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The objectives of the present study were (a) to determine the effects of a 12-week intervention using wearables promoted through physical education classes on physical activity, body composition, physical fitness and psychological well-being of overweight or obese adolescents; and (b) to analyze the differences in outcomes based on gender and baseline physical activity. Seventy-three overweight and obese adolescents (mean age: 13.44 ± 1.12 years) were randomly assigned to an experimental group (EG) or control group (CG). The EG used a physical activity wearable for 12 weeks. Both groups were assessed before and after the intervention. Regarding primary outcomes, the EG showed an increase in physical activity (p = 0.048) and reductions in body mass index (p = 0.007), fat mass (p < 0.001), and sum of 3 skinfolds (p = 0.002), with moderate-to-large effect sizes (η2 > 0.09). According to the secondary outcomes, improvements in physical fitness were limited, with increases observed only in abdominal muscular endurance, and these changes were also present in the CG. Subgroup analyses showed that females and adolescents with low baseline physical activity experienced greater benefits, particularly in fat-related variables (p < 0.001–0.037), with large effect sizes (η2 > 0.14). Additionally, adolescents with greater exposure to the wearable-based intervention showed more consistent improvements in fat-related outcomes (p < 0.001–0.032), with large effect sizes (η2 > 0.25). In conclusion, a wearable-based intervention promoted through physical education classes may contribute to meaningful improvements in body composition, particularly among females and previously inactive adolescents who are overweight or obese. However, effects on physical fitness and psychological well-being were limited, highlighting the importance of intervention design, adherence, and complementary motivational strategies.
This article examines an overlooked aspect of Xenophon’s philosophy: the crucial role of lower body training in his conception of physical fitness as an essential component of education for both humans and animals. Three key questions guide this investigation. Why does Xenophon appear to prioritize physical over intellectual education? Why does he emphasize lower body training for humans, hounds and horses? What unifying concepts connect Xenophon’s ideas about physical fitness and education? The article argues that the parallels between the physical education of Spartan children, Socrates’ shoelessness and the training of hounds and horses suggest shared physical characteristics across certain species, leading to similar methods for developing bodily vigour. Moreover, it contends that ideal education (paideia) must not only begin with but also maintain continuous emphasis on strengthening the body’s support structure—feet and legs—hence the focus on exercises like walking and running. The analysis reveals recurring foundational concepts: toil (πόνος), endurance (καρτερία)—two core principles of Socratic ethics—good health (ὑγίεια), exercise (ἄσκησις/μελέτη), gymnastics (γύμνασις) and good physical disposition (τοῦ σώματος εὐεξία). This pattern, present in both Socratic and non-Socratic works, offers new insights into Xenophon’s coherent vision of the relationship between physical fitness and education.
Low neuromuscular fitness is documented in adolescents with CHD and may be associated with clinical and morphological factors, indicating the need to assess strength in this population.
Objective:
To evaluate neuromuscular fitness with a multifactorial approach and its associations with other clinical and morphological factors in adolescents with CHD.
Methods:
This is an observational, cross-sectional study with adolescents with CHD, aged between 10 and 18 years. Neuromuscular fitness was calculated by the sum of the z-scores of four strength tests. Clinical factors of CHD were assessed by medical records and questionnaire. The morphological factors assessed were waist-to-height ratio, sum of skinfolds, and upper arm muscle area. Descriptive statistics, analysis of covariance, and linear regressions were performed.
Results:
Sixty adolescents with CHD participated, aged 12,7 ± 2,1 years, 55% girls. Maximum isometric strength was inadequate in 33%, jump height (power) in 33%, abdominal muscle strength resistance in 78%, and upper limb muscle strength resistance in 27%. Neuromuscular fitness was inadequate in 89% (n = 53) of adolescents with CHD. In the unadjusted regression, neuromuscular fitness was associated with arm muscle area (β = 0,12; p = 0,02; R2adj = 0,08) and in the unadjusted and adjusted regression it was lower in cyanotic (vs. acyanotic) CHDs (β = −1,76; p = 0,03 R2adj = 0,24).
