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This research was partly funded by Huawei Technologies Oy (Finland) Co. Ltd. A limited liability company headquartered in Helsinki, Finland., Background Technological advances have recently made possible the estimation of maximal oxygen consumption (VO2max) by consumer wearables. However, the validity of such estimations has not been systematically summarized using metaanalytic methods and there are no standards guiding the validation protocols. Objective The aim was to (1) quantitatively summarize previous studies investigating the validity of the VO2max estimated by consumer wearables and (2) provide best-practice recommendations for future validation studies. Methods First, we conducted a systematic review and meta-analysis of studies validating the estimation of VO2max by wearables. Second, based on the state of knowledge (derived from the systematic review) combined with the expert discussion between the members of the Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) consortium, we provided a set of best-practice recommendations for validation protocols. Results Fourteen validation studies were included in the systematic review and meta-analysis. Meta-analysis results revealed that wearables using resting condition information in their algorithms significantly overestimated VO2max (bias 2.17 ml·kg−1·min−1; limits of agreement − 13.07 to 17.41 ml·kg−1·min−1), while devices using exercise-based information in their algorithms showed a lower systematic and random error (bias − 0.09 ml·kg−1·min−1; limits of agreement − 9.92 to 9.74 ml·kg−1·min−1). The INTERLIVE consortium proposed six key domains to be considered for validating wearable devices estimating VO2max, concerning the following: the target population, reference standard, index measure, testing conditions, data processing, and statistical analysis. Conclusions Our meta-analysis suggests that the estimations of VO2max by wearables that use exercise-based algorithms provide higher accuracy than those based on resting conditions. The exercise-based estimation seems to be optimal for measuring VO2max at the population level, yet the estimation error at the individual level is large, and, therefore, for sport/ clinical purposes these methods still need improvement. The INTERLIVE network hereby provides best-practice recommendations to be used in future protocols to move towards a more accurate, transparent and comparable validation of VO2max derived from wearables., Huawei Technologies

It is currently unknown the most effective potentiation protocol to increase maximum strength. Hence, we investigated the separated and combined effects of post-tetanic potentiation (PTP) induced by whole-body electrostimulation (WB-EMS) and post-activation potentiation (PAP) induced by voluntary maximum isometric contractions on maximum isometric strength. Ten trained males were randomly evaluated on four occasions. In session A, maximum isometric strength (split squat) was measured in minutes 1, 4, and 8. In session B, the measurements were taken in minutes 2, 6, and 10. In session C, a WB-EMS protocol was applied to elicit PTP and the measurements were performed in minutes 1, 4, and 8. In session D, the same WB-EMS protocol was applied and the measurements were taken in minutes 2, 6, and 10. No significant differences in maximum isometric strength were observed between: (i) the control and WB-EMS in minutes 1 vs. 1 and 2 vs. 2; (ii) the control and PAP in minutes 1 vs. 4, 1 vs. 8, 2 vs. 6, and 2 vs. 10; and (iii) the PAP and WB-EMS plus PAP in minutes 4 vs. 4, 8 vs. 8, 6 vs. 6, and 10 vs. 10. In contrast, the WB-EMS plus PAP revealed a significant increase of 54% (~450 N) compared to the WB-EMS in minutes 4 and 8 compared to the minute 1 (p0.001), but not between minutes 2 vs. 6 and 2 vs. 10. The present results showed that PTP induced by WB-EMS in isolation or combined with PAP induced by voluntary maximum isometric contractions did not produce a significant increase in maximum isometric strength compared to the control and PAP alone, respectively.

Objective Colchicine, an approved treatment for gout, has been trialed in many diseases including osteoarthritis (OA) due to its anti-inflammatory effects. However, its efficacy and safety remain unclear in OA. This systematic review and metaanalysis evaluated the efficacy and safety of colchicine for the treatment of OA. Methods PubMed, Web of Science, Scopus, and Cochrane Central were searched from inception through September 2022. Two reviewers independently screened for randomized controlled trials (RCTs) comparing colchicine with placebo or other active comparators for the treatment of OA (knee, hand, or hip OA), extracted data, and performed Cochrane risk of bias assessments. Result Nine RCTs for the knee OA and one for the hand OA were identified, consisting of 847 patients (429 in colchicine arms, 409 in control arms). The studies were conducted between 2002 and 2021 with follow-up periods ranging from 2 to 12 months, in India, Iran, Turkey, Australia, Singapore, and Iraq. Moderate-quality evidence showed no clinically important pain reduction with colchicine compared to control (standardized mean difference [SMD], 0.17; 95% confidence interval [CI], − 0.55, 0.22). Moderate-quality evidence showed no improvement in function with colchicine compared to control in knee OA patients (SMD, − 0.37; 95% CI, − 0.87, 0.13). Colchicine showed an acceptable safety profile with AEs/SAEs comparable to control. Conclusion Current evidence does not suggest a benefit of colchicine in reducing pain and improving physical function in the overall cohort of hand/knee OA patients. Future trials should focus on the subgroups of OA patients with local or systemic inflammation and/or mineralization who might benefit from colchicine., International Graduate Research Scholarship, University of Tasmania, National Health and Medical Research Council (NHMRC) of Australia 2017-20, Operational Programme Research, Development, and Education CZ.02.2.69/0.0/0.0/18_053/0016952 CAUL

IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70%or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, andworking memory), and academic performancewere assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95%CI, 0.44-0.80]) compared with the control group (mean z score, –0.10 [95%CI, –0.28 to 0.09]; difference between groups, 0.72 SDs [95%CI, 0.46-0.97]; P < .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95%CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, –0.14 to 0.28]; difference between groups, 0.62 SDs [95%CI, 0.31-0.91]; P < .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, –0.17 [95%CI, –0.39 to 0.04]; difference between groups, 0.42 SDs [95%CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95%CI, 0.18-0.44]; control group, 0.10 [95%CI, –0.04 to 0.24]; difference between groups, 0.21 SDs [95%CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95%CI, 0.27-0.82]; control group, 0.13 [95%CI, –0.16 to 0.41]; difference between groups, 0.42 SDs [95%CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvementswere not identified., Spanish Government DEP2013-47540 DEP2016-79512-R DEP2017-91544-EXP, European Commission European Commission European Commission Joint Research Centre 667302, Alicia Koplowitz Foundation, ERDF (FEDER in Spanish) B-CTS-355-UGR18, University of Granada, Plan Propio de Investigacion, Visiting Scholar grants, Junta de Andalucia, Unit of Excellence on Exercise, Nutrition and Health (UCEENS), European Commission SOMM17/6107/UGR, EXERNET Research Network on Exercise and Health DEP2005-00046/ACTI, High Council of Sports 09/UPB/19, Spanish Government FPU 14/06837 FPI-BES-2014-068829 FJC2018-037925-I FJCI-2014-19563 IJCI-2017-33642 RYC2019-027287-I FPU15/02645 FJCI-2017-33396 IJC2019-041916-I, National Agency for Research and Development (ANID)/BECAS Chile 72180543, Ramon Areces Foundation

