Physical Activity Interventions Research Articles

Physical Activity and Exercise Interventions in Abdominal Wall Hernia Patients: Impact on Quality of Life and Health Outcomes - A Systematic Review and Meta-Analysis

ABSTRACT Objective Abdominal wall hernias are a common pathology in the surgical field, often leading to symptoms such as pain and tightness that can significantly reduce quality of life. Some studies have suggested that exercise and physical activity may improve both quality of life and health outcomes. This study aimed to evaluate the impact of exercise on quality of life and health outcomes in abdominal wall hernia patients through a qualitative systematic review and a quantitative meta-analysis. Design The systematic review identified six studies (n = 2409) that met the inclusion criteria, all demonstrating that exercise and physical activity positively affected health outcomes in abdominal wall hernia patients. Due to the limited number of studies available, the meta-analysis focused specifically on the effects of exercise and physical activity on quality of life and pain. Results The meta-analysis results indicated significant improvements in quality of life between pre- and postsurgery after a physical exercise intervention. However, no significant differences were found in pain levels between pre- and postsurgery following the exercise program. Conclusion This systematic review and meta-analysis offer promising insights into the potential benefits of physical activity and exercise interventions on health outcomes for AWH patients.

Associations of physical activity and sedentary time with health-related quality of life in patients with localized renal cell cancer: a cross-sectional analysis within the ReLife study

Abstract Purpose This study examined the associations of device-measured moderate-to-vigorous physical activity (MVPA) and sedentary time as well as self-reported MVPA with health-related quality of life (HRQoL) in patients with localized renal cell cancer (RCC) in the recovery phase after surgery. Methods At 3 months post-surgery, 341 patients with stage I-III RCC participating in the ReLife study wore an ActivPAL3 device to determine MVPA and sedentary time. The SQUASH questionnaire was used for assessing self-reported MVPA, and the EORTC QLQ-C30 for assessing HRQoL (range 0–100). Multivariable linear regression models were used to examine the cross-sectional associations of MVPA and sedentary time with HRQoL. Results The highest (≥ 6.7 h/week) versus lowest (≤ 2.7 h/week) quartile of MVPA was associated with a better global health status (β, 10.2; 95% CI, 5.1, 15.3), summary score (β, 4.6; 95% CI, 1.1, 8.1), physical (β, 7.7; 95% CI, 3.8, 11.6), role (β, 12.4; 95% CI, 4.7, 20.2), and social functioning (β, 7.3; 95% CI, 0.2, 14.4), and lower fatigue (β, − 11.2; 95% CI, − 18.1, − 4.2). Results for self-reported MVPA were in the same direction but weaker. The lowest (≤ 8.8 h/day) versus highest (≥ 11.5 h/day) quartile of sedentary time was associated with better physical functioning (β, 4.6; 95% CI, 0.8, 8.5). Conclusions In patients with localized RCC, higher MVPA 3 months post-surgery was associated with better HRQoL outcomes including less fatigue whereas lower sedentary time was only associated with better physical functioning. This information can contribute to the development of physical activity guidelines and interventions to improve HRQoL.

Associations of Physical Activity and Sedentary Behavior With Mental Distress According to Caregiver Status: Analysis of the Health Information National Trends Survey, 2022.

To (1) examine how physical activity and sedentary behavior are related to mental distress and (2) identify and compare how various levels of sedentary behaviors may differentially predict mental distress after accounting for physical activity, among caregivers vs non-caregivers. Cross-sectional secondary data. National Cancer Institute's Health Information National Trends Survey Cycle 6 fielded online from March-November 2022. U.S. adults aged 18 and older. The Patient Health Questionnaire-4 was administered along with caregiving status, moderate weekly physical activity, sedentary behavior, and sociodemographic characteristics. After applying population weights, we conducted multiple adjusted logistic regression models and estimated predictive margins to understand whether a specific dose of sedentary behavior (hours/day) is associated with risk of mental distress, at different levels of physical activity. Caregivers (15.41% of sample) reporting 10-hour of daily sedentary behavior were significantly more likely to experience mental distress, than those reporting lower amounts of sedentary behavior (OR = 3.372, 95%CI = 1.968, 5.776, P < 0.001). Regardless of physical activity amount, 10 hours of sedentary behavior may be a risk factor for mental distress among non-caregivers. Just 6 hours of sedentary behavior may be related to mental distress among caregivers. Physical activity interventions tailored to caregivers' needs, responsibilities, and circumstances are required. Innovative methodologies are needed to understand caregivers' daily behaviors and the intensity of their caregiving activities.

