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Ashley Kuzmik, Barbara Resnick, Pamela Cacchione, Rachel Arendacs, and Marie Boltz

Persons with dementia are at high risk for hospital-acquired disability, associated with low physical activity during hospitalizations. To determine the effectiveness of efforts to increase physical activity, a valid and reliable measurement approach is required. Data from an ongoing cluster randomized clinical trial examined the feasibility and validity of the MotionWatch 8 (MW8) triaxial actigraphy device. The sample included 321 participants of which 259 (81%) were willing to wear the MW8 for 24 hr. Regression analysis revealed that time in low activity, β = 0.17, t(255) = 2.9, p = .004, and time in moderate activity, β = 0.14, t(255) = 2.4, p = .017, measured by the MW8, were associated with participants’ physical function. Engagement in moderate physical activity was associated with return to baseline function at discharge (Wald χ2 = 4.10, df = 1, p = .043). The study provides preliminary support for the feasibility and validity of the MW8 in hospitalized persons with dementia.

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Jennifer R. Pharr, Jason D. Flatt, Lung-Chang Chien, Axenya Kachen, and Babayemi O. Olakunde

Introduction: There is a positive association between exercise and improved mental health in the general population. Although there is a greater burden of psychological distress among lesbian, gay, and bisexual (LGB) people, little is known about the association between exercise and mental health in this population. The authors explored the association between exercise and poor mental health reported by LGB adults in the United States. Methods: Our analyses used data from the 2017 Behavioral Risk Factor Surveillance System survey. Multiple regression analyses were used to determine the association between exercising and mental health days adjusting for sociodemographic characteristics. Results: Data were available for 6371 LGB participants. LGB adults who participated in any exercise reported almost 1.0 day less of poor mental health in the past 30 days compared with LGB adults who did not exercise (P ≤ .01). LGB adults who met one or both of the physical activity guidelines had between 1.2 and 1.7 days less of poor mental health compared with those who did not meet the guidelines (P ≤ .01). Conclusion: Fewer days of poor mental health were reported by LGB adults who exercised. Determining whether physical activity interventions, including aerobic and strengthening exercises, could improve mental health outcomes in LGB adults should be studied.

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Mário Esteves, Carina Silva, Sofia S. Pereira, Tiago Morais, Ângela Moreira, Madalena M. Costa, Mariana P. Monteiro, and José A. Duarte

Introduction: Benefits of regular physical exercise were demonstrated as preventive and coadjuvant nonpharmacological anticancer therapy. However, the role of exercise in modulating prostate cancer behavior has yet to be established. Methods: Prostate tumors were induced in C57BL/6 male mice (n = 28) by subcutaneous inoculation of a suspension of murine androgen-independent RM1 cells (1.5 × 105 cells/500 μL phosphate-buffered saline) in the dorsal region. Mice were randomly allocated into 2 study groups: sedentary tumor-induced (n = 14) and exercised tumor-induced (n = 14). Exercise consisted of voluntary running in wheeled cages. Mice (n = 7 per group) were sacrificed either 14 or 28 days after cell inoculation to evaluate tumor weight and percentage of area occupied by immunohistochemistry stained cells for Ki-67 and TdT-mediated dUTP-biotin nick end labeling, used as surrogate markers of cell proliferation and apoptosis, respectively. Results: Compared with sedentary tumor-induced mice, the tumors developed by exercised tumor-induced mice were significantly smaller at 14 days (0.17 [0.12] g vs 0.48 [0.24] g, P < .05) and at 28 days (0.92 [0.73] g vs 2.09 [1.31] g, P < .05), with smaller Ki-67 and greater TdT-mediated dUTP-biotin nick end-labeling stained areas (P < .05). Conclusion: These results suggest that regular voluntary running inhibits prostate cancer cell growth by reducing cell proliferation and enhancing apoptosis.

