Effects of School-Based High-Intensity Interval Training on Hemodynamic Parameters and Heart Rate Variability: A Randomized Controlled Trial.

ABSTRACT: Ketelhut, S, Ketelhut, K, Ketelhut, SR, and Ketelhut, RG. Effects of school-based high-intensity interval training on hemodynamic parameters and heart rate variability: A randomized controlled trial. J Strength Cond Res 38(6): 1033-1040, 2024-The purpose of this study was to assess the effects of a child-specific school-based high-intensity interval training (HIIT) implemented into physical education (PE) classes on various hemodynamic parameters and heart rate variability indices. Forty-six students (age 11 ± 1 year) were randomized into an intervention (INT n = 22) and a control group (CON n = 24). During a 12-week period, the INT and CON groups participated in regular PE twice weekly (45-90 minutes). The INT group received HIIT during the first 20 minutes of the 2 PE classes. Systolic and diastolic blood pressure, total peripheral resistance, aortic pulse wave velocity (aPWV), heart rate, SD of normal to normal heartbeat intervals, the root mean square of successive differences between normal heartbeats (RMSSD), the proportion of differences between adjacent normal to normal heartbeat intervals of more than 50 ms, low-frequency power, high-frequency power, and the LF/HF ratio were assessed before and after the experimental period. A p value ≤0.05 was considered statistically significant. Forty students (20 INT; 20 CON) were included in the analysis. A significant time × group interaction was detected for aPWV ( p = 0.05, η2 = 0.099), RMSSD ( p = 0.010, η2 = 0.161), low-frequency power ( p = 0.009, η2 = 0.165), high-frequency power ( p < 0.001, η2 = 0.272), and the LF/HF ratio ( p < 0.001, η2 = 0.354). The INT group revealed significant improvements for the respective parameters. School-based HIIT can induce improvements in cardiovascular parameters. These results highlight the potential of embedding HIIT within the school setting, offering a time-efficient exercise intervention.

Evaluating Changes in Perceived Enjoyment throughout a 12-Week School-Based Exergaming Intervention.

This study assessed whether a high-intensity exergame represents an enjoyable training tool for children in the elementary school setting. Furthermore, it evaluated whether gender, body mass index (BMI), waist-to-height ratio (WHtR), fitness level, weekly physical activity level, and general interest in sports moderate perceived enjoyment during the 12-week intervention. Thirty fifth- and sixth-grade students (10.5 ± 0.7 years; 50% girls) participated in this study. During baseline assessments, anthropometric measurements and a shuttle run test were conducted. Throughout the intervention period, the students participated in 15−20-min exergaming sessions (ES) in the ExerCube twice a week during school hours. Enjoyment was assessed after an ES in weeks 2 and 12. Additionally, enjoyment was evaluated after a physical education (PE) class in week 2. The results reveal no significant changes in enjoyment (p = 0.164) over time. The modest changes over time were significantly affected by BMI (p = 0.027), WHtR (p = 0.007), and weekly activity level (p = 0.016). Compared to the PE class, enjoyment was significantly higher during the ES (p < 0.001). None of the covariates showed a significant effect. Mean HR during the ES reached 87.1 ± 1.9% of students' individual maximum HR. In conclusion, the ExerCube provides a promising tool for schools to promote enjoyable moderate-to-vigorous physical activity.

Integrating Regular Exergaming Sessions in the ExerCube into a School Setting Increases Physical Fitness in Elementary School Children: A Randomized Controlled Trial.

