A Preliminary Randomized Crossover Trial Comparing Acute Glucose and Physiological Responses to Active Video Gaming and Traditional Exercise in Sedentary Office Workers
Abstract
1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedure
2.2.1. Inclusion Criteria
2.2.2. AVG Session
2.2.3. MICT Session
2.2.4. Control Session
2.3. Statistical Analysis
3. Results
3.1. Capillary Blood Glucose Responses
3.2. Heart Rate Responses
3.3. Rating of Perceived Exertion
3.4. Exercise Enjoyment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
| AVG | Active Video Game |
| MICT | Moderate Intensity Continuous Training |
| RPE | Rate of Perceived Exertion |
| MET | Metabolic Equivalent of Task |
| GLUT | Glucose Transporters |
| mg/dL | Milligrams per Deciliter |
| BMI | Body Mass Index |
| IPAQ-SF | International Physical Activity Questionnaire Short Form |
| HRmax | Maximum Heart Rate |
| PACES | Physical Activity Enjoyment Scale |
| EMMEANS | Estimated Marginal Means |
References
- WHO. Nearly 1.8 Billion Adults at Risk of Disease from Not Doing Enough Physical Activity. Available online: https://www.who.int/news/item/26-06-2024-nearly-1.8-billion-adults-at-risk-of-disease-from-not-doing-enough-physical-activity (accessed on 21 October 2025).
- Mclaughlin, M.; Atkin, A.J.; Starr, L.; Hall, A.; Wolfenden, L.; Sutherland, R.; Wiggers, J.; Ramirez, A.; Hallal, P.; Pratt, M.; et al. Worldwide Surveillance of Self-Reported Sitting Time: A Scoping Review. Int. J. Behav. Nutr. Phys. Act. 2020, 17, 111. [Google Scholar] [CrossRef]
- Ussery, E.N.; Fulton, J.E.; Galuska, D.A.; Katzmarzyk, P.T.; Carlson, S.A. Joint Prevalence of Sitting Time and Leisure-Time Physical Activity Among US Adults, 2015–2016. JAMA 2018, 320, 2036–2038. [Google Scholar] [CrossRef]
- Tremblay, M.S.; Aubert, S.; Barnes, J.D.; Saunders, T.J.; Carson, V.; Latimer-Cheung, A.E.; Chastin, S.F.M.; Altenburg, T.M.; Chinapaw, M.J.M.; Altenburg, T.M.; et al. Sedentary Behavior Research Network (SBRN)—Terminology Consensus Project Process and Outcome. Int. J. Behav. Nutr. Phys. Act. 2017, 14, 75. [Google Scholar] [CrossRef] [PubMed]
- Ekelund, U.; Brown, W.J.; Steene-Johannessen, J.; Fagerland, M.W.; Owen, N.; Powell, K.E.; Bauman, A.E.; Lee, I.-M. Do the Associations of Sedentary Behaviour with Cardiovascular Disease Mortality and Cancer Mortality Differ by Physical Activity Level? A Systematic Review and Harmonised Meta-Analysis of Data from 850 060 Participants. Br. J. Sports Med. 2019, 53, 886–894. [Google Scholar] [CrossRef]
- Clemes, S.A.; O’Connell, S.E.; Edwardson, C.L. Office Workers’ Objectively Measured Sedentary Behavior and Physical Activity during and Outside Working Hours. J. Occup. Environ. Med. 2014, 56, 298–303. [Google Scholar] [CrossRef]
- Smith, L.; Hamer, M.; Ucci, M.; Marmot, A.; Gardner, B.; Sawyer, A.; Wardle, J.; Fisher, A. Weekday and Weekend Patterns of Objectively Measured Sitting, Standing, and Stepping in a Sample of Office-Based Workers: The Active Buildings Study. BMC Public Health 2015, 15, 9. [Google Scholar] [CrossRef]
