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Ítalo R. Lemes, Rômulo A. Fernandes, Bruna C. Turi-Lynch, Jamile S. Codogno, Luana C. de Morais, Kelly A.K. Koyama and Henrique L. Monteiro

Background: Metabolic syndrome (MetS) is a combination of risk factors for cardiovascular disease and type 2 diabetes mellitus. The prevalence of MetS worldwide is increasing. There is no study investigating the economic burden of MetS, especially in developing countries, on medication-related expenditure. The aim of this study was to investigate the association of medication-related expenditures with MetS and to explore how physical activity (PA) may influence this association. Methods: A total of 620 participants, 50 years or older, randomly selected in the city of Bauru, Brazil. Participants were followed from 2010 to 2014, and data on health care expenditure were collected annually. PA questionnaire was applied at baseline, 2 (2012), and 4 (2014) years later. Results: Mean age was 64.7 (95% confidence interval, 64.1–65.3). MetS was associated with higher medication expenditure related to diseases of the circulatory (P <.01) and endocrine (P <.01) systems. MetS explained 17.2% of medication-related expenditures, whereas PA slightly attenuated this association, explaining 1.1% of all health care costs. Conclusion: This study demonstrates that MetS has a significant burden on health care expenditures among adults, whereas PA seems to affect this phenomenon significantly, but in low magnitude.

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Eduardo L. Caputo, Paulo H. Ferreira, Manuela L. Ferreira, Andréa D. Bertoldi, Marlos R. Domingues, Debra Shirley and Marcelo C. Silva

Background: To investigate whether engagement in leisure-time physical activity before or during pregnancy is associated with low back pain (LBP) outcomes during pregnancy and postpartum prevalence of LBP in women who reported LBP during pregnancy. Methods: Data from the 2015 Pelotas Birth Cohort Study, were used. Demographic, socioeconomic, and gestational characteristics, as well as physical activity prior to and during pregnancy were recorded at perinatal assessment. LBP outcomes during pregnancy (pain intensity, activity limitation, and care seeking) and postpartum (prevalence of LBP) were collected at the 1-year follow-up. Results: Pain intensity, care seeking, and prevalence of LBP postpartum period were not associated with physical activity either before or during pregnancy. However, women engaged in physical activity during pregnancy and at least for 2 trimesters had lower odds ratio of activity limitation associated with LBP during pregnancy (odds ratio: 0.60; 95% confidence interval, 0.41 to 0.88; odds ratio: 0.20; 95% confidence interval, 0.04 to 0.86, respectively). Conclusion: Meeting the recommended levels of physical activity during pregnancy is associated with less activity limitation related to LBP during pregnancy. However, physical activity levels, either before or during pregnancy, were not associated with pain intensity, care seeking, and postpartum LBP.

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Tania Pereira, John Durocher and Jamie Burr

Background: Insufficient physical activity (PA) is associated with numerous chronic diseases and premature mortality, and the challenge of meeting recommended PA guidelines is exacerbated in the winter. Snowmobiling can potentially contribute to PA accumulation, but the objective metabolic and physical demands are unclear. The purpose of this study was to assess the physical demands of riding a snowmobile. Methods: Habitual snowmobile riders responded to a survey describing a typical ride (n = 4015). Using this data, terrain-specific testing courses were created, and recreational snowmobile riders (n = 40) participated in a scaled representative ride (21 [8] min) while aerobic metabolism (VO2) and muscular fatigue were quantified. Results: The mean VO2 while riding, irrespective of terrain, was 18.5 (8.4) mL·kg−1·min−1, with significant differences based on geographic location (13.4 [5.2] vs 25.7 [6.6] mL·kg−1·min−1, P < .001). Muscular fatigue was apparent in maximal handgrip (−7% [8%], P < .001) across both riding terrains, but not lower body power, suggesting a greater influence of an upper body strength component. Conclusions: Snowmobiling is an activity that generally falls within the moderate-intensity activity range and involves both aerobic fitness and muscular strength. There were substantial differences in demand between terrains, suggesting that additional benefits may be conferred from mountain riding as it was more metabolically demanding.

