Targeting Sedentary Behavior in Minority Populations as a Feasible Health Strategy during and beyond COVID-19: On Behalf of ACSM-EIM and HL-PIVOT

Increased sedentary behavior has been an unintended consequence of social and physical distancing restrictions needed to limit transmission of SARS-CoV-2, the novel coronavirus that causes COVID-19. Sedentary behavior is defined as any waking behavior characterized by an energy expenditure ≤1.5 METs while in a sitting, reclining, or lying posture. These restrictions negatively affect peoples’ cardiometabolic and mental health and disproportionately affect certain sectors of the population, including racial/ethnic minorities. In part, the higher risk for complications of COVID-19 could be the result of an increased prevalence of comorbid diseases. Further, regular participation and adherence to current physical activity guidelines, defined as at least 150 min·wk−1 of moderate-intensity physical activity or muscle strengthening activities on 2 or more days a week, is challenging for many and may be especially difficult to achieve during the COVID-19 pandemic. A practical strategy to promote health and well-being during COVID-19 is reducing sedentary behavior. Reducing sedentary behaviors (e.g., breaking up periods of prolonged sitting with light-intensity physical activity) may be more easily achieved than physical activity for all individuals, including individuals of racial/ethnic decent, as it does not require purchasing equipment nor require compromising the physical restrictions necessary to slow the spread of COVID-19. The purpose of this commentary is to argue that sedentary behavior is a feasible, independent target to modify during COVID-19, particularly in minority populations, and to address this behavior we need to consider individual, environmental, and policy-level factors.N/

Current and Future Implications of COVID-19 among Youth Wheelchair Users: 24-Hour Activity Behavior.

Preventative measures taken worldwide to decrease the transmission of COVID-19 have had a tremendous impact on youth. Following social restrictions, youth with and without physical disabilities are engaging in less physical activity, more increased sedentary behavior, and poor sleep habits. Specifically, youth wheelchair users (YWU) are likely disproportionately affected by COVID- 19 and have a higher risk of contraction due to underlying comorbidities. While we cannot control all of the negative long-term implications of COVID-19 for YWU, participation in positive 24-h activity behaviors can decrease chronic disease risk and the likelihood of long-term complications resulting from infection. This commentary is to extend the discourse on the importance of 24-h activity behaviors by focusing on YWU. Specifically, we discuss the importance of chronic disease prevention, provide a brief overview of 24-h activity behaviors, and outline some of the lessons that can be learned from the COVID-19 pandemic.N/

Multisite Controlled Study of OROS Methylphenidate in the Treatment of Adolescents With Attention-Deficit/Hyperactivity Disorder

Background Despite the persistence of attention-deficit/hyperactivity disorder (ADHD) into adolescence, little is known about the efficacy and tolerability of stimulant medications in this age group. Objective To report the results of a multisite controlled study among adolescents with ADHD evaluating the efficacy and tolerability of osmotic-release oral system (OROS) methylphenidate. Design Adolescents (N = 220) having a confirmed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of ADHD underwent dose titration to identify dosages of OROS methylphenidate that improved symptoms to predefined criteria. Subjects successfully completing the dose titration phase (n = 177) (ie, tolerated and responded to treatment and adhered to the protocol) were randomized to receive 2 weeks’ treatment with their individualized dosage of OROS methylphenidate (18, 36, 54, or 72 mg once daily) or placebo. Treatment effectiveness was measured using investigator, parent, and adolescent assessments of ADHD. Results A significant reduction from baseline in the investigator-rated ADHD Rating Scale, the primary efficacy measure, was found with OROS methylphenidate treatment compared with placebo. Similar findings were noted with parent- and adolescent-report measures. Based on a Clinical Global Impression improvement subscale score of much or very much improved, 52% of subjects in the OROS methylphenidate group improved compared with 31% receiving placebo. Thirty-seven percent of subjects required the maximum dosage of 72 mg/d. The incidence of drug-related adverse events was similar between the 2 study groups. Conclusion In adolescents, once-daily OROS methylphenidate significantly reduced ADHD symptoms and was well tolerated using dosages up to 72 mg/d

Multisite Controlled Study of OROS Methylphenidate in the Treatment of Adolescents With Attention-Deficit/Hyperactivity Disorder

Background Despite the persistence of attention-deficit/hyperactivity disorder (ADHD) into adolescence, little is known about the efficacy and tolerability of stimulant medications in this age group. Objective To report the results of a multisite controlled study among adolescents with ADHD evaluating the efficacy and tolerability of osmotic-release oral system (OROS) methylphenidate. Design Adolescents (N = 220) having a confirmed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of ADHD underwent dose titration to identify dosages of OROS methylphenidate that improved symptoms to predefined criteria. Subjects successfully completing the dose titration phase (n = 177) (ie, tolerated and responded to treatment and adhered to the protocol) were randomized to receive 2 weeks’ treatment with their individualized dosage of OROS methylphenidate (18, 36, 54, or 72 mg once daily) or placebo. Treatment effectiveness was measured using investigator, parent, and adolescent assessments of ADHD. Results A significant reduction from baseline in the investigator-rated ADHD Rating Scale, the primary efficacy measure, was found with OROS methylphenidate treatment compared with placebo. Similar findings were noted with parent- and adolescent-report measures. Based on a Clinical Global Impression improvement subscale score of much or very much improved, 52% of subjects in the OROS methylphenidate group improved compared with 31% receiving placebo. Thirty-seven percent of subjects required the maximum dosage of 72 mg/d. The incidence of drug-related adverse events was similar between the 2 study groups. Conclusion In adolescents, once-daily OROS methylphenidate significantly reduced ADHD symptoms and was well tolerated using dosages up to 72 mg/d