Comparación de la efectividad entre distintas intervenciones en los síntomas posconmoción en adolescentes y jóvenes: una revisión bibliográfica / Comparison of effectiveness between different interventions in postconcussive symptoms in adolescents and young people: A literature review

Introducción: Actualmente la conmoción cerebral se considera un problema de gran magnitud, siendo los adolescentes y jóvenes la población de riesgo, ya que se encuentran en proceso de maduración. Nuestro objetivo ha sido comparar la eficacia de diferentes intervenciones (ejercicio físico terapéutico, terapia vestibular y descanso) en adolescentes y jóvenes con conmoción cerebral.Desarrollo: Se realizó una búsqueda bibliográfica en las principales bases de datos. Una vez aplicados los criterios de inclusión/exclusión y la escala metodológica Physiotherapy Evidence Database PEDro, fueron revisados seis artículos. Los resultados apoyan la utilización del ejercicio y la terapia vestibular en las etapas iniciales para disminuir los síntomas posconmoción. Según la mayoría de los autores, el ejercicio físico terapéutico y la terapia vestibular reportan mayores beneficios, aunque se necesitaría un protocolo que unificara escalas de valoración, variables de estudio y parámetros de análisis para poder realizar la inferencia en la población diana.Conclusión: Desde el momento del alta hospitalaria del paciente, la aplicación combinada de ejercicio físico y terapia vestibular, podría considerarse como la mejor opción para disminuir los síntomas posconmoción.(AU)

Introduction: Currently, concussion considers a problem of great magnitude, adolescents and young people being the population at risk, since it is in the process of maturation. Our goal has been to compare the effectiveness of different interventions (exercise therapy, vestibular rehabilitation and rest) in adolescents and young people with concussion. Development: A bibliographic search was carried out in the main databases. Once the inclusion / exclusion criteria and the PEDro methodological scale were applied, 6 articles were reviewed. The results support the use of exercise and vestibular rehabilitation in the initial stages to reduce post-concussion symptoms. According to most authors, therapeutic physical exercise and vestibular rehabilitation report greater benefits, although a protocol that unifies assessment scales, study variables and analysis parameters would be needed to be able to make the inference in the target population. Conclusión: From the moment of hospital discharge, the combined application of exercise and vestibular rehabilitation could be the best option to reduce post-concussion symptoms.(AU)

Square-stepping exercise in older inpatients in early geriatric rehabilitation. A randomized controlled pilot study.

BACKGROUND: Preservation of mobility and fall prevention have a high priority in geriatric rehabilitation. Square-Stepping Exercise (SSE) as an evaluated and standardized program has been proven to be an effective training for older people in the community setting to reduce falls and improve subjectively perceived health status. This randomized controlled trial (RCT), for the first time, examines SSE in the context of inpatient early geriatric rehabilitation compared to conventional physiotherapy (cPT). METHODS: Data were collected in a general hospital in the department of acute geriatric care at admission and discharge. Fifty-eight inpatients were randomized to control (CG, n = 29) or intervention groups (IG, n = 29). CG received usual care with cPT five days per week during their hospital stay. For the IG SSE replaced cPT for at least six sessions, alternating with cPT. Physical function was measured with the Short Physical Performance Battery (SPPB) and Timed "Up & Go" (TUG). Gait speed was measured over a distance of 10 m. In a subgroup (n = 17) spatiotemporal gait parameters were analyzed via a GAITRite® system. RESULTS: Both the SPPB total score improved significantly (p = < 0.001) from baseline to discharge in both groups, as did the TUG (p < 0.001). In the SPPB Chair Rise both groups improved with a significant group difference in favor of the IG (p = 0.031). For both groups gait characteristics improved: Gait speed (p = < 0.001), walk ratio (p = 0.011), step length (p = < 0.001), stride length (p = < 0.001) and double support (p = 0.009). For step length at maximum gait speed (p = 0.054) and stride length at maximum gait speed (p = 0.060) a trend in favor of the IG was visible. CONCLUSIONS: SSE in combination with a reduced number of sessions of cPT is as effective as cPT for inpatients in early geriatric rehabilitation to increase physical function and gait characteristics. In the Chair Rise test SSE appears to be superior. These results highlight that SSE is effective, and may serve as an additional component for cPT for older adults requiring geriatric acute care. TRIAL REGISTRATION: DRKS00026191.

