Effects of the inclusion of physical activity in secondary education academic classes on educational indicators and health markers: rationale and methods of the ACTIVE CLASS study.

Background: Increasing physical activity (PA) levels and reducing sedentary behaviors in children and adolescents is a need, especially in schools. Active breaks and physically active learning are examples of two emerging methodologies that have been shown to be effective in increasing PA levels and additionally produce improvements in children's educational markers. However, the evidence in adolescents is very limited. This paper presents the design, measurements, and interventions implemented in the ACTIVE CLASS study, whose objectives are: (i) evaluate the effects of two interventions on PA levels, sedentary time, health-related physical fitness academic indicators, cognition, and markers of psychological health among secondary education students; (ii) evaluate teachers' and students' experiences about the implementation of these the two school-based PA intervention. Methods: A randomized controlled study is conducted with a total of 292 students aged 12-14 years old from six schools (7th and 8th grade) in Spain (three in Cadiz and three in Caceres). One school from each study provinces is randomly assigned to either the active break intervention group, the physically active learning intervention group, or the control group. The interventions have a duration of 16 weeks. Nine main measurement categories are assessed: PA and sedentary time, health-related physical fitness, academic indicators, cognition, psychological health, motivational variables, dietary patterns, sociodemographic characteristics, as well as qualitative information through semi-structured individual interviews and focus groups. Three independent measurements of evaluation are distinguished: pre-intervention, post-intervention (week 16) and retention measurement (4 weeks after the intervention). For quantitative variables, descriptive, correlational, regression and repeated measures ANOVA will be applied. Discussion: To the best of our knowledge, the ACTIVE CLASS study is the first of its kind in Spain to evaluate the effects of incorporating active breaks and physically active learning in secondary education. In addition, this project provides important information on the effects of two school-based PA intervention arms on educational variables and health markers in adolescents. This will provide valuable and innovative training to the educational community, enabling them to implement teaching methodologies that have the potential to enhance academic performance and improve the quality of life for their students. Clinical trial registration: clinicaltrials.gov, NCT05891054.

Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review.

Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.

A longitudinal gender perspective of well-being and health in spanish youth: the UP&DOWN study.

Previous studies have observed a link between gender and well-being and health in young populations. The purpose of this research was twofold: (1) to analyse the cross-sectional relationship between gender status with well-being indicators and self-perceived health in adolescents at baseline and at 2-year follow-up and (2) to evaluate the prospective associations between gender at baseline and well-being indicators/self-perceived health assessed at 2-year follow-up. Well-being was measured using the KIDSCREEN-10 questionnaire (as a measure of health-related quality of life (HR-QoL)), the Children's Hope Scale and the Positive and Negative Affect Schedule. Health status of the adolescents was assessed using self-perceived health. Multilevel mixed-effects linear/logistic regression models were carried out to assess the associations between gender status and well-being and health of a sample of 1590 Spanish adolescents. Adolescent girls were shown to have lower HR-QoL scores and higher negative affect scores, and had a higher risk of reporting poor health than boys, in both cross-sectional and longitudinal analyses. Adolescent girls seem to be more vulnerable to poorer well-being and self-reported health than boys. When looking at hedonic and eudemonic well-being separately, longitudinal differential evolution of boys and girls seems to indicate greater deterioration of hedonic well-being among girls as compared to boys. Overall, gender may have a relevant impact on mental and physical health during adolescence.

Temporal Trends of Compliance With School-Based Physical Activity Recommendations Among Spanish Children, 2011-2018.

