Effects of resistance training on sleep quality and disorders among individuals diagnosed with cancer: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological strategies such as exercise interventions may be considered to counteract this phenomenon. The literature supports the beneficial effects of aerobic training (AT), while evidence on resistance training (RT) is scarce. Accordingly, our systematic review aims to investigate the potential novel effect of RT on sleep outcomes in cancer survivors. METHODS: The literature search was conducted on MEDLINE (Pubmed), Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases, including only randomized controlled trials (RCTs). The screening procedure was conducted using the web-based software COVIDENCE. Sleep outcomes assessed through self-reported questionnaires or objective sleep measurements were extracted from RCTs recruiting cancer survivors of any age and gender, on or off treatment. The risk of bias (RoB) for each study was assessed using the Cochrane RoB 2 tool for RCTs. Meta-analytic syntheses were performed on sleep quality and insomnia. RESULTS: A total of 21 studies were included in the review. Considering the mean percentage differences of all studies combined, promising positive results were found after combined aerobic and resistance exercise program (COMB) for sleep quality (-19%) and sleep disturbance (-17.3%). The meta-analysis results showed significant improvement for both sleep quality and insomnia (d = 0.28, SE: 0.11, Z = 2.51, p < 0.01, 95% CI: 0.07-0.49 and d = 0.43, SE: 0.20, Z = 2.18, p = 0.029, 95% CI: 0.07-0.49, respectively). CONCLUSION: RT interventions of 60 minutes per session, performed 2-3 times a week for 12 weeks, with exercise intensity ranging from 60% to 80% of one-repetition maximum can be administered to cancer survivors, aiming to improve sleep outcomes.

Inclusive physical activity games at school: The role of teachers' attitude toward inclusion.

Introduction: Inclusive physical activity games at school can be useful for teachers dealing with students with disabilities. The use of inclusive strategies and games can be directly linked to teachers' self-efficacy and familiarity with the inclusive strategies, while it could be indirectly influenced by their attitude toward inclusion and, in a smaller part, by social desirability in their response. Moreover, teachers' responses could be different among the different school grades. Therefore, the aim of the current study is to investigate the role of attitude toward inclusion, social desirability, self-efficacy, and familiarity in the use of physical activity games at school in teachers from all school grades. Methods: A sample of 1,583 schoolteachers was asked to fill out a questionnaire about their perceptions of governmental measures, self-efficacy, familiarity with inclusive strategies through physical activity, and two standardized questionnaires assessing attitudes toward inclusion and social desirability. Results: Teachers from primary school reported lower scores in attitude toward inclusion total score and dimensions, namely impact on teacher, impact on the environment, impact on the other children, and impact on the student with disability. Moreover, the path analysis model showed that the attitude toward inclusion indirectly influenced the use of inclusive strategy and had a small direct effect on familiarity with inclusive strategies and self-efficacy. Social desirability slightly influenced both familiarity and self-efficacy but not the use of inclusive strategies. Familiarity and self-efficacy had a direct effect on the use of inclusive physical activity games. Discussion: The results of the current study suggest that being familiar with and having a high self-efficacy in implementing inclusive strategies are well related to the use of inclusive strategies at school. In addition, more attention should be given to kindergarten and primary school teachers, who reported lower scores in the attitude toward inclusion and higher scores in social desirability.

The Switch to Online Learning during the COVID-19 Pandemic: The Interplay between Personality and Mental Health on University Students.

The switching from traditional to online learning during the COVID-19 pandemic was challenging for students, determining an increase in physical and mental health problems. The current paper applied a two-step cluster analysis in a large sample of n = 1028 university students (Mage = 21.10 years, SD = 2.45 years; range: 18-30 years; 78.4% females). Participants responded to an online survey exploring neuroticism, trait/state anxiety, general self-efficacy, academic motivation, fear of COVID-19, the impact of the COVID-19 pandemic on physical and mental health, and the help requests. Results showed two significant clusters of students having a Maladaptive Academic Profile (n = 456; 44.4%) or an Adaptive Academic Profile (n = 572; 55.6%). Significant differences were found between the two clusters, where students belonging to the Maladaptive Academic Profile reported higher levels of neuroticism, higher dispositional and situational anxiety, and fear of COVID-19, and lower self-efficacy and academic motivation than students of the Adaptive Academic Profile cluster. In addition, more physical or mental health problems and help requests, mainly to partners during the COVID-19 pandemic, were found in the Maladaptive Academic Profile cluster compared to the Adaptive Academic Profile. Finally, the practical implications of the study's results in implementing university counseling services as protective measures to contrast psychological distress in the long-term COVID-19 pandemic are discussed.