Usability and preliminary effectiveness of an app-based physical activity and education program for people with hip or knee osteoarthritis - a pilot randomized controlled trial.

BACKGROUND: Hip and knee osteoarthritis (OA) are highly prevalent worldwide. The guidelines recommend physical activity and education as the core treatments for osteoarthritis. Digital health has the potential to engage people in physical activity and disease management. Therefore, we conducted a pilot trial to assess the usability and preliminary effectiveness of an app-based physical activity and education program (Join2Move) compared to usual care for people with hip and/or knee OA in Germany. METHODS: A randomized controlled pilot study was conducted. Individuals with diagnosed or self-reported knee and hip OA were included. Allocation to the intervention or control group was randomized. The intervention group received the Join2Move program. The Join2Move program was previously developed as a website and evaluated in the Netherlands. For the current study, the program was translated and adapted to the German context and adjusted from a website to an app. The control group received usual care. The primary outcomes were usability and preliminary effectiveness (pain and physical functioning). Measurements were taken at baseline and at twelve weeks. The data analysis was performed using SPSS (IBM SPSS Statistics 29.0). RESULTS: Sixty participants, with a mean age of 61.9 (SD ± 7.2) years, were allocated to the intervention (n = 32) or the control group (n = 28) and included in the analysis. The majority of participants had knee OA (68%), and 12% had hip and knee OA. The dropout rate was n = 11 (18%). No adverse events were reported. Usability was rated as acceptable (mean System Usability Scale = 71.3/100) with a wide range (32.5 to 100). Statistically significant between-group differences were found only for pain (mean difference 8.52 (95% CI 1.01 to 16.04), p = 0.027). CONCLUSIONS: Join2Move demonstrated acceptable usability. The preliminary results of the pilot trial indicate the potential of a stand-alone app for the treatment of patients with hip or knee OA. However, the acceptable usability of Join2Move limits its recommendation for everyone. There appears to be room for improvement in app usability and in identifying patients for whom the app is suitable and the right time to use a stand-alone app. TRIAL REGISTRATION: German Clinical Trials Register DRKS00027164 .

The longitudinal relationship between fear of movement and physical activity after cardiac hospitalization: A cross lagged panel model.

BACKGROUND: Little is known about the association between fear of movement (kinesiophobia) and objectively measured physical activity (PA), the first 12 weeks after cardiac hospitalization. PURPOSE: To assess the longitudinal association between kinesiophobia and objectively measured PA and to assess the factor structure of kinesiophobia. METHODS: We performed a longitudinal observational study. PA was continuously measured from hospital discharge to 12 weeks using the Personal Activity Monitor. The PAM measures time spent per day in PA-intensity categories: light, moderate and heavy. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK) at four time points (hospital discharge, 3, 6 and 12 weeks). The longitudinal association between PA-intensity and kinesiophobia was studied with a random intercept cross lagged panel model (RI-CLPM). A RI-CLPM estimates effects from kinesiophobia on objectively measured PA and vice versa (cross-over effects), and autoregressive effects (e.g. kinesiophobia from one occasion to the next). RESULTS: In total, 116 patients (83.6% male) with a median age of 65.5 were included in this study. On no occasion did we find an effect of kinesiophobia on PA and vice versa. Model fit for the original model was poor (X2: = 44.646 P<0.001). Best model fit was found for a model were kinesiophobia was modelled as a stable between factor (latent variable) and PA as autoregressive component (dynamic process) (X2 = 27.541 P<0.12). CONCLUSION: Kinesiophobia and objectively measured PA are not associated in the first 12 weeks after hospital discharge. This study shows that kinesiophobia remained relatively stable, 12 weeks after hospital discharge, despite fluctuations in light to moderate PA-intensity.