ObjectivesTo investigate the effects of exercise on intelligence, executive functions, academic performance and brain outcomes in children with overweight/obesity. In secondary analyses, we explored potential mediators and moderators of the exercise effects.MethodsA total of 109 children (8-11.9y) with overweight/obesity were randomized (intention-to-treat) and 90 (82.6%) completed the post-exercise evaluation and attended ≥70% of the exercise sessions (per-protocol). Participants in the control group continued with their usual routines and received lifestyle recommendations, whereas the exercise group attended 3 sessions/week of aerobic plus resistance training during 20 weeks. Intelligence, executive functions (cognitive flexibility, inhibition, working memory) and academic performance were assessed with standardized tests; and hippocampal volume with magnetic resonance imaging (MRI).ResultsIn per-protocol analyses, the exercise intervention improved intelligence and cognitive flexibility (medium-large effect sizes observed, 0.4-0.7 SDs). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. Moreover, we found a positive, small-magnitude (i.e., 0.2-0.3 SDs) effect of exercise on academic performance (total, mathematics and problem solving), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain MRI outcomes studied were not affected by our exercise program. Our intervention increased cardiorespiratory fitness performance (0.4 SDs) and these changes in fitness mediated some of the effects. Effects were mostly consistent across the studied moderators, except for larger improvements for intelligence in boys compared to girls.ConclusionExercise positively impacts intelligence and cognitive flexibility during development in children with overweight/obesity, without changes in the structural and functional brain outcomes studied.Trial RegistrationClinicalTrials.gov Identifier: NCT02295072SUMMARY BOXWhat is already known on this topic-Pediatric obesity is associated not only with poorer physical health but also with poorer cognitive and brain development.-Previous exercise interventions have mostly focused on executive functions and other dimensions of cognition, yet is largely unknown the extent to which exercise can improve intelligence during childhood, and actually, at any period of life.-Studies integrating effects of exercise on behavioral and brain magnetic resonance outcomes in a single article are scarce.-A in-depth study of the exercise characteristics (mode) and intensity, potential compensatory/contamination effects and role of potential mediators and moderators of the exercise effects is warranted.What this study adds-A 20-week randomized controlled trial of exercise improved intelligence and cognitive flexibility in preadolescent children with overweight/obesity.-Moreover, we found a positive, small-magnitude effect of exercise on academic performance, which was partially mediated by cognitive flexibility.-Cardiorespiratory peak performance mediated some yet not all the exercise effects observed.-The structural and functional brain outcomes studied were not affected by participation in the exercise program.How this study might affect research, practice or policyOur investigation suggests that exercise can positively impact intelligence and cognitive flexibility during a sensitive period of brain development in childhood. This stimulus can positively affect academic performance, as shown in our study, indicating that an active lifestyle during preadolescent development may lead to more successful life trajectories. This is particularly important in children with overweight/obesity who are known to be at higher risk of poorer physical and brain health.

OBJECTIVE: To analyze whether 13 weeks of integrative neuromuscular training can benefit spatiotemporal and kinematic parameters of gait in children with overweight/obesity. METHODS: This is a non-randomized controlled trial. Fifty children (10.77 ± 1.24 years, 31 girls) with overweight/obesity were allocated to an exercise group (EG) (n = 25) that carried out a 13-week exercise program based on fundamental movement skills, strength activities and aerobic training, and a control group (CG) (n = 25) that followed their normal lifestyle. Spatiotemporal (i.e., cadence, stance and support times, step length, and stride width) and kinematic (i.e., hip, pelvis, knee, and ankle angles) parameters were evaluated under laboratory conditions through a 3D analysis. ANCOVA was used to test raw and z-score differences between the EG and CG at post-exercise, adjusting for pre-exercise values. RESULTS: The EG maintained their baseline stance and single-limb support times while the CG increased them during walking (groups' difference: 3.1 and 1.9 centiseconds). The EG maintained baseline maximum foot abduction angle during the stance phase whereas the CG showed an increase (groups' difference: 3.9º). Additional analyses on kinematic profiles demonstrated that the EG walked with similar pelvic tilt and ankle abduction angles at post-exercise, while the CG increased the pelvic anterior tilt in the whole stance phase (mean groups' difference: 7.7º) and the ankle abduction angles in early- and mid-stance phases (mean groups' difference: 4.6º). No changes were observed in the rest of spatiotemporal and kinematic parameters. CONCLUSIONS: The integrative neuromuscular training stopped the progression of some biomechanical alterations during walking in children with overweight/obesity. These findings could contribute to preventing common movement-derived musculoskeletal disorders in this population, as well as preserving an optimal mechanical efficiency during walking. ispartof: SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS vol:32 issue:7 pages:1119-1130 ispartof: location:Denmark status: published

Telerehabilitation interventions administered via a smartphone may provide new feasible and effective rehabilitation options at home for patients with hip fracture. However, to date, no such interventions have been shown to be effective in the recovery key health outcomes of these patients. The present multicentre randomized controlled trial (RCT) aims to test the effect of the ActiveHip+ m-Health system in the recovery of physical performance, functional level, quality of life, and other health-related outcomes in both patients with hip fracture and their family caregivers. A total of 104 patients older than 65 years, with hip fracture, and their family caregivers will be randomized into the ActiveHip+ rehabilitation (N = 52) or the control group (N = 52). ActiveHip+ is a 12-week smartphone-based rehabilitation program conducted in Granada and Cádiz (Spain) that includes: (1) 24 sessions of physical exercise and 12 sessions of occupational therapy; (2) seven educational modules for patients and for caregivers; and (3) general recommendations in activities of daily living. The control group will receive the usual rehabilitation protocol offered by the Andalusian Public Healthcare System. The primary outcome is the patient's physical performance, while the secondary outcomes are the patient's functional level, quality of life, pain, fear of falling, fitness perception, pre-fracture functional level, emotional status, and caregiver burden. The present project will substantially contribute to the existing knowledge by testing for the first time the efficacy and feasibility of a multidisciplinary m-Health system in the rehabilitation of patients with hip fracture.

Open Access funding provided by the IReL Consortium. This research was partly funded by Huawei Technologies, Finland. RA and BC are partly funded by Science Foundation Ireland (12/RC/2289_P2). PMG and FBO are supported by grants from the MINECO/FEDER (DEP2016-79512-R) and from the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES); Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades and European Regional Development Funds (ref. SOMM17/6107/UGR). JT and JS are partly funded by the Research Council of Norway (249932/F20). AG is supported by a European Research Council Grant (grant number 716657)., Background Consumer wearables and smartphone devices commonly offer an estimate of energy expenditure (EE) to assist in the objective monitoring of physical activity to the general population. Alongside consumers, healthcare professionals and researchers are seeking to utilise these devices for the monitoring of training and improving human health. However, the methods of validation and reporting of EE estimation in these devices lacks rigour, negatively impacting on the ability to make comparisons between devices and provide transparent accuracy. Objectives The Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The network was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables and smartphones in the estimation of EE. Methods The recommendations were developed through (1) a systematic literature review; (2) an unstructured review of the wider literature discussing the potential factors that may introduce bias during validation studies; and (3) evidence-informed expert opinions from members of the INTERLIVE network. Results The systematic literature review process identified 1645 potential articles, of which 62 were deemed eligible for the final dataset. Based on these studies and the wider literature search, a validation framework is proposed encompassing six key domains for validation: the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. Conclusions The INTERLIVE network recommends that the proposed protocol, and checklists provided, are used to standardise the testing and reporting of the validation of any consumer wearable or smartphone device to estimate EE. This in turn will maximise the potential utility of these technologies for clinicians, researchers, consumers, and manufacturers/ developers, while ensuring transparency, comparability, and replicability in validation., IReL Consortium, Huawei Technologies, Science Foundation Ireland, European Commission 12/RC/2289_P2, Spanish Government DEP2016-79512-R, University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES), Junta de Andalucia, European Commission SOMM17/6107/UGR, Research Council of Norway 249932/F20, European Research Council (ERC) 716657

