Associations of sport participation, muscle-strengthening exercise and active commuting with self-reported physical fitness in school-aged children

Subjective fitness relates to performance and can be improved by exercise in children and young adults with heart disease

INTRODUCTION

The Duke Activity Status Index is used to assess an individual patient's perception of their fitness abilities. It has been validated and shown to predict actual fitness in adults but has been studied less in the paediatric population, specifically those with heart disease. This study aims to assess if the Duke Activity Status Index is associated with measured markers of physical fitness in adolescents and young adults with heart disease.

METHODS

This retrospective single-centre cohort study includes patients who completed a minimum of 12 weeks of cardiac rehabilitation between 2016 and 2022. Cardiac rehabilitation outcomes included physical, performance, and psychosocial measures. A comparison between serial testing was performed using a paired t-test. Univariable and multivariable analyses for Duke Activity Status Index were performed. Data are reported as median [interquartile range].

RESULTS

Of the 118 participants (20 years-old [13.9-22.5], 53% male), 33 (28%) completed at least 12 weeks of cardiac rehabilitation. Median peak oxygen consumption was 60.1% predicted [49-72.8%], and Duke Activity Status Index was 32.6 [21.5-48.8]. On Pearson's correlation assessing the Duke Activity Status Index, there were significant associations with % predicted peak oxygen consumption (r = 0.49, p < 0.0001), 6-minute walk distance (r = 0.45, p < 0.0001), Duke Activity Status Index metabolic equivalents (r = 0.45, p < 0.0001), and dominant hand grip (r = 0.48, p < 0.0001). In multivariable analysis, the % predicted peak oxygen consumption (r = 0.40, p = 0.005) and dominant hand grip (r = 0.37, p = 0.005) remained statistically significant.

CONCLUSIONS

Duke Activity Status Index is associated with measures of physical fitness in paediatric and young adults with heart disease who complete a cardiac rehabilitation program.

Association of physical activity, screen time and sleep with substance use in children and adolescents: a large sample cross-sectional study

Background

24-h movement guidelines (24-HMG) play an important role in various demographics such as early years, children, youth, and the older adult. Nevertheless, most existing research exploring the links between socioeconomic factors, dietary intake, and substance use with sleep patterns, physical activity (PA), and sedentary behavior (SB) has been conducted in high-income Western countries.

Purpose

Hence, this study seeks to investigate the relationship between adherence to the 24-HMG and smoking and alcohol use behaviors among children and adolescents in China.

Methods

A comprehensive survey, in collaboration with the Municipal Education Commission, was carried out across primary and middle schools in Shenzhen, China. Sleep duration was gauged using the Pittsburgh Sleep Quality Index (PSQI), screen time was assessed with items adapted from the Health Behavior of School-aged Children (HBSC) survey, and PA was measured using a single item adapted from the HBSC survey. Results were presented as odds ratios (ORs) with 95% confidence intervals (CIs), considering p-values below 0.05 as statistically significant.

Results

Among the sample, 51.9% were boys and 48% were girls. Those who did not meet any guidelines had a higher probability of smoking (OR = 1.62 [95% CI: 1.03, 2.56], p = 0.037) among children and adolescents. Conversely, meeting one (OR = 0.94 [95% CI: 0.61, 1.52], p = 0.874) or two guidelines (OR = 0.84 [95% CI: 0.52, 1.34], p = 0.459) showed no significant impact. The data displayed an inverse correlation between the number of guidelines adhered to and the likelihood of alcohol use among children and adolescents: none (OR = 2.07, p < 0.001), one guideline (OR = 1.40, p = 0.006), and two guidelines (OR = 1.22, p = 0.106).

Conclusion

Not meeting guidelines elevates smoking and alcohol use risks in children and adolescents, whereas following more guidelines lowers these risks, highlighting the importance of guideline adherence in reducing substance use.

How many adults have sufficient muscle-strengthening exercise and the associated factors: A systematic review consisting of 2,629,508 participants

Purpose

The aim of this systematic review was to (1) estimate the prevalence of adhering to the MSE guidelines (at least 2 times/days a week) among adults; and (2) synthesize evidence on the correlates of adhering to the MSE guidelines.

