Background
Whilst there is increasing interest in the efficacy of high-intensity interval training in children and adolescents as a time-effective method of eliciting health benefits, there remains ...little consensus within the literature regarding the most effective means for delivering a high-intensity interval training intervention. Given the global health issues surrounding childhood obesity and associated health implications, the identification of effective intervention strategies is imperative.
Objectives
The aim of this review was to examine high-intensity interval training as a means of influencing key health parameters and to elucidate the most effective high-intensity interval training protocol.
Methods
Studies were included if they: (1) studied healthy children and/or adolescents (aged 5–18 years); (2) prescribed an intervention that was deemed high intensity; and (3) reported health-related outcome measures.
Results
A total of 2092 studies were initially retrieved from four databases. Studies that were deemed to meet the criteria were downloaded in their entirety and independently assessed for relevance by two authors using the pre-determined criteria. From this, 13 studies were deemed suitable. This review found that high-intensity interval training in children and adolescents is a time-effective method of improving cardiovascular disease biomarkers, but evidence regarding other health-related measures is more equivocal. Running-based sessions, at an intensity of >90% heart rate maximum/100–130% maximal aerobic velocity, two to three times a week and with a minimum intervention duration of 7 weeks, elicit the greatest improvements in participant health.
Conclusion
While high-intensity interval training improves cardiovascular disease biomarkers, and the evidence supports the effectiveness of running-based sessions, as outlined above, further recommendations as to optimal exercise duration and rest intervals remain ambiguous owing to the paucity of literature and the methodological limitations of studies presently available.
To assess physical activity (PA), mental health and well-being of adults in the United Kingdom (UK), Ireland, New Zealand and Australia during the initial stages of National governments’ Coronavirus ...disease (COVID-19) containment responses.
Observational, cross-sectional.
An online survey was disseminated to adults (n=8,425; 44.5±14.8y) residing in the UK, Ireland, New Zealand and Australia within the first 2-6 weeks of government-mandated COVID-19 restrictions. Main outcome measures included: Stages of Change scale for exercise behaviour change; International Physical Activity Questionnaire (short-form); World Health Organisation-5 Well-being Index; and the Depression Anxiety and Stress Scale-9.
Participants who reported a negative change in exercise behaviour from before initial COVID-19 restrictions to during the initial COVID-19 restrictions demonstrated poorer mental health and well-being compared to those demonstrating either a positive-or no change in their exercise behaviour (p<0.001). Whilst women reported more positive changes in exercise behaviour, young people (18-29y) reported more negative changes (both p<0.001). Individuals who had more positive exercise behaviours reported better mental health and well-being (p<0.001). Although there were no differences in PA between countries, individuals in New Zealand reported better mental health and well-being (p<0.001).
The initial COVID-19 restrictions have differentially impacted upon PA habits of individuals based upon their age and sex, and therefore have important implications for international policy and guideline recommendations. Public health interventions that encourage PA should target specific groups (e.g., men, young adults) who are most vulnerable to the negative effects of physical distancing and/or self-isolation.
The aim of this meta-analysis was to quantify the change in sedentary time during the COVID-19 pandemic and its effect on health outcomes in the general population. One thousand six hundred and one ...articles published after 2019 were retrieved from five databases, of which 64 and 40 were included in the systematic review and meta-analysis, respectively. Studies were grouped according to population: children (<18 years), adults (18–64 years) and older adults (>65 years). Average sedentary time was calculated, with sub-analyses performed by country, behaviour type and health outcomes. Children were most affected, increasing their sedentary time by 159.5 ± 142.6 min day−1, followed by adults (+126.9 ± 42.2 min day−1) and older adults (+46.9 ± 22.0 min day−1). There were no sex differences in any age group. Screen time was the only consistently measured behaviour and accounted for 46.8% and 57.2% of total sedentary time in children and adults, respectively. Increases in sedentary time were negatively correlated with global mental health, depression, anxiety and quality of life, irrespective of age. Whilst lockdown negatively affected all age groups, children were more negatively affected than adults or older adults, highlighting this population as a key intervention target. As lockdowns ease worldwide, strategies should be employed to reduce time spent sedentary. Trial registration: PROSPERO (CRD42020208909).