Funding for open access charge: Universidad de Granada/CBUA. This work is part of a PhD thesis conducted in the Official Doctoral Programme in Biomedicine of the University of Granada, Spain. Preliminary data from this manuscript has been presented previously in The International Society of Behavioral Nutrition and Physical Activity (ISBNPA) Xchange 2021 Annual Meeting. The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the "Fondo Europeo de Desarrollo Regional (FEDER)" (DEP201347540, DEP2016-79512-R, DEP2017-91544-EXP and RYC-201109011). L.V.T.-L. is supported by a Grant from the Spanish Ministry of Science, Innovation and Universities (FPU17/04802). J.H.M. is supported by a Grant from the Spanish Ministry of Education, Culture and Sport (FPU15/02645). C.C.-S. is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). IEC is supported by the Spanish Ministry of Science and Innovation (RYC2019-027287-I). Additional support was obtained from the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES), by the Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades, and European Regional Development Funds (ref. SOMM17/6107/UGR). In addition, funding was provided by the SAMID III network, RETICS, funded by the PNI + D + I 2017-2021 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (ERDF) (Ref. RD16/0022), the EXERNET Research Network on Exercise and Health (DEP2005-00046/ACTI; 09/UPB/19; 45/UPB/20; 27/UPB/21), the European Union's 2020 research and innovation program under grant agreement No.667302, and the HL-PIVOT network-Healthy Living for Pandemic Event Protection. Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Funds (ERDF in English, FEDER in Spanish, project ref: B-CTS-355-UGR18)., Approximately 4–11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8–12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β < -0.188, P > 0.065) or brain volumes (all P > 0.05). Conclusion: Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone., Universidad de Granada/CBUA, Spanish Government European Commission, Spanish Government DEP201347540 DEP2016-79512-R DEP2017-91544-EXP RYC-201109011, Spanish Government FPU17/04802 FPU15/02645 FJC2018-037925-I RYC2019-027287-I, University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES), Junta de Andalucia European Commission SOMM17/6107/UGR, SAMID III network, RETICS - PNI + D + I 2017-2021 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion, European Commission RD16/0022, EXERNET Research Network on Exercise and Health DEP2005-00046/ACTI 09/UPB/19 45/UPB/20 27/UPB/21, European Commission 667302, HL-PIVOT network-Healthy Living for Pandemic Event Protection, Andalusian Operational Programme, European Regional Development Funds (ERDF in English, FEDER in Spanish) B-CTS-355-UGR18

Musculoskeletal pain in childhood has increased alarmingly and preventive actions are needed to stop its progression to adulthood. This chapter reviews the scientific literature on the role of physical activity and fitness components in the prevention of musculoskeletal pain in childhood and adolescence. Furthermore, the chapter highlights potential risk factors such as biomechanical alterations, pediatric obesity, psychosocial factors, or atypical brain development, discussing whether physical activity and exercise can prevent the onset of musculoskeletal pain. Lastly, the chapter provides physical activity guidelines and exercise recommendations for children and adolescents aiming at both promoting optimal fitness development and preventing musculoskeletal pain.

BACKGROUND Hip fracture has a severe impact on patients’ quality of life, psychological factors and fitness level. Tele-rehabilitation has emerged in the last years as a promising alternative to conduct the rehabilitation process at home. However, there is no studies testing the effects of tele-rehabilitation interventions for patients with hip fracture on quality of life nor psychological factors, whereas the evidence on fitness level is scarce. OBJECTIVE To test the effects of the @ctivehip tele-rehabilitation program on the quality of life, psychological factors and fitness level of patients who had suffered a hip fracture. METHODS It is a non-randomized clinical trial including patients with 65 five years old onwards with a hip fracture as well as their family caregivers. The intervention group received a home-based multidisciplinary tele-rehabilitation intervention called @ctivehip lasting 12 weeks and the control group received the traditional care and rehabilitation provided by the Andalusian Public Health Care System. The outcomes measured were the patients’ quality of life through the EuroQol Quality of Life Questionnaire (EQ-5D), physiological factors (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS), and the fitness level, assessed with the International Fitness Scale (IFIS). Per-protocol (64 participants) and intention-to-treat (71 participants) analyses were performed, being the first one the main analysis. RESULTS The quality of life of the tele-rehabilitation group increased, while the control group scored worst at 3-month follow-up (medium effect size: 0.66 SDs; p = 0.006). The tele-rehabilitation group demonstrated a greater decrease than the control group in the total HADS score (medium effect size: -0.50 SDs; p = 0.015). Lastly, the tele-rehabilitation group recovered a fitness level close to the pre-hip fracture in comparison with the control group (small effect size: 0.49 SDs; p = 0.022). CONCLUSIONS The @ctivehip tele-rehabilitation program seem to be a promising treatment to improve the quality of life and psychological factors (i.e., anxiety and depression) of older adults after a hip fracture, as well as to recover their previous fitness level. CLINICALTRIAL ClinicalTrials.gov (Identifier: NCT02968589).

Background Further research is required to explore the associations between 24-h movement behaviours and health outcomes in the paediatric population. Therefore, this study aimed to examine the associations between novel data-driven 24-h activity metrics and adiposity among children and adolescents. Methods The sample included 382 children (8–13 years) and 338 adolescents (14–18 years). The average acceleration (AvAcc) of activity, intensity gradient (IG), and metrics representing the initial acceleration for the most active time periods of the 24-h cycle were calculated from raw acceleration data. Adiposity measures included body mass index z-score, fat mass percentage (FM%), and visceral adipose tissue (VAT). Data analysis was performed using multiple linear regression adjusted for wear time, sex, maternal education level, and maternal overweight and obesity. Results Children demonstrated higher values in all 24-h activity metrics than did adolescents (p < 0.001 for all). For children, the initial acceleration for the most active 2, 5, 15, and 30 min of the 24-h cycle were negatively associated with FM% (p ≤ 0.043 for all) and VAT (p p = 0.002) and VAT (p = 0.007). Moreover, initial acceleration for the most active 2, 5, 15, 30, 60, and 120 min were associated with FM% (p ≤ 0.007 for all) and with VAT (p ≤ 0.023 for all). Conclusions The intensity distribution of activity and initial acceleration for the most active 2, 5, 15, 30, 60, and 120 min within the 24-h cycle are beneficial for the prevention of excess adiposity in the paediatric population.

Low-intensity resistance training (LI-RT) combined with blood flow restriction (BFR) is an alternative to traditional moderate–high-intensity resistance training to increase strength and muscle mass. However, the evidence about the efficacy of this novel training method to increase strength and muscle mass in healthy and older adults with pathologies is limited. Furthermore, the possible risk and adverse effects with BFR training methodology in older adults should be considered. (1) To summarize the current evidence on training with BFR strategies in older adults aiming to improve strength and to increase muscle mass; and (2) to provide recommendations for resistance and aerobic training with BFR in older adults based on the studies reviewed. Studies that investigated the chronic responses to resistance training or aerobic training with BFR related to strength and muscle mass changes in older adults were identified. Two independent researchers conducted the search in PubMed, Web of Science, and Google Scholar databases from their inception up to November 1, 2018. Seventeen out of 35 studies, which performed resistance or aerobic training with BFR in older adults focused on strength and muscle mass outcomes, were included in this review. Studies performing resistance and aerobic training with BFR found better improvements in strength and higher increase in muscle mass compared to non-BFR groups that performed the same training protocol. High-intensity resistance training (HI-RT) without BFR provided greater improvements in strength and a similar increase in muscle mass compared to light-intensity resistance training (LI-RT) with BFR. Current evidence suggests that LI-RT and/or aerobic training with BFR improves strength and increases muscle mass in older people. Light-intensity training without BFR would normally not obtain such benefits. Therefore, LI-RT and aerobic training with BFR is an alternative to traditional methods to improve strength and by way of an increase in muscle mass, which are important in the elderly who have progressive muscle atrophy and are at higher risk of falls.

