Evaluation of feasibility, effectiveness, and sustainability of school-based physical activity “active break” interventions in pre-adolescent and adolescent students: a systematic review

Objective The present systematic review aimed to investigate the impact of school-based physical activity (PA) interventions of “active breaks” on PA levels, classroom behaviour, cognitive functions, and well-being in pre-adolescents and adolescents attending secondary and high school. Methods In March 2021, we performed a systematic research in CINAHL, Cochrane Library, Embase, MedLine, and PsycINFO databases and through grey literature. Quality assessment was performed in accordance with the Cochrane Tool for Quality Assessment for RCTs and the STROBE tool for observational studies. We included studies that investigated classroom PA interventions led by teachers such as active breaks or physically active lessons on PA levels, classroom behaviour, cognitive function, and quality of life in pre-adolescent and adolescent population attending secondary and high school. Synthesis Three studies met the inclusion criteria. Two studies showed a positive effect of active breaks on students’ classroom behaviour and quality of life. One study registered a positive effect in the increase in school PA levels; unfortunately, this effect was not found in the overall levels of PA or in the reduction of sedentary behaviour. All three studies showed the feasibility and acceptability of active breaks intervention in secondary and high school settings. Conclusion This systematic review suggests the potential benefit of this type of intervention integrated in the secondary and high school curriculum on classroom behaviour, school PA levels, and well-being.Objectif La présente revue systématique visait à étudier l’impact des interventions d’activité physique (AP) en milieu scolaire des « pauses actives » sur les niveaux d’AP, le comportement en classe, les fonctions cognitives et le bien-être des préadolescents et des adolescents fréquentant l’école secondaire et le lycée. Méthodes En mars 2021, nous avons effectué une recherche systématique dans les bases de données CINAHL, Cochrane Library, Embase, MedLine, PsycINFO et à travers la littérature grise. L’évaluation de la qualité a été réalisée conformément à l’outil Cochrane d’évaluation de la qualité pour les ECR et à l’outil STROBE pour les études observationnelles. Nous avons inclus les études portant sur les interventions d’AP en classe menées par les enseignants, telles que les pauses actives ou les leçons d’activité physique sur les niveaux d’AP, le comportement en classe, la fonction cognitive et la qualité de vie chez les préadolescents et les adolescents fréquentant l’école secondaire et le lycée. Synthèse Trois études répondaient aux critères d’inclusion. Deux études ont montré un effet positif des pauses actives sur le comportement en classe et la qualité de vie des élèves. Une étude a enregistré un effet positif dans l’augmentation des niveaux d’AP à l’école, malheureusement cet effet n’a pas été trouvé dans les niveaux globaux d’AP ou dans la réduction du comportement sédentaire. Les trois études ont montré la faisabilité et l’acceptabilité de l’intervention des pauses actives dans les écoles secondaires et les lycées. Conclusion Cette revue systématique suggère le bénéfice potentiel de ce type d’intervention intégrée dans le programme scolaire des collèges et lycées sur le comportement en classe, les niveaux d’AP à l’école et le bien-être

Physical Fitness and BodyWeight in Pre-Adolescent School Children: The EUROFIT Motor Fitness Test Explored on 11-12-Year-Old Children.

Nowadays, the early prevention of obesity in childhood is one of the most critical public health issues. More than half of children and adolescents worldwide do not meet the recommendation of 60 minutes of moderate to vigorous physical activity per day. This trend can reduce physical fitness and, consequently, cause a decrease in the quality of life throughout the lifespan. Physical fitness, defined as a set of abilities to perform physical activity and exercise (such as aerobic capacity, endurance, strength, flexibility), is considered one of the most important health markers in adulthood and childhood as well as adolescence. Methods: We conducted a cross-sectional study to investigate the physical fitness of pre-adolescent children of the Emilia-Romagna region. Children’s anthropometric parameters (height and weight) and physical fitness levels - assessed via the EUROFIT test battery - were measured. In all of the applied EUROFIT tests, children’s performance was below the sucient age and gender values. Moreover, it was negatively associated with obesity. Our research provided evidence that the general fitness of our sample was low and the performance of overweight/obese children was lower compared to the under/normal weight students

