Screen use and physical activity in children under 6 years old: what has changed after the COVID-19 pandemic?

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

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

Plenary conference: Keys to successful physical activity during childhood

To describe active and sedentary time in children with spina bifida and to compare their physical activity on weekdays versus weekends. In this exploratory cross-sectional study, data from 13 Canadian and 22 Dutch children with spina bifida (14 females, 21 males; mean age 10y 11mo, standard deviation [SD] 3y 6mo, range 5y 6mo-18y; Hoffer classification distribution: community [n=28], household [n=3], non-functional [n=3], and non-ambulator [n=1]) were analysed. Objective measures of physical activity and sedentary behaviour were obtained by using ActiGraph or Actiheart activity monitors. Data for the participants wearing the ActiGraph were compared with age- and sex-matched controls that were developing typically using independent-samples t-tests. Activity data collected on weekdays was compared to those on weekends. ActiGraph data demonstrated children with spina bifida spent more time sedentary (mean [SD] 49.5min/h [5.78]) and less time in moderate to vigorous physical activity (mean [SD] 2.33min/h [1.61]) compared with the typically developing group (mean [SD] 41.0min/h [5.76] and 5.46min/h [2.13], p=0.001 and p<0.001 respectively). For both ActiGraph- and Actiheart-derived data, physical activity and sedentary time were not significantly different between weekdays and weekends. Children with spina bifida have reduced levels of physical activity and increased sedentary behaviour, with no statistical differences seen between weekdays and weekends. Several methodological issues related to activity monitoring warrant consideration when choosing the appropriate method to quantify physical activity and sedentary behaviour. Reduced levels of physical activity and sedentary time were quantified in children with spina bifida. Objective quantification of physical behaviour in ambulatory and non-ambulatory school-aged children with spina bifida is possible.

Lower levels of physical activity in childhood predict adult depression

Background: Cerebral palsy (CP) is defined as a group of disorders of the development of movement and posture, causing activity limitations. Despite the known benefits of engaging in regular physical activity, children with cerebral palsy (CP) are less physically active than their typically developing peers. Active video games are gaining attention as a means of increasing physical activity in children with CP. ‘Move it to improve it’ or Mitii™ is a novel web-based multi-modal training program comprising upper-limb and visual perceptual training within the context of physical activity which uses virtual therapists to deliver an individualised therapy program. Should Mitii™ be effective in increasing physical activity it has the potential to reduce secondary health complications associated with physical inactivity.Aim: The primary aim of this doctoral program was to test the efficacy of Mitii™ to increase physical activity capacity and performance in independently ambulant children and adolescents with unilateral CP. Additional aims were to: i) determine the efficacy of virtual reality technologies to increase physical activity; ii) determine the clinimetric properties of measures of habitual physical activity; and iii) describe patterns of physical activity and characteristics associated with physical activity, in independently ambulant children and adolescents with CP.Research design and methodology: A matched pairs, waitlist controlled randomised trial was chosen to assess Mitii™ in independently ambulant children and adolescents aged eight to 17 years with unilateral CP. Participants (n=102) were allocated to receive 20 weeks of 6 days per week Mitii™ training (potential total dose 60 hours) immediately, or waitlisted receiving usual care. Outcomes were assessed at baseline and post-intervention (20 weeks). Physical activity capacity was recorded using functional strength (a series of maximal repetition exercises) and walking endurance (six-minute walk test); physical activity performance was recorded using ActiGraph® tri-axial accelerometers. Secondaryoutcomes were mobility limitations (Mobility Questionnaire 28) and recreational participation (recreation domain of the Assessment of Life Habits).Results: Two systematic reviews were performed prior to commencement of the randomised trial. The first investigated the effect of virtual reality interventions to increase physical activity in children with CP. Included studies were of low methodological quality meaning few conclusions were able to be drawn, though there appeared to be a positive effect of virtual reality training. The second described the clinimetric properties of measures of physical activity in primary school aged children with CP. Accelerometers were found to be the most valid and clinically useful tool to measure physical activity however, evidence for their reliability in children with CP was lacking. This led to a study examining the reliability of measuring physical activity in children with unilateral CP using accelerometers. Conclusions reached from this study were that three days of monitoring was required to produce reliable estimates (>0.7) of moderate to vigorous physical activity (MVPA) and agreement between repeated measures was good for light and MVPA (intraclass correlation coefficient [ICC]=0.80). In combination with the systematic review, this study confirmed that accelerometers would be used to objectively measure physical activity performance over four days in the Mitii™ randomised trial.Analysis of cross sectional data collected during baseline assessments for the randomised trial found that independently ambulant children with unilateral CP performed insufficient MVPA to meet national recommendations of 60 minutes daily, recording on average 0:44hrs per day. Characteristics associated with physical activity performance were age and sex, with younger children and males recording more physical activity than adolescents and females. Increased walking endurance and the frequency of participation in home and community environments (measured using the Participation and Environment Measure for Children and Youth) were significantly associated with increased physical activity. These findings suggest that physical inactivity is a problem in children with unilateral CP and that an intervention targeting an increase in physical activity capacity and/or participation could result in improved levels of physical activity.The randomised trial found a significant difference favouring the intervention group at 20 weeks on assessment of functional strength and walking endurance, but not physical activity performance, recreational participation or mobility limitations. The response for walking endurance was dose dependent, indicating a positive training effect.Conclusions: Delivering training using the web-based program Mitii™ and virtual trainers was effective at increasing physical activity capacity assessed using functional strength and walking endurance in independently ambulant children with unilateral CP. Improvements in physical activity capacity did not translate into improvements in physical activity performance or reduce inactivity. This reinforces the view that physical activity capacity and performance represent separate constructs requiring different treatment approaches. Mitii™ may have a role in increasing physical activity in children with CP; however may need to be considered in the context of multi-dimensional interventions which incorporate behavioural change strategies to overcome the barriers associated with participating in increased physical activity.

