in Plymouth, examined the exercise levels of 113 boys and 99 girls born in 1995 and 1996 over a four year period using accelerometers. They found just over half of the boys and nearly nine out of 10 girls fell short of the hour a day target. However, there was no impact on BMI but blood testing revealed clear differences in the underlying metabolic signs of health – such as insulin resistance and cholesterol levels. Archives of Disease in Children 2008 (30 June) http://adc.bmj.com/onlinefirst.dtl

research in brief n A study involving qualitative interviews with heads of physical education and heads of schools in Lancashire and Cornwall concluded that it is evident that barriers still exist within the delivery of PE that discourages physical activity. Researchers state more research is needed to particularly address the complex issues of elitism and the ethos of physical activity in schools. BMC Public Health 2008;8:273 www.biomedcentral.com/14712458/8/273/abstract n Depressed older adults are as likely to enrol in a physical activity programme as non-drepressed members, although they are at higher risk of attendance lapses, according to a research study. It also showed that greater participation in the physical activity programme was associated with lower depression risk. American Journal of Preventive Medicine 2008,35(2):111-117 n A supplement setting out the evidence and issues surrounding the benefits to health of walking has been published in the July issue of the following reference. Medicine and Science in Sports and Exercise 2008;40(7):S1 www.acsm-msse.org n Australian GPs could do better in promoting physical activity to their patients, conclude researchers after studying trends in GPs’ knowledge, confidence and practices in this area over a 10 year period (1997-2007). Most GPs felt confident in giving physical activity advice and saw it as their role to do so. The research found that GPs in 2007 were far more likely to discuss physical activity with their patients than in 1997. However, the percentage of new patients that were asked about their physical activity levels had not changed over the last decade. British Journal of Sports Medicine online first (15 July) http://bjsm.bmj. com/onlinefirst.dtl

sportEX health 2008;18(Oct):5-6


training skills academy By Florence Orban

O

ur National Skills Academy, coordinated by the sector skills council SkillsActive, is very much employer-led and employer-directed – in short, designed by the industry for the industry.

THE AIMS The main vision for the National Skills Academy is to professionalise the sport and active leisure workforce and to support a sector that is growing fast. It will provide one coherent approach to all skills training in our sector, ensuring the highest possible standards of training are set and the best training providers deliver it. Opening later this year, it will be the best place learners can go to find out about and access the qualifications and training needed to most effectively do their job (paid or unpaid). The National Skills Academy for sport and active leisure aims to be: n An industry recognised in its own right for its professionalism, with a highly skilled, committed and diverse workforce, and a regular supply chain of new talent coming through. n A sector at the heart of best practice skills training, benefiting fully from government programmes and support, but at the same time contributing new ideas to developing core life, coaching, people, management and leadership, equality and diversity skills in all people - but particularly the 19-24 year old age group. n A sector genuinely open to all, offering work opportunities throughout every community in England, and at all skills levels. n An industry hugely attractive to young people, to black and minority ethnic groups, the disabled and women, and one which, because four out of five of its job roles are voluntary, part-time, and/ or seasonal, has a key role to play as a ‘gateway to other careers’. This is largely because of its ability to provide essential generic, and employability, skills.

WHY IT IS NEEDED As one of the most vibrant industries in the UK, sport and active leisure has been challenged to deliver on twin ambitions set by the government: 1. To establish a successful legacy of active participation following the London Olympic games in 2012 www.sportEX.net

2. To see 50% of the population active and healthy by 2020. This currently stands at 21%. To deliver on both targets, we require 100,000 new jobs by 2014 as well as the 85,000 new employees each year needed to replace parttime and seasonal workers. Also these figures do not include the army of volunteers required - four out of five people who work in sport and active leisure are volunteers. They represent a vital part of the industry and make up the 28% shortfall in the number of skilled employees desperately needed by the sector. The National Skills Academy will focus training and skills development around the needs of the employer and the requirements of the sector.

HOW IT WILL WORK As a training facilitator, the skills academy will offer flexibility in the way training is delivered. Learners will be able to gain qualifications online, on the job or by attending a training establishment. The Skills Academy will operate at three levels: n A website containing almost all the information and resources you need about careers, events and training in the sport and active leisure sector n Regional hubs that will eventually cover all nine regions in England n A small national head office that, in the first instance, will be based in London.

SKILLS ACADEMY The National Skills Academy is a concept launched by the government to deliver the skills required by each sector of the economy. Sport and active leisure is one of the 12 industries to be included in the initiative. The idea is that skills academies put employers at the heart of skills training, which means employers have a real say. This article looks at the aims and ideas of the new National Skills Academy for Sport and Active Leisure.

Hubs The first hub will open in London, initially at Crystal Palace National Sports Centre, before moving into the London 2012 Olympic Stadium immediately after the Games. The other centres will be located at Sheffield United FC and the Centre for Outdoor Management, Education and Training (COMET) in Penrith, Cumbria. Most people, however, are likely to access the skills academy virtually. The innovative website is currently being designed and will act as the National Skills Academy’s overall entry point to find out about working in our vibrant sector. 7


WHAT IT WILL DO? The National Skills Academy for Sport and Active Leisure will train 80,000 new entrants, existing staff and future leaders in the sport and active leisure industry every year. The sport, fitness and outdoor sub-sectors will launch later this year as phase one, while the play, work and caravan sub-sectors will roll out in 2009 as part of phase two.

THE TRAINING Training will be highly personalised and prioritised to address our industry’s three most pressing skills issues: 1. At level 1 - more school leavers entering the workforce with suitable employability skills (particularly selfconfidence, taking responsibility and people skills) 2. At levels 2/3 - more workers gaining technical qualifications (29% shortfall currently) and customer service skills (estimated lacking in 79% of front line staff) 3. At level 4 - more staff progressing into management and leadership roles (relevant skills lacking in 69% of existing managers, and high drop out rate). The main qualifications targeted for integration and development under the National Skills Academy umbrella are: 1. Apprenticeships including YA (Young Apprenticeships) and AASE (Advanced Apprenticeships in Sporting Excellence) 2. The newly developed Diploma in Sport and Leisure 3. Technical qualifications in fitness leading to a license to practice/REPs (Register of Exercise Professionals) 4. UK Coaching Certificate 5. Sport and leisure related foundation degrees 6. Business and management courses at Levels 3/4.

THE LEARNING ENVIRONMENT The learning environment will be leading edge and innovative but entirely dependant on the training provided and more importantly the preference of the learner.

Much learning can take place online via the new virtual platform. It will have three main components: an information centre that will be accessible to all visitors; a resource centre that employer members and individuals will have access to; and a communications centre for partners, which will include best practice guides and other operational information. Learners will also be able to access a more traditional trainerstudent environment. The regional hubs will have identified centres of excellence which, in many cases, will be located at established colleges, universities and other accredited training centres. These will comprise a wide range of training organisations and will be organised to ensure a good geographical spread of opportunities for learners to follow specialist courses. There will be a strong emphasis on work-based and bite-sized training, which is tailor-made to an employer or individual’s needs.

THE FINANCES

HOW IS IT DIFFERENT TO WHAT’S AVAILABLE NOW?

THE NEXT STEPS

There will be nine main differences immediately apparent for learners: 1. Ease of access to learning that is nationally directed and locally delivered 2. Quality of learning that is badged and guaranteed 3. Clear routes to employment, underpinned by recognised qualifications 4. High quality careers advice provided pre-entry 5. Increased access to level 3 qualifications 6. Increased chances to be promoted to supervisor/manager level 7. All learners equipped with an ‘active passport’ to support their qualifications and continuing professional development (CPD) 8. Increased opportunities for volunteering through better skills acquisition 9. A specific offer to volunteers that is based on equal access to qualifications.

there will be a strong emphasis on work-based and bite-sized training, which is tailormade to an employer or individual’s needs 8

All National Skills Academies have a commercial focus and need to attract investment from employers. The capital cost of the skills academy is estimated at £12.7m. Our skills academy will be supported by the Learning and Skills Council for the first three years of operation but will become self-funding after that. The current plan is to raise revenue through five main sources: 1. A percentage contribution from learner fees 2. An annual membership fee for chosen training providers 3. Employer subscriptions in return for support services, training provider support systems, learning materials, short course programmes and business development tools offered at a reduced cost 4. Government/Learning Skills Council subsidy 5. Commercial sponsorship and group buying power.