- Aune, D.; Schlesinger, S.; Neuenschwander, M.; Feng, T.; Janszky, I.; Norat, T.; Riboli, E. Diabetes Mellitus, Blood Glucose and the Risk of Heart Failure: A Systematic Review and Meta-Analysis of Prospective Studies. Nutr. Metab. Cardiovasc. Dis. 2018, 28, 1081–1091. [Google Scholar] [CrossRef]
- Gonzales, P.N.G.; Ampil, E.R.; Catindig-Dela Rosa, J.-A.S.; Villaraza, S.G.; Joson, M.L.C. Increased Risk of Alzheimer’s Disease with Glycemic Variability: A Systematic Review and Meta-Analysis. Cureus 2024, 16, e73353. [Google Scholar] [CrossRef] [PubMed]
- Nasr, M.; Rahimian, F.; Rahmanian, S.; Aliasghari, F.; Soleimani, E.; Aryaei, M.; Daneshmandi, H. Lipid Profile and Fast Blood Glucose in Office Workers: BMI and Sex Differences. Obes. Med. 2022, 32, 100412. [Google Scholar] [CrossRef]
- Lee, Y.; Seo, E.; Lee, W. Long Working Hours and the Risk of Glucose Intolerance: A Cohort Study. Int. J. Environ. Res. Public Health 2022, 19, 11831. [Google Scholar] [CrossRef]
- Van Der Berg, J.D.; Stehouwer, C.D.A.; Bosma, H.; Van Der Velde, J.H.P.M.; Willems, P.J.B.; Savelberg, H.H.C.M.; Schram, M.T.; Sep, S.J.S.; Van Der Kallen, C.J.H.; Henry, R.M.A.; et al. Associations of Total Amount and Patterns of Sedentary Behaviour with Type 2 Diabetes and the Metabolic Syndrome: The Maastricht Study. Diabetologia 2016, 59, 709–718. [Google Scholar] [CrossRef] [PubMed]
- Gao, W.; Sanna, M.; Chen, Y.-H.; Tsai, M.-K.; Wen, C.-P. Occupational Sitting Time, Leisure Physical Activity, and All-Cause and Cardiovascular Disease Mortality. JAMA Netw. Open 2024, 7, e2350680. [Google Scholar] [CrossRef]
- Asfaw, M.S.; Dagne, W.K. Physical Activity Can Improve Diabetes Patients’ Glucose Control; A Systematic Review and Meta-Analysis. Heliyon 2022, 8, e12267. [Google Scholar] [CrossRef]
- Mikus, C.R.; Oberlin, D.J.; Libla, J.L.; Taylor, A.M.; Booth, F.W.; Thyfault, J.P. Lowering Physical Activity Impairs Glycemic Control in Healthy Volunteers. Med. Sci. Sports Exerc. 2012, 44, 225–231. [Google Scholar] [CrossRef] [PubMed]
- Hamasaki, H. Daily Physical Activity and Type 2 Diabetes: A Review. World J. Diabetes 2016, 7, 243–251. [Google Scholar] [CrossRef]
- Shambrook, P.; Kingsley, M.I.; Taylor, N.F.; Wundersitz, D.W.; Wundersitz, C.E.; Paton, C.D.; Gordon, B.A. A Comparison of Acute Glycaemic Responses to Accumulated or Single Bout Walking Exercise in Apparently Healthy, Insufficiently Active Adults. J. Sci. Med. Sport 2020, 23, 902–907. [Google Scholar] [CrossRef]
- Chandrasekaran, B.; Pesola, A.J.; Rao, C.R.; Arumugam, A. Does Breaking up Prolonged Sitting Improve Cognitive Functions in Sedentary Adults? A Mapping Review and Hypothesis Formulation on the Potential Physiological Mechanisms. BMC Musculoskelet. Disord. 2021, 22, 274. [Google Scholar] [CrossRef]
- Magnon, V.; Vallet, G.T.; Auxiette, C. Sedentary Behavior at Work and Cognitive Functioning: A Systematic Review. Front. Public Health 2018, 6, 239. [Google Scholar] [CrossRef]
- Wheeler, M.J.; Dempsey, P.C.; Grace, M.S.; Ellis, K.A.; Gardiner, P.A.; Green, D.J.; Dunstan, D.W. Sedentary Behavior as a Risk Factor for Cognitive Decline? A Focus on the Influence of Glycemic Control in Brain Health. Alzheimers Dement. 2017, 3, 291–300. [Google Scholar] [CrossRef] [PubMed]
