Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association ...between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention.
The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents.
A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease CVD and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients.
Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was r = -0.25 (95% CI -0.41 to -0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was r = 0.39 (95% CI 0.34-0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate.
The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.
Many adults without a diagnosed sleep disorder report poor sleep health, which is defined by dissatisfactory levels of sleep duration, sleep quality, or the timing of sleep. No previous review has ...summarized and described interventions targeting poor sleep health in this population. This meta-analysis aimed to quantify the efficacy of behavioral and cognitive sleep interventions in adults with poor sleep health, who do not have a sleep disorder. Electronic databases (Medline, Embase, PsycInfo, Cinahl) were searched with restrictions for age (18–64 y) and English language full-text, resulting in 18,009 records being screened and 592 full-texts being assessed. Eleven studies met inclusion criteria, seven of which reported a measure of overall sleep health (Pittsburgh sleep quality index PSQI). Following appraisal for risk of bias, extracted data were meta-analyzed using random-effects models. Meta-analyses showed interventions had a medium effect on sleep quality (Hedge's g = −0.54, 95% confidence interval (CI) −0.90 to −0.19, p < 0.01). Baseline sleep health was the only significant effect moderator (p = 0.01). The most frequently used intervention components were stress management and relaxation practice, stimulus control, sleep hygiene, and exercise. Interventions targeting cognitive and behavioral self-regulation improve sleep quality in adults without clinical sleep disorder.
Emerging literature suggests that physical activity and fitness may have a positive effect on cognitive and mental health in adolescents. The purpose of the current study was to evaluate the efficacy ...of two high-intensity interval training (HIIT) protocols for improving cognitive and mental health outcomes (executive function, psychological well-being, psychological distress, and physical self-concept) in adolescents.
Participants (n = 65; mean age = 15.8 ± 0.6 yr) were randomized to three conditions: aerobic exercise program (AEP; n = 21), resistance and aerobic program (RAP; n = 22), and control (n = 22). HIIT sessions (8-10 min per session) were delivered during physical education lessons or at lunchtime three times per week for 8 wk. Assessments were conducted at baseline and immediately postintervention to detect changes in executive function (trail making test), psychological well-being, psychological distress, and physical self-description by researchers blinded to treatment allocation. Intervention effects were examined using linear mixed models. Cohen's d effect sizes and clinical inference were also calculated.
While results were not significant, small improvements in executive function (mean change (95% CI) -6.69 (-22.03, 8.64), d = -0.32) and psychological well-being (mean change (95% CI) 2.81 (-2.06, 7.68), d = 0.34) were evident in the AEP group; and moderate improvements in executive function (mean change (95% CI) -10.73 (-26.22, 4.76), d = -0.51), and small improvements in well-being (mean change (95% CI) 2.96 (-1.82, 7.75), d = 0.36) and perceived appearance (mean change (95% CI) 0.32 (-0.25, 0.86), d = 0.35), were observed for the RAP group. Mean feeling state scores improved from preworkout to postworkout in both HIIT conditions, with significant results for the AEP (P = 0.001).
This study highlights the potential of embedding HIIT within the school day for improving cognitive and mental health among adolescents.
Abstract Objective. Little is known regarding health-related quality of life and its relation with physical activity level in the general population. Our primary objective was to systematically ...review data examining this relationship. Methods. We systematically searched MEDLINE, EMBASE, CINAHL, and PsycINFO for health-related quality of life and physical activity related keywords in titles, abstracts, or indexing fields. Results. From 1426 retrieved references, 55 citations were judged to require further evaluation. Fourteen studies were retained for data extraction and analysis; seven were cross-sectional studies, two were cohort studies, four were randomized controlled trials and one used a combined cross sectional and longitudinal design. Thirteen different methods of physical activity assessment were used. Most health-related quality of life instruments related to the Medical Outcome Study SF-36 questionnaire. Cross-sectional studies showed a consistently positive association between self-reported physical activity and health-related quality of life. The largest cross-sectional study reported an adjusted odds ratio of “having 14 or more unhealthy days” during the previous month to be 0.40 (95% Confidence Interval 0.36–0.45) for those meeting recommended levels of physical activity compared to inactive subjects. Cohort studies and randomized controlled trials tended to show a positive effect of physical activity on health-related quality of life, but similar to the cross-sectional studies, had methodological limitations. Conclusion. Cross-sectional data showed a consistently positive association between physical activity level and health-related quality of life. Limited evidence from randomized controlled trials and cohort studies precludes a definitive statement about the nature of this association.
Smartphone apps are a promising tool for delivering accessible and appealing physical activity interventions. Given the large growth of research in this field, there are now enough studies using the ..."gold standard" of experimental design-the randomized controlled trial design-and employing objective measurements of physical activity, to support a meta-analysis of these scientifically rigorous studies.
This systematic review and meta-analysis aimed to determine the effectiveness of smartphone apps for increasing objectively measured physical activity in adults.
