Characteristics and Frequency of Physical Activity and Exercise-Related Side Effects in People Receiving Peritoneal Dialysis.

OBJECTIVE: People receiving peritoneal dialysis may receive health benefits from physical activity or exercise. However, on-going uncertainty and fear regarding safety may result in this population missing out on the health benefits of participation. The aim of this study was to explore the characteristics and frequency of physical activity and/or exercise-related side effects (e.g., symptoms such as pain or shortness of breath) and negative health events (e.g., stroke or hyper/hypoglycemia) experienced by people receiving peritoneal dialysis. METHODS: An international online survey involving adults receiving peritoneal dialysis was conducted with questions related to nature, occurrence, and impact of side effects and/or negative health events experienced during or soon after participation in physical activity or exercise. RESULTS: Fifty-two people completed the survey reporting 151 side effects that were related to physical activity and exercise and 67 that were possibly related. Fatigue (58% of respondents), muscle/joint soreness or pain (54%), and dizziness (43%) were the most frequently reported side-effect types. The majority occurred occasionally (58% of all side effects), if not rarely (24%) and participation in on-going physical activity or exercise was typically prevented only occasionally (39%) or not at all (31%). Side effects were mainly self-managed (54% of all side effects) or did not require treatment (19%) and had low (38%) or no effect (30%) on ability to do daily activities. CONCLUSIONS: People receiving peritoneal dialysis generally experience side effects that can be considered a normal response to physical activity or exercise engagement. Furthermore, the risk of serious or peritoneal dialysis-specific side effects as a result of physical activity or exercise appears to be low. The results add to the emerging evidence suggesting physical activity and exercise appear to be safe for people receiving peritoneal dialysis.

Single-Leg Heel Raise Capacity is Lower, and Perceived Ankle Instability is Greater, in Dancers and Athletes With Posterior Ankle Impingement Syndrome.

OBJECTIVE: To compare clinical assessment findings between elite athletic populations with and without a clinical diagnosis of posterior ankle impingement syndrome (PAIS). DESIGN: Cross-sectional case-control study. SETTING: Elite ballet and sport. PARTICIPANTS: Ten male and female professional ballet dancers and athletes with a clinical diagnosis of PAIS and were matched for age, sex, and activity to 10 professional ballet dancers and athletes without PAIS. INDEPENDENT VARIABLES: Posterior ankle pain on body chart and a positive ankle plantarflexion pain provocation test. MAIN OUTCOME MEASURES: Single-leg heel raise (SLHR) endurance test, range of motion testing for weight-bearing ankle dorsiflexion, passive ankle plantarflexion, and first metatarsophalangeal joint dorsiflexion, and Beighton score for generalized joint hypermobility. Participants also completed the Cumberland Ankle Instability Tool (CAIT) questionnaire. RESULTS: The group with PAIS achieved significantly fewer repetitions on SLHR capacity testing ( P = 0.02) and were more symptomatic for perceived ankle instability according to CAIT scores ( P = 0.004). CONCLUSIONS: Single-leg heel raise endurance capacity was lower, and perceived ankle instability was greater in participants with PAIS. The management of this presentation in elite dancers and athletes should include the assessment and management of functional deficits.

Associations between clinical and imaging findings in posterior ankle impingement syndrome: a systematic review.

BACKGROUND: Posterior ankle impingement syndrome (PAIS) is a common and debilitating condition, commonly affecting people who participate in activities that involve repetitive ankle plantarflexion. The relationship between clinical and imaging findings in PAIS has not been established. PURPOSE: To investigate the relationship between clinical and imaging features in PAIS by reviewing the literature comparing symptomatic patients to asymptomatic controls. MATERIAL AND METHODS: A systematic literature search was performed to identify all English-language articles that compared imaging features in patients diagnosed with PAIS to imaging in an asymptomatic control group. RESULTS: A total of 8394 articles were evaluated by title and abstract, and 156 articles were read in full text. No articles compared imaging findings to an asymptomatic control group, thus no articles met the inclusion criteria. CONCLUSION: This systematic review found no published research that compared the imaging findings of people diagnosed with PAIS to asymptomatic people. Until this information is available, imaging features in people with posterior ankle impingement should be interpreted with caution.