BACKGROUND: According to the current physical activity (PA) recommendations, children should accumulate 60 minutes of moderate to vigorous PA (MVPA) throughout the day, 30 minutes of MVPA during the school hours, and 50% of the recess time in MVPA. Our aim was to examine the temporal trends of accelerometer-based PA during the previously mentioned day segments and the proportion of children who met the PA recommendations. METHODS: This was a cross-sectional study with 2 independent samples: 499 fourth graders (49.2% females) in 2011-2012 and 364 fourth graders (46.9% females) in 2017-2018. Hip-worn accelerometers were used to assess PA. RESULTS: A decline in light PA, moderate PA, vigorous PA, MVPA, and total PA during whole day, and in the rate of compliance with daily MVPA recommendations in males (P < .01) was observed from 2011-2012 to 2017-2018. Females decreased their daily light PA and moderate PA (P < .05). A decline in all PA variables during school hours in both sexes (P < .05) and in the rate of compliance with the 30 minutes of MVPA recommended during school hours in males (P < .001) were observed. There were no differences in PA during recesses. CONCLUSIONS: Interventions are needed to attenuate the temporal decrease in PA levels in children.

The relative age effect on physical fitness in preschool children.

The aim of the present study was to investigate the existence of a relative age effect (RAE) on physical fitness of preschoolers. Anthropometry and physical fitness were assessed in 3147 children (3-5 years old) using the PREFIT battery. Based on the birth year, participants were divided into 3year groups (3-, 4- and 5-years). Within each year group, 4quarter groups were created: quarter 1, preschoolers born from January to March; quarter 2, from April to June; quarter 3, from July to September; quarter 4, from October to December. The MANCOVA analysis revealed a main effect of year group (Wilks' λ = 0.383; F10,5996 = 369.64; p < 0.001, ηp 2 = 0.381) and of quarter (Wilks' λ = 0.874; F15,8276.6 = 27.67; p < 0.001; ηp 2 = 0.044) over the whole battery of tests. To the best of our knowledge, this is the first study to report the existence of RAE at the preschool stage. In general, performance improved as the relative age increased (i.e., those born in quarter 1 performed better than those in the other quarters). Individualization strategies should be addressed within the same academic year not only in elementary or secondary years but also in preschoolers.

The Role of School in Helping Children and Adolescents Reach the Physical Activity Recommendations: The UP&DOWN Study.

BACKGROUND: The aims were to: (1) examine the levels of physical activity (PA) during different time periods (ie, daily PA, school hour PA, recess PA, physical education classes [PEC] PA) in children and adolescents; and (2) identify the rate of compliance with the specific PA recommendations for these time periods. METHODS: The participants were 1925 (940 girls) children and adolescents from 40 Spanish schools. Hip-worn accelerometers were used to assess PA during different time periods. RESULTS: Boys and children were more physically active and had a greater percentage meeting the daily PA recommendation and the school-based PA recommendation than girls and adolescents, respectively. Compliance with daily PA recommendation was markedly higher than that with the school-based PA recommendation, regardless of sex and age groups (ie, 80.4% vs 24.1% for daily and school-based PA recommendations, respectively, in child boys). A very low percentage (ie, 9.7% and 1.2% of child boys with almost 50% of moderate-to-vigorous PA during recess and PEC, respectively) of students reached the recommended PA levels for recess and PEC. CONCLUSIONS: Physical activity levels during school hours, recess, and PEC in children and adolescents are very low. Promoting PA in school settings is essential, especially in girls and adolescents.

Environmental correlates of total and domain-specific sedentary behaviour in young people. The UP&DOWN study.

This study investigated the associations between the characteristics of the nearby physical environment with the total and domain-specific leisure-time sedentary behaviour (SB) in young people. The study included 1578 youth (9-18 years) from the UP&DOWN study. Total leisure-time SB was objectively-assessed by accelerometers. Participants self-reported the time spent during leisure-time in different domains of SB (i.e. screen-based, educational-based, social-based, and other-based SB). Information regarding the basic characteristics of the house, the perceived neighbourhood environment, the amount of physical activity facilities, equipment and materials attainable at home, and the media equipment available at home and in the own bedroom was collected. Linear mixed models were performed, including school and city as random effects. The availability of yard was related to lower total SB and time spent surfing the Internet in boys, but not in girls. More favourable perceived neighbourhood environment was associated with lower total SB and time spent playing video games in girls, but not in boys. The amount of physical activity materials at home was negatively associated with screen-based SB, while the availability of a computer in the own bedroom was positively related to the time spent surfing the Internet in boys and girls. The number of televisions at home and having a computer in the own bedroom was associated with lower time in educational-based SB in boys and girls, respectively. Increasing the number of PA materials at home and decreasing the number of TVs at home and the availability of a computer in the bedroom could improve SB profiles of youth.