A Randomized Clinical Trial to Evaluate the Efficacy and Safety of the ACTLIFE Exercise Program for Women with Post-menopausal Osteoporosis: Study Protocol

Osteoporosis (OP) is a systemic disease of the skeleton characterized by increased risk of fracture. There is a general consensus on the efficacy of physical activity in the prevention of bone loss, falls and fractures, but there is no agreement on the best setting to exercise. The aim of the study is to evaluate the efficacy of a 12-months exercise protocol for women with post-menopausal OP when administered as individual home training (IHT) versus gym group training (GGT). The study is a randomized trial with two parallel groups. Sedentary patients with primary post-menopausal osteoporosis are recruited at the Istituto Ortopedico Rizzoli of Bologna. In the first group, the 12-month ACTLIFE program is performed as IHT, while in the second as GGT. The program is aimed at improving joint mobility, muscle force, balance, motor coordination and endurance. The study is single blinded. Patients are assessed at baseline and after 6 and 12 months. The primary outcome is the modification of quality of life measured with the Short Osteoporosis Quality of Life Questionnaire (ECOS-16). The findings of this study will highlight advantages and disadvantages of exercising in the two different settings and provide evidence on how to increase physical activity in osteoporotic women

Active Breaks and Distance Learning: new strategies for well-being and movement education Active Breaks e DAD: nuove strategie per educare al benessere ed al movimento

La situazione pandemica ha drasticamente ridotto le opportunità di movimento e di socializzazione dei bambini anche in ambito scolastico, costringendo ad effettuare le lezioni a distanza, la Didattica a distanza e la Didattica Aumentata Digitalmente. Pertanto, si proporrà il metodo delle pause attive o active breaks che consistono in brevi momenti della lezione (5-10 min.) per effettuare delle attività strutturate. Tali interventi non necessitano di spazi e di attrezzature particolari ma possono essere praticate più volte al giorno e per brevi periodi non solo nel contesto classe ma anche a casa e in autonomia da ogni singolo bambino. Gli studi IMOVE e ABS sono un punto di partenza e una testimonianza dell’efficacia e della sostenibilità degli interventi school-based. Studi futuri dovranno concentrarsi sugli effetti a lungo termine delle active breaks sulla performance scolastica e sul beneficio nel lavoro degli insegnanti.The pandemic situation has drastically reduced the opportunities for movement and socialization of children even in the school environment, forcing them to carry out remote lessons, distance learning and digitally augmented education. Therefore, we will propose the method of active breaks or active breaks which consist of short moments of the lesson (5-10 min.) To carry out structured activities. These interventions does not require special spaces and equipment but can be practiced several times a day and for short periods not only in the classroom context but also at home and independently by each individual child. The I-MOVE and ABS studies are a starting point and a testimony of the effectiveness and sustainability of school-based interventions. Future studies will have to focused on the long-term effects of active breaks on school performance and on the benefit of the work of teachers

Effects of School Nurse-Led Interventions in Collaboration with Kinesiologists in Promoting Physical Activity and Reducing Sedentary Behaviors in Children and Adolescents: A Systematic Review

The World Health Organization (WHO) recommends that schools adopt a whole-school strategy for healthy behaviors involving different health professionals. The present systematic review aimed to evaluate the efficacy of nurse-led interventions in collaboration with kinesiologists on physical activity and lifestyle behaviors’ outcomes in school settings. The protocol was registered in PROSPERO (ID: CRD42022343410). The primary research study was developed through the PICOS question: children and adolescence 6–18 years (P); school nurse-led interventions in promoting physical activity (PA) and reducing sedentary behaviors (I); usual lessons, no intervention focusing on PA (C); PA levels, sedentary behaviors, and healthy lifestyle behaviors (O); experimental or observational study with original primary data and full-text studies written in English (S). Seven studies were included. Interventions were heterogeneous: besides physical activities carried out in all studies, the interventions were based on different health models and strategies (counselling, face-to-face motivation, education). Five out of seven articles investigated PA levels or their related behaviors using questionnaires, and two used ActiGraph accelerometers. Lifestyle behaviors were assessed with heterogeneous methods. Five out of seven articles showed an improvement in at least one outcome after the interventions, whereas two papers showed a statistically non-significant improvement. In conclusion, school interventions involving nurses, also in association with other professionals such as kinesiologists, can be effective in reducing sedentary behaviors and improving healthy lifestyles in children and adolescents

