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Guan-Bo Chen, Che-Wei Lin, Hung-Ya Huang, Yi-Jhen Wu, Hung-Tzu Su, Shu-Fen Sun, and Sheng-Hui Tuan

Because of a shortage of health care providers, providing rehabilitation in health care facilities is difficult. Virtual reality–based rehabilitation is effective in older populations. There are only a few studies among patients with sarcopenia. This is a quasi-experimental, single-group, pretest–posttest design evaluating the clinical effectiveness of virtual reality–based progressive resistance training among residents aged over 60 years with sarcopenia in rural care facilities. The authors used Oculus Rift with headsets to provide the virtual reality–based progressive resistance training. The authors administered the program twice per week, 30 min per session, for 12 weeks. The primary outcomes were dominant handgrip strength, walking speed, and appendicular skeletal muscle mass index. Data from 30 participants were analyzed. Significant improvements in handgrip strength and walking speed were observed. Although an increasing trend in appendicular skeletal muscle mass index was observed, it did not reach statistical significance. The authors concluded that the virtual reality–based progressive resistance training is partially effective in older sarcopenic adults in health care facilities.

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Jacob Szeszulski, Kevin Lanza, Erin E. Dooley, Ashleigh M. Johnson, Gregory Knell, Timothy J. Walker, Derek W. Craig, Michael C. Robertson, Deborah Salvo, and Harold W. Kohl III

Background: Multiple models and frameworks exist for the measurement and classification of physical activity in adults that are applied broadly across populations but have limitations when applied to youth. The authors propose a conceptual framework specifically designed for classifying youth physical activity. Methods: The Youth Physical Activity Timing, How, and Setting (Y-PATHS) framework is a conceptualization of the when (timing), how, and where (setting) of children’s and adolescents’ physical activity patterns. The authors developed Y-PATHS using the design thinking process, which includes 3 stages: inspiration, ideation, and implementation. Results: The Y-PATHS includes 3 major components (timing, how, and setting) and 13 subcomponents. Timing subcomponents include (1) school days: in-school, (2) school days: out-of-school, and (3) nonschool days. How subcomponents include: (1) functional, (2) transportation, (3) organized, and (4) free play. Setting subcomponents include: (1) natural areas, (2) schools, (3) home, (4) recreational facilities, (5) shops and services, and (6) travel infrastructure. Conclusions: The Y-PATHS is a comprehensive classification framework that can help researchers, practitioners, and policymakers to better understand youth physical activity. Specifically, Y-PATHS can help to identify the domains of youth physical activity for surveillance and research and to inform the planning/evaluation of more comprehensive physical activity programming.

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Ralph Beneke and Renate M. Leithäuser

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Iñigo Mujika

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Rona Macniven, Rachel Wilson, Tim Olds, and John Evans

Background: Emerging evidence suggests that Indigenous children have higher physical activity levels that non-Indigenous children, yet little is known of the factors that influence these levels or how they may be optimized. This study examines correlates of achieving ≥1 hour/day of physical activity among Indigenous Australian children aged 8–13 years. Methods: Data were collected through parental self-report in the Longitudinal Study of Indigenous Children. Proportions of children achieving ≥1 hour/day physical activity, approximating the Australian aerobic physical activity recommendations, were calculated, and associations with sociodemographic, family composition, and movement-related factors were quantified using multiple logistic regression analyses. Results: Half of the 1233 children achieved ≥1 hour/day physical activity. Children from families with low parental education and unemployment, remote residence, low socioeconomic status, and without a father in the household were more likely to meet the recommendations. Achieving ≥1 hour/day of physical activity was also associated with low levels of playing electronic games and total screen time. Conclusions: Sociodemographic correlates of physical activity among Indigenous Australian children run counter to those typically found in non-Indigenous Australian children. Further longitudinal examination of the predictors of these associations would provide a greater understanding of Indigenous physical activity determinants, to inform strategies to facilitate participation.

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Karin Weman Josefsson

Sweden has adopted a somewhat different approach to handle the corona pandemic, which has been widely debated both on national and international levels. The Swedish model involves more individual responsibility and reliance on voluntary civic liability than law enforcement, while common measures in other countries are based on more controlling strategies, such as restrictive lockdowns, quarantines, closed borders, and mandatory behavior constraints. This commentary aims to give a brief overview of the foundations of the Swedish model as well as a discussion on how and why it has been adopted in the Swedish society based on Swedish legislations, culture, and traditions. Finally, perspectives on how the Swedish model could be connected to the tenets of self-determination theory will be discussed.

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Andrea Ramírez Varela and Michael Pratt

In 2012, the Global Observatory for Physical Activity (GoPA!) was established to provide information that would enable countries to initiate or improve research capacity, surveillance systems, program development, and policymaking to increase physical activity levels. Findings from the first GoPA! Country Cards showed an unequal distribution of physical activity surveillance, research productivity, and policy development and implementation around the world. Regular global monitoring of these factors, especially in countries with the largest data gaps, was recommended to combat the global pandemic of physical inactivity. After 6 years and using standardized methods, GoPA! is launching the second set of Country Cards based on data up to 2019 from 217 countries. Overall results showed that periodic national surveillance of physical activity was less common in low-income countries, compared with middle- and high-income countries. Large inequities were seen with more than a 50-fold difference in publications between high- and low-income countries and 32% of the countries worldwide had no physical activity policy. GoPA! has a critical role in facilitating evidence-based physical activity promotion building on international guidelines and the World Health Organization Global Action Plan. GoPA! will continue to monitor progress as we battle the global pandemic of physical inactivity.

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Bethany Barone Gibbs, Melissa A. Jones, John M. Jakicic, Arun Jeyabalan, Kara M. Whitaker, and Janet M. Catov

Background: Though moderate- to vigorous-intensity physical activity is recommended, limited research exists on sedentary behavior (SED) during pregnancy. Methods: The authors conducted a prospective cohort study to describe objectively measured patterns of SED and activity during each trimester of pregnancy. Women wore thigh- (activPAL3) and waist-mounted (ActiGraph GT3X) activity monitors. SED and activity were compared across trimesters using likelihood ratio tests and described using group-based trajectories. Exploratory analyses associated SED and activity trajectories with adverse pregnancy outcomes and excessive gestational weight gain. Results: Pregnant women (n = 105; mean [SD] age = 31 [5] y; prepregnancy body mass index = 26.2 [6.6] kg/m2) had mean SED of 9.7, 9.5, and 9.5 hours per day (P = .062) across trimesters, respectively. Some activities differed across trimesters: standing (increased, P = .01), stepping (highest in second trimester, P = .04), steps per day (highest in second trimester, P = .008), and moderate- to vigorous-intensity physical activity (decreased, P < .001). Prolonged SED (bouts ≥ 30 min) and bouted moderate- to vigorous-intensity physical activity (≥10 min) were stable (P > .05). In exploratory analyses, higher SED and lower standing, stepping, and steps per day trajectories were associated with increased odds of adverse pregnancy outcomes (P < .05). No trajectories were associated with excessive gestational weight gain. Conclusions: Pregnant women exhibited stable SED of nearly 10 hours per day across pregnancy. Future research evaluating SED across pregnancy and adverse pregnancy outcome risk is warranted.