Inspiration for the Future: The Role of Inspiratory Muscle Training in Cystic Fibrosis.

Cystic fibrosis (CF) is an inherited, multi-system, life-limiting disease characterized by a progressive decline in lung function, which accounts for the majority of CF-related morbidity and mortality. Inspiratory muscle training (IMT) has been proposed as a rehabilitative strategy to treat respiratory impairments associated with CF. However, despite evidence of therapeutic benefits in healthy and other clinical populations, the routine application of IMT in CF can neither be supported nor refuted due to the paucity of methodologically rigorous research. Specifically, the interpretation of available studies regarding the efficacy of IMT in CF is hampered by methodological threats to internal and external validity. As such, it is important to highlight the inherent risk of bias that differences in patient characteristics, IMT protocols, and outcome measurements present when synthesizing this literature prior to making final clinical judgments. Future studies are required to identify the characteristics of individuals who may respond to IMT and determine whether the controlled application of IMT can elicit meaningful improvements in physiological and patient-centered clinical outcomes. Given the equivocal evidence regarding its efficacy, IMT should be utilized on a case-by-case basis with sound clinical reasoning, rather than simply dismissed, until a rigorous evidence-based consensus has been reached

Compensatory changes in physical activity and sedentary time in children and adolescents with cystic fibrosis

Physical activity (PA) is a key element in Cystic Fibrosis (CF) treatment strategies, yet little is known as to whether activity compensation occurs. This study examined whether PA and/or sedentary time on one day were temporally associated with time spent in these intensities the following day in youth with CF. Time spent sedentary and in different PA intensities were objectively-measured for seven consecutive days in 50 youth (22 boys; 12.0 ± 2.7 years); 25 with mild-to-moderate CF and 25 age- and sex-matched controls. Multilevel analyses (day and child) were conducted using generalised linear latent and mixed models. On any given day, every additional 10 minutes spent in sedentary time or moderate-to-vigorous physical activity (MVPA) were associated with 1.9 (95%CI: −3.6 to −1.2) and 12.4 (95%CI: −22.1 to −2.9) minutes less sedentary time the following day, respectively. These temporal associations were also observed when split by group (3.1 vs. 1.9 minutes for healthy and CF, respectively). These findings indicate that youth do not compensate their PA, irrespective of disease status, between days, but may compensate their sedentary time between days. Experimental studies are warranted to fully elucidate whether compensatory responses to PA and sedentary time occur, which is fundamental for informing PA promotion strategies

Energy Cost of Free-Play Activities in 10- to 11-Year-Old Children

Objective: This study sought to ascertain the energy expenditure (EE) associated with different sedentary and physically active free-play activities in primary school-aged children. Methods: Twenty-eight children (13 boys; 11.4±0.3 years; 1.45±0.09 m; 20.0±4.7 kg∙m-2) from one primary school in Northwest England engaged in six activities representative of children’s play for 10 minutes (drawing, watching a DVD, playground games and free-choice) and 5 minutes (self-paced walking and jogging), with 5 minutes rest between each activity. Gas exchange variables were measured throughout. Resting energy expenditure was measured during 15 minutes of supine rest. Results: Child (Schofield-predicted) MET values for watching a DVD, self-paced jogging and playing reaction ball were significantly higher for girls (p<0.05). Conclusion: Utilising a field-based protocol to examine children’s free-living behaviours, these data contribute to the scarcity of information concerning children’s EE during play to update the Compendium of Energy Expenditures for Youth

Raw and Count Data Comparability of Hip-Worn ActiGraph GT3X+ and Link Accelerometers

To enable inter- and intrastudy comparisons it is important to ascertain comparability among accelerometer models. Purpose: The purpose of this study was to compare raw and count data between hip-worn ActiGraph GT3X+ and GT9X Link accelerometers. Methods: Adults (n = 26 (n = 15 women); age, 49.1 T 20.0 yr) wore GT3X+ and Link accelerometers over the right hip for an 80-min protocol involving 12–21 sedentary, household, and ambulatory/exercise activities lasting 2–15 min each. For each accelerometer, mean and variance of the raw (60 Hz) data for each axis and vector magnitude (VM) were extracted in 30-s epochs. A machine learning model (Montoye 2015) was used to predict energy expenditure in METs from the raw data. Raw data were also processed into activity counts in 30-s epochs for each axis and VM, with Freedson 1998 and 2011 count-based regression models used to predictMETs. Time spent in sedentary, light, moderate, and vigorous intensities was derived from predicted METs from each model. Correlations were calculated to compare raw and count data between accelerometers, and percent agreement was used to compare epoch-by-epoch activity intensity. Results: For raw data, correlations for mean acceleration were 0.96 T 0.05, 0.89 T 0.16, 0.71 T 0.33, and 0.80 T 0.28, and those for variance were 0.98 T 0.02, 0.98 T 0.03, 0.91 T 0.06, and 1.00 T 0.00 in the X, Y, and Z axes and VM, respectively. For count data, corresponding correlations were 1.00 T 0.01, 0.98 T 0.02, 0.96 T 0.04, and 1.00 T 0.00, respectively. Freedson 1998 and 2011 count-based models had significantly higher percent agreement for activity intensity (95.1% T 5.6% and 95.5% T 4.0%) compared with theMontoye 2015 raw data model (61.5% T 27.6%; P G 0.001). Conclusions: Count data were more highly comparable than raw data between accelerometers. Data filtering and/or more robust raw data models are needed to improve raw data comparability between ActiGraph GT3X+ and Link accelerometers

Mixed-Methods Systematic Review to Identify Facilitators and Barriers for Parents/Carers to Engage Pre-School Children in Community-Based Opportunities to Be Physically Active