- Tanaka, Y.; Ogata, H.; Park, I.; Ando, A.; Ishihara, A.; Kayaba, M.; Yajima, K.; Suzuki, C.; Araki, A.; Osumi, H.; et al. Effect of a Single Bout of Morning or Afternoon Exercise on Glucose Fluctuation in Young Healthy Men. Physiol. Rep. 2021, 9, e14784. [Google Scholar] [CrossRef]
- van Dijk, J.-W.; Venema, M.; van Mechelen, W.; Stehouwer, C.D.A.; Hartgens, F.; van Loon, L.J.C. Effect of Moderate-Intensity Exercise versus Activities of Daily Living on 24-Hour Blood Glucose Homeostasis in Male Patients with Type 2 Diabetes. Diabetes Care 2013, 36, 3448–3453. [Google Scholar] [CrossRef]
- Cartee, G.D. Mechanisms for Greater Insulin-Stimulated Glucose Uptake in Normal and Insulin-Resistant Skeletal Muscle after Acute Exercise. Am. J. Physiol. Endocrinol. Metab. 2015, 309, E949–E959. [Google Scholar] [CrossRef]
- Momma, H.; Kawakami, R.; Honda, T.; Sawada, S.S. Muscle-Strengthening Activities Are Associated with Lower Risk and Mortality in Major Non-Communicable Diseases: A Systematic Review and Meta-Analysis of Cohort Studies. Br. J. Sports Med. 2022, 56, 755–763. [Google Scholar] [CrossRef]
- Wang, Y.; Lee, D.-C.; Brellenthin, A.G.; Eijsvogels, T.M.H.; Sui, X.; Church, T.S.; Lavie, C.J.; Blair, S.N. Leisure-Time Running Reduces the Risk of Incident Type 2 Diabetes. Am. J. Med. 2019, 132, 1225–1232. [Google Scholar] [CrossRef]
- Minnock, D.; Annibalini, G.; Le Roux, C.W.; Contarelli, S.; Krause, M.; Saltarelli, R.; Valli, G.; Stocchi, V.; Barbieri, E.; De Vito, G. Effects of Acute Aerobic, Resistance and Combined Exercises on 24-h Glucose Variability and Skeletal Muscle Signalling Responses in Type 1 Diabetics. Eur. J. Appl. Physiol. 2020, 120, 2677–2691. [Google Scholar] [CrossRef]
- Scott, S.N.; Cocks, M.; Andrews, R.C.; Narendran, P.; Purewal, T.S.; Cuthbertson, D.J.; Wagenmakers, A.J.M.; Shepherd, S.O. Fasted High-Intensity Interval and Moderate-Intensity Exercise Do Not Lead to Detrimental 24-Hour Blood Glucose Profiles. J. Clin. Endocrinol. Metab. 2019, 104, 111–117. [Google Scholar] [CrossRef]
- Babir, F.J.; Riddell, M.C.; Adamo, L.M.; Richards, D.L.; Gibala, M.J. The Effect of Bodyweight Exercise on 24-h Glycemic Responses Determined by Continuous Glucose Monitoring in Healthy Inactive Adults: A Randomized Crossover Study. Sci. Rep. 2023, 13, 20884. [Google Scholar] [CrossRef]
- Hulteen, R.M.; Smith, J.J.; Morgan, P.J.; Barnett, L.M.; Hallal, P.C.; Colyvas, K.; Lubans, D.R. Global Participation in Sport and Leisure-Time Physical Activities: A Systematic Review and Meta-Analysis. Prev. Med. 2017, 95, 14–25. [Google Scholar] [CrossRef]
- Lai, B.; Logan, M.; Young, R.; Wright, A.; Terrell, J.; Bright, L.; Davis, D.; Mendonca, C.J. Feasibility of Vigorous Extended Reality Tele-Exergaming for Cardiometabolic Health in Youth with Mobility Disabilities: Protocol for a Case Series Study. JMIR Res. Protoc. 2026, 15, e85246. [Google Scholar] [CrossRef]
- Bock, B.C.; Dunsiger, S.I.; Wu, W.-C.; Ciccolo, J.T.; Serber, E.R.; Lantini, R.; Marcus, B.H. Reduction in HbA1c with Exercise Videogames among Participants with Elevated HbA1c: Secondary Analysis of the Wii Heart Fitness Trial. Diabetes Res. Clin. Pract. 2019, 154, 35–42. [Google Scholar] [CrossRef]