Parental Resources in Parents of Children with Special Needs (SNs) at the Time of COVID-19.

Background. The limitations imposed by governments for containing the spread of COVID-19 have affected familial relationships, especially those of families dealing with children with special needs or chronic illness conditions. The current study aims to better understand what pathological/disability condition has impacted parental resources, sense of competence, and perception of children's executive functioning the most. Methods. A sample of 648 parents was asked to answer a survey assessing children's condition (typical development, specific learning disorder, autism spectrum syndrome, chronic illness), parental resources, parenting sense of competence (distinguished into parental satisfaction and self-efficacy), and parents' perception of their children's executive functioning. A MANOVA model was performed to assess differences in parental resources, sense of competence, and perception of the children's executive functions according to their condition. A path analysis model was performed to examine the impact of sense of competence and children's condition on parental resources and children's executive functions. Results. Parents with children with specific learning disorder reported lower scores of parental resources in terms of total scores, common antecedents, and specific antecedents compared to parents with typically developed children (total scores: MD = 56.45, p < 0.001; common antecedents: MD = 22.28, p < 0.00; specific antecedents: MD = 34.17, p < 0.001), parents with autistic children (total scores: MD = 62.79, p = 0.01; common antecedents: MD = 24.03, p = 0.01; specific antecedents: MD = 38.76, p = 0.02) and parents of children with chronic illness (total scores: MD = 37.42, p = 0.04; common antecedents: MD = 16.59, p = 0.01). The path analysis model shows a direct effect of parental satisfaction (ß = 0.26) and pathology/disability (ß = −0.10) on parental resources that, in turn, influence parents' perception of their children's executive functioning (ß = 0.24). Conclusion. Although no data about the prepandemic situation is available, the current study highlights that parental stress influence children's cognition. Moreover, parents of children with special needs seemed to be challenged during COVID-19, especially parents of children with specific learning disorders, that are already stressed out by their children's condition. Therefore, academic services should undertake preventive measures to preserve parental well-being and to provide a supportive environment for children, especially for those with atypical development.

Motor Coordination and Global Development in Subjects with Down Syndrome: The Influence of Physical Activity.

BACKGROUND: Many research studies have investigated motor impairments and delayed development in children with Down Syndrome (DS). However, very few studies detected these features in adults with DS. Hence, this study aimed to investigate the relationship between motor coordination and global development in subjects with DS, including adults. Furthermore, the second aim was to detect any differences in motor coordination and global development as a function of the practice of physical activity (PA) in this population. METHODS: Twenty-five participants with DS (10 f, 15 m), with a chronological mean age of 27.24 years and development mean age of cognitive area of 4.93 years, were enrolled and divided into a physically active group (PA-G; n = 15) and a physically inactive group (PI-G; n = 10). All participants performed the Movement Assessment Battery for Children (M-ABC) to assess fine and gross motor skills, while the Developmental Profile 3 (DP-3) checklist was administered to the parents in order to screen strengths and weaknesses of five developmental areas of their relatives with DS. RESULTS: Our results showed positive correlations between the following variables: global motor coordination and global development, global motor coordination and adaptive behavior development area, aiming and catching skills and global development, aiming and catching skills and adaptive behavior development area. As for the practice of PA, PA-G showed higher scores than PI-G in all the tasks of both the M-ABC and the DP-3, though significant differences were found only for the global motor coordination, for the aiming and catching skills, as well as for the physical development area. CONCLUSIONS: The findings of this study reinforce the need to implement and encourage the practice of PA in order to promote well-being and social inclusion in subjects with DS.

Moral Disengagement in Youth Athletes: A Narrative Review.