Methods

Five electronic databases were searched (March 2022), with a total of 30 observational studies consisting of 2,629,508 participants meeting the eligibility criteria. A meta-analysis was conducted to pool the prevalence of adhering to the MSE guidelines using the results of 21 eligible studies (study aim 1); and data reporting correlates of adhering to the MSE guidelines using 12 eligible studies were synthesized and categorized based on the Socioecological Model Framework (study aim 2).

Results

Overall, 22.8 % (95%CI: 18.18 % ─ 27.77 %) of adults adhered to the MSE guidelines, and 23 potential correlates at five levels were examined. Five variables (i.e., sex, age, education level, socioeconomic status) at the sociodemographic level and two variables (i.e., body mass index, self-rated health) at the physical related level were identified as consistent correlates, but displaying weak to moderate association strengths.

Conclusions

Less than a quarter of adults meet the MSE guidelines and multidimensional correlates are associated with the adherence to the guidelines, particularly sociodemographic correlates (e.g., sex, age, and educational level). Findings highlight the need to further promote the importance of engaging in MSE among adults and investing effective interventions that not only provide opportunities for MSE for adults, but also facilitate the development of skills and confidence to engage in MSE.

Research on aerobic fitness in children and adolescents: a bibliometric analysis based on the 100 most-cited articles

Introduction

This study aims to conduct a bibliometric analysis of the 100 most-cited articles to examine research trends, hot topics, and gaps in aerobic fitness research in children and adolescents, addressing the lack of evidence synthesis.

Methods

The Web of Science Core Collection database was used for literature search, and bibliometric characteristics of the included research articles were imported and calculated. Descriptive statistics and visualizations by the VOS viewer were used for the presentation of bibliometric characteristics.

Results

The 100 most cited articles received an average of 104 citations. British Journal of Sports Medicine and Medicine and Science in Sports and Exercise were the two top journals that published aerobic fitness research in children and adolescents. The United States was the top country that contributed to the most-cited research articles. Three top research topics were identified from the analysis, such as neuroscience, developmental psychology, and aerobic health.

Conclusion

Aerobic fitness research in children and adolescents has received much attention and interest since 2000. The most contributing authors in this research field were from developed countries, such as the United States, and cognition and health-related research were priorities.

Current teachers' perceptions and students' perspectives regarding activities modalities, instructional settings during primary school physical education classes in China: a cross-sectional observational study

Introduction

This study set out to understand the association between teaching practices, teacher confidence, competence, self-efficacy, and the resulting student outcomes.

Methods

Data regarding teaching behaviours were collected via video recording and then evaluated using the MASTER Observation Tool. The information about demographics, self-reported teaching confidence, competence, self-efficacy, and student outcomes was collected using questionnaires. The association between teacher characteristics, and teacher and/or student outcome variables were tested using a one-way analysis of variance (ANOVA).

Results

A total of ten primary schools were involved, including 597 children (age range: 10-12 years, grade 4-6) and 16 grade 4-6 PE teachers (with 16 PE classes). Most of the Physical Education (PE) lesson time was spent in training-form activities (60.2% ± 9.1), followed by instructional time (33.1% ± 8.6%), reflection (3.4% ± 2.3%), and warm-up (2.9% ± 2.0 %). It was observed that teaching behaviours and student outcomes were significantly better in urban than rural areas. Smaller class sizes (21-30 children) were found to have more positive feedback than larger ones (41-50 children). PE teachers with more than 10 years of teaching experience reported more teaching competence and self-efficacy than teachers with less than 10 years of experience. PE teachers with class sizes of 21-30 children enjoyed significantly better scores in self-efficacy than classes with 41-50 children. They also scored more highly in confidence and competence than classes with 41-50 and 51-60 pupils.

