Exercise Strategies for Children

Physical Activity Measures in the Healthy Communities Study.

Status and Potential of Community-Engaged Research to Investigate Physical Activity Interventions for Children with Autism Spectrum Disorder in Chinese-American Communities

Physical activity in the prevention and treatment of obesity and its comorbidities: evidence report of independent panel to assess the role of physical activity in the treatment of obesity and its comorbidities.

635 Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition

<p dir="ltr">Background</p><p dir="ltr">Physical inactivity and functional decline represent significant challenges for aging populations, warranting effective intervention strategies and reliable assessment methodologies. This thesis investigated test-retest reliability of physical activity and fitness measurements in older adults, examined effects of structured exercise, and assessed longitudinal recovery trajectories in hip osteoarthritis patients following total hip arthroplasty (THA).</p><p dir="ltr">Methods</p><p dir="ltr">Four studies were conducted. Study I (n=78, age 70.9+4.7 years) evaluated accelerometer measurement reliability and monitored physical activity changes following an 8-week exercise intervention (twice-weekly, 60-minute combined training). Study II (n=1,407, age 65-84 years) assessed test-retest reliability of a comprehensive field-based fitness test battery and post an 8-week exercise period across multiple age groups. Study III (n=265, age 71.4+4.7 years) examined sustained and cumulative effects of identical 8-week exercise programs performed in consecutive years. Study IV (n=78, age 74.0+4.5 years) investigated physical fitness and activity patterns in hip osteoarthritis patients undergoing THA, with two assessments pre-operative, 4 months, and 1-year post-surgery.</p><p dir="ltr">Results</p><p dir="ltr">Physical activity parameters demonstrated good to excellent test-retest reliability. Similarly, field-based fitness tests generally showed good reliability across age and sex strata. The 8-week exercise intervention produced significant improvements in physical activity pattens and multiple physical fitness tests. Most fitness test parameters remained stable during the 9-month inter-intervention period, with declines observed in trunk strength endurance. Hip osteoarthritis patients exhibited pre-operative deficits compared to healthy controls in several fitness tests and in moderate- to vigorous physical activity, whereas post-operative improvements at 1-year follow-up were observed for a multitude of physical fitness parameters and exceeding the recommended physical activity levels.</p><p dir="ltr">Conclusions</p><p dir="ltr">This thesis established good test-retest reliability of accelerometer-measured physical activity and most included fitness assessments for monitoring older adults. Structured exercise generated physical activity and fitness benefits in healthy older adults. Moreover, substantial functional and activity improvements were seen following total hip arthroplasty without structured post-operative intervention. These findings underscore the importance of exercise engagement and appropriate surgical intervention to improve both functional capacity and physical activity in older adult populations.</p><h3>List of scientific papers</h3><p dir="ltr">This thesis includes four papers, these will be referenced using their Roman numerals listed below:</p><p dir="ltr">I. <b>Manne Godhe</b>, Marjan Pontén, Johnny Nilsson, Lena Kallings & Eva Andersson. Reliability of the accelerometer to control the effects of physical activity in older adults. Plos One, 17(9), e0274442. (2022). <br><a href="https://doi.org/10.1371/journal.pone.0274442">https://doi.org/10.1371/journal.pone.0274442</a><br><br></p><p dir="ltr">II. <b>Manne Godhe</b>, Gustaf Rönquist, Johnny Nilsson, Örjan Ekblom, Lillemor Nyberg, Gustav Edman, & Eva Andersson Reliability in Novel Field-Based Fitness Measurements and Postexercise Scores from a Physical Fitness Test Battery in Older Adults. Gerontology, 70(6), 639-660. (2024). https://doi.org/10.1159/000538446<br><a href="https://doi.org/10.1159/000538446">https://doi.org/10.1159/000538446</a><br><br></p><p dir="ltr">III. <b>Manne Godhe</b>, Johnny Nilsson, & Eva Andersson. Short-and Long-Term Effects on Physical Fitness in Older Adults: Results from an 8-Week Exercise Program Repeated in Two Consecutive Years. Geriatrics, 10(1), 15. (2025). https://doi.org/10.3390/geriatrics10010015<br><a href="https://doi.org/10.3390/geriatrics10010015">https://doi.org/10.3390/geriatrics10010015</a><br><br></p><p dir="ltr">IV. <b>Manne Godhe</b>, Anders Stålman, Johnny Nilsson & Eva Andersson. Physical fitness Improvements and Achievement of Recommended Physical Activity Levels One Year After Total Hip Arthroplasty: A Longitudinal Study of Physical Function and Activity Patterns [Manuscript]</p><p dir="ltr">Papers I & III were published under Creative Commons CC BY license. Paper II is reproduced in this thesis with permission from Karger Publishers. Paper IV is in manuscript form.</p>