COVID-19 caused closures of movement supporting environments such as gyms and schools in Canada. This study evaluated the association between Ontario parents' and children's physical activity levels across time during COVID-19, controlling for variables that were identified as significant predictors of children's and parents' physical activity (e.g.,children's age, parents' employment status). Parents (n = 243; mean age = 38.8y) of children aged 12 and under (n = 408; mean age = 6.3y) living in Ontario, Canada completed 2 online surveys, the first between August and December 2020 and the second between August and December 2021. At baseline, parents were asked to recall prepandemic physical activity levels. To determine the association between parent and child physical activity during COVID-19, a cross-lagged model was estimated to determine the cross-sectional and longitudinal associations between parents' and children's physical activity across time. Bivariate associations revealed that parents' and children's physical activity levels were significantly related during lockdown and postlockdown but not prelockdown. The autoregressive paths from prelockdown to during lockdown were significant for children (β = 0.53, P < .001) and parents (β = 1.058, P < .001) as were the autoregressive paths from during lockdown to postlockdown for children (β = 0.61, P < .001) and parents (β = 0.48, P < .001). In fully adjusted models, the cross-lagged association between parents' physical activity prelockdowns was significantly positively associated with their children's physical activity during lockdowns (β = 0.19, P = .013). Resources are needed to ensure that children and parents are obtaining sufficient levels of physical activity, particularly during a pandemic.