Conclusion

The current study confirmed that teachers dedicated a large proportion of lesson time to PE delivering training-form activities, followed by instructional time. Teaching behaviour and student outcomes were associated with location and class size, but not gender. The study contributes to our understanding of PE instruction in Chinese primary schools and offers preliminary evidence to improve future PE teaching strategies in the country.

Physical activity and sedentary behavior among school-going adolescents in low- and middle-income countries: insights from the global school-based health survey

Background

The Global School Student Health Survey (GSHS) is being carried out by students in various countries across the globe to advance improved health programs for youth. However, in comparison to high-income countries, adolescents in low- and middle-income countries (LMICs) are generally at an early stage of understanding regarding physical activity (PA) and sedentary behavior (SB), often exhibiting low levels of PA and high levels of SB. Furthermore, there is limited evidence connecting PA and SB in school-going adolescents from LMICs.

Purpose

The objective of this review was to synthesize the available evidence regarding PA and sedentary behavior among school-going adolescents in LMICs using data from the GSHS.

Method

On March 18, 2023, a systematic literature search was performed across four electronic databases, namely Web of Science, PubMed, ScienceDirect, and EBSCO with n odaterestrictions. Studies were eligible if they: (1) utilization of data sourced from the Global Student-based Health Survey; (2) exploration of physical activity; (3) specific focus on adolescents; (4) conducted in low- and middle-income countries; (5) study design encompassing observational; (6) published as English journal articles.

Results

Among the 29 studies included in the analysis, the majority revealed elevated levels of sedentary behavior and diminished levels of PA in low- and middle-income countries. Furthermore, notable disparities in physical engagement and sedentary behavior were noted between male and female adolescents (p < 0.001). Augmented PA among teenagers was observed to correlate with higher consumption of vegetables and fruits (AOR = 1.30; 95% CI [1.13-1.50]; p < 0.001), decreased alcohol consumption, and a reduced prevalence of loneliness and depression (aOR 1.37, 95% CI [1.18-1.59]).

Conclusions

The results of this review affirm that in contrast to high-income countries, adolescents in low- and middle-income countries (LMICs) are in the early stages of comprehending physical activity, marked by low levels of PA. Physical activity and sedentary behavior in school-going adolescents from LMICs appear to be influenced by factors such as policies, cultural norms, socioeconomic conditions, as well as gender, and age.

Association Between Frequency of Muscle-Strengthening Exercise and Depression Symptoms Among Middle and High School Students: Cross-Sectional Survey Study

BACKGROUND

Existing literature on the association between the frequency of muscle-strengthening exercise (MSE) and depression among adolescents is limited and contradictory.

OBJECTIVE

This study aimed to elucidate the association of MSE frequency with depression symptoms among middle and high school students in China.

METHODS

A total of 27,070 students in grades 7-12 from 376 middle and high schools were surveyed using an anonymous self-administered questionnaire between April and June 2022. Information on engaging in MSE was self-reported, and depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Poisson regression was used to examine the association between MSE frequency and depression symptoms.

RESULTS

Among the 27,006 eligible students, 51.6% (n=13,933) were boys, and the mean age was 15.6 (SD 1.7) years. The overall prevalence of meeting MSE recommendations (ie, engaging in MSE ≥3 days/week) was 34.6% (95% CI 32.6%-36.6%; n=9145); the prevalence was higher in boys (43.8%, 95% CI 41.8%-45.8%; 6067/13,933) than in girls (24.3%, 95% CI 22%-26.6%; 3078/13,073; P<.001). A total of 5882 (21.8%) students reported having depression symptoms. After adjustment for sociodemographic status, lifestyle factors, academic performance, and experience of physical fighting, compared to students who did not engage in MSE, the prevalence ratios (PRs) for depression symptoms were 0.98 (95% CI 0.97-0.99) for those engaging in MSE once a week, 0.95 (95% CI 0.93-0.97) for 2 days/week, 0.93 (95% CI 0.90-0.96) for 3 days/week, 0.90 (95% CI 0.87-0.94) for 4 days/week, 0.88 (95% CI 0.84-0.93) for 5 days/week, 0.86 (95% CI 0.81-0.92) for 6 days/week, and 0.84 (95% CI 0.78-0.90) for 7 days/week, respectively.