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes.

OBJECTIVE: To assess the association between clinical features and magnetic resonance imaging (MRI) findings in posterior ankle impingement syndrome (PAIS) and to compare the prevalence of imaging findings between participants with and without a clinical diagnosis of PAIS. DESIGN: Case-control study. SETTING: Elite ballet and sport. PARTICIPANTS: Eighty-two male (54%) and female participants comprising ballet dancers (n = 43), cricket fast bowlers (n = 24), and football (soccer) players (n = 15). INDEPENDENT VARIABLES: Clinical: posterior ankle pain on body chart, passive plantarflexion pain provocation test. Patient-reported outcome measures: Oslo Sports Trauma Research Center Overuse Injury Questionnaire, Foot and Ankle Ability Measure Sports subscale. MAIN OUTCOME MEASURES: Imaging findings including posterior ankle bone marrow edema, os trigonum (± bone marrow edema, and increased signal at synchondrosis), Stieda process (± bone marrow edema), talocrural and subtalar joint effusion-synovitis size, flexor hallucis longus tendinopathy, and tenosynovitis identified as present or absent on 3.0-Tesla MRI. RESULTS: Imaging findings were not associated with posterior ankle pain or a positive ankle plantarflexion pain provocation test. Imaging findings were not associated with patient-reported outcome measures. Imaging findings did not differ between PAIS-positive and PAIS-negative groups. Os trigonum and Stieda process were prevalent despite clinical status. CONCLUSIONS: The lack of association between imaging findings and clinical features questions the role of imaging in PAIS. Clinicians should rely primarily on clinical assessment in the diagnosis and management of patients with PAIS.

Schedules of standing and sitting directed by musculoskeletal discomfort in workers transitioning to sit-stand workstations: a cross-sectional study.

Sit-stand workstations are growing in popularity, however limited guidelines exist regarding optimal schedules of sitting and standing. This was the first known study to observe sit-stand workstation schedules when postural change is based on maintaining musculoskeletal discomfort within 'acceptable' levels. Fourteen healthy adults new to sit-stand workstations completed computer-based work at a sit-stand desk for half a workday. Participants changed between standing and sitting postures each time discomfort reached the maximum acceptable threshold. On average, the amount of standing and sitting was greatest in the first standing (median 40 minutes, interquartile range 40 minutes) and sitting (median 30 minutes, interquartile range 115 minutes) bouts. Average durations spent standing and sitting were lower in all consecutive bouts. Stand-sit ratios indicated an equal amount of standing to sitting or somewhat less standing. The schedules had substantial inter-participant variability. Future studies should consider that optimal schedules may vary with regard to time and be individual-specific.

Refined guidelines are needed regarding effective use of sit-stand workstations. This study proposed a novel method of investigating potentially optimal schedules, in which postural change was based on reaching a threshold of musculoskeletal discomfort. The findings suggest that an optimal schedule may vary with time and be individual-specific. Abbreviations: BMI: body mass index; Borg CR-10 scale: Borg Category Ratio-10 scale; IQR: interquartile range; LMD questionnaire: the localised musculoskeletal discomfort questionnaire; MHT: maximum holding time; SD: standard deviation.

Magnetic resonance imaging findings associated with posterior ankle impingement syndrome are prevalent in elite ballet dancers and athletes.

