Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants.

BACKGROUND: Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. OBJECTIVES: To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. METHODS: Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. RESULTS: A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). CONCLUSIONS: A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839.

The Impact of Removing the 10-Minute Bout Requirement and of Different Survey Administration Methods on National Physical Activity Estimates in Austria.

BACKGROUND: Monitoring survey methods, as well as movement recommendations, evolves over time. These changes can make trend observations over time difficult. The aim of this study was to examine the differences between 2 computer-assisted survey administration methods and the effect of the omission of the 10-minute minimum bout requirement in physical activity (PA) questions on PA outcomes. METHODS: We used data from the second Austrian PA Surveillance System for 2998 adults (18-64 y), applying computer-assisted personal interviewing and computer-assisted web interviewing. Within the computer-assisted web interviewing sample only, we added PA questions without the 10-minute requirement. Quantile and logistic regressions were applied. RESULTS: Between computer-assisted web interviewing and computer-assisted personal interviewing, within the computer-assisted personal interviewing sample, we found lower PA estimates in the leisure domain and work and household domain, but not in the travel domain, and no significant difference in the proportion of people meeting the PA recommendations. In all 3 PA domains, the median minutes did not differ when assessed with or without the 10-minute requirement. However, the percentage participation in the travel domain and work and household domain performing >0 minutes per week PA was higher when there was no 10-minute requirement. The proportion of people meeting the Austrian aerobic recommendation for adults when computed with or without the 10-minute requirement did not differ. CONCLUSION: Our findings suggest that the omission of the 10-minute requirement does not seem to result in marked differences in PA estimates or the proportion of adults meeting the recommendations.

Performance of Different Accelerometry-Based Metrics to Estimate Oxygen Consumption during Track and Treadmill Locomotion over a Wide Intensity Range.

Accelerometer data can be used to estimate incident oxygen consumption (VO2) during physical activity. Relationships between the accelerometer metrics and VO2 are typically determined using specific walking or running protocols on a track or treadmill. In this study, we compared the predictive performance of three different metrics based on the mean amplitude deviation (MAD) of the raw three-dimensional acceleration signal during maximal tests performed on a track or treadmill. A total of 53 healthy adult volunteers participated in the study, 29 performed the track test and 24 the treadmill test. During the tests, the data were collected using hip-worn triaxial accelerometers and metabolic gas analyzers. Data from both tests were pooled for primary statistical analysis. For typical walking speeds at VO2 less than 25 mL/kg/min, accelerometer metrics accounted for 71-86% of the variation in VO2. For typical running speeds starting from VO2 of 25 mL/kg/min up to over 60 mL/kg/min, 32-69% of the variation in VO2 could be explained, while the test type had an independent effect on the results, except for the conventional MAD metrics. The MAD metric is the best predictor of VO2 during walking, but the poorest during running. Depending on the intensity of locomotion, the choice of proper accelerometer metrics and test type may affect the validity of the prediction of incident VO2.

Development of national physical activity recommendations in 18 EU member states: a comparison of methodologies and the use of evidence.

OBJECTIVES: The aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were chosen for detailed case study analysis of development processes. DESIGN: Cross-sectional survey. PARTICIPANTS: The representatives of the 28 EU member state governments to the EU physical activity Focal Point Network. OUTCOME MEASURES: From national documents we extracted data on (1) the participants of the development process, (2) the different methods used during development, and (3) on which sources national PA recommendations were based. An additional survey for case study countries provided details on (1) anonymised information on the participants of development process, (2) methods employed and rationale for choosing them, (3) development process and timeline, and (4) main source documents used for recommendation development. RESULTS: Eighteen national documents on PA recommendations contained information about development process. The results showed that countries used different approaches to develop national recommendations. The main strategies were (1) adoption of WHO 2010 recommendations or (2) a combination of analysis and adoption of other national and international recommendations and literature review. All of the five case study countries relied on review processes rather than directly adopting WHO recommendations. CONCLUSIONS: While there are arguments for the use of particular strategies for PA recommendation development, there is currently no evidence for the general superiority of a specific approach. Instead, our findings highlight the broad spectrum of potential development methods, resources utilisation and final recommendations design currently available to national governments. These results may be a source of inspiration for other countries currently planning the development or update of national PA recommendations.

