Physical Activity Patterns In Children Research Articles

Examination of Physical Activity Patterns of Children, Reliability and Structural Validity Testing of the Hungarian Version of the PAQ-C Questionnaire.

Several studies report on the importance of physical activity (PA) in childhood, which influences attitudes towards health in adulthood. For monitoring PA, trustworthy measurement tools are needed. The study aimed to adapt the Physical Activity Questionnaire for Children (PAQ-C) to the Hungarian language and assess its validity, reliability, and factor structure. A total of 620 children (the average age was 10.62 (SD 2.36)) participated in the cross-sectional study. To assess physical activity, the PAQ-C questionnaire was used. The collected data were analysed using IBM SPSS version 28.0 and IBM SPSS AMOS 29.0 software. The internal consistency was acceptable (alpha = 0.729) and the test-retest reliability showed acceptable agreement (ICC = 0.772). The confirmatory factor favoured a one-factor structure of the questionnaire. The average PAQ-C score for girls was 2.87 (SD 1.07), and for boys it was 3.00 (SD 1.05), which showed a significant difference (p = 0.005). Based on our findings, our study tested the validity and reliability of the one-factor PAQ-C questionnaire, a valid and reliable measurement tool to test the physical activity patterns of primary school children in a Hungarian sample. Further research is needed to develop physical activity monitoring of Hungarian children.

Fatigue and Physical Activity Patterns in Children With Inflammatory Bowel Disease.

Fatigue is a common symptom in children with inflammatory bowel disease (IBD). Diagnostic tests to evaluate biological causes of fatigue commonly include markers of inflammation and hemoglobin (Hb), yet functional parameters have been inadequately studied in pediatric IBD. In this study, we compared fatigued and non-fatigued children with IBD from both a biological and functional point of view. A cross-sectional study of 104 pediatric IBD patients with mild to moderately active IBD was conducted. Fatigued children were defined as those with a Pediatric Quality of Life Inventory Multidimensional Fatigue Scale z score <-2.0. Non-fatigued children had a z score ≥-2.0. Disease-specific quality of life (measured with IMPACT-III score), C-reactive protein (CRP), fecal calprotectin (FC), hemoglobin z score (Hb z score), and physical activity tests including 6-minute walking distance z score (6MWD z score) and triaxial accelerometry (TA) were evaluated. Fatigued children (n = 24) had a significant lower IMPACT-III score than non-fatigued children (n = 80). Hb z scores, CRP, FC, and 6MWD z scores were not significantly different between groups. TA was performed in 71 patients. Wear time validation requirements were met in only 31 patients. Fatigued patients spent significant shorter median time in moderate-to-vigorous activity than non-fatigued patients (18.3 vs 37.3 minutes per day, P = 0.008). Biological parameters did not discriminate fatigued from non-fatigued patients. TA possibly distinguishes fatigued from non-fatigued patients; the potential association may provide a target for interventions to combat fatigue and improve quality of life.

S02-2 Socioeconomic determinants of physical activity, sleep and screen time among children aged 6-9 years of age in Europe

Abstract Background Physical activity is key for preventing obesity and development of noncommunicable diseases later in life. Previous research suggests that socioeconomic factors, such as parental education or income, may influence a child’s risk of obesity. However, previous research on this has provided heterogeneity in results. Our aim was to investigate the socioeconomic disparities between physical activity, sedentary behaviour and sleep patterns in school-aged children aged 6 to 9 years in 24 European countries, using a large nationally-representative sample of children from 24 countries (Albania, Bulgaria, Croatia, Czechia, Denmark, France, Georgia, Ireland, Italy, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Malta, Montenegro, Poland, Portugal, Romania, Russian Federation – only Moscow, San Marino Republic, Spain, Tajikistan, Türkiye and Turkmenistan). Methods COSI collected information on physical activity patterns of children, sedentary behaviour and sleep duration through a questionnaire filled by parents. Among these, the paper focused on the following behaviours: Transportation to and from schools, Time spent on practising sports, Time spent on actively/vigorously playing, Time spent watching TV or using electronic devices and Hours of sleep per night. For the paper purpose, countries were grouped in 4 macro-regions according to United Nations “Standard Country or Area Codes for Statistical Use”. Results Findings indicated that a high prevalence of motorized school transport among children of employed parents in Southern Europe. The highest prevalence of insufficient sports and active play was among families from West-Central Asia who meet the end of the month with troubles, the highest prevalence of excessive screen time is among families from Eastern Europe, where both parents have a low level of education and the highest prevalence of insufficient sleep is among families from West-Central Asia where both parents have a high level of education. Conclusions There are important differences in the socioeconomic determinants of PA, sleep and screen related behaviours both between countries and sub-regions across the WHO European Region. This analysis of results from the COSI survey provides important insights that can help guide policy makers to take action to address the childhood obesity epidemic.