The sports environment can be considered as a context characterized by interactions typical of social groups, where children have the chance to learn good values. Positive and negative behaviours in sports, also called prosocial and antisocial behaviours, have been studied according to a moral perspective, as has doping behaviour, taking into consideration the concept of moral disengagement. Moral disengagement in children has been associated with maladaptive behaviours later in life, even though it should disappear with growth. Concerning the sports environment, previous reviews on the topic have extensively illustrated the role of moral variables in sport and their relation to antisocial behaviour and doping, positing some research questions that should be investigated in the future. Starting from these questions, the current narrative review aims to update literature about the effects of moral disengagement on youth athletes. Therefore, new studies about the predictors of moral disengagement are introduced, followed by contributions concerning the relationship between moral disengagement and doping and between moral disengagement and antisocial behaviour. Finally, the review summarizes which research questions have been solved in the last decade and which should be researched further on.

Impact of exercise interventions on physical fitness in breast cancer patients and survivors: a systematic review.

BACKGROUND: This systematic review aims to identify the effects of exercise interventions in patients with breast cancer (BCP) and survivors (BCS) on selected variables of physical fitness. METHODS: A comprehensive literature search was conducted using Medline and Scopus. Randomized controlled trials with isolated exercise interventions in BCP and BCS women (< 5 years from therapy completion) were included. The risk of bias (RoB) assessment was conducted using the Cochrane RoB-2-tool. Variables regarding cardiorespiratory fitness (CRF), strength (ST), fatigue (F) and health-related quality of life (HRQoL) were discussed. RESULTS: Of the 336 studies initially identified, 22 met all the inclusion criteria and were deemed eligible. RoB assessment indicated that the studies had predominantly "some concerns" or had "low RoB", with only 3 studies presenting a "high RoB". The mean duration and frequency of exercise interventions were 19 weeks and 3 sessions/week, performed at moderate intensity (65% VO2max and 66% 1RM, for aerobic and resistance-training interventions, respectively). CONCLUSIONS: Exercise interventions seem to be a valuable strategy in BCP to avoid the decline of CRF, ST, F and HRQoL. Conversely, improved physical function among BCS is observed for the same variables. Resistance training and combined interventions seem to provide the most encouraging variations of the selected outcomes. PROSPERO REGISTRATION ID: CRD42021237917.

The Role of Psychological Factors in Judo: A Systematic Review.

(1) Background: Psychological parameters are relevant in the practice of judo. Previous studies have shown that parameters such as anxiety or motivation can have a negative or positive impact on the athlete's performance and general well-being, depending on the athlete's perception. This systematic review aimed to summarize the studies examining the influence of various psychological parameters on well-being and performance in judo athletes; (2) Methods: We followed preferred reporting elements for systematic reviews and meta-analyses. We searched the Web of Science database for studies that explained the role of these parameters in elite athletes. Of the 286 articles initially identified, 17 met our eligibility criteria and were included in the review. In total, we analyzed data from 721 judo athletes; (3) Results: The studies found have demonstrated the impact of various psychological parameters during high-level performance and how these parameters can influence and lead an athlete to win or lose a competition. The feelings of tension, anger, anxiety, and nervousness were significantly increased in athletes who were facing defeat, while a decrease in the same segments and an increase in motivation among athletes who were experiencing better performance was observed. Further research under standardized conditions is needed to better understand the effects of these parameters on judo athletes; (4) Conclusions: Considering the athlete's psychological state can affect performance, and it is therefore important to monitor and train these factors.

The differences of Slovenian and Italian daily practices experienced in the first wave of covid-19 pandemic.

BACKGROUND: The COVID-19 pandemic situation with the lockdown of public life caused serious changes in people's everyday practices. The study evaluates the differences between Slovenia and Italy in health-related everyday practices induced by the restrictive measures during first wave of the COVID-19 pandemic. METHODS: The cross-sectional cohort study examined changes through an online survey conducted in nine European countries from April 15-28, 2020. The survey included questions from a simple activity inventory questionnaire (SIMPAQ), the European Health Interview Survey, and some other questions. To compare difference in changes between European countries we examined Italy with severe and its neighbour country Slovenia with low incidence and victims of COVID-19 epidemic. 956 valid responses from Italy (N = 511; 50% males) and Slovenia (N = 445; 26% males) were investigated. RESULTS: During the survey, there was a 4.7-fold higher incidence and 12.1-fold more deaths (per 100,000) in Italy than in Slovenia. Barring periods and measures were similar, the latter more stringent in Italy. We found more changes in Italy than in Slovenia: physical inactivity increased (Italy: + 65% vs. Slovenia: + 21%; p < 0.001), walking time decreased (Italy: -68% vs. Slovenia: -4.4%; p < 0.001); physical work increased by 38% in Slovenia (p < 0.001), and recreation time decreased by 37% in Italy (p < 0.001). Italians reported a decrease in quality of general health, fitness level, psychological well-being, quality of life and care for own health (p < 0.001); Slovenians showed a decline in psychological well-being and quality of life (p < 0.001) but generally had a higher concern for their own health (p = 0.005). In pooled participants, changes in eating habits (meal size and consumption of unhealthy food), age and physical inactivity were positively correlated with increases in body mass, while changes in general well-being and concern for health were negatively correlated. CONCLUSION: The study shows that the negative impact of COVID -19 measures is greater in Italy where the pandemic COVID -19 was more prevalent than in Slovenia with low prevalence. Additional consideration should be given to the negative impact of COVID-19 measures on some health-related lifestyle variables when implementing further measures to mitigate the COVID-19 pandemic.

