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Time Reallocations From Sedentary Behavior to Physical Activity and Cardiovascular Risk Factors in Children and Adolescents: A Systematic Review

Leonardo Alex Volpato, Julio Cesar Costa, Wendell Arthur Lopes, Jeffer Eidi Sasaki, Catiana Leila Possamai Romanzini, Enio Ricardo Vaz Ronque, and Marcelo Romanzini

Background: Recent statistical approaches have allowed consideration of the integrated relationships between sedentary behavior (SB) and physical activity (PA) with different health outcomes. The present paper aimed to systematically review the literature and synthesize evidence about associations between hypothetical reallocations from SB to different PA intensities and cardiovascular risk factors in youth. Methods: A systematic search of 8 databases was performed. Observational studies with a population of children and/or adolescents and based on statistical analysis that investigated the associations between time reallocations from SB to PA and cardiovascular risk factors were included. Results: Twenty-eight studies met the inclusion criteria. Level of evidence (derived from cross-sectional studies) indicated that the reallocation from SB to moderate to vigorous PA was beneficially associated with adiposity, cardiorespiratory fitness, and cardiometabolic biomarkers in youth. Reallocation from SB to light PA was not associated with the analyzed outcomes. Associations derived from longitudinal studies were mostly inconclusive. Conclusion: Cardiovascular risk factors could be improved by increasing moderate to vigorous PA at the expense of time spent in SB in pediatric populations. Prospective studies or studies investigating the effects of reallocating sedentary bouts to PA are needed.

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Volume 20 (2023): Issue 9 (Sep 2023): Special Issue: Life Course Epidemiology Applied to Physical Activity Research

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The Effect of a Physical Activity Intervention on Burden and Depressive Symptoms in Depressed Family Caregivers of Patients With Schizophrenia: A Randomized Controlled Trial

Kerime Bademli, Neslihan Lök, and Sefa Lök

Background: The study aimed to investigate the efficacy of a 12-week physical activity intervention for caregivers of patients with schizophrenia. Method: Family caregivers of patients with schizophrenia were recruited and randomized into either a physical activity group (n = 31) or a control group (n = 31). The 12-week “Physical Activity Program” consisted of 10 minutes of warm-up activities as the initial segment, 20 minutes of rhythmic exercises as the activity segment, 10 minutes of cool-down exercises as the final segment, and 40 minutes of free walking. The physical activity program was designed to accommodate the ergonomics and physiological structure of the caregiver. The program consisted of 12 sessions. The Zarit Caregiver Burden Scale and the Beck Depression Inventory were used to the physical activity and control groups before the program’s implementation. Results: A total of 62 caregivers were randomized to the intervention (n = 31) or control group (n = 31). Postintervention measurement was completed by 61 caregivers, and all the caregivers completed the intervention. Mean scores of Zarit Caregiver Burden Scale score and Beck Depression Inventory score in the physical activity group of caregivers at postintervention, significantly reduced at <.05 level than their mean baseline scores. Conclusions: Engagement in a 12-week physical activity intervention can improve the perceived burden of caregiving and symptoms of depression. Future research should examine with larger sample groups, carry out interventions, and apply the physical activity intervention by targeting caregivers, along with different interventions.

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Effect of Gender and Celebrity Status of Models in Printed Advertisements Promoting Physical Activity

Ho Keat Leng, Denise Yap, Lishanth Thangavelu, and Yi Xian Philip Phua

Public health organizations have embarked on various campaigns to increase the level of physical activity in the population. The aim of this study is to examine whether printed advertisements promoting physical activity can be made more effective by manipulating the model used in advertisements. Two experiments were conducted. The aim of the first experiment was to examine whether the gender of the model affects the effectiveness of the advertisement. Seventy-five respondents were randomly split into a control group featuring no model, experimental group 1 featuring a female model, and experimental group 2 featuring a male model. The study found that while respondents spend more time looking at advertisements with models, male respondents in the male model group reported an intent to participate in higher levels of physical activity compared with the other 2 groups. The aim of the second experiment was to examine whether the celebrity status of the model affects the effectiveness of the advertisement. Fifty-nine respondents were randomly split either into a group featuring a sports celebrity or an unknown athlete. The results show that while the sports celebrity was more attractive, it was respondents in the noncelebrity group that reported an intent to participate in higher levels of physical activity. The findings from this study suggest that noncelebrity male models in printed advertisements promoting physical activity are more effective.

