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Brigid M. Lynch, Charles E. Matthews, Katrien Wijndaele and on behalf of the Sedentary Behaviour Council of the International Society for Physical Activity and Health

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Viviene A. Temple, Dawn L. Lefebvre, Stephanie C. Field, Jeff R. Crane, Beverly Smith and Patti-Jean Naylor

This study examined the influence of physical health and well-being vulnerability on participation in physical activities, and whether motor skill proficiency mediated this relationship. Kindergarten children (n = 260) completed the Test of Gross Motor Development-2 and the Children’s Assessment of Participation and Enjoyment survey. A multivariate analysis of covariance was used to compare the motor skills and participation in physical activities of children in schools classified as more or less vulnerable. We also examined whether motor skill proficiency mediated the relationship between vulnerability status and participation. Children in neighborhoods with higher vulnerability demonstrated lower motor skill proficiency and participation. Object control skill proficiency mediated the relationship between vulnerability and participation. Children from more vulnerable schools started their school career with less developed motor skills and a narrower array of recreation participation. Children in vulnerable neighborhoods need more opportunities to master object controls skills and access recreational activities. Fortunately, motor skill proficiency among children considered ‘at risk’ is amenable to improvement and intervention early in the children’s school career may have a beneficial impact on children’s physical activity at school and beyond the school environment.

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Daniel Birrer

A rigorous training schedule with insufficient recovery can lead to nonfunctional overreaching (NFOR) or overtraining syndrome (OTS). Research has suggested the multifactorial etiology of these phenomena. Stressors that contribute to and are symptoms and consequences of NFOR and OTS and adjustment disorder are almost identical. In this case study of an elite rower, the author illustrates an intervention approach that can be taken when overtraining is viewed as a sport-specific form of adjustment disorder. The intervention involved treatment that improved the athlete’s awareness of his basic biopsychosocial processes, developed sources of self-worth beyond athletic performance, and challenged his 1-dimensional athletic identity. The intervention included cognitive-behavioral therapy methods (e.g., autogenic training) and mindfulness- and acceptance-based interventions to enhance the athlete’s psychological flexibility. Mood monitoring was used as a diagnostic and evaluative instrument. Intervention effectiveness was evaluated through an in-depth interview with the athlete. The consulting sport psychologist also engaged in reflection about treatment effectiveness and predominant challenges. Challenging the athlete and clarifying his personal values were judged to be very important. Evaluation suggested that viewing NFOR and OTS as forms of adjustment disorder may help us recognize the multifaceted nature of an athlete’s maladjusted state and widen treatment options.

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Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols

It is estimated that 1.6 million people in the United States are currently diagnosed with an eating disorder. Eating disorders (EDs) have high rates of morbidity and mortality and remain the most severe mental illness. Unfortunately, rates of EDs and disordered eating behaviors (DEBs) among athletes appear to be increasing. In this study, authors summarize ED-related risks that pose compromises in psychological and social functioning, medical health, and overall quality of life. The importance of early detection and formal evaluation in preserving the athlete’s health, well-being and sustaining successful sport participation, and performance are highlighted. Athlete-specific factors, which challenge the ease and accuracy of ED detection and assessment, are noted. The recommended components of effective ED assessment are identified, including use of self-report measures and clinical interviews conducted by ED certified and licensed professionals. The importance of being well informed in tenets of ED awareness, prevention and supporting early detection, and referral for formal ED assessment are noted. Conclusions reflect the vital roles that both the multidisciplinary sport personnel and the sport environment/culture play in reducing the serious health risks of DEBs and EDs. Each is needed to protect an athlete’s well-being while fostering safe and successful sport participation.

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Laura K. Fewell, Riley Nickols, Amanda Schlitzer Tierney and Cheri A. Levinson

The current study tested if athlete patients differed from non-athlete patients in measures of eating disorder (ED) and related pathology. Athlete (n = 91 in Study 1; n = 39 in Study 2) and non-athlete (n = 76 in Study 1; n = 26 in Study 2) patients completed self-report measures, and body mass index (BMI) was calculated. Athlete patients had significantly lower ED symptomatology and depression than non-athlete patients (ps < .05). ED impairment, worry, psychosocial functioning, BMI, obsessive-compulsiveness, and compulsive exercise did not significantly differ between groups (ps > .08). Greater ED symptomatology was associated with higher psychosocial functioning among athlete patients and higher obsessive-compulsive symptoms and compulsive exercise among non-athlete patients. This is a novel study comparing ED symptomatology and related measures of mental health in athlete and non-athlete patients engaged in residential or partial hospitalization ED treatment. Future research should further investigate how participation in high-level sport impacts the presentation, treatment, and outcome of individuals with EDs.