OBJECTIVE: To report the prevalence of MRI features commonly associated with posterior ankle impingement syndrome in elite ballet dancers and athletes and to compare findings between groups. MATERIALS AND METHODS: Thirty-eight professional ballet dancers (47.4% women) were age- and sex-matched to 38 elite soccer or cricket fast bowler athletes. All participants were training, playing, and performing at full workload and underwent 3.0-T standardised magnetic resonance imaging of one ankle. De-identified images were assessed by one senior musculoskeletal radiologist for findings associated with posterior ankle impingement syndrome (os trigonum, Stieda process, posterior talocrural and subtalar joint effusion-synovitis, flexor hallucis longus tendon pathology and tenosynovitis, and posterior ankle bone marrow oedema). Imaging scoring reliability testing was performed. RESULTS: Posterior talocrural effusion-synovitis (90.8%) and subtalar joint effusion-synovitis (93.4%) were common in both groups, as well as the presence of either an os trigonum or Stieda process (61.8%). Athletes had a higher prevalence of either os trigonum or Stieda process than dancers (74%, 50% respectively, P = 0.03). Male athletes had a higher prevalence of either os trigonum or Stieda process than male dancers (90%, 50% respectively, P = 0.01), or female athletes (56%, P = 0.02). Posterior subtalar joint effusion-synovitis size was larger in dancers than athletes (P = 0.02). Male and female dancers had similar imaging findings. There was at least moderate interobserver and intraobserver agreement for most MRI findings. CONCLUSION: Imaging features associated with posterior impingement were prevalent in all groups. The high prevalence of os trigonum or Stieda process in male athletes suggests that this is a typical finding in this population.

Compliance With Mobile Ecological Momentary Assessment of Self-Reported Health-Related Behaviors and Psychological Constructs in Adults: Systematic Review and Meta-analysis.

BACKGROUND: Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. OBJECTIVE: This study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical samples of adults. METHODS: In total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (>18 years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets. RESULTS: Of the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets; secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%); median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2>90%), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. CONCLUSIONS: In this 10-year sample of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.

Cluster patterns of behavioural risk factors among children: Longitudinal associations with adult cardio-metabolic risk factors.

Much of what is known about childhood clusters of cardiovascular disease behavioural risk factors (RFs) comes from cross-sectional studies, providing little insight into the long-term health impacts of different behavioural cluster profiles. This study aimed to establish the longitudinal relationship between cluster patterns of childhood behavioural RFs and adult cardio-metabolic RFs. Data were from an Australian prospective cohort study of 1265 participants measured in 1985 (ages 9-15 yrs), and in 2004-06 (ages 26-36 yrs). At baseline, children self-reported smoking status, alcohol consumption, physical activity (PA), dietary behaviour and psychological well-being. At follow-up, participants completed questionnaires and attended study clinics where the following component indicators of the metabolic syndrome (MetS) score were measured: waist circumference, blood pressure, fasting blood glucose and lipids. TwoStep cluster analyses were carried out to identify clusters in childhood. Linear regression was used to examine the longitudinal associations between cluster patterns of childhood behavioural RFs and adult cardio-metabolic RFs. Four childhood cluster patterns of behavioural RFs labelled 'most healthy', 'high PA', 'most unhealthy', and 'breakfast skippers' were identified. The unhealthier childhood clusters predicted a significantly higher adult MetS score ('most unhealthy': ß = 0.10, 95%CI = 0.01, 0.19) and adult waist circumference ('most unhealthy': ß = 2.29, 95%CI = 0.90, 6.67; 'breakfast skippers': ß = 2.15, 95%CI = 0.30, 4.00). These associations were independent of adult behavioural RFs and socio-economic position. These findings emphasise the impact of multiple childhood behavioural RFs on important adult health outcomes and may be useful for the development of early intervention strategies, where identification of children at higher risk of poorer adult cardio-metabolic health is vital.

Temporal trends in the sit-ups performance of 9,939,289 children and adolescents between 1964 and 2017.

We estimated international/national temporal trends in sit-ups performance for children and adolescents, and examined relationships between national trends in sit-ups performance and national trends in health-related/sociodemographic indicators. Data were obtained by systematically searching studies reporting on temporal trends in sit-ups performance for apparently healthy 9-17 year-olds, and by examining nationally representative fitness datasets. Trends at the country-sex-age level were estimated by sample-weighted regression models relating the testing year to mean sit-ups performance. International/national trends were estimated by a post-stratified population-weighting procedure. Pearson's correlations quantified relationships between national trends in sit-ups performance and national trends in health-related/sociodemographic indicators. A total of 9,939,289 children and adolescents from 31 countries/special administrative regions between 1964 and 2017 collectively showed a large improvement of 38.4% (95% CI: 36.8 to 40.0) or 7.1% per decade (95% CI: 6.8 to 7.4). Large international improvements were experienced by all age and sex groups, with the rate of improvement slowing from 1964 to 2000, stabilizing near zero until 2010, before declining. Trends differed between countries, with national trends in vigorous physical activity a strong, positive correlate of national trends in sit-ups performance. More sit-ups data are needed from low- and middle-income countries to better monitor trends in muscular fitness. PROSPERO REGISTRATION NUMBER: CRD42013003657.