Although we are taking a phased approach, there will be some intense activity this year. We have started recruiting key personnel for the national head office and also the regions taking part in phase one – London, Yorkshire and the Humber and North West. Some of the other key activities will include developing the online portal and establishing the regional hubs. The first centres of excellence and skills academy training providers will also be accredited during the next few months.

MORE INFORMATION For further details on the development of the National Skills Academy for Sport and Active Leisure, visit www.skillsactive.com/academy

The Author Florence Orban is interim chief executive of the National Skills Academy for Sport and Active Leisure, where she will head the launch of a national initiative tailored to the skills needs of employers and learners. Prior to this, Florence joined SkillsActive as head of business development in June 2005 before taking on the role of project director for the National Skills Academy. Florence was responsible for the overall delivery of the project and submission of the business plan to the Learning and Skills Council.

sportEX health 2008;18(Oct):7-8


older people chair based exercise BY Bex Townley and Dawn Skelton

A QUESTION OF PERCEPTION The notion of ‘keeping fit’ is a question of perception that will undoubtedly change depending who you speak to, but important to our ageing population is that a great deal of disability associated with old age is a result of disuse, not disease. As we as an industry develop our knowledge and skills into ‘condition-specific’ exercise and with it embrace the concept of ‘ageing well’ (4,5) - it is vital that GPs and other health professionals working with older people give positive information about the benefits of regular appropriate exercise (5). Of key importance to us is that these professionals have awareness of the qualifications and skills of the people that deliver them (4,5). Chair-based exercise is probably the lesser-known qualification to the very key people that can help promote it and in turn modify the perceptions of what it means to ‘keep fit’.

WHO CAN BENEFIT Chair-based exercise is a safe and effective intervention for most frailer older people. Although it does form part of a falls prevention exercise continuum it is not an intervention exclusively for those at risk of falls, but serves as a purposeful and achievable form of exercise for those who have reduced mobility and/or impaired walking/standing capacity. It should be noted that participants do not have to be completely restricted to a chair to benefit, however if the participant is ‘too fit’, they will not be challenged sufficiently enough to progress (see box 1 for participant profile). The key component of the chair-based session structure involves seated strength exercises. Although many of the exercises lend themselves to be performed in a seated position, you would expect that, in view of their limitation, this is the most appropriate position for the target audience to adopt in order to achieve optimum strength gains at minimal risk. Chair-based exercise for some will be about maintaining functionality but for others it will be the first step with a view to progressing, over time, to functional standing and balance strength exercise.

TAKE A SEAT Physical activity is of benefit to all and even those who take up exercise in later years reap phenomenal benefits (1,2). The biggest problem within activity promotion is that the majority of older people mistakenly believe that they already do enough exercise to keep fit (3). This article looks at the case and place for chair-based exercise for older people. BOX 1: Chair based exercise participant profile n Requires walking aid to attend session n Able to transfer safely to suitable chair n Able to sit safely in a chair without arms n Able to support themselves in upright seated position without sway (will require regular rest in supported position)

THE EVIDENCE Decreasing physical capacity takes older people closer and closer to critical “thresholds” of performance necessary for everyday activities (3,6). In particular, decreasing strength, balance and coordination appear to be key risk factors for older people in falling. This is simply illustrated by the change in site of fracture with increasing age. In the 40-65 age group, wrist fractures become more common. Fractures of the hip become more prevalent after the age of 80 due to reduced reaction times. But as already stated, the benefits of chair-based exercise are not condition-specific. It can help increase habitual physical activity levels and improve functional capacity and independence in this vulnerable population.

Chair based exercise is a safe and effective intervention for most frailer older people www.sportEX.net

Chair-based exercises have been shown to have a beneficial effect at maintaining or promoting independence and mobility in older people. The wider range of improvements to both community dwelling and frail institutionalised older people have been demonstrated in research trials, lasting eight weeks or longer (6,7), examining the impact of chair-based seated and chair-assisted standing exercises (1,2). These include: An INCREASE in: n Strength n Power n Flexibility n Ability to perform everyday tasks n Balance.

And a DECREASE in: n Depression n Body fat n Arthritic pain n Postural hypotension n Risk of falls n Fatigue.

The scope of this article does not allow the full list of evidenced material to be referenced but suffice to say the Chair-based Exercise Leadership module put together by Later Life Training uses specific exercises shown to be of benefit in published research (3,4). 9


Bonus benefits In addition to the potential for physical gains in strength and function, as with any type of exercise comes a whole host of other benefits and positive ‘spin-offs’ to body and mind (1,2). This is of particular relevance to our ageing population where reduced mobility and resulting decreases in confidence, bring with it reduced opportunities to socialise and potential isolation. This is not to imply that all of our target audience would jump at the chance to take part. The usual barriers to exercise still apply (along with more). However a trained chair leader or exercise instructor can remove the logistical headaches of transport provision by working in any setting with nothing more than a bag of resistance bands, at a time suitable to the participants and in the comfort of their own home/environment. The need for movement and basic mobility within this progressively sedentary (leading to chair bound) population is obvious. Unfortunately, it is the opportunities for this to happen that are lacking. Sheltered housing complexes, day centres, social groups, condition-specific support groups and residential care settings are all prime locations where our suitable participants can be found. Programmed activities including ‘physical activities’, are commonplace within these settings however, how purposeful or beneficial is it? One could argue that any level of activity and psychosocial interaction in these environments is of benefit, but we can do more towards maintaining independence with a more focused approach to our chair-bound target population.

THE QUALIFICATION The qualification was originally funded by the Department of Health as part of an exercise continuum for frailer older people (www.laterlifetraining.co.uk/page4.html). The Chair-Based Exercise Leader qualification is appropriate for any of the following wishing to lead chairbased exercise sessions: n Healthcare professionals already working with older people n Qualified exercise instructors n Volunteers already working with older people n Care workers (in residential/day care settings) n Sheltered housing wardens. The course acknowledges that across this diverse selection of occupations comes a massive gap in prior (exercise physiology etc) knowledge. To this end the course is available as a two day course to existing exercise instructors already holding an NVQ in Exercise and Fitness, and a five day course for those with no prior learning of this subject.

Fitness instructor v volunteer leader: ensuring safe, effective and consistent delivery? The aim of chair-based exercise is to improve circulation, mobility, strength and flexibility through safe evidenced

The real beauty of it is it doesn’t necessarily take a highly qualified fitness professional in a dedicated role to ofFer this choice 10

exercises. This is achieved through a structured programme where candidates learn to lead 17 specific and pre-set chairbased exercises with particular emphasis on technique and safety. There is no requirement for programme design, which is one key reason why it lends itself to delivery by nonfitness trained individuals.

Structure The programme follows a set structure of exercise to include: n Boosting circulation n Increasing mobility n Stretches n Strengthening exercises n Pelvic floor work n Flexibility n Relaxation and revitalising. The session aims to: n Improve performance of activities of daily living n Strengthen key muscle groups n Promote a sense of rhythm n Improve posture n Promote circulation n Increase range of movement at each major joint n Stimulate movement memory n Improve co-ordination.

THE FUTURE OF GETTING OLDER There is an urgent need to appreciate the value of enthusiasm, positive images and sound advice rather than the inaccurate, ‘What do you expect at your age?’ attitude. Chair-based exercise offers a simple solution along with a massive opportunity for a vast population rendered sedentary because they just do not have a choice. The ‘older olds’ in sheltered housing, day centres and residential care, for example, just cannot access this ‘elixir of life’ as easily as the rest of us. The real beauty of it is it doesn’t necessarily take a highly qualified fitness professional in a dedicated role to offer this choice. As the following example details, the versatility of the course structure allows anyone, already working with older sportEX health 2008;18(Oct):9-11


older people chair based exercise people, to gain this qualification and help make purposeful, enjoyable, safe and achievable exercise more accessible.

