Explore the vast range of titles available.

Background Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention. Objective The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents. Methods A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease [CVD] and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients. Results Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was r  = −0.25 (95 % CI −0.41 to −0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was r  = 0.39 (95 % CI 0.34–0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate. Conclusion The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.

Muscle-strengthening exercise (use of weight machines, free weights, push-ups, sit-ups), has multiple independent health benefits, and is a component of the Global physical activity guidelines. However, there is currently a lack of multi-country muscle-strengthening exercise prevalence studies. This study describes the prevalence and correlates of muscle-strengthening exercise across multiple European countries. Data were drawn from the European Health Interview Survey Wave 2 (2013-14), which included nationally representative samples (n = 3,774-24,016) from 28 European countries. Muscle-strengthening exercise was assessed using the European Health Interview Survey Physical Activity Questionnaire. Population-weighted proportions were calculated for (1) \"insufficient\" (0-1 days/week) or (2) \"sufficient\" muscle-strengthening exercise (≥2 days/week). Prevalence ratios were calculated using multivariate Poisson regression for those reporting sufficient muscle-strengthening by country and by sociodemographic/lifestyle characteristics (sex, age, education, income, self-rated health etc.). Data were available for 280,605 European adults aged ≥18 years. Overall, 17.3% (95% CI = 17.1%-17.5%) reported sufficient muscle-strengthening exercise (≥2 days/week). Muscle-strengthening exercise was geographically patterned with the lowest prevalence reported in South-eastern European countries (Romania, Malta and Cyprus: range: 0.7%-7.4%), and the highest prevalence in the Nordic countries (Iceland, Sweden, and Denmark: range: 34.1%-51.6%). Older age, insufficient aerobic activity, poorer self-rated health, lower income/education, being female, and being overweight/obese were significantly associated with lower likelihood of reporting sufficient muscle-strengthening exercise, independently of other characteristics. Most European adults do not report sufficient muscle-strengthening exercise, and prevalence estimates varied considerably across countries. Low participation in muscle-strengthening exercise is widespread across Europe, and warrants public health attention.

Background The standing broad jump (SBJ) is an excellent functional measure of explosive lower-body strength that is significantly related to health among children and adolescents. Objectives The aim of this study was to estimate national (country-level) and international (pooled global data) temporal trends in SBJ performance for children and adolescents, and to examine the relationships between national trends in SBJ performance and national trends in health-related and socioeconomic/demographic indicators. Methods Data were obtained from a systematic search of studies reporting temporal trends in SBJ performance for 9- to 17-year-olds, and by examining national fitness datasets. Sample-weighted regression models estimated trends at the study/dataset-country-sex-age level, with national and international trends estimated by a post-stratified population-weighting procedure. Pearson’s correlations quantified relationships between national trends in SBJ performance and national trends in health-related and socioeconomic/demographic indicators. Results Data from 34 studies/datasets were extracted to estimate trends for 10,940,801 children and adolescents from 24 high-, 4 upper-middle-, and 1 low-income countries between 1960 and 2017. Collectively, there was a negligible (per decade) improvement in SBJ performance of 1.73 cm (95% CI 1.71–1.75), 0.99% (95% CI 0.97–1.01) or a standardized effect size of 0.07 (0.07–0.07) over the entire period, with the rate of improvement steady from the 1960s to the 1980s, slowing in the 1990s, before declining. Sex- and age-related temporal differences were negligible. Trends differed between countries, with most countries experiencing declines. National trends in SBJ performance were not significantly related to national trends in health-related and socioeconomic/demographic indicators. Conclusions SBJ performance of children and adolescents has declined since 2000 (at least among most of the countries in this analysis) and is suggestive of a modern decline in functional explosive lower-body strength. Growing recognition of the importance of muscular fitness as a marker of population health highlights the need for continued tracking of temporal trends in SBJ, especially among low- and lower-middle-income countries for which temporal data are lacking. PROSPERO Registration Number CRD42013003657.