The Influence of Stretching the Hip Flexor Muscles on Performance Parameters. A Systematic Review with Meta-Analysis.

The hip flexor muscles are major contributors to lumbar spine stability. Tight hip flexors can lead to pain in the lumbar spine, and hence to an impairment in performance. Moreover, sedentary behavior is a common problem and a major contributor to restricted hip extension flexibility. Stretching can be a tool to reduce muscle tightness and to overcome the aforementioned problems. Therefore, the purpose of this systematic review with meta-analysis was to determine the effects of a single hip flexor stretching exercise on performance parameters. The online search was performed in the following three databases: PubMed, Scopus, and Web of Science. Eight studies were included in this review with a total of 165 subjects (male: 111; female 54). In contrast to other muscle groups (e.g., plantar flexors), where 120 s of stretching likely decreases force production, it seems that isolated hip flexor stretching of up to 120 s has no effect or even a positive impact on performance-related parameters. A comparison of the effects on performance between the three defined stretch durations (30-90 s; 120 s; 270-480 s) revealed a significantly different change in performance (p = 0.02) between the studies with the lowest hip flexor stretch duration (30-90 s; weighted mean performance change: -0.12%; CI (95%): -0.49 to 0.41) and the studies with the highest hip flexor stretch duration (270-480 s; performance change: -3.59%; CI (95%): -5.92 to -2.04). Meta-analysis revealed a significant (but trivial) impairment in the highest hip flexor stretch duration of 270-480 s (SMD effect size = -0.19; CI (95%) -0.379 to 0.000; Z = -1.959; p = 0.05; I2 = 0.62%), but not in the lowest stretch duration (30-90 s). This indicates a dose-response relationship in the hip flexor muscles. Although the evidence is based on a small number of studies, this information will be of great importance for both athletes and coaches.

[Effects of Physical Activity on Health]. / Auswirkungen von Bewegung auf die Gesundheit.

Regular physical activity contributes to both maintaining and improving health, and is important for human development throughout the entire lifespan of a person. There is strong evidence for the beneficial effects of physical activity on health, in the areas of all-cause mortality, cancer, cardiovascular health, musculoskeletal health, metabolic health, and neurocognitive health. Physical activity includes any form of movement in which the contraction of skeletal muscles results in an increase in energy consumption. It is quantified and controlled via the frequency, duration, intensity, and weekly extent. All those forms of movement that improve health and in which the risk of injury is low are defined as health-enhancing physical activity. The Austrian recommendations for health-enhancing physical activity include endurance-oriented movement, plus strength and coordination training. Exercise is aimed at initiating adaptation processes, in order to improve functionality. Therefore, it has to be adapted to the different levels of individual performance ability, activity levels, and age, and should be carried out according to certain principles. Exercise leads to a positive change in physiological parameters, which in turn are closely linked to an improvement in the state of health. Through regular endurance-oriented and muscle-strengthening physical activity, far-reaching health effects can be achieved. Nevertheless, undesirable events can occur during activity, and the musculoskeletal and circulatory systems can be particularly affected. However, through adequate preparation, suitable equipment, and appropriate exercise, the personal and also the public health benefits of physical activity and sport can be increased.

[Austrian Physical Activity Guidelines for Adults and Older Adults with and without Physical, Sensory, or Mental Disabilities, as well as for Adults with Chronic Diseases]. / Österreichische Bewegungsempfehlungen für Erwachsene und ältere Erwachsene ohne und mit Körper-, Sinnes- oder Mentalbehinderung sowie für Menschen mit chronischen Erkrankungen.