An example Chair-based exercise leaders in practice To date over 2,100 chair-based exercise leaders have qualified, reaching over 12,000 older people each week. Perth and Kinross Healthy Communities Collaborative wanted to extend their specialist falls exercise continuum, led by physiotherapists and postural stability instructors, to a wider group of professionals working with older people. Having identified limited opportunities for frailer older people to exercise, through their collaborative working, five sheltered housing wardens and four volunteers gained the Chair Leaders exercise qualification. As a result: n 14 chair exercise groups now take place on a regular basis within sheltered housing community lounges, and one in a local leisure centre. n Approximately 120 older people are benefiting but most importantly they are having the opportunity to exercise, the majority in their own housing complex. n Solely older volunteers run two of the groups. In some of the more remote locations, if numbers allow, non-residents may have the opportunity to attend. “These groups have not only had a positive influence on the physical health of the older people attending, they also inspired those attending to meet for other social interaction including indoor kurling, knitting and short supervised health walks. The whole experience continues to contribute to their physical and mental well being and improving their quality of life,� commented Jackie Doe, project manager, Perth and Kinross Healthy Communities Collaborative.

The Authors Bex Townley works with specialist populations in South Wales. Dr Dawn Skelton is a reader in ageing and health at Glasgow Caledonian University. Both work with Later Life Training.

References 1. Young A, Dinan S. Active in later life. Chapter in McLatchie G, Harries M, Williams C et al (eds). ABC of Sports Medicine (2nd Edition). British Medical Journal Books 2005. ISBN-10 0727918133 2. Nelson ME et al. Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Medicine, Science, Sports and Exercise 2007; 39(8):1435-1445 3. Skelton DA et al. Physical Activity in Later Life: Further analysis of the Allied Dunbar National Fitness Survey and the HEASAH. Health Education Authority 1998 4. Jones CJ, Rose DJ eds. Physical Activity Instruction of Older Adults. Human Kinetics 2005. ISBN-10 0736045139 5. Dinan SM. Exercise for Vulnerable Older Patients. In Young A, Harries M, eds. Exercise Prescription for Patients. Royal College of Physicians 2001 6. Skelton DA et al. Effects of resistance training on strength, power and selected functional abilities of women aged 75 and over. Journal of the American Geriatric Society 1995;43:1081-1087 7. Skelton DA and McLaughlin A. Training functional ability in old age. Physiotherapy, Theory and Practice 1996;82:159-167.

FURTHER INFORMATION n Later Life Training Ltd www.laterlifetraining.co.uk e-mail: info@laterlifetraining.co.uk phone: 01838 300310 n Chair Leaders info at www.laterlifetraining.co.uk/ChairLeaders.html

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schools getting girls active

The energy project The Energy Project is a joint initiative involving the Helen Storey Foundation and the Women’s Sports and Fitness Foundation. They commissioned the Faculty of Health and Well Being at Sheffield Hallam University to conduct a study to find ways to increase physical activity among schoolgirls through the creative use of existing school time. This article looks at the ideas the project schools came up with and provides tips for teachers.

by JAckie cresswell

WHAT THE PROJECT SET OUT TO DO? The project explored the relationship between energy, education and physical well being and considered the following questions: n What is the total energy expenditure of girls over the course of a school week? n Can the school day be restructured to introduce new activities and rearrange lesson to increase girls’ physical activity and energy expenditure? n What impact do higher levels of physical activity have on girls’ sense of well-being and their learning and behaviour? It looked at how to raise the energy levels of girls when required but also examined at calming them down for better concentration in lessons. They were also interested in looking at what opportunities there are to increase activity across the school day outside of PE lessons.

WHAT THE PROJECT INVOLVED Three schools in south London took part in the project involving 45 girls and 15 teachers. They were asked to wear accelerometers for a week to measure their activity levels throughout the school day. The girls and teachers recorded what they did outside of school and described when they felt most energised through the day, and when they felt at their least energised. They were also asked for ideas on how to raise their energy levels as well as their activity. The project then worked with the schools to introduce new activities and to rejig their school day to enable the girls to try new ways of being active. This went on for a week, when the girls and teachers wore accelerometers again, 12

to see the impact. The girls and teachers then fed back their views on what they thought of the new rejigged week.

BRIEF FINDINGS Briefly, there was no improvement in the mean accelerometer count between the two weeks but the project did show that the specific interventions to boost physical activity introduced at registration, break and lunch worked well.

SOME IDEAS FROM THE SCHOOLS Breakfast clubs followed by a 25 minute activity session built into the assembly. Activities inlcude Tai Chi, cheerleading, Pilates, cricket and gospel singing n The first break of the day became a structured sport break including supervised activities such as football and power walking n Staff were encouraged to create energy lifting activities in lessons, such as movement, raps and spelling chants n Fresh fruit and water were made available throughout the week n 10 minutes of aerobics or dance activity after morning registration with 10 minutes of yoga after lunch were introduced n Introduced brain gym activities n Making sports facilities and equipment available during the lunch break n Structured lunchtime activities were offered such as football, badminton, circus skills, roller blading, space hopper relays and double-dutch skipping. n

The Energy project’s tips for teachers n Make sure the senior management team of the school are on board and other teachers are committed to redesigning the school timetable. It might be useful to explain the benefits of altering energy levels on student behaviour and motivation n Involve and empower the student to make decisions – consult them about what activities they might want to do n Prepare the students about what to expect. The project found that young girls found it hard to exercise within a classroom context and benefited from a briefing about the activities covered n The changes don’t need to be huge to make an impact. Small changes made to already scheduled curriculum lessons proved successful. n Start small. It’s easier to use a sample from one class or year group to develop ideas that can then be rolled out more widely. n Think beyond the obvious n Demonstrate what the effects of exercise can be in helping students focus mentally n Think about using your off-curriculum time - each of the schools in the project invented their own off-curricular activities.

Information: Full report and information on the energy project can be found at http://wsf.org.uk/itstime/Energy_Project.php

sportEX health 2008;18(Oct):12


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Welcome to a sneak preview of what’s coming up at the Major Moves 03("/*4&% #: conference 2008 - 23rd September 2008, NEC Birmingham!

The theme of the conference is how to use technology to promote physical activity. Read on for more information.

´JOTQJSBUJPO JOOPWBUJPO NPUJWBUJPO At Major Moves 2008, For more information visit you will: www.MajorMoves08.com If you are BSPVOE UIF XPSME JO B EBZ¾ booking from a school, PCT/LA or

l Beam physical activity information to phones l Discover the power of Google Pedometer as a motivation tool l Understand how to use Facebook and Second Life.....for work! 5IJT ZFBSÂľT UIFNF JT ²#FTU QSBDUJDF QIZTJDBM BDUJWJUZ l Try out some of the latest ‘exergame’ inQSPNPUJPO QSPKFDUT GSPN BSPVOE UIF XPSMEÂł GPDVTJOH PO novations â—? DIJMESFO BOE TDIPPMT l Review the evidence base - which games â—? FNQMPZFFT BOE UIF XPSLQMBDF work, for what and who â—? IBSE UP SFBDI HSPVQT l Find out what the rest of the world is doing. l Take part in an exercise-driven loyalty â—? PMEFS BEVMUT system 1-64 QSBDUJDBM EFNPOTUSBUJPO TFTTJPOT JO -*8 l And true to sportEX style - we promise it will be jargon-free, highly practical and most of all a whole lot of fun! Here we will introduce you to the exciting new technologies that are 13*$*/( revolutionising your industry &BTZ +FU UZQF QSJDJOH QPMJDZ TJHO VQ GFF TUBSUT MPX BOE

other organisation and do not wish to pay by credit please have NB K P Scard, N PWFT J O Q I Z T J DB M B DUJ W J UZ Q SP N P UJPO a purchase order number to hand when booking, to secure your place.

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It’s not too late to buy tickets for this year’s event. We’ll be taking bookings right up to 22nd September – if you are booking through an organisation and therefore aren’t paying by credit50 #00, DBMM VT PO PS WJTJU XXX TQPSU&9 OFU card eg. school, PCT, LA etc. please make sure you have an official purchase order number when you make your BOOK NOW £95 per delegate booking to guarantee your place. 16HXp24OBC.indd 1

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Contact us on +44 (0)845 652 1906 or www.MajorMoves08.com www.sportEX.net

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By Biray Alsac, MS

Statements like ‘Google it’ and ‘upload to YouTube’ is a clear indication that the web we know today is significantly different from the one ten years ago. Websites have become more user-friendly and user-centric. Online participation has turned into a cut-and-paste, click-n-drag interaction. This shift from being the world’s ‘information superhighway’ to being a platform for dynamic interaction has captured the attention of more online users. And now, conversations about its relevance and application to health promotion and physical activity are becoming much more prevalent. This article looks at how to make the best use of this technology.