Machine Learning Methods to Personalize Persuasive Strategies in mHealth Interventions That Promote Physical Activity: Scoping Review and Categorization Overview.

Although physical activity (PA) has positive effects on health and well-being, physical inactivity is a worldwide problem. Mobile health interventions have been shown to be effective in promoting PA. Personalizing persuasive strategies improves intervention success and can be conducted using machine learning (ML). For PA, several studies have addressed personalized persuasive strategies without ML, whereas others have included personalization using ML without focusing on persuasive strategies. An overview of studies discussing ML to personalize persuasive strategies in PA-promoting interventions and corresponding categorizations could be helpful for such interventions to be designed in the future but is still missing. First, we aimed to provide an overview of implemented ML techniques to personalize persuasive strategies in mobile health interventions promoting PA. Moreover, we aimed to present a categorization overview as a starting point for applying ML techniques in this field. A scoping review was conducted based on the framework by Arksey and O'Malley and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) criteria. Scopus, Web of Science, and PubMed were searched for studies that included ML to personalize persuasive strategies in interventions promoting PA. Papers were screened using the ASReview software. From the included papers, categorized by the research project they belonged to, we extracted data regarding general study information, target group, PA intervention, implemented technology, and study details. On the basis of the analysis of these data, a categorization overview was given. In total, 40 papers belonging to 27 different projects were included. These papers could be categorized in 4 groups based on their dimension of personalization. Then, for each dimension, 1 or 2 persuasive strategy categories were found together with a type of ML. The overview resulted in a categorization consisting of 3 levels: dimension of personalization, persuasive strategy, and type of ML. When personalizing the timing of the messages, most projects implemented reinforcement learning to personalize the timing of reminders and supervised learning (SL) to personalize the timing of feedback, monitoring, and goal-setting messages. Regarding the content of the messages, most projects implemented SL to personalize PA suggestions and feedback or educational messages. For personalizing PA suggestions, SL can be implemented either alone or combined with a recommender system. Finally, reinforcement learning was mostly used to personalize the type of feedback messages. The overview of all implemented persuasive strategies and their corresponding ML methods is insightful for this interdisciplinary field. Moreover, it led to a categorization overview that provides insights into the design and development of personalized persuasive strategies to promote PA. In future papers, the categorization overview might be expanded with additional layers to specify ML methods or additional dimensions of personalization and persuasive strategies.

Exploring the perceptions and experiences of older people on the use of digital technologies during the COVID-19 pandemic: a qualitative study.

Physical inactivity is an ongoing problem throughout the lifespan. For older people, inactivity has a negative impact on wellbeing, which worsened during the COVID-19 pandemic. Digital technologies can be employed to encourage uptake of social and physical activity through remotely delivered interventions to improve wellbeing, however, we need to understand older people's perceptions and experiences of using digital technologies before implementing these interventions. To explore the perceptions and experiences of older people on the use of digital technologies during the COVID-19 pandemic. Qualitative semi-structured interviews were conducted with 16 community dwelling older people from Hertfordshire, United Kingdom who were all programme participants in a remotely delivered mind-body physical activity programme called Positive Movement. Interviews were conducted before programme participation. The audio recorded interviews were transcribed and analysed using thematic analysis. Four themes emerged from the data. The perceived impact of COVID-19 on social contact, perceived impact of COVID-19 on mental wellbeing, using digital platforms for health or exercise and using digital platforms for social contact. Participants reported reduced social contact due to COVID-19. Most participants reported using digital technologies for social inclusion rather than health reasons, and there were mixed views on the willingness to use digital technologies for physical activity. Digital technologies offered a lifeline during COVID-19 to maintain social contact and their use was found acceptable by older people. Digital platforms such as Zoom can be further employed to conduct remotely delivered interventions with the aim to increase uptake of social and physical activity interventions within this population.

Physicians' perspectives on cancer-related fatigue management and their suggestions for improvements in medical training: a cross-sectional survey study in Germany.

