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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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Wang C, Tian Z, Hu Y, Luo Q. Physical activity interventions for cardiopulmonary fitness in obese children and adolescents: a systematic review and meta-analysis. BMC Pediatr 2023; 23:558. [PMID: 37932667 PMCID: PMC10626758 DOI: 10.1186/s12887-023-04381-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/22/2023] [Indexed: 11/08/2023] Open
Abstract
PURPOSE This study [PROSPERO CRD42023416272] systematically analysed the effects of a physical activity intervention on cardiorespiratory fitness in obese children and adolescents and elucidated the factors that influenced those effects. METHODS A systematic review of the literature on physical activity interventions for improving cardiopulmonary fitness in obese children and adolescents from January 1, 2011, to March 1, 2023, was conducted. The search was performed on the Web of Science and PubMed databases, and the selected literature was first screened and then assessed for quality. Finally, a systematic review was conducted. RESULTS Out of the initially identified 1424 search records, 28 studies were eventually included in the systematic review. These studies encompassed a total of 2724 participants aged 5 to 18 years, with the publication dates of the literature primarily ranging from 2011 to 2023. Physical activity was found to effectively improve the following parameters in obese children and adolescents: weight [mean difference (MD), -2.03 (95% confidence interval, -2.59 to -1.47), p < 0.00001], maximal oxygen consumption [MD, -1.95 (95% CI, -1.06 to -2.84), p < 0.0001], heart rate [MD, -2.77 (95% CI, -4.88 to -0.67), p = 0.010], systolic blood pressure [MD, -8.11 (95% CI, -11.41 to -4.81), p < 0.00001], and diastolic blood pressure [MD, -4.18 (95% CI, -5.32 to -3.03), p < 0.00001]. High-intensity exercise was found to yield greater improvements than low- to moderate-intensity exercise in maximal oxygen consumption [MD, 1.43 (95% CI, 0.04 to 2.82), p = 0.04] and diastolic blood pressure [MD, -6.94 (95% CI, -10.61 to -3.26), p = 0.0002] in obese children and adolescents. CONCLUSION Physical activity can effectively improve the body weight, maximal oxygen consumption, heart rate, systolic blood pressure, and diastolic blood pressure of obese children and adolescents. The type of physical activity directly influences the participation interest of obese children and adolescents, with moderate- to high-intensity physical activity showing the most significant impact on intervention outcomes. High-frequency, long-term interventions yield better results than short-term interventions.
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Affiliation(s)
- Chaochao Wang
- Department of Physical Education, Hunan University, Changsha, Hunan Province, 410000, China
| | - Zuguo Tian
- Department of Physical Education, Hunan University, Changsha, Hunan Province, 410000, China.
| | - Yuting Hu
- Department of Physical Education, Hunan University, Changsha, Hunan Province, 410000, China
| | - Qiaoyou Luo
- Department of Physical Education, Hunan University, Changsha, Hunan Province, 410000, China
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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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Mijalković S, Stanković D, Tomljanović M, Batez M, Grle M, Grle I, Brkljačić I, Jularić J, Sporiš G, Fišer SŽ. School-Based Exercise Programs for Promoting Cardiorespiratory Fitness in Overweight and Obese Children Aged 6 to 10. CHILDREN 2022; 9:children9091323. [PMID: 36138633 PMCID: PMC9498030 DOI: 10.3390/children9091323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to conduct a systematic review of the school-based exercise programs for promoting cardiorespiratory fitness in overweight and obese children aged 6 to 10. Electronic databases (Web of Science and PubMed) were used as searching tools for collecting adequate studies published in the past 20 years. A total of 13 studies met the criteria for inclusion in this review, with a total of 2810 participants, both male and female. According to the results of this systematic review, overweight and obese children aged 6 to 10 who underwent certain interventions had their CRF improved. Furthermore, evidence suggested that interventions carried out during a longer period of time suggested led to greater improvement of cardiorespiratory fitness than a shorter one, but the level of cardiorespiratory fitness gradually decreases after the intervention.