Validity and Reliability of Hand-Held Dynamometry for Abdominal Flexion Muscular Assessment.

CONTEXT: Abdominal musculature underpins core stability, which can allow for optimal performance in many activities of daily living (eg, walking and rising from a chair). Therefore, assessment of the abdominal muscles poses as an important consideration for clinicians in order to identify people at risk of injury or functional decline. OBJECTIVE: This study aimed to build on the limited amount of knowledge surrounding abdominal muscle strength assessments by investigating the validity and reliability of hand-held dynamometry (HHD) for the assessment of isometric abdominal flexion strength. STUDY DESIGN AND PARTICIPANTS: Comparative analysis for validity and test-retest reliability was employed on a cohort of apparently healthy individuals. HHD was compared with the criterion, isokinetic dynamometry, through an isometric contraction of trunk flexion on both instruments. Hand-held dynamometry assessments only were performed on a subsequent day for reliability analysis. The peak values for all assessments were recorded. RESULTS: A total of 35 participants were recruited from the University of South Australia and the general public. Comparative analysis between the HHD and isokinetic dynamometer showed good agreement (intraclass correlation coefficients = .82), with the Bland-Altman plots confirming no proportional bias. Reliability analysis for the HHD reported good consistency (intraclass correlation coefficients = .87). CONCLUSION: HHD together with the participant setup (supine, trunk flexed, and supported at 25° with the legs horizontal and remaining unfixed) is a valid and reliable tool to assess isometric abdominal flexion strength.

Self-Reported Wellness in Training and Performance: A Comparison of Professional Ballet Dancers and Professional Athletes.

OBJECTIVE: In high-performance sport, the use of self-report measures is expanding. The exploration of wellness states in response to training and performance requires further investigation for professional ballet dancers and athletes. This study therefore aimed to: compare wellness scores between professional ballet dancers and athletes in training and performance; report frequency of self-reported modified participation during training and performance; and report frequency of self-reported inability to participate due to pain and illness in dancers and athletes. METHODS: Fourteen professional ballet dancers (mean 26 yrs, SD 2.6) and 14 sex- and age-matched professional athletes (mean 27.7 yrs, SD 2.9) recorded daily wellness (fatigue, stress, sleep quality and quantity), participation (full, rest, modified, or unable to participate) and activity (performance, training) into a wellness application on their smart phone over a 4-month period. Mixed factorial ANOVAs were conducted to assess the interaction between group (ballet dancers and athletes) and activity (performance and training) on the dependent variables (stress, fatigue, sleep quality, and sleep quantity). RESULTS: Stress and fatigue levels were higher for both dancers and athletes during performance compared to training periods. Dancers recorded lower sleep quantity than athletes, with no difference in sleep quality. Modified participation appears more common in dancers compared to athletes. Dancers and athletes were rarely unable to train or perform/compete over the 4 months. CONCLUSION: Self-reported wellness scores appear sensitive to activity type and can provide valuable information to guide intervention and recovery strategies. Further research on the impact of poor wellness on performance, illness, and injury in professional ballet is warranted.

The feasibility of fundamental movement skill assessments for pre-school aged children.