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WHAT HAS CHANGED OVER THE YEARS? 1. The capabilities of the user have increased. People can easily create and regulate content without the barriers of knowing code or having webmasters. This distinction is why the web is now referred to as the ‘read/write web’ or ‘semantic web’ (and sometimes ‘Web 2.0’). 2. The advent of broadband technology has allowed more information to be transmitted over the internet. What once took hours to download, now takes seconds to download or stream live. 3. The move from wired to wireless has made ‘being online’ much more convenient and flexible. Anyone, anywhere, at anytime can check email, keep up on current events, or record a live media broadcast instantaneously. And the best part, most of these tools are free!

WHAT DOES IT MEAN FOR HEALTH AND FITNESS? Despite these technological milestones, what do these advancements actually mean in the world of health and fitness? Its appeal is understandable with powerful mobile phones in the palm of your hand, the addictive nature of networking on Facebook, and the freedoms of the avatar lifestyle. But these things aren’t going to solve the increased incidences of cardiovascular disease, Type-II diabetes in children and obesity rates. Or are they? Could our efforts online play a significant role in impacting the health and wellness of a society? The long-term effects of using web 2.0 for health promotion and physical activity initiatives are inconclusive due to the fact that most of these tools are still in their infancy. However, the enthusiasm behind their potential application warrants further exploration. This may be why health organisations and fitness experts are embracing these online tools. Perhaps they are hoping to engage a greater audience, enhance their current professional efforts, and expand their field of expertise.

sportEX health 2008;18(Oct):14-16


TECHNOLOGY activity promotion on the net

Blog, twitter or facebook for health EXAMPLES AND EXPERIMENTS Below are examples and experiments on how these technologies have been applied to various health and fitnessrelated objectives:

viewing weekly vodcasts (video broadcast) made by those participating in the wellness plan. Podcasts are being used to guide people in audio fitness workouts and educating them in health news.

Social bookmarking

Social networking platforms (Facebook, Bebo)

This is a way for internet users to store, classify, share and search internet bookmarks. It is being used to increase resourcefulness and professional authority on a topic or series of topics. By ranking and sorting information through a trained eye (as opposed to a random Google search), professionals are creating a repository of useful links, websites and data simply by highlighting the web. Programme directors and personal trainers are utilising online chatting services and instant messaging programmes to establish an online presence and increase additional points of support within their community. For example, Twitter (a micro-blogging site that also acts as an instant-messaging or text-messaging platform) can be effective in motivating individuals to exercise more by reinforcing their behaviours via short encouraging statements.

These have opened pathways for health professionals to network within various communities, often reaching an untapped audience. Besides an alternative arena for marketing and promoting health events, social networking sites are often helpful in understanding the behaviours of a demographic in an informal setting. Although broader networks like Facebook tend to be the most popular, niche networks (Gyminee, Wellsphere) have surfaced to encourage interactions and build communities specific to health and fitness.

Media sharing sites (Flickr, YouTube, Utterz)

Blogging What about blogging for health and fitness? According to Technorati, there are over 112 million blogs online. In October of 2007, the Nursing Online Education Database listed the top 100 Health and Wellness blogs which included blogs on diet and nutrition, weight-loss, walking and hiking, general fitness, physical health, strength training and alternative

These are mainly used to document people and events but are being used in nutrition and weight-loss programmes. Clients are tracking what they eat by submitting imagebased food diaries online. Fitness progress is monitored by

Definitions Blogging - pages on a website usually maintained by an individual, with regular entries of commentary (derived from the term web log) Micro-blogging - another type of blogging which consists of posts with very short posts (comments). Instant messaging (IM) - a form of real-time communication between two or more people based on typed text conveyed over a network like the internet. Social network - a social network made of nodes (eg. individuals or organisations) that are tied by one or more interdependencies like values,

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visions, friendship. Examples include Facebook, MySpace or Twitter. Avatars - a computer-user’s representation of themselves, a personality connected with a screen name of an internet user. Podcasts - digital media files distributed over the internet - it can refer to the material itself or to the method by which its distributed (podcasting) Virtual worlds - a computer-based simulated environment in which users interact via ‘avatars’ Web 2.0 - a development in internet technology that aims to enhance creativity, information sharing and collaboration

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health. Although these blogs often publicly document a health experience or highlight a professional’s expertise, wellness coaches and personal trainers are using private blogs to monitor clients’ progress and enhance professional relationships among staff or employees.

Virtual worlds (SecondLife) Health and fitness correspondents are also experimenting in virtual worlds, delivering educational programmes and facilitating activity classes through their avatars. It is not uncommon to find yoga seminars and guided meditation classes. There are simulated virtual islands dedicated to promoting health-related topics, from cancer and HIV awareness, to mindfulness and exercise. In fact, coaches are offering virtual cycling classes. And avatar athletes are participating in monthly triathlons! The American Cancer Society holds an annual Relay for Second Life fundraiser and this year they have raised over $US200,000 for their efforts.

A FRESH APPROACH Whether it be blogging, podcasting or Flickr-ing, individually these tools bring a fresh new approach to fitness programming and health campaigns. But the real excitement begins when these tools are integrated together. When a picture you take from your mobile phone uploads to Flickr in one click. And the picture you post on Flickr instantly shows up on your blog. And the content you write on your blog informs your group on Facebook. And the connections you make on Facebook links to a crowd on Twitter. And finally the feeds you follow on Twitter show up as text-messages on your mobile phone. It is in these types of cyclical scenarios when the power of the web is ultimately realised.

BUT FIRST CONSIDER THESE Since there are hundreds of new online social media sites, not all may be effective in delivering the same return on your investment. Although the web is inspiring and empowering many professionals to build greater online presence, there are few things to consider prior to utilising these resources. 1. Going ‘real-time’: Every community has its own set of unofficial guidelines. If you want to interact with an online community, you should be prepared to engage in ‘realtime’. People expect content to be timely, feedback to be immediate, and information to be relevant. How much of your resources and time are you willing to devote to developing online efforts? 2. Being authentic: With information being transparent online, it is easy for anyone to reference-check various topics. Keep your efforts authentic and messages genuine. People immediately sense when organisations are engaging an audience under false pretenses (ie. a blogger getting paid to write positively about product or service). The online community will respond when you articulate your purpose and stand by it, consistently. 3. Being approachable: Having a human quality to your online 16

interactions is favourable. It is not necessary to disclose personal information (phone numbers and email addresses) in order to give the impression there’s a ‘real’ person behind your online efforts. Web tools are allowing people to be approachable without giving up their privacy. For instance, people can use Twitter to direct-message you, post a comment on your blog to express their opinion, or write a note on your Facebook ‘wall’ in order to connect with you. 4. Accepting criticism: When you post content online you are exposing yourself to multiple forms of feedback and criticism. Are you prepared follow-up these conversations effectively? For instance, if you get a negative comment on a blog post, should you delete it or approve and post a followup response? When does moderating feedback become a form of censorship? This ties in with considerations 1 and 2 – stick to what you know and respond in a timely fashion to concerns and comments. 5. Social media policy: What are the rewards and consequences from participating in the online environment? A social media policy is helpful in determining online expectations and setting appropriate standards for your organisation. Some health and wellness centres or programmes that are corporations, government or academic institutions may already have policies and regulations regarding online marketing and publicity. If you work with a legal department, it might prove helpful to include them in these conversations, too.

THE MAIN EVENT Today’s cutting edge technology is preparing professionals to think laterally in this next generation of health promotion and fitness programming. Carly Fiorina, ex-CEO of Hewitt-Packard, once said that: “The past 25 years in technology has been a ‘warm-up’ act. What we’re entering is the main event, and by ‘main event’ I mean an era in which technology will truly transform every aspect of business, of government, of society, of life.” The question is not whether or not technology will evolve. The question is how will health professionals adopt and apply these technologies in order to determine their future evolution. Could these web-based tools be integral in those efforts to help people adopt healthier lives in the next era? I sure hope so!