Obesity-Preventive Behaviors and Improvements in Depression among Diverse Utah Women Receiving Coaching from Community Health Workers.

OBJECTIVES: This study evaluated how high versus low-intensity community wellness coaching and health behaviors were associated with changes in depression screen results over one year. METHODS: This was an analysis of secondary data collected in a 12-month obesity-related community health worker (CHW) program for 485 Utah women of color. Depression screen (Patient Health Questionnaire-2 score ³3) and self-reported fruit/vegetable consumption and physical activity (FV/PA) were recorded quarterly. Associations between FV/PA and changes in depression screen over time were evaluated in multivariable models. RESULTS: Positive depression screen prevalence declined over 12 months (21.7% to 9.5%) with no difference between study arms. Overall, FV ³5 times/day (AOR=1.5; 95% CI 1.0-2.2), any PA (AOR=3.1; 95% CI 1.5-6.4), and muscle strengthening activities (AOR=1.13; 95% CI 1.01-1.26) were associated with improved depression screen results over time. CONCLUSION: These results indicate value in addressing and evaluating depression in obesity-related interventions in underserved communities.

The mediating effect of subject well-being between physical activity and the internet addiction of college students in China during the COVID-19 pandemic: a cross-sectional study.

Background: Internet addiction poses a significant threat to the health of college students worldwide, but physical activity, as a highly safe and effective rehabilitative measure, has shown promise for alleviating this issue nowadays. However, during the COVID-19 pandemic, the mediating processes in this association remained unclear. This study aims to explore the impact of physical activity on internet addiction among college students and the mediating role of subjective well-being. Methods: A survey was conducted on 216 eligible college students using the physical activity level scale, the internet addiction test, and the subjective well-being scale. For data analysis, independent sample t-tests, correlation analysis, hierarchical regression analysis, and mediating effect tests were in turn carried out in this work. Results: The study revealed noteworthy gender disparities in physical activity and internet addiction among college students (ß = -0.356, p < 0.01; ß = 0.140, p < 0.05). Compared to females, male students manifest elevated levels of physical activity and lower scores in internet addiction. Physical activity and subjective well-being exerted a significantly negative predictive influence on internet addiction (ß = -0.162, p < 0.05; ß = -0.508, p < 0.001). What's more, subjective well-being assumed a crucial mediating role in the relationship between physical activity and internet addiction, with the mediating effect accounting for 72.81% of the total effect. Conclusion: This study deepens the understanding of how physical activity reduces internet addiction risk while emphasizing that enhancing subjective well-being is an effective strategy for college students to cope with Internet addiction.

Development and validation of a smartwatch algorithm for differentiating physical activity intensity in health monitoring.

To develop and validate a machine learning based algorithm to estimate physical activity (PA) intensity using the smartwatch with the capacity to record PA and determine outdoor state. Two groups of participants, including 24 adults (13 males) and 18 children (9 boys), completed a sequential activity trial. During each trial, participants wore a smartwatch, and energy expenditure was measured using indirect calorimetry as gold standard. The support vector machine algorithm and the least squares regression model were applied for the metabolic equivalent (MET) estimation using raw data derived from the smartwatch. Exercise intensity was categorized based on MET values into sedentary activity (SED), light activity (LPA), moderate activity (MPA), and vigorous activity (VPA). The classification accuracy was evaluated using area under the ROC curve (AUC). The METs estimation accuracy were assessed via the mean absolute error (MAE), the correlation coefficient, Bland-Altman plots, and intraclass correlation (ICC). A total of 24 adults aged 21-34 years and 18 children aged 9-13 years participated in the study, yielding 1790 and 1246 data points for adults and children respectively for model building and validation. For adults, the AUC for classifying SED, MVPA, and VPA were 0.96, 0.88, and 0.86, respectively. The MAE between true METs and estimated METs was 0.75 METs. The correlation coefficient and ICC were 0.87 (p < 0.001) and 0.89, respectively. For children, comparable levels of accuracy were demonstrated, with the AUC for SED, MVPA, and VPA being 0.98, 0.89, and 0.85, respectively. The MAE between true METs and estimated METs was 0.80 METs. The correlation coefficient and ICC were 0.79 (p < 0.001) and 0.84, respectively. The developed model successfully estimated PA intensity with high accuracy in both adults and children. The application of this model enables independent investigation of PA intensity, facilitating research in health monitoring and potentially in areas such as myopia prevention and control.