This study aimed to investigate the effects of a school-based exergame intervention on anthropometric parameters and physical fitness. Fifty-eight students (10.4 ± 0.8 years; 48% girls) were randomized into an intervention (IG) and a control (CG) group. Both groups participated in regular physical education classes during the three-month intervention period. The IG additionally received a 20-minute exergame intervention twice per week. At baseline and following the intervention period, body mass index (BMI) and waist-to-height ratio (WHtR) were assessed. Furthermore, a sprint test (ST), a countermovement jump test (CMJ), and a shuttle run test (SRT) were performed. Due to prescribed quarantine measures, only 34 students (18 IG; 16 CG) were included in the final analysis. A significant group−time interaction was determined in CMJ performance (p < 0.001; η2 = 0.403), with a significant increase (+2.6 ± 2.4 cm; p < 0.001; η2 = 0.315) in the IG and a significant decrease (−2.0 ± 3.1 cm; p = 0.009; η2 = 0.190) in the CG. Furthermore, ST performance significantly improved in the IG (−0.03 ± 0.08 s; p = 0.012; η2 = 0.180) but not in the CG (0.13 ± 0.16 s; p = 0.460; η2 = 0.017), revealing significant interaction effects (p = 0.02; η2 = 0.157). Significant group−time interaction was observed for the SRT (p = 0.046; η2 = 0.122), with a significant increase (+87.8 ± 98.9 m; p = 0.028; η2 = 0.147) in the IG and no changes (−29.4 ± 219.7 m; p = 0.485; η2 = 0.016) in the CG. Concerning BMI (p = 0.157; η2 = 0.063) and WHtR (p = 0.063; η2 = 0.114), no significant interaction effects were detected. School-based exergaming is a suitable tool to influence students' physical fitness positively.

Gaming Instead of Training? Exergaming Induces High-Intensity Exercise Stimulus and Reduces Cardiovascular Reactivity to Cold Pressor Test.

INTRODUCTION: The present study assessed if an exercise session in an innovative exergame can modulate hemodynamic reactivity to a cold pressor test (CPT) to a similar extent as a typical moderate endurance training (ET). Furthermore, cardiorespiratory, and affective responses of an exergame session and an ET were compared. METHODS: Twenty-seven healthy participants aged 25 ± 4 years (48% female; BMI 23.0 ± 2.1 kg/m2) participated in this cross-sectional study. All participants completed both an ET on a treadmill and training in the ExerCube (ECT). HR and oxygen consumption were recorded during both training sessions. Before and after both exercise sessions, the hemodynamic reactivity to a CPT was determined. RESULTS: During ECT, HR, oxygen consumption, energy expenditure, and the metabolic equivalent of the task were significantly higher than those obtained during ET (p < 0.001). With regard to the CPT, the participants showed significantly lower responses in peripheral systolic (p = 0.004) and diastolic blood pressure (p = 0.009) as well as central systolic (p = 0.002) and diastolic BP (P = 0.01) after ECT compared to ET. The same was true for pulse wave velocity (p = 0.039). CONCLUSION: The ECT induced a significantly higher exercise stimulus compared to the ET. At the same time, it attenuated hemodynamic stress reactivity. The ECT presents a relevant training stimulus that modulates cardiovascular reactivity to stress, which has been proven as a predictor for the development of hypertension. TRIAL REGISTRATION: ISRCTN registry, ISRCTN43067716, 14 April 2020, Trial number: 38154.

A Game-Based Approach to Lower Blood Pressure? Comparing Acute Hemodynamic Responses to Endurance Exercise and Exergaming: A Randomized Crossover Trial.

The present randomized crossover study aimed to determine whether an exergaming session in an innovative, functional fitness game could be an effective exercise approach that elicits favorable blood pressure (BP) responses, such as a typical moderate endurance exercise (ET). Therefore, acute hemodynamic responses after a training session in the ExerCube and an ET on a treadmill were assessed and compared. Twenty-eight healthy recreational active participants (13 women; aged 24.8 ± 3.9 years) completed an exergaming session (EX) and an ET in a randomized and counterbalanced order. Before and throughout the 45 min after the training, the peripheral and central BP were measured. After the ET, there was a moderate decrease in both peripheral systolic (-1.8 mmHg; p = 0.14) and diastolic (-0.8 mmHg; p = 0.003), as well as central diastolic (-1.5 mmHg; p = 0.006) pressure compared to the resting value before the exercise. After the EX, there was a significant decrease in peripheral systolic (-6.3 mmHg; p < 0.001) and diastolic (-4.8 mmHg; p < 0.001), as well as central systolic (-5.8 mmHg; p < 0.001) and diastolic (-5.3 mmHg; p < 0.001) pressure compared to baseline. The interaction effects showed significant differences in peripheral and central systolic BP as well as in peripheral diastolic BP (p = 0.05). The EX seems to be an effective training approach that triggers relevant peripheral and central BP-responses, which are more pronounced than after a typical ET. Therefore, the ExerCube can be a time-efficient training tool to improve cardiovascular health.

Acute Effects of Heart Rate-Controlled Exergaming on Vascular Function in Young Adults.

