A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools.

BACKGROUND: In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS: PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS: Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS: Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

The Development and Efficacy of a High School Athlete Education Program for Safe Nutritional Supplement Use.

Many high school athletes report using nutritional supplements. Due to a lack of education at the high school level, the use of safe for sports third-party tested nutritional supplements may be limited. To determine the impact of a short online nutritional supplement education program on safe dietary supplement behavior a cross-sectional repeated measures design was used. Therefore, a convenience sample of 106 high school athletes (14-19 years old) was recruited to measure pre-post education difference for nutritional supplement use and third-party tested (TPT) supplements. Additionally, it was analyzed if nutritional supplement related Theory of Planned Behavior (TPB) constructs were associated with athlete choices. The most popular supplements included protein powder (65%), caffeine from beverages (45%), and different types of vitamins (ranging from 38-44%). Consistent use of (safe) third-party tested individual supplements was low, ranging from 35-77% for the most frequently reported supplements. The combined TPB determinants explained 26% of the variance of the intention to use safe supplements (F3, 102 = 13.03, p < 0.001, Adj R2 = 0.26). The self-reported intention to use third-party tested supplements increased significantly (+7%-36% per individual supplement) after following the education program (Z = -3.288, p = 0.001) resulting in an intentional use of 54-94% TPT supplements. In conclusion, education resulted in more high school athletes reporting future third-party tested supplements use, and TPB construct scores did not change over time but could explain a substantial part of the variance of safe supplement use intentions.

System for Observing Play and Leisure Activity in Youth: A Systematic Review of US and Canadian Studies.

BACKGROUND: The System of Observing Play and Leisure Activity in Youth (SOPLAY) has assisted in providing valid and reliable data of youth physical activity and characteristics specific to environmental contexts. The review aimed to examine empirical research that employed the SOPLAY instrument to measure physical activity in leisure-based activity environments in North American countries. METHODS: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A systematic search was conducted with an exhaustive process using 10 electronic databases to locate peer-reviewed studies implementing SOPLAY that were published between 2000 and 2021. RESULTS: A total of 60 studies were included in the review. Most studies (n = 35) reported physical activity findings related to contextual characteristics measured using SOPLAY. Interestingly, a few of the studies (n = 8) found the provision of equipment and supervision, particularly adult supervision, significantly increased child physical activity observed. CONCLUSIONS: This review provides information relative to the group-level physical activity observed across multiple contexts (ie, playgrounds, parks, recreation centers) using a validated direct observation instrument.

The Relationship Between Policy Strength and Physical Activity Practices in Arizona Public Elementary Schools.

BACKGROUND: Many school-based physical activity statutes and regulations have been enacted, with the expectation that schools will comply. However, policy alone does not equate to implementation, and many policies fail for a variety of reasons. The purpose of the study was to determine whether the strength of reported state, district, and school-level physical activity policies were associated with reported recess, physical education, and other school-based physical activity practices at elementary schools in Arizona. METHODS: A modified Comprehensive School Physical Activity Program (CSPAP) Questionnaire was administered to staff at elementary schools across Arizona (N = 171). Summative indices of the number of school physical activity policies and best practices at the state, district, and school levels were created. Relationships between policy strength and best practices were examined using linear regression analyses stratified by recess, physical education, and other school-based physical activity practices. RESULTS: Stronger physical activity-related policies were associated with a greater number of recess (F1,142 = 9.87, P < .05), physical education (F4,148 = 4.58, P < .05, Adj. R2 = .09), and other school-based physical activity (F4,148 = 4.04, P < .05, Adj. R2 = .07) best practices at all levels while controlling for school-level demographic factors. CONCLUSIONS: The strength of policies may improve opportunities for comprehensive physical activity for children in schools. Strengthening policy language (eg, specifying duration and frequency) may contribute to better physical activity practices in schools, improving children's health at the population level.

Executive Function Improves Following Acute Exercise in Adults with Down Syndrome.