A total of 7 electronic databases (EMBASE, EmCare, MEDLINE, Scopus, Sport Discus, The Cochrane Library, and Web of Science) were searched from 2007 to January 2018. Following the Population, Intervention, Comparator, Outcome and Study Design format, studies were eligible if they were randomized controlled trials involving adults, used a smartphone app as the primary or sole component of the physical activity intervention, used a no- or minimal-intervention control condition, and measured objective physical activity either in the form of moderate-to-vigorous physical activity minutes or steps. Study quality was assessed using a 25-item tool based on the Consolidated Standards of Reporting Trials checklist. A meta-analysis of study effects was conducted using a random effects model approach. Sensitivity analyses were conducted to examine whether intervention effectiveness differed on the basis of intervention length, target behavior (physical activity alone vs physical activity in combination with other health behaviors), or target population (general adult population vs specific health populations).
Following removal of duplicates, a total of 6170 studies were identified from the original database searches. Of these, 9 studies, involving a total of 1740 participants, met eligibility criteria. Of these, 6 studies could be included in a meta-analysis of the effects of physical activity apps on steps per day. In comparison with the control conditions, smartphone apps produced a nonsignificant (P=.19) increase in participants' average steps per day, with a mean difference of 476.75 steps per day (95% CI -229.57 to 1183.07) between groups. Sensitivity analyses suggested that physical activity programs with a duration of less than 3 months were more effective than apps evaluated across more than 3 months (P=.01), and that physical activity apps that targeted physical activity in isolation were more effective than apps that targeted physical activity in combination with diet (P=.04). Physical activity app effectiveness did not appear to differ on the basis of target population.
This meta-analysis provides modest evidence supporting the effectiveness of smartphone apps to increase physical activity. To date, apps have been most effective in the short term (eg, up to 3 months). Future research is needed to understand the time course of intervention effects and to investigate strategies to sustain intervention effects over time.
Abstract Purpose Evidence suggests sitting time is independently associated with a range of health issues in adults, yet the relationship between sedentary behavior and health indicators in young ...people is less clear. Age-related increases in sedentary behavior are well-documented; the behavioral patterns of adolescent girls are of particular concern. More than one third of adolescent girls’ sedentary behavior time is accumulated through use of recreational screen-based behaviors. The objective of this review was to investigate the association between recreational screen-based sedentary behavior and the physical, behavioral, and psychosocial health indicators for adolescent girls. A secondary objective was to identify studies that have adjusted sedentary behavior indicators for physical activity. Methods A structured electronic search of all publication years (through December 2011) was conducted to identify studies in: CINAHL, Communications and Mass Media Complete, ERIC, MEDLINE with Full Text, PsycINFO, and SPORTDiscus with Full Text. Included publications were observational and interventional studies involving adolescent girls (12–18 years) that examined associations between screen-based, sedentary behavior and health indicators (physical, psychosocial, and/or behavioral). The search identified 33 studies that evaluated health indicators of screen-based sedentary behaviors among adolescent girls. Results Strong evidence for a positive association between screen-based sedentary behavior and weight status was found. A positive association was observed between screen-time and sleep problems, musculoskeletal pain and depression. Negative associations were identified between screen time and physical activity/fitness, screen time and psychological well-being, and screen time and social support. The relationship between screen-based sedentary behavior and diet quality was inconclusive. Less than half of the studies adjusted sedentary behavior indicators for physical activity. Conclusions Screen-based sedentary behavior is associated with a range of adverse health consequences, but additional longitudinal studies are needed to better understand the health impacts. In addition, screen-time guidelines for youth should be regularly revised and updated to reflect rapid technological changes.
Evidence suggests that physical self-concept is associated with physical activity in children and adolescents, but no systematic review of this literature has been conducted.
The primary aim of this ...systematic review and meta-analysis was to determine the strength of associations between physical activity and physical self-concept (general and sub-domains) in children and adolescents. The secondary aim was to examine potential moderators of the association between physical activity and physical self-concept.
A systematic search of six electronic databases (MEDLINE, CINAHL, SPORTDiscus, ERIC, Web of Science and Scopus) with no date restrictions was conducted. Random effects meta-analyses with correction for measurement were employed. The associations between physical activity and general physical self-concept and sub-domains were explored. A risk of bias assessment was conducted by two reviewers.
The search identified 64 studies to be included in the meta-analysis. Thirty-three studies addressed multiple outcomes of general physical self-concept: 28 studies examined general physical self-concept, 59 examined perceived competence, 25 examined perceived fitness, and 55 examined perceived appearance. Perceived competence was most strongly associated with physical activity (r = 0.30, 95% CI 0.24-0.35, p < 0.001), followed by perceived fitness (r = 0.26, 95% CI 0.20-0.32, p < 0.001), general physical self-concept (r = 0.25, 95% CI 0.16-0.34, p < 0.001) and perceived physical appearance (r = 0.12, 95% CI 0.08-0.16, p < 0.001). Sex was a significant moderator for general physical self-concept (p < 0.05), and age was a significant moderator for perceived appearance (p ≤ 0.01) and perceived competence (p < 0.05). No significant moderators were found for perceived fitness.