Conclusion:
The findings reveal deficits in different presentations of musculoskeletal strength in a large proportion of adolescents with CHD, reinforcing the need to measure fitness from a broader perspective. Low muscle mass and the presence of cyanotic CHD may imply in reduced neuromuscular fitness in adolescents with CHD.
This chapter invites readers to engage in a daily morning dance practice, highlighting the numerous physical, mental, and emotional benefits of dancing. It suggests a curated playlist of diverse music genres, spanning the last hundred years, to accompany this practice. The author encourages readers to personalize their dance experience, emphasizing the importance of enjoyment and positive emotions. By promoting a shared experience of dancing, the chapter aims to foster a sense of community and well-being, ultimately demonstrating how music can invigorate and uplift our daily lives.
A critical challenge for biomedical investigators is the delay between research and its adoption, yet there are few tools that use bibliometrics and artificial intelligence to address this translational gap. We built a tool to quantify translation of clinical investigation using novel approaches to identify themes in published clinical trials from PubMed and their appearance in the natural language elements of the electronic health record (EHR).
Methods:
As a use case, we selected the translation of known health effects of exercise for heart disease, as found in published clinical trials, with the appearance of these themes in the EHR of heart disease patients seen in an emergency department (ED). We present a self-supervised framework that quantifies semantic similarity of themes within the EHR.
Results:
We found that 12.7% of the clinical trial abstracts dataset recommended aerobic exercise or strength training. Of the ED treatment plans, 19.2% related to heart disease. Of these, the treatment plans that included heart disease identified aerobic exercise or strength training only 0.34% of the time. Treatment plans from the overall ED dataset mentioned aerobic exercise or strength training less than 5% of the time.
Conclusions:
Having access to publicly available clinical research and associated EHR data, including clinician notes and after-visit summaries, provided a unique opportunity to assess the adoption of clinical research in medical practice. This approach can be used for a variety of clinical conditions, and if assessed over time could measure implementation effectiveness of quality improvement strategies and clinical guidelines.
Medical advances in the management of CHD have shifted the focus from childhood mortality to life-long morbidity; therefore, clinical research in paediatric cardiology tends to replace mortality outcomes with functional and patient-reported outcomes. Despite these advances, the stratification of disease severity using a simple and reproducible CHD classification has not been established. The aim was to determine which classification best predicts functional status in children with CHD, in terms of cardiopulmonary fitness.
Method:
This retrospective cohort study was assessed from a cohort study of 296 children (mean age 11.3 ± 3.1 years, 129 female), who underwent a baseline and final cardiopulmonary exercise tests with a mean follow-up of 4.1 ± 1.6 years.
Results:
Seven CHD classifications were identified, assessing anatomical, physiological, therapeutic, or functional parameters in foetal, paediatric, or adult CHD populations. The four-stage paediatric CHD disease severity classification established by Uzark et al. best predicted functional status at the final cardiopulmonary exercise test assessment, with an area under the receiver operating characteristics curves of 0.62 (0.55–0.69) for impaired cardiopulmonary fitness (maximum oxygen uptake (VO2max) or ventilatory anaerobic threshold < −1.64 Z-score). The best inter-judge classification agreement was also observed for Uzark classification, with a Kappa coefficient of 0.88 (0.78–0.98).
Conclusion:
The CHD classification by Uzark is reliable in terms of functional status prediction and reproducibility in children with CHD. This simple classification may contribute to identifying children with CHD most at risk of cardiopulmonary fitness impairment and initiating early preventive cardiovascular interventions in paediatric cardiology.
Dance for older adults is increasingly being used to support health and well-being. While dance may be enjoyable for many, understanding its benefits for those with limited physical and cognitive abilities may provide further support for how dance may be used in these contexts. This was a study of Sharing Dance Older Adults, a dance program with remotely streamed sessions. Data were collected from 48 older adults who took part in the On Your Feet version of the program, and from 38 who took part in the In Your Seat version. Measures included interviews, physical fitness tests and surveys on mood, quality of life, and program satisfaction. Physical fitness significantly improved for both groups, unlike for mood, social well-being, or quality of life. This contrasts with qualitative findings, with participants reporting how the program enhanced their mood, social interactions, and quality of life.
