High-intensity interval training in children and adolescents with special educational needs: a systematic review and narrative synthesis.

BACKGROUND: High-intensity interval training (HIIT) has been promoted as a time-efficient exercise strategy to improve health and fitness in children and adolescents. However, there remains little consensus in the literature regarding its efficacy in children and adolescents with special educational needs (SEN). This study aimed to examine HIIT as a means of improving key health and fitness parameters in children and adolescents with SEN. METHODS: A systematic search was conducted on eight databases (MEDLINE, Embase, SPORTDiscus, Web of Science, Scopus, PsycINFO, CINAHL, and Cochrane Library). Studies were eligible if they 1) included an HIIT protocol, 2) examined parameters related to both physical and mental aspects of health and fitness, and 3) examined children and adolescents with SEN aged 5-17 years. RESULTS: Of the 1727 studies yielded by the database search, 13 (453 participants) were included and reviewed. We found that HIIT generally improved body composition, physical fitness, and cardiometabolic risk biomarkers across a spectrum of SEN (e.g., attention deficit hyperactivity disorder, cerebral palsy, developmental coordination disorder, and mental illness). Improvements in mental health and cognitive performance following HIIT have also been observed. CONCLUSION: This review provides up-to-date evidence for HIIT as a viable exercise strategy for children and adolescents with SEN. Further research investigating the benefits of HIIT in a wider range of SEN populations is warranted. TRIAL REGISTRATION: This study was registered in the International Prospective Register of Systematic Review (PROSPERO; registration number CRD42022352696).

Associations Between Perceived Social Support, Perceived Competence, and Physical Activity in Hong Kong Children With Disabilities During the COVID-19 Pandemic.

This study aimed to examine the associations between perceived social support, perceived competence, and physical activity in children with physical and intellectual disabilities during the COVID-19 pandemic. During the third wave of the pandemic in Hong Kong (i.e., July through December 2020), 291 participants age 6-17 years from 27 special schools were included. After controlling for demographic variables, the total variance explained by perceived social support and perceived competence was 24%, F(2, 240) = 12.42, p < .001, with perceived competence having a stronger association with physical activity (ß = 0.29, p < .001) than perceived social support (ß = 0.07, p = .22). This study highlights two key facilitators for shaping physical activity involvement among children with disabilities during the COVID-19 pandemic.

Physical activity and mental health in children and adolescents with intellectual disabilities: a meta-analysis using the RE-AIM framework.

BACKGROUND: Children and adolescents with intellectual disabilities (IDs) tend to have lower levels of physical activity and poorer mental health than their typically developing peers. Studies on the effects of physical activity on the mental health of children with IDs using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework are scarce. METHODS: A systematic literature review using six databases (CINAHL, Eric, PsycINFO, PubMed, SPORTDiscus, and Web of Science) was conducted from January 2000 to September 2021. Studies reporting at least one physical activity intervention and mental health outcome in children and adolescents with IDs aged between 5 and 17 years were included in the meta-analysis. Preferred Reporting Items for Systematic Review and Meta-Analysis guideline, Comprehensive Meta-Analysis, and the RE-AIM framework were utilized. RESULTS: A total of 15 studies that met the inclusion criteria were included in the meta-analysis. The effects of physical activity on mental health in children and adolescents with IDs were significant and large (Hedges' g = 0.897, p < 0.01), with medium effects on psychological health (Hedges' g = 0.542, p < 0.01) and large effects on cognitive function (Hedges' g = 1.236, p < 0.01). Randomized controlled trial (RCT) design and intervention components (> 120 minutes per week, therapeutic, and aerobic exercise) demonstrated the strongest effects. Moreover, study background (publication year, study location, and sample size), participant characteristics (age and sex), and Maintenance (RE-AIM framework) moderated the effects of physical activity on mental health. Based on the RE-AIM framework, there were higher proportions in the dimensions of Reach and Effectiveness than Adoption, Implementation, and Maintenance. CONCLUSIONS: Physical activity appears to have positive effects on mental health, including psychological health and cognitive function, in children and adolescents with IDs. Physical activity interventions using the RE-AIM framework are recommended to assess short- and long-term impacts and translate scientific evidence into practice. TRIAL REGISTRATION: The protocol for this meta-analysis was registered with PROSPERO ( CRD42021256543 ).