The Author Biray specialises in teaching health, fitness and wellness professionals how to integrate internet technologies and social media in their own initiatives. Biray also works at an adjunct faculty in the Exercise Science & Physical Education department of Mesa Community College in Arizona. Her teaching area includes courses that cover healthful living and basic principles of fitness and wellness. She is also the 2007-08 facilitator to one of the Faculty Professional Learning Communities (FPLC) on campus for New Media Technology, a group of faculty/staff who gather regularly to discuss ways teachers can integrate new technologies into their classrooms to improve student learning.

sportEX health 2008;18(Oct):14-16


TECHNOLOGY exergames BY By Alisdair Thin, BSc, Phd

THE START OF THE QUEST It all started more than three years ago on a winter break, staying with relations in southern Germany. One evening my cousin hooked up his Playstation 2 to the television and set his EyeToy camera on the top (detects body movement) and away we went. These were video games with a difference. In the words of the introduction to the games compendium “You are the controller!” Out with the joy pad and the twiddling of fingers and thumbs and in with arm waving, head nodding and dodging from side to side. So I frantically washed a never ending sequence of windows, headed footballs, spun plates, karate chopped myself out of danger and went three rounds against a robot in a boxing ring. In this latter game my arms were burning and I was starting to get a bit breathless. Hold on a minute…I am having fun playing video games in front of a television but it is also jolly hard work. It was all rather surreal. It was at this point that my training as a scientist, specifically an exercise physiologist, came to the fore. This wasn’t exercise as we know it in the conventional sense, but whatever it was, it required real effort and was great fun at the same time! For many, exercise is not synonymous with fun. Even the term ‘working out’ suggests something that is tedious and a chore. On my return to Scotland, I reflected on what I had experienced. I had taken a module on health promotion in my final undergraduate year and had worked for a short period in the field after graduating. I began to wonder that, rather than trying to tell people to exercise because it was good for them, they might just rather play a game, have some fun and be physically active all at the same time. But first I would need to collect the experimental evidence in order to justify this.

COLLECTING EVIDENCE The purchase order of a Playstation 2 and a couple of EyeToy games raised a few eyebrows at work, “Surely this wasn’t really for research purposes was it?” Spurred on by media reports of rising levels of childhood obesity, I set about organising three research projects to start in the autumn of 2004. The degree of physical exertion and www.sportEX.net

EXERGAMES: A PERSONAL QUEST It has now become an occupational hazard to be asked “So tell me Dr Thin, what it is like playing video games all day for a living,” by journalists. What started as a personal quest has now grown as the potential for ‘exergames’ to boost physical activity has begun to be recognised. This article looks at that personal quest to find exergames for health.

hence energy expenditure (EE) would be determined by measuring oxygen (O2) consumption and for comparison purposes heart rate (HR) would also be recorded. The former gives an indication of the energetic demands of an activity and the latter shows the degree of

rather than trying to tell people to exercise because it was good for them, they might just rather play a game, have some fun and be physically active all at the same time

Above: Boxing-based game played with motion-sensing gloves Top: Exergame played by punching and kicking sensors in sequence as they light up

strain on the cardiovascular system. Subjects were hooked up to a gas analysis system via a face mask and O2 consumption was measured throughout game play. HR was measured using a monitor strap that is worn by the subject around the chest. While any increase in daily EE is to be welcomed, the optimal intensity for health-related exercise is recommended by the American College of Sports Medicine to be between 50-85% of the difference between a subject’s resting and their maximal rate of O2 consumption. For practical purposes, a similar range of 17


Balance-based game played by tilting platform

Boxing-based game played with motion-sensing gloves

Dance game played using mats with integral foot switches (two mats in centre)

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HR values is available. Conventional forms of exercise usually involve leg or whole body movement and for these types of activities there is a validated relationship between HR and O2 consumption. However, for arm exercises, the relationship breaks down and HR has been found to be disproportionately higher for a given level of EE. This indicates that when studying the exertional demands of exergames, HR should not be used as a primary indicator as it may lead to an overestimation of energetic demands. All subjects had a familiarisation session with the games before measurements were made on a separate occasion. These commenced with resting baseline measurements before proceeding to periods of game play. In addition to the cardiorespiratory measurements, a range of other factors that might affect the level of exertion were also assessed including hand-eye coordination, postural stability and training in martial arts. The results for two of the early games, Kung Foo, a martial arts based game with a sporadic arm chopping type of action and Groove, an exercise to music game requiring rhythmic arm waving in time to the beat of the music, were a little disappointing. The level of EE required to play both these games was significantly below the target range for health benefits. The results for the third game were much more promising. The game, Boxing Chump, involves rapid-fire arm movement to play and the EE was within the lower end of the target range. The subjects in this study also undertook an incremental exercise test using a wall mounted arm crank ergometer. Interestingly, the results from the test indicated that the subjects were playing the Exergame at an intensity close to the limit of the capacity of their arms. There were obvious limitations with the game as it was only exercising a relatively limited muscle mass (there is only so much arm waving that you can do) and so the level of EE that you can achieve is restricted. Having reached the limit of the then current games technology a year passed before the next study was to begin. In the meantime, EyeToy Kinetic came on the market, a game that was specifically designed to be a work out. It includes virtual personal

trainers, exercise schedules and a diary function. Two games from EyeToy Kinetic were studied: Cascade, which requires whole body movement to play and to me looks very much like an improvised version of exercise to music without any rhythm to it. The measured EE for this game scraped in at just above the bottom end of the target range needed for exercise to provide some health benefits. Sidewinder, which requires all out rapid-fire arm punching in conjunction with torso and leg movements. Most impressively, this game produced an EE that was in excess of the top end of the target range and convinced me that I was most definitely onto something. As I was analysing the results of the EyeToy Kinetic project due to be submitted for the Life Sciences 2007 conference in Glasgow in July, the recently released Nintendo Wii was starting to attract a lot of interest. Here was a whole games console-based around body-movement controlled gaming rather than just an add-on. Anecdotal reports indicated that people were working up a real sweat playing the games with a downside of overuse injuries due to unaccustomed exercise. The conference and its submissions had attracted press attention and there was growing interest in this field against the backdrop of rising obesity levels.

EXERGAMES SYMPOSIUM This growing interest led to my involvement in the planning of a symposium on exergames for the International Society for Behavioral Nutrition and Physical Activity’s 2008 annual conference in Banff, Canada. Around the same time the Games for Health 2008 conference in Baltimore came to my notice and I realised I ought to be there too. A number of individuals in the US were beginning to explore the potential of so called exergames. I managed to get some funding from the Carnegie Trust and so was able to go and visit a number of the individuals concerned and see some “exergaming� facilities. At the time of writing this article, I am still digesting the information I gathered and other academic duties have had to take precedence.

PRACTICAL APPLICATIONS In terms of practical applications, if the goal is to maximise energy expenditure sportEX health 2008;18(Oct):17-19


tecnology exergames then maximising the muscle mass involved is the key. Also rapid fire games rather than rhythmic ones appear better as they don’t rely on the sense of timing of the player.

Expertise not necessary There was no evidence of any relationship between Game Score and EE. In fact, in the game with the highest EE (Sidewinder) some subjects lost points as fast as they could accumulate them. There were also no relationships between hand-eye coordination or postural stability and EE. Half of the subjects who were involved in the Kung Foo game study were trained martial artists and although their average game score was significantly higher, there was no difference in the EE between the two groups. So, basically, game score is not an indicator of EE (in these games at least)! Until games are designed with the ability to adapt to an individual player’s skill and level of fitness, you could monitor the level of physical exertion using a heart rate monitor as a rough guide, although it will tend to over-estimate the intensity of games based solely on arm movement. Remember though that we are talking about games, the primary goal of which is fun. So I would like to express a note of caution and be wary of simply shoehorning exergames into established health promotion schemes.

Will the novelty wear off? There were several questions on this issue at the ISBNPA symposium. At present, I think that current exergames are only scraping the surface of what is possible – so the likelihood is these games will be developed further. Indeed, I have begun a dialogue with video games developers as to how best to take the field forward.

THE PERFECT EXERGAME So from a health promotion perspective, what would the perfect “ExerGame” look like and what sorts of features would it have? I would suggest it would at least offer: n Positive feedback n Monitor game play time and exertion level n Provide a progress chart n Reward feedback n Offer exercise tips and advice n Give skills development and coaching My quest for perfection will keep www.sportEX.net

me occupied for a good few years to come and can be followed on my blog www.gamersizescience.org.

Try it It is worth trying the Wii Fit to see what is going on and start to get an idea of what is possible. Add in the networking of exergames over the internet and a real sociability could develop. Obviously the long-term appeal is an issue that needs to be carefully considered and addressed when designing future games.

