Physical activity in youth dance classes

Physical activity and sedentary time of youth in structured settings: a systematic review and meta-analysis

BACKGROUND

Structured settings, such as school, childcare, afterschool programs, summer camps, and physical activity/sport programs are crucial to promoting physical activity (PA) opportunities and reducing sedentary (ST) for children and adolescents. However, little is known about how much PA and ST children and adolescents accumulate in structured settings. The aim of this study is to conduct a systematic review and meta-analysis of the absolute amount of time youth spend physically active and sedentary in different structured settings (Prospero number: 42018111804).

METHODS

Observational and experimental/quasi-experimental studies (baseline data only) with full-text available, written in English and published in a peer-reviewed journal, reporting the total amount of objectively measured PA (light, moderate, vigorous, and/or total physical activity) and/or time spent ST during structured settings among youth (3 to 18 years) were eligible. Adjusted meta-analysis was conducted to estimate the pooled mean of time spent in PA and ST, by settings and sex.

RESULTS

A total of 187 studies (childcare n=60; school n=91; afterschool programs n=14; summer camp n=4; and Physical activity/ sport programs n=18) from 30 countries (47.9% United States), representing 74,870 youth (mean age 8.6 years old) were included. Overall, there was a high variation between studies in outcomes and settings. The meta-analyses revealed, on average, youth spend 221.8 minutes (36.7 min/hour) in ST and 32.1 minutes (5.1 min/hour) in MVPA during childcare hours, and 223.9 minutes (36.7min/hour) in ST and 27.8 min (4.4 min/hour) in MVPA at school. Relatively, youth are engaged in more MVPA in afterschool programs (11.7 min/hour), PA/ sport programs (20.9 min/hour), and summer camps (6.4 min/hour), when compared to childcare and school.

CONCLUSION

Total PA accumulated during childcare and MVPA accumulated during schools hours were close to recommendations, despite high proportion of ST. Afterschool programs, summer camp and PA/ sport programs are important settings that can contribute to daily PA and reduced ST. Ensuring all youth have access to these structured settings may be an important step forward for public health.

Female Athlete and Sports-Related Concussions

Female athletes are participating in collision sports in greater numbers than previously. The overall incidence of concussion is known to be higher in female athletes than in male athletes participating in similar sports. Evidence suggests anatomic, biomechanical, and biochemical etiologies behind this sex disparity. Future research on female athletes is needed for further guidance on prevention and management of concussion in girls and women.

Effects of dancing on physical activity levels of children and adolescents: a systematic review

BACKGROUND

Dancing has been suggested to increase the levels of physical activity of the youth. However, it is not clear what are the physiological characteristics of the dance classes for young people, mainly regarding the levels of moderate to vigorous physical activity (MVPA) during classes. It is also unclear if regular engagement in dance practices can contribute with increases in the amounts of daily/weekly MVPA, recommended by health organizations.

OBJECTIVES

To conduct a systematic review verifying the amount of time spent at MVPA (primary outcome), by children and adolescents in the following situations: i) During dance classes, and ii) Before and after dance interventions. Secondary outcomes included: markers of exercise intensity during class, such as oxygen consumption (VO₂) and heart rate (HR); VO₂peak and lipid profile before and after dance interventions.

METHODS

Six data sources were accessed (MEDLINE, EMBASE, Cochrane Wiley, PEDRO and SCOPUS). Study selection included different designs (acute, cohort, randomized controlled trials and others). Participants were from 6 to 19 years old, regularly engaged in dance practices. Methodological quality was assessed using the Downs and Black checklist. Two independent reviewers extracted characteristics and results of each study.

RESULTS

3216 articles were retrieved, and 37 included. Studies indicated that dance classes do not achieve 50% of total class time at MVPA. However, there are peaks of HR and VO₂ during dance classes, which reach moderate and vigorous intensities. MVPA/daily/weekly did not improve before and after dance interventions for most of the studies, also VO₂peak did not. The few results on lipid profile showed improvements only in overweight and obese participants.

LIMITATIONS

Lack of meta-analysis, because there were not enough articles to be analyzed on any given outcome of interest, neither under the same study design.

CONCLUSIONS

Results of individual studies indicated that dance classes did not active 50% of the total time at MVPA levels. This may be related to the absence of improvements in daily/weekly MVPA before and after dance interventions. VO₂ and HR attained peaks of moderateto vigorous intensity during dance classes, suggesting that the structure of the classes may be manipulated to maintain longer periods at MVPA levels. Lack of data on cardiorespiratory fitness and metabolic outcomes limit conclusions on these parameters.