Overall, a significant association has been consistently demonstrated between physical activity and physical self-concept and its various sub-domains in children and adolescents. Age and sex are key moderators of the association between physical activity and physical self-concept.
The goal of this study was to evaluate the impact of the Active Teen Leaders Avoiding Screen-time (ATLAS) intervention for adolescent boys, an obesity prevention intervention using smartphone ...technology.
ATLAS was a cluster randomized controlled trial conducted in 14 secondary schools in low-income communities in New South Wales, Australia. Participants were 361 adolescent boys (aged 12-14 years) considered at risk of obesity. The 20-week intervention was guided by self-determination theory and social cognitive theory and involved: teacher professional development, provision of fitness equipment to schools, face-to-face physical activity sessions, lunchtime student mentoring sessions, researcher-led seminars, a smartphone application and Web site, and parental strategies for reducing screen-time. Outcome measures included BMI and waist circumference, percent body fat, physical activity (accelerometers), screen-time, sugar-sweetened beverage intake, muscular fitness, and resistance training skill competency.
Overall, there were no significant intervention effects for BMI, waist circumference, percent body fat, or physical activity. Significant intervention effects were found for screen-time (mean ± SE: -30 ± 10.08 min/d; P = .03), sugar-sweetened beverage consumption (mean: -0.6 ± 0.26 glass/d; P = .01), muscular fitness (mean: 0.9 ± 0.49 repetition; P = .04), and resistance training skills (mean: 5.7 ± 0.67 units; P < .001).
This school-based intervention targeting low-income adolescent boys did not result in significant effects on body composition, perhaps due to an insufficient activity dose. However, the intervention was successful in improving muscular fitness, movement skills, and key weight-related behaviors.
Abstract Purpose To systematically review and examine the explanatory power of key social-cognitive theories used to explain physical activity (PA) intention and behavior, among adolescents. Methods ...A systematic review and meta-analysis of the literature was performed using the electronic databases Medline, Cumulative Index to Nursing and Allied Health Literature, SPORTdiscus, EBSCO and Education Resources Information Center, Proquest Education Journals Collection, Science Direct, Web of Science and Scopus for social-cognitive theories (i.e., Health Promotion Model, Theory of Planned Behavior, Theory of Reasoned Action, Protection Motivation Theory, Social Cognitive Theory/Self-Efficacy Theory, Health Belief Model, Self-Determination Theory, Transtheoretical Model) used to explain PA intention and behavior. Related keywords in titles, abstracts, or indexing fields were searched. Results Twenty-three studies satisfied the inclusion criteria and were retained for data extraction and analysis; 16 were cross-sectional studies and seven were longitudinal studies. Most studies employed self-report measures. In general, the models explained greater proportions of variance for intention compared to behavior. The meta-analyses revealed 33% and 48% of the variance respectively for PA and intention were explained by social cognitive models. Conclusions Few studies have tested the predictive capacity of social cognitive theories to explain objectively measured PA. The majority of PA variance remains unexplained and more theoretical research is needed.
BACKGROUND: Although previous studies have demonstrated that children with high levels of fundamental movement skill competency are more active throughout the day, little is known regarding ...children’s fundamental movement skill competency and their physical activity during key time periods of the school day (i.e., lunchtime, recess and after-school). The purpose of this study was to examine the associations between fundamental movement skill competency and objectively measured moderate-to-vigorous physical activity (MVPA) throughout the school day among children attending primary schools in low-income communities. METHODS: Eight primary schools from low-income communities and 460 children (8.5 ± 0.6 years, 54% girls) were involved in the study. Children’s fundamental movement skill competency (TGMD-2; 6 locomotor and 6 object-control skills), objectively measured physical activity (ActiGraph GT3X and GT3X + accelerometers), height, weight and demographics were assessed. Multilevel linear mixed models were used to assess the cross-sectional associations between fundamental movement skills and MVPA. RESULTS: After adjusting for age, sex, BMI and socio-economic status, locomotor skill competency was positively associated with total (P = 0.002, r = 0.15) and after-school (P = 0.014, r = 0.13) MVPA. Object-control skill competency was positively associated with total (P < 0.001, r = 0.20), lunchtime (P = 0.03, r = 0.10), recess (P = 0.006, r = 0.11) and after-school (P = 0.022, r = 0.13) MVPA. CONCLUSIONS: Object-control skill competency appears to be a better predictor of children’s MVPA during school-based physical activity opportunities than locomotor skill competency. Improving fundamental movement skill competency, particularly object-control skills, may contribute to increased levels of children’s MVPA throughout the day. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry No: ACTRN12611001080910 .
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