Exercise and Oxidative Stress Biomarkers among Adult with Cancer: A Systematic Review

Evidence shows that exercise can have a favourable effect in cancer patients. The exercise's clinical benefits are likely to concern multiple interrelated biological pathways, among which oxidative stress plays a key role. Regular training can induce an adaptive response that strengthens the antioxidative status of the body. To formulate public health recommendations regarding the optimal exercise prescription for cancer patients, a detailed understanding is needed regarding the effect of exercise on variables linked to oxidative stress and antioxidant status of patients. The goal of this systematic review, based on PRISMA, was to explore and critically analyse the evidence regarding the efficacy of exercise on oxidative stress biomarkers among people with cancer. Study search was conducted in the following databases: PubMed, Cochrane, CINAHL, Embase, PEDro, and SPORTDiscus. The studies' quality was assessed with the Cochrane risk-of-bias tool and STROBE scale. After identification and screening steps, 10 articles were included. The findings provide an encouraging picture of exercise, including resistance training and aerobic activities, in people with cancer. The exercise improved the indicators of the total antioxidant capacity, increased the antioxidant enzymes' activity, or reduced the biomarkers of oxidative damage in various forms of cancer such as breast, lung, head, and neck Regarding oxidative DNA damage, the role of exercise intervention has been difficult to assess. The heterogeneity of study design and the plethora of biomarkers measured hampered the comparison of the articles. This limited the possibility of establishing a comprehensive conclusion on the sensitivity of biomarkers to estimate the exercise's benefits. Further high-quality studies are required to provide data regarding oxidative stress biomarkers responding to exercise. This information will be useful to assess the efficacy of exercise in people with cancer and support the appropriate prescription of exercise in anticancer strategy

Impact of a risk management plan on Legionella contamination of dental unit water

The study aimed to assess the prevalence of Legionella spp. in dental unit waterlines of a dental clinic and to verify whether the microbiological parameters used as indicators of water quality were correlated with Legionella contamination. A risk management plan was subsequently implemented in the dental health care setting, in order to verify whether the adopted disinfection protocols were effective in preventing Legionella colonization. The water delivered from syringes and turbines of 63 dental units operating in a dental clinic, was monitored for counts of the heterotrophic bacteria P. aeruginosa and Legionella spp. (22 degrees C and 37 degrees C). At baseline, output water from dental units continuously treated with disinfection products was more compliant with the recommended standards than untreated and periodically treated water. However, continuous disinfection was still not able to prevent contamination by Legionella and P. aeruginosa. Legionella was isolated from 36.4%, 24.3% and 53.3% of samples from untreated, periodically and continuously treated waterlines, respectively. The standard microbiological parameters used as indicators of water quality proved to be unreliable as predictors of the presence of Legionella, whose source was identified as the tap water used to supply the dental units. The adoption of control measures, including the use of deionized water in supplying the dental unit waterlines and the application of a combined protocol of continuous and periodic disinfection, with different active products for the different devices, resulted in good control of Legionella contamination. The efficacy of the measures adopted was mainly linked to the strict adherence to the planned protocols, which placed particular stress on staff training and ongoing environmental monitoring

The effect of active breaks on cognitive performance and classroom behaviour: the I-move study