The influence of exercise on brain function is an important topic, especially in persons with intellectual deficits. The aim of this study is to determine the effect of an acute bout of resistance training (RT) compared to assisted cycle therapy (ACT) and no training (NT) in adults with DS on cognitive function. Fourteen participants attended four sessions: a baseline assessment, an assisted cycling therapy (ACT) session, a resistance training (RT) session, and a session of no training (NT). In the RT session, the leg press, chest press, seated row, leg curl, shoulder press, and latissimus pulldown were performed. The ACT session consisted of 30 min of cycling and in NT session consisted of 20 min of board games. Inhibition was measured by the Erikson flanker task and cognitive planning was measured by the Tower of London test and both were administered prior to (pretest) and after each intervention (posttest). Our results showed that inhibition time improved more following RT and ACT than NT. There was also a significant difference between ACT and NT. For cognitive planning, improvements were seen following ACT and NT. In conclusion, an acute session of ACT demonstrated a significant trend towards improvements in executive functions in adults with DS which we interpreted using a model of neural changes and the cognitive stimulation hypothesis.

Trends in physical activity, health-related fitness, and gross motor skills in children during a two-year comprehensive school physical activity program.

OBJECTIVES: The purpose of this study was to examine the trends in school-day step counts, health-related fitness, and gross motor skills during a two-year Comprehensive School Physical Activity Program (CSPAP) in children. DESIGN: Longitudinal trend analysis. METHODS: Participants were a sample of children (N=240; mean age=7.9±1.2 years; 125 girls, 115 boys) enrolled in five low-income schools. Outcome variables consisted of school day step counts, Body Mass Index (BMI), estimated VO2 Peak, and gross motor skill scores assessed using the Test of Gross Motor Development-3rd Edition (TGMD-3). Measures were collected over a two-year CSPAP including a baseline and several follow-up time-points. Multi-level mixed effects models were employed to examine time trends on each continuous outcome variable. Markov-chain transition models were employed to examine time trends for derived binary variables for school day steps, BMI, and estimated VO2 Peak. RESULTS: There were statistically significant time coefficients for estimated VO2 Peak (b=1.10mL/kg/min, 95% C.I. [0.35mL/kg/min-2.53mL/kg/min], p=0.009) and TGMD-3 scores (b=7.8, 95% C.I. [6.2-9.3], p<0.001). There were no significant changes over time for school-day step counts or BMI. Boys had greater change in odds of achieving a step count associating with 30min of school day MVPA (OR=1.25, 95% C.I. [1.02-1.48], p=0.044). CONCLUSIONS: A two-year CSPAP related to increases in cardio-respiratory endurance and TGMD-3 scores. School day steps and BMI were primarily stable across the two-year intervention.

Perioperative and long-term complications among obese women undergoing vaginal surgery.

OBJECTIVE: To determine whether obesity influenced the risk of perioperative and long-term complications in patients undergoing vaginal surgery. METHODS: Women diagnosed with pelvic organ prolapse who underwent vaginal surgery between March 1999 and May 2007 were classified into 3 groups: normal weight (body mass index [BMI, calculated as weight in kilograms divided by the square of height in meters] 18.5-23.0); overweight (BMI 23.0-27.5); and obese (BMI >or=27.5). Complications were subdivided into perioperative (<1 month) and long-term (>or=1 month). Statistical analysis was performed using analysis of variance, chi(2) test, and logistic regression. RESULTS: Demographic information showed no differences among the groups, except for the presence of comorbidity (P=0.03). Blood loss and transfusion as a perioperative complication and urinary retention as a long-term complication were significantly different among the groups: odds ratio (OR) 2.46 (95% confidence interval [CI], 1.38-4.39; P<0.01); and OR 2.20 (95% CI, 1.21-4.03; P=0.03), respectively. CONCLUSION: Major complications were rare, and most were not significantly different among the groups. However, obesity was a protective factor against blood loss and transfusion, and long-term urinary retention.