IMPLICATIONS OF KEYS FINDS

Considering there are peaks of HR and VO₂ during dance classes, we suggest that the structure of a dance class can be manipulate in order to induce cardiorespiratory and metabolic adaptations. Thus, dancing is a potential strategy to contribute with a healthy life style since the earliest ages. Prospero registration: CRD42020144609.

Effects of a Curriculum-Integrated Dance Program on Children's Physical Activity

BACKGROUND

Curriculum-integrated dance programs are a promising but relatively under-researched strategy for increasing children's physical activity (PA). The aim of this study was to determine the impact of a curriculum-integrated dance program on children's PA.

METHODS

A total of 134 primary children aged 7-9 years from 4 New Zealand schools were assigned to either a dance group (n = 78) or a control group (n = 56). The dance group participated in a 6-week curriculum-integrated dance program during school time. Although the dance program focused on curricular learning, fitness and coordination were embedded in the dance sessions. Intensity of PA varied according to the focus of each dance session. PA was measured at baseline and postintervention using a waist-mounted ActiGraph GT3X+ accelerometer for 8 consecutive days.

RESULTS

There were no significant intervention effects on PA levels between the dance and control groups postintervention.

CONCLUSION

Dance-embedded learning did not increase overall levels of PA in this study. Future studies may consider assessing longer term effects of a dance-based intervention, or programs that place more focus on PA promotion.

Self-Reported Physical Activity Level in Student Athletes at Preparticipation Physical Evaluations

OBJECTIVE

Quantify physical activity in healthy student athletes.

DESIGN

Cross-sectional survey.

SETTING

Five Central Ohio schools during mass preparticipation physicals.

PARTICIPANTS

Three hundred sixty-five children between the ages 10 and 18 years.

INDEPENDENT VARIABLES

Days per week of moderate to vigorous physical activity (MVPA), minutes per day of MVPA, and number of activities.

MAIN OUTCOME MEASURES

Minutes per week of MVPA.

RESULTS

One hundred eighty high school and 177 middle school subjects responded to the survey. There were 198 male and 162 female respondents. Mean age recorded 14.2 ± 1.7 years. There were no differences in activity volume based on sex. Mean minutes per week of MVPA reported 316.0 ± 231.0. High school subjects reported fewer activities than middle school cohort 2.7 ± 1.2 versus 3.2 ± 1.5 (P < 0.05).

CONCLUSION

Only 7% of respondents reported exercising 60 minutes daily. Twenty-seven percent of respondents met minutes per week (420 minutes of MVPA) by training in large volumes on fewer days. Surprisingly, this physically active population did not meet the national standards of daily MVPA. In addition, middle school athletes reported more variety of activities compared with high school athletes surveyed which reached statistical significance. Screening for daily physical activity is important in the athletic population because young athletes may not meet daily MVPA recommendations.

Children's physical activity levels during organised sports practices

OBJECTIVES

This study measured the physical activity levels of children during practice sessions of four popular organised sports in Australia.

DESIGN

Cross-sectional observational design.

METHODS

Participants comprised children from four local organised sports clubs in suburban Adelaide, South Australia. The sports examined were Australian Rules Football (AFL), girls' netball, boys' soccer and girls' soccer. Each participant wore a waist-mounted GT3X or GT3X+Actigraph accelerometer in either one or two of the practice sessions.

RESULTS

Participants typically spent 40-50% of each sport practice session in moderate to vigorous physical activity (MVPA). Participants in the boys' soccer teams spent significantly greater time in MVPA (mean=47% of practice time, 95% CI=37%, 57%) than participants in the girls' netball teams (mean=40%, 95% CI=30%, 50%), participants in the girls' soccer teams (mean=38%, 95% CI=28%, 48%) and participants in the boys' AFL teams (mean=40%, 95% CI=36%, 44%). The practice sessions contributed approximately half of the 60min of MVPA per day recommended by physical activity guidelines for children and young people.

CONCLUSIONS

The results suggested that organised sports provide a supportive environment for physical activity accrual; however, one practice session is insufficient for children to reach the amount of MVPA recommended in daily physical activity guidelines.

