Physical Exercise as a Nonpharmacological Intervention for the Treatment of Neuropsychiatric Symptoms in Persons With Dementia: A Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Neuropsychiatric symptoms (NPS) are prevalent in dementia and affect both patients and caregivers in multiple ways. Because of the complications of drug treatments, nonpharmacological interventions, such as exercise, are of particular value. This study aimed to investigate the effect of exercise on the NPS of dementia and draw recommendations for the disease management. METHODS: Meta-analyses were conducted on the findings of randomized controlled trials identified during an initial systematic review of the literature, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The included studies examined the effect of exercise interventions on patients with dementia or mild cognitive impairment using valid assessment tools. The quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation analysis. RESULTS: The meta-analyses revealed that exercise significantly limits NPS [mean difference: -5.28, (95% CI, -9.46, -1.11), P = 0.01] and symptoms of depression [standardized mean difference: -0.16, (95% CI, -0.29, -0.02), P = 0.02], and has a beneficial effect on agitation symptoms. The Grading of Recommendations, Assessment, Development, and Evaluation analysis results showed that exercise has a moderate and high confidence positive effect on NPS and depression, respectively. CONCLUSIONS: Exercise could be an alternative approach for nonpharmacological treatment of NPS in dementia. Therefore, exercise could be utilized as a treatment of choice or to support existing treatment regimens.

Associations of Motor Competence, Cardiorespiratory Fitness, and Physical Activity: The Mediating Role of Cardiorespiratory Fitness.

Purpose: Supporting children's physical activity (PA) behavior is imperative in order to safeguard their health. In an attempt to gain a deeper understanding about children's PA behavior, the aim of this study was to investigate the associations among motor competence (MC), cardiorespiratory fitness (CRF) and ambulatory PA during middle and late childhood. Method: A cross-sectional design was adopted and a total of 576 8-12-year-old children (Mage = 10.2 years, SD = 1.3) were examined. MC was assessed by the Canadian Agility and Movement Skill Assessment; daily PA (steps/day) was obtained by pedometers; CRF was measured by the Progressive Aerobic Cardiovascular Endurance Run. The associations among the key study variables were investigated by correlation and mediation analyses. Using a bootstrap method, two mediation models were tested: (a) MC predicting PA through CRF, (b) PA predicting MC through CRF. Results: MC, CRF, and PA present significant and positive associations both in boys and girls (p < .05). CRF fully mediates the relationship between MC and PA in both directions [Model 1: b = .138, 95% CI (.0952, .1869), Model 2: b = .108, 95% CI (.0752, .1445)]. The pathway leading from PA to MC (R2 = .375, p < .0001) has stronger predictive utility than the reverse pathway (R2 = .124, p < .0001). Conclusion: MC and CRF are important predictors of children's PA participation; therefore, systematic and targeted interventions focused on the enhancement of these two factors should be used as a mechanism to reinforce children's PA behavior.

Exploring physical literacy in children aged 8 to 12 years old: a cross-cultural comparison between China and Greece.

BACKGROUND: The concept of physical literacy (PL) has been advocated as a crucial determinant for increasing the quality and quantity of movement and physical activity (PA). Children's PL has been rarely compared across countries, although it has shown low levels in many countries. This study aimed to explore and compare children's PL from China and Greece. METHODS: A total of 327 Chinese (47.1% boys) and 295 Greek children (48.1% boys) aged 8 to 12 years participated in this study. Children's PL was objectively assessed by the Chinese and Greek version of the Canadian Assessment of Physical Literacy, 2nd edition, which consists of four domains: Daily Behavior, Physical Competence, Motivation and Confidence, and Knowledge. and Understanding. Univariate analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) on total PL and domain scores were conducted in both countries, respectively. RESULTS: MANOVA revealed significant differences in total PL and distribution scores between two countries (Pillais' trace = 0.260, F = 53.855, p < 0.001, η2 = 0.260), with Greek children scoring better than Chinese. Nevertheless, most children failed to present an adequate PL level as they were mostly in the "progressing" stage. The chi-square denoted that the distribution of Chinese and Greek participants across the CAPL-2 interpretive categories was statistically different for total PL (χ2 [3] = 18.726, p < 0.001, Cramer's V = 0.174), with more Greek children being classified as "achieving" and "excelling". CONCLUSIONS: The variance between Chinese and Greek children may be attributed to cultural differences in the context of PA, such as PE policies and settings. The relatively low level of PL shown in both countries echoes the global trend of the declining PA among children, with an increasing amount of their time spent in a sedentary lifestyle. These findings highlight the need to consider children's cultural factors and pedagogical strategies in terms of developing their PL. Future research is required to explore the impact of cultural background on PL development among children and appropriate strategies to migrate their influence.