Physical Activity Surveillance in Adolescents with Type 1 Diabetes: A Pilot Mixed-Methods Investigation.

Type 1 diabetes (T1D) affects over 2,500 children in Ireland. Insulin replacement is the mainstay of treatment for T1D, and physical activity (PA) is an important, modifiable lifestyle factor for sustaining health. Surveillance of PA for both research and clinical purposes in paediatric T1D has been limited. This study deployed both quantitative (accelerometry) and qualitative (self-report) measures to assess habitual PA patterns in children with T1D. Twenty-one participants (9 females, 12 males) between 10 and 17 years (mean 13.7 ± 1.94 years) were recruited from an Outpatients Paediatric Diabetes Clinic. Total steps, standing time (minutes (mins)) and sitting time (mins) were recorded using the activPAL 3 microactivity monitor. Clinical parameters (HbA1c, insulin regimen, and weight centiles) were measured. A self-report diary was used to measure perceived activity levels. The findings of this study show that participant children with T1D are not achieving the required steps per day to sustain physical health (recommended minimum 11,500). Females (mean = 7,306 steps ± 5,468) achieved significantly less (p = 0.001) steps per day compared to males (10,806 steps ± 5,904). No significant differences were found between genders for sitting time or standing time. Overweight or obesity was identified in 44% of female participants and 15% of male participants. Mean HbA1c for both females 8.25% (67 mmol/mol) and males 7.97% (64 mmol/mol) was above the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommended <7.0% (53 mmol/mol) for children. Further research is warranted to investigate PA promotion strategies in populations of children with paediatric T1D.

A Quasi-Experimental Study of the Effects of an Outdoor Learning Program on Physical Activity Patterns of Children with a Migrant Background: the PASE Study

<strong>Introduction:</strong> Despite the recognized benefits of physical activity on health, most youth, especially those with a migrant background, do not meet movement guidelines. Outdoor learning is recognized as a promising intervention to address this issue. The objective of this quasi-experimental study was to measure the effects of the PASE (<em>“Outdoors, Health and Environment”</em>) outdoor learning program on the physical activity of students with a migrant background compared to a control group with similar sociocultural characteristics. <strong>Methods: </strong>In October 2019, 91 participants from six elementary grade 6 classes (47.3% female, age 11.61 ± 0.41) wore a validated accelerometer for 7 consecutive days. Three comparative analyses were performed: full week, school day, and activity domains. The Mann-Whitney U test for independent samples was used to compare the differences in means and Cohen’s d was calculated to obtain their effect sizes. <strong>Results:</strong> Analysis of the full week revealed no significant differences between groups. Analysis of school days without physical education classes showed that girls exposed to PASE spent a greater percentage of their time in MVPA than those in the control group (+4.30%, 95% CI = 1.93 to 6.68; p &lt; 0.01) with a strong effect size (<em>d</em> = 1.14). In the activity domain analysis, more time in MVPA was spent in PASE outdoor learning than in the regular classroom (+11.15%, 95% CI = 9.70 to 12.61; p &lt; 0.01) with a strong effect size (<em>d</em> = 3.63). <strong>Conclusion: </strong>Outdoor learning has positive effects on the physical activity of students with a migrant background during school hours. Further studies are needed to confirm these observations.