Lower levels of physical activity in childhood associated with adult depression

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

Objectives: In this study we examined the moderation effects of child attributes on the relationship between parent perception of child coordination, physical activity (PA) parenting practices, child enjoyment of PA, and child PA participation and examined the mediation effects of PA par enting practices and child PA enjoyment on the association between parent perception of child coordination and PA participation. Methods: Parents (N = 120) provided consent and completed data about their children's PA and related correlates. We used linear regression to examine child sex, age, race, and weight status as moderators, and to examine parent support and child enjoyment as mediators of the relationship between child coordination and PA participation. Results: Child race (b = 0.70, 95% CI: 0.20, 1.20) and weight status (b = 0.52, 95% CI: 0.05, 0.99) moderated the relationship between child coordination and parent support of child PA. Parent support of child PA and child enjoyment fully mediated the relationship between child coordination and PA participation (95% CI: 0.08, 0.36), mediating 56% of the observed effect. Conclusions: Our findings suggest that future interventions need to examine parent and child attributes (eg, perception of child coordination and race/weight status) as effect modifiers of the relationship between PA parenting practices and child PA participation.

Physical Activity Measures in the Healthy Communities Study.

Previous research has shown that fundamental movement skills (FMS) proficiency influences physical activity (PA) in children, such that those who are more proficient tend to be more active. Sufficient PA engagement in childhood has been associated with positive health outcomes, but little is known about PA levels in children with disabilities. Children with cerebral palsy (CP) represent the largest diagnostic group in pediatric rehabilitation. In one systematic review and six studies, FMS proficiency and PA levels among children with CP were measured, analyzed, and compared with typically developing children. The lack of a valid objective PA measurement method for children with CP was determined in the systematic review, and the first study (Chapter 2) validated the Actigraph accelerometer as a valid objective PA measurement instrument in this population group. FMS measurement in children with CP was addressed in the second study (Chapter 3), which showed that process-and product-oriented measurement are both important in characterizing FMS proficiency in a holistic manner. With the said measurement techniques validated, the third study (Chapter 4) utilized a cross- sectional study design to examine FMS proficiency and PA in children with and without CP. It was found that children were less active and more sedentary during weekends than weekdays. FMS proficiency was negatively associated with sedentary time and positively associated with time spent in moderate to vigorous PA in both groups of children. Process-oriented FMS measures were found to have a stronger influence on PA in children with CP than in typically developing children. With the intention to examine these relationships in a cause-effect study design, a theoretical model for FMS training programs was tested in children with and without disabilities in the fourth and fifth studies (Chapter 5). A movement training approach that minimized the amount of practice errors was found to facilitate improvements in FMS proficiency. This approach was then utilized in the sixth study (Chapter 6), wherein the relationship of FMS proficiency and PA were examined in a quasi-experimental design. It was found that by training FMS, weekend PA was heightened and weekend sedentary time was decreased among children with CP. In comparison, typically developing children manifested decreased weekend sedentary time after FMS training. The findings from these studies contribute to understanding the measurement of FMS and PA in children with CP, the implementation of FMS training in children in general, and the relationship between FMS and PA in children with and without disabilities.

Purpose – The aim of the research is to emphasise the role of material culture, and especially the role of objects related to physical activities, in children's socialization. It involves children's bodies but also symbolic meanings and values which introduce children to the universe of sport's consumption. Design/methodology/approach – The research is grounded on the construction of a system of objects related to children's physical activities in France. The production of a corpus of objects involves a methodological circle where the choice of the objects goes together with a reflexive analysis about the operations of categorization of objects. The analysis of objects require both technological and semiotical approaches. Findings – In the context of globalization and commodification of childhood, but also of the globalization and mediatization of sports, the research shows that objects for children's physical activities are inscribed in a double transformation: sportification of children's games and childification of sports. Research limitations/implications – The research focuses on material culture and does not investigate children's uses of the objects for physical activity and does not determine the process of their conception and design. Practical implications – The paper emphasises the difference between two faces of children's physical activities: spending calories and the development of motor skills and interpretative competences linked to sports' culture and children's mass culture. Originality Value – In contrast to the work done on food and digital culture, the field of children's physical activities and sports is not as well researched. This is especially the case for the objects designed for children and this research is one of the first in the field in international literature. It constitutes also the first attempt for including this topic in the worlds of children's consumption.

Physical activity in young children

Investigating within-day and longitudinal effects of maternal stress on children's physical activity, dietary intake, and body composition: Protocol for the MATCH study