Exercise in the treatment of youth substance use disorders: Review and recommendations

Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth

Cortical functioning in children with developmental coordination disorder:a motor overflow study

This study examined brain activation in children with developmental coordination disorder (DCD) to reveal areas that may contribute to poor movement execution and/or abundant motor overflow. Using functional magnetic resonance imaging, 13 boys with DCD (mean age = 9.6 years ±0.8) and 13 typically developing controls (mean age = 9.3 years ±0.6) were scanned performing two tasks (finger sequencing and hand clenching) with their dominant hand, while a four-finger motion sensor recorded contralateral motor overflow on their non-dominant hand. Despite displaying increased motor overflow on both functional tasks during scanning, there were no obvious activation deficits in the DCD group to explain the abundant motor overflow seen. However, children with DCD were found to display decreased activation in the left superior frontal gyrus on the finger-sequencing task, an area which plays an integral role in executive and spatially oriented processing. Decreased activation was also seen in the left inferior frontal gyrus, an area typically active during the observation and imitation of hand movements. Finally, increased activation in the right postcentral gyrus was seen in children with DCD, which may reflect increased reliance on somatosensory information during the execution of complex fine motor tasks

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

“It's like a counselling session … but you don't need to say anything:” exercise program outcomes for youth within a drug and alcohol treatment service

Objectives: Evidence for exercise as an adjunct therapy in youth substance use disorder (SUD) treatment is scarce, despite support for its efficacy among adult populations. In this study, youth undergoing residential treatment for SUDs were provided with twice-weekly exercise sessions, with the aim of examining their perceptions about the outcomes associated with regular exercise participation during their recovery. Design: Qualitative – interpretivist approach. Method: Qualitative (i.e., focus group) methods were employed to capture the experiences of 27 youth and 10 staff members employed in the facility, and content analytic procedures were employed to understand the outcomes (i.e., exercise perceptions, recovery-specific outcomes, and other health outcomes) associated with exercise participation during recovery. Results: Within three broad themes (i.e., exercise perceptions, recovery-specific outcomes, other health outcomes), youth and staff reported that, among other things, regular exercise contributed to the establishment of a healthy routine, more positive perceptions about one's appearance, improved sleep and interpersonal relationships, cathartic effects, and a sense of accomplishment. Conclusions: Based on the ‘lived experiences’ of youth and staff, the results of this study indicated that participation in regular, structured, and personalized exercise may be an important part of successful SUD treatment. The benefits of exercise align with a range of important outcomes including exercise perceptions (i.e., barriers to exercise participation, exercise motivation), recovery factors (e.g., cravings and withdrawals, routine), and health outcomes (e.g., self-esteem and mental health, physical health) among youth undergoing SUD treatment

Descriptive statistics according to condition.

<p>Descriptive statistics according to condition.</p

Aggregate-level skewness, kurtosis, and zero-order correlations for all variables (including GPA) across the entire sample.

<p>Aggregate-level skewness, kurtosis, and zero-order correlations for all variables (including GPA) across the entire sample.</p

Exploring associations between neuromuscular performance, hypermobility, and children's motor competence

Objectives: To evaluate if neuromuscular performance and hypermobility are factors associated with children’s motor competence. Design: Cross-sectional observation study. Methods: Data was collected on 60 children aged 6–12 years; motor competence was determined using the Movement Assessment Battery for Children-2 test, with children classified into 3 groups (Typically Developing n = 30; ‘At Risk’ of low motor competence (LMC) n = 9; LMC n = 21). Neuromuscular performance was determined utilising the Resistance Training Skills Battery for Children (RTSBc), 5-repetition maximum (5RM) leg press and Biodex dynamometry to assess isometric and isokinetic peak torque of the knee flexors and extensors. Hypermobility was measured using the Beighton and Lower Limb Assessment Score. Results: Between-groups MANCOVA revealed typically developing children scored significantly higher on the RTSBc than those ‘at risk’ of LMC (p = 0.021) and those in the LMC group (p < 0.001). 5RM scores also differed between groups, with typically developing children achieving significantly higher scores than the LMC group. No differences were found between groups for isometric or isokinetic measures of strength. Sequential regression analysis revealed neuromuscular performance variables explained 44.7% of the variance in motor competence, with RTSBc (p < 0.001) and 5RM (p = 0.019) emerging as positive significant predictors. Hypermobility failed to explain significant variance in motor competence beyond that explained by neuromuscular performance. Conclusions: Neuromuscular performance of children varies according to levels of motor competence, with those with LMC performing poorly on tasks requiring multi-joint movement. Furthermore, neuromuscular performance predicted almost half the variance observed in motor competence and highlights a novel intervention strategy