Contrary to guidelines, many cancer patients are not screened for cancer-related fatigue (CRF) and do not receive information or adequate treatment. As physicians play a key role in cancer therapy, their knowledge of this common sequela and perspectives on its management are of major interest. For an online survey, physicians working in oncology in Germany were systematically drawn from registers and invited by using institutional newsletters or colleagues. Descriptive analyses, logistic regression analysis of physicians' knowledge, and Mann‒Whitney U tests were performed. Two-thirds of the 148 surveyed physicians felt (rather) well informed about CRF and capable of counseling patients. Only 32% of the sample were aware of CRF-specific guidelines. Despite of this, participants rated the scientific evidence for recommending physical activity, exercise programs, and psychotherapeutic interventions in accordance with guidelines as being mostly (very) strong. However, despite 82.4% of the physicians being (rather) aware of its evidence, only 56.1% often to almost always recommended psychotherapeutic interventions. CRF was rarely covered in medical studies and medical specialist training. The completion of advanced training for palliative care increased the likelihood of knowing guidelines (OR = 2.6, 95% CI [1.1-6.0], p < 0.05). Suggestions for improving training included the mandatory coverage of CRF in medical training or its consideration in interprofessional supportive care workshops. Although awareness and recommendation rates were adequate for some interventions in CRF treatment (such as physical activity), there were lower recommendation rates for others, including psychotherapy. Studies are required assessing for the reasons of this knowledge-to-practice gap. Moreover, training is needed among physicians in order to enhance knowledge of CRF guidelines. Clinicaltrials.gov , identifier: NCT04921644. Registered in June 2021.

Meta-analysis of a Moderate-to-Vigorous Physical Activity Intervention for Academic Achievement in Children and Adolescents.

To analyze the intervention effect of moderate-to-vigorous physical activity (MVPA) on the academic performance of children and adolescents. Experimental studies on the effects of MVPA on the academic performance of children and adolescents were comprehensively searched in Web of Science, China Knowledge Network and other databases, and the Cochrane Risk of Bias Assessment Tool was used to assess the quality of the literature, and the Meta-analysis was performed by Review Manager 5.3. 1) A total of 11 high-quality literature were included, including 4552 subjects; 2) MVPA had a positive effect on the academic performance of children and adolescents (SMD=0.24; 95%CI:0.13, 0.35, P<0.0001), with differences in the effect of different subjects, and the mathematics has the best effect (SMD=0.23; 95%CI:0.11, 0.34, P≤0.0001), followed by reading (SMD=0.24; 95% CI:0.02, 0.46, P<0.05), and the comprehensive achievement intervention effect was not significant (SMD=0.33; 95% CI:-0.15, 0.80, P=0.18); 3) MVPA has the greatest impact on children aged 9-11 years (SMD=0.30; 95%CI:0.06, 0.54, P<0.05); 4) The optimal dose of intervention for MVPA is a long cycle of 30-60 minutes per session(SMD=0.34; 95%CI:0.12, 0.56, P<0.01), 2 times per week(SMD=0.28; 95%CI:0.2, 0.35, P<0.001); 5) The effect of literature publication bias detection was positive. 1) MVPA has a moderate effect on promoting academic achievement in children and adolescents, with younger age groups often benefiting more than older adolescents due to age-related cognitive plasticity; 2) MVPA has limited intervention effect on the performance of other subjects, which leads to the unsatisfactory effect of the intervention on the comprehensive performance; 3) Attention should be paid to the fine control of the intensity of the physical activity to guarantee individual MVPA participation to promote the academic achievement of children and adolescents; 4) Long-term participation, 30-60 minutes per session, 2-3 times per week of MVPA has been shown to be an effective intervention dose to enhance academic performance.

A Novel Scale of Lifestyle Physical Activity: Measure Description and Intervention Responsiveness

Lifestyle physical activity (LPA) interventions emphasize small bouts of movement that can be flexibly integrated into one’s everyday routine. Despite research illustrating benefits for LPA on health outcomes, few LPA interventions and measurement tools have been developed and tested. The purpose of this study was to present a novel LPA self-report scale, including its content, scoring, and internal consistency reliability, and summarize its intervention responsiveness. The LPA scale was administered in a pilot randomized controlled trial that tested a 12-week LPA + Fitbit intervention against a health education (HE) control (matched to LPA + Fitbit on contact time) in a sample of 50 women with depression in alcohol treatment. The LPA scale includes 22 items covering five domains relevant to LPA. Results demonstrated good internal consistency reliability for the total score (ω = 0.84) but poor-to-acceptable internal consistency reliability for the domain scores (ω range: 0.43-0.80). Participants randomized to the LPA + Fitbit intervention had significantly greater improvements in the LPA total score and two domain scores compared to HE participants. Overall, results demonstrate good internal consistency reliability and intervention responsiveness of the LPA scale total score. A larger, more comprehensive psychometric evaluation is needed for validation of this scale.