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Colin B. Shore, Gill Hubbard, Trish Gorely, Angus M. Hunter, and Stuart D.R. Galloway

Background: Exercise referral schemes (ERS) aim to tackle noncommunicable disease via increasing levels of physical activity. Health benefits are reliant on uptake and attending ERS sessions. Hence, it is important to understand which characteristics may influence these parameters to target interventions to improve uptake and attendance to those who need it most. Method: Secondary analysis of one ERS database was conducted to (1) profile participants’ nonuptake of exercise referral; (2) describe any differences between nonattenders and attenders; and (3) report session count of attenders, exploring any relationship between attender demographics and session count. Results: The study showed that (1) sociodemographic profile of nonattenders was very similar to that of those who attended; (2) there was a high, early withdrawal rate of attenders wherein 68% exited the scheme at 5 exercise sessions or less; and (3) session count did not appear to differ by demographic characteristics. Conclusions: Nonattendance and session count did not appear to differ by demographic characteristics. Attendance at ERS was low. Nonuptake and reduced attendance may limit any associated health benefits that may be achieved from ERS. Therefore, it is important to identify additional factors that may influence participants’ choice to uptake and attend ERS.

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Christianne F. Coelho-Ravagnani, Jeeser A. Almeida, Xuemei Sui, Fabricio C.P. Ravagnani, Russell R. Pate, and Steven N. Blair

Background: The effects of compliance with the US Physical Activity (PA) Guidelines and changes in compliance over time on cardiovascular disease (CVD) mortality are unknown. Methods: Male participants in the Aerobics Center Longitudinal Study (n = 15,411; 18–100 y) reported leisure-time PA between 1970 and 2002. The frequency of and time spent in PA were converted into metabolic equivalent minutes per week. The participants were classified into remained inactive, became active, became inactive, or remained active groups according to their achievement of the PA guidelines along the follow-up, equivalent here to at least 500 metabolic equivalent minutes of PA per week. Cox regression adjusted for different models was used for the analyses, using age, body mass index, smoking and drinking status, hypertension, diabetes, hypercholesterolemia, and parental history of CVD. Results: Over a mean follow-up of 6.2 years, 439 CVD deaths occurred. Consistently meeting the PA guidelines, compared with not meeting, was associated with a 54% (95% confidence interval, 0.32–0.67) decreased risk of CVD mortality. After controlling for all potential confounders, the risk reduction was 47% (95% confidence interval, 0.36–0.77). Conclusions: Maintaining adherence to the PA guidelines produces substantial reductions in the risk of CVD deaths in men. Furthermore, discontinuing compliance with the guidelines may offset the beneficial effects on longevity.

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Nivash Rugbeer, Demitri Constantinou, and Georgia Torres

Background: High-intensity training is comprised of sprint interval training (SIT) and high-intensity interval training (HIIT). This study compared high-intensity training with moderate-intensity continuous training (MICT) on cardiorespiratory fitness (CRF) and body fat percentage for overweight or obese persons. Methods: A systematic search of randomized controlled trials using the health science databases occurred up to April, 2020. Twenty-six studies were included for complete analysis. A total of 784 participations were analyzed. The unstandardized mean difference for each outcome measurement was extracted from the studies and pooled with the random effects model. Results: MICT was significantly better at improving CRF compared with SIT (mean difference = −0.92; 95% confidence interval, −1.63 to −0.21; P = .01; I 2 = 10%). Furthermore, there was no significant difference between MICT versus HIIT on CRF (mean difference = −0.52; 95% confidence interval, −1.18 to 0.13; P = .12; I 2 = 23%). There was no significant difference in body fat percentage between MICT versus HIIT and MICT versus SIT. Conclusions: MICT was significantly better at improving CRF than SIT in overweight or obese persons.

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João R. Pereira, Dylan P. Cliff, Eduarda Sousa-Sá, Zhiguang Zhang, Jade McNeill, Sanne L.C. Veldman, and Rute Santos

Background: This study aimed to understand whether a higher number of sedentary bouts (SED bouts) and higher levels of sedentary time (SED time) occur according to different day types (childcare days, nonchildcare weekdays, and weekends) in Australian toddlers (1–2.99 y) and preschoolers (3–5.99 y). Methods: The SED time and bouts were assessed using ActiGraph GT3X+ accelerometers. The sample was composed of 264 toddlers and 343 preschoolers. The SED bouts and time differences were calculated using linear mixed models. Results: The toddlers’ percentage of SED time was higher on nonchildcare days compared with childcare days (mean difference [MD] = 2.3; 95% confidence interval, 0.7 to 3.9). The toddlers had a higher number of 1- to 4-minute SED bouts on nonchildcare days compared with childcare days. The preschoolers presented higher percentages of SED time during nonchildcare days (MD = 3.1; 95% confidence interval, 1.6 to 4.5) and weekends (MD = 1.9; 95% confidence interval, 0.4 to 3.4) compared with childcare days. The preschoolers presented a higher number of SED bouts (1–4, 5–9, 10–19, and 20–30 min) during nonchildcare days and weekends compared with childcare days. No SED times or bout differences were found between nonchildcare days and weekends, neither SED bouts >30 minutes on toddlers nor on preschoolers. Conclusion: The SED time and bouts seem to be lower during childcare periods, which means that interventions to reduce sedentary time should consider targeting nonchildcare days and weekends.