Mobile app-based interventions have the potential for wide-reach and therefore may be a useful tool in up-scaling physical activity interventions. In larger-scale interventions, face-to-face assessments are less cost-effective, and researchers often rely on surveys or activity trackers to assess outcomes. However, there is limited evidence of valid muscular fitness assessments that can be self-administered within mHealth interventions. As such, this study will evaluate the concurrent validity of upper and lower body muscular fitness that have been independently assessed by participants via the ecofit app, and face-to-face assessments conducted by a trained researcher. This study compared baseline data from two muscular fitness tests from the ecofit two-armed randomised controlled trial and self-assessed data collected via the ecofit smartphone app (i.e., validated 90-degree push-up and 60-second sit-to-stand test). To assess the concurrent validity, the self-assessed push-up and sit-to-stand tests (i.e., collected via the ecofit app) were correlated using Spearman's correlation coefficient against the researcher-assessed results (i.e., objective results collected during baseline assessment for the ecofit trial). Bland-Altman plots were also used to allow visualisation of the differences between the self- and research-assessed tests. Participants (N = 54) completed the push-up (24.1%) and sit-to-stand (100%) tests within 14-days of receiving the app. The results revealed a strong significant correlation for the push-up test (0.83, p<0.001) and a moderate significant correlation for the sit-to-stand test (0.63, p<0.001). This study provides support for the concurrent validity of self-reported upper and lower body muscular fitness assessments (i.e., the push-up and sit-to-stand tests) in mHealth. While these tests may be a feasible option for large scale physical activity interventions, more research is needed to determine the generalisability of these results.

Leadership is a valuable skill that can be taught in school, and which may have benefits within and beyond the classroom. Learning to Lead (L2L) is a student-led, primary school-based leadership program whereby older 'peer leaders' deliver a fundamental movement skills (FMS) program to younger 'peers' within their own school. The aims of the study are to determine the efficacy of a peer-led FMS intervention on: (i) peer leaders' (aged 10 to 12 years) leadership effectiveness (primary outcome), leadership self-efficacy, well-being, and time on-task in the classroom; (ii) peers' (aged 8 to 10 years) physical activity levels, actual and perceived FMS competency, cardiorespiratory fitness, muscular power, and executive functioning; and (iii) teachers' (referred to as 'school champions') work-related stress and well-being. L2L will be evaluated using a two-arm parallel group cluster randomised controlled trial. Twenty schools located within a two-hour drive of the University of Newcastle, Australia will be recruited. We will recruit 80 students (40 peer leaders and 40 peers) from each school (N = 1,600). L2L will be implemented in three phases: Phase 1 -school champions' training via a professional learning workshop; Phase 2 -school champions' delivery of leadership lessons to the peer leaders; and Phase 3 -peer leaders' delivery of the FMS program to their younger peers. The FMS program, consisting of 12 x 30-minute lessons, will be delivered over the course of one school term (10 weeks). Study outcomes will be assessed at baseline (between mid-March to June, Terms 1 and 2), intervention end (mid-August to September, Term 3), and follow-up (November to mid-December, Term 4. This trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR); registration number: ACTRN12621000376842.

The aim of our systematic review and meta-analysis was to quantitatively synthesise the effects of school-based peer-led interventions on leaders’ academic, psychosocial, behavioural, and physical outcomes. Eligible studies were those that: (i) evaluated a school-based peer-led intervention using an experimental or quasi-experimental study design, (ii) included an age-matched control or comparison group, and (iii) evaluated the impact of the intervention on one or more leader outcomes. Medline, Sportdiscus, Psychinfo, Embase, and Scopus online databases were searched on the 24th of October, 2022 which yielded 13,572 results, with 31 included in the narrative synthesis and 12 in the meta-analysis. We found large positive effects for leaders’ attitudes toward bullying (d = 1.02), small-to-medium positive effects for leaders’ literacy (d = 0.39), and small positive effects for leaders’ self-esteem (d = 0.18). There were mixed findings for behavioural outcomes and null effects for physical outcomes. Notable limitations of this research are the inclusion of a relatively small number of studies, and high heterogeneity in those included. Our findings have the potential to inform educational practice, but also highlight the need for further research examining the mechanisms that might account for the observed effects. Our systematic review was prospectively registered with PROSPERO (CRD42021273129).

