Journal of physical activity & health最新文献

Background: Increased engagement in screen-based behaviors may contribute to decreased physical activity (PA) participation and is associated with mental health among adolescents. Yet, there remain knowledge gaps in how types and duration of screen-based behaviors may moderate the associations between PA, psychological distress, internalizing, and externalizing symptoms. This population-based study aimed to examine this relationship.

Methods: Longitudinal data were obtained from the Millennium Cohort Study and adolescents were followed up from the 14-year to 17-year waves. Data on device-based moderate to vigorous PA (MVPA), screen-based behaviors (watching videos and playing videogames), internalizing (emotional and peer problems) and externalizing symptoms (hyperactivity and conduct problem), and psychological distress were analyzed using negative binomial regression (stratified by gender) with interaction terms of continuous device-based PA and categorical screen-based behaviors being applied.

Results: The final sample included 3397 adolescents (mean age = 13.8, 54% girls). Device-based MVPA was associated with a lower incidence of emotional problems (boys [incidence rate ratio (IRR) = 0.97], and girls [IRR = 0.98]), peer problems (IRR = 0.97), and psychological distress (girls only, IRR = 0.98). Video watching for ≥2 hours per day was associated with a higher incidence of conduct problem in boys (IRR = 1.20) and videogames playing ≥2 hours per day was associated with all internalizing and externalizing symptoms in girls (IRR range 1.10-1.21). A buffering effect of MVPA on various symptoms among those spent <2 hours per day on screen-based behaviors was observed.

Conclusions: Reducing screen-based behaviors may help maximize the benefits of MVPA on mental health outcomes in adolescents therefore implementing interventions targeting screen-based behaviors reduction should be recognized as first-line priority.

Background: Physical activity has many benefits but can be hard to achieve for people living with severe mobility impairments. Robotic walking may be an effective way for these individuals to achieve physical activity.

Objective: The aim of this study is to characterize the physical activity performed by children and small adults with severe mobility impairments during a single session of robotic walking.

Methods: We conducted a series of single-session assessments to evaluate the heart rate response experienced by children and small adults with severe mobility impairments during overground walking with an untethered robotic walking aid designed for children (Trexo). Outcomes evaluating physical activity were the average percent heart rate reserve (%HRR) throughout the training session, the most intense minute of training, and the total time spent physically active (at >20% HRR). Nonparametric descriptive statistics are presented as median (25th-75th percentiles).

Results: Fifteen individuals (aged 5-24) unable to walk independently participated in this study. Participants using the robotic walker had an average %HRR during training of 30% (21%-35%) and reached 40% (30%-50%) HRR in the highest minute of training. Participants spent a median of 17 (10-27) minutes and 99% (57%-100%) of the robotic walking time physically active.

Conclusion: This study demonstrates that robotic walking can facilitate at least light physical activity for children and small adults with severe mobility impairments. The results of this study can be used to inform future providers on the physical activity benefits of robotic walking.

Background: Previous research has independently associated air pollution and physical inactivity with increased mortality and morbidity. There is an ongoing debate about whether those factors interact to cause an even higher burden, suggesting potential syndemics. This study aimed to estimate the interaction between air pollution and physical inactivity on cognitive decline in older adults.

Methods: The study utilized the Northern Ireland Cohort for the Longitudinal Study of Ageing. The outcome was a ≥3 points decline in the Mini-Mental State Examination score between 2 cohort waves. Exposures were annual mean particulate matter smaller than 2.5 μm (PM2.5) in a 1-km buffer around participants' residences estimated based on national monitoring and self-reported recreational moderate to vigorous physical activity (MVPA) minutes per week. Logistic regression models were used to estimate additive and multiplicative interactions between exposures adjusting for confounders.

Results: Among 2836 participants, 137 (4.8%) had cognitive decline between waves. The median PM2.5 was 6.6 μg/m3 (interquartile range: 5.6-7.6), and 50% reported no MVPA in a week (interquartile range: 0-251.2). Models indicated additive (relative excess risk due to interaction = 0.63; 95% CI, -0.98 to 2.24) and multiplicative (synergy factor = 1.76; 95% CI, 0.84 to 3.72) interactions between high PM2.5 and low MVPA on the risk of cognitive decline; however, estimates were not precise.

Conclusions: This study presents a novel quantitative investigation of a potential syndemic focusing on a less-explored outcome of cognitive decline. However, outcome and exposure measurements limited the certainty of our findings. Future studies should include areas with higher variation in air pollution and use more granular exposure and sensitive outcome measures.