Children's Involvement in Different Sport Types Differentiates Their Motor Competence but Not Their Executive Functions.

Sports provide a context where important aspects of children's health, such as motor skills and cognitive functions, can be enhanced. However, it is unknown which type of sport may be better for the development of motor competence (MC) and executive functions (EFs). This study investigated potential differences in MC and EFs in boys and girls, being involved in different types of sports (team, individual open skill, individual closed skill). A total of 115 children (49 boys), 8-12 years old (10.30 ± 1.19 years), participated in the study. Their MC was assessed with the Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form, whereas for EFs, the Attention Network Test, the digits backwards test, and the how many-what number test were utilized. Significant MC differences among participants in different types of sports were revealed, favoring those from closed-skill sports; nevertheless, their EFs were at similar levels. Furthermore, no significant gender MC and EFs differences were detected. It seems that children's participation in specific types of sports differentiates their motor skills but not their EFs, whereas boys and girls, when provided with the same opportunities, present similar levels of MC and EFs.

The effectiveness of physical exercise interventions in the management of neuropsychiatric symptoms in dementia patients: a systematic review.

BACKGROUND: The management of neuropsychiatric symptoms (NPS) in patients with dementia is a major challenge. Since no effective therapy has been found to date and drug treatments are associatedwith significant side effects, there seems to be a pressing need for alternative non-pharmacological interventions. OBJECTIVES: The current study aims to investigate and compare the effect of different types of physical exercise on the NPS. METHODS: A systematic review of the literature was conducted according to the PRISMA guidelines. Five databases (SCOPUS, PubMed, SPORT Discus, Web of science and ScienceDirect) were searched using the appropriate algorithm. What was sought out was randomized control trials (RCTs) that applied physical activity interventions with specific characteristics (type, frequency, intensity, and duration) in patients with dementia or mild cognitive impairment, studied the effect of exercise on their NPS and compared this effect with a control group that did not follow an exercise program. RESULTS: From 512 articles, 13 studies were included in this review, involving a total of 1,925 patients. The results were analyzed and synthesized according to the type of exercise applied - aerobic exercise, multidimensional interventions and muscular strength training programs. In particular, the results showed that repetitive aerobic exercise three to five times a week had a positive effect on NPS, whereas multidimensional interventions combining different types of exercise did not appear to be as effective. Strength training programs have been found to significantly reduce depression symptoms and behavioral problems in demented patients with mobility problems. CONCLUSIONS: There is clear evidence that physical activity and especially aerobic exercise may be effective in the management of NPS. However, it is necessary to apply specific practical recommendations and specially designed programs to incorporate physical exercise into the daily routine of these patients.

Towards a Functional Approach to the Assessment of Daily Life Physical Activity in Children: Are the PAQ-C and Fitbit Flex-2 Technically Adequate?

Considering the need for functional physical activity (PA) measures in PA settings, this study sought to determine the technical adequacy of the Physical Activity Questionnaire for Older Children (PAQ-C) and the Fitbit Flex-2, two instruments with promising features for wide use, using the Actigraph GT3X+ accelerometer as the criterion reference. A total of 218 Greek children (94 boys, 124 girls; mean age = 10.99 ± 1.52 years) volunteered to join in. Participants wore the PA trackers for seven days and completed the PAQ-C. Moreover, a sub-group (n = 60) recompleted the PAQ-C after a week. Results revealed acceptable internal consistency and excellent test-retest reliability for the PAQ-C. Regarding concurrent validity, weak to moderate correlations with PA parameters recorded by the GT3X+ were revealed for the total PAQ-C and were excellent for the Flex-2, while a Bland-Altman plot indicated good agreement. Finally, in alignment with relevant literature, significant gender, but no age, differences were found in participants' PA records in all the tools applied. The above results support the use of the PAQ-C and the Fitbit Flex-2 in children. Considering that they shed light into different parameters of children's habitual PA, their combined utilisation, providing comprehensive information, is strongly recommended.