Objective: Acute and regular moderate-intensity endurance exercise (MIEE) is known to positively affect vascular function. The present study assessed if an exercise session in an innovative exergame called the ExerCube can induce similar vascular reactions as an MIEE session. Materials and Methods: Twenty-eight healthy recreationally active participants (13 females and 15 males; aged 24.8 ± 3.9 years; with body mass index 23.2 ± 2.3 kg/m2) completed an exergaming session (EGS) in the ExerCube (25 minutes) and an MIEE session on a treadmill (35 minutes, 65%-70% of maximal heart rate [HR]) in a randomized order. Both before and throughout the 45 minutes after the training sessions, pulse wave velocity (PWV), total peripheral resistance (TPR), stroke volume (SV), and HR were recorded. The study was approved by the Research Ethics Board of the Martin-Luther-Universität Halle-Wittenberg (Medical Faculty of the Martin-Luther-Universität 2019-177). Results: There were different hemodynamic responses to both types of exercises. PWV was significantly decreased 45 minutes after the EGS (P < 0.001). No significant changes were detected after MIEE (P = 0.109). TPR was significantly lower after both exercise sessions (P < 0.01). Only the EGS resulted in a significant decrease in SV 15 minutes after exercise (P < 0.001). The HR was significantly (P < 0.05) higher after both exercise sessions. After the EGS, the increase in HR was still significantly higher (P = 0.011) 45 minutes after the session. The interaction effects revealed significant differences in PWV (15 minutes, P = 0.035; 30 minutes, P = 0.004; and 45 minutes, P < 0.001), favoring the EGS. Conclusion: The EGS seems to induce a relevant exercise stimulus that can modulate vascular function. Therefore, this exergame may present an effective tool for prevention of cardiovascular diseases.

The New Way to Exercise? Evaluating an Innovative Heart-rate-controlled Exergame.

Exergames may offer novel opportunities to expand physical activity. Most games, however, only result in low to moderate-intensity activities that are too low to allow relevant physical adjustments. In the present study, the exercise intensity of a new, heart rate controlled, functional fitness game was assessed. 28 subjects (aged 24.8±3.8 yrs; 46% female; BMI 23.2±2.3 kg/m2) were enrolled in this study. VO2max and maximal heart rate (HRmax) were assessed during a maximal graded exercise test on a treadmill and compared with the oxygen consumption (VO2) and heart rate (HR) during a game in the ExerCube.In the ExerCube, the subjects reached a peak HR of 187.43±9.22 bpm, which corresponds to 96.57±3.64% of their HRmax. The mean HR throughout the game was 167.11±10.94 bpm, corresponding to 86.07±4.33% of HRmax. VO2peak reached 41.57±5.09 ml/kg/min during the game in the ExerCube, which corresponds to 84.75±7.52% of VO2max. The mean VO2 consumption during the game reached 32.39±4.04 ml/kg/min, which corresponds to 66.01±5.09% of VO2max. The ExerCube provides a form of vigorous physical exercise. Due to its playful, immersive, and motivating nature, the ExerCube seems to be a promising tool to facilitate physical activity.

Adaptive High-Intensity Exergaming: The More Enjoyable Alternative to Conventional Training Approaches Despite Working Harder.

Objective: The purpose of this study was to assess psychological and physiological responses to an exergaming session in the ExerCube (EX) and compare them with the responses of a moderate endurance run (ER). Materials and Methods: Twenty-eight healthy adults (13 women) aged 24.8 ± 3.8 years took part in this study. The first test day, participants performed a graded exercise test on a treadmill to determine maximal heart rate (HR) and lactate levels. The following test days 2 and 3, the participants completed an EX session and an ER on a treadmill in a randomized counterbalanced order. HR, rate of perceived exertion (RPE), and lactate levels were assessed during both sessions. After the sessions, the participants completed the "Physical Activity Enjoyment Scale" and the "Flow Short Scale." Results: The analysis of variance revealed that enjoyment (P = 0.036), flow (P = 0.042), RPE (P = 0.005), as well as mean and peak HR (P < 0.001) during the EX session were significantly higher compared with the ER. Gender did not affect the differences between the two conditions for mean HR (P = 0.61), maximal HR (P = 0.122), RPE (P = 0.862), flow (P = 0.376) nor enjoyment (P = 0.867). During the EX session, the lactate levels of all participants exceeded the individual lactate threshold (LT). During the ER, lactate values remained below the LT. Conclusion: The ExerCube presents both a physiological relevant exercise stimulus and a joyful gaming experience. Despite the higher exercise intensity achieved during the EX session, enjoyment was significantly higher compared with the ER. Therefore, the EX can be a promising and appealing tool to facilitate physical activity. Trial registration: ISRCTN registry, ISRCTN43067716, April 14, 2020. Trial number: 38154.