Movement behaviors and mental health of caregivers of preschoolers in China during the COVID-19 pandemic.

This study aimed to examine the associations between physical activity (PA), sedentary behavior (SB), sleep, and the mental health of caregivers of preschool children following the COVID-19 outbreak. From 5 October to 16 December 2020, responses from 2476 respondents in China were collated through an online survey or a written questionnaire. Movement behaviors (PA, SB, screen time, and sleep), mental health (depression, anxiety, and stress), and demographic information were self-reported by the respondents. Linear mixed models were used for data analysis. Valid responses were received from 2002 caregivers (35.5 ± 4.9 years old, 76.3% females) of children between 3 and 6 years old in China (Hong Kong 3.2%, Shanghai 20.6%, Guangzhou 34.1%, Guiyang 26.7%, Xuzhou 11.3%, Xi'an 4.1%). A higher level of PA was associated with a lower score of depression, while lower SB and longer sleep duration were associated with lower scores of depression, anxiety, and stress. Meeting the Canadian 24-h movement guidelines was associated with less symptoms of depression, anxiety, and stress. Higher PA was associated with lower levels of depression, while longer sleep and lower SB were associated with better scores of depression, anxiety, and stress. Meeting the Canadian 24-h movement guidelines has been associated with better mental health during the COVID-19 pandemic. Interventions to improve mental health among caregivers should involve enhancing their overall movement behaviors.

Effect of sedentary behavior interventions on vascular function in adults: A systematic review and meta-analysis.

Sedentary behavior (SB) results in hemodynamic alterations within the vasculature, leading to vascular dysfunction that may be attenuated by various interventions. This systematic review and meta-analysis examined the effect of SB interventions on vascular function in adults using seven databases searched on December 17, 2020. All types of SB interventions were included such as short- and long-term interventions (≥7 days) in participants aged ≥18 years. The pooled effect (mean difference) of intervention on three outcomes, namely, flow-mediated dilation (FMD), shear rate (SR), and pulse wave velocity (PWV), was evaluated using random effects meta-analyses. The revised Cochrane risk-of-bias tool for randomized trials was employed to assess the quality of the included studies. Twenty-six studies (21 short-term and six long-term interventions) involving 669 participants from eight countries were included. Evidence from meta-analysis showed that short-term interventions targeting SB improved FMD by 1.50% (95% confidence interval [CI] 1.00-1.99) and increased SR by 12.70 S-1 (95% CI 7.86-17.54); no significant pooled effect was found for PWV. Long-term SB interventions resulted in a 0.93% increase in FMD (95% CI 0.25-1.62) and had no significant effect on PWV. Findings of this systematic review and meta-analysis suggest that both short- and long-term SB interventions improved FMD but had no effect on PWV. Short-term interventions had a greater effect in improving lower extremity arterial function. Further studies targeting long-term SB interventions on vascular function in adults are warranted.

Associations between meeting 24-hour movement guidelines and health in the early years: A systematic review and meta-analysis.

This systematic review examined the compliance with the 24-h movement guidelines, and investigated its associations with health indicators for healthy children under 5 years of age. MEDLINE, PsycINFO, EMBASE, PubMed, Web of Science and SPORTDiscus were searched for peer-reviewed studies and the last search was conducted on 27 October 2020. The Newcastle-Ottawa Scales were used to assess the quality of included studies. Eighteen articles including 8,943 participants from 11 countries were included. On average around 13% of the children met all three guidelines. Meta-analyses of the associations between meeting all three guidelines and adiposity yielded no significant results (r = - 0.03; 95% CI = - 0.12, 0.06; I2 = 51%; P = 0.48). Meeting more guidelines was associated with better psychosocial health (3/4 studies). Associations between meeting individual or combined guidelines and motor development yielded mixed results (2/2 studies), while no associations between meeting guidelines and cognitive development were observed (1 study). Compliance with all three guidelines was low. Further evidence is required to understand the associations between meeting the 24-h movement guidelines and health outcomes. Nevertheless, there was evidence of a dose-response relationship between meeting the guidelines and better psychosocial health in the early years.

Validity of accelerometry for predicting physical activity and sedentary time in ambulatory children and young adults with cerebral palsy.