It is known that obesity is associated with biomechanical alterations during locomotor tasks, which is considered a potential risk factor for the development of musculoskeletal disorders (MSKD). However, the association of obesity with biomechanical alterations of walking in the early stages of life have not yet been systematically reviewed. Thus, this review aims to summarize the biomechanical characteristics of walking in children and adolescents with overweight/obesity (OW/OB) versus their normal-weight (NW) counterparts. PubMed and Web of Science were systematically searched until November 2018. We found strong and moderate evidence supporting biomechanical differences in the gait pattern of OW/OB with respect to NW. Based on strong evidence, the gait patterns of OW/OB present greater pelvis transversal plane motion, higher hip internal rotation, higher hip flexion, extension and abduction moments and power generation/absorption, greater knee abduction/adduction motion, and higher knee abduction/adduction moments and power generation/absorption. Based on moderate evidence, OW/OB walk with greater step width, longer stance phase, higher tibiofemoral contact forces, higher ankle plantarflexion moments and power generation, and greater gastrocnemius and soleus activation/forces. These biomechanical alterations during walking in OW/OB could play a major role in the onset and progression of MSKD. ispartof: OBESITY REVIEWS vol:20 issue:7 pages:1033-1044 ispartof: location:England status: published

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants, 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants, 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen’s d, p &lt, 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen’s d, p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

The search for determinants of adiposity gain in older women has become vitally important. This study aimed to (1) analyze the adiposity gain based on the participants’ age and (2) determine the prospective associations of baseline intrapersonal, built environment, physical activity, and sedentary behavior variables with the adiposity gain in older women. This was a seven-year prospective study (baseline: 2009 to 2012, follow-up: 2016 to 2019) in older women (n = 178, baseline age = 62.8 ± 4.1 years). Baseline and follow-up adiposity (bioelectrical impedance) and baseline physical activity, sedentary behavior (accelerometers), and intrapersonal and built environment (Neighborhood Environment Walkability Scale questionnaire) variables were included. The body mass index (BMI) increment tended to be inversely associated with the women’s age (p = 0.062). At follow-up, 48, 57, and 54% of the women had a relevant increase (d-Cohen &gt, 0.2) in their BMI, percentage of body fat, and fat mass index, respectively. The women that spent ≥8 h/day being sedentary were 2.2 times (1.159 to 4.327 CI95%, p &lt, 0.02) more likely to increase BMI (0.82 to 0.85 kg/m2) than non-sedentary women. No built environment variables were associated with seven-year adiposity gain (all ps &gt, 0.05). A reduction in sedentary time should be promoted for adiposity gain prevention and health preservation in older women.

JMM is partly funded by Private Stiftung Ewald Marquardt fur Wissenschaft und Technik, Kunst und Kultur. UE and JS are partly funded by the Research Council of Norway (249932/F20). ELS is supported by TrygFonden (grant number 310081). PBJ is supported by the Portuguese Foundation for Science and Technology (SFRH/BPD/115977/2016). PMG and FBO are supported by grants from the MINECO/FEDER (DEP2016-79512-R) and from the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES); Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades and European Regional Development Funds (ref. SOMM17/6107/UGR). WJ is partly funded by Science Foundation Ireland (12/RC/2289_P2). AG is supported a European Research Council Grant (grant number 716657). This research was partly funded by Huawei Technologies, Finland., Assessing vital signs such as heart rate (HR) by wearable devices in a lifestyle-related environment provides widespread opportunities for public health related research and applications. Commonly, consumer wearable devices assessing HR are based on photoplethysmography (PPG), where HR is determined by absorption and reflection of emitted light by the blood. However, methodological differences and shortcomings in the validation process hamper the comparability of the validity of various wearable devices assessing HR. Towards Intelligent Health and Well-Being: Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables assessing HR by PPG. The recommendations were developed through the following multi-stage process: (1) a systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, (2) an unstructured review of the wider literature pertaining to factors that may introduce bias during the validation of these devices and (3) evidence-informed expert opinions of the INTERLIVE Network. A total of 44 articles were deemed eligible and retrieved through our systematic literature review. Based on these studies, a wider literature review and our evidence-informed expert opinions, we propose a validation framework with standardised recommendations using six domains: considerations for the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. As such, this paper presents recommendations to standardise the validity testing and reporting of PPG-based HR wearables used by consumers. Moreover, checklists are provided to guide the validation protocol development and reporting. This will ensure that manufacturers, consumers, healthcare providers and researchers use wearables safely and to its full potential., Private Stiftung Ewald Marquardt fur Wissenschaft und Technik, Kunst und Kultur, Research Council of Norway 249932/F20, TrygFonden 310081, Portuguese Foundation for Science and Technology SFRH/BPD/115977/2016, MINECO/FEDER DEP2016-79512-R, University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES), European Commission SOMM17/6107/UGR, Science Foundation Ireland, European Commission 12/RC/2289_P2, European Research Council (ERC) European Commission 716657, Huawei Technologies, Junta de Andalucia

Colchicine, in the form of Colchicum autumnale, has been used to treat joint swelling for centuries. The anti-inflammatory action o colchicine and the higher prevalence of calcium pyrophosphate crystal deposition (CPPD) in osteoarthritis (OA) joints have led to th use of colchicine as a potential treatment for OA, however, the quality of the evidence on this regards is still limited. The curren protocol aims to conduct a systematic review and meta-analysis proving the efficacy and safety of colchicine for the treatment of adul patients with OA. For that purpose, Scopus®, Web of Sciences®, Medline® and Cochrane Library® will be inspected for the availabl trials testing the efficacy and safety of colchicine for the treatment of any type of OA (e.g., hand, knee or hip). Cochrane tool will b used to assess the risk of bias of included trials. A meta-analysis of dichotomous (e.g., adverse events) or continuous data (e.g., mea difference in pain scale) will be performed depending on the data reporting. Review Manager 5 (RevMan) and RStudio Version 1.2.133 will be used to conduct the statistical analysis.

Whereas 3D optical motion capture (OMC) systems are considered the gold standard for kinematic assessment in sport science, they present some drawbacks that limit its use in the field. Inertial measurement units (IMUs) incorporating gyroscopes have been considered as a more practical alternative. Thus, the aim of the study was to evaluate the level of agreement for angular velocity between IMU gyroscopes and an OMC system for varying tennis strokes and intensities. In total, 240 signals of angular velocity from different body segments and types of strokes (forehand, backhand and service) were recorded from four players (two competition players and two beginners). The angular velocity of the IMU gyroscopes was compared to the angular velocity from the OMC system. Level of agreement was evaluated by correlation coefficients, magnitudes of errors in absolute and relative values and Bland-Altman plots. Differences between both systems were highly consistent within players’ skill (i.e. along the broad range of velocities) and axes ( x, y, z). Correlations ranged from 0.951 to 0.993, indicating a very strong relationship and concordance. The magnitude of the differences ranged from 4.4 to 35.4 deg·s−1. The difference relative to the maximum angular velocity achieved was less than 5.0%. The study concluded that IMUs and OMC systems showed comparable values. Thus, IMUs seem to be a valid alternative to detect meaningful differences in angular velocity during tennis groundstrokes in field-based experimentation.

