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Liu Y, Wadey CA, Barker AR, Williams CA. Process evaluation of school-based high-intensity interval training interventions for children and adolescents: a systematic review and meta-analysis of randomized controlled trials. BMC Public Health 2024; 24:348. [PMID: 38308213 PMCID: PMC10835840 DOI: 10.1186/s12889-024-17786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Several systematic reviews have been published to investigate the effectiveness of high-intensity interval training (HIIT) in schools. However, there has been limited attention given to understanding the functioning of the intervention processes, which is of paramount importance for interpreting and translating the intervention effectiveness. The aim of this systematic review is to determine the extent to which process evaluation is measured in school-based HIIT interventions and to explore the effects of process evaluation and intervention characteristics on cardiorespiratory fitness (CRF), body composition, muscular strength, and blood pressure. METHODS A comprehensive search was conducted in SPORT Discus (EBSCOhost), Web of Science, Scopus, Medline (Ovid) and Cochrane Central Register of Controlled Trials. The extent to which process evaluation is measured was narratively reported, alongside with the guidance of process evaluation of complex interventions by UK Medical Research Council. Meta-analyses and meta-regressions were conducted to determine the effects of process evaluation and intervention characteristics to the intervention outcomes. RESULTS The literature search identified 77 studies reporting on 45 school-based HIIT interventions. In total, five interventions reported process evaluation in a section or in a separate study, and only one intervention adopted a process evaluation framework. On average, 6 out of 12 process evaluation measures were reported in all interventions. Subgroup analyses did not indicate any beneficial treatment effects for studies with process evaluation group, whereas all pooled data and studies without process evaluation group showed significant improvement for CRF and body composition. CONCLUSION Process evaluation is frequently omitted in the literature of school-based HIIT in children and adolescents. Although reporting of process evaluation measures may not directly associate with better intervention outcomes, it allows accurate interpretation of intervention outcomes, thereby enhancing the generalisability and dissemination of the interventions.
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Affiliation(s)
- Yong Liu
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK
| | - Curtis A Wadey
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, Devon, EX1 2LU, UK.
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Duncombe SL, Stylianou M, Price L, Walker JL, Barker AR. Making a HIIT: Methods for quantifying intensity in high-intensity interval training in schools and validity of session rating of perceived exertion. J Sports Sci 2023; 41:1678-1686. [PMID: 38164965 DOI: 10.1080/02640414.2023.2291736] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024]
Abstract
Using the data from Making a HIIT, this paper aimed to: 1) investigate the different heart rate (HR) quantification methods reported in school-based high-intensity interval training (HIIT) studies; and 2) assess the criterion validity of session rating of perceived exertion (RPE). During an 8-week HIIT intervention, 213 students (13.1 (0.6) years; 46% female) completed 10-minute HIIT workouts during physical education lessons. In total, 1057 HR and RPE measurements were collected across 68 HIIT workouts. For aim 1, the average and peak HR across all participants and workouts were 79% (8%) and 92% (6%) of HRmax, respectively. The average RPE was 6 (2) points on a 10-point scale. An average of 51% of students in a class had an average HR ≥ 80% for each workout. The between-person variation for peak and average HR were 19% and 30% , respectively. Both average and peak HR decreased by 0.5% each week (p < 0.001). To assess aim 2, a within-participant correlation was calculated for the internal training load produced using HR and RPE data. The correlation was 0.39 (p < 0.001), which suggests utility of using RPE when HR is not a viable option.