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Ryan S. Garten, Matthew C. Scott, Tiffany M. Zúñiga, Austin C. Hogwood, R. Carson Fralin and Jennifer Weggen

Background: This study sought to determine the impact of an acute prior bout of high-intensity interval aerobic exercise on attenuating the vascular dysfunction associated with a prolonged sedentary bout. Methods: Ten young (24 ± 1 y) healthy males completed two 3-hour sessions of prolonged sitting with (SIT-EX) and without (SIT) a high-intensity interval aerobic exercise session performed immediately prior. Prior to and 3 hours into the sitting bout, leg vascular function was assessed with the passive leg movement technique, and blood samples were obtained from the lower limb to evaluate changes in oxidative stress (malondialdehyde and superoxide dismutase) and inflammation (interleukin-6). Results: No presitting differences in leg vascular function (assessed via passive leg movement technique-induced hyperemia) were revealed between conditions. After 3 hours of prolonged sitting, leg vascular function was significantly reduced in the SIT condition, but unchanged in the SIT-EX. Lower limb blood samples revealed no alterations in oxidative stress, antioxidant capacity, or inflammation in either condition. Conclusions: This study revealed that lower limb vascular dysfunction was significantly attenuated by an acute presitting bout of high-intensity interval aerobic exercise. Further analysis of lower limb blood samples revealed no changes in circulating oxidative stress or inflammation in either condition.

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Julie D. Guldager, Anja Leppin, Jesper von Seelen and Pernille T. Andersen

Background: The reasons for the mixed evidence of the effectiveness of school-based physical activity programs can be many, including implementation challenges. Studying program implementation can potentially contribute to enhancing effectiveness, the design of future interventions, improved implementation, and the interpretation of outcomes. Methods: For this process evaluation, individual interviews were conducted with 16 teachers who had implemented the program “Active All Year Round” in a fifth-grade school class (students aged 9–11 y) in 2017. Through systematic text condensation feasibility and barriers of program implementation, perceived program reach and the programs’ influence on social cohesion were identified and discussed. Results: Teachers described the program as very feasible to implement and identified very few implementation barriers, the most prominent being time constrains. Perceived program reach was very high, and teachers reported that those students who are less confident when it comes to physical activity did not have differential participation than those feeling more confident about physical activity. Finally, the program was perceived to positively affect social cohesion in class. Conclusions: Active All Year Round is a standardized, flexible, and easily implemented program in Danish schools. Future studies are needed to study implementation from a student’s perspective and/or students’ role in and experiences with competition-based health programs.

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Chelsea L. Kracht, Elizabeth K. Webster and Amanda E. Staiano

Background: Little is known about variation in meeting the 24-Hour Movement Guidelines (including physical activity [PA], sleep, and screen time [ST]) in early childhood. The aim was to evaluate sociodemographic differences in meeting the 24-Hour Movement Guidelines. Methods: Parents of 3–4 year old children reported sociodemographic information and ST. Sleep and PA were measured using accelerometry, and height and weight were objectively measured. The 24-Hour Movement Guidelines include daily PA (total PA: ≥3 h; including ≥1 h of moderate to vigorous), sleep (10–13 h), and ST (≤1 h). Meeting guidelines by age, sex, race, poverty level, and weight status were assessed using chi-square and linear regression models. Results: Of 107 children, 57% were white and 26% lived in households at or below the poverty level. Most children met the PA (91.5%) and sleep (86.9%) guidelines, but few met ST (14.0%) or all 3 (11.3%) guidelines. African American children and children who lived at or below the poverty level were less likely to meet the sleep, ST, and all 3 guidelines compared with others (P < .01 for all). There were no other differences. Conclusion: These results suggest future interventions should focus on reducing differences in movement, namely in sleep and ST.