Physical and mental health are inextricably linked. Research tells us that even a little bit of physical exercise in your daily routine can have an impact on your emotionall well-being and stress resilience. In this chapter we hear from military service members including Vietnam War POWs, who turned to increasingly strenous activity to boost their confidence, support their overall health, and cushion the impact of extremely stressful situations. As you will learn from the experiences of a young physician facing physical illness, exercise can also boost the process of recovery. You will learn to make a habit of exercise and gradually push yourself to accomplish bigger goals. Finally, you will see that physical exercise can also teach us important lessons about humility and perseverance.
The aim of this study was to investigate whether moderate physical activity and group size influence physical fitness, the level of social interactions in the home cage and rats’ performance in the Elevated Plus Maze and a handling test. Forty-eight male Sprague Dawley rats were kept in groups of two, four or eight for seven weeks in cages adjusted to the group size. Home cage social interactions were studied during direct observations. Half of the number of rats from each cage were subjected to moderate exercise on a treadmill for five weeks. An exercise test was performed at the beginning and end of the experimental period, during which time lactate levels were analysed via blood sampling. Rats living in groups of four or eight performed better in the second exercise test, had more social interactions and showed more activity, open-arm entries and risk assessment in the Elevated Plus Maze test, compared to rats living in pairs. The trained rats had lower blood lactate levels in the second exercise test, lower bodyweight and plasma insulin levels and had a greater relative heart weight at the end of the study compared to control rats. In conclusion, rats kept in larger groups had more social interactions, a lower lactate response during exercise and showed less emotional reactivity. Moderate treadmill exercise resulted in the expected increase in the rats’ physical fitness. The results show that both group size and physical activity are important factors for animal welfare.
This study aimed to identify the association of recommended dairy intake with several dietary habits, obesity, physical fitness (PF), physical activity (PA), screen time and sleep. Population data were derived from a health survey on a representative sample of 177 091 children aged 8–17 years. Dairy intake and dietary habits were evaluated using questionnaires (KIDMED index). Participants were characterised as ‘dairy products consumers’ based on whether they met current recommendations for milk or dairy consumption (e.g. if they consumed two yogurts and/or 40 g cheese and a cup of milk daily). Participants who did not consume the above-mentioned quantities were characterised as ‘non-consumers.’ Anthropometric and PF data were obtained by trained investigators. PA status, screen time and sleeping habits were assessed through self-completed questionnaires. Boys and girls consuming recommended dairy products were 25 % (95 % CI: 0·71, 0·79) and 43 % (95 % CI: 0·51, 0·64) less likely to have low performances in cardiorespiratory fitness tests, Participants from both sexes classified as dairy products consumers had lower odds of central obesity by 10 % (95 % CI: 0·86, 0·95), as compared with non-consumers. Moreover, recommended dairy products consumers had lower odds for insufficient sleep by 8 % (95 % CI: 0·89, 0·96) in boys and 14 % (95 % CI: 0·83–0·90) in girls, for inadequate PA levels by 15 % (95 % CI: 0·77, 0·93) in boys and 16 % (95 % CI: 0·76, 0·90) in girls and for increased screen time by 11 % (95 % CI: 0·83, 0·95) in boys and 9 % (95 % CI: 0·85, 0·97) in girls than no-consumers. In conclusion, recommended dairy intake is associated with less obesity, better PF and a healthier lifestyle profile.
Preschooler inactivity and insufficient motor development have serious long-term consequences. The Chinese Ministry of Education launched a nationwide football-focused pilot project aimed at kindergartens in 2019 and issued the policy “Notice on the Establishment of National Football Kindergartens” in 2020. However, the impact of fundamental movement skills (FMS) interventions on other aspects of child development is unclear.