Energy expenditure during a Vinyasa yoga session.

BACKGROUND: Vinyasa yoga has been recently promoted as one of the most popular mindful exercises to improve overall health, including body weight management. The purpose of this study was to determine the metabolic response of 24 moderately trained individuals during a 90-min group Vinyasa yoga routine. METHODS: Heart rate (HR) time course of 12 males and 12 females (age: 39±7.33 years) was recorded during two group Vinyasa yoga sessions consisted of four sections (warm-up, high-intensity Surya Namaskar (HSN), no Surya Namaskar postures, and cool-down). Maximal oxygen uptake (V̇O2peak) and maximum HR had been estimated earlier after a maximal treadmill test. V̇O2 during Vinyasa yoga sessions was estimated from individual regression equations using the relationship of V̇O2 and HR values derived from V̇O2peak test, while the metabolic rate (kcal/min) was calculated from the relationship of HR and kcal/min. Total session energy consumption was the average value of the two yoga sessions. RESULTS: The 2 (gender) × 4 (sections) mixed ANOVA revealed no significant interaction between the two factors (P=0.101) for the mean metabolic rate (7.1±2.6 kcal/min). Mean metabolic rate thought was higher (P=0.015) in males compared to females at each section. Also, significant differences were found among the four Vinyasa yoga sections (P<0.001) in the rate of energy expenditure, with HSN presenting the highest mean values (P<0.05). CONCLUSIONS: It seems that systematic participation in Vinyasa yoga may effectively improve cardiorespiratory fitness and promote body weight loss, as an alternative method to traditional aerobic exercise.

Physical Activity and Sedentary Behaviors of Young Children: Trends from 2009 to 2018.

Over the last decade, the lives of children in several countries, including Greece, have been affected by recession. The aim of the present study was (a) to examine time trends in physical activity (PA) and screen time (ST) of Greek preschool children, together with their family affluence (FA), from 2009 until 2018, and to explore the associations among them; and (b) to investigate the connections of parental educational level and children's BMIs to their achieving ST (<1h/day) and PA (11,500 steps/day) guidelines. A total of 652 children from four cross-sectional cohorts participated. PA was recorded with Omron HJ-720IT-E2 pedometers, whereas ST, family affluence (FA) and parental educational level were reported by participants' parents. The results of the one-way ANOVAs that were computed revealed statistically significant differences among cohorts, albeit of no practical importance, in PA, ST and FA. According to the regressions calculated, neither BMI nor the educational level was related to membership in ST and PA guidelines groups. ST was a significant predictor of children's PA in all week periods (school-time, leisure-time, weekend), whereas FA was not such a strong predictor. Multilevel interventions aiming at both ST and PA seem to be imperative for the benefit of young children's health.

How physically literate are children today? A baseline assessment of Greek children 8-12 years of age.

Developing Physical Literacy (PL) in children is considered a promising concept for establishing active lifestyle habits; yet research evidence is scarce. This study aimed at comprehensively assessing PL in 8-12-year-old Greek children. For that purpose, the Canadian Assessment of Physical Literacy (CAPL-2) was administered to 715 children (M age = 10.2, SD = 1.3 years). Analyses of variance were applied on participants' total, domain and individual measures scores, examining potential gender and age differences; whereas, participants' classification and proportion across CAPL-2 interpretive categories were computed. Results revealed that there were no practically important differences (η2 < .14) between boys and girls or younger (grades 3 & 4) and older children (grades 5 & 6). Greek children presented insufficient levels of PL (their total score classified them into "progressing" PL level). CAPL-2 domains and individual measures scores showed that participants were highly motivated and felt confident to participate in physical activity (PA); however, they exhibited low PA as well as unsatisfactory physical competence, knowledge, and understanding to value and take responsibility for engagement in PA. Although further research is needed for a comprehensive picture of PL correlates, our findings highlight the need for providing Greek children with ample opportunities to enhance their PL.

Physical activity in pre-school children: Trends over time and associations with body mass index and screen time.

