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Gregory A. Hand, Robin P. Shook, Daniel P. O’Connor, Madison M. Kindred, Sarah Schumacher, Clemens Drenowatz, Amanda E. Paluch, Stephanie Burgess, John E. Blundell and Steven N. Blair

Background: The present study examined, among weight-stable overweight or obese adults, the effect of increasing doses of exercise energy expenditure (EEex) on changes in total daily energy expenditure (TDEE), total body energy stores, and body composition. Methods: Healthy, sedentary overweight/obese young adults were randomized to one of 3 groups for a period of 26 weeks: moderate-exercise (EEex goal of 17.5 kcal/kg/wk), high-exercise (EEex goal of 35 kcal/kg/wk), or observation group. Individuals maintained body weight within 3% of baseline. Pre/postphysical activity between-group measurements included body composition, calculated energy intake, TDEE, energy stores, and resting metabolic rate. Results: Sixty weight-stable individuals completed the protocols. Exercise groups increased EEex in a stepwise manner compared with the observation group (P < .001). There was no group effect on changes in TDEE, energy intake, fat-free mass, or resting metabolic rate. Fat mass and energy stores decreased among the females in the high-exercise group (P = .007). Conclusions: The increase in EEex did not result in an equivalent increase in TDEE. There was a sex difference in the relationship among energy balance components. These results suggest a weight-independent compensatory response to exercise training with potentially a sex-specific adjustment in body composition.

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Nicola Brown, Jacky Forsyth, Rachael Bullingham and Claire-Marie Roberts

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Nicole Johnson, Katie Hanna, Julie Novak and Angelo P. Giardino

While society at large recognizes the many benefits of sport, it is important to also recognize and prevent factors that can lead to an abusive environment. This paper seeks to combine the current research on abuse in the sport environment with the work of the U.S. Center for SafeSport. The inclusion of risk factors unique to sport and evidence-informed practices provides framing for the scope and response to sexual abuse in sport organizations in the United States. The paper then explores the creation and mission of the U.S. Center for SafeSport, including the role of education in prevention and of policy, procedures, audit, and compliance as important aspects of a comprehensive safeguarding strategy. This paper provides preliminary data on the reach of the Center, established in 2017. This data captures the scope of education and training and the increase in reports to the Center from within the U.S. Olympic and Paralympic Movement.

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Lori A. Gano-Overway

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Samantha M. Ross, Ellen Smit, Joonkoo Yun, Kathleen Bogart, Bridget Hatfield and Samuel W. Logan

Background: Children and adolescents with disabilities often report low levels of physical activity (PA). Estimating the magnitude of PA disparities has been previously challenged by underreporting and variability in subsampling of disability. Using the National Survey of Children’s Health, this study estimated the population-level PA disparities experienced and the association between disability status and PA engagement. Methods: Weighted prevalence of PA engagement (National Physical Activity Guidelines for Americans (2nd edition) and sports participation) was compared across disability groups for children (n = 20,867, 6–11 y) and adolescents (n = 28,651, 12–17 y) and found to be 12%. Age-stratified multivariable logistic regressions estimated the likelihood of PA engagement as a function of disability status and type, after adjusting for child and household factors. Results: Children, but not adolescents, with disabilities had significantly lower odds of being sufficiently active compared with peers without disabilities (adjusted odds ratio = 0.75; 95% confidence interval, 0.60–0.94). Across age groups, the lowest prevalence rates were observed among those experiencing function and mobility disabilities. Children and adolescents were significantly less likely to participate in sports compared with peers. Conclusion: Children with function and mobility disabilities were identified as priority subpopulations least likely to be sufficiently active. The disparity in sports participation highlights a critical intervention point for increasing PA among children with disabilities.

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Ignacio Perez-Pozuelo, Thomas White, Kate Westgate, Katrien Wijndaele, Nicholas J. Wareham and Soren Brage