Abstract 4140142: Neighborhood Perceptions Associate with Lipid Biomarkers in African-American Women with Cardiovascular-Kidney-Metabolic Syndrome: Data from the Step It Up Digital Health-Enabled, Community-Engaged Physical Activity Intervention

Background: Cardiovascular-kidney metabolic (CKM) syndrome is exacerbated among individuals experiencing chronic exposure to both environmental and psychosocial stressors. Both neighborhood and individual-level stressors increase chronic inflammation resulting in worsened CKM factors, such as hypertension, diabetes, and dys/hyperlipidemia. However, associations between neighborhood perceptions (NP) and lipid profiles remain understudied. Therefore, we examined associations between NP domains and lipid profiles among African-American (AA) women with ≥Stage 1 CKM syndrome (overweight/obesity) residing in resource-limited neighborhoods within the Washington, DC area. Methods: Participants were enrolled in Step It Up, a technology-enabled, community-engaged physical activity (PA) intervention. Fasting blood samples were drawn at baseline to measure lipoproteins using Nuclear Magnetic Resonance (NMR) spectroscopy. Factor analysis of overall NP identified four perception sub-scores: disorder, social cohesion, violence, and safety (higher score=favorable perception). Associations between NP domains and lipoprotein particles were analyzed using multivariable regression adjusting for BMI, ASCVD 10-year risk score, and lipid-lowering therapy. Results: Participants (n=169) had mean age=57.16 ± 12.00 and BMI 35.99 ± 6.57. Perceptions of safety were positively associated with LDL concentrations (LDLc) and large LDL particles (L-LDLp) (β=4.70 [SD=2.41], p=0.05, β= 43.75 [17.70], p= 0.01), respectively). Perceptions about neighborhood violence were positively associated with L-LDLp (marginally) and very-low-density lipoprotein size (VLDLz) (β= 7.10 [3.96], p=0.08, β= 0.31 [0.14], p= 0.02, respectively). No associations were found between disorder and social cohesion with lipid biomarkers. Conclusions: After adjusting for BMI, ASCVD risk, and lipid-lowering therapy, there were significant associations between neighborhood perceptions of safety and violence with lipid profiles among AA women with CKM syndrome. Greater perceived safety was associated with higher LDLc and L-LDLp while more favorable perception about neighborhood violence was associated with higher L-LDLp. Future work should examine whether improving neighborhood resources and perceptions may improve CKM health among urban AA women.

Effectiveness of a digital health and financial incentive intervention to promote physical activity in patients with type 2 diabetes: study protocol for a randomised controlled trial with a nested qualitative study-ACTIVATE trial.

The prevention of type 2 diabetes (T2DM) is recognised as a health care priority in the UK. In people living with T2DM, lifestyle changes (e.g. increasing physical activity) have been shown to slow disease progression and protect from the development of associated comorbidities. The use of digital health technologies provides a strategy to increase physical activity in patients with chronic disease. Furthermore, behaviour economics suggests that financial incentives may be a useful strategy for increasing the maintenance and effectiveness of behaviour change intervention, including physical activity intervention using digital health technologies. The Milton Keynes Activity Rewards Programme (MKARP) is a 24-month intervention which combines the use of a mobile health app, smartwatch (Fitbit or Apple watch) and financial incentives to encourage people living with T2DM to increase physical activity to improve health. Therefore, this randomised controlled trial aims to examine the long-term acceptability, health effects and cost-effectiveness of the MKARP on HbA1c in patients living with T2DM versus a waitlist usual care comparator. A two-arm, single-centre, randomised controlled trial aiming to recruit 1018 participants with follow-up at 12 and 24months. The primary outcome is the change in HbA1c at 12months. Secondary outcomes included changes in markers of metabolic, cardiovascular, anthropometric, and psychological health along with cost-effectiveness. Recruitment will be via annual diabetes review in general practices, retinal screening services and social media. Participants aged 18 or over, with a diagnosis of type 2 diabetes and a valid HbA1c measurement in the last 2months are invited to take part in the trial. Participants will be individually randomised (1:1 ratio) to receive either the Milton Keynes Activity Rewards Programme or usual care. The intervention will last for 24months with assessment for outcomes at baseline, 12 and 24months. This study will provide new evidence of the long-term effectiveness of an activity rewards scheme focused on increasing physical activity conducted within routine care in patients living with type 2 diabetes in Milton Keynes, UK. It will also investigate the cost-effectiveness of the intervention. ISRCTN 14925701. Registered on 30 October 2023.