CONCLUSIONS

The overall prevalence of meeting MSE recommendations among Chinese adolescents is low. The frequency of MSE was inversely associated with depression symptoms.

Establishment of health related physical fitness evaluation system for school adolescents aged 12-16 in Pakistan: a cross-sectional study

Background

The decline in adolescent physical fitness is a significant global public health concern, and Pakistan is no exception. The country's absence of a health-related physical fitness (HRPF) evaluation system has compounded this issue. To bridge this gap, this study aims to develop a scientifically-based HRPF evaluation system for the adolescent population that meets international standards. The evaluation system identifies at-risk children and improves adolescent health outcomes, including obesity, cardiovascular and musculoskeletal disorders, chronic diseases, and psychological illnesses, through crucial physical fitness evaluation. This study specifically aims to establish an HRPF evaluation system for school adolescents aged 12-16 in Pakistan.

Methods

A cross-sectional study was conducted among 2,970 school adolescents aged 12-16 years in the South Punjab, Pakistan. The study used a stratified sampling technique to select participants. The HRPF evaluation system included four components: cardiorespiratory endurance, core muscular endurance, muscular strength, and body composition. Data were collected through standardized tests and anthropometric measurements.

Results

The study's results indicated that the HRPF evaluation scoring system was feasible and valid for evaluating the HRPF of school adolescents in the South Punjab region of Pakistan. The results of the evaluation system categorized participants into five groups based on their performance: excellent (6.2%), good (24.9%), medium (50.7%), poor (17%), and very poor (1.2%).

Conclusion

The study establishes an HRPF evaluation system for Pakistani school adolescents. This system lays the foundation for implementing effective strategies to improve their physical health. The findings offer valuable insights to policymakers, health professionals, and educators, enabling them to promote fitness and devise impactful interventions for enhancing HRPF in this population.

The Relationship between Physical Fitness and Perceived Well-Being, Motivation, and Enjoyment in Chinese Adolescents during Physical Education: A Preliminary Cross-Sectional Study

Purpose: The purpose of this study is to investigate the relationship between physical fitness (PF) level and Chinese middle-school students’ perceived well-being, motivation, and enjoyment. Method: In this study, the participants were randomly selected from 16 Beijing-based middle schools in China. In addition to the collection of demographic data (i.e., gender, age, and parental education), tools including the Warwick-Edinburgh Mental Well-Being Scale, the Behavioural Regulation in Sport Questionnaire, and the Physical Activity Children’s Enjoyment Scale were employed for collecting data on other variables of well-being, motivation, and enjoyment, respectively. Results: A total of 1678 adolescents (M age = 14.66 years, SD = 1.80) participated in this study. According to the results, significant gender differences could be observed in the PF categories of mean age, BMI, vital capacity, 50-m sprint, muscular strength, and flexibility (all p < 0.05). In contrast, there was no significant gender difference in the levels of well-being, motivation, and enjoyment observed, with similar scores for boys and girls (p > 0.05). Indeed, adolescents with low BMI scores and high levels of vital capacity, muscular strength, and flexibility showed better well-being, motivation, and enjoyment. However, no association was observed between timed sit-ups and pull-ups and well-being, motivation, and enjoyment. Conclusions: This study produced preliminary findings on the relationship between PF and Chinese adolescents’ perceived well-being, motivation, and enjoyment. To improve the health of adolescents, it is necessary to adopt prospective and experimental research designs for advocating for fitness education in school-based programs in future research.

Exploring the self-reported physical fitness and self-rated health, mental health disorders, and body satisfaction among Chinese adolescents: A cross-sectional study

Background

Physical activity (PA) and Physical fitness (PF) have received tremendous attention in the field of physical and mental health. However, limited attention has been given to the associations of self-reported physical fitness with some health-related outcomes. Given the COVID-19 pandemic is still active in many Chinese regions, assessing health-related physical fitness (HRPF) in adolescents using field-based assessment (such as a shuttle run for cardiorespiratory fitness) is unrealistic, therefore, this study was conducted via a self-reported questionnaire.