Molina-Garcia, P, Mora-Gonzalez, J, Migueles, JH, Rodriguez-Ayllon, M, Esteban-Cornejo, I, Cadenas-Sanchez, C, Plaza-Florido, A, Gil-Cosano, JJ, Pelaez-Perez, MA, Garcia-Delgado, G, Vanrenterghem, J, and Ortega, FB. Effects of exercise on body posture, functional movement, and physical fitness in children with overweight/obesity. J Strength Cond Res 34(8): 2146-2155, 2020-This study aims to analyze whether a 13-week exercise program based on "movement quality" and "multi-games" can lead to simultaneous benefits to body posture, fundamental movements, and physical fitness of children with overweight/obesity. A total of 64 children (10.9 ± 1.3 years, 25.9 ± 3.8 kg·m, 38 girls and 26 boys) with overweight/obesity were assigned either to a 13-week exercise-based intervention group (IG) (n = 33) or to a control group (CG) (n = 31). Subjects underwent assessments of basic anthropometry (body mass and height), body posture (2-dimensional photogrammetry), fundamental movements (Functional Movement Screen), and physical fitness (1 repetition maximum [1RM] arm and leg press, and ALPHA test battery). After the exercise program, the IG reduced lower limb angle (high effect size: -0.82 SDs; p = 0.001) and plumb-tragus distance (low effect: -0.43 SDs; p = 0.002) in the sagittal plane and increased lower limb angle in the frontal plane (high effect: 0.82 SDs; p = 0.003) compared with the CG. The IG improved their performance in deep squat (p = 0.004), active straight leg raise (p < 0.001), 1RM arm (low effect: 0.46 SDs; p = 0.002), handgrip strength (medium effect: 0.53 SDs; p < 0.001), and standing long jump (medium effect: 0.59 SDs; p = 0.003), all compared with the CG. In conclusion, children with overweight/obesity who participated in our 13-week exercise program developed a better alignment of the head and lower limb, improved their performance in fundamental movements, and experienced global muscular strength gains compared with the peers who continued with their usual lives. Among other potential implications, these improvements could contribute to the prevention of musculoskeletal disorders associated with childhood obesity and could increase adherence by positioning these children in a better physical status to keep practicing exercise. ispartof: JOURNAL OF STRENGTH AND CONDITIONING RESEARCH vol:34 issue:8 pages:2146-2155 ispartof: location:United States status: published

BACKGROUND: Childhood obesity is known to negatively impact body posture with severe consequences for the musculoskeletal system. Physical performance could play a positive role in the body posture conformation of these children, but there is little evidence to date. RESEARCH QUESTION: Is physical performance (i.e., physical fitness and functional movement) associated with a better body posture in children with overweight/obesity (OW/OB)? If so, is physical performance more determinant than their obesity degree in the body posture conformation? METHOD: A total of 62 children with OW/OB (10.86 ± 1.25 years, 58 % girls) were included. BMI, physical fitness components (one-repetition-maximum (1RM) arms and leg press, and ALPHA test battery), functional movement quality (Functional Movement Screen™) and body posture (two-dimensional photogrammetry) were evaluated. RESULTS: Physical fitness components and functional movement were overall associated with a more aligned posture of the head, lumbar and thoracic spines and lower limb. BMI was associated with head protraction, thoracic hyperkyphosis, lumbar hyperlordosis and lower limb valgus. BMI was the best predictor of head and lumbar spine posture, cardiorespiratory fitness of lower limb posture in frontal plane, speed-agility of lower limb posture in the sagittal plane and functional movement of thoracic spine. SIGNIFICANCE: Our findings reveal that physical fitness and functional movement are associated with a better global body posture in children with OW/OB, and that in some musculoskeletal structures are even better predictors than their obesity degree. ispartof: GAIT & POSTURE vol:80 pages:331-338 ispartof: location:England status: published

The present study aims (i) to examine the association of physical fitness components (i.e., cardiorespiratory fitness, speed-agility, and muscular fitness) with brain current source density during working memory; and (ii) to examine whether fitness-related current density was associated to working memory performance and academic achievement. Eighty-five children with overweight/obesity aged 8-11 years participated in this cross-sectional study. Physical fitness components were assessed using the ALPHA test battery. Electroencephalography recordings were performed during a Delayed Non-Match-to-Sample task that assessed working memory. Brain source analysis was carried out using sLORETA to estimate regional current source density differences between high and low (H-L) working memory loads. Academic achievement was measured by the Spanish version of the Woodcock-Johnson III test battery. The main results showed that higher cardiorespiratory fitness was associated with higher H-L current density differences in frontal, limbic, and occipital regions during encoding and maintenance task's phases (β≥0.412, p ≤ 0.019). A limbic area was further related to better working memory performance (β=0.267, p = 0.005). During retrieval, higher cardiorespiratory fitness was also associated with higher current density in temporal regions (β=0.265, p = 0.013), whereas lower muscular fitness was associated with higher current density in frontal regions (β=-0.261, p = 0.016). Our results suggest that cardiorespiratory fitness, but not speed-agility nor muscular fitness, is positively associated with brain current source density during working memory processes in children with overweight/obesity. Fitness-related current density differences in limbic regions were associated with better working memory.

Knee osteoarthritis (OA) is the most common form of OA which affects knee joints and there is currently no disease-modifying treatment available for OA. Therefore, an ideal strategy to prevent the development of OA is to identify and intervene at the modifiable risk factors for the development and progression of OA. Early-life factors such as obesity and malalignment may affect the mechanical aspect of the knee (i.e. alterations in normal knee kinematics) and could be the risk factor for the development of knee OA in later life. Identifying early-life (gestational factors, congenital defects, childhood, adolescence, early adulthood) factors which affect the development of knee OA in later stages of the life may help to develop targeted prevention programs in early-life itself to prevent the development of knee OA. Hence, this systematic review protocol provides the method to be used to comprehensively summarise the existing evidence on early life modifiable risk factors associated with the development and progression of knee OA.

Whereas numerous studies have investigated the relationship of cardiorespiratory fitness with inhibition and neuroelectric activity, the role of other physical fitness components and physical activity (PA) intensities in this relationship remain unclear, especially in children with obesity. Therefore, the purpose of this study was to investigate the association of physical fitness, PA, and sedentary time with inhibitory control and neuroelectric activity in children. Eighty-four children (8-11 years) with overweight or obesity performed the ALPHA battery to assess their physical fitness components (i.e., muscular strength, speed-agility, and cardiorespiratory fitness). PA and sedentary time were assessed from hip and nondominant wrist-worn accelerometers. Inhibitory control was evaluated using a flanker task, and expressed as reaction time (RT) and response accuracy. P3 amplitude and latency were recorded using electroencephalography. Higher speed-agility and cardiorespiratory fitness were associated with shorter RT and larger P3 amplitude on incongruent trials. Higher speed-agility was associated with shorter RT on congruent trials. Hip-assessed moderate and moderate-to-vigorous PA were associated with longer P3 latency across trials, and vigorous PA with larger P3 amplitude on incongruent trials. Our results provide initial evidence suggesting that not only cardiorespiratory fitness, but also speed-agility, are associated with inhibitory control and P3 amplitude, whereas no significant associations were observed for muscular strength. The associations between PA (moderate, vigorous and moderate to-vigorous) and neuroelectric activity were accelerometer location-dependent. Promoting PA programs that enhance the cardiorespiratory fitness and speed-agility will contribute to better understanding whether such health improvements benefit inhibitory control in youth with overweight or obesity.