Youth Athletes' Perception of Existence and Prevalence of Aggression and Interpersonal Violence and Their Forms in Serbia.

Aggression and interpersonal violence (IV) against children and youth are issues in contemporary society. The current study reports on the youth athletes' perception of the aggression and IV prevalence and its manifestation forms in a Serbian context. The sample included athletes (N = 2091) between the age of 11 and 18 years. Data were collected through an ad-hoc questionnaire created by the authors. Respondents' answers to introductory questions about the frequency of IV indicated its absence (78.1%). However, the answers to the questions about specific forms of violent peer behavior indicated forms as well as the time and place where IV most often occurs. They underlined that IV takes place mainly after training or competition and during sports camps; and that the dressing room is the most favorable place for these behaviors. They also confirmed that the most prevalent subtypes of IV are psychological (roughly 40%) and physical (approximately 30%). The respondents' opinions and experiences about IV (psychological, physical, sexual) revealed that factors such as gender, location, and parents' education level may influence the IV manifestation. Highlighting the prevalence and the most frequently manifesting types of aggression and IV could help in awareness-raising of these social issues.

Living in the "Bubble": Athletes' Psychological Profile During the Sambo World Championship.

Background: The COVID-19 pandemic has changed the way we conduct daily life, as well as sports training and sports competitions. Given the stress produced by COVID-19, and the "bubble" safety measures for the World Sambo Championship, held in Novi Sad, from the 6th to the 8th of November, 2020, athletes might have experienced more stress than athletes normally would in non-pandemic conditions. Therefore, the current study aimed to create a psychological profile of sambo athletes participating in the Sambo World Championship and living in this condition. Methods: One-hundred-fifteen participants took part in the study, completing the Profile of Mood Scale (POMS), the Pittsburg Sleep Quality Index, the Perceived Stress Scale (PSS), and the Fear of COVID-19 Scale. A mediation model with Fear of COVID-19 predicting both stress level directly and stress level through mood disturbance was hypothesized. Gender differences were evaluated through t-test. Results: The results showed that the sample presented higher levels of stress but no problems in sleeping. In particular, data analysis confirmed an indirect effect of Fear of COVID on Perceived stress through mood disturbance (ß = 0.14, Z = 2.80, and p = 0.005), but did not have a significant impact on the direct effect (ß = -0.04, Z = -0.48, and p = 0.63). Gender differences emerged in the perceived stress level (t = -2.86, df = 114, and p = 0.005) and daytime dysfunction (t = -2.52, df = 114, and p = 0.01) where females scored higher than males for both aspects. Conclusion: The athletes participating to the World Sambo Championship experienced stress levels determined by the mood disturbance produced by the fear of the COVID-19 pandemic. Female athletes were more stressed and showed higher daytime dysfunction. The findings of the current study are useful to understand the psychological profile of the athletes competing in the "bubble" conditions during COVID-19 pandemic.

A Cross-Country Examination on the Fear of COVID-19 and the Sense of Loneliness during the First Wave of COVID-19 Outbreak.