THE BOTTOM LINE Even if all exergames manage to do is get the player comfortable with the bodily sensations that result from physical exertion and improve their confidence (self-efficacy) to try new activities then they will have helped to overcome two important barriers to becoming physically active. They could be seen as a stepping stone to becoming physically active and there is no reason these games cannot happily coexist alongside conventional activities and sports. Indeed they could be a good substitute when it is too cold, dark and wet in the winter to play outdoors (Scottish winter), or when it is 100ºF (37ºC) in California and too hot to exercise outside.

OTHER ASPECTS Motor skills There is also potential for exergames in the development, maintenance and rehabilitation of motor skills. A quick search on the web will pull up a good number of media reports of clinicians turning to exergames as a way to make rehabilitation exercises more interesting. There has also been some talk that youngsters are clumsier these days than they used to be. There is reason to believe that lack of outdoor play may be a factor, although I failed to find any research reports on this topic. However, exergames may well have applications in this area too.

Using the games It is important to recognise that exergames have arisen out of a long history of video games development. Clearly all games are not equal and some are more intense than others. While heart rate may underestimate the intensity of exertion when playing an ExerGame, it will help give an idea of the amount of time spent actually

Balance-based ski jumping game played by shifting centre of pressure on a board

being active. I would therefore suggest that if exergames are to be used in an intervention, then HR data will provide useful information. In the early stages let players’ own curiosity dictate what they do, although they may well need some coaching here and there to get started on some games. As players’ skill levels improve, depending on how much time they spend being active, a degree of structure to their play could be introduced, as it can be quite easy to become a spectator.

FINAL THOUGHTS The video games industry is huge and definitely here to stay. There is a real opportunity to capitalise on the wave of enthusiasm for active video games that have turned them into a social phenomenon. However, if excessive claims are made, or they are simply slotted into traditional health interventions or game design is not informed by exercise physiology, then a real opportunity to have a significant positive health impact may very well be lost. The Author Dr Alasdair Thin BSc, PhD is lecturer in human physiology at Heriot-Watt University, Edinburgh. After completing his undergraduate degree in Physiology and Sports Science at Glasgow University, he worked for a time in health promotion before moving into lecturing. He studied for his doctorate in clinical exercise physiology at University College, Dublin prior to taking up his current post.

Acknowledgments I would like to thank all the students and staff at HeriotWatt University who worked on the various projects and also the School of Life Sciences Heriot-Watt University, The Physiological Society and the Carnegie Trust for the Universities of Scotland who provided financial support. For more information see: www.gamesforhealth.org www.itechfitness.com/ www.xrtainmentzone.com/ www.gamersizescience.org/ www.time.com/time/magazine/article/0,9171,1661688,00.html 19


By Andrew smith

THE MOBILE PHONE The mobile phone has quickly become an essential item for most people. In a study of young people it was described by most as the ‘thing they could not bear to be without’ (3). The mobile phone has also become used as a personal item where private information is stored or transferred to others.

SMS VS BLUETOOTH Many services have started to use the mobile phone as a contact medium via SMS (short message service) to contact clients or patients (4,5), and although this has shown to be an excellent way of engaging many people in services, there are some clear problems with this kind of communication method. To use a text message service you need a database of mobile phone numbers and an agreement that you can contact clients or patients in this way, there is an economic cost to this service at around 4p per text plus the data entry into an SMS programme. Bluetooth on the other hand is a free service that doesn’t require any personal data and may be the way to target specific client groups with specialist information. All you need is: n A Bluetooth transmitter n Ideas on how you want to use it n Some assistance in setting up transmissions.

HOW IT WORKS Bluetooth is the most widely used WPAN (Wireless Personal Area Network) (1) and although it is a relatively new advance in communication technology, in a comparatively short time, it has become a staple on most mobile phones, PDAs (personal digital assistant) and laptops. As a result of the way in which Bluetooth works it seems to be the perfect way to transmit targeted messages to specific groups of people. Basically, Bluetooth works by sending a message from a Bluetooth transmitter, this transmitter can be a specialist piece of equipment or another mobile phone, PDA or laptop. The transmission searches for other Bluetooth enabled devices in the area and then tries to send its message to these devices. If the message is sent to a mobile phone, laptop or PDA the user has to accept the data transfer to download the message. Once the message is accepted then data transfer occurs and the transmission of the message is completed. Messages can be sent in a variety of formats including photo images, text images, animated images, contact information and even music files. You can try this process on your mobile phone by sending photos, music, contact information or messages via Bluetooth to your colleagues.

THE STUDY Although there is currently no published data about the use of Bluetooth for health promotion and this article may very well be one of the first to discuss Bluetooth this way, a small study, carried out by myself, into the use of Bluetooth to deliver messages to a target audience has very recently been carried out for an MSc Dissertation (2). The study explored a range of issues to evaluate the communication method including: 20

Download rate The use of a prompt to elicit message download Behavioural action related to the intervention Acceptability of the communication method to young people in two further education establishments. Unfortunately at the time of writing it is not possible to give any specifics about the study as it has not been ratified yet, (so really this is a very sneak preview), but there are some themes that can be discussed and lessons that can be applied to the world of physical activity. n n n n

THE THEMES Short range The short-range ability of Bluetooth means health promoters have to be really smart about how they use the technology. Messages must either be aimed at a specific audience where transmission is focused or very general so that it can reach the majority of the population. For example messages beamed in the local football club could target men’s health issues, (targeted and specific), and messages transmitted in the local shopping centre could give information about health walks, (general and population wide).

Prompting Although it looks like the technological world is running away with itself there is still the need with Bluetooth transmission

Messages must either be aimed at a specific audience where transmission is focused or very general so that it can reach the majority of the population sportEX health 2008;18(Oct):20-21


TECHNOLOGY BluEtooth and activity promotion

Can wireless wizardry cast its spell on health? Most people have heard of Bluetooth but don’t really know what it is or how it can be used. For those technophobes reading this it is the thing that connects your mobile phone to your hands free headset in the car. For those of us who want to know a little bit more then Bluetooth is a low power, short range, low cost data transfer system (1) that is available on the majority of mobile phones (2). So why should health promoters be interested in this bit of wireless wizardry? This article looks at the potential of using Bluetooth as a means of delivering health promoting messages for physical activity. for some type of prompt to encourage people to turn on their Bluetooth and accept messages. A prompt such as a poster or TV screenshot in your transmission area has shown to increase download rate by around 10% (2).

Scepticism There is also a level of Bluetooth scepticism and slow uptake of Bluetooth use from the general population. The Bluetooth study (2) reports this as concerns about viruses and hacking as well as concerns about unsolicited information being sent, even though Bluetooth seems to be a relatively safe piece of technology. In the past, there were concerns about hacking into Bluetooth but increased security protocols have solved these particular issues.

Fast-moving technological advances We need to be aware that technology is moving fast and smart phones with almost fully functioning web browsers are increasing in the market. Whether we should see this as an issue for Bluetooth or not is a question that still needs to be answered, there are positives and negatives. Bluetooth will quickly become the poor cousin of mobile phone data transfer, yet, at the same time the increased power of phones will boost the possibilities of what can be transferred by Bluetooth. Bluetooth will still be able to advertise our services and encourage behavioural action and down loaders with smart phones could have almost instant access services through mobile web access.

GRASPING THE WIRELESS Accessing information through technology is fast superseding traditional methods of obtaining information in all areas. The Internet is fast replacing traditional methods of health seeking behaviour, (6) and this technology filled life is leading to increased sedentary behaviour. As physical activity promoters www.sportEX.net

it is important that technology is grasped by the wireless and used to increase activity. There are a great deal of ‘Bluetoothable’ opportunities out there that can be delivered locally at a low cost, such as: n Transmitting walking ideas at bus stops n Yoga positions at Women’s Institute coffee mornings n Baby gym ideas at toddler groups n Warm-up positions at community sports events. The possibilities are endless and the only thing stopping us is our imagination.