Independent and combined associations of physical fitness components with inflammatory biomarkers in children and adolescents.

BACKGROUND: We aimed to examine the independent and combined associations of cardiorespiratory fitness, muscular fitness, and motor ability with single and clustered inflammatory biomarkers in children and adolescents. METHODS: This study included 503 children and adolescents. Cardiorespiratory fitness, upper- and lower-muscular fitness, and motor ability were assessed using field-based tests. Fasting blood samples were obtained to determine the levels of a set of inflammatory biomarkers. Global physical fitness and clustered inflammatory biomarker scores were computed. Associations between physical fitness and inflammatory biomarkers were analyzed through linear regression. Differences in inflammatory biomarker levels between physical fitness tertiles were tested. RESULTS: Global physical fitness was inversely associated with single and clustered inflammatory biomarkers in children (p < 0.05); and with C-reactive protein, complement factor C4, leptin, and clustered inflammatory biomarkers in adolescents (p < 0.025). Cardiorespiratory fitness and upper-muscular fitness were negatively and independently associated with several single and clustered inflammatory biomarkers in children and adolescents (p < 0.05). Differences were found between the lowest and the highest tertiles of global physical fitness in clustered inflammatory biomarker levels (p < 0.010). CONCLUSION: Physical fitness was negatively associated with single and clustered inflammatory biomarkers, independently of body mass index. Increasing physical fitness levels in youth might contribute to reduce the cardiovascular risk.

Reliability and validity of the Youth Leisure-time Sedentary Behavior Questionnaire (YLSBQ).

OBJECTIVES: To develop a questionnaire able to assess time spent by youth in a wide range of leisure-time sedentary behaviors (SB) and evaluate its test-retest reliability and criterion validity. DESIGN: Cross-sectional observational. METHODS: The reliability sample included 194 youth, aged 10-18 years, who completed the questionnaire twice, separated by one-week interval. The validity study comprised 1207 participants aged 8-18 years. Participants wore an accelerometer for 7 consecutive days. The questionnaire was designed to assess the amount of time spent in twelve different SB during weekdays and weekends, separately. In order to avoid usual phenomenon of time over reporting, values were adjusted to real available leisure-time (LT) for each participant. Reliability was assessed by using Intraclass Correlation Coefficients (ICC) and weighted (quadratic) kappa (k), and validity was assessed by using Pearson correlation and Bland-Altman plots. RESULTS: The reliability of questionnaire showed a moderate-to-substantial agreement for the most (91%) of items (k=0.43-0.74; ICC=0.41-0.79) with three items (4%) reaching an almost perfect agreement (ICC=0.82-0.83). Only 'sitting and talking' evidenced fair-to-moderate reliability (k=0.27-0.39; ICC=0.34-0.46). The relationship between average sedentary time assessed by the questionnaire and accelerometry was moderate (r=0.36; p<0.001). Systematic biases were not found between questionnaire and accelerometer sedentary time for average day (r=0.05; p=0.11) but Bland-Altman plots suggest moderate discrepancies between both methods of SB measurement (mean=19.86; limits of agreement=-280.04 to 319.76). CONCLUSIONS: The questionnaire showed moderate to good test-retest reliability and a moderate level of validity for assessing SB in youth, similar or slightly better to previously published in this population.