Effects of Square Stepping Exercise on cognitive, physical, psychological, and group functioning in sedentary older adults: A center-based hybrid trial.

BACKGROUND: The Square Stepping Exercise (SSE) is an exercise training program that integrates physical exercise and cognitive elements and can be conducted in a group setting. The potential of SSE in delaying cognitive decline in older adults is promising. However, the coronavirus pandemic has made it more difficult for older adults worldwide to exercise together in person. To address this issue, this study conducted a wholistic evaluation of the effects of a center-based hybrid SSE trial on cognitive, physical, psychological, and group functioning in sedentary older adults. METHODS: A total of 93 older adults (19 men, 74 women) participated in the study. Fifty-eight participants (9 men, 49 women) completed center-based hybrid SSE sessions over 12 weeks under coronavirus pandemic circumstances, whereas other 35 participants in the control group maintained their current level of daily activities. Cognitive functions focused on executive functions assessed by the Stroop Color-Word Test (inhibition) and the Trail Marking Test (TMT) (set-shifting). Psychological and group functioning were assessed by the Subjective Vitality Scale and the Physical Activity Group Environment Questionnaire. Physical function was evaluated by measuring gait speeds. A repeated ANOVA was conducted on the measured variables separately for the intervention and control groups to focus on the change of participant's performance over data collection points. RESULTS: Outcomes of the Stroop Color-Word Test and the TMT revealed that the hybrid SSE was highly effective in improving executive function. Stroop performance (correct trials) was significantly improved in the incongruent condition, as well as both TMT-A and -B over the intervention period in the intervention group. The hybrid SSE was also beneficial to improve physical (gait speed at usual pace and at the maximum pace) as well as psychological functioning (subjective vitality). Furthermore, SSE participants reported increased engagement with the SSE task, social communication, and increased bonding and closeness with their group members through the hybrid SSE. CONCLUSIONS: In this study, hybrid SSE was found to be effective in enhancing cognitive, physical, psychological, and group functioning in sedentary older adults. The findings of this study are crucial to provide older adults with a safer and efficient option to exercise.

Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care.

BACKGROUND: Cardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme. METHODS: A random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein). RESULTS: Self-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables. CONCLUSIONS: Participation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01741428), 04/12/2012.

Association between movement behavior patterns and cardiovascular risk among Chinese adults aged 40-75: a sex-specific latent class analysis.