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Aashirwad Mahajan, Satish Mahajan, and Swanand Tilekar

The primary objective of this pilot randomized controlled trial was to study the feasibility (recruitment and retention rates) for interval training and sleep hygiene (SH) in adults aged above 60 years. Thirteen out of 46 screened individuals from a home for older adults in Shirdi (Maharashtra, India) were randomly assigned by permuted block randomization to either an interval training with SH group (n = 6) or an SH alone group (n = 7). The authors measured sleep with the S+ sleep monitor manufactured by ResMed (USA) Pittsburgh Sleep Quality Index and quality of life with Short Form-12 health survey version 2. Interval training consisted of 8 weeks of stationary cycling, whereas SH consisted of lecture and handouts. Recruitment was 38.2%, retention was >80% for both the interventions, and there was one loss to follow-up in SH. Interval training and SH were feasible for older adults and supported a full-scale randomized controlled trial.

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Lyndel Hewitt, Anthony D. Okely, Rebecca M. Stanley, Marjika Batterham, and Dylan P. Cliff

Background: Tummy time is recommended by the World Health Organization as part of its global movement guidelines for infant physical activity. To enable objective measurement of tummy time, accelerometer wear and nonwear time requires validation. The purpose of this study was to validate GENEActiv wear and nonwear time for use in infants. Methods: The analysis was conducted on accelerometer data from 32 healthy infants (4–25 wk) wearing a GENEActiv (right hip) while completing a positioning protocol (3 min each position). Direct observation (video) was compared with the accelerometer data. The accelerometer data were analyzed by receiver operating characteristic curves to identify optimal cut points for second-by-second wear and nonwear time. Cut points (accelerometer data) were tested against direct observation to determine performance. Statistical analysis was conducted using leave-one-out validation and Bland–Altman plots. Results: Mean temperature (0.941) and z-axis (0.889) had the greatest area under the receiver operating characteristic curve. Cut points were 25.6°C (temperature) and −0.812g (z-axis) and had high sensitivity (0.84, 95% confidence interval, 0.838–0.842) and specificity (0.948, 95% confidence interval, 0.944–0.948). Conclusions: Analyzing GENEActiv data using temperature (>25.6°C) and z-axis (greater than −0.812g) cut points can be used to determine wear time among infants for the purpose of measuring tummy time.

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Victor E. Ezeugwu, Piush J. Mandhane, Nevin Hammam, Jeffrey R. Brook, Sukhpreet K. Tamana, Stephen Hunter, Joyce Chikuma, Diana L. Lefebvre, Meghan B. Azad, Theo J. Moraes, Padmaja Subbarao, Allan B. Becker, Stuart E. Turvey, Andrei Rosu, Malcolm R. Sears, and Valerie Carson

Background: Movement behaviors (physical activity, sedentary time, and sleep) established in early childhood track into adulthood and interact to influence health outcomes. This study examined the associations between neighborhood characteristics and weather with movement behaviors in preschoolers. Methods: A subset of Canadian Healthy Infant Longitudinal Development birth cohort (n = 385, 50.6% boys) with valid movement behaviors data were enrolled at age 3 years and followed through to age 5 years. Objective measures of neighborhood characteristics were derived by ArcGIS software, and weather variables were derived from the Government of Canada weather website. Random forest and linear mixed models were used to examine predictors of movement behaviors. Cross-sectional analyses were stratified by age and season (winter and nonwinter). Results: Neighborhood safety, temperature, green space, and roads were important neighborhood characteristics for movement behaviors in 3- and 5-year-olds. An increase in temperature was associated with greater light physical activity longitudinally from age 3 to 5 years and also in the winter at age 5 years in stratified analysis. A higher percentage of expressways was associated with less nonwinter moderate to vigorous physical activity at age 3 years. Conclusions: Future initiatives to promote healthy movement behaviors in the early years should consider age differences, neighborhood characteristics, and season.