REFERENCES: 1. Zheng P, Lionel M. Smart Phone and the Next Generation Mobile Computing. Morgan Kaufman Publishing 2006. ISBN10:0120885603 2. Smith A. Turning on Bluetooth: A study to evaluate the use of Bluetooth technology as a new media for delivering health messages. MSc Dissertation. South Bank University, London 2008 3. Haste H. Joined-Up Texting:The role of mobile phones in young people’s lives. Nestle Social Research Programme 2005 www.spreckley.co.uk/nestle/reports.htm#text 4. Health Protection Agency. The National Chlamydia Screening Programme in England: Core Requirements. National Chlamydia Screening Programme. Health Protection Agency 2008. www.hpa.org.uk 5. Harvey J. Textual Healing: SMS patient messaging systems in surgeries. Management in Practice 2007:9:30-32 6. Cocoran N. Communicating Health: Strategies for Health Promotion. Sage Publications Ltd 2007. ISBN-10:1412924030

The Author Andrew Smith is currently HIV prevention service officer for Hampshire Primary Care Trust. He has just completed an MSc in Public Health and Health Promotion at South Bank University, London where his dissertation explored evaluating the use of Bluetooth technology as a new media for delivering health messages.

21


Technology and activity promotion friend or foe? The intention of this article is to provide an overview of the types and breadth of technology which can play a part in activity promotion.

By Tor Davies, publisher

E

very time I sit down to write this article I discover something new. The intention of this article is to provide an overview of the types and breadth of technology which can play a part in activity promotion. Booming rates of obesity and diabetes and escalating health problems resulting from growing levels of physical inactivity, particularly in children, will mean this industry will undoubtedly gather momentum at a clattering speed. What is also certain is that the technology opportunities are huge, and the variety widespread, we have the web, ‘exergames’ and a growing population of smaller gadgets. The range and sophistication is vast as

is the difference in infrastructure supporting the users. Some types may be totally equipment-free with little or no cost, for example some of the web-based services, while some may be web-based with a charge. Others may involve small pieces of equipment from the generally affordable pedometer and its more sophisticated cousin, the accelerometer, through to more high-tech heart rate monitors, the most sophisticated of which now even incorporate GPS trackers. There are proprietary technologies like Technogym’s key-based system which plugs in and communicates with Technogym equipment, as well as generic technologies like In Style Fitness’s Simultrainer which can be attached to most home-based exercise machines. Then there is the medium through which the technology is delivered. Many utilise the web, for example in VirtualGym TV and the various route mapping sites. For others the web is just a gateway for delivering services which require other recipients like the iPhone, iPod and PDAs - the main recipient used in the PumpOne concept. Alternatively the web might be used in conjunction with equipment as part of the supporting infrastructure to help build community, motivate and inspire, as with the Nike+ concept, the Horsepower Pedometer Challenge and the virtual reality racing. Outlined below is a just a taste of what is to come. The aim is to look at the diversity of techonology being used, not to provide a comprehensive review. I have selected items which I believe best demonstrate this diversity within the space available!

Web based Virtual ‘gym’ concept n Pump One - www.pumpone.com

- branded as your handheld personal trainer, this site is unashamedly American and can be slow but consists of a whole range of exercise programmes made up of video, audio and image instructions that you can download to most any handheld device

22

sportEX health 2008;18(Oct):22-25


TECHNOLOGY activity promotion

Booming rates of obesity and diabetes and escalating health problems resulting from growing levels of physical inactivity, will mean this industry will undoubtedly gather momentum at a clattering speed such as an iPod, iPhone, nano, Zune, and even in some cases your mobile phone although download speed is still a factor. The ‘trainers’ show you exactly what exercises to perform, in what order and with a proper intensity - all while listening to your own music. n VirtualGym TV - www.virtualgym. tv - UK based site jammed full of exercise classes of all variety and level from strength and conditioning through to Tai Chi. Members pay either £15 per month or £135 per year - you download classes onto your computer and can play them as often as you wish. It advertised a Pay as You Go rate for classes but details weren’t obvious. If you want downloadable exercise sessions there’s plenty here. There is also a virtual personal trainer area where you fill in information about your lifestyle, health status, attitude, personality type and goals.

Route mapping n Walkjogrun - www.Walkjogrun.com

- Click on the map to set a starting point and then keep clicking from point to point to draw a route. Click on any of the markers for your route and see how far this point is from the start and what the estimated time would be for a given speed. Create an account and see all your runs in one place. You can save your maps by clicking on any of your markers and hit “Save Your Route” to add it to the database. Next time you or anyone else in your neighborhood is looking for a route, they will see your pin. Based on Google Pedometer - this site effectively is a stored database of users’ runs, enter in your location (including UK because obviously it starts in the US!) and select runs based on distance. Alternatively add in your own and save it. Nice and simple! n www.MapMyRun.com - much the same as above except more www.sportEX.net

commercial and therefore more sophisticated. It includes much greater function around creating training plans, setting goals, calculating training zones etc. There are also other variations including MapMyTri (triathlon), MapMyWalk (walking), and MapMyRide (cycling). n Sanoodi - www.sanoodi.com - a European site, does all the above and more - the more being the presentation of routes for kayaking or cross country skiing - as well as links to Flickr photos taken along the posted routes. n Cyclists will want to check out pedaling.com, a site that, unlike those above, is not powered by Google Maps, and one that lets users search by length, difficulty and environment of ride. n Google Pedometer is a nice simple facility (once you’ve navigated away from the US to the UK!). Type in the place you want to create a map for - turn on the recording function and double click through your route putting down pointers as you go along until reaching your finishing point. It will tell you the total distance of your route and will automatically plot your mile markers. You can even turn on a calorie counter as well as save routes and print maps or even export as a GPX file. Great for runs and cycles but not so great if you travel off-road!

Social networks n Already a number of projects in the UK have utilised the power, reach and cost-effectiveness of social networking sites to encourage participation, and increase levels of physical activity, in users of these sites. Social networks include websites like Facebook, Bebo, MySpace, Flickr, Second Life and YouTube. According to Wikipedia a social network website focuses on building online communities of people who share interests and activities, or 23


who are interested in exploring the interests and activities of others. Most social network services are web-based and provide a variety of ways for users to interact, such as email and instant messaging services. Social networking has created powerful new ways to communicate and share information. Social networking websites are being used regularly by millions of people, and it now seems that social networking will be an enduring part of everyday life. For more information on the uses of social networks and social networking websites read the article on page 12 from our Major Moves’ keynote speaker, Biray Alsac, who talks about the practical power of these sites in physical activity promotion.

Movement-tracking equipment Perhaps one of the most exciting areas of development, particularly given the growing evidence base supporting the use of pedometers in physical activity promotion, is the development of pedometer-based games. n A rather culture-specific but potentially exciting idea is the combination of the original concept of a Tamagotchi, a digital handheld pet which you had to feed and play games with to keep healthy, with an inbuilt pedometer. The result is an Arukotchi, which seems to have become rather rare and therefore hard to come by, but the concept deserves

24

further exploration. Arukotchi was a little girl who as she walked, collected steps, and as these steps accumulated, she encountered boys who would give her a gift or a picture. The more she walked, the more gifts and pictures she would collect and from here she went on to collect other ‘beautiful’ attributes like cooking abilities and nice dresses! n A Western variation on this theme is the Horsepower Challenge, pioneered by a company in Kentucky, USA. Groups of kids get together in teams, each team is represented by a virtual bus! Each child in each team is represented by a horse (the local link being the world famous horse race, the Kentucky Derby). As each child accumulates steps, he/she earns virtual dollars and with these dollars each child can ‘pimp their horse’ (‘buy’ accessories to make them more cool). The better the accessory, the more steps required to buy it. Each student’s horse is visible on the team’s bus, so anyone can log in to their bus and see what other people have bought and also see graphs of who’s done what, both individually as well as within their teams. Watch www.youtube.com/ watch?v=9L9Pnl5Bj1M n The Horsepower Challenge has been developed by Humana Games which is sponsored by Humana, one of the largest health benefits companies in the US. This website (www.humanagames. com) is one of Humana’s many efforts to positively impact health and wellness through the use of innovative technology. In addition to the Horsepower Challenge, there are games for the workplace, older adults (the following movie is well worth watching for those of you who doubt that older adults can’t also benefit from innovative technology) www.humanagames.com/#/experience/ hg4hvideo/ n Last but not least for this section how about this for an idea....power your TV by doing exercise! The EnterTrainer does just that - www.