<p dir="ltr">Background</p><p dir="ltr">Physical inactivity and functional decline represent significant challenges for aging populations, warranting effective intervention strategies and reliable assessment methodologies. This thesis investigated test-retest reliability of physical activity and fitness measurements in older adults, examined effects of structured exercise, and assessed longitudinal recovery trajectories in hip osteoarthritis patients following total hip arthroplasty (THA).</p><p dir="ltr">Methods</p><p dir="ltr">Four studies were conducted. Study I (n=78, age 70.9+4.7 years) evaluated accelerometer measurement reliability and monitored physical activity changes following an 8-week exercise intervention (twice-weekly, 60-minute combined training). Study II (n=1,407, age 65-84 years) assessed test-retest reliability of a comprehensive field-based fitness test battery and post an 8-week exercise period across multiple age groups. Study III (n=265, age 71.4+4.7 years) examined sustained and cumulative effects of identical 8-week exercise programs performed in consecutive years. Study IV (n=78, age 74.0+4.5 years) investigated physical fitness and activity patterns in hip osteoarthritis patients undergoing THA, with two assessments pre-operative, 4 months, and 1-year post-surgery.</p><p dir="ltr">Results</p><p dir="ltr">Physical activity parameters demonstrated good to excellent test-retest reliability. Similarly, field-based fitness tests generally showed good reliability across age and sex strata. The 8-week exercise intervention produced significant improvements in physical activity pattens and multiple physical fitness tests. Most fitness test parameters remained stable during the 9-month inter-intervention period, with declines observed in trunk strength endurance. Hip osteoarthritis patients exhibited pre-operative deficits compared to healthy controls in several fitness tests and in moderate- to vigorous physical activity, whereas post-operative improvements at 1-year follow-up were observed for a multitude of physical fitness parameters and exceeding the recommended physical activity levels.</p><p dir="ltr">Conclusions</p><p dir="ltr">This thesis established good test-retest reliability of accelerometer-measured physical activity and most included fitness assessments for monitoring older adults. Structured exercise generated physical activity and fitness benefits in healthy older adults. Moreover, substantial functional and activity improvements were seen following total hip arthroplasty without structured post-operative intervention. These findings underscore the importance of exercise engagement and appropriate surgical intervention to improve both functional capacity and physical activity in older adult populations.</p><h3>List of scientific papers</h3><p dir="ltr">This thesis includes four papers, these will be referenced using their Roman numerals listed below:</p><p dir="ltr">I. <b>Manne Godhe</b>, Marjan Pontén, Johnny Nilsson, Lena Kallings & Eva Andersson. Reliability of the accelerometer to control the effects of physical activity in older adults. Plos One, 17(9), e0274442. (2022). <br><a href="https://doi.org/10.1371/journal.pone.0274442">https://doi.org/10.1371/journal.pone.0274442</a><br><br></p><p dir="ltr">II. <b>Manne Godhe</b>, Gustaf Rönquist, Johnny Nilsson, Örjan Ekblom, Lillemor Nyberg, Gustav Edman, & Eva Andersson Reliability in Novel Field-Based Fitness Measurements and Postexercise Scores from a Physical Fitness Test Battery in Older Adults. Gerontology, 70(6), 639-660. (2024). https://doi.org/10.1159/000538446<br><a href="https://doi.org/10.1159/000538446">https://doi.org/10.1159/000538446</a><br><br></p><p dir="ltr">III. <b>Manne Godhe</b>, Johnny Nilsson, & Eva Andersson. Short-and Long-Term Effects on Physical Fitness in Older Adults: Results from an 8-Week Exercise Program Repeated in Two Consecutive Years. Geriatrics, 10(1), 15. (2025). https://doi.org/10.3390/geriatrics10010015<br><a href="https://doi.org/10.3390/geriatrics10010015">https://doi.org/10.3390/geriatrics10010015</a><br><br></p><p dir="ltr">IV. <b>Manne Godhe</b>, Anders Stålman, Johnny Nilsson & Eva Andersson. Physical fitness Improvements and Achievement of Recommended Physical Activity Levels One Year After Total Hip Arthroplasty: A Longitudinal Study of Physical Function and Activity Patterns [Manuscript]</p><p dir="ltr">Papers I & III were published under Creative Commons CC BY license. Paper II is reproduced in this thesis with permission from Karger Publishers. Paper IV is in manuscript form.</p>

Are children and adolescents less active if parents restrict their physical activity and active transport due to perceived risk?