Educational Strategies For Healthy Habits in Secondary School: Promoting Integral Health

Objectives: This article aims to integrate positive habits in secondary education, focusing on students' mental and physical health. It aims to promote self-care practices and emotional resilience. Theoretical Framework: It is based on theories of emotional education, active learning, and public health, highlighting the importance of training in healthy behaviors for students' physical, emotional, and social well-being. Method: A mixed method was used, using interactive activities, awareness-raising workshops, and digital technologies. Periodic evaluations were carried out to measure the impact of the interventions and encourage the active participation of teachers and students. Results and Discussion: Implementing the educational strategies improved physical activity intervention and reduced risk behaviors, such as substance use. Research Implications: The findings suggest that promoting positive behaviors in secondary education increases academic achievement and contributes to students' overall development. They highlight the need for educational policies that support these initiatives and encourage collaboration between school, family, and community. Originality/Value: It offers an innovative educational proposal that prioritizes students' personal growth and creates an environment conducive to learning. It fosters active collaboration between students and teachers and develops socio-emotional skills that strengthen the sense of community and belonging.

Physical activity interventions: an update on advancing sedentary time, technology, and dissemination and implementation research.

Approximately 28% of American adults meet both the physical activity (PA) and strength training guidelines despite the numerous health benefits associated with a physically active lifestyle. The purpose of this paper is to provide an update of the 2017 Society of Behavioral Medicine PA Special Interest Group article that outlined future directions in sedentary time reduction interventions, technology-based PA interventions, and the dissemination and implementation of PA interventions. Since the prior review, there has been significant progress on effective interventions for reducing sedentary time. However, there has been less progress for improving the specificity of sedentary time guidelines. There has been a dramatic increase in the number of studies examining PA mHealth interventions and support for mHealth intervention has generally been positive, though sustaining engagement in mHealth interventions remains a challenge. Promising newer technologies that have been explored more extensively since the prior review including artificial intelligence (AI). Knowledge of how to implement and scale-up effective PA interventions has also increased. Several current trends in PA intervention research that continue to advance the field include examining the moderating effect of the built environment on the effectiveness of behavioral interventions, cultural tailoring of interventions, Just in Time Adaptive Interventions (JITAIs), and exercise snacks (vigorous intensity PA sessions that are less than one minute). Overall, there has been significant progress in the PA intervention field but significant work remains for creating effective interventions that can be readily implemented into real world settings.

The Mediating Role of Physical Activity and Self-Rated Health in the Association Between Depression and Quality of Life in Older Europeans: An Analysis Differentiated by Sex

Objectives: This study investigates the mediating role of moderate physical activity (MPA), vigorous physical activity (VPA), and self-rated health (SRH) in the association between depression and quality of life (QoL) in a large sample of Europeans aged 50 and over, differentiated by sex. Methods: Data from the 2017 Survey of Health, Ageing and Retirement in Europe were analyzed, including 11,986 individuals (6843 women) aged 50 and older. All information was collected through face-to-face interviews: sociodemographic data, SRH, physical activity levels, depression (EURO-D scale), and QoL (CASP-12). Results: Comparatively, women reported a higher prevalence of depression, a lower perception of QoL, and slightly lower levels of SRH, MPA, and VPA. Parallel mediation models revealed, for both sexes, that an increase in VPA levels was more effective in benefiting SRH; and MPA proved to be a better promoter of QoL. When comparing sexes, only the path depression → VPA → QoL showed a significant difference (p &lt; 0.001). Conclusions: These results provide valuable insights for developing physical activity interventions capable of improving mental health and promoting QoL in older European adults.