Rural Latino parent and child physical activity patterns: family environment matters

BackgroundRural Latino children and adults are less active than urban and non-Latino counterparts. We examined physical activity (PA) patterns of rural Latino children and their parents, and explored parental beliefs about and reported barriers of Latino family physical activity. Latino families in a rural area in eastern Washington state, with children in grades 3–5 were included.MethodsWe used mixed methods. Children (n = 27) and parents (n = 25) wore an accelerometer for 5 days; parents (n = 31) participated in a semi-structured interview and completed a demographic survey. Parent and child activity levels were compared using paired t-tests; interviews were analyzed with qualitative content analysis.ResultsAlthough 100% children and 46% parents met physical activity guidelines, parents and children spent most of the day in sedentary behaviors. Parent-reported PA barriers included their long work hours, lack of transportation, and their child’s screen-time.ConclusionAddressing barriers and reducing sedentary time could increase PA of rural Latino families.

Physical Literacy for Children Labeled With Autism Spectrum Disorder: Mothers' Experiences of Ableism, Exclusion, and Trauma.

Countering the declining physical activity patterns of children labeled with autism spectrum disorder (ASD) has gained considerable research attention given its impact on health and quality of life. The purpose of this study was to explore how parents of children labeled with ASD understand the concept of physical literacy, based on their children's participation in community-based physical activity programs. Using interpretive phenomenological analysis, six mothers of children labeled with ASD participated in one-on-one semistructured interviews. The conceptual framework of ecological systems theory supported the rationale for the study purpose, provided structure for the interview guide, and offered a reflexive context for interpretation. Four themes were generated from the thematic analysis: From embodied movement to normative skill expectations, Be flexible, not rigid, Systematic exclusion, and Valuable? . . . Absolutely! Despite experiences of marginalization, exclusion, and trauma within physical activity programs, mothers valued physical literacy development for their children given the positive outcomes of increasing family connections, engagement with peers, and enhanced wellness.

Longitudinal Perspectives on Children's Physical Activity Patterns: "Do Physical Education-Related Factors Matter?"

This study examined longitudinal associations of motor competence (MC) and physical activity (PA) enjoyment with moderate to vigorous PA and sedentary behavior among boys and girls aged 10-12 years old. In addition, this study explored the predictive strength of satisfaction of basic psychological needs in physical education (PE) and PA enjoyment. At 3 time points (baseline, +1y, and +2y), PA levels, MC, PA enjoyment, satisfaction of basic psychological needs in PE and height and weight of 371 children were measured. Data were analyzed using repeated-measures linear mixed model analyses stratified for gender and adjusted for relevant covariates. Sedentary behavior decreased over time and was significantly predicted by PA enjoyment in boys and by PA enjoyment and MC in girls. Boys' moderate to vigorous PA decreased over time and was predicted by MC, whereas girls' moderate to vigorous PA remained low, yet stable over time and was predicted by PA enjoyment and MC. Furthermore, children's need for competence and teacher relatedness (girls only) during PE significantly predicted PA enjoyment. Children need sufficient and well-designed opportunities to improve their MC and PA enjoyment. PE may be pivotal in advancing PA enjoyment, indicating that PE could have more beneficial effects on PA levels in children, especially in girls.

Accelerometer measured physical activity patterns of children during segmented school day in Abu Dhabi

BackgroundThe overwhelming majority of United Arab Emirates (UAE) school-aged children do not meet the 60 min per day recommendation of moderate-to-vigorous physical activity (MVPA). Understanding the different school day segments contribution to children reaching this goal is a crucial step toward developing successful strategies to promote school day MVPA levels. This study aimed to objectively measure children’s’ physical activity levels and to examine the difference in physical activity levels between high active and low active children during the school day in Abu Dhabi.MethodsA total of 133 school children (56% boys; mean age 10.5 years; grades 4–7) from two elementary schools in Abu Dhabi wore accelerometers (ActiGraph GT9X Link) for up to 5 non-consecutive days during spring 2019. Children’s’ MVPA was estimated during the following school segments: class time, lunch, recess, physical education (PE), and whole school day. Children were stratified as “high active” meeting the ≥30 min/day MVPA school time guideline or “low active” accumulating < 30 min/day MVPA.ResultsOn average children accumulated 21.8 ± 22.6 min/day of MVPA on PE days and 22.4 ± 15.9 min/day of MVPA on non-PE days. Only 19% of children met the 30 min or more of school day MVPA recommendation, with higher proportion of boys (27%) meeting such recommendation compared to girls (8%). High active boys, spent the highest percent of time in MVPA during PE (28%), followed closely by lunch (27%). In compression, high active girls spent the highest percent of time in MVPA during lunch (14.2%) followed by recess (9.1%). High active children accumulated 15.06 more minutes of MVPA during PE (p < 0.001), 2 more minutes during recess (p < 0.001), 3 more minutes of MVPA during lunch (p < 0.001) and 5 more minutes of MVPA during class time (p < 0.001).ConclusionThe overwhelming majority of school children did not meet the recommended 30 min /day MVPA during school time. Girls substantially accumulated less MVPA and more sedentary minutes across all segments during the school days compared to boys. Further research is needed to investigate school day segments contribution to children MVPA in the UAE.