BACKGROUND: Cardiovascular disease (CVD) is a major global health threat, particularly in China, contributing to over 40% of deaths. While sleep behaviors, sedentary behaviors, and physical activities are recognized as independent lifestyle risk factors for CVD, there remains limited understanding of specific movement behavior patterns and their CVD risks, especially considering sex-specific differences. This study examines movement behavior patterns among Chinese adults (40-75) and their associations with cardiovascular risk, with a focus on sleep, physical activity (PA), and sedentary behavior (SB). METHODS: Data pertaining to 13,465 male participants and 15,613 female participants, collected from the Chronic Disease and Risk Factor Surveillance Survey in Nanjing from February 2020 to December 2022. The latent class analysis method was employed to identify underlying movement patterns across sexes. Multinomial logistic regression models assessed CVD risk, and the China-PAR model calculated 10-year risk. RESULTS: Three male and four female movement patterns emerged. Active Movers (17.10% males, 5.93% females) adhered to PA recommendations but had poorer sleep quality. Moderate Achievers (61.42% males, 45.32% females) demonstrated moderate behavior. Sedentary Sleepers (21.48% males, 10.20% females) exhibited minimal PA but good sleep. Female Moderate Physical Activity (MPA) Dominant Movers demonstrated a prevalent adherence to recommended MPA levels. Active movers had the lowest CVD risk. After adjusting for potential confounders, moderate achievers (OR = 1.462, 95% CI 1.212, 1.764) and sedentary sleepers (OR = 1.504, 95% CI 1.211, 1.868) were both identified as being associated with a high-risk of cardiovascular diseases (CVDs) compared to active movers in males, demonstrating a similar trend for intermediate risk. Such associations were not statistically significant among females. CONCLUSIONS: Our study revealed sex-specific movement patterns associated with CVD risks among middle-aged Chinese adults. We suggest that adopting an active movement behavior pattern, characterized by meeting or exceeding recommended levels of vigorous physical activity (VPA) and reducing sedentary behavior, is beneficial for all middle-aged adults, particularly males. An active lifestyle could help counteract the adverse effects of relatively poor sleep quality on the risk of developing CVD in this population. Integrating sleep, PA, and SB information provides a holistic framework for understanding and mitigating CVD risks.

The good, the bad and the ugly - a Swedish qualitative interview study about the landscape of meaning-imbued, exercise-related physical pain, as experienced by 'normal' gym-users.

BACKGROUND: The gym is a well-known place for health promoting or rehabilitating exercise whose availability to all is regarded significant for people's personal health work and the public's health. In this context, physical pain is usually discussed as something negative that people seek to dispose of. However, certain painful experiences appear to be an appreciated part of the gym experience. To investigate this seemingly contradictory landscape of meaning-imbued physical pain, the study aims to explore the different kinds of physical pain present at the gym and their significance for exercising, as experienced by 'normal' gym-users. METHODS: 24 semi-structured in-depth interviews with active, dedicated, reasonably healthy (= normal) adult gym-users have been analyzed using qualitative content analysis from a hermeneutical stance. RESULTS: Participants differentiate between three kinds of physical pain: the good pain of enhancement (often connected to muscle soreness and effort burn), the bad pain of impediment (primarily related to acute damage) and the composite, neutral pain of acceptance (potentially linked to all pains). CONCLUSION: When pursuing the goal of personal health development, normal gym-users argue that exercising at the gym means to expose yourself to pain and to do so willingly, even longingly. Refusing to share this understanding may diminish people's chances to occupy the gym space and, hence, reduce their chances to promote their health.

[Emotional and physical aftereffects of cancer Utility and impact of a rehabilitation program]. / Séquelles émotionnelles et physiques du cancer. Utilité et impact d'un programme de réadaptation.

An increasing number of people are surviving cancer in Switzerland : 163,450 people were still alive in 2006 after a cancer diagnosis less than ten years prior, compared to 210,350 in 2016. However, most have to cope with debilitating emotional and physical aftereffects. A new 12-week rehabilitation program aims to restore patients' abilities. It consists of group-led therapies: adapted physical activity, psycho-oncology, dietetics, management of cognitive disorders, and integrative medicine. The first 116 patients who benefited from the program reported a general reduction in symptoms at the end of the program, an improvement that lasts even after 9 months, although fatigue and mood become concerning again. Some express a desire for post-rehabilitation follow-up.

De plus en plus de personnes survivent au cancer en Suisse : 163 450 personnes étaient encore en vie après un diagnostic de cancer remontant à moins de dix ans en 2006, contre 210 350 en 2016. La plupart doivent toutefois faire face à des séquelles émotionnelles et physiques invalidantes. Un nouveau programme de réadaptation de 12 semaines vise à restaurer les capacités des patients. Il est composé de thérapies menées en groupe : activité physique adaptée, psycho-oncologie, diététique, gestion des troubles cognitifs et médecine intégrative. Les 116 premiers patients bénéficiaires expriment une diminution générale des symptômes à l'issue du programme, une amélioration qui perdure après 9 mois, même si la fatigue et le moral redeviennent préoccupants. Certains expriment le souhait d'un suivi post-réadaptation.