Background: Low physical activity levels in young children is a major concern. For children aged 0–5 years, engagement with opportunities to be physically active are often driven by the adults responsible for the child’s care. This systematic review explores the barriers and facilitators to parents/caregivers engaging pre-school children in community-based opportunities for physical activity, within real-world settings, or as part of an intervention study. Methods: EBSCOhost Medline, CINHAL plus, EBSCOhost SPORTDiscus, Web of Science, ProQuest, and ASSIA were systematically searched for quantitative and qualitative studies published in English between 2015 and 16 May 2022. Data extracted from 16 articles (485 parents/carers; four countries) were quality-assessed using the Mixed Methods Assessment Tool and coded and themed via thematic analysis. Results: Nine themes (eight core, one minor) were identified and conceptualised into a socio-ecological model, illustrating factors over four levels: Individual—beliefs and knowledge (and parental parameters); Interpersonal—social benefits, social network, and family dynamic; Community—organisational factors and affordability; and Built and Physical Environment—infrastructure. Discussion: The findings provide valuable insights for practitioners and policy makers who commission, design, and deliver community-based physical activity opportunities for pre-school children. Developing strategies and opportunities that seek to address the barriers identified, as well as build on the facilitators highlighted by parents, particularly factors related to infrastructure and affordability, are imperative for physical activity promotion in pre-school children. The perspectives of fathers, socioeconomic and geographical differences, and the importance parents place on physical activity promotion all need to be explored further

Profiling Movement Quality Characteristics of Children (9-11y) During Recess

Introduction. Frequency spectrum characteristics derived from raw accelerometry, such as spectral purity, have the potential to reveal detailed information about children’s movement quality, but remain unexplored in children’s physical activity. The aim of this study was to investigate and profile children’s recess physical activity and movement quality using a novel analytical approach. Materials and Methods. A powered sample of twenty-four children (18 boys) (10.5±0.6y, 1.44±0.09m, 39.6±9.5kg, body mass index; 18.8±3.1 kg.m2) wore an ankle-mounted accelerometer during school recess, for one school-week. Hierarchical clustering, Spearman’s rho and the Mann-Whitney U test were used to assess relationships between characteristics, and to assess inter-day differences. Results. There were no significant inter-day differences found for overall activity (P>0.05), yet significant differences were found for spectral purity derived movement quality (P 0.05), sin embargo, se encontraron diferencias significativas para la calidad del movimiento derivado de la pureza espectral (P <0.001). La actividad global se agrupó jerárquicamente y se correlacionó positivamente con la pureza espectral (P <0,05). Discusión. Este es el primer estudio que informa la pureza espectral de la calidad del movimiento derivado de la actividad física de los niños, en un entorno no controlado y nuestros resultados destacan el potencial para la investigación futura

National Policy Response to the United Nations Sustainable Development Goals: A Physical Activity Case Study of Wales

Background: Population level changes in physical activity (PA) may benefit from policy intervention. In response to the UN Sustainable Development Goals, Wales introduced legislation to holistically improve health and well-being, including Public Service Boards (PSBs) to improve the translation of national policy into practice. Method: An audit of policies published by national and sub-national public bodies since 2015 was conducted. Content of the policies were extracted and synthesised to determine: (i) how many policies included a PA action; (ii) what the drivers of those policies were; (iii) the content of the PA actions; and (iv) how the PA actions aligned with the Well-being of Future Generations (Wales) Act 2015. Results: 16 national-level documents with a PA action have been published by 4/13 public bodies. The policies vary in terms of the clarity and specificity of the actions, the assignment of clear roles/responsibilities, and the setting of targets. Of the 19 sub-national PSBs well-being policies, 15 included PA actions. Conclusion: This audit provides a valuable example of how connections between national and sub-national policy can be achieved. The appointment of PSBs has supported the translation of policies into practice in Wales, and similar approaches could be utilised in other countries

Ten-Year Secular Changes in Selected Health and Fitness Parameters of 10-11 Years Old Swansea School Children – 2003-2013

Purpose: The aim of this study was to highlight the secular changes in selected health and fitness measures (body mass index, prevalence of overweight and obesity and grip strength) in 10-11 year old Swansea school children, using data obtained in 2003 and 2013.Methods: Stature, body mass and grip strength data were collected for 512 participants (n= 230 boys, n= 282 girls) in 2003 during a Crucial CrewDay and for 414 participants (n= 198 boys, n= 216 girls) in 2013 during the Swan-Linx programme. BMIs were calculated from this data and used to calculate BMI standard deviation scores. A two-way ANOVA was conducted to examine if there was a statistically significant difference in BMI z-score by gender and year of testing. A two-way ANCOVA was used to investigate if there were differences on grip strength by gender and year of testing, with BMI z-score as a covariate.Results: BMI z-scores decreased significantly (p = 0.001) between 2003 and 2013 for both boys (0.80 to 0.40) and girls (0.58 to 0.41). Prevalence of overweight and obesity decreased for both boys and girls from 31.7% to 23.8% and 33.8% to 29.7%, respectively. After BMI z-scores adjustment, grip strength decreased significantly for boys (18.43kg to 16.88kg, p < 0.001), but not for girls (16.53kg to 16.59kg).Conclusion: The study shows promising results in terms of BMI z-scores and prevalence of overweight and obesity. However, the prevalence of overweight and obesity recorded in 2013 is still high, therefore further decreases in prevalence should continue to be an aim. The study also shows that muscular strength, in boys in particular, should be a focus for future interventions regarding physical fitness, in addition to an area for further investigation