BACKGROUND: /Objectives: This study aimed to validate five published ActiGraph (AG) cut-off points for the measurements of physical activity (PA) and sedentary time (ST) in ambulatory children and young adults with cerebral palsy (CP). Additionally, four energy expenditure (EE) prediction equations based on AG counts and activPAL (AP) steps were examined in this population, using oxygen uptake (VO2) as the criterion. METHODS: Four male and six female participants with CP (Gross Motor Function Classification System levels I-III, ages 9-21 years) completed seven activities while simultaneously wearing an AG, AP monitor and indirect calorimetry unit. VO2 was measured on a breath-by-breath basis using the indirect calorimetry and was converted into EE using metabolic equivalents. AG counts were classified as sedentary, light PA (LPA) or moderate-to-vigorous PA (MVPA) using five cut-off points: Puyau, Evenson, Romanzini, Clanchy and Baque. The predicted EE was computed using three AG-based equations (Freedson, Trost and Treuth) and an AP step-based equation. RESULTS: Based on 1920 available data points from the 10 participants, Baque (r = 0.896, κ = 0.773) and Clanchy (r = 0.935, κ = 0.721) AG cut-off points classified PA and ST most accurately. All the equations overestimated EE during sitting activities and underestimated EE during rapid walking. The Freedson, Treuth and AP equations exhibited systematic bias during rapid walking, as their differences from the criterion measure increased progressively with increasing activity intensity. CONCLUSIONS: The AG accurately classified PA and ST when the Baque and Clanchy cut-off points were used. However, none of the available AG or AP equations accurately predicted the EE during PA and ST in children and young adults with CP. Further development is needed to ensure that both devices can estimate EE accurately in this population.

Perceived and actual physical literacy and physical activity: A test of reverse pathway among Hong Kong children.

BACKGROUND/OBJECTIVE: The directional relationship between physical literacy (PL) and physical activity (PA) in children remains unclear. This study explored the directionality of the relationship between children's actual PL and PA, and whether their PL perceptions mediate this relationship. METHODS: This was a cross-sectional study. In total, 371 children (153 boys; Mage = 10.0 ± 1.0) from Chinese primary schools were recruited to complete all the assessments. Structural equation modeling (SEM) was conducted to determine a reciprocal relationship between Motivation and Confidence, Daily Behavior and moderate-to vigorous-intensity physical activity (MVPA). RESULTS: When perceived PL was examined as a mediator, the model with direction from MVPA to actual PL was observed with significance in Motivation and Confidence (ß = 0.48) and Daily Behavior (ß = 0.20). Perceived PL displayed no mediation effect for the direction from actual PL to MVPA. CONCLUSIONS: This study provides evidence that engagement in PA might be useful to support the continuous development of PL. As perceived PL is an integral part of this relationship, future research is needed to understand its role for providing potential intervention targets to improve these outcomes among Chinese children.

Associations between perceived and actual physical literacy level in Chinese primary school children.

BACKGROUND: The concept of physical literacy (PL) is gaining popularity within public health and physical education circles. However, little is known about the relationship between perceived and actual PL levels among school-aged children. The aim of this study is to explore the associations between perceived and actual levels of PL of primary school students in China. METHODS: A total of 327 children (153 boys and 174 girls) with a mean (SD) age of 10.0 (±1.0) years were included for analysis. PL perceptions were measured using the Perceived Physical Literacy Instrument. Children's actual level of PL was objectively assessed by the Chinese version of the Canadian Assessment of Physical Literacy, 2nd edition, which consists of four domains: Daily Behavior, Physical Competence, Motivation and Confidence, and Knowledge and Understanding. Pearson's correlation coefficients were calculated to examine the relationship between students' perceived and actual PL levels, whereas Multivariate Analysis of Variance (MANOVA) was calculated to investigate the gender, relative age differences, and interaction effect (2 × 4) on perceived and actual PL levels respectively. RESULTS: Significant correlations were observed between the perceptions and actual PL scores in both boys (r = .46, p < .01) and girls (r = .41, p < .01). Low to moderate significances were shown between each domain of perceived PL and actual PL (from .16 to .49). Further MANOVA results revealed that there were significant gender differences in the Daily Behavior domain of actual PL (F (1, 319) = 30.15, p < .001, Wilks' Λ = 540.88, η2partial = .09). Overall, boys had both higher actual PL scores (58.9) and PL perceptions (37.3) than girls. Neither relative age effect nor interaction effect (2 × 4) was observed for the current participants in all the variables. CONCLUSIONS: This study is the first to examine the associations between the perceived and actual levels of PL in Chinese children. Additional studies should explore the importance of children's perceptions of PL when assessing the actual level of PL in physical education and health settings. Girls should be more encouraged by PE teachers to participate actively in physical activities in the school environment.