Pilot evaluation on an adapted tele-behavioral activation to increase physical activity in persons with depression: a single-arm pilot study

BackgroundPhysical activity has the potential to improve physical and mental health outcomes of persons with depression. However, feasible and acceptable strategies to integrate physical activity interventions into real-world settings are needed.ObjectiveTo assess the feasibility and acceptability of a manualized Behavioral Activation intervention aimed to increase physical activity in persons with depression (defined as a PHQ-9 score ≥ 10).MethodsA single-arm pilot study was conducted. The intervention consisted of 8 tele-therapy sessions delivered over a 10-week period. Measures of feasibility included screening, enrollment, intervention adherence, outcome data availability, and intervention fidelity. Acceptability was assessed with a post-intervention survey and qualitatively through focus groups and interviews. Preliminary efficacy of the intervention was assessed by evaluating pre-to-post changes in physical activity and depressive symptoms.ResultsAll feasibility metrics exceeded predetermined feasibility goal metrics with the exception of Fitbit wear and screening rate, which was due to a greater than anticipated enrollment rate. Participants (n = 15) reported perceived benefits from the intervention and convenience in attending tele-therapy sessions. Depressive symptoms, as measured by the PHQ-9 improved (16.8 at enrollment to 10.1 post intervention, Cohen’s d = 1.13). Self-reported moderate-to-vigorous physical activity (MVPA) increased from 22.0 min/week at baseline to 36.67 min/week post-intervention (d = 0.58). Physical activity as measured by the Fitbit showed little change (daily step 5543.29 during Week 1 to 6177.48 during Week 10, (d = 0.14); MVPA 21.23 min/week during Week 1 to 19.22 at Week 10 (d = 0.0.06).ConclusionsResults of the pilot study suggest the intervention is feasible to deliver and acceptable to participants. Preliminary results suggest the intervention may be effective in improving depressive symptoms and increasing self-reported physical activity.Trial registrationClinicalTrials.gov NCT04990401, Registered July 21, 2021.

Feasibility and Acceptability of a Peer Training Program to Deliver a Theory-Based Physical Activity Behavior Change Intervention to Inactive People Living With and Beyond Cancer: A Mixed Methods Study

Theory-based physical activity (PA) interventions include PA promotion strategies that can be delivered by exercise professionals, friends, family and peers. Peer-delivery presents a valuable opportunity for community implementation. Few peer-led PA interventions for people living with and beyond cancer (LWBC) report the feasibility of their peer mentor training methods. The purpose of this study was to assess the feasibility and acceptability of a peer mentor training program to deliver a behavioural PA intervention to inactive people LWBC using a mixed methods approach. Peer mentors (active people LWBC [≥90 min/week of PA]) participated in an online training program. Weeks 1 to 4 (Phase I) included knowledge and skill development (1-hour online module and 2-hour live workshop weekly). The Assessment phase (Phase II) explored peer mentor readiness (≥80% on a knowledge quiz and ≥3/5 points [Satisfactory] on a mock role play). Feasibility was assessed using enrollment rates, retention rates, adherence, and semi-structured interviews. Acceptability was measured using a satisfaction questionnaire assessing level of agreement with several statements about training program components. Peer mentors (&lt;em&gt;N &lt;/em&gt;= 14; M&lt;sub&gt;age&lt;/sub&gt; = 65.4 ± 10.7 years) were diagnosed with primarily prostate (57.1%) or breast (21.4%) cancer. Enrollment and retention rates were 73.7% and 92.9%, respectively. Workshops and online modules had 100% and 87.5% adherence rates, respectively. Majority of peer mentors met readiness criteria for the knowledge quiz (92.3%) and mock role play (84.6%) on their first attempt, with 92.3% delivering the follow-up peer-led PA intervention. Peer mentor satisfaction scores ranged from 3.9 to 4.6 out of 5. Interviews generated themes around overall impressions, feedback on timing, structure, and content of the training program and mock role play, and peer mentor preparedness. Structured training for delivering peer-led PA interventions show promise; however, individualized support may be needed for some people LWBC to strengthen mentorship knowledge and skills.

Systematic review and meta-analysis of combined cognitive-behavioral therapy and physical activity and exercise interventions for pediatric chronic disease.