theentertrainer.com and even won an award from Reader’s Digest for it! The EnterTrainer is a home electronic’s product which works for everyone but is particularly pitched at motivating children. The combination of the heart monitor and universal remote controle provides the virtual experience of powering the TV with exercise. If the heart rate falls below a chosen target, so does the TV volume. Users must pick up the pace of their exercise to continue or the TV will turn off! n CredX - this is an innovative incentive-based exercise initiative involving a simple swipe-based activator mechanism like a credit card, key fob or simple braclet containing a receptor, along with receivers which can be placed anywhere including at the bottom and tops of stairwells in offices, around entrance and exit points in parks, or even used in a handheld form by gym staff or teachers. Credits can be given for an almost limitless range of activities and these credits in turn can be associated with discounts or free products and services. This concept and technology will be demonstrated at Major Moves. n The Nike+iPod Sports Kit is a device which measures and records the distance and pace of a walk or run. The Nike+iPod consists of a small accelerometer attached to or embedded in a shoe, which communicates with either the Nike+ Sportband or a receiver plugged into an iPod. If using the iPod, iTunes software can be used to view the walk or run history. Nike+ is now supported by an ever expanding website community which can be used to increase motivation. n Garmin have probably stolen the march in compact GPS tracking software. Their top of the range running product has GPS inbuilt in what is little more than a slightly oversized watch. You can’t download maps onto it but you can track your run/cycle and your sportEX health 2008;18(Oct):22-25


TECHNOLOGY activity promotion speed, set yourself milestones to race against and it will wirelessly download onto your computer and synch with an online website. Some versions come bundled with a heart rate monitor. They can be a little pricey though with top end watches costing around £250.

Exergames/ equipment-based technology Physical playground-environment based games n ZigZag’s business is based around children’s activity solutions. ZigZagUK www.zigzaguk.com - has six trailblazing pieces of equipment from a sportwall and dancemats to circuits and exercise stations. Most of us with a bit of kid inside us would itch to play some of these games. The sportwall and the dancemats look fantastic and will be on display at Leisure Industry Week. Delegates of our Major Moves conference (see below) will also be able to try the out equipment first hand. n SmartUs - www.smartus.com playful learning, physical gaming, smart movement is the description for the SmartUs technology. SmartUs offers different configurations, consisting of games and play elements, that can be combined in different ways or even stand alone within any surrounding to create a playful learning environment. These elements include iStation (central electronic hubs which links and coordinates the SmartUs equipment), iGrids (grid mats), iPosts (posts), iCard (a credit card sized sensor for use with SmartUs environment it). The equipment comes in both indoor and outdoor vesions.

Computer consoles/TV-based games n Nintendo Wii Fit and Wii Sport - well we can hardly write an article on the use of technology in increasing activity, without mentioning the highly publicised Nintendo Wii! Based around your TV and a Nintendo Wii games console players can box against each other, compete at tennis and now with Wii Fit try out a variety of other exercisebased activites like Yoga, balancebased exercise like snowboarding and more traditional strength training. A number of other games manufacturers have got variations on these themes including Sony.

www.sportEX.net

Virtual reality and the web There are obviously many forms of exercise equipment suitable for stand alone home use - the developments currently are around connecting this equipment to the PC or even the web which then opens many doors to both virtual reality racing as well as webbased competition. Virtual reality racing may be a CD/DVD ROM playing on your own PC which with compatibles sockets may be able to be plugged into a larger TV for better visual effects and providing you with world-famous or scenic routes through which you can cycle. The link with the web offers the opportunity of actually cycling in real time against competitors all over the world. Examples of these include www. simultrainer.co.uk which is a small bit of kit produced by In Style Fitness which costs around £130 and can be attached to your existing exercise equipment and provide you with the opportunity to race on the web. The attraction is that almost all major exercise equipment is compatible with the SimulTrainer including running, rowing and cycling machines (all of which are also available through In Style. Users can also download different routes. TACX Cycle Trainers at www.tacx.com have several variations on equipment where you can slot your own bike onto the frame. The more expensive versions even simulate going up and down hills and rough and smooth terrain. Software accessories are also available to link your cycling to a PC and also if desired the web.

Summary This area as you can see is quite literally exploding but this article hopefully at least gives you a broad overview of where many of the opportunities lie currently. The foundation on which nearly everything is based, and on which every product’s success rests, is on their individual ability to motivate and keep motivating in order to bring about a lasting adoption of a physically active lifestyle. One thing we do know is that different things appeal to different people and so quite rightly there is unlikely to be just one golden goose but time will certainly start to reveal which out of these technologies are the most sustainable.

Major Moves Conference 2008 - Using technology to increase physical activity Many of the technologies discussed above will be explored in more detail at our at our ground-breaking (real life!) conference Major Moves 2008 - which will take place in conjunction with Leisure Industry Week at the Birmingham NEC on the 23rd September 2008. If you are booking from a school, PCT, LA or company, all we need is a purchase order to confirm your place at this conference. To book visit www.MajorMoves08.com or call us on 0845 652 1906.

25


RESOURCES

Resources EXERGAMES The main two products that dominate the market in active games are: Nintendo’s Wii Which offers four different training modes of yoga, balance games, strength training and aerobic training. It operates through a balance board that can weigh you and read real life movements and bring them to life on screen, so, for example, you can snowboard down a virtual mountain. Progress can be viewed through graphs and charts and goals can be set. You can also record how much exercise time has been done outside of the Wii Fit. Wii Sports is also available where, using a handheld device, in conjunction with the appropriate virtual sport, you can play bowls, tennis, baseball, golf or boxing. http://uk.wii.com/ Sony’s Eyetoy This is a wide angle lens USB camera that detects body movement as it sits on top of your TV and which is plugged into a Playstation2 (see article Exergames on page 15). The camera puts your image on screen and then you use whatever part of your body is required to play the relevant games. Eyetoy Kinetic is the exergame directly aimed at exercise. It is designed to provide a personalised workout programme to improve stamina, body conditioning and relaxation. There are also other games designed to raise heart levels such as AntiGrav, Kinetic Combat along with many others. www.eyetoy.com

A CHALLENGING CYCLE RIDE Instyle Fitness combines computer technology with fitnessbased machines. It has recently launched a new indoor cycling product to motivate individuals to become fitter and challenge themselves. The S2 aims to physically challenge the rider and keep them mentally absorbed by the on screen race simulation. n You can also link up the technology online that allows the rider to compete with anyone in the world or just with the rider on the bike next to you at the gym.. www.instylefitness.co.uk

26

This resources pages has been written to complement the theme of this issue (and our Major Moves 2008 conference) - the use of technology for promoting physical activity. We have taken a brief look at simple technology products designed to motivate and encourage people to exercise. PERSONAL TRAINERS DELIVERED THROUGH DEVICES n Pocket PT was devised with the aim of delivering health and fitness advice through a personal trainer. The site caters for technophobes and is designed to reach everyone from those who have never exercised, to athletes in full training. The personally devised routines can be downloaded to all types of mobile devices with the relevant technology. Users can take out three, six or 12 months subscriptions. www. pocketpt.co.uk n VirtualGym TV aims to provide a broad range of service to improve the health by encouraging people to exercise more and eat better. It broadcasts a range of health and fitness exercise sessions covering classes such as aerobics, combat, Pilates and Tai Chi. and offer

starter sessions for those who have never participated in that exercise before. It also offers the services of a Virtual Personal Trainer, which will make appropriate exercise recommendations after personal data is entered into the system. Again these are available through a subscription scheme. www.virtualgym.tv/ n PumpOne personal trainers can be downloaded to most handheld devices such as iPod, iPhone, Zune and others. The trainers show you what exercises to perform, in order and with a proper intensity. There are hundreds of workouts to choose from intense weight loss, strength training and toning, to min-body yoga and Pilates. With this product you buy the packages you want to use. www.pumpone.com

A TALKING SHOE keeps us walking A running shoe that talks may sound a little far-fetched but it is what Nike+ does – well almost – it does not talk out aloud or to you but to your iPod nano. Nike+ shoes feature a built in pocket under the insole specially engineered for the Nike+ iPod sensor. You attach a receiver to your iPod nano and off you go. The shoe keeps track of every step and broadcasts the information to the receiver. This in turn can track your time, distance, pace and calories burned. You can choose to have real-time spoken feedback that can alert you to milestones throughout your workout. The information can then be recorded onto the Nike+ website. If you don’t have an iPod Nano you see it all on your wrist with a Nike+ SportBand. The Nike+ website allows individuals to train and compete with friends or rivals. You can issue or join challenges with your running partners. Individuals can then compete with other people tapping into people’s desire for gaming and competitive instincts. http://nikeplus.nike.com/nikeplus/

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