Dance participation and academic performance in youth girls

Dance is a predominant type of physical activity among girls. Dance characteristics imply skills associated to health-related physical fitness, as well as others such as learning and memory, mental representation, imagination and creativity, which are related to cognitive development. Although dance has been shown to influence physical health among youth girls, whether dance may influence academic performance and cognition in youth remains to be elucidated. The objective of this work was to examine the association between participation in dance and academic performance in youth girls.

Dance participation and academic performance in youth girls

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Introducción y objetivos: un dispositivo llamado FeelBreathe ® (FB) se ha diseñado, desarrollado y patentado para el entrenamiento de la musculatura inspiratoria (IMT). Para examinar los efectos de FB en la ventilación pulmonar y el intercambio gaseoso durante el ejercicio, se tomaron medidas de 27 voluntarios varones sanos entrenados (edad: 32,5 ± 7,2 años). Métodos: al inicio del estudio se midieron tanto la presión inspiratoria máxima estática (PIM) y la capacidad pulmonar mediante espirometría. Seguidamente, se realizó un test incremental en cicloergómetro para determinar el VO 2 pico. Cada sujeto, tres días más tarde, realizó aleatoriamente tres pruebas idénticas submáximas en cicloergómetro a una intensidad comprendida al 50% entre los umbrales ventilatorios bajo tres condiciones de respiración diferentes: a) respiración oronasal (ONB), b) respiración nasal (NB) y c) la respiración nasal a través del FB. Resultados: la prueba con FB mostró una ventilación minuto (VE) y una frecuencia respiratoria (BF) inferior que en las pruebas de NB, la cual a su vez tenía menor BF, pero similar VE que ONB (p < 0,001). A pesar de esto, FB obtuvo valores similares de VO 2 , cociente respiratorio (RER), frecuencia cardiaca (HR) y saturación de oxígeno capilar periférica (SpO2) en comparación con NB y ONB. Esto último puede ocurrir debido en parte al aumento del volumen tidal (VT) y el tiempo de expiración (Tex) en FB hasta el mismo nivel que en la prueba de NB, los cuales fueron un 15% y 14% en ambas pruebas, respectivamente, superiores a ONB (p < 0,001). El porcentaje de tiempo de inspiración (Ti/Tot) fue 7% mayor en la prueba de FB en comparación con NB y ONB (p < 0,001). Solamente en la prueba de FB se encontró un aumento de la presión final de la espiración de CO 2 (P ET CO 2 ) y la reducción de la presión final de la espiración de O 2 (P ET O 2 ) y la fracción de expiración de O 2 (FEO 2 ). Conclusiones: FeelBreathe es un nuevo dispositivo de restricción nasal que estimula los músculos inspiratorios para producir un patrón de respiración más eficiente durante el ejercicio en los seres humanos bien entrenados.

Effects of a nasal ventilator restriction device on lung ventilation and gas exchange during exercise in healthy subjects / Efectos de un dispositivo de restricción ventilatoria nasal sobre la ventilación pulmonar e intercambio gaseoso durante el ejercicio en personas sanas

Introduction and objectives: A device called FeelBreathe® (FB) has been designed, developed and patented for inspiratory muscle training (IMT). In order to examine the effects of FB on lung ventilation and gas exchange during exercise, 27 trained male healthy volunteers (age: 32.5 ± 7.2 years) were measured. Methods: Maximum static inspiratory pressure (PImax) and spirometry to determine lung capacity were measured at baseline. We continued with an incremental cycloergometer to determine the VO2 peak. Three days later, each subject performed randomly three identical submaximal cycloergometer tests at 50% between ventilatory thresholds under three different breathing conditions: a) oronasal breathing (ONB), b) nasal breathing (NB) and c) nasal breathing through the FB. Results: FB trial showed lower minute ventilation (VE) and breathing frequency (BF) than NB, which had lower BF, but similar VE than ONB (p < 0.001). The percentage of inspiration time (Ti/Tot) was 7% greater in FB compared to NB and ONB (p < 0.001). Increased end-tidal pressure of CO2 (PETCO2 ) and reduced end-tidal pressure of O2 (PETO2 ) and fraction of O2 expiration (FEO2 ) were found only in FB. Conclusions: FeelBreathe is a new nasal restriction device that stimulates the inspiratory muscles to produce a breathing pattern more efficiency during exercise in well-trained humans (AU)