PURPOSE: To investigate the effect of a 13-wk exercise program, based on "movement quality" and "multigames" work, on plantar pressure during walking in children with overweight/obesity (OW/OB). METHOD: Seventy children (10.8 ± 1.2 yr, 58.5% girls) with OW/OB, as defined by the World Obesity Federation, were assigned to either a 13-wk exercise program (intervention group [EG]; n = 39), or to a usual lifestyle control group (CG) (n = 31). Children underwent assessments of basic anthropometry (weight and height) and plantar pressure during walking before and after the intervention period, recording plantar surface area (cm), maximum force (N), and force-time integrals (N·s). RESULTS: After the 13-wk intervention period, the EG participants showed no significant change in total plantar surface area, while the CG participants experienced an increase in this variable (small effect size, -2.5 SD; P = 0.015). Compared with the GC participants, the EG participants showed a greater increase in the maximum force supported beneath the forefoot during walking at the end of the intervention period (small effect size, 0.33 SD; P = 0.012), specifically under the lateral and medial forefoot (both P < 0.05). Force-time changed similarly in both groups by the end of the intervention period (all regions P > 0.05). CONCLUSIONS: These results suggest the exercise program led to positive structural and functional changes in plantar pressure during walking. The increase in maximum force supported by the forefoot in the EG children might indicate a change toward a more normal foot rollover pattern and a more adult gait. ispartof: MEDICINE AND SCIENCE IN SPORTS AND EXERCISE vol:52 issue:3 pages:654-662 ispartof: location:United States status: published

Heart rate variability (HRV) is a non-invasive indicator of autonomic nervous system function. HRV recordings show artefacts due to technical and/or biological issues. The Kubios software is one of the most used software to process HRV recordings, offering different levels of threshold-based artefact correction (i.e., Kubios filters). The aim of the study was to analyze the impact of different Kubios filters on the quantification of HRV derived parameters from short-term recordings in three independent human cohorts. A total of 312 participants were included: 107 children with overweight/obesity (10.0 &plusmn, 1.1 years, 58% men), 132 young adults (22.2 &plusmn, 2.2 years, 33% men) and 73 middle-aged adults (53.6 &plusmn, 5.2 years, 48% men). HRV was assessed using a heart rate monitor during 10&ndash, 15 min, and the Kubios software was used for HRV data processing using all the Kubios filters available (i.e., 6). Repeated-measures analysis of variance indicated significant differences in HRV derived parameters in the time-domain (all p &lt, 0.001) across the Kubios filters in all cohorts, moreover similar results were observed in the frequency-domain. When comparing two extreme Kubios filters, these statistical differences could be clinically relevant, e.g. more than 10 ms in the standard deviation of all normal R-R intervals (SDNN). In conclusion, the results of the present study suggest that the application of different Kubios filters had a significant impact on HRV derived parameters obtained from short-term recordings in both time and frequency-domains.

Recent studies investigated the association of cardiorespiratory ftness with white matter microstructure in children, yet little work has explored to what extent other components of physical ftness (i.e., muscular or motor ftness) are associated with white matter microstructure. Indeed, this association has not been previously explored in children with overweight/obesity who present a diferent white matter development. Therefore, we aimed to examine associations between physical ftness components and white matter microstructure in children with overweight/obesity. In total, 104 (10.04 ± 1.15 years old; 43 girls) children were included in this cross-sectional study. Physical ftness was assessed using the ALPHA-ftness test battery. Fractional anisotropy (FA) and mean difusivity were derived from difusion tensor imaging (DTI). No association was found between physical ftness and global DTI metrics (all P> 0.082). Within individual tracts, all associations became non-signifcant when analyses were adjusted for multiple comparisons. Using the voxel-wise approach, we identifed a small cluster in the left lateral frontal lobe where children with greater upper-body muscular ftness showed higher FA (PFWE-corrected = 0.042). Although our results cannot conclude physical ftness is related to white matter microstructure in children with overweight/obesity; those fndings indicate that the association of muscular ftness with white matter microstructure might be more focal on frontal areas of the brain, as opposed to global diferences., Spanish Ministry of Economy and Competitiveness DEP2013-47540 DEP2016-79512-R DEP2017-91544-EXP RTI2018-095284-J-100, European Union (EU), European Commission Joint Research Centre 667302, Alicia Koplowitz Foundation, University of Granada, Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme: Units of Excellence, Scientific Unit of Excellence on Exercise and Health (UCEES), Andalusian Regional Government, Regional Ministry of Economy, Knowledge, Entreprises and University, European Union (EU) SOMM17/6107/UGR, SAMID III network, RETICS - PN I+D+I 2017-2021 (Spain), Spanish Ministry of Education, Culture and Sport FPU14/06837 FPU 16/02760, Government of Andalusian, Integrated Territorial Initiative 2014-2020 for the province of Cadiz PI-0002-2017, Spanish Ministry of Science, Innovation and Universities FJCI-2017-33396

We are grateful to Ana Yara Postigo-Fuentes for her assistance with English language., The aim of this study was to examine the associations of sedentary behaviour, physical activity, cardiorespiratory fitness (CRF), and body composition parameters with risk of sleep-related breathing disorders (SRBD) in children with overweight/obesity. One-hundred and nine children (10.0 ± 1.1 years old, 45 girls) with overweight (n = 27) and obesity (n = 82) were included. Television viewing time was self-reported by using the Spanish adaptation of the “Youth Activity Profile” (YAP) questionnaire. Sedentary time and physical activity were measured with accelerometry. CRF was assessed with the 20-m shuttle-run test and body composition parameters with Dual-energy X-ray absorptiometry. SRBD were evaluated by using the Spanish version of the Pediatric Sleep Questionnaire. Television viewing time was positively associated with risk of SRBD (r = 0.222, p = 0.021). CRF was negatively correlated with risk of SRBD (r = −0.210, p = 0.030). Body composition parameters were positively associated with risk of SRBD (all p < 0.05), except fat mass index. Stepwise regression analyses showed that body mass index (BMI) explained the largest proportion of the variance in SRBD (r 2 = 0.063, p = 0.01) and television viewing time was the only one added after BMI (r 2 change = 0.048, p = 0.022). This study supports the notion that higher body weight status negatively influences risk of SRBD and adds that unhealthy behaviours could contribute to worsen SRBD, related to an increased risk of cardiovascular diseases. All the significant association observed in this manuscript were of small magnitude, indicating than other factors in addition to the one hereby studied contribute to explain the variance in SRBD., Spanish Ministry of Economy and Competitiveness, European Union (EU) DEP2013-47540 DEP2016-79512-R DEP2017-91544-EXP RYC-2011-09011, Spanish Ministry of Science, Innovation and Universities FPU17/04802, University of Granada, Plan Propio de Investigacion y Transferencia 2018, Spanish Ministry of Education, Culture and Sport FPU15/02645 FPU 16/02760, Spanish Ministry of Economy and Competitiveness BES-2014-068829, Government of Andalusian, Integrated Territorial Initiative 2014-2020 for the province of Cadiz PI-0002-2017, Spanish Government FJC2018-037925-I, University Jaume I PREDOC/2015/13 E-2017-13, Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT) 72180543, University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES), Junta de Andalucia, European Union (EU), European Union (EU) SOMM17/6107/UGR, SAMID III network, RETICS, PNI + D + I 2017-2021 (Spain), ISCIIISub-Directorate General for Research Assessment and Promotion, EXERNET Research Network on Exercise and Health in Special Populations DEP2005-00046/ACTI, European Union (EU) 667302