Background: Pre-school years are important for adopting health behaviours; however, today's children seem to be overweight, present low physical activity (PA) levels and exceed screen time (ST) recommendations.Aim: To examine (a) time trends in PA in Greek pre-school children, (b) the associations among PA, body mass index (BMI) and ST and (c) potential PA differences between boys and girls.Subjects and methods: Data from five cross-sectional cohorts (2005 [n = 252]; 2008 [n = 212]; 2011 [n = 187]; 2014 [n = 194]; 2017 [n = 128]) were compared. PA was assessed using Omron HJ-720IT-E2 pedometers, whereas ST was reported by participants' parents. A 4-way ANOVA was applied on children's average week step counts.Results: A significant association (F = 828.90, p < 0.001, η2 = 0.638) between ST and PA was revealed, with children that had ST < 1 hour/day presenting the higher PA levels and being the only ones that met PA recommendations (11,500 steps/day). Statistically significant PA differences, though of no practical importance, were found among cohorts. There were no significant PA differences between boys and girls or among BMI categories. Nevertheless, obesity prevalence was found to exist at alarming levels (24.5% in 2008-41.4% in 2017), and a large percentage of children (23.6% in 2008-63.3% in 2017) presented excessive ST (> 2 hours/day).Conclusion: Effective interventions aiming at reducing ST and enhancing PA seem imperative if children's health is to be safeguarded.

Enhancing Motor Competence and Physical Activity in Kindergarten.

BACKGROUND: This study aimed at evaluating the effect of the "Walk," an 8-month physical activity (PA) program led by classroom and physical education teachers, on the motor competence (MC) and PA of 5- to 6-year-old children. METHODS: A total of 143 children (mean age = 61.51 [1.85] mo) participated in the study and were randomly assigned to the experimental and control groups. Children's MC was assessed by the Körperkoordination Test für Kinder (KTK), and PA was objectively measured by Omron HJ-720IT-E2 pedometers. Measurements were performed at baseline, midintervention, and postintervention. A 1-sample t test computed at baseline step counts revealed that children presented significantly lower PA than recommended for their age (P < .001). To examine the effect of the intervention on children's MC and PA, several repeated-measures analyses of variance were utilized on (1) KTK item scores and (2) pedometer data. RESULTS: The results revealed that the Walk project led to practically significant changes in the experimental group compared with the control group in both MC (P < .001, η2 > .14 for all KTK items) and PA (P < .001, η2 = .23). CONCLUSIONS: This study highlights the efficacy of a PA project, involving both classroom and physical education teachers, for the enhancement of children's MC and PA.

Child and parental physical activity: Is there an association with young children activity?

OBJECTIVES: The aim of the study is to examine the physical activity (PA) of young children and their parents on weekdays and at the weekend, as well as possible associations between them. METHODS: Fifty-eight children (29 boys), aged 5-8 years (mean age = 6.53 years) and the parent who spent more time with them (25 fathers, 33 mothers, mean age 40.67 years) wore Omron HJ-720IT pedometers for seven consecutive days. Two ANOVAs for repeated measures were applied to examine PA differences between genders and week phases (weekdays vs. weekend days) in children and parents. Moreover, one sample t-tests were used to compare participants' PA to the recommended PA, while linear regression analyses were utilized to examine whether parental PA in each week phase was associated with children's PA. RESULTS: Children accumulated more steps on weekdays than at the weekend (F1,56 = 18.58, p < 0.001, η2 = 0.27), while boys presented higher PA than girls (F1,56 = 12.42, p = 0.001, η2 = 0.20), and accomplished the recommended daily PA, in contrast to girls. Mothers and fathers presented similar PA (p = 0.67, η2 = 0.004), with more steps on weekdays than at the weekend (F1,56 = 9.22, p = 0.004, η2 = 0.16). However, their PA was significantly lower than the recommended. Finally, there were no statistically significant associations between parents' and boys' ambulatory activity either on weekdays (p = 0.938) or at the weekend (p = 0.095). On the contrary, parents' PA explained 47% of girls' PA on weekdays (R = 0.68, F1,28 = 22.81, p < 0.001) and 23% at the weekend (R = 0.48, F1,28 = 6.40, p = 0.02) Conclusions: Boys appear to be more physically active than girls in Greece, whereas mothers and fathers present similar ambulatory activity. Moreover, parents' PA is related to that of their daughters and not to that of their sons. Taking into account that both girls and parents did not meet PA recommendations, family-based interventions are needed for both children and parents benefit.

Can Motor Proficiency in Preschool Age Affect Physical Activity in Adolescence?