Daily physical activity patterns in children and adolescents with inflammatory bowel disease.

The aim of this study was to assess PA patterns among children and adolescents with inflammatory bowel disease (IBD). Sixty participants with IBD (42 Crohn's disease [CD], 10 ulcerative colitis [UC], and 8 IBD-unclassified [IBD-U], 30 male patients) in remission (n = 45) or with mild disease (n = 15) were compared with 60 healthy age- and sex-matched controls. Each participant wore a triaxial accelerometer during 4 consecutive days for objective daily PA quantification. Overall, there was no significant difference in daily PA patterns between patients with IBD and healthy controls, with 31.7% of patients with IBD and 38.3% of healthy controls fulfilling the recommendation of 60 min of moderate-to-vigorous physical activity (MVPA) daily (NS). Male patients with IBD spent significantly less time in MVPA compared with matched healthy controls (mean difference, 16.2 min day-1; p < 0.05). No difference was observed for female patients with IBD. No difference in sedentary pattern between male patients with IBD and controls was found. Children and adolescents with inactive or mildly active IBD have similar PA patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. By far, most patients with IBD do not fulfill the MVPA recommendations for health benefits. There is few data on PA patterns in pediatric patients with IBD. Methodological issues to assess PA limit the strengths of these studies. Pediatric IBD patients with inactive or mildly active IBD have similar physical activity patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. Most patients with IBD do not fulfill the MVPA recommendations for health benefits.

Active Parents-Active Children-A Study among Families with Children and Adolescents with Down Syndrome.

From a public health perspective, it is important that children with Down syndrome (DS) lay the foundations of physical activity (PA) early in life to keep active in school, as teenagers and as adults. The aims were to investigate PA patterns in children and adolescents with DS, as well as their parents’ and siblings’ PA patterns. Methods: A survey was performed among 310 families with children with DS (54% boys and 46% girls) aged 8–18 years (mean 14.04, SD 3.18) in Sweden. Chi-squared tests and multiple logistic regression were carried out. Results: Nineteen percent of children and adolescents with DS and 34% of the parents were active three or more times per week. The child’s PA level was significantly associated with parents’ PA (OR = 5.5), siblings’ PA (OR = 5.1) and the child’s locomotion ability (OR = 3.5). Physically active parents had active children to a greater extent than inactive parents (59% vs. 29%; p < 0.001). Conclusions: Physically active parents have active children. To promote PA among children and adolescents with DS, it is important to promote and pay attention to the parents’ and siblings’ PA behavior, as children with DS are dependent on support from the family.

Physical Activity Patterns in Children and Adolescents With Heart Disease.

To quantify the differences in daily physical activity (PA) patterns, intensity-specific volumes, and PA bouts in youth with and without heart disease (HD). Seven-day PA was measured on children/adolescents with HD (n = 34; median age 12.4y; 61.8% male; 70.6% single ventricle, 17.7% heart failure, and 11.8% pulmonary hypertension) and controls without HD (n = 22; median age 12.3y; 59.1% male). Mean counts per minute were classified as sedentary, light, and moderate to vigorous PA (MVPA), and bouts of MVPA were calculated. PA was calculated separately for each hour of wear time from 8:00 to 22:00. Multilevel linear mixed modeling compared the outcomes, stratifying by group, time of day, and day part (presented as median percentage of valid wear time [interquartile range]). Compared with the controls, the HD group had more light PA (33.9% [15%] vs 29.6% [9.5%]), less MVPA (1.7% [2.5%] vs 3.2% [3.3%]), and more sporadic bouts (97.4% [5.7%] vs 89.9% [9.2%]), but fewer short (2.0% [3.9%] vs 7.1% [5.7%]) and medium-to-long bouts (0.0% [1.9%] vs 1.6% [4.6%]) of MVPA. The HD group was less active in the late afternoon, between 15:00 and 17:00 (P < .03). There were no differences between groups in sedentary time. Children/adolescents with HD exhibit differences in intensity-specific volumes, PA bouts, and daily PA patterns compared with controls.