There is sound scientific evidence that regular physical activity enhances physical, psychological, and mental health. Specific physical activity guidelines for target groups make an essential contribution to the promotion of physical activity behavior at a population level. In this article, we introduce the updated Austrian physical activity guidelines for adults and older adults with and without physical, sensory, or mental disabilities, as well as for adults with chronic diseases. We have also added comments to key elements of the guidelines. The scientific basis of the physical activity guidelines is the scientific report by the US advisory committee, as well as the 2nd edition of the physical activity guidelines for Americans. Guidelines for a new target group - adults with chronic health conditions - have been included. Furthermore, people with disabilities are now explicitly part of the (older) adult target groups. Instead of providing one cut-off point to separate people into meeting the guidelines/not meeting the guidelines, a range of 150 to 300 minutes per week is now recommended. Placing the guidelines for strength training above those for aerobic training emphasizes the importance of this type of training. In addition, it is now recommended that prolonged sitting is avoided by regularl interruptions. We believe that the publication of the physical activity guidelines for Austria will make an important contribution to the promotion of health through regular physical activity. However, the promotion of regular physical activity will only be successful if all target groups have a fair chance to reach physical activity competence, and attractive environments are created for regular physical activity.

[Determinants of Exercise, Fulfilling the Recommendations for Aerobic Physical Activity and Health Status: Results of a Correlation Study in the Federal States of Austria]. / Bewegungsdeterminanten, Erfüllung der Empfehlungen für ausdauerorientierte Bewegung und Gesundheit: Ergebnisse einer Korrelationsstudie aus den österreichischen Bundesländern.

STUDY AIM: The aim of this study was to examine the association between the proportion of the population that fulfilled the endurance-based recommendations for health-enhancing physical activity and the proportion with correct knowledge of these recommendations, exercise-friendly culture and environment, and health status in the federal states of Austria. METHODS: The analysis is based on data from the Austrian Physical Activity Monitoring 2017, the Austrian Health Interview Survey 2014, the Austrian Mortality Register 2015, the database of Fit Sports Austria, the Austrian Chamber of Commerce, the Federal Ministry for Traffic, and an online platform for running events. Correlation coefficients (Pearson) for the various parameters and the proportion of the population that fulfilled the endurance-based recommendations for health-enhancing physical activity are presented. RESULTS: There is a significant correlation between endurance-based physical activity and the knowledge regarding the recommended extent of physical activity (0.91), the number of offers in sports clubs (0.87), the subjective accessibility of sports clubs (0.85), the accessibility of green spaces (0.84), the number of sports clubs with certified health-promoting programs (0.76), and the perceived possibilities to go running (0.72). In addition, endurance-based physical activity is significantly and negatively correlated with age-adjusted cardiovascular mortality (-0.96), total mortality (-0.95), the prevalence of obesity (-0.83), ischemic heart mortality (-0.76), and the prevalence of chronic diseases in total (-0.68), and is positively correlated with subjective health (0.79). CONCLUSIONS: The correlations show the significant associations between exercise behavior and health knowledge, the infrastructure for exercise, and culture. In addition, they show the significant correlation between exercise behavior and health status in the Austrian federal states. This information is important for tailored recommendations for the individual federal states.

Is running associated with a lower risk of all-cause, cardiovascular and cancer mortality, and is the more the better? A systematic review and meta-analysis.

OBJECTIVE: To investigate the association of running participation and the dose of running with the risk of all-cause, cardiovascular and cancer mortality. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Journal articles, conference papers and doctoral theses indexed in Academic Search Ultimate, CINAHL, Health Source: Nursing/Academic Edition, MasterFILE Complete, Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus and Web of Science. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies on the association between running or jogging participation and the risk of all-cause, cardiovascular and/or cancer mortality in a non-clinical population of adults were included. RESULTS: Fourteen studies from six prospective cohorts with a pooled sample of 232 149 participants were included. In total, 25 951 deaths were recorded during 5.5-35 year follow-ups. Our meta-analysis showed that running participation is associated with 27%, 30% and 23% lower risk of all-cause (pooled adjusted hazard ratio (HR)=0.73; 95% confidence interval (CI) 0.68 to 0.79), cardiovascular (HR=0.70; 95% CI 0.49 to 0.98) and cancer (HR=0.77; 95% CI 0.68 to 0.87) mortality, respectively, compared with no running. A meta-regression analysis showed no significant dose-response trends for weekly frequency, weekly duration, pace and the total volume of running. CONCLUSION: Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity. Any amount of running, even just once a week, is better than no running, but higher doses of running may not necessarily be associated with greater mortality benefits.