Background Since the outbreak and global spread ofCOVID-19, countries rapidly introduced a range of preventative measures and isolation protocols to ensure safety, which ultimately led to the implementation of total lockdowns. As a result, children lost access to spaces where they typically engage in physical activity and were required to stay indoors. Objective The objective of this study is to assess the impact of the COVID-19 pandemic on children's physical activity levels and analyze the factors influencing their physical activity during this period. Methods Parents from various Emirates participated in an online survey to evaluate changes in their children's physical activity during the COVID-19 lockdown compared to the pre-lockdown period. The survey included questions about time spent on sedentary activities, general physical activity, and specific play behaviors before and during the lockdown. It also assessed the parents' own physical activity and their involvement in their children's activities. The relationships between these behaviors, as well as demographic and environmental factors, were analyzed. Results The study included 272 parents who completed an online survey about their child's physical activity during the COVID-19 lockdown. Many parents reported significant changes in their children's physical activity and screen time. Specifically, 89 (32.7%) observed a major decrease in physical activity, while 77 (28.3%) noted a minor decrease. Regarding screen time, 79 (29.0%) of parents reported a major increase, and 87 (32.0%) saw a minor increase. Key factors influencing children's physical activity were identified. Most notably, parents' own activity levels had a significant impact on their children's activity (p < 0.001). Additionally, children living in villas were more active than those living in apartments or traditional houses (p = 0.007), and UAE national children were slightly more active than non-nationals (p = 0.023). Conclusion This study demonstrated the significant impact of the COVID-19 lockdown on children's activity and emphasized the importance of parental involvement in supporting their children's activity levels. It highlights the need for increased attention during the recovery phase from this crisis and calls for the development of strategies and guidelines to prevent similar challenges in future pandemics or similar emergencies.

To evaluate the effects of a comprehensive physical activity (PA) promotion programme in elementary schools on children's total PA levels, leisure-time PA, physical fitness and psychosocial correlates of PA. A pre-test-post-test design over two school years. Sixteen elementary schools (764 children, mean age: 11.2 +/- 0.7 years) were randomly assigned to the intervention condition (n = 8) and the control condition (n = 8). The intervention included a health-related physical education programme, an extracurricular PA promotion programme and classroom-based PA education lessons. In the total sample, leisure-time PA, psychosocial correlates of PA and physical fitness were measured using a PA questionnaire and the Eurofit test battery. In a sub-sample, total PA levels were measured using an accelerometer. According to accelerometer data, children's moderate PA and moderate-to-vigorous PA (MVPA) levels decreased less in the intervention schools than in the control schools (P < 0.01). The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools. Children in the intervention schools reported significantly more moderate PA in leisure time than the controls (P < 0.05). No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found. The comprehensive PA promotion programme was successful in preventing a decline in children's total activity levels. Furthermore, the intervention increased children's PA engagement in leisure time. Therefore, implementation needs to be encouraged.

The school effect on children's school time physical activity: The PEACH Project

The rapid development of cities results in many public health and built-up environmental problems, which have vital impacts on children's growth environment, the development of children, and city contradictions. There is a lack of children being a main concern when constructing new urban areas or reconstructing old districts. Children's activity spaces tend to be standardized and unified (kit, fence, and carpet) “KFC style” designs, which leads to the urban neighborhood space and the environment being insufficient to attract children to conduct activities. Therefore, starting from the urban neighborhood space environment, this paper explores what kind of spatial environment is needed for children's physical activity and its impact on children's physical activity. Taking six residential areas in the Changchun Economic Development Zone as the research object, based on the theory of children's ability development and game value, this paper uses the Woolley and Lowe evaluation tool to quantify the impact of the theory on the urban neighborhood space environment and children's physical activity. It can be confirmed that there is a significant correlation between the spatial characteristics of an urban neighborhood and the general signs of the environment on the duration and intensity of the physical activity of children. The results show that: (1) the differences in children's ages result in differences in the duration and intensity of children's physical activity in the urban neighborhood space environment; (2) the open space factor of the neighborhood space has the most significant influence on the duration of children's physical activity; (3) in terms of the environmental characteristics, whether children can be provided with education and learning opportunities has a significant impact on the duration of children's physical activity; (4) there is a significant positive correlation between children's age and the duration and intensity of the physical activity, exercise type, and imaginative activity. These results show that the urban neighborhood space environment can affect the duration of children's physical activity. In future urban residential area planning and design, urban children can meet the self-demand of physical activity in the neighborhood space through the reasonable balance and combination of neighborhood space characteristics and environmental characteristics.