As the global population ages, interventions that support physical and respiratory health in older adults are essential. This study investigates the experiences of older participants in a combined 8-week Tai Chi and Inspiratory Muscle Training (IMT) program, aiming to explore the facilitators and barriers to participation. Thirty-one adults aged 60+ were recruited and assigned to either an experimental or sham IMT plus Tai Chi intervention with a double-blind, randomized controlled trial approach. Qualitative data were gathered from 10 participants (6 IMT; 4 sham-IMT), through semistructured focus groups and individual interviews, and reflexive thematic analysis identified 4 key themes: external disruptions and the struggle for consistency, physical discomfort and adaptation, challenges in sustained engagement, and balancing social interaction with personalized support. In particular the themes show distinction between: (1) challenges, including external disruptions and the struggle for consistency, physical discomfort, and difficulties in sustaining engagement and motivation; (2) facilitators, such as social connection, perceived health benefits, and initial support from instructors; (3) adaptations, including strategies participants used to overcome discomfort, manage routines, and seek personalized ways to engage with the program. Findings highlight that while participants value the health benefits of Tai Chi and IMT, they encounter social and environmental constraints, physical discomfort, motivational challenges, and a need for clear guidance and personalized feedback. These insights underscore the importance of designing flexible, adaptive interventions that consider older adults' unique needs to improve engagement and outcomes. Future research should further investigate dual interventions like Tai Chi and IMT to refine delivery strategies and maximize health benefits for aging populations.

Objectives: This study examined the impact of physical education (PE) participation on moderate to vigorous physical activity (MVPA) among adolescents in Canada, controlling for observed differences in individual characteristics using propensity scores.

Methods: This study utilized linked longitudinal data from Ontario students who participated in 3 years (2015/2016-2018/2019) of the COMPASS study. Sex-stratified linear mixed models were used to examine associations between PE participation and minutes of MVPA from grades 10 through 12. Models were adjusted using doubly robust propensity score methodology, through inverse probability of treatment weighting, accounting for observed covariates that may influence PE participation.

Results: Overall, 988 female and 872 male students were included in analyses. Female and male students who participated in PE during the semester of data collection reported on average 29 (22-35) and 36 (29-43) additional minutes of MVPA per day, respectively, compared with those who did not participate in PE that year. Female and male students who participated in PE during the opposite semester of data collection reported on average 11 (4-18) and 14 (7-22) additional minutes of MVPA per day, respectively, compared with students who did not participate in PE that year.

Conclusions: Findings suggest that secondary school PE participation has a significant impact on MVPA levels over time. Effects appear to be most pronounced among male students and during the semester of PE participation. These findings highlight the potential benefits of daily PE on physical activity patterns and provide evidence in support of approaches aimed at increasing PE enrollment throughout secondary schools in Ontario.

Background: Disability acceptance is considered a key factor in improving the subjective well-being of people with visual impairment. This study investigated disability acceptance across different levels of leisure-time physical activity (LTPA) participation while considering the duration and etiology of disability.

Methods: We analyzed data from the 2017 to 2022 Panel Survey of Employment for the Disabled, focusing on Korea adults with visual impairment (n = 396). LTPA participation was categorized into high, mid, and low groups based on the amount of participation. Disability duration was measured from 2 points: the onset of the disability and the point of self-awareness. The causes of disability were categorized as either innate or acquired. A Generalized Estimating Equation was used for analysis.

Results: The high LTPA group reported significantly higher levels of improvement in disability acceptance (B = 1.47; 95% confidence interval [CI], 0.32 to 2.61) compared with the low group. Disability acceptance decreased with increasing time after disability onset (B = -0.09; 95% CI, -0.18 to -0.01) but increased with increasing time after disability self-awareness (B = 0.10; 95% CI, 0.01 to 0.19). Acquired disabilities showed higher acceptance levels than did those who reported innate disabilities (B = 1.73; 95% CI, 0.24 to 3.22).

Conclusions: Individuals who participated in LTPA for more than 20 minutes more than 5 days a week reported significantly larger improvements in disability acceptance compared with those with lower levels of participation. These findings, while considering the roles of several covariates, can be useful in informing the design of LTPA-based therapeutic programs.

Background: This systematic review evaluated the effects of interventions targeting 24-hour movement behaviors and socioecological outcomes on improving fundamental motor skills in preschool children aged 4-6.

Methods: Randomized controlled trials (RCTs) published up to November 15, 2023, were included if they reported at least 1 24-hour movement behavior, and socioecological factors postintervention in preschoolers aged 4-6 years. A random-effects inverse variance model with Paule-Mandel adjustment was used to estimate overall effect sizes (Hedges g) and 95% CI. Risk of bias was assessed using Rob2 and RobVis, and the certainty of evidence was rated using the GRADE approach.

Results: Twelve RCTs involving 4754 preschoolers (53.1% girls) were included. All interventions aimed to enhance gross motor skills and involved varying levels of teacher and/or parent engagement. Interventions significantly improved overall fundamental motor skills, particularly object control skills such as throwing and catching. However, small and nonsignificant effects were found for physical fitness components (eg, cardiorespiratory fitness, jumping, balance) and 24-hour movement behaviors (eg, total physical activity, light-to-vigorous activity, sedentary time, screen time, body mass index). Overall, intervention duration did not significantly moderate outcomes.