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Efficacy of Yoga for COVID-19 Stress Prophylaxis

Sudeep Mitra, Mousumi Mitra, Purna Nandi, Madhumita Pandey, Mousumi Chakrabarty, Mantu Saha, and Dilip Kumar Nandi

Background: The global COVID-19 lockdown restricted daily routines due to the psychological fear of infection, which imposed an unknown universal threat on female college students, affecting physiological health and well-being. However, scant information concerning the efficacy of yogic practice on female college students during the stressful COVID-19 pandemic situation is available. Methods: In a randomized controlled trial (n = 74, age = 21.65 [4.05] y), a study was conducted with a well-conceptualized yogic module for 5 days/week for 3 months (40 min daily in the morning) among yogic volunteers. Pre–post analysis of anthropometric, physiological, and biochemical indices in pandemic-stressed female college students was done for the control and yoga groups. Results: After 3 months of yogic practice, significant reduction (P < .05) in heart rate (d = 0.64, meandiff = 5.43), systolic blood pressure (d = 0.59, meandiff = 5.32), cortisol (d = 0.59, meandiff = 6.354), and triglycerides (P < .01, d = 0.45, meandiff = 13.95) was observed. After yogic follow-up significant improvement (P < .01) in high-frequency (d = 0.56, meandiff = −7.3), total power (d = 0.46, meandiff = −1150) and time domain parameters of heart rate variability led to ameliorate the stress index. Superoxide dismutase (P < .01, d = 0.78, meandiff = 0.69), catalase (P < .05, d = 0.48, meandiff = −7.37), glutathione (P < .001, d = 0.83, meandiff = −4.15), high-density lipoprotein (P < .05, d = 0.48, meandiff = −11.07), and dopamine (P < .001, d = 0.97, meandiff = −135.4) values along with inflammatory markers (P < .001) significantly improved among yogic volunteers after regular practice. Conclusions: Our findings suggest that a 3-month well-conceptualized yogic intervention during COVID-19 may be considered as a prophylactic tool to improve female college students’ universal psychophysiological health by ameliorating autonomic functions, cardiometabolic risk factors, and immune metabolisms in an economical and environment-friendly manner.

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Effects of a School-Based Physical Activity Intervention on Adolescents’ Mental Health: A Cluster Randomized Controlled Trial

Kazi Rumana Ahmed, Sharon Horwood, and Asaduzzaman Khan

Background: The aim of this study was to evaluate the effectiveness of a school-based multicomponent physical activity intervention on mental health of adolescents. Methods: A clustered, randomized, controlled trial was employed in 8 high schools in Dhaka, Bangladesh, which were randomly assigned to either an intervention or control group; 40 students in grades 8 and 9 from each school took part in the trial (n = 160/group). Students in the intervention schools participated in a 12-week physical activity intervention with multiple components (eg, supervised circuits, lunchtime sports, health education, infographics), while control schools received no intervention. Participants completed baseline and postintervention surveys measuring depressive symptoms (Center for Epidemiologic Studies Depression Scale) and life satisfaction (Cantril Ladder), along with other sociodemographic and behavioral characteristics. Linear mixed-effects modeling was used to evaluate the intervention effects. Results: Depressive symptoms in the intervention group decreased at postintervention, but remained stable in the control group. There was an increase in life satisfaction in the intervention group and a decrease in the control group. Multivariable modeling showed that students in the intervention group had a significantly lower level of depressive symptoms (β = −4.60; 95% confidence interval, −5.76 to −3.46) and higher level of life satisfaction (β = 1.43; 95% confidence interval, 0.77 to 2.10) compared with their counterparts in the control group. Sensitivity analyses supported the positive effects of the intervention. Conclusions: Our school-based, multicomponent physical activity intervention is effective in improving mental health indicators in adolescents. Future trials should be ramped up to include schools in rural and regional settings, using robust measures  of mental well-being.

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Validity and Reliability of the Persian Version of Barriers to Physical Activity Questionnaire for People With Mobility Impairments