- de Brito Gomes, J.L.; Martins Vancea, D.M.; Cappato de Araújo, R.; Soltani, P.; de Sá Pereira Guimarães, F.J.; da Cunha Costa, M. Cardiovascular and Enjoyment Comparisons after Active Videogame and Running in Type 1 Diabetes Patients: A Randomized Crossover Trial. Games Health J. 2021, 10, 339–346. [Google Scholar] [CrossRef]
- De Brito Gomes, J.L.; Vancea, D.M.M.; Farinha, J.B.; Barros, C.B.A.; Costa, M.C. 24-h Blood Glucose Responses after Exergame and Running in Type-1 Diabetes: An Intensity- and Duration-Matched Randomized Trial. Sci. Sports 2023, 38, 726–733. [Google Scholar] [CrossRef]
- Moreno, P.; Corrales, N.; Espinoza-Gutiérrez, R.; Calleja-Núñez, J.; Montero-Herrera, B.; Cerna, J.; Aburto-Corona, J.A. Energy Expenditure Validation of an Exergame Platform: Ring Fit Adventure Use in Adults with Overweight and Obesity. Games Health J. 2024, 13, 288–296. [Google Scholar] [CrossRef]
- Philippe, A.G.; Goncalves, A.; Korchi, K.; Deshayes, M. Exergaming in Augmented Reality Is Tailor-Made for Aerobic Training and Enjoyment among Healthy Young Adults. Front. Public Health 2024, 12, 1307382. [Google Scholar] [CrossRef]
- Junkersfeld, S.E.; Braun-Trocchio, R. Virtual Reality and Exercise: Impacts on Affective Responses, Ratings of Perceived Exertion, Attention, and Rowing Performance. Res. Q. Exerc. Sport 2026, 1–12. [Google Scholar] [CrossRef]
- Gellish, R.L.; Goslin, B.R.; Olson, R.E.; McDonald, A.; Russi, G.D.; Moudgil, V.K. Longitudinal Modeling of the Relationship between Age and Maximal Heart Rate. Med. Sci. Sports Exerc. 2007, 39, 822–829. [Google Scholar] [CrossRef]
- Borg, G. Psychophysical Bases of Perceived Exertion. Med. Sci. Sports Exerc. 1982, 14, 377–381. [Google Scholar] [CrossRef]
- Carraro, A.; Young, M.C.; Robazza, C. A Contribution to the Validation of the Physical Activity Enjoyment Scale in an Italian Sample. Soc. Behav. Personal. 2008, 36, 911–918. [Google Scholar] [CrossRef]
- Moreno, J.-A.; González-Cutre, D.; Martínez, C.; Alonso, N.; López, M. Propiedades psicométricas de la Physical Activity Enjoyment Scale (PACES) en el contexto español. Estud. Psicol. 2008, 29, 173–180. [Google Scholar] [CrossRef]
- Merz, K.; Thurmond, D. Role of Skeletal Muscle in Insulin Resistance and Glucose Uptake. Compr. Physiol. 2020, 10, 785–809. [Google Scholar] [CrossRef]
- Philippe, M.; Krüsmann, P.; Mersa, L.; Eder, E.; Gatterer, H.; Melmer, A.; Ebenbichler, C.; Burtscher, M. Acute Effects of Concentric and Eccentric Exercise on Glucose Metabolism and Interleukin-6 Concentration in Healthy Males. Biol. Sport 2016, 33, 153–158. [Google Scholar] [CrossRef] [PubMed]
- Andersen, O.E.; Nielsen, O.B.; Overgaard, K. Early Effects of Eccentric Contractions on Muscle Glucose Uptake. J. Appl. Physiol. 2019, 126, 376–385. [Google Scholar] [CrossRef]
- Vogt, M.; Hoppeler, H.H. Eccentric Exercise: Mechanisms and Effects When Used as Training Regime or Training Adjunct. J. Appl. Physiol. 2014, 116, 1446–1454. [Google Scholar] [CrossRef]
- Klimmt, C.; Possler, D.; May, N.; Auge, H.; Wanjek, L.; Wolf, A.-L. Effects of Soundtrack Music on the Video Game Experience. Media Psychol. 2019, 22, 689–713. [Google Scholar] [CrossRef]
