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Physical Activity and Spinal Cord Injury: Lessons Learned at the Lowest End of the Physical Activity Spectrum

Kendra R. Todd and Kathleen A. Martin Ginis

Given profound physical, psychosocial, and environmental barriers to physical activity (PA), people living with spinal cord injury (SCI) are less active than virtually every other segment of the population. Nevertheless, people with SCI are not universally “sedentary.” Many people with SCI live physically active lives, and behavioral interventions have proven effective at increasing and maintaining both PA and fitness. This paper discusses PA and inactivity in the SCI population and reviews the who, what, and how of effective SCI PA-enhancing interventions. The authors conclude with 3 recommendations for increasing PA in other low-active populations: Know your audience and the issues, develop audience-specific messages and tailored interventions, and use behavior-change theory to develop messages and interventions.

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Physical Activity: Cornucopia and Conundrums

Kenneth E. Powell and Steven N. Blair

The number and scope of established health-related benefits from physical activity continue to expand. Notable recent additions include improved weight status and bone health in children 3–5 years of age, prevention of excessive weight gain among adults, reduced risk of dementia, and improved cognition and a variety of other brain-health benefits. Greater flexibility in receiving health benefits is also apparent. No threshold of moderate to vigorous physical activity (MVPA) must be exceeded for benefits to accrue; small increments by individuals performing little to no MVPA produce larger reductions in risk than similarly sized increments in individuals already performing greater amounts of MVPA, bouts of MVPA <10 min in duration contribute to the accumulation of MVPA, and light-intensity physical activity can benefit individuals currently doing little or no MVPA. MVPA is indirectly related to the adverse effects of sedentary behavior. The definition of physical activity continues to be debated.

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Physical Activity Within School Contexts: The Bigger Bang Theory

Thomas L. McKenzie

Schools are salient locations for promoting and providing physical activity, but they fail to meet the public health recommendation of providing at least half the 60 min of physical activity that children need daily. To help solve this school deficit, the author proposes that the “biggest bang” would result from developing and implementing school physical activity policies. However, this remains a theory because school policy studies are in their infancy and rarely include direct measures of physical activity. Physical activity does not just happen generally in schools but occurs within specific contexts such as physical education and leisure-time programs. Alternative methods to self-reports are needed to study physical activity policies, and direct observation tools are available to assess physical activity within specific contexts. Private and charter schools are understudied, and they should be included in future investigations.

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Preschool-Based Physical Activity Interventions in African American and Latino Preschoolers: A Literature Review

Sofiya Alhassan, Christine W. St. Laurent, and Sarah Burkart

The purpose of this review was to assess the effectiveness of physical activity (PA) interventions in African American and Latino/Hispanic preschool children. A systematic search was conducted for English-language printed research articles published between January 1980 and December 2017. The inclusion criteria for studies in this review were that they were experimental PA studies conducted in the preschool setting in the United States that targeted African American/Black or Latino/Hispanic children between the ages of 2.9 and 5 years. A total of 1,533 articles were located, of which 10 met the inclusion criteria. Overall, studies reported positive changes in preschool-day PA levels, yet only 2 reported significant improvements in total daily PA. Limited scientific literature suggests that preschool-based interventions are effective in improving aspects of PA during the preschool day for children of color. However, minimal evidence exists on the effectiveness of these interventions in changing total daily PA.

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Sedentary Behavior in Persons With Multiple Sclerosis: Is the Time Ripe for Targeting a New Health Behavior?

Robert W. Motl and Rachel Bollaert

Sedentary behavior is prominent in persons with multiple sclerosis (MS) and may be associated with negative health consequences, yet our knowledge of sedentary behavior and its measurement, correlates, and consequences is in a stage of infancy—the focus on behavioral interventions might even be premature. This underscores the need for a research agenda focusing on sedentary behavior and its measurement, correlates, and consequences to inform the design of targeted interventions for persons with MS. Such research is important, as sedentary behavior represents a large opportunity for focal, theory-based behavioral interventions that could not only decrease sedentary behavior but also provide consequential life-changing benefits for persons with MS. The time is ripe for focal inquiry on sedentary behavior in MS and pursuing a new paradigm on health behavior change in this population.

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Sedentary Time in Older Adults: Sitting Is Not the New Smoking

Jennifer L. Copeland

A growing body of literature suggests that excessive sedentary time may have deleterious health consequences, particularly among inactive individuals. Given that older adults are the least physically active and most sedentary of any demographic group, research on active, healthy aging must consider both the cause and the consequences of prolonged time spent sitting. Current evidence suggests that reducing sedentary time may be beneficial to older adults and allow them to better maintain their functional capacity and autonomy, but more research is needed to enable the development of evidence-based behavioral goals that will improve health outcomes. There is also a need to consider sedentary behavior from an organizational and societal perspective that moves beyond workplace and school settings to be inclusive of older adults, the fastest growing population in the world.

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Teacher Socialization in Physical Education: A Scoping Review of Literature

K. Andrew R. Richards, Colin G. Pennington, and Oleg A. Sinelnikov

Occupational socialization theory (OST) has framed research on physical education (PE) teacher recruitment, professional preparation, and ongoing socialization in schools for nearly 40 yr. Using scoping-review methods, the authors sought to understand the current scope of published research on PE-teacher socialization using OST by descriptively and thematically reviewing 111 identified studies published in English-language journals between 1979 and 2015. Results indicate a predominance of qualitative, cross-sectional research related to PE-teacher socialization, most of which was conducted by a relatively small group of scholars. Themes derived from the analysis of study findings communicate the complexity of teacher socialization experiences and are used to develop recommendations for future research and practice that work toward helping improve teachers’ lived experiences while creating better contexts in which students can learn. The paper concludes with a discussion of extending OST research to understand the recruitment, professional education, and socialization of kinesiology faculty members and professionals across subdisciplines.

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Toward Comprehensive Step-Based Physical Activity Guidelines: Are We Ready?

Catrine Tudor-Locke and Elroy J. Aguiar

Step counting is now a widespread and acceptable approach to self-monitoring physical activity courtesy of the recent surge in wearable technologies. Nonetheless, there remains no recommendation for steps/day in federal physical activity guidelines. The authors review current scientific literature to consider evidence regarding the volume, dose (frequency, intensity, duration, timing), and dose-response relationships for step-based metrics, including steps/day (volume), cadence (steps/min; intensity), peak 30-min cadence (steps/min; composite index of frequency, intensity, and duration), and zero cadence (proxy for sedentary behavior). Preliminary evidence suggests that communicating federal physical activity guidelines using step-based metrics could facilitate individuals’ ability to comprehend and achieve a physically active lifestyle.

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Wearable Activity Trackers in Clinical Research and Practice

David R. Bassett, Patty S. Freedson, and Dinesh John

In recent years, there has been tremendous growth in the use of wearable activity trackers in biomedical research. Activity trackers are also becoming more popular with consumers, who are able to share their data with researchers and practitioners. Steps per day is a useful variable that is estimated from most wearable activity trackers. It has intuitive meaning, is strongly associated with health variables, and has the potential to be standardized across devices. Activity trackers and other wearable medical devices could provide new information on health-related behaviors and their interaction with genetic and environmental variables. If integrated into medical practice, wearable technologies could help motivate patients to change their health behaviors and might eventually be used to diagnose medical conditions. The convergence of wearable medical devices, computer applications, smart phones, and electronic medical records could influence the practice of lifestyle medicine.