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Affiliation(s)
- Stephanie L Duncombe
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Lisa Price
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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Wu J, Yang Y, Yu H, Li L, Chen Y, Sun Y. Comparative effectiveness of school-based exercise interventions on physical fitness in children and adolescents: a systematic review and network meta-analysis. Front Public Health 2023; 11:1194779. [PMID: 37342273 PMCID: PMC10278967 DOI: 10.3389/fpubh.2023.1194779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/18/2023] [Indexed: 06/22/2023] Open
Abstract
Background Schools provide a favorable setting for health education, however, the most effective school-based exercise mode for improving physical fitness remains unclear. This network meta-analysis was designed to assess and rank the comparative efficacy of six exercise modalities on physical fitness indicators in a school-based setting. Methods An online search of the Web of Science, PubMed, SPORTDiscus, and Scopus databases was conducted. Randomized and quasi-randomized controlled trials were considered. Outcomes included measures of anthropometry and body composition, muscular fitness, and cardiorespiratory fitness. Data were pooled with a random effects model using the frequentist framework. Results A total of 66 studies with 8,578 participants (48% girls) were included. High-intensity interval training was the most effective intervention reducing body mass index (mean difference (MD) = -0.60 kg·m-2, 95% confidence interval (95%CI) = -1.04 to -0.15, p = 0.009), elevating VO2max (MD = 3.59 mL·kg-1·min-1, 95% CI = 2.45 to 4.74, p < 0.001), and 20-meter sprint performance (MD = -0.35 s, 95% CI = -0.55 to -0.14, p = 0.001). Aerobic training had the highest probability of reducing waist circumference (standardized mean difference (SMD) = -0.60, 95% CI = -0.88 to -0.32, p < 0.001). Active video games emerged as a promising modality for improving countermovement jump (MD = 2.43 cm, 95% CI = 0.06 to 4.80, p = 0.041) and shuttle running performance (SMD = 0.86, 95% CI = 0.29 to 1.43, p = 0.003). Strength training was the best exercise mode for improving standing long jump performance (SMD = 1.03, 95% CI = 0.07 to 1.98, p = 0.035) while combined training was rated the first for decreasing body fat percent (MD = -2.56%, 95% CI = -4.73 to -0.40, p = 0.022) and increasing push-up repetitions (SMD = 3.59, 95% CI = 0.81 to 6.37, p = 0.012). Conclusion School-based exercise interventions have multiple effects on physical fitness. The findings of this study will help to inform physical education teachers and coaches how best to deliver exercise programs in a school setting. Since the study was limited by the original research, the conclusions will require further verification using high-quality randomized controlled trials. Systematic Review Registration PROSPERO, Identifier: CRD42023401963.
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Affiliation(s)
- Jin Wu
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Yuhang Yang
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Huasen Yu
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Liqiang Li
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Yanying Chen
- Business School, NingboTech University, Ningbo, China
| | - Youping Sun
- College of Physical Education and Health, East China Normal University, Shanghai, China
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Men J, Zou S, Ma J, Xiang C, Li S, Wang J. Effects of high-intensity interval training on physical morphology, cardiorespiratory fitness and metabolic risk factors of cardiovascular disease in children and adolescents: A systematic review and meta-analysis. PLoS One 2023; 18:e0271845. [PMID: 37167291 PMCID: PMC10174557 DOI: 10.1371/journal.pone.0271845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 04/20/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE To systematically evaluate the safety and efficacy of high-intensity interval training in children and adolescents. METHODS Eight databases were searched. Descriptive analysis of the efficacy and safety of high-intensity interval training on body shape, cardiorespiratory fitness, and metabolic risk markers of cardiovascular disease in children and adolescents. Subgroup analysis was performed using age, participants, intervention time, and exercise frequency as covariates. RESULTS 47 studies included 2995 children and adolescents. The results of the meta-analysis showed that high-intensity interval training significantly improved cardiorespiratory fitness indicators (VO2max, SBP, DBP and HRmax) and cardiovascular disease biomarkers (TC and HDL-C). HIIT had no significant effect on body shape indicators (BMI, BF% and WC) or cardiovascular disease biomarkers (TG and LDL-C). CONCLUSION Currently, there is insufficient evidence that HIIT with interval running as the predominant form improves physical indicators in children and adolescents. However, HIIT can be promoted in children and adolescents to improve cardiorespiratory fitness and reduce some metabolic risk of cardiovascular disease.
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Affiliation(s)
- Jie Men
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Shuangling Zou
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Jia Ma
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Chenmin Xiang
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
| | - Shufeng Li
- Department of Medical Laboratory Science, Fengyang College, Shanxi Medical University, Shanxi, China
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Duncombe SL, Barker AR, Bond B, Earle R, Varley-Campbell J, Vlachopoulos D, Walker JL, Weston KL, Stylianou M. School-based high-intensity interval training programs in children and adolescents: A systematic review and meta-analysis. PLoS One 2022; 17:e0266427. [PMID: 35507539 PMCID: PMC9067698 DOI: 10.1371/journal.pone.0266427] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/18/2022] [Indexed: 01/27/2023] Open
Abstract
PURPOSE 1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions. METHODS We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5-17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups. RESULTS Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment-insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups. CONCLUSION School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings. TRIAL REGISTRATION NUMBER PROSPERO CRD42018117567.