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Affiliation(s)
- Stefan Mijalković
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia
| | - Dušan Stanković
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia
- Correspondence:
| | - Mario Tomljanović
- Faculty of Kinesiology, University of Split, Ruđera Boškovića 31, 21000 Split, Croatia
| | - Maja Batez
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Maki Grle
- Orthopedic Clinical Department, University Clinical Hospital in Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Ivana Grle
- Clinical Department for Physical Medicine and Rehabilitation, University Clinical Hospital in Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Ivan Brkljačić
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Josip Jularić
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Goran Sporiš
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Suzana Žilič Fišer
- Institute of Media Communications, Faculty of Electrical Engineering and Computer Science, University of Maribor, Koroška Cesta 46, 2000 Maribor, Slovenia
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Slow and Steady, or Hard and Fast? A Systematic Review and Meta-Analysis of Studies Comparing Body Composition Changes between Interval Training and Moderate Intensity Continuous Training. Sports (Basel) 2021; 9:sports9110155. [PMID: 34822354 PMCID: PMC8619923 DOI: 10.3390/sports9110155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/19/2022] Open
Abstract
Purpose: To conduct a systematic review and multilevel meta-analysis of the current literature as to the effects of interval training (IT) vs moderate intensity continuous training (MICT) on measures of body composition, both on a whole-body and regional level. Methods: We searched English-language papers on PubMed/MEDLINE, Scopus, CINAHL, and sportrxiv for the following inclusion criteria: (a) randomized controlled trials that directly compared IT vs MICT body composition using a validated measure in healthy children and adults; (b) training was carried out a minimum of once per week for at least four weeks; (c) published in a peer-reviewed English language journal or on a pre-print server. Results: The main model for fat mass effects revealed a trivial standardized point estimate with high precision for the interval estimate, with moderate heterogeneity (−0.016 (95%CI −0.07 to 0.04); I2 = 36%). The main model for fat-free mass (FFM) effects revealed a trivial standardized point estimate with high precision for the interval estimate, with negligible heterogeneity (−0.0004 (95%CI −0.05 to 0.05); I2 = 16%). The GRADE summary of findings suggested high certainty for both main model effects. Conclusions: Our findings provide compelling evidence that the pattern of intensity of effort and volume during endurance exercise (i.e., IT vs MICT) has minimal influence on longitudinal changes in fat mass and FFM, which are likely to minimal anyway. Trial registration number: This study was preregistered on the Open Science Framework.
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Response of obese schoolchildren to high-intensity interval training applied in the school context. ENDOCRINOLOGÍA, DIABETES Y NUTRICIÓN (ENGLISH ED.) 2019. [DOI: 10.1016/j.endien.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Response of obese schoolchildren to high-intensity interval training applied in the school context. ACTA ACUST UNITED AC 2019; 66:611-619. [PMID: 31439501 DOI: 10.1016/j.endinu.2019.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 04/30/2019] [Accepted: 05/15/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND High-intensity interval training (HIIT) has been widely used to fight cardiovascular risk factors in adolescents and adults, but no data are available on its applicability in children. OBJECTIVES To assess the effects of HIIT on different anthropometric and cardiovascular parameters of overweight and obese children aged 7-9 years. MATERIAL AND METHODS Four groups were formed: 1) an overweight control group (OWCG, n=30, BMI=21.60±3.72kg/m2); 2) an obesity control group (OCG, n=34, BMI=23.92±3.11kg/m2); 3) an overweight intervention group (OWIG, n=69, BMI=20.01±1.88kg/m2), and 4) an obesity intervention group (OIG, n=141, BMI=24.12±2.66kg/m2). BMI, body fat (BF), waist circumference, height-waist ratio, systolic and diastolic blood pressure and cardiorespiratory fitness (CRF) were assessed before and after intervention. RESULTS There were significant differences in BMI (P<.001), BF (P<.001), and CRF (P<.001) between the groups (control vs. intervention) before and after intervention (OWCG vs. OWIG and OCG vs. OIG). BMI decreased in the OWIG (BMI, 20.01±1.88 at baseline vs. 19.00±2.02 after HIIT, P<.001) and OIG (BMI, 24.12±2.66 at baseline vs. 23.23±3.23 after HIIT, P<.001) groups. Similarly, BF decreased in the OWIG (BF, 21.84±4.97 at baseline vs. 19.55±4.81% after HIIT, P<.001) and OIG (BF, 30.26±11.49 at baseline vs. 26.81±6.80% after HIIT, P<.001) groups. CRF improved in both intervention groups (P<.001). There was a significant decrease in the prevalence rate of schoolchildren with obesity (from 66.4% to 49.6%) (P<.001). CONCLUSION The intervention conducted in the school setting improved the anthropometric and cardiovascular parameters of schoolchildren, and also allowed for reducing the proportion of schoolchildren with obesity.
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Cao M, Quan M, Zhuang J. Effect of High-Intensity Interval Training versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness in Children and Adolescents: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1533. [PMID: 31052205 PMCID: PMC6539300 DOI: 10.3390/ijerph16091533] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/21/2019] [Accepted: 04/23/2019] [Indexed: 12/12/2022]
Abstract
Enhancing cardiorespiratory fitness (CRF) can lead to substantial health benefits. Comparisons between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on CRF for children and adolescents are inconsistent and inconclusive. The objective of this study was to perform a meta-analysis to compare the effects between HIIT and MICT on CRF in children and adolescents. We searched MEDLINE, PubMed, Web of Science, and Google Scholar to identify relevant articles. The standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated to determine the pooled effect size of HIIT and MICT on CRF. A total of 563 subjects from 17 studies (18 effects) were identified. The pooled effect size was 0.51 (95% CI = 0.33-0.69) comparing HIIT to MICT. Moreover, intervention duration, exercise modality, work and rest ratio, and total bouts did not significantly modify the effect of HIIT on CRF. It is concluded that compared with endurance training, HIIT has greater improvements on cardiorespiratory fitness among children and adolescents.
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Affiliation(s)
- Meng Cao
- School of Physical Education and Sports Training, Shanghai University of Sport, Shanghai 200438, China.
| | - Minghui Quan
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China.
| | - Jie Zhuang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China.
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