BACKGROUND: This study investigated if motor proficiency (MP) in preschool age associate with physical activity (PA) in adolescence. METHODS: In 2004, the Bruininks-Oseretsky Test of Motor Proficiency-Short Form (BOTMP-SF) (7) was administered to 413 children, aged 4-6 years, who were classified to MP groups according to their BOTMP-SF total score (TS). In 2014, the PA of 106 former participants (47 boys, 59 girls) was measured with Omron pedometers. MP [three (high; above average; average)] × gender (two) ANOVA and Bonferroni tests were computed on average of steps/week. RESULTS: A significant interaction between the two factors was revealed (F = 15.27, p < .001, η2=.153), indicating that MP influenced male and female PA differently. Only in average MP group, males presented higher PA than females, whereas there were no differences between the two genders in the higher MP groups. Moreover, the only significant difference in PA among male groups was that between high and above average MP groups, while in females there were significant differences among all groups. CONCLUSION: High MP at preschool age positively associated with the PA in adolescence, especially in females. Emphasis on the development of proficient young movers might be beneficial for lifelong PA.

Construct and Concurrent Validity of the Democritos Movement Screening Tool for Preschoolers.

PURPOSE: To examine the construct and concurrent validity of the Democritos Movement Screening Tool for Preschool Children (DEMOST-PRE). METHODS: The DEMOST-PRE was administered to 435 Greek children, aged 48 to 71 months. Construct validity was investigated through correlations between total scores and individual item scores, and scores according to age and sex, whereas concurrent validity was checked by using the Bruininks-Oseretsky Test of Motor Proficiency-Long Form as the test-criterion on a subsample of 50 children. RESULTS: Moderate to strong, significant correlations (r = 0.390-0.831; P < .001) supported the internal consistency of the test. Age displayed a significant effect on children's scores, whereas sex did not. Furthermore, the intra-rater class coefficient calculated for concurrent validity was found to be 0.80. CONCLUSIONS: On the basis of the aforementioned findings, the DEMOST-PRE has adequate psychometric properties for the Greek sample analyzed.

ORGANIZED PHYSICAL ACTIVITY AND HEALTH IN PRESCHOOL AGE: A REVIEW.

AIM: The aim of this study was to investigate how organized Physical Activity (oPA) can contribute to the promotion of preschool aged children's health and specifically to health indicators such as adiposity, bone and skeletal health, cardiometabolic health, motor skill development, cognitive development, and psychosocial health. METHODS: A literature search of interventions aimed at improving health in preschool age was conducted in five electronic databases. Included in the review were only studies meeting the following criteria: published or accepted for publication studies; written in English; intervention with any type of oPA; 2-6 years old participants; pre- and post-objective assessments of the intervention effects; presence of a control group. RESULTS: The majority of studies that met the inclusion criteria (n = 13) considered the effect of oPA on children's motor development, while limited were those which examined the rest of the health indicators--adiposity (n = 4), bone and skeletal health (n = 2), cardiometabolic health (n = 0), cognitive development (n = 2), and psychosocial health (n = 4). CONCLUSIONS: The information about how oPA can influence preschoolers' health status, although promising in most cases, was deficient. Questions about the kind, intensity, amount or frequency of physical activity (PA) required so as children's health to be enhanced still remain. Further research into the relationship between oPA and health in preschool age is required in order to draw conclusions enabling the development of efficient PA programmes to promote children's health.

Pedometer determined physical activity and obesity prevalence of Greek children aged 4-6 years.

BACKGROUND: Pre-school age is important for developing healthy attitudes towards physical activity (PA). However, research on pre-schoolers' pedometer-determined PA is limited. AIM: To describe pre-schoolers' ambulatory activity; investigate step count differences in respect to Body Mass Index (BMI) categories and examine the prevalence of obesity. SUBJECTS AND METHODS: Pre-school aged children (n = 250; 5.5 ± 0.4 years) from Komotini (Greece) wore Omron HJ-720IT-E2 pedometers for 10 consecutive days. Height and weight were measured and BMI was calculated. RESULTS: Three-way repeated measures ANOVAs revealed that children performed more steps on weekdays than during weekends (p < 0.001) and during leisure time than school (p < 0.001). Significant differences appeared between normal and obese children's counts on weekdays (p < 0.001), weekend days (p < 0.05), during school (p < 0.001), after school (p < 0.005) and in weekly steps (p < 0.005). No gender differences were detected. Moreover, according to a sample t-test analysis, children's daily steps were significantly different from the 10,000 steps/day guideline, while obesity prevalence was 15.6%. CONCLUSION: School-based ambulatory activity is lower than after school ambulatory activity, independent of BMI-category and gender, although obese children demonstrated fewer steps. Taking into account the high rate of both the obesity prevalence and children not meeting the 10,000 steps/day guideline, the need for preventive policies becomes obvious.