Fundamental movement skill (FMS) assessment in preschools allows for early intervention; however it is unclear what assessments are feasible. The purpose of this review is to systematically review the feasibility of FMS assessments for pre-school aged children. The search was conducted across four databases, MEDLINE, Scopus, ERIC and SportsDiscus. Search terms included synonyms of "fundamental movement skills" and "pre-school children". Inclusion criteria were: (i) FMS assessment; (ii) feasibility data; (iii) assessment of children aged three to six years; (iv) assessment of typically developing children; and (v) peer reviewed full text publications in English. Feasibility concepts (administration time, equipment, space, assessment type, item, training, qualification) were each coded as 'poor = 1', 'average = 2' and 'good = 3'; potential total of 21. A total of 330 full text articles were considered but a quarter (n = 86) were excluded due to no feasibility data. Sixty-five studies using 13 different FMS assessments were included. The Athletic Skills Track and DEMOST-PRE assessments were most feasible (18/21) and the Test of Gross Motor Development and Movement Assessment Battery for Children were common but among the least feasible (12-14/21). This review allows pre-school staff to choose a FMS assessment based on feasibility. Future studies need to present feasibility of assessments.

Validity and feasibility of an obstacle course to assess fundamental movement skills in a pre-school setting.

Failure to master age-appropriate fundamental movement skills (FMS) at a young age can limit motor skill competence affecting health. Assessments often have issues with feasibility and implementation in a field setting. As such, the purpose of this study was to investigate the validity and feasibility of the Athletic Skills Track (AST), in a pre-school setting. For the validation study sixty-five 3-6 year old children (25 boys and 40 girls) from five pre-schools across Adelaide, Australia participated. Correlations and linear regression analysis (adjusted for age and gender) were used to investigate the association between the time to complete the AST and the raw score of the Test of Gross Motor Development 2 (TGMD-2). For the feasibility study pre-school staff completed a semi-structured interview regarding the feasibility of the AST. The AST took less than a minute per child and the TGMD-2 around 20 minutes for two children. There was a strong negative correlation (r = -0.63, p < 0.01) between the AST scores and the TGMD-2 scores. All five staff reported strengths of the AST to be its short administration time, setup and appropriateness. These results suggest that the AST could be a feasible and valid method of FMS assessment in Australian pre-schools.

Everybody's working for the weekend: changes in enjoyment of everyday activities across the retirement threshold.

BACKGROUND: the aim of this study was to explore the associations between use of time and momentary hedonic affect ('enjoyment') in adults in the peri-retirement period. METHODS: a total of 124 adults [61 males, 63 females; age 62 (4) years] completed a computerised use-of-time recall on 4 days at each of four time points (3-6 months pre-, 3, 6 and 12 months post-retirement), as well as surveys regarding self-reported health, well-being, sleep quality and loneliness. They reported how much they enjoyed each activity on a 0-10 scale. An individual Enjoyment Index was calculated as the time-weighted average of each participant's enjoyment ratings. Time-weighted enjoyment ratings were also calculated for nine mutually exclusive and exhaustive activity domains (Sleep, Chores, Work, Social, Screen Time, Self-care, Quiet Time, Transport, Physical Activity) and sub-domains. RESULTS: the mean (±SD) Enjoyment Index was 7.43 ± 0.61, and was significantly and positively associated with well-being (P = 0.003 to P < 0.0001) and sleep quality (P = 0.03 to P < 0.0001), and negatively associated with loneliness (P = 0.003 to P < 0.0001). Mean Enjoyment Index values increased significantly (P < 0.0001) from pre-retirement (7.19 ± 0.82) to post-retirement (7.46 ± 0.89, 7.42 ± 0.91 and 7.49 ± 0.89 at 3, 6 and 12 months post-retirement). There were significant differences in enjoyment across domains, with Physical Activity (7.86 ± 1.11) and Social (7.66 ± 0.85) being the most enjoyable, and Work (7.10 ± 0.89) and Chores (7.09 ± 0.85) the least enjoyable. CONCLUSION: enjoyment of everyday activities increased after retirement and remained elevated for at least 12 months. Work appears to constitute a relative hedonic deficit.

Submaximal Exercise-Based Equations to Predict Maximal Oxygen Uptake in Older Adults: A Systematic Review.