Cognitive-behavioral (CBT) interventions combined with either a physical activity (CBT+PA) or exercise intervention (CBT+Ex) are becoming more common in pediatric populations. Considering the independent effects of PA and exercise on health and psychological outcomes, it is unclear whether CBT alone differs from CBT+PA or CBT+Ex in efficacy. The main objective of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to assess the efficacy of CBT+PA and CBT+Ex interventions in pediatric chronic disease. This review included RCTs in children (≤18 years) with a chronic condition, a CBT+Ex or CBT+PA intervention, and an objective measure of PA&Ex. Seven databases were searched using MeSH terms and key terms and included studies published before July 1, 2023. Abstracts were reviewed for inclusion by two independent reviewers, data was extracted by three independent reviewers. Risk of bias (RoB 2) and study quality were coded. Random effect meta-analyses of differences in between-group change in PA&Ex were conducted. Eligible studies (k = 5) reported outcomes for a combined 446 children. A small, nonsignificant overall effect was found (d = 0.10, 95% CI -0.16, 0.35) indicating intervention groups (CBT+PA or CBT+Ex) increased engagement in PA&Ex more than comparator groups (CBT). Additional analyses were inconclusive due to the small number of eligible studies. Additional RCTs are needed with integrated PA&Ex interventions targeting pediatric chronic disease. Future trials should report more detailed PA&Ex data. The full protocol for this analysis was prospectively registered in Open Science Framework (project ID: osf.io/m4wtc).

Assessing the Feasibility and Acceptability of Virtual Reality for Remote Group-Mediated Physical Activity in Older Adults: Pilot Randomized Controlled Trial.

Physical inactivity represents a major health concern for older adults. Most social, at-home physical activity (PA) interventions use videoconference, email, or telephone communication for program delivery. However, evidence suggests that these platforms may hinder the social connection experienced by users. Recent advancements in virtual reality (VR) suggest that it may be a rich platform for social, at-home interventions because it offers legitimate options for intervention delivery and PA. This pilot study aims to determine the feasibility and acceptability of VR compared to videoconference as a medium for remote group-mediated behavioral intervention for older adults. The information generated from this investigation will inform the use of VR as a medium for intervention delivery. Nine low-active older adults (mean age 66.8, SD 4.8 y) were randomized to a 4-week home-based, group-mediated PA intervention delivered via VR or videoconference. Feasibility (ie, the total number of sessions attended and the number of VR accesses outside of scheduled meetings) and acceptability (ie, the number of participants reporting high levels of nausea, program evaluations using Likert-style prompts with responses ranging from -5=very difficult or disconnected to 5=very easy or connected, and participant feedback on immersion and social connection) are illustrated via descriptive statistics and quotes from open-ended responses. None of the participants experienced severe VR-related sickness before randomization, with a low average sickness rating of 1.6 (SD 1.6) out of 27 points. Attendance rates for group meetings were 98% (59/60) and 96% (46/48) for the VR and videoconference groups, respectively. Outside of scheduled meeting times, participants reported a median of 5.5 (IQR 5.3-5.8, range 0-27) VR accesses throughout the entire intervention. Program evaluations suggested that participants felt personally connected to their peers (VR group: median 3.0, IQR 2.5-3.5; videoconference group: median 3.0, IQR 2.7-3.3), found that goals were easy to accomplish (VR group: median 3.0, IQR 2.8-3.3; videoconference group: median 3.0, IQR 2.6-3.4), and had ease in finding PA options (VR group: median 4.0, IQR 3.5-4.3; videoconference group: median 2.0, IQR 1.6-2.4) and engaging in meaningful dialogue with peers (VR group: median 4.0, IQR 4.0-4.0; videoconference group: median 3.5, IQR 3.3-3.8). Open-ended responses regarding VR use indicated increased immersion experiences and intrinsic motivation for PA. These findings suggest that VR may be a useful medium for social PA programming in older adults, given it was found to be feasible and acceptable in this sample. Importantly, all participants indicated low levels of VR-related sickness before randomization, and both groups demonstrated very high attendance at meetings with their groups and behavioral coaches, which is promising for using VR and videoconference in future interventions. Modifications for future iterations of similar interventions are provided. Further work using larger samples and longer follow-up durations is needed. ClinicalTrials.gov NCT04756245; https://www.clinicaltrials.gov/study/NCT04756245.