Aim:
This study will evaluate the effects of ball skills physical education projects on the development of Chinese preschoolers’ physical, motor, cognitive, and social competencies and examine the influencing factors.
Method:
This is a quasi-experimental study evaluating how well the “Hello Sunshine” curriculum project promotes children’s development over 10 weeks. The trial will be conducted from September 2021 to November 2021 in 12 classes from 3 kindergartens with a total of 249 children aged 4 to 6 years in Haikou, China. Pre- and posttest analyses will include tests on participants’ physical fitness, FMS, cognitive self-regulation, and emotional competence. Participants’ background information will be collected through questionnaires answered by parents and teachers. The intervention will focus on game-based basic ball skills.
Findings:
If this intervention provides evidence that these skills improve children’s multidimensional development, it will support the promotion of similar programs in China. We will also outline the social-ecological factors affecting the intervention’s results, providing further information for improving pedagogical methods related to preschool ball skills.
Exercise counteracts obesity effects, but information on how early-life obesity may affect long-term adaptation to exercise is lacking. This study investigates the impact of early-life postnatal overfeeding (PO) on animals’ adaptation to exercise. Only male Wistar rats were used. On postnatal day (PN) 30, rats from control (NL-9 pups) or PO (SL-3 pups) litters were separated into four groups: NL-sedentary (NL-Se), NL-exercised (NL-Ex), SL-sedentary (SL-Se), and SL-exercised (SL-Ex). Exercised groups performed moderate-intensity exercise, running on a treadmill, from PN30 to PN90. Further experiments were carried out between PN90 and PN92. PO promoted obesity in SL versus NL rats (P < 0.05). Exercise reduced body weight (P < 0.001), body fat (P < 0.01), and improved glucose homeostasis in SL-Ex versus SL-Se. SL-Ex presented lower VO2max (P < 0.01) and higher post-exercise LDH (P < 0.05) compared to NL-Ex rats. Although moderate exercise counteracted obesity in SL rats, early-life overnutrition restricts fitness gains in adulthood, indicating that early obesity may impair animals’ adaptation to exercise.
Studies examining the impact of adolescent and young adult cannabis use on structural outcomes have been heterogeneous. One already-identified moderator is sex, while a novel potential moderator is extent of aerobic fitness. Here, we sought to investigate the associations of cannabis use, sex, and aerobic fitness levels on brain volume. Second, we explored brain–behavior relationships to interpret these findings.
Methods:
Seventy-four adolescents and young adults (36 cannabis users and 38 controls) underwent 3 weeks of monitored cannabis abstinence, aerobic fitness testing, structural neuroimaging, and neuropsychological testing. Linear regressions examined cannabis use and its interaction with sex and aerobic fitness on whole-brain cortical volume and subcortical regions of interests.
Results:
No main-effect differences between cannabis users and nonusers were observed; however, cannabis-by-sex interactions identified differences in frontal, temporal, and paracentral volumes. Female cannabis users generally exhibited greater volume while male users exhibited less volume compared to same-sex controls. Positive associations between aerobic fitness and frontal, parietal, cerebellum, and caudate volumes were observed. Cannabis-by-fitness interaction was linked with left superior temporal volume. Preliminary brain–behavior correlations revealed that abnormal volumes were not advantageous in either male or female cannabis users.
Conclusions:
Aerobic fitness was linked with greater brain volume and sex moderated the effect of cannabis use on volume; preliminary brain–behavior correlations revealed that differences in cannabis users were not linked with advantageous cognitive performance. Implications of sex-specific subtleties and mechanisms of aerobic fitness require large-scale investigation. Furthermore, present findings and prior literature on aerobic exercise warrant examinations of aerobic fitness interventions that aimed at improving neurocognitive health in substance-using youth.
To explore the relationship between dietary patterns and physical fitness among older Chinese (≥60 years) individuals.