The authors would like to thank all the participants who volunteered for this investigation. This work is the part of a Ph.D. Thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spain., The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fphys.2019.00895/full#supplementary-material, Background: Heart rate variability (HRV) is negatively associated with body mass index and adiposity in several populations. However, less information is available about this association in children with overweight and obesity, especially severe/morbid obesity, taking into consideration the dependence of HRV on heart rate (HR). Objectives: (1) to examine associations between body composition measures and HRV, (2) to study differences in HRV between children with overweight and severe/morbid obesity; and (3) to test whether relationships and differences tested in objectives 1 and 2, respectively are explained by the dependency of HRV on HR. Methods: A total of 107 children with overweight/obesity (58% boys, 10.03 ± 1.13 years) participated in this study. Body composition measures were evaluated by Dual-energy X-ray absorptiometry (DXA). HRV parameters were measured with Polar RS800CX®. Results: Body composition measures were negatively associated with HRV indicators of parasympathetic activity (β values ranging from −0.207 to −0.307, all p < 0.05). Children with severe/morbid obesity presented lower HRV values with respect to children with overweight/mild obesity in HRV parameters indicators of parasympathetic activity (p = 0.035). All associations disappeared after further adjustment for HR (all p > 0.05). Conclusion: All associations between adiposity/obesity and HRV could be explained by HR, suggesting a key confounding role of HR in HRV studies in children with weight disturbances., This work was supported by the Spanish Ministry of Economy and Competitiveness (Reference DEP2013-47540 and DEP2016-79512-R). CC-S was supported by a grant from the Spanish Ministry of Economy and Competitiveness (BES-2014-068829). AP-F, JM, and JM-G were supported by the Spanish Ministry of Education, Culture and Sport (FPU 16/02760, FPU15/02645, and FPU14/06837, respectively). IE-C was supported by a grant from the Alicia Koplowitz Foundation and for the Spanish Ministry of Science and Innovation (IJCI-2017-33642). MR-A was supported by the National Operational Programme on Youth Employment. Additional support was obtained from the Unit of Excellence on Exercise and Health (UCEES) and EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI). This work was partially funded by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES), and by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades and European Regional Development Fund (ERDF), ref. SOMM17/6107/UGR.

BACKGROUND Best-practice early interventions to increase physical activity (PA) in children with overweight and obesity should be both feasible and evidence based. Walking is a basic human movement pattern that is practical, cost-effective, and does not require complex movement skills. However, there is still a need to investigate how much walking—as a proportion of total PA level—is performed by children who are overweight and obese in order to determine its utility as a public health strategy. OBJECTIVE This study aimed to (1) investigate the proportion of overall PA indicators that are explained by step-based metrics and (2) study step accumulation patterns relative to achievement of public health recommendations in children who are overweight and obese. METHODS A total of 105 overweight and obese children (mean 10.1 years of age [SD 1.1]; 43 girls) wore hip-worn accelerometers for 7 days. PA volumes were derived using the daily average of counts per 15 seconds, categorized using standard cut points for light-moderate-vigorous PA (LMVPA) and moderate-to-vigorous PA (MVPA). Derived step-based metrics included volume (steps/day), time in cadence bands, and peak 1-minute, 30-minute, and 60-minute cadences. RESULTS Steps per day explained 66%, 40%, and 74% of variance for counts per 15 seconds, LMVPA, and MVPA, respectively. The variance explained was increased up to 80%, 92%, and 77% by including specific cadence bands and peak cadences. Children meeting the World Health Organization recommendation of 60 minutes per day of MVPA spent less time at zero cadence and more time in cadence bands representing sporadic movement to brisk walking (ie, 20-119 steps/min) than their less-active peers. CONCLUSIONS Step-based metrics, including steps per day and various cadence-based metrics, seem to capture a large proportion of PA for children who are overweight and obese. Given the availability of pedometers, step-based metrics could be useful in discriminating between those children who do or do not achieve MVPA recommendations. CLINICALTRIAL ClinicalTrials.gov NCT02295072; https://clinicaltrials.gov/ct2/show/NCT02295072

The authors would like to thank all the participants who volunteered for this investigation. This work is part of a Ph.D. thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spain., The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fphys.2019.00510/full#supplementary-material, Cardiac autonomic function can be quantified through mean heart rate (HR) or heart rate variability (HRV). Numerous studies have supported the utility of different HRV parameters as indicators of cardiorespiratory fitness (CRF). However, HR has recently shown to be a stronger predictor of CRF than HRV in healthy young adults, yet these findings need to be replicated, in other age groups such as children. Therefore, this study aimed: (1) to study the associations between indicators of cardiac autonomic function (HR, standard and corrected HRV parameters) and CRF in overweight/obese children; and (2) to test which of the two indicators (i.e., HR or HRV) is a stronger predictor of CRF. This study used cross-sectional baseline data of 107 overweight/obese children (10.03 ± 1.13 years, 58% boys) from the ActiveBrains project. Cardiac autonomic indicators were measured with Polar RS800CX®. CRF was assessed using a gas analyzer while performing a maximal incremental treadmill test. Correlations and stepwise linear regressions were performed. Mean HR and standard HRV parameters (i.e., pNN50, RMSSD, and SDNN) were associated with CRF (r coefficients ranging from -0.333 to 0.268; all p ≤ 0.05). The association of HR with CRF persisted after adjusting for sex, peak height velocity (PHV), adiposity moderate-to-vigorous physical activity, energy intake and circadian-related variable intradaily variability of activity patterns whilst for HRV parameters (i.e., pNN50, RMSSD, and SDNN) disappeared. Stepwise linear regression models entering HR and all HRV parameters showed that mean HR was the strongest predictor of CRF (β = -0.333, R2 = 0.111, p < 0.001). Standard and corrected HRV parameters did not provide additional value to the coefficient of determination (all p > 0.05). Our findings suggest that HR is the strongest indicator of CRF. It seems that quantification of HRV parameters in time and frequency domain do not add relevant clinical information about the cardiovascular health status (as measured by CRF) in overweight/obese children beyond the information already provided by the simple measure of HR., The project was funded by the Spanish Ministry of Economy and Competitiveness (Reference DEP2013-47540 and DEP2016-79512-R). CC-S is supported by a grant from the Spanish Ministry of Economy and Competitiveness (BES-2014-068829). AP-F, JM, and JM-G are supported by the Spanish Ministry of Education, Culture and Sport (FPU 16/02760, FPU15/02645 and FPU14/06837; respectively). IE-C is supported by a grant from the Alicia Koplowitz Foundation. MR-A is supported by the National Operational Programme on Youth Employment. PS-U was supported by a grant from CONICYT/BECAS Chile/72180543. Additional support was obtained from Unit of Excellence on Exercise and Health (UCEES) and EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI). This study has been partially funded by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES), and by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades and European Regional Development Fund (ERDF), ref. SOMM17/6107/UGR.