The effect of low-volume high-intensity interval training on cardiometabolic health and psychological responses in overweight/obese middle-aged men.

High-intensity interval training (HIIT) has been proposed as a time-efficient exercise protocol to improve metabolic health, but direct comparisons with higher-volume moderate-intensity continuous training (MICT) under unsupervised settings are limited. This study compared low-volume HIIT and higher-volume MICT interventions on cardiometabolic and psychological responses in overweight/obese middle-aged men. Twenty-four participants (age: 48.1±5.2yr; BMI: 25.8±2.3kg·m-2) were randomly assigned to undertake either HIIT (10 X 1-min bouts of running at 80-90% HRmax separated by 1-min active recovery) or MICT (50-min continuous jogging/brisk walking at 65-70% HRmax) for 3 sessions/week for 8 weeks (2-week supervised + 6-week unsupervised training). Both groups showed similar cardiovascular fitness (VO2max) improvement (HIIT: 32.5±5.6 to 36.0±6.2; MICT: 34.3±6.0 to 38.2±5.1mL kg-1 min-1, p < 0.05) and %fat loss (HIIT: 24.5±3.4 to 23.2±3.5%; MICT: 23.0±4.3 to 21.5±4.1%, p< 0.05) over the 8-week intervention. Compared to baseline, MICT significantly decreased weight and waist circumference. No significant group differences were observed for blood pressure and cardiometabolic blood markers such as lipid profiles, fasting glucose and glycated haemoglobin. Both groups showed similar enjoyment levels and high unsupervised adherence rates (>90%). Our findings suggest that low-volume HIIT can elicit a similar improvement of cardiovascular fitness as traditional higher-volume MICT in overweight/obese middle-aged men.

Cross-validation of the Canadian Assessment of Physical Literacy second edition (CAPL-2): The case of a Chinese population.

The present study aimed to culturally adapt the Canadian Assessment of Physical Literacy, Second Edition (CAPL-2) and examine its validity and reliability among Chinese children aged 8 to 12 years. The original manual of CAPL-2 was translated and culturally adapted from English into Chinese. A total of 327 children (153 boys, mean age = 10.0) completed CAPL-2 (Chinese) assessments. Internal consistency reliability and construct validity for subscales and total model was explored. Results reported a good fit after adjusting for covariation paths, chi-square (χ 2 = 70.16, df = 43, p < 0.05), RMSEA = 0.04, 90% CI (0.024 - 0.062), CFI = 0.94, TLI = 0.90. Motivation and Confidence showed a good internal consistency (α = 0.82), compared to Knowledge and Understanding (α = 0.52). In general, there were few significant correlations between age and the subdomains as developmentally expected, and gender differences were observed with boys performing better than girls in total CAPL2 (Chinese) scores. This study was the first to cross-validate the CAPL-2 into the Chinese population. CAPL-2 (Chinese) offers the possibility of assessing physical literacy for researchers and practitioners and Chinese children's physical literacy development could be easily tracked in school settings.

Results from Hong Kong's 2019 report card on physical activity for children and youth with special educational needs.

BACKGROUND: /Objective: The Active Healthy Kids 2019 Hong Kong Report Card on Physical Activity for Children and Youth with Special Educational Needs (SEN) provides evidence-based assessments for nine indicators of physical activity behaviors and related sources of influence for 6- to 17-year-olds with SEN in Hong Kong. This is the first Report Card for this population group in Hong Kong. METHODS: The best available data between 2008 and 2019 were reviewed by a panel of experts. Following the Active Healthy Kids Global Alliance (AHKGA) development process, letter grades were assigned to nine indicators (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behaviors, Family & Peers, School, Community & Environment, and Government Strategies & Investments). RESULTS: Two behavior indicators (Overall Physical Activity: F; Sedentary Behaviors: D+) and two contextual indicators (School: B; Government Strategies & Investments: C-) were assigned a letter grade. The remaining indicators including Organized Sport Participation, Active Play, Active Transportation, Family & Peers, and Community & Environment were not graded due to insufficient data. CONCLUSIONS: A majority of children and youth with SEN in Hong Kong are physically inactive and have a high level of sedentary behaviors. Schools are ideal settings to promote physical activity for this population. There is a need to develop a comprehensive surveillance system to monitor this population, assess efforts to improve the grades, and promote physical activity opportunities for children and youth with SEN.