Introduction
Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that ...the exercise-longevity relationship may be ‘J’ shaped; with elite athlete’s likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes.
Methods
38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio’s (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis.
Results
Athletes lived significantly longer than the general population (male SMR 0.69 95% CI 0.61–0.78; female SMR 0.51 95% CI 0.40–0.65; both
p
< 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 95% CI 0.91–1.12). Although male athlete’s CVD (SMR 0.73 95% CI 0.62–0.85) and cancer mortality (SMR 0.75 95% CI 0.63–0.89), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 0.86–1.40) or END athletes cancer mortality (SMR 0.73 0.50–1.07). There was insufficient data to calculate female sport-specific SMR’s.
Discussion
Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the ‘J’ shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation.
Trial registration
PROSPERO (registration number: CRD42019130688).
•Overall evidence ratings for interventions implemented within school settings showed no evidence of effects of moderate-to-vigorous physical activity and inconclusive evidence of effects of ...sedentary time.•There was evidence of a moderate effect on physical activity measured during actual interventions, but this was not replicated across the whole day, suggesting compensatory behaviors.•Meta-analysis of the studies with whole-day accelerometer measures suggested a pooled effect size of 0.57 and 1.57 for moderate-to-vigorous physical activity and sedentary time, respectively, but with low precision, significant heterogeneity, and considerable inconsistency.•Expansion of opportunities for physical activity, including after-school clubs, active travel, class physical activity breaks, and physically active learning appeared to be the most promising types of intervention.
The aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions in increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5–11 years, as well as to explore their effectiveness in relation to categories of the theory of expanded, extended, and enhanced opportunity (TEO).
Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 5 databases were searched using predefined search terms. Following title and abstract screening of 1115 records, the removal of duplicates (n = 584) and articles that did not meet the inclusion criteria agreed to a priori (n = 419) resulted in 112 records that were full-text screened. Two independent reviewers subsequently used the mixed-methods appraisal tool to assess the methodological quality of 57 full-text studies that met the inclusion criteria after full-text screening. The interventions were summarised using the TIDierR checklist and TEO. The strength of evidence was determined using a 5-level rating system utilising a published decision tree.
Overall evidence ratings for interventions implemented within school settings were: no evidence of effects on moderate-to-vigorous physical activity (MVPA) and inconclusive evidence of effects on sedentary time. In relation to the TEO, expansion of PA appeared to be the most promising intervention type for MVPA, with moderate evidence of effect, whereas extension and enhancement of PA opportunity demonstrated no evidence of effect. A critical issue of possible compensatory behavior was identified by analysis of intervention effect in relation to PA measurement duration; when studies measured changes in PA during the actual intervention, there was moderate evidence of effect, whereas those that measured changes in PA during the school day presented inconclusive evidence of effect, and those that measured changes in PA over a whole day yielded no evidence of effect. Two meta-analyses of those studies using a whole-day accelerometer measure for MVPA or ST showed a significant but moderate effect for MVPA (effect size = 0.51; 95% confidence interval (CI): 0.02–0.99) and a large but nonsignificant effect for ST (effect size = 1.15; 95%CI: –1.03 to 3.33); both meta-analyses demonstrated low precision, considerable inconsistency, and high heterogeneity.
The findings have important implications for future intervention research in terms of intervention design, implementation, and evaluation.
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The benefits of physical activity (PA) and the negative impacts of sedentary time (SED) on both short- and long-term health in youth are well established. However, uncertainty remains about how PA ...and SED jointly influence maximal oxygen uptake (Formula: see text). Therefore, the aim of this study was to determine the joint influence of PA and SED on Formula: see text using compositional analyses. 176 adolescents (84 girls, 13.8 ± 1.8 years) completed an incremental ramp test and supramaximal validation bout on a cycle ergometer, with PA and SED recorded for seven consecutive days on the right hip using a ActiGraph GT3X accelerometer. Time spent in Sleep, SED, light, moderate and vigorous PA was analysed using a compositional linear regression model. Compositions with 10 minutes more time in vigorous PA (> 27.5 mins⋅day-1) compared to the average 17.5 mins⋅day-1 were associated with a + 2.9% - 11.1% higher absolute and scaled Formula: see text whilst compositions with less (> -10 mins⋅day-1) VPA were associated with a reduced absolute and allometrically scaled Formula: see text (-4.6% - 24.4%). All associations were irrespective of sex, maturity, and training status. The proportion of time spent sedentary had little impact on absolute and scaled Formula: see text (0.01-1.98%). These findings therefore highlight that intensity of PA may be of greater importance for increases in Formula: see text than reductions in SED and should be incorporated into future intervention designs.