Purpose

The present cross-sectional study was aimed at delving into the relationship between self-reported physical fitness with self-rated health, depression, anxiety, and body satisfaction in adolescents. Three thousand eight hundred and seven study participants from 12 public schools in South-eastern China were recruited and 2,407 of them provided valid data on variables that this study needed for analysis.

Materials and methods

Study participants were asked to self-report their sociodemographic factors (e.g., sex, grade, age), independence, and outcomes. Generalized linear models were used to explore the associations of self-reported physical fitness (comprising general physical fitness, cardiorespiratory fitness, muscular strength, speed and agility, and flexibility) with depression, anxiety, and body satisfaction. A total of 2,407 children and adolescents with a mean age of 13.82 (±2.1) years were included in the final study analysis.

Results

Higher self-reported levels of general physical fitness and cardiorespiratory fitness were associated with better self-rated health, and body satisfaction but with lower risks of depression and anxiety.

Conclusion

The current study offered evidence on the roles of self-reported physical fitness and health-related outcomes. To facilitate health in children and adolescents, advocating fitness education, and promotion could be a feasible approach.

Movement behaviours and anxiety symptoms in Chinese college students: A compositional data analysis

In the current research, sleep duration, sedentary behaviour, physical activity, and their relationship with several anxiety symptoms among college students were examined. This study was a cross-sectional study, and study respondents were recruited from college students. A total of 1,475 of college students were included for analysis. Sedentary behaviours and physical activity were assessed by the International Physical Activity Questionnaire Short Form, while sleep duration was assessed by the Chinese version Pittsburgh Sleep Quality Index. To assess the anxiety symptoms of study respondents, the Generalised Anxiety Disorder-7 was used. The compositional data was analysed in R to estimate the associations between replacements among physical activities, sedentary behaviours, and sleep and anxiety symptoms. Results indicated a greater impact was imposed on the alleviation of anxiety symptoms by substituting sedentary behaviours with physical activity at moderate to vigorous intensity. In the current research, the significance of moderate to vigorous physical activity should be highlighted in preventing anxiety among Chinese college students.

Associations of muscle-strengthening exercise with overweight, obesity, and depressive symptoms in adolescents: Findings from 2019 Youth Risk Behavior Surveillance system

Background

Previous studies have focused on the opposite relation between muscle strength, obesity, and depression in adults. Moreover, the evidence has indicated that obesity and depression in adults might be significantly decreased with Muscle Strength Exercise (MSE) albeit it might be insufficient. Therefore, the current study aimed to investigate the association between MSE, adiposity, and depression among United States adolescents.

Materials and methods

This cross-sectional study used the Youth Risk Behavioral Survey (YRBS) data. In YRBS, a cluster sample was used, and the investigation was divided into three stages. The study surveyed 13,677 high school students and conducted self-reported questionnaires on sex, grade, race/ethnicity, MSE days, overweight, obesity, and depressive symptoms. The study got the nationally representative population of American students in Grade 9 to 12 (around 12–18 years).

Results

A total of 13,677 participants (female = 6,885, male = 6641) were included in the final analysis. The participants meeting the guidelines’ requirements seemed more likely to be obese than those not meeting (OR = 1.28, 95% CI = 1.06–1.55). There was no statistical significance in the relations between the MSE guidelines and overweight and depression (OR = 0.86, 95% CI = 0.73–1.01: OR = 0.94, 95% CI = 0.83–1.06). For all the participants, the prevalence of those conforming to MSE was 30.1%. One-fifth of the participants reported no MSE per week, 7.8% reported 3 days of MSE per week, and 7.7% reported 7 days.

Conclusion

The main finding of this study indicated a positive relationship between the normative MSE required in guidelines and low-level obesity. Beyond that, the evidence was insufficient to confirm the positive links between MSE and depression among American adolescents. Our study could offer evidence for future MSE interventions in adolescents.