Family Influence on Children's Nutrition and Physical Activity Patterns in Oman

PurposeThe objective of this study is to expand the understanding of the family influence on children's nutrition and physical activity patterns in Oman. Design and methodsA cross-sectional research design was used in this study. We recruited 204 dyads (a mother with a child) conveniently. Research data were collected in public cycle one schools, nongovernmental community centers, and home visits from five provinces in Oman. Study measures included a general information survey, anthropometric measurements, electronic children and family nutrition and physical activity questionnaires, and a single-day dietary recall for children. Univariate, bivariate, and multivariate analyses were used. ResultsChildren's nutrition intake was significantly associated with parental education level, family income, and family nutrition and physical activity patterns, while children's physical activity patterns were significantly associated with maternal BMI and parental education level. ConclusionsChildren's nutrition and physical activity patterns are associated with maternal BMI, family's sociodemographic characteristics, and family's nutrition and physical activity pattern. Practice implicationsFamily is a key element in shaping and influencing children's lifestyle-related behaviors. School-health programs that actively involve the families hold promise in promoting children's nutrition and physical activity pattern. Future research should be directed toward understanding the moderating and mediating factors.

A Systematic Review of Children's Physical Activity Patterns: Concept, Operational Definitions, Instruments, Statistical Analyses, and Health Implications.

Despite the widespread use of the expression “physical activity pattern” (PAP), there apparently is no general consensus regarding its definition. This systematic review aimed to examine available research focussing on (1) definitions of PAP, (2) instruments/techniques used to describe PAP, (3) statistical approaches used to analyse PAP, and (4) implications of PAP on children’s health. A systematic review of the available literature was done to identify studies published up to October 2019, and 76 studies were eligible. None of the studies presented a formal definition of PAP; a wide range of instruments were used to investigate children’s PAP, and most of the revised studies did not explicitly present a formal statistical model to define PAP. Twenty-four papers purported to examine associations between PAP and health indicators. The review highlights no consensus on a clear PAP definition whatever the instrument used to capture it, and we did not find any agreement regarding how best to analyse PAP. We suggest that PAP should be used when targeting the investigation of similarities/dissimilarities, as well as stabilities and/or changes in children’s PA at an intra-personal level. In sum, PAP should be used to best describe individual streams of behaviours, and not exclusively PA levels/intensities.

Characterizing Dietary and Physical Activity Patterns in Relation to Hydration Among Pre-Adolescent Children

Abstract Objectives The aim of this study was to characterize food and fluid consumption as well as and physical activity patterns in children in relation to ad libitum hydration. Methods Child participants aged 9–11 years (N = 55, 28 females) reported beverage consumption with a 7-day fluid diary. Overall diet was reported using a 7-day diet record and analyses were run using the Nutritional Data System for Research (NDSR). Physical activity was assessed with hip worn accelerometers (Actigraph wGT3x+, Pensacola, FL) over 7 days and aerobic fitness was measured with a VO2 max test. Body composition was assessed with dual energy x-ray absorptiometry (DXA). Urine was collected over a 24hr period and was analyzed separately with a refractometer and freezing point depression for specific gravity (USG) and osmolality (UOsm), respectively. Results Children reported ad libitum consumption of 1645 ± 856 mL of total fluid per day, which was comprised of 37% plain water and 12% milk. The remaining 51% was composed of juice, carbonated, sports, fruit, and caffeinated beverages. Mean 24 h UOsm was 780 ± 250 mOsm/kg and USG was 1.019 ± 0.007. Activity data showed participants spent 52 minutes of MVPA/day. Partial correlations, adjusting for VO2 max, % body fat, sex, energy intake, and accelerometer wear time per day, revealed relationships between plain water consumption and USG (r = −0.32, P = 0.05). USG was related to sedentary activity/day (r = −0.37, P = 0.03); however, there were no other relationships between physical activity and urine hydration markers or plain water intake (all p's &amp;gt; 0.05). Total healthy eating index score (HEI) was not related to plain water intake (r = 0.16, P = 0.34) but trended with UOsm (r = −0.30, P = 0.07). Further, UOsm was inversely correlated with the specific HEI subcomponents of higher vegetable (Rho = −0.32, P = 0.02) and lower saturated fat (Rho = −0.28, P = 0.04) consumption. Conclusions Water consumption in children was below recommendations, and fruit drinks, carbonated drinks, and juice comprised a significant proportion of beverages consumed. Higher water consumption was correlated with lower urine concentration, providing additional support for the importance of water for hydration in children. Finally, hydration was not related to weight status, % body fat, or habitual physical activity. Funding Sources Danone Research, Palaiseau, France.