Understanding the day-to-day lived experiences of individuals who have had or are still recovering from Coronavirus Disease-19 (COVID-19), whilst a complex challenge, presents the opportunity to ...listen and learn. Composite vignettes provide a novel approach to explore and present descriptive portrayals of the most commonly derived experiences and recovery journeys. The thematic analysis of 47 shared accounts (semi-structured interviews with adults aged ≥18 years; 40 females; 6-11 months post-COVID-19 infection) produced a series of four intricate character stories written through the lens of a single individual. Each vignette gives a voice to and captures a different experience trajectory. From the point of initial symptom development onwards, the vignettes depict how COVID-19 has affected everyday lives, focusing on the secondary non-biological socio-psychological effects and implications. The vignettes highlight in participants' own words: i) the potential negative implications of not addressing the psychological effects of COVID-19; ii) the lack of symptom and recovery linearity; iii) the ongoing 'lottery' of access to healthcare services; and iv) the highly variable, yet generally devastating, impacts that COVID-19 and consequent long-COVID has had across multiple facets of daily living.
Research pertaining to the experiences of women in rugby is scarce, which, coupled with the limited visibility of the sport and difficulty accessing resources, suggest that women's rugby remains ...undervalued. Indeed, evidence of such gender inequalities remains largely anecdotal, with little rigorous research undertaken to understand the perspectives of women in rugby. This study aimed to explore the experiences of a diverse cohort of rugby players in relation to their participation in the sport and their ability to access resources. Twenty UK-based rugby players (10 men, 9 women and 1 non-binary person aged 29.1 ± 8.3 years) from school, university, club, military, and semi-professional environments, volunteered to participate in semi-structured interviews (36 ± 12 minutes) discussing their rugby experiences in relation to their gender and playing level. Interviews were transcribed verbatim, and a reflexive thematic analysis was undertaken. A widespread under-prioritisation of women in rugby was highlighted. Gender biases were apparent in access to changing rooms, pitches, quality coaches, and playing opportunities, and were reportedly propagated at the managerial level. Irrespective of gender, some amateur players reported difficulty accessing a suitable rugby environment. Insufficient player numbers precluded the formation of second teams, often resulting in inexperienced players competing beyond their ability. Women's rugby players experienced considerable gender bias. This exploratory study highlights a need to address such issues to protect player welfare. Interventions to change the culture in rugby clubs and increased representation of women in managerial positions in rugby are recommended to enact meaningful change.
Robust evidence supports the role of physical activity and exercise in increasing longevity, decreasing morbidity and helping older adults maintain the highest quality of life attainable. However, ...the majority of older adults are not sufficiently physically active and interventions are needed to change their behaviors. Familial or intergenerational contact has been positively linked to health and well-being in older adults. Therefore, this study aimed to i) establish acceptability and test the functionality and useability of a novel technology-driven intergenerational intervention targeting physical activity and age stereotypes, and ii) identify any potential issues with recruitment and retention. Four familial dyads (adult ≥ 65 and child 7-11 years) engaged with the intervention. Working collaboratively during a four-week trial, they combined daily step-counts (acquired via any activity of their choice, using PA trackers) to complete a virtual walk route using online platform World Walking. Thematic analysis of three post-intervention focus groups (one older adult; one child; one additional parental cohort) identified eight subthemes: Engagement; Provision of a Positive Experience; Participant Stimuli; Generated Outcomes; Operationality; Limitations; Mediators; Facilitators, and Perceptions. Participants enjoyed and successfully engaged with the intervention; when designing behaviour change interventions for older adults, flexibility within pre-established routines, individual choice, and avoiding rigidly imposed structures, is important. Strategies to challenge negative perceptions of older adults' engagement with technology and PA should be integrated into recruitment processes.