School-Based Exercise Intervention Improves Blood Pressure and Parameters of Arterial Stiffness in Children: A Randomized Controlled Trial.

PURPOSE: To evaluate the effectiveness of a school-based exercise intervention on endurance performance (EP), blood pressure (BP), and arterial stiffness in children. METHODS: A total of 105 students (mean age = 8.2 [0.6] y; 51% girls; body mass index = 17.8 [3.0] kg/m2) were randomized to the intervention group (IG, n = 51) and control group (CG, n = 54). During a 37-week experimental period, the IG received an exercise intervention (2 × 45 min/wk) in addition to their regular school physical education class (3 × 45 min/wk). EP, peripheral and central BP, pulse pressure, augmentation pressure, augmentation index, and aortic pulse wave velocity were assessed. RESULTS: Following the intervention, significant changes (P < .05) in EP, peripheral and central systolic BP, pulse pressure, augmentation pressure, augmentation index, and aortic pulse wave velocity were found in the IG. Children in the CG displayed significant changes in peripheral and central diastolic BP. An analysis of the baseline-to-post changes revealed significant between-group differences in EP (P < .001), pulse pressure (P = .028), augmentation pressure (P = .007), and aortic pulse wave velocity (P = .037) that favored the IG and in peripheral and central diastolic BP that favored the CG. CONCLUSION: The school-based exercise intervention had beneficial effects not only on EP but also on different hemodynamic parameters.

Effectiveness of Multi-activity, High-intensity Interval Training in School-aged Children.

The present study aimed to evaluate the effectiveness of a school-based multi-activity HIIT on aerobic fitness (AF) and hemodynamic parameters in children. 46 students were randomized into an intervention group (INT) (N=22) and a control group (CON) (N=24). Throughout a 3-month intervention period, both INT and CON participated in the regular physical education classes (PE) twice a week. Only INT received an instructed HIIT during the first 20 min of the PE. In addition to an AF-test, peripheral (pBP) and central (cBP) blood pressure, augmentation pressure (AP), and aortic pulse wave velocity (aPWV) were assessed. Significant differences in intervention effects in favor of INT were detected for AF (7.73, P=0.007), peripheral systolic BP (-6.13 mmHg, P=0.038), central systolic BP (-5.19 mmHg, P = 0.041), AP (-2.02 mmHg, P=0.013), and aPWV (-0.19 m/sec, P=0.031). The regular HITT intervention showed beneficial effects on AF, BP, and parameters of vascular stiffness already in children.

Effectiveness of a physical activity intervention in preschoolers: A cluster-randomized controlled trial.

Several activity interventions in preschool settings exist, but little attention has been paid to effects on hemodynamic factors. The study aimed to assess the effectiveness of an exercise program on health-related outcomes including blood pressure (BP) and markers of vascular function in preschoolers, with focus on socioeconomic background. This study is a cluster-randomized controlled trial, with preschool as unit of randomization and children as unit of analysis. Preschools with 3- to 6-year-old children, stratified by social area, were randomly allocated to: intervention (three clusters, n = 92) including 2 d·wk-1 /45 min (6 months) exercise lessons or control (two clusters, n = 43). In total, 135 children (4.8 ± 0.8 y) had minimum one outcome measurement at baseline and follow-up. Primary outcome: peripheral BP. Secondary outcomes: central BP, pulse wave velocity (PWV), BMI, waist circumference, physical activity measures, motor skills. Maternal education was used as an indicator of socioeconomic status. Mixed models were applied to evaluate differences in mean change. Group allocation had no effect on primary or secondary outcomes. However, the intervention was effective in reducing increases in peripheral systolic BP (-3.4 mm Hg; 95% CI: -6.6; -0.2; P = 0.037), central systolic BP (-3.8 mm Hg; -6.4; -1.1; P = 0.006), and PWV (-0.1 m/s; -0.2; -0.0; P = 0.045) among children whose mothers had the lowest educational level. We found no evidence for effectiveness of a 6-months preschool-based exercise program on hemodynamics, anthropometrics, activity, or motor skills, but lack of process evaluations and poor fidelity preclude interpretation of the causal relation. However, the results indicate that children from lower social backgrounds could benefit from early exercise-promoting interventions.