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Affiliation(s)
- Stephanie L. Duncombe
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Alan R. Barker
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Bert Bond
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Renae Earle
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
| | - Jo Varley-Campbell
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Dimitris Vlachopoulos
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Jacqueline L. Walker
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
| | - Kathryn L. Weston
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, University of Queensland, Saint Lucia, Queensland, Australia
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Ertürk G, Günday Ç, Evrendilek H, Sağır K, Aslan GK. Effects of high intensity interval training and sprint interval training in patients with asthma: a systematic review. J Asthma 2021; 59:2292-2304. [PMID: 34706200 DOI: 10.1080/02770903.2021.1999470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study is to review the effects of high-intensity interval training (HIIT)/sprint interval training (SIT) on asthma symptoms, cardiorespiratory functions, and other variables among asthmatic patients. DATA SOURCES Randomized controlled trials published between January 2000 and January 2021 were searched in PubMed/MEDLINE, Web of Science, and Cochrane Library databases. STUDY SELECTIONS Following pre-specified inclusion criteria, this review included 7 randomized controlled studies that compare HIIT/SIT as an intervention with any other intervention and/or control group. RESULTS Of the included studies only four reported the chronic phase effects of the HIIT/SIT protocols. HIIT and SIT protocols applied in studies differ. HIIT improved forced expiratory volume in 1 s (FEV1) in the acute phase and maximal oxygen consumption (VO2max) in the chronic phase in the asthmatic patients (p < 0.05). CONCLUSION To our knowledge, our systematic review is the first study evaluating the effects of HIIT/SIT protocols on asthma patients. HIIT/SIT protocols have beneficial effects on asthma patients. In order to better understand the results of these training procedures, studies that will be designed with high methodology are needed.
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Affiliation(s)
- Gamze Ertürk
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Insitute of Graduate Studies, Istanbul, Istanbul, Turkey.,Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Istanbul Kultur University, Istanbul, Turkey
| | - Çiçek Günday
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Insitute of Graduate Studies, Istanbul, Istanbul, Turkey.,Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Bahçeşehir University, Turkey
| | - Halenur Evrendilek
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Insitute of Graduate Studies, Istanbul, Istanbul, Turkey.,Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Istanbul Kultur University, Istanbul, Turkey
| | - Kübra Sağır
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Insitute of Graduate Studies, Istanbul, Istanbul, Turkey.,Faculty of Health Science, Department of Physiotherapy and Rehabilitation, Istinye University, Istanbul, Turkey
| | - Gökşen Kuran Aslan
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Faculty of Health Science, Istanbul, Turkey
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Mackintosh KA, McNarry MA, Berntsen S, Steele J, Sejersted E, Westergren T. Physical activity and sedentary time in children and adolescents with asthma: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1183-1195. [PMID: 33576534 DOI: 10.1111/sms.13937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 12/18/2022]
Abstract
The influence of asthma on physical activity (PA) in youth remains equivocal. This review synthesizes the evidence regarding the influence of asthma on PA and sedentary time and evaluates the role of key moderators for this relationship. In accordance with PRISMA guidelines, six electronic databases and gray literature were searched. Primary studies in English were included if they reported device-assessed PA in youth with and without asthma. Random effects meta-analyses examined the effect of asthma on PA and, separately, sedentary time. Mixed-effect meta-regression analyses were conducted using age and sex as moderators, with sub-group comparisons for study quality and asthma diagnosis criteria. Overall, of 3944 citations retrieved, 2850 were screened after the removal of supplication and 2743 citations excluded. Of the 107 full-text publications reviewed, 16 were included in data extraction and analysis, with 15 and five studies included in the PA and sedentary time meta-analyses, respectively. The robust effect size estimate for the influence of asthma on PA and sedentary time was -0.04 [95% CI = -0.11, 0.03] and -0.09 [95% CI = -0.12, -0.06], indicating a non-significant and significant trivial effect, respectively. The effect of asthma on PA levels or sedentary time was not associated with age or sex. Youth with controlled asthma are equally physically (in)active as their healthy peers, with asthma associated with less sedentary time. However, methodological limitations and a paucity of clear methodological reporting temper these conclusions. More rigorous device-based assessments, with a particular focus on sedentary time, and more robust diagnoses of asthma, especially with regard to severity, are needed.
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Affiliation(s)
| | | | - Sveinung Berntsen
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - James Steele
- School of Sport, Health and Social Sciences, Solent University, Southampton, UK.,Ukactive Research Institute, London, UK
| | - Ellen Sejersted
- University Library, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
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