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Volume 34 (2024): Issue 6 (Nov 2024)

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Evaluation of Exercise Program for Overweight and Obese Pediatric Participants in a Single Tertiary Center in Singapore

Kylie Leong, Muhammad Munir Tohid, Bernard Xian Wei Liew, Siao Hui Toh, Mohammad Ashik Zainuddin, Fadzlynn Fadzully, Brandon Guoqiang Feng, Muhammad Alif Bin Abu Bakar, and Benny Kai Guo Loo

Purpose: Pediatric obesity is rising in prevalence. We audited the results of an exercise program for overweight and obese pediatric participants in a tertiary pediatric hospital. The main aim was to determine the program’s effectiveness, with the main outcome of change in body mass index (BMI). Method: Retrospective review of data from all pediatric participants attending the program between January 2017 and December 2022. Inclusion criteria for analysis were BMI ≥90th centile, ages 6–15, attendance in at least 2 sessions and for at least 1 week. Statistical analysis was done using Generalized Additive Modeling. Results: One hundred thirty seven participants were included. The average duration in the program was 16 months (min = 1 wk, max = 57 mo). Majority (66%, n = 94) attended at intervals of >4 weeks. Only 7% (n = 9) attended weekly. The shorter the visit intervals, the more likely the BMI loss. The greatest decrease in BMI (−0.275; 95% confidence interval, −0.381 to −0.17) was in 15-year-old obese participants with visit intervals of <1 week. At the last visit, 84.7% maintained, 12.4% improved and 2.9% worsened in BMI category, respectively. Conclusion: Participants who attended an exercise program at least weekly demonstrated the best outcomes. Most did not adhere to the recommended frequency and thus had poorer outcomes. We have since made improvements to our program to increase visit frequency.

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Gender Gap for Accelerometry-Based Physical Activity Across Different Age Groups in 5 Brazilian Cohort Studies

Luiza I.C. Ricardo, Andrea Wendt, Debora Tornquist, Helen Gonçalves, Fernando Wehrmeister, Bruna Gonçalves C. da Silva, Luciana Tovo-Rodrigues, Iná Santos, Aluisio Barros, Alicia Matijasevich, Pedro C. Hallal, Marlos Domingues, Ulf Ekelund, Renata M. Bielemann, and Inácio Crochemore-Silva

Objectives: This study aims to evaluate the gender inequalities in accelerometer-based physical activity (PA) across different age groups using data from 5 Pelotas (Brazil) cohorts. Methods: The data come from 4 birth cohort studies, covering all live births in the urban area of Pelotas for each respective year (1982, 1993, 2004, and 2015), and the Como vai? cohort study focusing on 60 years and above. Raw accelerometry data were collected on the nondominant wrist using GENEActive/ActiGraph devices and processed with the GGIR package. Overall PA was calculated at ages 1, 2, 4, 6, 11, 15, 18, 23, 30, and 60+ years, while moderate to vigorous PA was calculated from 6 years onward. Absolute (difference) and relative (ratio) gender inequalities were calculated and intersectionality between gender and wealth was also evaluated. Results: The sample sizes per cohort ranged from 965 to 3462 participants. The mean absolute gender gap was 19.3 minutes (95% confidence interval, 12.7–25.9), with the widest gap at 18 years (32.9 min; 95% confidence interval, 30.1–35.7) for moderate to vigorous PA. The highest relative inequality was found in older adults (ratio 2.0; 95% confidence interval, 1.92–2.08). Our intersectionality results showed that the poorest men being the most active group, accumulating around 60 minutes more moderate to vigorous PA per day compared with the wealthiest women at age 18. Conclusions: Men were more physically active than women in all ages evaluated. PA gender inequalities start at an early age and intensify in transition periods of life. Relative inequalities were marked among older adults.

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Supporting People With Musculoskeletal Conditions From Underserved Communities in the United Kingdom to Engage With Physical Activity: A Realist Synthesis and Q-Methodology Study

Alice Berry, Terence Brady, Natasha Bradley, Nicky Harris, Caroline Flurey, Faatihah Niyi-Odumosu, Emma Dures, and Nicola Walsh