Archetype analysis and the PHATE algorithm as methods to describe and visualize pregnant women's levels of physical activity knowledge.

The knowledge of physical activity (PA) recommended for pregnant women and practical application of it has positive impact on the outcome. Nevertheless, it is estimated that in high-income countries over 40% of pregnant women are insufficiently physically active. One of the reasons is insufficient knowledge pregnant women have about allowed effort during pregnancy and both recommended and not recommended physical activities. Description of knowledge about physical activity the women have and distinguishing patterns of their knowledge is becoming an increasingly important issue. A common approach to handle survey data that reflect knowledge involves clustering methods or Principal Component Analysis (PCA). Nevertheless, new procedures of data analysis are still being sought. Using survey data collected by the Institute of Mother and Child Archetypal analysis has been applied to detect levels of knowledge reflected by answers given in a questionnaire and to derive patterns of knowledge contained in the data. Next, PHATE (Potential of Heat-diffusion for Affinity-based Trajectory Embedding) algorithm has been used to visualize the results and to get a deeper insight into the data structure. The results were compared with picture derived from PCA. Three archetypes representing three patterns of knowledge have been distinguished and described. The presentation of complex data in a low dimension was obtained with help of PHATE. The formations revealed by PHATE have been successfully described in terms of knowledge levels reflected by the survey. Finally, comparison of PHATE with PCA has been shown. Archetype analysis combined with PHATE provides novel opportunities in examining nonlinear structure of survey data and allows for visualization that captures complex relations in the data. PHATE has made it possible to distinguish sets of objects that have common features but were captured neither by Archetypal analysis nor PCA. Moreover, for our data, PHATE provides an image of data structure which is more detailed than interpretation of PCA.

Bone health and physical activity in adolescents with juvenile idiopathic arthritis: a cross-sectional case-control study.

BACKGROUND: Adolescents with juvenile idiopathic arthritis (JIA) tend to engage in less physical activity than their typically developing peers. Physical activity is essential for bone development and reduced physical activity may detrimentally effect bone health. Thus, we examined differences in total body bone mineral content (BMC) and areal bone mineral density (aBMD) between adolescents with JIA and adolescent controls without JIA. We also examined associations between moderate-to-vigorous physical activity (MVPA), lean mass, and bone outcomes. METHODS: Participants included 21 adolescents with JIA (14 females, 7 males) and 21 sex- and age-matched controls aged 10-20 years. Assessments included: height; weight; triple-single-leg-hop distance (TSLH); MVPA by accelerometry; and total body BMC, aBMD, and lean mass measured using dual X-ray absorptiometry. Height-adjusted z-scores were calculated for BMC and aBMD and used for all analyses. Multiple linear mixed effects models examined group differences in BMC and aBMD, adjusting for sex, maturity, MVPA, TSLH, and lean mass. Participants clusters, based on sex and age (within 18 months), were considered random effects. RESULTS: Adolescents with JIA had lower total body aBMD z-scores [ß (95% CI); -0.58 (-1.10 to -0.07), p = 0.03] and BMC z-scores [-0.47 (-0.91 to -0.03), p = 0.04] compared with controls. Mean daily MVPA was 22.0 min/day lower in adolescents with JIA than controls; however, MVPA was not associated with aBMD [-0.01 (-0.01 to 0.01), p = 0.32] or BMC [0.00 (-0.01 to 0.00), p = 0.39]. Lean mass was positively associated with aBMD [0.05 (0.01 to 0.09) g/cm2, p = 0.03] and BMC [0.06 (0.03 to 0.10) g, p < 0.001]. CONCLUSION: Adolescents with JIA had lower total body aBMD and BMC compared with sex- and age-matched controls without JIA. Group differences in bone outcomes were not associated with the lower MVPA participation of adolescents with JIA. Despite this, physical activity should still be encouraged as it promotes physical well-being.

