The purpose of this study was to evaluate the efficacy of a specific 8-week exercise rehabilitation program as an intervention to treat recurrent nonspecific low back pain in adolescents. A randomized controlled trial involving 54 adolescents (14.6 ± 0.6 years) who suffered from recurrent nonspecific low back pain participated in either the exercise rehabilitation program or a control condition. Pre- and postintervention measures of low back pain status and biological risk indicators were taken. Two-way mixed ANOVA was conducted and significance was set at p < .01. Significant improvement was noted in the exercise rehabilitation group for perceived severity of pain (effect size 1.47) and number of occasions missing physical activity (effect size 0.99). Significant improvement in the exercise rehabilitation group for sit-and-reach performance, hip range of motion, lumbar sagittal mobility (modified Schöber), and number of sit-ups in 60 s were also identified. In conclusion, the specific exercise program appeared to provide positive benefits for adolescents suffering from recurrent nonspecific low back pain. Further evaluation is required to evaluate the effectiveness of the exercise rehabilitation program in relation to other interventions and to assess the long-term effectiveness.
Michelle Jones, Gareth Stratton, Tom Reilly, and Vishwanath Unnithan
Nicola D. Ridgers, Stuart J. Fairclough, and Gareth Stratton
Recess is an opportunity for children to engage in daily physical activity. The aim of this study was to investigate the 12-month effects of a playground intervention on children’s moderate-to-vigorous (MVPA) and vigorous physical activity (VPA) during morning and lunchtime recess.
Four hundred and seventy children (232 boys, 238 girls) from 26 elementary schools participated in the study. Fifteen schools redesigned the playground environment using playground markings and physical structures. Eleven schools served as socioeconomic matched controls. Physical activity levels were quantified using heart rate and accelerometry at baseline, 6 months, and 12 months post-intervention. A 3-level (time, pupil, and school) multilevel analysis was used to determine the effects of the intervention across time on MVPA and VPA.
Positive yet nonsignificant intervention effects were found for MVPA and VPA during morning and lunchtime recess. Intervention children were more active during recess than control children. Interactions revealed that the intervention effect was stronger at 6 months than 12 months post-intervention.
A playground markings and physical structures intervention had a positive effect on intervention children’s morning and lunchtime MVPA and VPA when assessed using heart rate and accelerometry, but this effect is strongest 6-months post-intervention and decreased between 6 months and 12 months.
Nicola D. Ridgers, Gareth Stratton, and Thomas L. McKenzie
Children frequently engage in diverse activities that are broadly defined as play, but little research has documented children’s activity levels during play and how they are influenced by social contexts. Assessing potentially modifiable conditions that influence play behavior is needed to design optimal physical activity interventions.
System for Observing Children’s Activity and Relationships during Play (SOCARP) was developed to simultaneously assess children’s physical activity, social group sizes, activity type, and social behavior during play. One hundred and fourteen children (48 boys, 66 girls; 42% overweight) from 8 elementary schools were observed during recess over 24 days, with 12 days videotaped for reliability purposes. Ninety-nine children wore a uni-axial accelerometer during their observation period.
Estimated energy expenditure rates from SOCARP observations and mean accelerometer counts were significantly correlated (r = .67; P < .01), and interobserver reliabilities (ie, percentage agreement) for activity level (89%), group size (88%), activity type (90%) and interactions (88%) met acceptable criteria. Both physical activity and social interactions were influenced by group size, activity type, and child gender and body weight status.
SOCARP is a valid and reliable observation system for assessing physical activity and play behavior in a recess context.
Kelly A. Mackintosh, Kate Ridley, Gareth Stratton, and Nicola D. Ridgers
This study sought to ascertain the energy expenditure (EE) associated with different sedentary and physically active free-play activities in primary school-aged children.
Twenty-eight children (13 boys; 11.4 ± 0.3 years; 1.45 ± 0.09 m; 20.0 ± 4.7 kg·m-2) from 1 primary school in Northwest England engaged in 6 activities representative of children’s play for 10 minutes (drawing, watching a DVD, playground games and free-choice) and 5 minutes (self-paced walking and jogging), with 5 minutes rest between each activity. Gas exchange variables were measured throughout. Resting energy expenditure was measured during 15 minutes of supine rest.
Child (Schofield-predicted) MET values for watching a DVD, self-paced jogging and playing reaction ball were significantly higher for girls (P < .05).
Utilizing a field-based protocol to examine children’s free-living behaviors, these data contribute to the scarcity of information concerning children’s EE during play to update the Compendium of Energy Expenditures for Youth.