- Newsome, A.M.; Sansone, J.; McAvoy, C. 2024 ACSM Worldwide Fitness Trends: Future Directions of the Health and Fitness Industry. ACSM’s Health Fit. J. 2024, 28, 14–26. [Google Scholar] [CrossRef]



| Exercise | Type of Punch | Intensity | Body Work | Time (min:s) | Punches per Minute |
|---|---|---|---|---|---|
| Straight 1 | Jab and straight | High | Arms | 12:20 | 41.7 |
| Uppercut 2 | Jap, straight and uppercut | High | Chest and legs | 12:20 | 38.3 |
| Crochets 2 | Jap, straight and crochet | Low | Abdomen and legs | 06:10 | 43.0 |
| Variable | Mean ± SD |
|---|---|
| Age | 41.4 ± 8 |
| PA (MET-min/week) | 425.8 ± 232.2 |
| Sedentary time (h/week) | 6.9 ± 2.6 |
| Body mass (kg) | 85.6 ± 19.8 |
| Height (cm) | 166.5 ± 9.2 |
| BMI (kg/m2) | 30.6 ± 5.3 |
| Muscular mass (kg) | 29.7 ± 7.4 |
| Body fat (%) | 35.7 ± 8.7 |
| Condition | Baseline | Immediately After | After 24 h | Full Model Statistics | Main Effect | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Condition × Time | Condition | Time | |||||||||||
| F | p | ηp2 | F | p | ηp2 | F | p | ηp2 | |||||
| Capillary blood glucose (mg/dL) | Control | 111.9 ± 31.0 | 109.1 ± 42.9 | 104.5 ± 33.6 | 2.153 | 0.084 | 0.119 | 0.175 | 0.840 | 0.011 | 6.794 | 0.003 | 0.298 |
| AVG | 116.9 ± 41.0 * | 110.4 ± 30.4 * | 103.1 ± 30.4 | ||||||||||
| MICT | 114.2 ± 34.8 | 103.5 ± 23.1 | 110.4 ± 31.0 | ||||||||||
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.
Share and Cite
Torres-Hernández, C.; López-Miguel, A.; Montero-Herrera, B.; Santamaría-Guzmán, K.; Espinoza-Gutiérrez, R.; Calleja-Núñez, J.J.; Guzmán-Gutiérrez, E.C.; Aburto-Corona, J.A. A Preliminary Randomized Crossover Trial Comparing Acute Glucose and Physiological Responses to Active Video Gaming and Traditional Exercise in Sedentary Office Workers. Obesities 2026, 6, 35. https://doi.org/10.3390/obesities6030035
Torres-Hernández C, López-Miguel A, Montero-Herrera B, Santamaría-Guzmán K, Espinoza-Gutiérrez R, Calleja-Núñez JJ, Guzmán-Gutiérrez EC, Aburto-Corona JA. A Preliminary Randomized Crossover Trial Comparing Acute Glucose and Physiological Responses to Active Video Gaming and Traditional Exercise in Sedentary Office Workers. Obesities. 2026; 6(3):35. https://doi.org/10.3390/obesities6030035
Chicago/Turabian StyleTorres-Hernández, Carlos, Agali López-Miguel, Bryan Montero-Herrera, Keven Santamaría-Guzmán, Roberto Espinoza-Gutiérrez, Juan J. Calleja-Núñez, Elena C. Guzmán-Gutiérrez, and Jorge A. Aburto-Corona. 2026. "A Preliminary Randomized Crossover Trial Comparing Acute Glucose and Physiological Responses to Active Video Gaming and Traditional Exercise in Sedentary Office Workers" Obesities 6, no. 3: 35. https://doi.org/10.3390/obesities6030035
APA StyleTorres-Hernández, C., López-Miguel, A., Montero-Herrera, B., Santamaría-Guzmán, K., Espinoza-Gutiérrez, R., Calleja-Núñez, J. J., Guzmán-Gutiérrez, E. C., & Aburto-Corona, J. A. (2026). A Preliminary Randomized Crossover Trial Comparing Acute Glucose and Physiological Responses to Active Video Gaming and Traditional Exercise in Sedentary Office Workers. Obesities, 6(3), 35. https://doi.org/10.3390/obesities6030035