Predictors of healthier and more sustainable school travel mode profiles among Hong Kong adolescents.

BACKGROUND: Adolescent travel mode choices to/from school vary in their physical activity (PA) component and environmental sustainability. Research has typically focussed on correlates of active travel, the most healthy and sustainable mode, in comparison to other modes combined. Under the premise that a small shift from less to more healthy/sustainable modes may be a more feasible than a shift to 'pure' active travel (e.g., walking), we examined potential correlates of the odds of undertaking more vs. less healthy/sustainable modes. METHODS: Hong Kong adolescents attending secondary school and a parent/caregiver (n = 1299 dyads) participated in this cross-sectional study. Latent profile analyses identified groups of adolescents with different transport mode profiles to/from school. Profiles were ranked based on relative PA/sustainability outcomes. Multilevel logistic regression identified environmental, social and psychological factors associated with more vs. less PA/sustainable transport mode profiles to/from school. RESULTS: Most frequent transport modes were walking and public transport. Latent profile analysis resulted in a 7-profile model (walk (n = 430); walk & public transport (n = 93); public transport (n = 486); bicycle, car & taxi (n = 60); school bus to & public transport from school (n = 54); school bus (n = 106); car to & car/public transport from school (n = 70)). All profile comparisons were associated with at least one environmental variable. School proximity, access to services and parent transport-related PA were generally associated with higher odds of healthier-more sustainable transport modes. Adolescent-perceived distance and effort barriers to walking and cycling were generally associated with lower odds of more healthy/sustainable modes. DISCUSSION: Most adolescents engaged in relatively healthy/sustainable travel modes to/from school. Public transport to walking and school bus to public transport mode shifts are likely to have the biggest impact towards more healthy/sustainable modes. Encouraging parent-related transport PA may positively influence adolescent mode choice. Relatively dense, destination-rich neighbourhoods may encourage more healthy/sustainable transport modes to/from school by providing easy access to schools and services. CONCLUSION: Government policy encouraging enrolment in the closest local school and private school encouragement of public transport rather than school buses may have the greatest impact on shifts to more healthy/sustainable transport modes to/from school in Hong Kong adolescents.

Effect of pre-exercise ingestion of α-lactalbumin on subsequent endurance exercise performance and mood states.

This study investigated the effect of pre-exercise α-lactalbumin ingestion on subsequent endurance exercise performance, muscle pain and mood states. In a two-stage cross-over counterbalance design, eleven male endurance runners (age: 31 (se 2) years, height: 169·5 (se 4·4) cm, weight: 63·6 (se 5·1) kg, V̇O2max: 58·8 (se 6·3) ml/kg per min) consumed two solutions (carbohydrate+α-lactalbumin, CA; carbohydrate+whey protein isolate, CW) 2 h before a self-paced 21-km run. Creatine kinase, IL-6, muscle pain, pressure pain threshold (PPT) and mood states were assessed 2 h before exercise, immediately before exercise (Pre-ex0) and immediately after exercise (Post-ex0). No difference was found in 21-km running performance between two trials (CA v. CW: 115·85 (se 5·20) v. 118·85 (se 5·51) min, P=0·48). Compared with CW, CA led to higher PPT at Pre-ex0 (41·77 (se 2·27) v. 35·56 (se 2·10) N/cm2, P<0·01) and Post-ex0 (38·76 (se 3·23) v. 35·30 (se 3·55) N/cm2, P=0·047). Compared with CW, CA reduced the feeling of fatigue at Post-ex0 (P<0·01); CA also reduced salivary cortisol levels at Post-ex0 (0·72 (se 0·07) v. 0·83 (se 0·13) ng/ml, P<0·01). In conclusion, the ingestion of α-lactalbumin did not improve the 21-km time-trial performance. However, compared with the pre-exercise ingestion of whey protein, that of α-lactalbumin led to superior results during similar levels of endurance exercise: it elevated PPT and reduced the feeling of fatigue and the cortisol levels.

Compliance and Practical Utility of Continuous Wearing of activPAL™ in Adolescents.