The aim of the current study is to examine gender, age. and cross-country differences in fear of COVID-19 and sense of loneliness during the lockdown, by comparing people from those countries with a high rate of infections and deaths (e.g., Spain and Italy) and from countries with a mild spread of infection (e.g., Croatia, Serbia, Slovakia, Slovenia, and Bosnia and Herzegovina). A total of 3876 participants (63% female) completed an online survey on "Everyday life practices in COVID-19 time" in April 2020, including measures of fear of COVID-19 and loneliness. Males and females of all age groups in countries suffering from the powerful impact of the COVID-19 pandemic reported greater fear of COVID-19 and sense of loneliness. In less endangered countries, females and the elderly reported more symptoms than males and the young; in Spanish and Italian samples, the pattern of differences is considerably more complex. Future research should thoroughly examine different age and gender groups. The analysis of emotional well-being in groups at risk of mental health issues may help to lessen the long term social and economic costs due to the COVID-19 outbreak.

Patterns of rapid weight loss in elite sambo athletes.

BACKGROUND: Rapid weight loss (RWL) is commonly practiced in combat sports. Both magnitude and methods used to induce RWL are largely similar among combat sports, but currently, there is no data on RWL methodology used by sambo athletes. Therefore, the aim of this study was to determine RWL procedures sambo athletes apply to lose weight rapidly. METHODS: The sample consisted of 199 participants, of which 132 males and 67 females who participated in the World Sambo Championship 2020 held in Novi Sad, Serbia. Each participant received RWL questionnaire that was available in multiple languages, and every participant was instructed how to fill it out. RESULTS: Almost 87% of sambo participants declared to have intentionally cut their weight prior to the competition, whereby 5.27 kg (SD: ±7.57) was lost. Gradual dieting, sauna use and skipping meals were the most dominant methods used to reduce weight prior to competition while more extreme methods of RWL such as the use of laxatives, diuretics, diet pills and vomiting were also implemented but by much smaller fragment of the participants involved. CONCLUSIONS: Findings from our study largely match with previously conducted RWL studies in terms of prevalence, magnitude and methods used by combat sport athletes, especially in judo and wrestling. Knowing the hazardous consequences of RWL, alternative methods of sustainable weight loss should be considered.

The effect of resistance training programs on lean body mass in postmenopausal and elderly women: a meta-analysis of observational studies.

Aging and menopause are associated with morphological and functional changes which may lead to loss of muscle mass and therefore quality of life. Resistance training (RT) is an effective training mode to increase muscle mass. We reviewed the existing literature to identify studies implementing RT protocols and evaluating muscle hypertrophy exclusively in healthy, postmenopausal and elderly women. Participants' age range was comprised between 50 and 80 years. The primary outcome observed was muscle hypertrophy. Fat mass was also evaluated, if available. PubMed and Web of Science were the screened database, and original articles written in English and published from 2000 up to 2020 were included. 26 articles were considered eligible and included. Quality assessment revealed a "moderate quality" of the included studies, however the majority of studies was able to reach level 4 of evidence and on overall grade of recommendation C. In total, data from 745 female participants subjected to different forms of resistance training were considered. Heterogeneity across studies was present regarding study design, intervention length (mean 16 weeks), training frequency (3 d/w), no. of exercises (n = 7.4) and participants' age (65.8 ± 4.9 years). Small-to-moderate significant increases (k = 43; SMD = 0.44; 95% CI 0.28; 0.60; p < 0.0001) of lean body mass were observed in post-menopausal and elderly women, regardless of age, intervention period, weekly training frequency and no. of exercises. No effects were noted for fat mass (k = 17; SMD = 0.27; 95% CI - 0.02; 0.55; p = 0.07). Studies need to concentrate on providing information regarding training parameters to more effectively counteract the effects of aging and menopause on skeletal muscle mass.

Use of alcohol, drugs, inhalants, and smoking tobacco and the long-term risk of depression in men: A nationwide Swedish cohort study from 1969-2017.

BACKGROUND: The use of alcohol, drugs, inhalants, and smoking tobacco may lead to mood disorders such as depression. However, knowledge on the independent contributions of the use of these substances to the risk of depression is lacking. METHODS: The study cohort consisted of 24,564 men included in the Swedish national military conscription register who were conscripted in 1969-1970 and followed until 2017. Cox proportional hazard ratios were used to estimate the risk of depression according to alcohol, drug, inhalant, and cigarette consumption, and adjusted for body mass index, verbal comprehension test scores, handgrip strength, and the other main exposures investigated. RESULTS: During an average follow-up period of 44 years, 4500 men were diagnosed with or treated for depression at a mean age of 54 years. A dose-dependent association was found in men who smoked cigarettes, with the highest risk for smoking >20 cigarettes per day, at time of conscription (aHR 1.86, 95 % CI 1.61-2.16, p < 0.001). Independent associations with an increased risk of depression were found for the use of drugs at least once (aHR 1.21, 95 % CI 1.10-1.32, p < 0.001) and >50 times (aHR 1.48, 95 % CI 1.23-1.77, p < 0.001) and the use of inhalants (aHR 1.16, 95 % CI 1.05-1.29). Excessive alcohol intake was not associated with the risk of depression. CONCLUSION: The results suggest that people who reported to have used cigarettes, alcohol, or drugs at 18 years of age have a moderately increased risk of depression later in life.