Positive Effects of Promoting Physical Activity and Balanced Diets in a Primary School Setting with a High Proportion of Migrant School Children.

Background Children with migration background are at particular risk for overweight. We assessed the effects of a primary school-based initiative targeted at enhancing physical activity and dietary education among children with a high proportion of migration background. Methods Four 3rd and 4th grade classes (n=70 children, 77% with migration background) participated in a 10-months intervention comprising 2 additional exercise lessons weekly and 10 nutrition lessons per school year. 6 school classes (n=125 children, 65% with migration background) served as control. Before and after the intervention, an assessment of physical fitness and motor skills and questionnaires on dietary behavior and knowledge were conducted. In a subgroup (n=37), after 6 months of the intervention, daily physical activity was assessed by accelerometer-based monitoring. Differences in changes between the groups were assessed using linear regression analyses. Results Changes between the 2 time points for fitness and motor skill tests (differences in standard deviation scores) were larger in the intervention than in the control group for the total mean test value (ß=0.38, p<0.001), driven by higher improvements in 5 of the 8 test items, i.e., obstacle race (speed) (ß=0.22, p=0.049), standing long jump (strength) (ß=0.35, p<0.001), sit-ups (strength) (ß=0.33, p=0.002), stand and reach (mobility) (ß=0.22, p=0.042), and 6 min run (endurance) (ß=0.40, p<0.001), independently of confounders. Changes in dietary knowledge and consumption frequencies did not differ between groups. Conclusions Promoting guided physical activity in a primary school setting with a high proportion of children with migration background positively affected parameters of fitness and motor skills.

[Concentration enhancement for retaining daily living competence in dementia]. / Konzentrationssteigerung zum Erhalt der Alltagskompetenz bei Demenz.

BACKGROUND: Dementia is characterized by reduced memory and concentration abilities leading to a decrease in activities of daily living. Various studies have shown that various forms of physical exercise have a positive therapeutic effect at an early stage of dementia. OBJECTIVE: In the present study the effects of an exercise-based Brain-Gym concept on the concentration and routine daily competences were evaluated in dementia patients. MATERIAL AND METHODS: During a 4-month intervention period specially trained nursing staff and healthcare students put this exercise program into practice. Using an intervention and control group design, the concentration abilities of the dementia patients were tested on a monthly base. Additionally, the routine daily competence of the patients was evaluated by the nursing staff. RESULTS: Even though no significant differences could be detected, the intervention group achieved higher scores in concentration abilities than the control group on all four testing dates. Furthermore, the routine daily competence was improved in the intervention group throughout the intervention period. CONCLUSION: This concept can be used for dementia patients. Due to the low requirements concerning coordination and condition Brain-Gym is suitable for the target group and can easily be implemented by caregivers; however, significant evidence of positive impacts on concentration and everyday life competence could not yet be found in this study.

Does physical education modify the body composition?--results of a longitudinal study of pre-school children.

The aim of the study is the analysis of body composition, motor development and cardiovascular parameters of preschool-children. In 2001/2002 a longitudinal study started in 17 nursery schools in Berlin. A total of 160 children out of the 264 children participated in a regular exercise programme. After 24 months of training significant differences of body composition, motor skills and cardiovascular parameters between 5 complete year old children of the intervention and the control group were observed. The results show that such an exercise programme is successful as a preventive measure to decrease the risk of obesity.

[Physical and motor development of children with different social origins]. / Körperliche und motorische Entwicklung von Kindern unterschiedlicher sozialer Herkunft.

The aim of the study is the analysis of body composition and motor development of 3 years old children due to their social status. In 2001/2002 a longitudinal study started in 17 nursery schools in Berlin. The results of the first investigation on 224 children are demonstrated here. There are no differences in body development and body composition in 3 years old children due to the social level in Germany, there are, however, differences in motor development due to the social level. Children with a low social level had lower outcomes in all motor skills.