OBJECTIVE: To evaluate and discuss the accuracy of submaximal exercise-based equations to predict maximum oxygen uptake (V˙o2max), validated using direct gas analysis, in older apparently healthy adults. DATA SOURCES: Studies were identified by searching 5 electronic databases and manually scanning reference lists of included articles from the respective inception of each database through April 2015. STUDY SELECTION: Studies were included if they used at least 1 submaximal exercise-based variable in the prediction, the actual V˙o2max was directly measured using a gas analysis device, and if participants were apparently healthy older adults (mean age ≥65y). Eligible studies were required to report at least 1 validity statistic (eg, Pearson product-moment correlation [r]) and either a predicted and measured V˙o2max value or a directional significant difference between the measured and predicted V˙o2max values. No limits were placed on year of publication, but only full-text, published articles in the English language were included. DATA EXTRACTION: Nine articles and 13 equations were retained from the systematic search strategy. If the same prediction equation was used across multiple trials, data from the most accurate trial were reported. DATA SYNTHESIS: Submaximal equations predicted directly measured V˙o2max with a moderate to strong correlation strength (r range, 0.4-0.9). Predicted V˙o2max significantly differed from directly measured in 2 of the 13 equations. The preferred mode of ergometry was walking or running (7 equations); a stepping protocol was the most accurate (R(2)=0.9, not significant between predicted and measured V˙o2max). CONCLUSIONS: Factors to consider when choosing a submaximal exercise-based equation are the accuracy of the equation, the population tested, the mode of ergometry, the equipment availability, and the time needed to conduct familiarization sessions.

Does walking improve disability status, function, or quality of life in adults with chronic low back pain? A systematic review.

OBJECTIVE: To establish the effectiveness of walking alone and walking compared to other non-pharmacological management methods to improve disability, quality of life, or function in adults with chronic low back pain. DATA SOURCES: A systematic search of the following databases was undertaken: Medline, Embase, CINAHL, Scopus, Pedro, SportDiscus, Cochrane Central Register of Controlled Trials. The following keywords were used: 'back pain' or 'low back pain' or 'chronic low back pain' and 'walk*' or 'ambulation' or 'treadmill*' or 'pedometer*' or 'acceleromet*' or 'recreational' and 'disability' or 'quality of life' or 'function*'. REVIEW METHODS: Primary research studies with an intervention focus that investigated walking as the primary intervention compared to no intervention or any other non-pharmacological method in adults with chronic low back pain (duration >3 months). RESULTS: Seven randomised controlled trials involving 869 participants were included in the review. There was no evidence that walking was more effective than other management methods such as usual care, specific strength exercises, medical exercise therapy, or supervised exercise classes. One study found over-ground walking to be superior to treadmill walking, and another found internet-mediated walking to be more beneficial than non-internet-mediated walking in the short term. CONCLUSION: There is low quality evidence to suggest that walking is as effective as other non-pharmacological management methods at improving disability, function, and quality of life in adults with chronic low back pain.

Changes in sedentary behaviours across the retirement transition: a systematic review.

BACKGROUND: Prolonged sedentary behaviour has been associated with a number of chronic health conditions. This issue is compounded by inactivity increasing with age. OBJECTIVE: This systematic review aimed to identify evidence regarding changes in sedentary behaviours as people move into retirement. SEARCH STRATEGY AND SELECTION CRITERIA: Nine databases (Ageline, CINAHL, Cochrane, Embase, MEDLINE, ProQuest, PubMed, SportDiscus and Web of Science) were searched in May 2014. Search terms included retirement, time use and a range of sedentary behaviours, with no date limit. Articles were selected and appraised for risk of bias by two independent reviewers. Due to the variations in measures used for reporting, data synthesis of results was qualitative. RESULTS: Two studies measured total sitting time and reported declines across retirement. Several studies examined self-reported time spent in specific sedentary leisure activities and generally reported increases in duration, prevalence or frequency (television: 7/9 studies; reading: 4/6 studies). Few other sedentary behaviours were considered. CONCLUSIONS: Changes in sedentary time across retirement are currently poorly understood with varying patterns of change identified by different study methodologies (total sitting time versus specific leisure sedentary activities). Future research that simultaneously investigates changes in a comprehensive range of sedentary behaviours across retirement is required. To date, findings suggest that interventions aimed at improving the health of this population need to be targeted at specific sedentary behaviours to provide maximum benefit.