Cardiovascular Responses to Muscle Stretching: A Systematic Review and Meta-analysis.

The aim of this study will be to review the current body of literature to understand the effects of stretching on the responses of the cardiovascular system. A literature search was performed using the following databases: Scopus, NLM Pubmed and ScienceDirect. Studies regarding the effects of stretching on responses of the cardiovascular system were investigated. Outcomes regarded heart rate(HR), blood pressure, pulse wave velocity (PWV of which baPWV for brachial-ankle and cfPWV for carotid-femoral waveforms), heart rate variability and endothelial vascular function. Subsequently, the effects of each outcome were quantitatively synthetized using meta-analytic synthesis with random-effect models. A total of 16 studies were considered eligible and included in the quantitative synthesis. Groups were also stratified according to cross-sectional or longitudinal stretching interventions. Quality assessment through the NHLBI tools observed a "fair-to-good" quality of the studies. The meta-analytic synthesis showed a significant effect of d=0.38 concerning HR, d=2.04 regarding baPWV and d=0.46 for cfPWV. Stretching significantly reduces arterial stiffness and HR. The qualitative description of the studies was also supported by the meta-analytic synthesis. No adverse effects were reported, after stretching, in patients affected by cardiovascular disease on blood pressure. There is a lack of studies regarding vascular adaptations to stretching.

Dual-Task Conditions on Static Postural Control in Older Adults: A Systematic Review and Meta-Analysis.

Dual-task (DT) consists of the performance of two tasks simultaneously. An index of DT difficulty has been linked to decreased postural control. Because a wide range of DT is employed, this study aimed to evaluate its effects in static balance in older adults. PubMed, Web of Science, and Scopus were screened, and the secondary tasks were grouped as manual, reaction time, discrimination and decision making, mental tracking, verbal fluency, working memory, or "other" tasks. A total of 66 studies have been included. The meta-analysis was conducted on 28 effects and showed a significant mean effect size of d = 0.24 (p = .02, SE = 0.10; confidence interval [0.04, 0.44]), indicating a worsening in stability during DT. In conclusion, postural control was worsened by the Stroop test and the arithmetic tasks improved it. The results do not underpin any conclusive statement on the impact of DT, and a standard operating procedure was created.

The Influence of an Enriched Sport Program on Children's Sport Motivation in the School Context: The ESA PROGRAM.

PURPOSE: Besides the evident positive effect on body development, physical activity has proven to boost executive functions, especially if the exercises are enriched with cognitive stimuli. Previous studies have shown that introducing challenging exercises in the physical activity routine can also enhance motivation. Therefore, enriching a physical education program with cognitively challenging exercises may also foster children's motivation during physical education classes, where the motivation is high at the beginning of the school year and low at the end of it. Therefore, the purpose of this paper is to test if a sport program enriched by cognitive stimuli may improve kids' motivation or take them out from a state of amotivation along the school year. METHODS: A sample of 342 school children (203 boys, 139 girls) took part in the study. Participants were asked to complete a battery of motivation and perceived social support questionnaires before and after they completed the ESA Program, a sport program enriched with cognitive stimuli. Moreover, parents of these children attended four seminars about the importance of supporting children for the practice of regular physical activity (PA). A control group consisting of children that attended the ordinary physical education school class was also included. RESULTS: A repeated measures MANOVA model showed that the ESA Program was able to improve children's general motivation, in particular the intrinsic motivation. The program was not effective in social support, but, independently from the group, the family social support in sports activities decreased for females. CONCLUSION: Apart from cognitive improvement, the ESA Program can have beneficial effects on children's sports motivation in physical education, but not on perceived social support.