Physical fitness levels and trends of kindergarteners in Hong Kong during the COVID-19 pandemic

Introduction. The main focus of our study was to evaluate the body posture in a group of 147 children aged 6.4 – 9.8 y. In the study, we tried to find a statistically significant relationship among a body posture, particular components of physical fitness and the amount of physical activity. Methods. To evaluate the body posture, a modified Matthias test was used. To test the physical fitness, the UNIFITTEST 6-60 was used, including defining the somatotypes and it´s specific features. To find out the amount of physical activity, a questionnaire was used, which was completed by parents due to the age of the respondents. Results. The results have shown disbalances in body posture in the observed group of young school-age children. In total 53.1 % of children of the monitored group had poor body posture. Based on the t-test, statistically significant difference in the evaluation of the quality of body posture was found between the groups of boys and girls (t=3.21; p&lt;0.01), boys scored worse in the body posture test. Only a feeble correlation between the quality of the body posture and the amount of organized physical activity was measured in the group of girls (rs=-0.24; p&lt;0.05) – girls with a higher volume of extracurricular physical activities had better results in the evaluation of posture; however, this effect was small. The study has not shown any relations between the body posture and the individual components of physical fitness. The quality of the body posture is neither related to the amount of subcutaneous fat nor the BMI. Those children who practice some organized physical activity less frequently did worse in most tests concerning physical endurance. Their amount of subcutaneous fat was higher than in children who often participate in various after school activities more. The results of tests of fitness in both groups of girls and boys are even, the only statistically significant difference between these groups was found in the test result of the maximum reach while sitting, boys scored worse in this test (Z=-2,686; p&lt;0.01). Conclusion. More than half of the children of young school-age in the observed group children had poor body posture or at leas some posture deviation, the boys had a worse posture than the girls. The results of our research did not show a relationship between posture and performance in physical fitness tests. There was no evidence of a relation between body posture and body composition (measured by amount of subcutaneous fat and BMI). Sufficient physical activity probably has a positive effect on increasing fitness, but the relationship to posture is inconclusive.

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Background: Systemic inflammation, attacks, deterioration of thoracic region mechanics, medications used, and decreased physical activity level (PAL) and fitness negatively may affect respiratory muscle strength. The primary aim of this study was to evaluate dynamic inspiratory muscle strength (S-index), PAL, and physical fitness in children with asthma compared to healthy peers. The secondary aim of this study was to investigate the relationships between S-index and peak inspiratory flow (PIF) values and functional parameters in childhood asthma. Methods: This cross-sectional prospective study consisted of participants of 6-11 years of age, specifically, 20 children with asthma and 20 healthy peers. The device (POWERbreathe K5) evaluated PIF and S-index variables. PAL was determined with the Physical Activity Questionnaire-Child (PAQ-C) and fitness was evaluated with the FITNESSGRAM test battery. Results: The PIF Average (Avg): 1.8 ± 0.6, Best: 2.6 ± 0.6 (asthmatic children) vs. Avg: 2.4 ± 0.7, Best: 3.1 ± 0.9 (healthy children); p = 0.017, p = 0.027, respectively) and S-index (Avg: 34.1 ± 10.3, Best: 45.6 ± 9.9 (asthmatic children) vs. Avg: 43.2 ± 12.1, Best: 56.6 ± 14.7 (healthy children); p = 0.015, p = 0.008 respectively) values of children with asthma were significantly lower compared to healthy peers. The PAL and physical fitness of asthmatic and healthy peers were similar (p > 0.05). There were significant relationships between S-indexavg and S-indexbest with the PAQ-C score (r = 0.498, p < 0.025 r = 0.547, p < 0.013, respectively) and PIFavg and PIFbest with the PAQ-C score (r = 0.490, p < 0.028 r = 0.602, p < 0.005) in children with asthma. Conclusions: Dynamic respiratory muscle strength is negatively affected in children with asthma whereas their physical activity and fitness levels are comparable to their peers. However, it was found that children with a higher S-index and PIF rate had higher PALs. These findings suggest that pulmonary rehabilitation interventions to improve respiratory muscle function should be considered an important strategy to maintain and increase physical activity levels in children with asthma.