‘They deserve a treat’: the nature and antecedents of parental licensing surrounding children’s physical activity

Objective: Little is known about parents’ compensatory health beliefs (CHB) surrounding their children’s engagement in physical activity (PA). Our aim was to provide evidence regarding the nature of, and factors underpinning, parents’ PA-related compensatory beliefs for their children. Design: A qualitative descriptive approach and thematic content analysis were employed. Setting: Parents were recruited from community sport and PA programmes. Participants: Eighteen parents aged 32–52 years (mean age = 40·8 (sd 5·4) years; six males; twelve females). Results: Analyses indicated that parents compensate through ‘passive’ or ‘active’ means. Among parents who compensated, most described their provision of ‘treat’ foods/drinks and a minority described allowing extended sedentary time to their children. Parents’ reasons underpinning these beliefs related to their child’s general physical/health status and psychological characteristics, and their own motivation and mood state. Conclusions: These findings provide the first evidence of unhealthy dietary and sedentary behaviour CHB that parents may hold regarding their children’s involvement in PA

Physiological characteristics, self-perceptions, and parental support of physical activity in children with, or at risk of, developmental coordination disorder

Children with low movement proficiency have been identified as having poorer physiological and psychosocial outcomes; however, the varied measurement approaches used to assess these outcomes have varied resulting in conflicting evidence regarding the presence and magnitude of differences compared to Typically Developing (TD) children. Additionally, there has been limited research into the role of parental support for physical activity (PA) in this group. We compared children with varying levels of movement proficiency on physiological characteristics and self-perceptions regarding PA. In addition, these children's parents were compared on physiological characteristics and support of their children's PA. Children (N = 117) aged 6 to 12 years, along with their parent/guardian, participated in this study. Children were classified according to the Movement Assessment Battery for Children-2 test (Typically Developing (TD) = 60; At Risk = 19; Developmental Coordination Disorder (DCD) = 38). Children's PA, muscle strength, cardio-respiratory fitness (CRF), body composition, and self-perceptions regarding PA were assessed, with parents assessed on CRF, body composition, and PA support. Compared to TD children, children with DCD had lower PA (p = 0.036), predilection (p ≤0.001) and adequacy (p ≤0.001) regarding PA, higher body fat percentage (p = 0.019), and received less logistic support (i.e., transportation) from their parents (p = 0.012). TD children had increased muscle strength compared to the DCD (p ≤ 0.001) and At Risk (p ≤ 0.001) groups. Results indicated that, relative to TD children, children with DCD have multiple physiological deficits, receive less parental logistic support for PA involvement, and report lower scores on psychological constructs that are predictive of PA involvement

Development of a Kinect Software Tool to Classify Movements during Active Video Gaming

<div><p>While it has been established that using full body motion to play active video games results in increased levels of energy expenditure, there is little information on the classification of human movement during active video game play in relationship to fundamental movement skills. The aim of this study was to validate software utilising Kinect sensor motion capture technology to recognise fundamental movement skills (FMS), during active video game play. Two human assessors rated jumping and side-stepping and these assessments were compared to the Kinect Action Recognition Tool (KART), to establish a level of agreement and determine the number of movements completed during five minutes of active video game play, for 43 children (m = 12 years 7 months ± 1 year 6 months). During five minutes of active video game play, inter-rater reliability, when examining the two human raters, was found to be higher for the jump (r = 0.94, p < .01) than the sidestep (r = 0.87, p < .01), although both were excellent. Excellent reliability was also found between human raters and the KART system for the jump (r = 0.84, p, .01) and moderate reliability for sidestep (r = 0.6983, p < .01) during game play, demonstrating that both humans and KART had higher agreement for jumps than sidesteps in the game play condition. The results of the study provide confidence that the Kinect sensor can be used to count the number of jumps and sidestep during five minutes of active video game play with a similar level of accuracy as human raters. However, in contrast to humans, the KART system required a fraction of the time to analyse and tabulate the results.</p></div