Design:
Cross-sectional survey. Dietary data were collected by a simplified semi-quantitative FFQ. The 30-s Chair Stand test (30sCST), 30-s Arm Curl test (30sACT), 8-foot Time Up-and-Go test (8fTUAGT) and 6-min Walking test (6mWT) were used to assess physical fitness. Dietary patterns were obtained by factor analysis. The association between dietary patterns and physical fitness was explored by multiple logistic regression.
Setting:
Six communities (villages) of three districts in Liaocheng City (Shandong Province, China).
Participants:
A total of 596 residents were recruited from April to May 2017.
Results:
Among 556 residents who were finally enrolled, 196 were men (35 %) and 360 were women (65 %). Three dietary patterns were identified: ‘Western’, ‘Vegetarian’ and ‘Modern’. The 30sACT revealed that men in the fourth quartile of the Western pattern were less likely to be classified in the ‘high-level’ group, but men in the fourth quartile of the Vegetarian pattern were classified in the high-level group. The 6mWT revealed that men in the fourth quartile of the Modern pattern were classified in the high-level group. These associations were independent of confounding factors.
Conclusions:
Adherence to the Vegetarian pattern and Modern pattern may be protective factors for maintaining good physical fitness in older Chinese individuals. The Western pattern may lead to poor physical fitness in this population.
To investigate the reproducibility of the Eurofit physical fitness test battery in patients with schizophrenia or schizoaffective disorder. Secondary aims were to assess clinical and demographic characteristics that correlate with the performance on the Eurofit and evaluation of the feasibility of the test.
Methods
Fifty patients with schizophrenia or schizoaffective disorder (mean age of 32.9±9.5years) with a mean body mass index (BMI) of 26.1±6.0kg/m2 performed two Eurofit tests administered within 3days.
Results
All Eurofit items showed good reproducibility with intraclass correlation coefficients ranging from 0.72 for flamingo balance to 0.98 for standing broad jump test. All participants could perform five of the seven test items without problems. The whole body balance and abdominal muscle endurance test could be executed by 74 and 90%, respectively. Significant correlations were found with age, BMI, waist circumference, dose of antipsychotic medication and extrapyramidal, negative and cognitive symptoms.
Conclusions
The Eurofit test showed good reproducibility and can be recommended for evaluating physical fitness parameters in patients with schizophrenia or schizoaffective disorder. Physical fitness measures were related to both physical and mental health parameters.
Birthweight (BW) has been associated with anthropometry, body composition and physical fitness during growth and development of children. However, less is known about the mediation effect of those variables on the relationship between BW and basal metabolic rate (BMR) in children.
Objective:
To analyse the mediation effect of anthropometry, body composition and physical fitness on the association between BW and BMR in children.
Methods:
In total, 499 children (254 boys, 245 girls) aged 7–10 years were included. Anthropometry (weight, height, head, waist and hip circumferences), body composition (skinfolds thickness, body fat percentage), physical fitness (handgrip strength, flexibility, muscular endurance, muscular explosive power, agility, running speed) and BMR were evaluated. The analyses were conducted by: single-mediator analysis (SMA) and multi-mediator analysis (MMA).
Results:
The SMA indicates height, head, waist and hip circumferences and handgrip strength as significant mediators of BW on BMR for boys and height, hip circumference and handgrip strength as significant mediators of BW on BMR for girls. In MMA for girls, there were significant indirect effects for height, hip circumference and handgrip strength, with 79.08% of percent mediation. For boys, the head and waist circumferences mediation had a significant indirect effect, with 83.37% of percent mediation.
Conclusion:
The anthropometric variables associated with BW were body height, head, hip and waist circumferences for boys and body height and hip circumference for girls. The current study provides new evidence that height and handgrip strength during childhood mediated the relationship between BW and BMR.