Short-and Long-Term Effectiveness of a Physical Activity Intervention with Coordinated Action between the Health Care Sector and Local Sports Clubs. A Pragmatic Trial in Austrian Adults.

(1) Background: Collaboration between the health care sector and the sports sector to increase physical activity (PA) behaviour among inactive adults is still rare. The objective of the study was to evaluate the short- and long-term effectiveness of a mixed PA intervention on the PA behaviour in an adult population. (2) Methods: In a quasi-experimental study with two follow-up measurements (four and 12 months), adults were contacted by post before their stay in a health resort. During the health resort stay, the intervention group (IG) received PA counselling and a coupon for 12 standardised free-of-charge sessions in a sports club. The participants in the comparator group (CG) received PA counselling and written material. PA was measured with an accelerometer (GENEActive). Linear mixed-effects models were applied to examine the change in PA behaviour, both within and between groups in moderate- to vigorous-intensity PA over time. (3) Results: We obtained at least one follow-up measurement from 217 participants (IG = 167, CG = 50), who were 50% female, with an average age of 53 (±6) years. PA significantly increased from the baseline to the four-month measurement by 58 min./wk (95% CI 36, 80) and to the 12-month measurement by 24 min./wk (95% CI 2, 46) within the IG. No change in PA occurred in the CG. We also found a short-term between-group (IG vs. CG) difference in change over time, but not a long-term difference. (4) Conclusions: The study confirms that a collaboration between the health care sector and local sports clubs is a feasible method of recruiting people into a standardised PA programme and to increase their PA over the long term.

A Qualitative Examination of the Physical Activity Needs of People with Severe Mental Illness.

It is recognised that physical activity has a positive impact on quality of life, social well-being and overall health of people with severe mental illness. However, there is a lack of theory informed programmes that support people with mental illness to adopt regular physical activity behaviour. The aim of this case study was to identify determinants of long-term physical activity among people with severe mental illness that may then inform the development of more suitable physical activity programmes. Semi-structured interviews were conducted with 15 people (13 men and 2 women) with a mean age of 36.7 [standard deviation (SD)=11.8] who had a diagnosed mental illness and were attending a physical activity programme run by a mental health non-governmental organisation. Interview data was analysed using the documentary method to emphasise the perspective of people with severe mental illness. Three participation types were generated in the context of individuals' physical activity orientation and social background-first 'rehabilitative orientated' (physical activity as a supportive measure to re-enter the labour market and develop a daily routine); second 'social-orientated' (social well-being within the group as the primary motive); finally, 'trust-orientated' (a sense of trust that encourages participation). Based on these type-specific categories, it is suggested that different settings (mental health care centres and sport clubs) might be needed to attract and maintain the physical activity engagement of people with severe mental illness. In the context of sport clubs, it is recommended that coaches undergo training in mental health literacy.

Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths.

Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees' motivation for ACW, which is the first step towards behavior change.

Effects of frequency, intensity, duration and volume of walking interventions on CVD risk factors: a systematic review and meta-regression analysis of randomised controlled trials among inactive healthy adults.