Comparison of enjoyment and energy expenditure of exergame with and without blood flow restriction in men and women.

This study compared the effects of blood flow restriction (BFR) on intensity and perceived enjoyment during an exergame. Fourteen healthy young participants engaged in a boxing exergame for 20 min, with or without BFR, across two sessions. Perceived enjoyment levels were assessed using the Physical Activity Enjoyment Scale. Heart rate was monitored, and energy expenditure (EE) during exercise was calculated. A mixed model analysis of variance with repeated measures was used to evaluate differences in EE and enjoyment between exergame conditions (with and without BFR) as well as the interaction effects of these protocols with gender. Although not statistically significant, perceived enjoyment decreased with BFR inclusion for both genders. No significant differences were observed between men and women for both protocols. Regarding EE, there was no significant difference between the two groups (with and without BFR). However, a significant main effect of gender was found, with men exhibiting higher EE values in both protocols compared to women. In conclusion, exergames incorporating BFR impact perceptual responses, particularly perceived enjoyment. Furthermore, significant gender differences in EE were found, with men displaying higher values.

'We get to learn as we move': effects and feasibility of lesson-integrated physical activity in a Swedish primary school.

BACKGROUND: Physical activity (PA) promotes health in adults as well as children. At the same time, a large proportion of children do not meet the recommendations for PA, and more school-based efforts to increase PA are needed. This study investigates the effectiveness and feasibility of lesson-integrated PA in a Swedish primary school. METHODS: We evaluate a new method called 'Physical Activity and Lesson in Combination' (abbreviated FALK in Swedish) using a mixed methods approach; a quasi-experimental study followed by qualitative interviews. Two schools participated in the study, one constituting the intervention group (I-school, n = 83) and the other the control group (C-school, n = 81). In addition to regular physical education, the I-school had three 30-minute FALK lessons each week. A total of 164 students aged 7-9 years wore pedometers for a whole week, four times over two semesters, and the number of steps per day (SPD) and the proportion of students with < 10,000 SPD were compared. Statistical differences between the schools were tested with ANOVA, Chi2, t-tests, and ANCOVA. Interviews with students (n = 17), parents (n = 9) and teachers (n = 9) were conducted and analysed using qualitative content analysis. RESULTS: The results show that FALK led to the I-school getting more SPD and fewer students with < 10,000 SPD. Also, FALK was experienced as a positive, clear, and flexible method, simultaneously encouraging PA and learning. Challenges experienced concerned the teachers' work situation, time, finding suitable learning activities, outdoor school environment changes, and extreme weather conditions. CONCLUSIONS: This study indicates that FALK has the desired effects on PA and is a feasible method of integrating PA into theoretical teaching. We conclude that FALK is worth testing at more schools, given that implementation and sustainment of FALK considers both general enablers and barriers, as well as context-specific factors at the individual school.

Association between body mass index and tic disorders in school-age children.

OBJECTIVE: To explore the relationship between body mass index (BMI ) and the severity of tic disorders (TDs) in children 6-14 years old. METHODS: A total of 86 children diagnosed with TDs in a hospital between Jan. 2023 and Sept. 2023 were collected by convenient sampling method, and the general data and TD-specific data were collected and analyzed. RESULTS: Univariate analysis showed that patients with different Yale Global Tic Severity Scale (YGTSS) grades had statistically significant differences in age, BMI, residence, snacking pattern, weekly physical exercise frequency, weekly physical exercise time, and proportion of cesarean birth. Multiple linear regression analysis showed that the YGTSS score grades were related to BMI, snacking pattern, and cesarean birth of the patients. Correlation analysis revealed a positive correlation between BMI grades and the YGTSS score grades, with a higher BMI indicating more severe TDs. Predictive value evaluation showed that BMI, snacking pattern, and cesarean birth had predictive values for TD severity, and the highest value was found in the combined prediction. CONCLUSION: BMI, snacking pattern, and cesarean birth are of predictive values for the severity of TDs. In addition, BMI is positively correlated with the severity of TDs, and a higher BMI suggests more severe TDs.