Background: Active Breaks (ABs) intervention involves short bouts of moderate to vigorous physical activity (MVPA) conducted during or between curricular lessons by the appropriately trained teachers. The aim of the Imola Active Breaks Study (IMOVE study) was to evaluate the effect of an ABs intervention on cognitive function and classroom behaviour in primary school children. Methods: The study was quasi-experimental, and it involved two groups attending a primary school in Imola (Bologna, Italy). The Active Breaks group (ABsG) performed the I-MOVE protocol consisting in 10 minutes of ABs divided in warm up, tone-up with high intensity interval training and cool-down. This is repeated three times a day for one year and half. The control group (CG) continued with regular lessons. The baseline assessment was conducted in October 2019 and the follow-up in May 2021. Cognitive performance was assessed using working memory test and classroom behaviour was monitored using an ‘‘ad hoc questionnaire’’. Results: Working memory performance increased significantly more in the ABsG (change: 1.30 1.17) than in CG (0.96 1.20), p < 0.05. Almost the entire sample of the children wanted to continue with this intervention in the next following year. Children reported improvements in their school-life quality, including feeling better in class (75.40%) and in school (82.50%) when using ABs. Improvements were also reported in children time-on-task behaviours: 52.90% said they work easily in class, 52.90% that they could listen more clearly, 58.80% reported they can stay seated easily, and 59.60% that they learned better and were more focused after ABs. Conclusions: In conclusion the program has proven to be very effective on the children’s cognitive improvement and classroom behaviour. Since the ABs intervention demonstrates these positive effects, its implementation in schools can have a beneficial, sustainable and long-term impact on childhood health. Key messages: ABs intervention represents a cost-effective strategy to be implemented in the school settings regardless of the age and sex differences, to make the school a more dynamic environment. Despite the pandemic difficulties, the ABs intervention proved to be sustainable, and to have a positive effect on classroom behaviour by improving children’s concentration and attention in class

The Impact of an Adapted Physical Activity Program on Bone Turnover, Physical Performance and Fear of Falling in Osteoporotic Women with Vertebral Fractures: A Quasi-Experimental Pilot Study

Physical activity has been indicated as a potential strategy to counteract osteoporosis (OP). This study of post-menopausal women with osteoporotic vertebral fractures investigated the effect of an adapted physical activity (APA) program on two serum bone turnover biomarkers (Bone Alkaline Phosphatase, B-ALP and C-terminal telopeptide of type 1 collagen, CTX-1), functional capacity (6-Minutes Walking Test, 6MWT), and risk and fear of falls (Tinetti and Falls Efficacy scale). The APA group (n = 12) performed a 1-h group session twice per week for 6 months whereas the control group (n = 9) was asked to maintain their current lifestyle. The exercise program did not affect the serum concentrations of B-ALP and CTX-1 biomarkers measured at the baseline and after 6 months in women of the APA group. Moreover, at the end of intervention no significant differences in serum concentrations for either biomarker was observed between the two study groups. Interestingly, when compared to the control group, women in the APA group showed significant improvement in the functional capacity measures by 6MWT (p = 0.037) and a decrease of the risk and fear of falls as indicated by the Tinetti test (p = 0.043). Based on these findings, exercise could provide new perspectives for the care and management of OP

Active breaks in primary school: Teacher awareness

The need for movement, which characterizes the current generations of children, has become urgent and worrying. Despite the continuous projects carried out in primary school, few seems to improve health and motivation to adopt active lifestyles. Among the many projects carried out in recent years, active breaks seem to be gaining ground for their easiness of realization and sustainability over time. The active breaks proved to be very effective towards well being and cognitive activation representing an additional dose of physical activity that can help children in meeting the recommended levels of daily physical activity. Moreover, the active breaks represent an innovative strategy to improve the classroom climate and facilitate the educational action of teachers. Teachers, involved in the I-MOVE and ABS studies, of an inter-university study group (University of Bologna and University of Roma Tre), responded with great enthusiasm to the practice of active breaks. Teachers highlighted that active break produced a positive effect toward school routine, learning environment and activation of cognitive functions in children. The present paper reports data related to the awareness of teachers, with regard to the application of active breaks in their school day, in terms of feasibility, management and organization in the face of effects considered absolutely positive for the daily school experience