The plane lifts off and is soaring high above the urban landscape. The sun creeps behind a tall building. Then suddenly, the sky gets a little darker, and the ultralight craft isn't alone. Another plane is coming, and it's firing its weapons.
This is a Dogfight -- a new computer game by Electronic Sports, where competitors go head to head in an effort to shoot each other down.
It's not just another new arcade game. Yes, there is a screen complete with realistic computer-generated sights and sounds. But it's hooked up to a stationary bike, and competitors have to pedal to play.
This is a so-called "healthy game," and the visuals aim to distract the players from the "drudgery" of cycling in place, said Joe Dean, the company president and chief executive. It's one of hundreds of new games that are the latest weapons in the battle against obesity and other health-related problems.
They are played on computers that have long been contributors to the sedentary ways of children, who spend hours at a time sitting behind a screen in pursuit of the high score. Some game developers, health care companies and medical researchers now are teaming up to use the joystick's power for good.
Many new games require players to move to make them work and are increasingly being used in schools, community centers and gyms. Other games aimed at education rather than exercise are being handed out by health care companies to patients and school kids and by medical institutions to trainees and first responders.
Together, they broadly comprise the nascent but rapidly growing healthy games market. The segment may now make up close to one-third of the nation's $1.5 billion "serious games" industry, which includes games with some sort of purpose beyond entertainment like modeling and simulation for business or the military.
Healthy games are not likely to generate the buzz or record sales of the traditional video game Grand Theft Auto IV, which topped $500 million in its first week this month. But at least one may push them more into the mainstream and grab more of the $40 billion overall video game market worldwide. Nintendo's Wii Fit went on sale to individual consumers this month for about $90 and offers skiing, soccer and other games to agile players with a footboard.
"The special nature of games is that they motivate you," said Ben Sawyer, a Portland, Maine-based technology developer who launched the Games for Health Project (gamesforhealth.org) four years ago to assess the effectiveness of the genre and put on a conference for those in the field.
"Games have an ease and a sexiness about them," he said. "Can we actually change people's habits and the health of at-risk populations through games? It makes sense that we can."
Sawyer's Games for Health conference brought gaming professionals to Baltimore this month to learn from each other, help some find funding for their ideas and let others show off their equipment.
Dogfight was on display there. Executives, who have opened a Salt Lake City sales office, were hoping to attract a chain of gyms to invest in the new technology. It's already an arcade game.
Another game was Lightspace Play, which uses a stage that's just over 9 feet by 9 feet and harks back to the disco era with its glowing tiles. It prompts school kids to jump from square to square to hit a virtual tennis ball or hockey puck or dodge a dodgeball or snowball. It's been marketed to schools and community centers for several years and is designed to get kids thinking that exercise is fun, said Katie Miner, Boston-based Lightspace Corp.'s operations manager.
On the health front, video games aren't just for cardio workouts either.
Digital Steamworks of Hunt Valley has created Play Visualizer that turns football and other game tape into three-dimensional action. The Baltimore Ravens use it so players equipped with special glasses can watch video versions of themselves throwing passes, tackling opponents or running for the end zone.
Kaiser Permanente and Humana health care companies showed games they hope will make learning about disease care and proper nutrition more engaging. Humana, a gaming conference sponsor, has been testing the effectiveness of games for seniors and students.
Kaiser has developed Amazing Food Detective and offered it to schools. It takes kids through a virtual mystery until they uncover the proper things to eat. Since the game doesn't actually get the kids moving, it shuts off automatically after 20 minutes and prompts the players to do something active.
"We're trying to see what works," said Kaiser spokeswoman Lorna D. Fernandes. "Childhood obesity is a big problem that costs everyone. We really need to look at everything."
Hunt Valley's BreakAway Ltd. is targeting professionals with the virtual medical school it is developing. In Pulse, trainees can learn to treat injuries from explosives or diagnose anthrax, which is often mistaken for the flu. Players can see the inside of a hospital and walk, flip through charts and examine patients. They are prompted to check the eyes and listen to the heart, which can be heard beating.
There are plenty of other games and ideas that hold promise in the health arena, said Chinwe R. Onyekere, a program officer for the Robert Wood Johnson Foundation. The charitable foundation granted $8.2 million over four years toward Sawyer's four-year-old Games for Health Project.
She said part of the foundation's mission is to help reduce obesity and other health issues that have been cropping up in younger Americans. There's no conclusive evidence yet to show that video games work, she said. But they are so widely popular that tapping them to help solve health care problems seems worth a try.
"We're hoping the research shows it works," she said. "And we're hoping to build a community so they can find each other and learn from each other."
Douglas Goldstein is convinced healthy games are effective. He formed iConecto, a company that has launched a Web site this month called gaming4health .com. It's a database of more than 100 healthy games and a social networking site for developers and users. He'd like to make it a distributor of games, too.
He sees everyone from kids in school to athletes in training to regular people at the gym playing healthy games. For now, Goldstein will focus on making a cohesive industry out of a bunch of companies trying to individually market or give away their products.
"There's a need for these games," he said. "If you can get healthy by playing a fun game, why not do it?"
Games people play
About 16 percent of Americans exercise on an average day, according to the Bureau of Labor Statistics' latest Time Use Survey, which is available at www.bls.gov/spotlight. Roughly five times as many people watched television on an average day during the same time period, from 2003 to 2006.
Here are some other facts from the survey:
The Pacific region had the most regular exercisers, with 20 percent working out on an average day; the South Central region was the least active, with 13 percent regularly exercising; and the South Atlantic region, which includes Maryland, was about average at 15 percent.
People with a bachelor's degree or higher were most likely to regularly exercise, with 23 percent working out on an average day. Those with less than a high school diploma were the least likely, with 10 percent regularly exercising.
Walking was the most popular activity, with 30 percent choosing it on an average day. Weightlifting was next popular with 13.1 percent. Other popular activities were using cardiovascular equipment, swimming, running and basketball.
Football, basketball and golf were the most popular sports for men, while aerobics, yoga and walking were most popular among women.