Low birth weight is associated with cognitive impairments persisting into adolescence and early adulthood. The purposes of this study was two-fold: to analyse the association between birth weight (BW) and school performance, and to determine the influence of adolescent aerobic capacity and muscular strength on the association between BW and school performance in children at 12–13 years. The study included 395 children (50.4% boys, aged 12–13 years). Self-reported BW was evaluated. We measured school performance (mean of the grades obtained in language and mathematics) and two physical fitness tests (aerobic capacity and muscular strength). Analysis of variance was used to analyse the differences in school performance according to BW categories (⩽2500, 2500–3500 and ⩾3500 g). Linear regression models fitted for mediation analyses examined whether the association between BW and school performance was mediated by aerobic capacity and/or muscular strength. Higher BW was associated with better school performance independent of current body mass index. These differences disappeared after controlling for aerobic capacity, which also mediated the association between BW and school performance (13.4%). The relationship between BW and school performance seems to be dependent on aerobic capacity fitness. Our results are of importance because the consequences of BW tend to continue into childhood, and current physical fitness of the children may potentially be modified to improve school performance.
Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n=29, age 18–31 years) and older adults (n=31, ages 55–82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults. (JINS, 2015, 21, 780–790)
The aim of this study was to examine cross-sectionally whether higher cardiorespiratory fitness (CRF) might favorably modify amyloid-β (Aβ)-related decrements in cognition in a cohort of late-middle-aged adults at risk for Alzheimer’s disease (AD). Sixty-nine enrollees in the Wisconsin Registry for Alzheimer’s Prevention participated in this study. They completed a comprehensive neuropsychological exam, underwent 11C Pittsburgh Compound B (PiB)-PET imaging, and performed a graded treadmill exercise test to volitional exhaustion. Peak oxygen consumption (VO2peak) during the exercise test was used as the index of CRF. Forty-five participants also underwent lumbar puncture for collection of cerebrospinal fluid (CSF) samples, from which Aβ42 was immunoassayed. Covariate-adjusted regression analyses were used to test whether the association between Aβ and cognition was modified by CRF. There were significant VO2peak*PiB-PET interactions for Immediate Memory (p=.041) and Verbal Learning & Memory (p=.025). There were also significant VO2peak*CSF Aβ42 interactions for Immediate Memory (p<.001) and Verbal Learning & Memory (p<.001). Specifically, in the context of high Aβ burden, that is, increased PiB-PET binding or reduced CSF Aβ42, individuals with higher CRF exhibited significantly better cognition compared with individuals with lower CRF. In a late-middle-aged, at-risk cohort, higher CRF is associated with a diminution of Aβ-related effects on cognition. These findings suggest that exercise might play an important role in the prevention of AD. (JINS, 2015, 21, 841–850)
Cardiovascular fitness influences many aspects of brain function. However, the relationship between cardiovascular fitness and suicidal behaviour is unknown. Therefore, we aimed to determine whether cardiovascular fitness at age 18 years is associated with future risk of suicide attempt/death.
Method
We performed a population-based Swedish longitudinal cohort study of male conscripts with no previous or ongoing mental illness (n = 1 136 527). The conscription examination, which took place during 1968–2005, included the cycle ergonometric test and tests of cognitive performance. Future risk of suicide attempt/death over a 5- to 42-year follow-up period was calculated with Cox proportional hazards models controlling for several confounders including familial factors.
Results
At least one suicide attempt was recorded for 12 563 men. Death by suicide without a prior attempt was recorded in 4814 additional individuals. In fully adjusted models low cardiovascular fitness was associated with increased risk for future attempt/death by suicide [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.64–1.94]. The HR changed only marginally after exclusion of persons who received in-patient care for depression (HR 1.76, 95% CI 1.61–1.94). Poor performance on both the cardiovascular fitness and cognitive tests was associated with a fivefold increased risk of suicide attempt or suicide death (HR 5.46, 95% CI 4.78–6.24).
Conclusions
Lower cardiovascular fitness at age 18 years was, after adjustment for a number of potential confounders, associated with an increased risk of attempt/death by suicide in adulthood. It remains to be clarified whether interventions designed to improve fitness in teens can influence the risk of suicidal behaviour later in life.