OBJECTIVE: Walking interventions in healthy populations show clinically relevant improvements for many cardiovascular disease (CVD) risk factors. We aimed to assess the changes in CVD risk factors and the dose-response relationship between frequency, intensity, duration and volume of walking and cardiovascular risk factors based on randomised controlled trials (RCTs). DESIGN: A systematic review with meta-analysis and meta-regression. DATA SOURCES: Four electronic databases searched from January 1971 to April 2017. ELIGIBILITY CRITERIA: Walking RCTs reporting one or more CVD risk factor outcomes; trials including at least one group with walking intervention and a no-walking control group; duration ≥8 weeks; participants ≥18 years old, inactive but healthy; risk factors assessed preintervention and postintervention; English-language articles in peer-reviewed journals. RESULTS: Thirty-seven RCTs, involving 2001 participants (81% women) and assessing 13 CVD risk factors, were identified. Pooled meta-analysis showed favourable effects (P≤0.05) of walking intervention for seven CVD risk factors (body mass, body mass index, body fat, systolic and diastolic blood pressure, fasting glucose and VO2max). There were no significant effects (P>0.05) for waist circumference, waist-to-hip ratio and four blood lipid variables.Despite testing 91 possible dose-response relationships, linear meta-regression analysis adjusted for age indicated just 7 (or 7.7%) statistically significant findings. SUMMARY/CONCLUSION: Walking interventions benefit a number of CVD risk factors. Despite multiple studies and tested metrics, only a few dose-response relationships were identified and the possibility of chance findings cannot be ruled out. There is insufficient evidence to quantify the frequency, length, bout duration, intensity and volume of the walking required to improve CVD risk factors. PROSPERO REGISTRATION NUMBER: CRD42016039409.

How Does Counselling in a Stationary Health Care Setting Affect the Attendance in a Standardised Sports Club Programme? Process Evaluation of a Quasi-Experimental Study.

Actions in partnership across sectors is one principle for the promotion of health behaviours. The objective of this study was to describe the participation in a sports club-based exercise programme-named JACKPOT-following an intervention in a health care setting. Focus was given to the recruitment into JACKPOT, the attendance level, and whether the different programme elements were implemented as intented. The practicability of the project was also retrospectively rated. Participants were 238 inactive people (50% women) between 30 and 65 years of age who attended a health resort. Of these, 77% were assigned to the intervention group (IG). The recruitment into the 12 JACKPOT sessions and the attendance levels were recorded via attendance lists. The implementation of the intervention standards was assessed with structured interviews and participatory observation. The Pragmatic Explanatory Continuum Indicator Summary (PRECIS)-2 tool served to rate the practicability of the project. Almost 50% of the IG subjects attended JACKPOT sessions at least once and 54% of the attenders visited ≥75% of the 12 sessions. Some of the programme elements were not delivered fully. The process evaluation results showed that the project worked in a real-world setting, and also uncovered potential reasons such as incomplete information delivery for the moderate recruitment and attendance level.

Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2) to 3.0 pg/l (min-max = 2.0-20.8), and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9) to 0.3 mg/dl (min-max = 0.1-3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

The unrealised potential of bike share schemes to influence population physical activity levels - A narrative review.

The recent proliferation of bike share schemes (BSS, also known as public bicycle use programs) in many cities has focused attention on their potential for reducing motorised traffic congestion, improving air quality and reducing car use. Since 2005, hundreds of bike share schemes have been implemented in many cities, with bike share usage patterns monitored in many of them. This paper assesses the development of BSS and provides a rationale for their potential health benefits. The key research question, as yet unanswered, is whether BSS themselves can contribute to improving population health, particularly through increasing population cycling, which would increase population levels of health-enhancing physical activity. This paper presents a framework for evaluating the contribution of BSS to population physical activity, and uses examples of new data analyses to indicate the challenges in answering this question. These illustrative analyses examine cycling in Australia, and [i] compares rates of cycling to work in BSS cities compared to the rest of Australia over time, and [ii] modelling trends in bike counts in Central Melbourne before and after introduction of the BSS in 2010, and compared to adjacent regions in nearby suburbs unexposed to a BSS. These indicative examples point to difficulties in attributing causal increases in cycling for transport to the introduction of a BSS alone. There is an evidence gap, and a need to identify opportunities to improve the health-related components of BSS evaluations, to answer the question whether they have any impact on population physical activity levels.