PURPOSE: The aim of this study was to examine the factors that influence compliance and practical utility of a continuous wear protocols for activPAL™ among adolescents. METHODS: Seven hundred and fifty-five (11-18 y; 50.6% girls) students wore the waterproof activPAL™ for 7 consecutive days. The effects of factors such as weather and practical strategies on compliance were assessed. Students were asked to note reasons for removing it in a log. After the 7-day period, students anonymously completed a practical utility questionnaire. RESULTS: The final sample used to analyze compliance contained 588 available data points; 72.4% met the validity criteria, which were ≥4 valid days. Rainfall was inversely associated with total wear time, whereas using alcohol pads and cartoon stickers during the application were positively associated with total wear time. Sweating (25.2%) and skin irritation (39.0%) were the most reasons for 290 removal episodes by 235 students. The 131 questionnaires showed that 80.1% regarded the continuous wear period as too long and encountered problems, and 55% would rather not wear it again. CONCLUSION: Rainy weather affected girls' compliance with the continuous wear protocol for activPAL™. Skin irritation and sweat-induced inadvertent drops caused removal. Future studies should investigate more user-friendly protocols.

Influence of Perceived Physical Literacy on Coaching Efficacy and Leadership Behavior: A Cross-Sectional Study.

The concept of physical literacy has evolved to work as a guiding ideology in physical education, physical activity and heath, while little is known for coaching context. The purpose of this study was to examine the influence of perceived physical literacy (PPL) in predicting coaching efficacy and leadership behavior from the perceptions of student-athletes in Hong Kong secondary schools. A total of 352 (200 boys, 152 girls) student-athletes (14.78 ± 1.73 years old) participated in this study. Perceived Physical Literacy Instrument (PPLI) for adolescents, Coaching Efficacy Scale (CES) and Leadership Scale for Sport (LSS) for student-athletes were adopted to assess the student-athletes' self-reported PL, perceptions of coaching efficacy and leadership behavior, respectively. Hierarchical linear regressions revealed that student-athletes' knowledge and understanding of physical literacy significantly predicted all the dimensions of coaching efficacy (18%-23%, p<0.01) and leadership behavior (15%-27%, p < 0.05) except for autocratic behavior after controlling for the effects of demographic variables (such as age, gender, and training experience). The PPL attribute of Sense of Self and Self-confidence also demonstrated significant predictions with coaching efficacy (17%-19%, p < 0.01), while the PPL attribute of Self-expression and Communication with others only significantly predicted social support behavior (14%, p < 0.05). Path analysis showed PPL of student-athletes has significant predictions to their perceptions of coaches' leadership and this relationship was partially mediated by their perceptions of coaching efficacy (ß = 0.57). Discussion highlights that this study is the first empirical study to explore PPL in the coaching context and its strength in predicting coaching effectiveness. The study provides a new perspective for coaching education programs or coach-oriented interventions by emphasizing the concept of physical literacy.

Mechanisms Linking Physical Activity With Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review.

INTRODUCTION: Physical activity (PA) is a promising way to improve mental health in children and adolescents with neurodevelopmental disorders (NDDs). However, the underlying mechanisms remain unclear. The current review aimed to explore the potential neurobiological, psychosocial, and behavioral mechanisms between PA interventions and mental health in children and adolescents with NDDs. METHODS: Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC were searched from inception to June 2023. Randomized controlled trials/quasi-experimental designs applying PA interventions and reporting at least one mental health outcome and at least one potential mechanism in children and adolescents with NDDs were included. The best evidence synthesis rating system was adopted to determine the strength and consistency of potential mechanisms and was performed in 2024. RESULTS: In total, 45 studies were included, 29 of which were randomized controlled trials and 16 were quasi-experimental, with a total of 1,751 participants. According to the best evidence synthesis rating system, neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms were the frequently examined and consistent mechanisms through which PA affected mental health in children and adolescents with NDDs. However, evidence regarding P3 latency, beta activity, and physical self-concept was insufficient. DISCUSSION: Future PA interventions could consider neurobiological (theta activity and P3 amplitude), psychosocial (social skills and social participation), and behavioral (motor skills and sleep) mechanisms. Alternatively, PA can be developed as an adjunctive approach with interventions that specifically focus on these mechanisms to enhance mental health in children and adolescents with NDDs.