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Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols

Eating disorders (EDs) and disordered-eating behaviors (DEBs), pose a high risk of morbidity and mortality, threatening physical health, emotional health, and overall quality of life. Unfortunately, among athletes, prevalence rates continue to increase. This document summarizes the challenges of establishing and navigating the multidisciplinary care needed to effectively treat EDs and DEBs among athletes. The benefits of timely and frequent communication within the multidisciplinary treatment team (MDTT) are emphasized and discussed. Authors advise who should be selected as members of the MDTT and suggest that all personnel, including athletic coaches, athletic trainers, physical therapists, and certified fitness professionals be ED-informed and ED-sensitive. Vital components of care are noted including use of a variety of evidence-based psychotherapeutic modalities, interventions which target emotional regulation, and prioritize values based compassionate care. Authors caution that performance decrements and medical/physiological changes are not always easily observable in individuals with EDs and DEBs and therefore, attuned, consistent, and ongoing monitoring is needed. Consensus regarding previously established parameters for return to play and careful titration of physical activity throughout the ED recovery process are suggested as important for preserving health, preventing re-injury, or relapse and facilitating successful return to sport participation.

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Laura K. Fewell, Riley Nickols, Amanda Schlitzer Tierney and Cheri A. Levinson

Understanding the unique needs of athletes who undergo eating disorder (ED) treatment is sorely needed. This study explores changes of strength and power in athlete (n = 21) and non-athlete (n = 36) patients from intake to discharge. Maximal oxygen consumption, vertical jump, push-ups, hand grip strength, and body mass index (in anorexia nervosa; AN) were measured among treatment center patients. The number of push-ups and hand grip strength were significantly improved upon discharge in the full sample (ps < .005) and in AN only (ps < .001). Body mass index was also significantly higher in AN (p < .001). Maximal oxygen consumption and vertical jump did not significantly improve between admission and discharge in either group (ps > .40). This study is the first to investigate measures of strength in athletes engaged in intensive eating disorder treatment and indicates the need to address the psychological mindset around physical activity using exercise education as part of a comprehensive program. Recommendations for incorporating exercise into an intensive ED treatment center are also provided.

Open access

Levi Frehlich, Christine Friedenreich, Alberto Nettel-Aguirre, Jasper Schipperijn and Gavin R. McCormack

Despite continued interest in neighborhood correlates of physical activity, few self-report questionnaires exist that capture neighborhood-based physical activity. Furthermore, there is little evidence about the measurement validity of self-report measures of neighborhood-based physical activity. Notably, self-reported neighborhood physical activity has not been validated against combined accelerometer and global positioning system (GPS)–assessed physical activity. Thus, the purpose of this study was to estimate the concurrent validity of a recently adapted tool for capturing self-reported neighborhood-based physical activity (i.e., the Neighborhood International Physical Activity Questionnaire; N-IPAQ). Adults (n = 75) from four Calgary (Alberta, Canada) neighborhoods wore an accelerometer and GPS monitor for 7 consecutive days after which they self-reported their physical activity from the past week using the N-IPAQ. Bland-Altman plots and Spearman correlations estimated the concurrent validity between N-IPAQ and accelerometer/GPS physical activity (estimated for the administrative boundary, 400-m and 800-m radial buffers). The mean (95% Confidence Interval [CI]) difference between the N-IPAQ and accelerometer/GPS estimated total daily minutes of physical activity differed for the 400-m (1.9 min, −26.2 to 29.9), 800-m (10.6 min, −16.0 to 37.1), and administrative boundary buffers (14.7 min, −11.5 to 41.0). The strongest Spearman correlations were found between the N-IPAQ and 800-m radial buffer accelerometer-captured vigorous-intensity physical activity (r = .41 [95% CI: .18 to .60]), and the N-IPAQ and administrative boundary accelerometer-captured vigorous-intensity physical activity (r = .43 [95% CI: .20 to .62]). Our findings suggest that the N-IPAQ provides good estimates of neighborhood-based physical activity and could be used when investigating neighborhood correlates of physical activity.

Open access

Tamara Vehige Calise, William DeJong, Timothy Heren, Chloe Wingerter and Harold W. Kohl III

Background: Older age groups are less likely than their younger counterparts to be regularly active and women are even less active. Ecological models suggest that multiple levels of influence with each level influencing the next level impacts physical activity behaviors. Methods: Hierarchical multiple regressions were used to determine factors within and across the ecological model that predicted both total physical activity and walking for recreation. Findings: The overall predictors of total physical activity were different than those of walking for recreation, with the exception of dog ownership and perceived barriers. Gender and age were significant predictors of walking for recreation, but these associations were not present for total physical activity. Women and older adults walked more for recreation in a mixed-use community, Mueller, (and thus engaged in more total physical activity) compared with men and younger adults. Conclusion: Behavior-specific physical activity as well as total physical activity led to a better understanding of factors that may impact behavior among an overall aging population, especially women. This level of specificity is important in understanding specific factors that are associated with physical activity among vulnerable populations and can help guide the development of tailored, cost-effective, and efficient policies and interventions.