Exercise & Training

Physiological Responses, Exercise Intensity, and Enjoyment During Ring Fit Adventure in Adults With Chronic Diseases: Single-Arm, Pre-Post Experimental Study.

TL;DR

Ring Fit Adventure elicited moderate average exercise intensity with periods of vigorous intensity, reductions in capillary blood glucose, stable postexercise blood pressure, and high enjoyment among 20 adults with stable chronic diseases, suggesting it may be a feasible and engaging home-based exercise option, though the small sample, lack of control condition, and single-session design limit generalizability.

Key Findings

All 20 participants completed the Ring Fit Adventure (RFA) gameplay sessions with no adverse events or missing data.

  • Single-arm, pre-post pilot study of 20 adults aged 40 to 65 years with at least one stable chronic disease.
  • Participants completed 2 stages (World 1 and World 2) of RFA gameplay after baseline assessment and familiarization.
  • Recruitment used convenience and snowball sampling from a hospital-based setting and public channels.

The sample had a mean age of 54.3 years, was evenly split by sex, and hypertension was the most common condition.

  • Mean age was 54.3 (95% CI 51.25-57.25) years; 10 participants were male.
  • Hypertension n=14 (70%), hyperlipidemia n=11 (55%), obesity n=8 (40%), diabetes n=5 (25%).

Average heart rate during RFA gameplay corresponded to moderate intensity, while peak heart rate reached vigorous intensity.

  • Mean continuous HR was 111.6 (95% CI 102.6-120.6) bpm, or 67.2% of age-predicted maximum HR.
  • Peak HR was 138.6 (95% CI 128.9-148.3) bpm, or 83.5% of age-predicted maximum HR.
  • HR was monitored continuously during gameplay.

Heart rate rose significantly after each stage of gameplay.

  • After World 1, HR increased by 16.7 (95% CI 11.42-21.88; P<.001) bpm.
  • After World 2, HR increased by 20.7 (95% CI 13.28-28.12; P<.001) bpm.

Rate of perceived exertion increased significantly after each stage.

  • After World 1, increased by 2.83 (95% CI 2.32-3.33; P<.001) points.
  • After World 2, increased by 3.75 (95% CI 3.18-4.32; P<.001) points.

Capillary blood glucose decreased after each stage of gameplay with no hypoglycemic events.

  • After World 1, decreased by 1.4 (95% CI -1.95 to 0.78; P<.001) mmol/L.
  • After World 2, decreased by 1.6 (95% CI -2.46 to -0.80; P=.01) mmol/L.
  • No hypoglycemic events occurred.

No significant changes in systolic or diastolic blood pressure were observed after gameplay.

  • BP was measured at baseline and immediately after each stage.
  • The authors describe postexercise BP as stable.

Participants reported high enjoyment of RFA.

  • Mean Exergame Enjoyment Questionnaire score was 77.6 out of 100 (95% CI 74.7-80.5).

The authors conclude RFA may be a feasible, engaging home-based exercise option for adults with stable chronic diseases but note important limitations.

  • Limitations: small, heterogeneous sample, absence of a control condition, and single-session design.
  • Larger controlled longitudinal studies are needed to determine effects on exercise adherence, physical activity levels, and cardiometabolic outcomes.

What This Means

This small pilot study looked at what happens in the body when adults with long-term health conditions, such as high blood pressure, high cholesterol, obesity, or diabetes, play Ring Fit Adventure, a video game that combines aerobic and strength-style exercises. Twenty adults aged 40 to 65 played two stages of the game while researchers tracked heart rate, blood pressure, blood sugar, how hard the exercise felt, and how much they enjoyed it. The game raised heart rate to a moderate level on average, with peaks in the vigorous range. Participants felt they were working harder as play went on, and blood sugar dropped after each stage without any low blood sugar events. Blood pressure did not change significantly right after play. Participants rated the game as enjoyable (about 78 out of 100), and everyone finished without adverse events. This research suggests that the game could be a feasible and enjoyable way to do home-based exercise for people with stable chronic conditions. However, the study was small, had no comparison group, and tested only a single session, so it cannot show whether people would keep playing or whether it would improve health over time. Larger, longer studies with control groups are needed.

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Citation

Haron M, Ismail S, Yeo G. (2026). Physiological Responses, Exercise Intensity, and Enjoyment During Ring Fit Adventure in Adults With Chronic Diseases: Single-Arm, Pre-Post Experimental Study.. JMIR formative research. https://doi.org/10.2196/92345