An ecological dynamics approach to promote physical literacy and well-being of primary school children: a cluster randomised controlled trial study protocol.

BACKGROUND: Little is known about the impact of an ecological dynamics (ED) intervention (EDI) on primary school children's physical literacy and well-being in the Hong Kong context. The aim of this project is to introduce a physical literacy and well-being framework through an EDI that allows primary school children to develop good physical activity (PA) and daily behavioural habits. METHODS AND ANALYSIS: A four-arm (cluster) randomised controlled trial will be conducted to examine the effect of EDI on physical literacy and well-being in primary schools located in each of the 18 administrative districts of Hong Kong. Four classes in senior primary students (grade 4) at each school will be randomly assigned to the four different conditions. These participating schools will be equipped with sit-stand desks, PA recess facility and equipment, and sleep pillows. The research team will adopt both objective measures (aerobic fitness, fundamental movement skills, daily behaviour-physical activity and cognitive function) and self-reported measures (perceived physical literacy, quality of life, sleep quality) covering the elements and domains of physical literacy and well-being to examine the effects of EDIs at four time points, including baseline assessment, 3 months after intervention, postintervention and 3-month follow-up assessment. One-way analyses of variance (ANOVAs) will be used to test for differences in the baseline characteristics of participants between groups. Repeated measure ANOVAs and MANCOVA, with time (baseline, after intervention and follow-up) as within-subjects factor, and intervention group as between-subjects factors, will be used to evaluate the effects of different interventions on the students' physical literacy and well-being. A Bonferonni correction to the p value will be calculated to adjust for multiple tests. ETHICS AND DISSEMINATION: Ethical approval was sought from the Joint CUHK-NTEC Clinical Research Ethics Committee in Hong Kong (CREC Ref.No.:2024.027). The finding of this study will be disseminated via peer-reviewed journals, international conference presentations and academic lectures. For secondary analysis of the data, please contact the corresponding author for permission. TRIAL REGISTRATION NUMBER: ISRCTN84025914.

Effect of Physical Exercise-Based Rehabilitation on Long COVID: A Systematic Review and Meta-analysis.

PURPOSE: The number of persons living with post-coronavirus disease 2019 (COVID-19) conditions or long COVID continues to rise worldwide; however, the etiology and the treatment of long COVID remain nebulous. Therefore, efficient, feasible, and cost-effective therapeutic strategies for a large population with long COVID remain warranted. Physical exercise-based rehabilitation is a promising strategy for long COVID, although its therapeutic effects remain to be determined. This systematic review and meta-analysis aimed to examine the effects of physical exercise-based rehabilitation on long COVID. METHODS: The electronic databases Medline, Embase, Global Health (Ovid), CINAHL (EBSCO), Web of Science, WHO Global Research Database on COVID-19, LitCovid, and Google Scholar were searched from their inception to November 2022. The identified articles were independently screened by three reviewers, and a random-effects model was used to determine the mean differences in the meta-analysis. RESULTS: Twenty-three studies involving 1579 individuals who had COVID-19 (752 women) were included. Physical exercise-based rehabilitation showed beneficial effects on long COVID-related symptoms characterized by dyspnea, fatigue, and depression, as well as on the 6-min walk test, forced expiratory volume in 1 s/forced vital capacity, and quality of life in people who had COVID-19. CONCLUSIONS: Physical exercise-based rehabilitation is a potential therapeutic strategy against long COVID and can be applied as a routine clinical practice in people who have recovered from COVID-19. However, customized physical exercise-based rehabilitation programs and their effects on specific types of long COVID require future large-scale studies.

The Associations Between Accelerometer-Measured Physical Activity Levels and Mental Health in Children and Adolescents with Intellectual Disabilities During the COVID-19 Pandemic.

To examine the associations between physical activity (PA) levels and mental health in children and adolescents with intellectual disabilities (IDs) during the COVID-19 pandemic, 117 participants aged between 6 and 17 years with IDs from 10 Hong Kong special schools were included. There were positive dose-response associations between PA (i.e., light PA, moderate PA, and vigorous PA) and mental health, and participants with higher levels of moderate-to-vigorous PA (MVPA) and self-concept (SC) had better social quality of life (QoL) than those with lower levels of MVPA and SC. Moreover, personal and environmental factors such as age, body mass index, school, sex, ID level, and parental education level influenced the PA levels and QoL in children and adolescents with IDs.