Are health behavior change interventions that use online social networks effective? A systematic review.

BACKGROUND: The dramatic growth of Web 2.0 technologies and online social networks offers immense potential for the delivery of health behavior change campaigns. However, it is currently unclear how online social networks may best be harnessed to achieve health behavior change. OBJECTIVE: The intent of the study was to systematically review the current level of evidence regarding the effectiveness of online social network health behavior interventions. METHODS: Eight databases (Scopus, CINAHL, Medline, ProQuest, EMBASE, PsycINFO, Cochrane, Web of Science and Communication & Mass Media Complete) were searched from 2000 to present using a comprehensive search strategy. Study eligibility criteria were based on the PICOS format, where "population" included child or adult populations, including healthy and disease populations; "intervention" involved behavior change interventions targeting key modifiable health behaviors (tobacco and alcohol consumption, dietary intake, physical activity, and sedentary behavior) delivered either wholly or in part using online social networks; "comparator" was either a control group or within subject in the case of pre-post study designs; "outcomes" included health behavior change and closely related variables (such as theorized mediators of health behavior change, eg, self-efficacy); and "study design" included experimental studies reported in full-length peer-reviewed sources. Reports of intervention effectiveness were summarized and effect sizes (Cohen's d and 95% confidence intervals) were calculated wherever possible. Attrition (percentage of people who completed the study), engagement (actual usage), and fidelity (actual usage/intended usage) with the social networking component of the interventions were scrutinized. RESULTS: A total of 2040 studies were identified from the database searches following removal of duplicates, of which 10 met inclusion criteria. The studies involved a total of 113,988 participants (ranging from n=10 to n=107,907). Interventions included commercial online health social network websites (n=2), research health social network websites (n=3), and multi-component interventions delivered in part via pre-existing popular online social network websites (Facebook n=4 and Twitter n=1). Nine of the 10 included studies reported significant improvements in some aspect of health behavior change or outcomes related to behavior change. Effect sizes for behavior change ranged widely from -0.05 (95% CI 0.45-0.35) to 0.84 (95% CI 0.49-1.19), but in general were small in magnitude and statistically non-significant. Participant attrition ranged from 0-84%. Engagement and fidelity were relatively low, with most studies achieving 5-15% fidelity (with one exception, which achieved 105% fidelity). CONCLUSIONS: To date there is very modest evidence that interventions incorporating online social networks may be effective; however, this field of research is in its infancy. Further research is needed to determine how to maximize retention and engagement, whether behavior change can be sustained in the longer term, and to determine how to exploit online social networks to achieve mass dissemination. Specific recommendations for future research are provided.

A systematic review and meta-analysis of submaximal exercise-based equations to predict maximal oxygen uptake in young people.

Many equations to predict maximal oxygen uptake (VO2max) from submaximal exercise tests have been proposed for young people, but the composition and accuracy of these equations vary greatly. The purpose of this systematic review was to analyze all submaximal exercise-based equations to predict VO2max measured via direct gas analysis for use with young people. Five databases were systematically searched in February 2013. Studies were included if they used a submaximal, exercise-based method to predict VO2max; the actual VO2max was gas analyzed; participants were younger than 18 years; and equations included at least one submaximal exercise-based variable. A meta-analysis and narrative synthesis were conducted. Sixteen studies were included. The mean equation validity statistic was strong, r = .786 (95% CI 0.747-0.819). Subgroup meta-analysis suggests exercise mode may contribute to the overall model, with running- and walking-based predictive equations reporting the highest mean r values (running r = .880; walking r = .821) and cycling the weakest (r = .743). Selection of the most appropriate equation should be guided by factors such as purpose, logistic limitations, appropriateness of the validation sample, the level of study bias, and the degree of accuracy. Suggestions regarding the most accurate equation for each exercise mode are provided.