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Bruno P. Melo, Débora A. Guariglia, Rafael E. Pedro, Dennis A. Bertolini, Solange de Paula Ramos, Sidney B. Peres and Solange M. Franzói de Moraes

Background: Combined exercise (CE) has been recommended for individuals living with HIV/AIDS (ILWHA) under antiretroviral therapy. However, depending on the intensity and duration, physical exercise may occasionally increase inflammatory parameters and reduce immunological responses that if not reversed, cause health injury specifically in this population. Information about immunological and hormonal responses after CE in ILWHA has not been completely elucidated. Therefore, the aim is to verify the acute effects of CE on cortisol, testosterone, immunoglobulin A, and pro-inflammatory and anti-inflammatory cytokines over 24 hours in ILWHA. Methods: Noninfected individuals and ILWHA undergone 5 sessions of CE prior to the acute assessment session. Seventy-two hours after the last session, the subjects were submitted to one session of CE (aerobic exercise: 25 min at 60–70% reserve heart rate and resistance exercise: 3 sets of 15 maximum repetitions of 6 exercises). Saliva samples were collected before, immediately, 6 and 24 hours after CE. Results: CE reduced cortisol (6 h: 2.54 [0.58] vs 0.65 [0.22] pg·mL−1; P = .02), increased testosterone (all moments) and immunoglobulin A levels (24 h: 255.3 [44.7] vs 349.2 [41.9] μm·mL−1; P = .01) without significant difference in cytokines levels in ILWHA. Conclusion: CE modulates cortisol, testosterone, and immunoglobulin A levels without the change in immunological parameters in ILWHA.

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Estela Farías-Torbidoni and Demir Barić

Background: Protected areas are important attractions for promoting healthy life habits. Consequently, to date, a number of studies have examined the association between visitors’ characteristics and physical activities. However, little is known about the specific users inclined exclusively to have sedentary behavior during a visit. Thus, using the Alt Pirineu Natural Park (Spain) as a case study, the aim of this study is to determine the influence of sociodemographic, trip, motivational, and opinion descriptors on the likelihood of participating in sedentary behavior while visiting a protected natural area. Methods: The data used were randomly collected from visitors through an onsite structured questionnaire (N = 628). Results: Metabolic equivalent consumption was used to empirically distinguish the sedentary (22.6%) from the active (77.4%) visitor groups. A logistic regression analysis indicated that the trip and motivational descriptors explained the highest degree of the overall variation in reporting sedentary behavior. Conclusion: The study contributed to documenting the information about visitors’ behavior in protected areas, and the findings may aid park managers in developing effective management strategies for promoting and enhancing physical activity in protected natural areas.

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Jordan Andre Martenstyn, Lauren Powell, Natasha Nassar, Mark Hamer and Emmanuel Stamatakis

Background: Previous epidemiological studies examining the association between physical activity (PA) and mortality risk have measured absolute PA intensity using standard resting metabolic rate reference values that fail to consider individual differences. This study compared the risk of all-cause and cardiovascular mortality between absolute and corrected estimates of PA volume. Methods: 49,982 adults aged ≥40 years who participated in the Health Survey for England and Scottish Health Survey in 1994–2008 were included in our study. PA was classified as absolute or corrected metabolic equivalent (MET)-hours per week, taking participant’s weight, height, age, and sex into account. Cox regression models were used to examine the association between absolute and corrected PA volumes and all-cause and cardiovascular mortality. Results: The authors found no difference in the association between levels of PA and risk of all-cause and cardiovascular mortality for absolute and corrected MET-hours per week, although there was a consistent decrease in mortality risk with increasing PA. There was no difference in mortality when analyses were stratified by sex, age, and body mass index. Conclusions: The association between PA volume and risk of mortality was similar regardless of whether PA volume was estimated using absolute or corrected METs. There is no empirical justification against the use of absolute METs to estimate PA volume from questionnaires.