A Systematic Review of the Long-term Efficacy of Physical Activity Interventions in Reducing Risk Factors for Obesity in Adults

Background: Regular physical activity (PA) provides numerous health advantages, including lowering mortality rates and preventing obesity. Despite well-established guidelines advising 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic PA weekly, sedentary lifestyles remain prevalent, especially in industrialised nations. This systematic review examines the long-term effectiveness (12-24 months) of PA interventions aimed at reducing obesity risk among adults, with a particular focus on identifying strategies that promote sustained adherence. Methods: A comprehensive literature search was performed using multiple databases, including Cochrane Library, PubMed, and Embase, focusing on studies published between January 2004 and January 2024. The inclusion criteria focused on randomised controlled trials and similar designs targeting healthy adults, with interventions promoting sustained PA. Primary outcomes assessed were long-term PA adherence, reductions in obesity rates, and improvements in physical and metabolic health. Results: Twenty-one studies met the inclusion criteria, covering a range of intervention strategies. Most interventions featured structured PA programmes, often with personalised components and ongoing support. Several high-quality studies demonstrated long-term PA adherence, increased weekly energy expenditure, and improvements in fitness. However, adherence rates varied, with participants meeting recommended PA levels ranging from 4.6% to 81%. The meta-analysis showed a small to moderate positive effect of PA interventions on outcomes like PA levels and weight loss, with an effect size of 0.37 (CI: 0.25-0.50). Discussion: The results highlight the need for tailored, culturally sensitive interventions, particularly for vulnerable populations. Long-term PA adherence is stronger in older adults than middle-aged ones, but the sustainability of these effects remains unclear, warranting further research

Physical Activity as a Predictor of Internet Gaming Disorder in a Swiss Male Cohort (C-SURF): L'activité physique comme prédicteur des troubles liés aux jeux vidéo en ligne dans une cohorte de jeunes hommes suisses (C-SURF).

This study addresses the increasing global concerns surrounding Internet gaming disorder (IGD) by exploring their connection to physical activity (PA) as a potential preventive and early intervention measure. The research aims to examine the relationship between PA and the progression of IGD. Longitudinal data from the Cohort research on Substance Use Risk Factors involving young Swiss men undergoing army conscription was employed. PA levels were assessed using the International PA Questionnaire (IPAQ), while the Game Addiction Scale (GAS) and Compulsive Internet Use Scale determined IGD presence. Analysis involved zero-inflated negative binomial regression models. Higher PA levels were associated with lower IGD risk. Notably, individuals engaging in high physical exercise exhibited a lower IGD prevalence compared to those with moderate or low activity levels. The study suggests that intensive physical exercise might serve as a preventive strategy against developing IGD. This protective effect could stem from various mechanisms. However, the study's limitations, such as a male-only sample and a small low-activity group, should be considered when interpreting results. The longitudinal study demonstrates the positive influence of intense physical exercise on mitigating gaming-related issues. These findings underscore the potential of PA interventions in addressing the growing problem of IGDs and their impact on health. Further research is necessary to uncover underlying mechanisms behind the PA-IGD relationship and validate these findings across diverse demographics.

Prenatal exercise and its effects on postpartum mental health: systematic review and meta-analysis.

The perinatal period, spanning from pregnancy through the first year after childbirth, is characterized by significant physiological, psychological, and socio-contextual changes. Women face complex stressors including psychosocial pressures, financial constraints, interpersonal dynamics, anticipatory stress related to parenthood, hormonal fluctuations, and societal expectations. These factors collectively influence the perinatal experience, increasing vulnerabilities and stress levels. A systematic review was conducted in October 2023 using PubMed, SPORTDiscus, PsycInfo, and Scopus databases. Only English-language publications were included. For the meta-analysis, only randomized controlled trials (RCTs) using the Edinburgh Postnatal Depression Scale (EPDS) were considered. Data extraction was performed independently by two reviewers using Covidence, focusing on study characteristics, population demographics, interventions, and outcomes. The initial search identified 2,373 articles, with 1,196 duplicates removed, leaving 1,177 articles. After screening titles and abstracts, 1,247 were excluded for not meeting the inclusion criteria, resulting in 30 full-text articles reviewed for eligibility by two researchers. Nineteen studies were included in the systematic review, with four in the meta-analysis. Results indicated that higher levels of physical activity during pregnancy were consistently associated with improved postpartum mental health outcomes, including reduced depressive symptoms, lower anxiety, and enhanced overall well-being. Low-intensity exercises, such as yoga, were particularly effective in reducing postpartum depressive symptoms. The impact of moderate-intensity exercise varied, with some studies showing no significant effects. The meta-analysis of four RCTs using the EPDS demonstrated a significant reduction in depression and anxiety symptoms among postpartum women who participated in physical activity interventions, with a substantial overall effect size. Developing physical activity and exercise regimens encompassing a range of intensities can address the unique physiological and psychological demands of the perinatal period, maximizing the therapeutic benefits of physical activity interventions.