Simon J. Roberts, Lynne M. Boddy, Stuart J. Fairclough, and Gareth Stratton
The aims of this study were firstly to examine whether there was an observed relative age effect in the cardiorespiratory fitness scores of 9-10 and 11-12 year old children, and secondly whether any observed effect was maintained after controlling for somatic maturity. Cardiorespiratory fitness data from 11,404 children aged 9-10 years and 3,911 children aged 11-12 years were obtained from a large cross-sectional field-based fitness testing program. A one-way ANOVA revealed a statistically significant relative age effect (p < .01) existed in the 20mSRT scores across all the age groups. Furthermore, ANCOVA analyses identified a statistically significant relative age effect was maintained after controlling for somatic maturation (p < .05). From a public health perspective these results confirm the existence of relative age effects for the first time and consequently may hold implications for relatively younger children in the accurate assessment of their cardiorespiratory fitness scores.
Lee E.F. Graves, Nicola D. Ridgers, Greg Atkinson, and Gareth Stratton
Active video game interventions typically provide children a single game that may become unappealing. A peripheral device (jOG) encourages step-powered gaming on multiple games. This trial evaluated the effect of jOG on children’s objectively measured PA, body fat and self-reported behaviors. 42 of 58 eligible children (8–10 y) randomly assigned to an intervention (jOG) or control (CON) completed the trial. Intervention children received two jOG devices for home use. Analyses of covariance compared the intervention effect at 6 and 12 weeks from baseline. No differences were found between groups for counts per minute (CPM; primary outcome) at 6 and 12 weeks (p > .05). Active video gaming increased (adjusted change 0.95 (95% CI 0.25, 1.65) h·d−1, p<.01) and sedentary video gaming decreased (-0.34 (-1.24, 0.56) h·d−1, p > .05) at 6 weeks relative to CON. No body fat changes were observed between groups. Targeted changes in video game use did not positively affect PA. Larger trials are needed to verify the impact of active video games on children’s PA and health.
Mareesa O’Dwyer, Stuart J. Fairclough, Nicola Diane Ridgers, Zoe Rebecca Knowles, Lawrence Foweather, and Gareth Stratton
Identifying periods of the day which are susceptible to varying levels of physical activity (PA) may help identify key times to intervene and potentially change preschool children’s PA behaviors. This study assessed variability of objectively measured moderate-to-vigorous physical activity (MVPA) during weekdays and weekend days among preschool children.
One hundred and eighty-eight children (aged 3 to 5 years; 53.2% boys) from a northwest English city wore uni-axial accelerometers for 7 consecutive days.
Higher levels of MVPA were recorded in boys, particularly those who attended preschool for a half day. Children who attended preschool for a full day engaged in 11.1 minutes less MVPA than children who attended for a half day. After-school hours were characterized by a decrease in activity for all groups. Patterns of activity during the weekend were smoother with less variability.
This study identified discrete segments of the week, specifically afterschool and during the weekend, when preschoolers engage in low levels of PA. Higher levels of MVPA among children who attended preschool for less time each day suggests that the structured preschool environment is related to decreased activity. Consequently, there is a need for interventions in young children to focus on school and home environments.
Stuart J. Fairclough, Lynne M. Boddy, Nicola D. Ridgers, and Gareth Stratton
The study examined associations between children’s weight status, physical activity intensity, and physical self-perceptions. Data were obtained from 409 children (224 girls) aged 10–11 years categorized as normal-weight or overweight/obese. Physical activity was assessed using accelerometry, and children completed the Physical Self-Perception Profile. After controlling for the effects of age, maturation, and socioeconomic status vigorous physical activity was significantly associated with normal-weight status among boys (OR = 1.13, p = .01) and girls (OR = 1.13, p = .03). Normal-weight status was significantly associated with perceived Physical Condition (Boys: OR = 5.05, p = .008; Girls: OR = 2.50, p = .08), and Body Attractiveness (Boys: OR = 4.44, p = .007; Girls: OR = 2.56, p = .02). Weight status of 10–11 year old children was significantly associated with time spent in vigorous physical activity and self-perceptions of Body Attractiveness and Physical Condition.
Nicola D. Ridgers, Lee E.F. Graves, Lawrence Foweather, and Gareth Stratton
Understanding children’s physical activity (PA) patterns and the factors that may influence PA are important for developing interventions within this population. One hundred and ten children aged 9–10 years from 8 schools had their PA patterns assessed over 7 days. Physiological and self-report data were also collected. Multilevel analyses revealed that cardiorespiratory fitness was a consistent, significant and positive predictor of weekday and weekend PA, while the availability of home sedentary activities was a significant but negative predictor of PA. Since a range of variables were associated with PA levels, intervention developers should be cognizant of variables that may influence children’s activity.
Denise M. Roche, Sarah Edmunds, Tim Cable, Mo Didi, and Gareth Stratton
No studies to date have evaluated the relationship between exercise and microvascular function in youth with type 1 diabetes mellitus (T1DM). Twenty-nine complication free children and adolescents with T1DM were assessed for skin microvascular reactivity, aerobic fitness (VO2peak) and physical activity. VO2peak but not physical activity was significantly and independently associated with maximal hyperemia of the skin microcirculation (p < .01). No significant associations were found between venoarte-riolar reflex (VAR) vasoconstriction and VO2peak or physical activity. Aerobic fitness may be an important indicator or mediator of effective microvascular endothelial function in youth with T1DM.