Diet and lifestyle behaviours simultaneously act on frailty: it is time to move the threshold of frailty prevention and control forward.

BACKGROUND: To analyse the association among the simultaneous effects of dietary intake, daily life behavioural factors, and frailty outcomes in older Chinese women, we predicted the probability of maintaining physical robustness under a combination of different variables. METHODS: The Fried frailty criterion was used to determine the three groups of "frailty", "pre-frailty", and "robust", and a national epidemiological survey was performed. The three-classification decision tree model was fitted, and the comprehensive performance of the model was evaluated to predict the probability of occurrence of different outcomes. RESULTS: Among the 1,044 participants, 15.9% were frailty and 50.29% were pre-frailty; the overall prevalence first increased and then decreased with age, reaching a peak at 70-74 years of age. Through univariate analysis, filtering, and embedded screening, eight significant variables were identified: staple food, spices, exercise (frequency, intensity, and time), work frequency, self-feeling, and family emotions. In the three-classification decision tree, the values of each evaluation index of Model 3 were relatively average; the accuracy, recall, specificity, precision, and F1 score range were between 75% and 84%, and the AUC was also greater than 0.800, indicating excellent performance and the best interpretability of the results. Model 3 takes exercise time as the root node and contains 6 variables and 10 types, suggesting the impact of the comprehensive effect of these variables on robust and non-robust populations (the predicted probability range is 6.67-93.33%). CONCLUSION: The combined effect of these factors (no exercise or less than 0.5 h of exercise per day, occasional exercise, exercise at low intensity, feeling more tired at work, and eating too many staple foods (> 450 g per day) are more detrimental to maintaining robustness.

Feasibility and preliminary effects of a mindfulness-based physical exercise (MBPE) program for community-dwelling older people with sarcopenia: A protocol for a parallel, two-armed pilot randomised controlled trial.

INTRODUCTION: Physical exercise (PE) is essential for alleviating the symptoms of sarcopenia. Low motivation is a major barrier to PE. Mindfulness-based intervention (MBI) has the potential to improve motivation. However, few studies have used a mindfulness-based PE (MBPE) intervention among older people with sarcopenia. OBJECTIVES: To assess the feasibility, acceptability and preliminary effects of the MBPE program among community-dwelling older people with sarcopenia. METHODS AND ANALYSIS: A two-arm pilot randomised controlled trial will be conducted to assess the feasibility, acceptability and preliminary effects of an MBPE program among community-dwelling older people with sarcopenia. A total of 60 participants will be randomised into the intervention group, receiving the MBPE intervention twice a week over 12 weeks, or the control group, receiving health education with the same duration, number of sessions and frequency as the intervention group. Each session of the MBPE program will last about 60 min, including 5-10- min introduction, 20-min MBI, 30-min PE and 5-10-min sharing and discussion. The primary outcomes will be the feasibility (i.e., the time spent recruiting participants, the eligibility rate and the recruitment rate) and acceptability (i.e., the attendance rate, completion rate and attrition rate) of the MBPE program. The secondary outcomes will be the preliminary effects of the MBPE program on symptoms of sarcopenia, motivation for PE, psychological well-being, mindfulness level, physical activity level and quality of life. Individual interviews will be conducted to identify the strengths, limitations and therapeutic components of the intervention. The quantitative data will be analysed by generalised estimating equations. The qualitative data will be analysed by Braun and Clarke's thematic approach. CONCLUSION: The findings of this study will be able to provide evidence for the health professionals in adopting MBPE as a supportive intervention for the older adults with sarcopenia and the groundworks for the researchers in developing non-pharmacological intervention for older adults. The positive effects could facilitate healthy ageing and relief the burden of the medical system, especially in the countries facing the ageing population. TRIAL REGISTRATION NUMBER: NCT05982067; ClinicalTrials.gov.

Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents.

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.