Background: In the United Kingdom, 20 million individuals suffer from a musculoskeletal condition, for which physical activity (PA) is a core treatment. Minority ethnic communities experience a disproportionate impact, experiencing higher levels of pain and engaging in less PA. Research has identified various factors that affect their participation in PA, including lack of access to support, limited knowledge of resources, language barriers, fear of racial harassment while exercising, and insufficient communication/information from healthcare professionals. Methods: This project adopted a realist perspective, aiming to understand “what works, in which circumstances, and for whom?” The project had 4 steps: (1) defining review scope with stakeholders; (2) searching and extracting literature, creation of initial program theories; (3) refining/validating initial program theories with stakeholders; and (4) adopting Q-methodology to highlight priority areas. Results: 17 papers were included. Three program theories were identified: (1) Lack of initial access to health service support; (2) Nature of musculoskeletal self-management support—the importance of the therapeutic relationship and value of shared conversations; and (3) Accessible long-term support for PA engagement. The Q-sort exercise highlighted priority areas: (1) complex booking procedures and inadequate translation services, (2) time constraints impact effective patient-centered care, (3) dismissive attitudes/mismatched expectations impact shared decision making, (4) rebuilding trust to strengthen therapeutic relationships, (5) cultural relevance in developing therapeutic relationships, and (6) clinician recommended PA opportunities increase knowledge of PA. Conclusions: Our findings shed light on inequities across the UK’s musculoskeletal pathways, specifically in relation to PA engagement. This points toward priority areas for future research and interventions.

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Assessing the Use of Recommended Practices in Adapted Physical Activity/Education Experiential-Learning Programs

Layne Case, Joonkoo Yun, Megan MacDonald, Bridget E. Hatfield, and Samuel W. Logan

This study investigated the use of recommended practices in university-based experiential learning associated with adapted physical activity and education (APA/E) undergraduate courses. Participants (N = 165) were instructors of APA/E courses with an experiential-learning component and/or professionals involved in APA/E experiential-learning programs at their university. Participants completed an online questionnaire designed to describe program characteristics and evaluate the use of two sets of practices, including those recommended for involving students and people with disabilities. Findings highlight low proportions of the use of practices recommended for people with disabilities and indicate that significantly more practices recommended for students were implemented (Z = −10.45, p < .001). Findings from this study have several implications for evaluation and intervention in APA/E experiential learning, such as including the disability community in planning and designing programming to benefit both students and people with disabilities. Instructors should aim to increase their implementation of practices recommended for involving people with disabilities.

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“One Day . . . It Won’t Be a Big Story”: Analyzing the Media Response to Female National Football League Coaches

Katie Taylor

In 2015, Dr. Jen Welter became the first woman to coach in the National Football League (NFL). Other female coaches followed. Yet, sports-studies scholars know little about the media’s response to these football pioneers. This paper presents critical themes on how popular media discussed female coaches by analyzing the hiring announcements of four women who coach or have coached in the NFL. Utilizing a critical feminist lens, this paper demonstrates that media outlets reproduced conventional media tropes by reassuring readers that women have the requisite knowledge, trivializing women’s achievements, underscoring the need for male player support, emphasizing appearance, and permitting sexist comments. However, it is evident that online publishers are simultaneously making progress. In most cases, the articles represented the coaches in ways that differ from how female athletes have been historically depicted. This research reveals nonlinear and incremental progress toward gender equality in football.

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Physical Determinants of Sprint and Long Jump Performance in Male Youth Track-and-Field Athletes With Differing Maturity Statuses

James Baker, Paul Read, Philip Graham-Smith, Mauricio Monaco, Evdokia Varamenti, Marco Cardinale, and Thomas W. Jones

Purpose: This study examined the physical determinants of 60-m sprint and long jump (LJ) performance and differences between maturity groups in physical characteristics in young male track-and-field athletes. Methods: Competition results, countermovement jump, isometric leg press, 10-5 repeated jump test, and 50-m sprint were collected over 3 seasons for 54 male athletes (age 13 [1] y; stature 160.0 [8.9] cm; body mass, 48.0 [9.8] kg; percentage predicted adult height 92.2% [5.5%]) grouped by maturity status: approaching- (n = 16), circa- (n = 19), and post-peak height velocity (PHV) (n = 19). Results: There were significant between-group differences in 60 m, LJ, and all physical testing variables (P < .001, g = 0.88–5.44) when comparing the approaching- and circa-PHV groups with the post-PHV group. Significant differences were identified between the approaching- and circa-PHV groups in 40-m (P = .033, g = 0.89), 50-m (P = .024, g = 1.64), and 60-m (P < .001, g = 0.89) sprint times. Countermovement jump and 50-m sprint variables were consistently important for projection of 60 m and LJ performance across the valid multivariate models. Conclusions: Large differences in performance across maturity groups highlight the importance of understanding athletes’ maturity status to accurately interpret performance. Several physical performance variables were important for projecting competition 60 m and LJ performance.