Physical Activity Perceptions in Adolescents: A Qualitative Study Involving Photo Elicitation and Discussion Groups

Adolescence is a key period in life when most of the healthy habits that will affect health during adulthood are established. Numerous interventions based on the acquisition of regular physical activity (PA) in the adolescent population have so far yielded no success, mainly in the long term. Qualitative phenomenological research was used to identify adolescents’ perceived barriers and motivations to regular PA practice, and how they form the concept of PA through thought and action. This study constitutes an explicative design using photo elicitation (PE) and discussion group (DG) techniques to explore different aspects and meanings associated with PA, as well as their perceptions toward PA practice. The study was conducted on adolescents from a randomly selected district in Barcelona (Catalonia), Spain. Through the use of PE, a total of 67 photographs were analyzed. A DG was conducted with a group of 10 teenagers. Input from the DG was examined using interpretative phenomenological analysis. The findings show that social, familial, and environmental factors become motivational elements for the regular practice of PA. The findings observed relevant aspects linked to general barriers and to particular ones associated with young women. This study also considered implications for future interventions.

The school as a health promoter for children with asthma: The purpose of an education programme

BACKGROUND

Not only is asthma one of the leading causes of hospitalisation in children under 15 years and one of the main reasons for primary care outpatient visits, it also accounts for 13 million lost days of school annually, which can affect children's learning, integration at school and overall academic achievements.

MATERIAL AND METHODS

This review article highlights the important role of the school in helping children and adolescents to control and manage their asthma through integrated and coordinated actions of health professionals, school staff, family, and the community.

RESULTS

We recommended key elements for a multidisciplinary team asthma school programme that can be replicated and implemented especially in developing countries where children and adolescents are in a more disadvantaged environment.

CONCLUSION

This multidisciplinary asthma school intervention when demonstrated with efficacy can be applied in the context of the real world, where many children and families who need care the most currently do not receive it.

The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion

BACKGROUND

Physical activity interventions targeting children and adolescents (≤18 years) often focus on complex intra- and inter-personal behavioral constructs, social-ecological frameworks, or some combination of both. Recently published meta-analytical reviews and large-scale randomized controlled trials have demonstrated that these intervention approaches have largely produced minimal or no improvements in young people's physical activity levels.

DISCUSSION

In this paper, we propose that the main reason for previous studies' limited effects is that fundamental mechanisms that lead to change in youth physical activity have often been overlooked or misunderstood. Evidence from observational and experimental studies is presented to support the development of a new theory positing that the primary mechanisms of change in many youth physical activity interventions are approaches that fall into one of the following three categories: (a) the expansion of opportunities for youth to be active by the inclusion of a new occasion to be active, (b) the extension of an existing physical activity opportunity by increasing the amount of time allocated for that opportunity, and/or (c) the enhancement of existing physical activity opportunities through strategies designed to increase physical activity above routine practice. Their application and considerations for intervention design and interpretation are presented. The utility of these mechanisms, referred to as the Theory of Expanded, Extended, and Enhanced Opportunities (TEO), is demonstrated in their parsimony, logical appeal, support with empirical evidence, and the direct and immediate application to numerous settings and contexts. The TEO offers a new way to understand youth physical activity behaviors and provides a common taxonomy by which interventionists can identify appropriate targets for interventions across different settings and contexts. We believe the formalization of the TEO concepts will propel them to the forefront in the design of future intervention studies and through their use, lead to a greater impact on youth activity behaviors than what has been demonstrated in previous studies.

A systematic review of the prevalence of sedentary behavior during the after-school period among children aged 5-18 years

BACKGROUND

Independent of physical activity levels, youth sedentary behaviors (SB) have negative health outcomes. SB prevalence estimates during discretionary periods of the day (e.g., after-school), inform the need for targeted period-specific interventions. This systematic review aimed to determine children's and adolescents' SB prevalence during the after-school period.

METHODS

A computerized search was conducted in October 2015 (analysed November 2015). Inclusion criteria were: published in a peer-reviewed English journal; participants aged 5-18 years; measured overall after-school sedentary time (ST) objectively, and/or specific after-school SBs (e.g., TV viewing) objectively or subjectively; and provided the percentage of the after-school period spent in ST/SB or duration of behavior and period to calculate this. Where possible, findings were analyzed by location (e.g., after-school care/'other' locations). The PRISMA guidelines were followed.