Introducción y objetivos: un dispositivo llamado FeelBreathe® (FB) se ha diseñado, desarrollado y patentado para el entrenamiento de la musculatura inspiratoria (IMT). Para examinar los efectos de FB en la ventilación pulmonar y el intercambio gaseoso durante el ejercicio, se tomaron medidas de 27 voluntarios varones sanos entrenados (edad: 32,5 ± 7,2 años). Métodos: al inicio del estudio se midieron tanto la presión inspiratoria máxima estática (PIM) y la capacidad pulmonar mediante espirometría. Seguidamente, se realizó un test incremental en cicloergómetro para determinar el VO2 pico. Cada sujeto, tres días más tarde, realizó aleatoriamente tres pruebas idénticas submáximas en cicloergómetro a una intensidad comprendida al 50% entre los umbrales ventilatorios bajo tres condiciones de respiración diferentes: a) respiración oronasal (ONB), b) respiración nasal (NB) y c) la respiración nasal a través del FB. Resultados: la prueba con FB mostró una ventilación minuto (VE) y una frecuencia respiratoria (BF) inferior que en las pruebas de NB, la cual a su vez tenía menor BF, pero similar VE que ONB (p < 0,001). A pesar de esto, FB obtuvo valores similares de VO2 , cociente respiratorio (RER), frecuencia cardiaca (HR) y saturación de oxígeno capilar periférica (SpO2) en comparación con NB y ONB. Esto último puede ocurrir debido en parte al aumento del volumen tidal (VT) y el tiempo de expiración (Tex) en FB hasta el mismo nivel que en la prueba de NB, los cuales fueron un 15% y 14% en ambas pruebas, respectivamente, superiores a ONB (p < 0,001). El porcentaje de tiempo de inspiración (Ti/Tot) fue 7% mayor en la prueba de FB en comparación con NB y ONB (p < 0,001). Solamente en la prueba de FB se encontró un aumento de la presión final de la espiración de CO2 (PETCO2 ) y la reducción de la presión final de la espiración de O2 (PETO2 ) y la fracción de expiración de O2 (FEO2 ). Conclusiones: FeelBreathe es un nuevo dispositivo de restricción nasal que estimula los músculos inspiratorios para producir un patrón de respiración más eficiente durante el ejercicio en los seres humanos bien entrenados (AU)

Objectively measured physical activity has a negative but weak association with academic performance in children and adolescents.

AIM: There is an emerging body of evidence on the potential effects of regular physical activity on academic performance. The aim of this study was to add to the debate, by examining the association between objectively measured physical activity and academic performance in a relatively large sample of children and adolescents. METHODS: The Spanish UP & DOWN study is a 3-year longitudinal study designed to assess the impact, overtime, of physical activity and sedentary behaviours on health indicators. This present analysis was conducted with 1778 children and adolescents aged 6-18 years. Physical activity was objectively measured by accelerometry. Academic performance was assessed using school grades. RESULTS: Physical activity was inversely associated with all academic performance indicators after adjustment for potential confounders, including neonatal variables, fatness and fitness (all p < 0.05). This association became nonsignificant among quartiles of physical activity. There were only slight differences in academic performance between the lowest and the second quartile of physical activity, compared to the highest quartile, with very small effect size (d < 0.20). CONCLUSION: Objectively measured physical activity may influence academic performance during both childhood and adolescence, but this association was negative and very weak. Longitudinal and intervention studies are necessary to further our understanding.