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24-Hour Movement Behaviors of LGBTQA+ Young People: A Systematic Review

Kathryn Fortnum, Sjaan R. Gomersall, Megan H. Ross, James Woodforde, George Thomas, Yu-Shu Wen, Francisco Perales, and Michalis Stylianou

Background: The movement behaviors of LGBTQA+ young people, who encounter specific health, and other, challenges are not well understood. This systematic review examines the 24-hour movement behaviors of LGBTQA+ young people compared with population estimates of meeting the 24-hour movement guidelines. Methods: Seven electronic databases were searched from inception to January 2024. Observational studies published in English and reporting quantitative data for physical activity, sedentary behavior, or sleep duration for LGBTQA+ individuals <24 years old were included. Data were narratively synthesized for children/adolescents (<18 years) and young adults (18–24 years), guided by the Cochrane Synthesis Without Meta-analysis guidelines. Results: Fifty-six studies were included; 46 were of “fair” quality and 37 were conducted in the United States. Physical activity, sedentary behavior, and sleep outcomes were reported in 46, 11, and 14 studies, respectively. Ninety unique LGBTQA+ terms were identified. Based on outcomes reported in ≥1 study, and compared to population estimates, LGBTQA+ young people were less likely to meet aerobic physical activity and strength/resistance training guidelines. LGBTQA+ children/adolescents were less likely to meet the sleep guidelines. Young adults demonstrated similar adherence to sleep guidelines as population estimates. Conclusions: Overall, our results suggest that LGBTQA+ young people have suboptimal 24-hour movement behaviors; in some cases, worse than population estimates. Utilization of more robust measures of exposure and outcome variables is recommended, with a focus on sleep and sedentary behavior.

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Impact of Generalized Versus Individualized Load–Velocity Equations on Velocity-Loss Magnitude in Bench-Press Exercise: Mixed-Model and Equivalence Analysis

Miguel Sánchez-Moreno, Beatriz Bachero-Mena, Juan Sánchez-Valdepeñas, Fabio Yuzo Nakamura, and Fernando Pareja-Blanco

Purpose: This study analyzed the influence of 2 velocity-based training-load prescription strategies (general vs individual load–velocity equations) on the relationship between the magnitude of velocity loss (VL) and the percentage of repetitions completed in the bench-press exercise. Methods: Thirty-five subjects completed 6 sessions consisting of performing the maximum number of repetitions to failure against their 40%, 60%, and 80% of 1-repetition maximum (1RM) in the Smith machine bench-press exercise using generalized and individualized equations to adjust the training load. Results: A close relationship and acceptable error were observed between percentage of repetitions completed and the percentage of VL reached for the 3 loading magnitudes and the 2 load-prescription strategies studied (R 2 from .83 to .94; standard error of the estimate from 7% to 10%). A simple main effect was observed for load and VL thresholds but not for load-prescription strategies. No significant interaction effects were revealed. The 40% and 60% 1RM showed equivalence on data sets and the most regular variation, whereas the 80% 1-repetition maximum load showed no equivalence and more irregular variation. Conclusion: These results suggest that VL is a useful variable to predict percentage of repetitions completed in the bench-press exercise, regardless of the strategy selected to adjust the relative load. However, caution should be taken when using heavy loads.

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Understanding the Relationships Between Physical Activity and Climate Change: An Umbrella Review

Milena Franco Silva, Ana Luiza Favarão Leão, Áine O’Connor, Pedro C Hallal, Ding Ding, Erica Hinckson, Tarik Benmarhnia, and Rodrigo Siqueira Reis

Background: Physical activity is crucial for maintaining health and preventing chronic diseases. However, climate conditions can impact physical activity patterns, and conversely, physical activity can impact climate change. This umbrella review aims to summarize the existing evidence regarding the relationships between physical activity and climate change, as revealed in previous reviews. Methods: Systematic reviews and meta-analyses were analyzed. Searches were conducted across GreenFILE, PubMed, and Web of Science databases for peer-reviewed articles published in English. A 2-stage independent screening process was conducted, and methodological quality was assessed using the JBI framework. Standardized data extraction methods were then applied. Results: Out of 1292 articles retrieved, 7 met all eligibility criteria and were included in the review. Three articles examined physical activity as a primary exposure, 3 focused on the impacts of climate change, and one considered both physical activity and climate change as primary exposures. Conclusions: Findings reveal an interplay between climate change and physical activity. While rising temperatures may prompt outdoor activities up to a certain temperature threshold, air pollution and extreme heat can have harmful effects. Active transportation and improved logistics around large-scale sporting events can mitigate climate change by reducing greenhouse gas emissions, but transportation systems linked to sports venues may increase emissions. Research on the reciprocal relationship between climate change and physical activity domains, and integrating the community into climate discussions, is crucial for equity, especially for marginalized communities. Incorporating climate adaptation and mitigation strategies in physical activity infrastructure to minimize environmental impacts is critical.