RESULTS

Twenty-nine studies were included: 24 included children (≤12 years), four assessed adolescents (>12 years) and one included both; 20 assessed ST and nine assessed SB. On average, children spent 41% and 51% of the after-school period in ST when at after-school care and other locations respectively. Adolescents spent 57% of the after-school period in ST. SBs that children and adolescents perform include: TV viewing (20% of the period), non-screen based SB (including homework; 20%), screen-based SB (including TV viewing; 18%), homework/academics (13%), motorised transport (12%), social SB (9%), and screen-based SB (excluding TV viewing; 6%).

CONCLUSION

Children spent up to half of the after-school period in ST and this is higher among adolescents. A variety of screen- and non-screen based SBs are performed after school, providing key targets for interventions.

TRIAL REGISTRATION

PROSPERO registration number CRD42015010437.

Process evaluation of the Bristol girls dance project

Background

The Bristol Girls Dance Project was a cluster randomised controlled trial that aimed to increase objectively measured moderate-to-vigorous physical activity (MVPA) levels of Year 7 (age 11–12) girls through a dance-based after-school intervention. The intervention was delivered in nine schools and consisted of up to forty after-school dance sessions. This paper reports on the main findings from the detailed process evaluation that was conducted.

Methods

Quantitative and qualitative data were collected from intervention schools. Dose and fidelity were reported by dance instructors at every session. Intervention dose was defined as attending two thirds of sessions and was measured by attendance registers. Fidelity to the intervention manual was reported by dance instructors. On four randomly-selected occasions, participants reported their perceived level of exertion and enjoyment. Reasons for non-attendance were self-reported at the end of the intervention. Semi-structured interviews were conducted with all dance instructors who delivered the intervention (n = 10) and school contacts (n = 9) in intervention schools. A focus group was conducted with girls who participated in each intervention school (n = 9).

Results

The study did not affect girls’ MVPA. An average of 31.7 girls participated in each school, with 9.1 per school receiving the intervention dose. Mean attendance and instructors’ fidelity to the intervention manual decreased over time. The decline in attendance was largely attributed to extraneous factors common to after-school activities. Qualitative data suggest that the training and intervention manual were helpful to most instructors. Participant ratings of session enjoyment were high but perceived exertion was low, however, girls found parts of the intervention challenging.

Conclusions

The intervention was enjoyed by participants. Attendance at the intervention sessions was low but typical of after-school activities. Participants reported that the intervention brought about numerous health and social benefits and improved their dance-based knowledge and skills. The intervention could be improved by reducing the number of girls allowed to participate in each school and providing longer and more in-depth training to those delivering the intervention.

Trial registration

ISRCTN52882523 Registered 25th April 2013.

Effect and cost of an after-school dance programme on the physical activity of 11-12 year old girls: The Bristol Girls Dance Project, a school-based cluster randomised controlled trial

Background

The aim of this study was to examine the effectiveness and cost of an after-school dance intervention at increasing the physical activity levels of Year 7 girls (age 11–12).

Methods

A cluster randomised controlled trial was conducted in 18 secondary schools. Participants were Year 7 girls attending a study school. The Bristol Girls Dance Project (BGDP) intervention consisted of up to forty, 75-minute dance sessions delivered in the period immediately after school by experienced dance instructors over 20-weeks. The pre-specified primary outcome was accelerometer assessed mean minutes of weekday moderate to vigorous physical activity (MVPA) at time 2 (52 weeks are T0 baseline assessments). Secondary outcomes included accelerometer assessed mean minutes of weekday MVPA at time 1 (while the intervention was still running) and psychosocial outcomes. Intervention costs were assessed.

Results

571 girls participated. Valid accelerometer data were collected from 549 girls at baseline with 508 girls providing valid accelerometer data at baseline and time 2. There were no differences between the intervention and control group for accelerometer assessed physical activity at either time 1 or time 2. Only one third of the girls in the intervention arm met the pre-set adherence criteria of attending two thirds of the dance sessions that were available to them. Instrumental variable regression analyses using complier average causal effects provided no evidence of a difference between girls who attended the sessions and the control group. The average cost of the intervention was £73 per girl, which was reduced to £63 when dance instructor travel expenses were excluded.

Conclusion

This trial showed no evidence that an after-school dance programme can increase the physical activity of Year 7 girls. The trial highlighted the difficulty encountered in maintaining attendance in physical activity programmes delivered in secondary schools. There is a need to find new ways to help adolescent girls to be physically active via identifying ways to support and encourage sustained engagement in physical activity over the life course.

Trial registration

ISRCTN52882523

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0289-y) contains supplementary material, which is available to authorized users.