Background: Wrist-worn accelerometry is the commonest objective method for measuring physical activity in large-scale epidemiological studies. Research-grade devices capture raw triaxial acceleration which, in addition to quantifying movement, facilitates assessment of orientation relative to gravity. No population-based study has yet described the interrelationship and variation of these features by time and personal characteristics. Methods: 2,043 United Kingdom adults (35–65 years) wore an accelerometer on the non-dominant wrist and a chest-mounted combined heart-rate-and-movement sensor for 7 days free-living. From raw (60 Hz) wrist acceleration, we derived movement (non-gravity acceleration) and pitch and roll (forearm) angles relative to gravity. We inferred physical activity energy expenditure (PAEE) from combined sensing and sedentary time from approximate horizontal arm angle coupled with low movement. Results: Movement differences by time-of-day and day-of-week were associated with forearm angles; more movement in downward forearm positions. Mean (SD) movement was similar between sexes ∼31 (42) mg, despite higher PAEE in men. Women spent longer with the forearm pitched >0°, above horizontal (53% vs 36%), and less time at <0° (37% vs 53%). Diurnal pitch was 2.5–5° above and 0–7.5°below horizontal during night and daytime, respectively; corresponding roll angles were ∼0° (hand flat) and ∼20° (thumb-up). Differences were more pronounced in younger participants. All diurnal profiles indicated later wake-times on weekends. Daytime pitch was closer to horizontal on weekdays; roll was similar. Sedentary time was higher (17 vs 15 hours/day) in obese vs normal-weight individuals. Conclusions: More movement occurred in forearm positions below horizontal, commensurate with activities including walking. Findings suggest time-specific population differences in behaviors by age, sex, and BMI.

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Matthew Pearce, Tom R.P. Bishop, Stephen Sharp, Kate Westgate, Michelle Venables, Nicholas J. Wareham and Søren Brage

Harmonization of data for pooled analysis relies on the principle of inferential equivalence between variables from different sources. Ideally, this is achieved using models of the direct relationship with gold standard criterion measures, but the necessary validation study data are often unavailable. This study examines an alternative method of network harmonization using indirect models. Starting methods were self-report or accelerometry, from which we derived indirect models of relationships with doubly labelled water (DLW)-based physical activity energy expenditure (PAEE) using sets of two bridge equations via one of three intermediate measures. Coefficients and performance of indirect models were compared to corresponding direct models (linear regression of DLW-based PAEE on starting methods). Indirect model beta coefficients were attenuated compared to direct model betas (10%–63%), narrowing the range of PAEE values; attenuation was greater when bridge equations were weak. Directly and indirectly harmonized models had similar error variance but most indirectly derived values were biased at group-level. Correlations with DLW-based PAEE were identical after harmonization using continuous linear but not categorical models. Wrist acceleration harmonized to DLW-based PAEE via combined accelerometry and heart rate sensing had the lowest error variance (24.5%) and non-significant mean bias 0.9 (95%CI: −1.6; 3.4) kJ·day−1·kg−1. Associations between PAEE and BMI were similar for directly and indirectly harmonized values, but most fell outside the confidence interval of the criterion PAEE-to-BMI association. Indirect models can be used for harmonization. Performance depends on the measurement properties of original data, variance explained by available bridge equations, and similarity of population characteristics.

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Melanna F. Cox, Greg J. Petrucci Jr., Robert T. Marcotte, Brittany R. Masteller, John Staudenmayer, Patty S. Freedson and John R. Sirard

Purpose: Develop a direct observation (DO) system to serve as a criterion measure for the calibration of models applied to free-living (FL) accelerometer data. Methods: Ten participants (19.4 ± 0.8 years) were video-recorded during four, one-hour FL sessions in different settings: 1) school, 2) home, 3) community, and 4) physical activity. For each setting, 10-minute clips from three randomly selected sessions were extracted and coded by one expert coder and up to 20 trained coders using the Observer XT software (Noldus, Wageningen, the Netherlands). The coder defines each whole-body movement which was further described with three modifiers: 1) locomotion, 2) activity type, and 3) MET value (used to categorize intensity level). Percent agreement was calculated for intra- and inter-rater reliability. For intra-rater reliability, the criterion coder coded all 12 clips twice, separated by at least one week between coding sessions. For inter-rater reliability, coded clips by trained coders were compared to the expert coder. Intraclass correlations (ICCs) were calculated to assess the agreement of intensity category for intra- and inter-rater comparisons described above. Results: For intra-rater reliability, mean percent agreement ranged from 91.9 ± 3.9% to 100.0 ± 0.0% across all variables in all settings. For inter-rater reliability, mean percent agreement ranged from 88.2 ± 3.5% to 100.0 ± 0.0% across all variables in all settings. ICCs for intensity category ranged from 0.74–1.00 and 0.81–1.00 for intra- and inter-rater comparisons, respectively. Conclusion: The DO system is reliable and feasible to serve as a criterion measure of FL physical activity in young adults to calibrate accelerometers, subsequently improving interpretation of surveillance and intervention research.