Background Youth with disability are less physically active and more likely to have chronic health conditions than their peers without disability. The aim of our study was to assess the effectiveness of a scalable school-based physical activity intervention for youth with disability on functional capacity and a range of secondary outcomes. Methods We conducted a two-arm cluster randomized controlled trial involving adolescents aged 15–19 years with diagnosed disabilities ( N  = 255) from 28 secondary schools in New South Wales, Australia. Schools were randomized to the Burn 2 Learn adapted (B2La) intervention, or a wait-list control. The B2La intervention included foundational resistance exercises (e.g., push-ups, bodyweight squats), aerobic exercises (e.g., shuttle runs), and sport skills (e.g., catching, kicking), delivered as classroom activity breaks 2–3 times per week by trained special education teachers. The primary outcome was functional capacity assessed using the 6-min walk or push test. Secondary outcomes were muscular fitness, body mass index, physical activity (accelerometers), resistance training motor competence, motivation for physical activity, high-intensity interval training self-efficacy, quality of life, and externalizing behaviors. Assessments were conducted at baseline, 6-months (primary endpoint), and 9-months (follow-up). Results At 6-months, the intervention group demonstrated a significant improvement in functional capacity, with a group-by-time effect of 20.3 m (95% CI, 3.1–37.1). At 9-months, the effect was 17.8 m (95% CI, 0.0–35.6). The intervention had a small effect on muscular fitness, resistance training motor competence, and high-intensity interval training self-efficacy. No effects were observed for the other outcomes and no adverse events were recorded. Conclusions Physical activity breaks delivered by special education teachers during the school day improved functional capacity and a range of secondary outcomes in youth with disability. Activity breaks may need to be longer, more frequent, or more intense to achieve clinically important health effects. Trial registration Australian New Zealand Clinical Trials Registry Number: ACTRN12621000884808; prospectively registered 15th November, 2021.

Background Muscle-strengthening activity (MSA) is beneficial for school-aged children, but most school-based MSA interventions have been delivered by external specialists or research staff, limiting scalability. We aimed to assess the feasibility of a teacher-delivered MSA intervention for children in advance of a future efficacy trial. Methods We conducted a single-group feasibility trial with two Stage 2 (i.e. grade 3–4) classes from one primary school in New South Wales, Australia. The 6-week Muscle Movers intervention included (i) enhanced PE lessons focused on foundational MSA skills (1 × 45 min/week), (ii) classroom energiser breaks (2 × 5 min/week), and (iii) active homework tasks (1 × 10 min/week). We assessed acceptability, implementation, adaptation, and practicality using survey and interview methods. We also assessed pre–post change in children’s perceived strength, upper-body muscular endurance, and lower-body muscular power. Data were analysed in SPSS (V.25) using descriptive statistics and paired-samples t -tests, with Cohen’s d as a measure of effect size. Results Two female teachers (31 and 59 years) and 30 students (mean [SD] = 9.8 [0.6] years; 40% female) were enrolled. Acceptability was high for teachers (mean [SD] = 5.0 [0.0] out of 5) and students (mean [SD] = 4.1 [1.0] out of 5). Teachers implemented all PE lessons and more than double the intended energiser breaks (mean [SD] = 5.5 [2.1] per week). Conversely, homework task assignment (mean [SD] = 5.0 [1.4]) and completion (mean [SD] = 2.5 [0.7]) were lower than intended. Teachers reported high confidence to deliver the program and viewed it as practical and adaptable. We found a moderate increase in children’s push-up performance (mean [95%CI] = 2.2 repetitions [0.7 to 3.8]; d = 0.61), but no meaningful changes in perceived strength (mean [95%CI] = 0.1 units [- 0.1 to 0.4]; d = 0.22) or standing long jump (mean [95%CI] = - 1.4 cm [- 7.4 to 4.7]; d = - 0.09). Conclusions Muscle Movers was feasible for classroom teachers to implement in a primary school setting. The observed improvement in students’ upper-body muscular endurance should be confirmed using an appropriately powered randomised controlled trial. Trial registration Retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12625000703404).

AbstractObjectiveTo identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions.DesignSystematic review and network meta-analysis.MethodsScreening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Bayesian arm based, multilevel network meta-analyses were performed for the primary analyses. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA) online tool.Data sourcesCochrane Library, Medline, Embase, SPORTDiscus, and PsycINFO databases.Eligibility criteria for selecting studiesAny randomised trial with exercise arms for participants meeting clinical cut-offs for major depression.Results218 unique studies with a total of 495 arms and 14 170 participants were included. Compared with active controls (eg, usual care, placebo tablet), moderate reductions in depression were found for walking or jogging (n=1210, κ=51, Hedges’ g −0.62, 95% credible interval −0.80 to −0.45), yoga (n=1047, κ=33, g −0.55, −0.73 to −0.36), strength training (n=643, κ=22, g −0.49, −0.69 to −0.29), mixed aerobic exercises (n=1286, κ=51, g −0.43, −0.61 to −0.24), and tai chi or qigong (n=343, κ=12, g −0.42, −0.65 to −0.21). The effects of exercise were proportional to the intensity prescribed. Strength training and yoga appeared to be the most acceptable modalities. Results appeared robust to publication bias, but only one study met the Cochrane criteria for low risk of bias. As a result, confidence in accordance with CINeMA was low for walking or jogging and very low for other treatments.ConclusionsExercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff. These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression.Systematic review registrationPROSPERO CRD42018118040.