Moving and Improving: Investigating Programming and Familial Influences on Physical Activity for Children with Autism Spectrum Disorder (ASD)

The primary characteristics of Autism Spectrum Disorder (ASD) fall into three broad categories: communication problems, difficulty relating to people, things and events, and repetitive body movements and behaviours (American Psychiatric Association, 2014). Unfortunately, potential barriers for children and youth (5–17 years old) with ASD achieving the recommended 60 minutes of physical activity (Canadian Society of Exercise Physiology, 2012) may be due to characteristics of the condition and/or the lack of specific guidelines for this population. The purpose of the current study was to explore the influence families and physical activity programming has on the physical activity patterns of children with ASD. The perspectives from both family members of children with ASD, and from instructors of physical activity programs for children with ASD were obtained. The participants completed questionnaires and participated in semi-structured one-on-one interviews. Two themes emerged from the data describing physical activity for children with ASD (1) physical activity, regardless of ability, and (2) the nature of ASD: programming and family challenges. Given the rich data collected, this paper will focus solely on the second theme. Two subthemes developed: “So how do we modify that activity”, and “It can be fantastic and then it can just be like a total nightmare”. Overall, this research indicated unique challenges for physical activity participation for children with ASD and provided suggestions on improvements to physical activity programming. Considering various challenges to physical activity for this population, physical activity instructors play a vital role in delivering effective programs for children with ASD.

Self-Perceived Scholastic Competence, Athletic Competence, and Physical Appearance Are Enhanced in Children and Young Adults with Physical Disabilities Following a Community-Based Running Program

Children and young adults with physical disabilities consistently report low self-concept across multiple domains. The purpose of this study was to (1) determine if a community-based running program working to improve physical activity patterns in children and young adults with physical disabilities also affected self-concept, and (2) identify specific self-concept domains affected by the community-based running program. Twenty children and young adults (17 males, 3 females, 7–24 years) participated in a community-based running program. The 10-week community-based program occurred twice weekly with a time-based progression of total run time each week. The Self-Perception Profile for Children (SPPC) was used to assess self-concept at baseline and following the program. Data were analyzed for 19 participants using mixed analysis of variance models. Mean improvements were noted in each subscale of the SPPC. Significant main effects (p < .05) were found in the specific domains of scholastic competence, athletic competence, and physical appearance. Among elementary aged children, the greatest improvements were found for scholastic competence (0.56, 95% CI 0.24 to 0.87); the greatest improvements were found for athletic competence among high school aged children and young adults (0.42, 95% CI -0.01 to 0.84). The community-based running program described in this study may have the ability to improve self-concept in young people with physical disabilities, particularly in the domains of scholastic competence, athletic competence, and physical appearance. The ability of a program to improve components of health beyond physical well-being has important implications for future implementation of community-based interventions.