Alireza Khani, Mahmood Bahramizadeh, Mohammad Ali Mardani, and Taher Babaee

Background: Although physical activity (PA) is an important determinant of health, physically disabled individuals tend to have a sedentary lifestyle. The Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) is a self-report instrument evaluating PA barriers. This study was intended to evaluate the validity and reliability of the Persian version of BPAQ-MI (P-BPAQ-MI) and to report the prevalence and severity of PA barriers among Persian-speaking individuals. Methods: The translation and back translation of the BPAQ-MI was conducted according to an internationally accepted guideline and tested on 163 participants to assess its reliability and validity. Internal consistency and test–retest reliability were analyzed using Cronbach alpha and Spearman correlation coefficient. Convergent construct validity was established by comparing the scores of P-BPAQ-MI and The Baecke Habitual Physical Activity Questionnaire. Known-groups construct validity was assessed with regard to type of assistive device and sex of the individual. Prevalence and severity of the barriers were reported by computing the percentage and means of “yes” answers. Results: The P-BPAQ-MI domains demonstrated very good internal consistency (Cronbach alpha of .77–.95) and excellent test–retest reliability (Spearman rho of .73–.96) with a significant inverse small correlation with Baecke Habitual Physical Activity Questionnaire indexes. The P-BPAQ-MI successfully discriminated between individuals with different assistive devices and sex. Community Built Environment barriers were the most prevalent and severe. Conclusions: The P-BPAQ-MI is a valid and reliable instrument to assess the PA barriers of people with physical disability. The community barriers were the most frequently reported obstacles to PA.

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Life Course Epidemiology Applied to Physical Activity Research

Gregore Iven Mielke, Ding Ding, Tracy Kolbe-Alexander, Esther van Sluijs, and Pedro C. Hallal

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Ten-Year Changes in the Physical Activity and Sedentary Behaviors of Adults: An Analysis of the 2 Cross-Sectional Observation of Cardiovascular Risk Factors in Luxembourg Studies

Marina Christofoletti, Paul Collings, Marion Tharrey, Camille Perchoux, and Laurent Malisoux

Background: Monitoring population physical activity (PA) and sedentary behavior over time is important to guide public health actions. The objective of this study was to investigate the changes in PA and sedentary behavior of adult residents in Luxembourg over 10 years. We also investigated variations in change over time across sociodemographic subgroups. Methods: Two population-based cross-sectional studies of adults living in Luxembourg (Observation of Cardiovascular Risk Factors in Luxembourg [ORISCAV-LUX] [2007–2008] and ORISCAV-LUX 2 [2016–2018]) were considered. Multilevel mixed-effects models were used to investigate changes over time between the studies with regard to self-reported total PA (metabolic equivalent of task-min/week), PA levels (inactive/sufficiently active/highly active), total sitting time, recreational television viewing, and personal computer (PC) use outside of work (in minutes per day). Results: The ORISCAV-LUX study included 1318 participants and the ORISCAV-LUX 2 study involved 1477 participants; 573 adults took part in both studies. The proportion of participants categorized as highly active increased over time by 6.9%. Total PA (761 metabolic equivalent of task-min/wk), television viewing (12 min/d), and PC use outside of work (13 min/d) also increased, whereas the total sitting time decreased by 25 minutes per day. Variations in change over time were observed by sex, country of birth, education, employment status, and perceived financial difficulty. Conclusions: Over a 10-year period, PA increased and total sitting time decreased in adults living in Luxembourg. With regard to specific sedentary behaviors, television viewing, and PC use outside of work increased. Specific population subgroups will benefit the most from targeted efforts to increase PA and minimize sedentary behavior.

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Associated Factors of Time Spent Walking for Community-Dwelling Stroke Survivors

Young-Ah Choi, Jung Soo Lee, and Yeo Hyung Kim

Background: This study aimed to investigate the factors associated with the time that community-dwelling stroke survivors spent walking. Methods: We analyzed the cross-sectional data of 1534 community-dwelling stroke survivors from the Korean National Health and Nutrition Examination Survey. Complex-sample logistic regression analyses were performed to determine the factors associated with insufficient walking time (<90 min/wk). The mean time spent walking was examined according to age, sex, resistance exercise level, and self-reported disability using complex-sample general linear models. Results: Women (odds ratio [OR] 1.5; 95% confidence interval [CI], 1.0–2.3), current smokers (OR 1.7; 95% CI, 1.1–2.8), insufficient resistance exercise (OR 2.3; 95% CI, 1.5–3.5), and those with rural residences (OR 1.4; 95% CI, 1.0–1.9) were independently associated with insufficient walking time. The mean time spent walking was significantly lower in older adults aged ≥65 years than in young adults aged <65 years (200.0 ± 42.0 min/wk vs 287.2 ± 36.6 min/wk, P = .002), in women than in men (200.9 ± 44.9 vs 286.2 ± 37.7 min/wk, P = .027), and in individuals engaging in insufficient resistance exercise compared with those engaging in sufficient resistance exercise (203.2 ± 36.2 vs 283.9 ± 43.0 min/wk, P = .008). The mean walking time did not vary according to the presence of self-reported disabilities. Conclusions: Environmental and personal factors are associated with insufficient walking time in community-dwelling stroke survivors.