The Democritos Movement Screening Tool for Preschool Children (DEMOST-PRE©): development and factorial validity.

The aim of this study was (a) to develop an assessment tool (the Democritos Movement Screening Tool for Preschool Children - DEMOST-PRE), designed to provide preschool educators, clinicians and researchers with information about assessment and screening of the motor proficiency of children aged 4-6 years, as well as the development and control of movement programmes and (b) to assess its factorial validity. First, tool's content and face validity were established and its final structure was determined. Then, the DEMOST-PRE was administered to 435 children (197 girls) aged 48-71 months (M=60.48 months, SD=6.98). The factor analysis conducted revealed two distinct components. Present evidence combined with the DEMOST-PRE administrative traits make it promising for preschool aged children's assessment.

The relationship between motor proficiency and pedometer-determined physical activity in young children.

UNLABELLED: The aim of this study was to examine the relationship between motor proficiency and pedometer-determined physical activity in 5-6 year-old children. Participants (n = 232) were randomly recruited and assessed from 30 kindergartens in Northern Greece. Two trained researchers administered the measurements for the assessment of children's motor proficiency by using the BOTMP-SF. Physical activity was assessed by OMRON pedometers. Significant relationships between BOTMP-SF standard score and steps (S), aerobic walking time (AWT) and aerobic steps (AS), (p < .05) were found. When motor proficiency was divided into quartiles to assess the distribution of the relationship between motor proficiency and pedometer-derived variables, significant associations were found for AWT, S and AS (p < .001). Young children with high levels of motor proficiency were more active in contrast to their peers with lower motor proficiency. The findings add to the growing body of literature that considers motor skills/abilities as important elements of physical activity participation. ( ABBREVIATIONS: S-steps per day; AS-aerobic steps per day; AWT-aerobic walking time (minutes·day(-1)); BOTMP-SF-Bruininks-Oseretsky Test of Motor Proficiency-Short Form (standard score)).

The validity of two Omron pedometers during treadmill walking is speed dependent.

The purpose of this study was to examine the effects of walking speed on the accuracy of measurement of steps, distance, and energy expenditure of two commercially available Omron pedometers [HJ-720IT-E2 (HJ-720) and HJ-113-E (HJ-113)]. Twenty-four untrained males (age, 22.7 ± 2.8 years; BMI, 24.38 ± 2.19 kg m(-2); body fat (%), 16 ± 2.2; VO(2max), 40.2 ± 6.5 ml kg(-1) min(-1)) and 18 females (age, 22.4 ± 2.9 years; BMI, 21.68 ± 2.43 kg m(-2); body fat (%), 23% ± 1.8; VO(2max), 35.9 ± 2.8 ml kg(-1) min(-1)) walked at five different velocities (54, 67, 80, 94 and 107 m min(-1)) on a treadmill in 5-min stages while wearing three types of pedometers: (a) HJ-720, (b) HJ-113, and (c) Yamax Digi-Walker SW-200 (YAM). Step-count for each pedometer was recorded at the end of each stage and compared with the value of a hand counter. Additionally, Omron pedometers were evaluated on their distance and energy expenditure (against VO(2) measurement with a gas-exchange analyzer) accuracy during each stage. HJ-720 and HJ-113 demonstrated high accuracy (r = 0.80-0.99) at all speeds. YAM underestimated step-count only at 54 m min(-1) (r = 0.46). HJ-720 and HJ-113 overestimated distance at slower speeds and underestimated distance at faster speeds, providing mean distance values that where to within 1.5-4% at 80 m min(-1). HJ-720 and HJ-113 underestimated energy expenditure (gross kilocalories) by 28%, when compared to indirect calorimetry. These results suggest that although the Omron HJ-720 and HJ-113 pedometers are accurate in the measurement of step-count, they demonstrate limited accuracy in the assessment of traveled distance and energy expenditure in a speed-dependent manner.