(154) Preoperative Physical Activity in Pediatric Posterior Spinal Fusion: An Observational Feasibility Study

Pediatric surgeries and postoperative pain interventions with opioids pose risks for functional recovery and analgesic dependence. Prehabilitation, optimizing of physical functioning prior to surgery, is a possibly efficacious intervention with minimal adverse effects not yet assessed among children. Little is known about typical physical activity patterns of children undergoing orthopedic surgeries, or whether measurement with commercial accelerometry is feasible. This pilot study aimed to determine the feasibility of actigraphy assessment in children undergoing posterior spinal fusion (PSF) and assess the variability of their pre-operative activity. Children and adolescents undergoing PSF (n=15) wore a Fitbit Flex for approximately two weeks between their preoperative clinic appointment and surgery date, with no instructed change to activity level. Daily step counts were obtained from the Fitbit account for each participant. Of 15 participants, two dropped out (surgery or postoperative visit canceled). Overall, 73% of data was obtained from the pre-surgical period. The median number of data points per day was 11 [IQR:4-13]. The median average steps per day was 5,423 [IQR:4222-8060], the median maximum was 11,513 [IQR:6862-16142] and the median difference between highest and lowest step counts was 10,680 [IQR:4,886-15,662]. Four participants had consistently lower counts, defined as ≥50% of the recorded day total th percentile of the population average (4,222 steps). No participants had consistently higher counts preoperatively, defined as ≥50% of the recorded day total >75 th percentile of the population average (8,060 steps). Results demonstrate that assessing children's physical activity preoperatively is feasible and provides a description of the typical patterns of physical activity among children undergoing posterior spinal fusion. These findings support the possibility for implementation of prehabilitation in children. Prehabilitation can help prevent poor post-surgical outcomes among adults undergoing orthopedic surgeries and holds promise for possible preventative intervention for children to reduce risks associated with surgeries and opioid use.

Variability in school children's activity occurs in the recess and before-school periods.

An accurate description of physical activity (PA) at school is required for appropriate health interventions. We examined PA patterns in children, and identified the time periods that influenced them. Forty students in five Japanese primary schools were asked to wear triaxial accelerometers for ≥7days. We obtained coefficients of variance (CV) at 15min intervals, and conducted factor analysis of the school periods. A questionnaire was used to investigate where students spent time before school, and during recess. The amount of PA, and its CV were higher around 8a.m. (before-school period), 10a.m. (morning recess), 1p.m. (lunch recess), and 4p.m. (commuting home from school). Moderate-vigorous PA (MVPA; ≥3.0 metabolic equivalent units [MET]) was highest during lunch recess and the after-school period (12.9 ± 7.4min and 12.6 ± 6.2min, respectively). The percentage of MVPA time was high (>15%) in the before-school period and morning and lunch recesses, but low (10%) in the after-school period. On factor analysis there were differences in PA patterns between the school period and the after-school period. The students who spent their time in the playground logged more MVPA time and less sedentary time (≤1.5 MET) than those who did not spend their time in the playground. Activities before school, and in the morning and lunch recesses influenced daily PA, and were different from after-school PA. Close attention to these periods may help in defining PA parameters during free time at school for PA interventions in children.

Daily Weather and Children's Physical Activity Patterns.

Understanding how the weather affects physical activity (PA) may help in the design, analysis, and interpretation of future studies, especially when investigating PA across diverse meteorological settings and with long follow-up periods. The present longitudinal study first aims to examine the influence of daily weather elements on intraindividual PA patterns among primary school children across four seasons, reflecting day-to-day variation within each season. Second, we investigate whether the influence of weather elements differs by day of the week (weekdays vs weekends), gender, age, and body mass index. PA data were collected by ActiGraph accelerometers for 1 wk in each of four school terms that reflect each season in southeast Australia. PA data from 307 children (age range 8.7-12.8 yr) were matched to daily meteorological variables obtained from the Australian Government's Bureau of Meteorology (maximum temperature, relative humidity, solar radiation, day length, and rainfall). Daily PA patterns and their association with weather elements were analyzed using multilevel linear mixed models. Temperature was the strongest predictor of moderate and vigorous PA, followed by solar radiation and humidity. The relation with temperature was curvilinear, showing optimum PA levels at temperatures between 20°C and 22°C. Associations between weather elements on PA did not differ by gender, child's age, or body mass index. This novel study focused on the influence of weather elements on intraindividual PA patterns in children. As weather influences cannot be controlled, knowledge of its effect on individual PA patterns may help in the design of future studies, interpretation of their results, and translation into PA promotion.