Conclusion: Fundamental motor skills-focused interventions in healthy preschoolers significantly improved motor competence, especially object control, but yielded only modest and nonsignificant changes on physical fitness and movement behaviors. These findings highlight the importance of targeting motor skill development in early childhood. Further research is needed to clarify the influence of the socioecological environment, including family and teacher roles, and to improve intervention strategies for broader behavioral and fitness outcomes.

Background: Both physical activity (PA) and sedentary behavior impact health, and defining combined patterns will help design targeted interventions and policies. There are marked differences between sexes in PA level. This work aimed to define sex-specific behavioral patterns combining leisure-time PA and sedentary behavior and to assess their relations with sociodemographic factors and obesity in a population-based national survey.

Methods: Data were collected in 2014-2016 from a representative sample of French adults (Esteban cross-sectional study) using the Recent Physical Activity Questionnaire. In 1491 women and 1157 men, behavioral clusters were identified using multiple correspondence analysis and hierarchical classification on most frequently performed leisure-time PA and screen time.

Results: Three clusters were identified in each sex. In women, cluster 1 (61.7%) included physically inactive individuals with high screen time. It was associated with lower education level (odds ratio [OR] = 1.6) and higher likelihood of obesity (OR = 2.4). Clusters 2 (22.2%) and 3 (16.1%) included women performing multiple PA of high or low duration, respectively. In men, cluster 1 (39.9%) included individuals with low PA level and high screen time. It was associated with younger age (OR = 3,9), obesity (OR = 2.5), single life (OR = 0.3), and urban residence (OR = 0.5). Cluster 2 (43.1%) included men performing mainly walking, cycling, DIY, and gardening and cluster 3 (17.0%) men with multiple PAs, both with low screen time.

Conclusions: In both sexes, the pattern including inactivity or low PA and high sedentary behavior was associated with obesity. Other patterns differed according to sex. The findings can guide targeted interventions to promote healthy behaviors, considering sex differences.

Background: Digital health interventions targeting physical activity in individuals with chronic conditions are increasingly common. However, the effectiveness of their components and delivery modes remains unclear. This review assessed the effects of intervention components to guide future approaches.

Methods: A systematic review and component network meta-analysis of randomized controlled trials was conducted. MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials were searched up to March 14, 2024. Random effects models, subgroup analyses, sensitivity analyses, and meta-regression were performed. The Confidence in Network Meta-Analysis framework was used to assess the certainty of the evidence.

Results: A total of 137 randomized controlled trials (18,443 participants) were included. Exercise combined with self-management was more effective than usual care (standardized mean differences [SMD]: 0.39; 95% CI, 0.20-0.58) and minimal self-management (SMD: 0.41; 95% CI, 0.23-0.60), as was self-management alone compared with usual care (SMD: 0.27; 95% CI, 0.17-0.37), and minimal self-management (SMD: 0.29; 95% CI, 0.17-0.42). Interventions using mixed technologies (eg, apps with phone calls or devices) (SMD: 0.35; 95% CI, 0.26-0.44), web/app platforms (SMD: 0.32; 95% CI, 0.18-0.45), and phone calls (SMD: 0.21; 95% CI, 0.07-0.36) were more effective than minimal or in-person controls. Type 2 diabetes patients showed the greatest increase in physical activity, while musculoskeletal conditions showed the least. Certainty of evidence was moderate for most comparisons, except for phone calls, which had low certainty.

Conclusions: The most effective digital health interventions for promoting physical activity in individuals with chronic conditions include exercise combined with self-management, delivered via mixed technologies, or web/app platforms.

Background: Schools are ideal settings for physical activity promotion; however, children and adolescents with disability have largely been neglected in school-based health promotion efforts. This review examines the effects of school-based physical activity interventions on academic, cognitive, and mental health outcomes of children and adolescents living with any type of disability (eg, intellectual, physical, behavioral).

Methods: Six databases (PubMed, PsycINFO, Scopus, MEDLINE, SPORTDiscus, and Embase) were searched from inception to September 2024. Studies were included if they: (1) examined children or adolescents (5-18 y) living with disability, (2) included an experimental or quasi-experimental study design, (3) delivered a school-based physical activity intervention, and (4) examined at least one academic, cognitive, or mental health outcome. Multilevel meta-analyses were conducted to examine intervention effects. Prespecified moderators were also examined.

Results: Thirty-three studies involving 1454 children and adolescents living with disability were included. Significant effects were found for cognitive (g = 0.42; 95% CI, 0.22 to 0.62) and mental health (g = 0.57; 95% CI, 0.21 to 0.94) outcomes, but not for academic outcomes. Disability classification, intervention length, and physical activity type significantly moderated intervention effects.

Conclusions: School-based physical activity programs for children and adolescents with disability can improve measures of cognition and mental health, but not academic performance. Most studies examined children with attention-deficit/hyperactivity disorder, and few were conducted with adolescents which may limit generalizability of study findings. More high-quality research with robust study designs and larger more diverse samples are needed.