Evidence suggests that participation in physical activity may support young people’s current and future mental health. Although previous reviews have examined the relationship between physical activity and a range of mental health outcomes in children and adolescents, due to the large increase in published studies there is a need for an update and quantitative synthesis of effects. The objectives of this study were to determine the effect of physical activity interventions on mental health outcomes by conducting a systematic review and meta-analysis, and to systematically synthesize the observational evidence (both longitudinal and cross-sectional studies) regarding the associations between physical activity and sedentary behavior and mental health in preschoolers (2–5 years of age), children (6–11 years of age) and adolescents (12–18 years of age). A systematic search of the PubMed and Web of Science electronic databases was performed from January 2013 to April 2018, by two independent researchers. Meta-analyses were performed to examine the effect of physical activity on mental health outcomes in randomized controlled trials (RCTs) and non-RCTs (i.e. quasi-experimental studies). A narrative synthesis of observational studies was conducted. Studies were included if they included physical activity or sedentary behavior data and at least one psychological ill-being (i.e. depression, anxiety, stress or negative affect) or psychological well-being (i.e. self-esteem, self-concept, self-efficacy, self-image, positive affect, optimism, happiness and satisfaction with life) outcome in preschoolers, children or adolescents. A total of 114 original articles met all the eligibility criteria and were included in the review (4 RCTs, 14 non-RCTs, 28 prospective longitudinal studies and 68 cross-sectional studies). Of the 18 intervention studies, 12 (3 RCTs and 9 non-RCTs) were included in the meta-analysis. There was a small but significant overall effect of physical activity on mental health in children and adolescents aged 6–18 years (effect size 0.173, 95% confidence interval 0.106–0.239, p

This study aimed to investigate the independent and combined associations between several fatness indicators and fitness components with functional movement quality in overweight/obese children. A total of 56 children (33 girls, aged 8-12) classified as overweight/obese according to the World Obesity Federation standard cut points, participated in this study. Participants underwent assessments of fatness [body mass index (BMI), waist circumference, and bioelectrical impedance measures], fitness [1 repetition maximum bench and leg press, and ALPHA test battery], and functional movement quality [4 tests from Functional Movement Screen TM (FMS)]. All fatness outcomes, except waist circumference, were negatively associated with total FMS score, after controlling for cardiorespiratory fitness. Cardiorespiratory fitness, lower limbs muscle strength, and speed-agility were positively associated with the total FMS score, regardless of BMI. Our results suggest that children with greater fatness indicators demonstrate lower functional movement quality independently of their fitness level, whereas children with better fitness level (i.e. cardiorespiratory fitness, lower limbs muscular strength, and speed-agility) demonstrate greater functional movement quality independently of their fatness level. However, children´s weight status seems to be more determinant than their fitness level in terms of functional movement quality, whereas being fit seems to moderately attenuate the negative influence of fatness. ispartof: JOURNAL OF SPORTS SCIENCES vol:37 issue:8 pages:878-885 ispartof: location:England status: published

We investigated the associations of different sedentary behaviors (SB) with gray matter volume and we tested whether SB related to gray matter volume is associated with intelligence. Methods: 99 children with overweight or obesity aged 8&ndash, 11 years participated in this cross-sectional study. SB was measured using the Youth Activity Profile-Spain questionnaire. T1-weighted images were acquired with a 3.0 T Magnetom Tim Trio system. Intelligence was assessed with the Kaufman Brief Test. Whole-brain voxel-wise multiple regression models were used to test the associations of each SB with gray matter volume. Results: Watching TV was associated with lower gray matter volume in six brain regions (&beta, ranging &minus, 0.314 to &minus, 0.489 and cluster size 106 to 323 voxels, p &lt, 0.001), playing video games in three brain regions (&beta, 0.391 to &minus, 0.359, and cluster size 96 to 461 voxels, 0.001) and total sedentary time in two brain regions (&beta, 0.341 to &minus, 0.352, and cluster size 897 to 2455 voxels, 0.001). No brain regions showed a significant positive association (all p &gt, 0.05). Two brain regions were related, or borderline related, to intelligence. Conclusions: SB could have the potential to negatively influence brain structure and, in turn, intelligence in children with overweight/obesity.

The aim of the present study was to examine the associations of physical fitness, sedentary time, and physical activity (PA) with working memory and neuroelectric activity in children with overweight/obesity. Seventy-nine children with overweight/obesity (10.2 ± 1.1 years old) participated in this cross-sectional study. We assessed physical fitness components (ie, muscular strength, speed agility, and cardiorespiratory fitness) using the ALPHA battery. Sedentary time and PA were assessed by GT3X+accelerometers (ActiGraph). Working memory was assessed using the delayed non-matched-to-sample task; mean reaction time (RT) and response accuracy were registered. Neuroelectric activity (ie, P3 amplitude and latency) was registered using the ActiveTwo System of BioSemi electroencephalogram. Higher upper-limb absolute strength was associated with lower response accuracy (P = 0.023), while higher lower-limb relative-to-weight strength was associated with larger P3 amplitude (P < 0.05). Higher speed agility and cardiorespiratory fitness levels were associated with shorter mean RT and larger P3 amplitude, and speed agility was also associated with shorter P3 latency (all P < 0.05). Vigorous PA was associated with larger P3 amplitude (P < 0.05). No associations were found for sedentary time or the rest of PA intensities (P ≥ 0.05). In addition to cardiorespiratory fitness, muscular strength and speed agility are also associated with working memory and neuroelectric activity in children with overweight/obesity. The association between PA and working memory is intensity-dependent, as significant findings were only observed for vigorous PA. Randomized controlled trials in this population would help to better understand whether improvements in different components of fitness and PA lead to better working memory and underlying brain function.

To examine the associations of physical fitness and physical activity with executive function in children with overweight and obesity.A cross-sectional study involving 100 children with overweight and obesity (10.1 ± 1.1 years old; 58.0% boys). We assessed physical fitness components (ie, muscular strength, speed-agility, and cardiorespiratory fitness) using the ALPHA battery, and physical activity and sedentary time by accelerometry. Cognitive flexibility was measured by the Design Fluency Test and Trail Making Test, inhibition by the Stroop test, and planning ability by the Zoo Map Test.Handgrip strength was positively associated with planning ability (P = .025). Speed-agility was positively related to cognitive flexibility and inhibition (P .05). Cardiorespiratory fitness and an overall fitness Z-score were positively associated with indicators of cognitive flexibility (P .05). No associations were found for physical activity and sedentary time with executive function (P ≥ .05).Muscular strength, speed agility, and cardiorespiratory fitness are associated with executive function in children with overweight and obesity. Cognitive flexibility seems to be more robustly associated with all fitness components, whereas planning ability and inhibition might depend on the component analyzed. The positive associations found in the present study in children with overweight and obesity call for more exercise-based randomized controlled trials in this population.

This study aimed to compare estimations of sedentary time (SED) and time spent in physical activity (PA) intensities in children with overweight/obesity across different age-appropriate cut-points based on different body-worn attachment sites and acceleration metrics. A total of 104 overweight/obese children (10.1 ± 1.1 years old, 43 girls) concurrently wore ActiGraph GT3X+ accelerometers on their right hip and non-dominant wrist for 7 days (24 hours). Euclidean norm -1 g (ENMO) and activity counts from both vertical axis (VACounts) and vector magnitude (VMCounts) were derived. We calculated estimates of SED and light, moderate, vigorous, and moderate-to-vigorous (MVPA) intensity PA using different published cut-points for children. The prevalence of children meeting the recommended 60 min/d of MVPA was calculated. The time spent in SED and the different PA intensities largely differed across cut-points based on different attachment sites and acceleration metrics (ie, SED = 11-252 min/d; light PA = 10-217 min/d; moderate PA = 1-48 min/d; vigorous PA = 1-35 min/d; MVPA = 4-66 min/d). Consequently, the prevalence of children meeting the recommended 60 min/d of MVPA varied from 8% to 96% of the study sample. The present study provides a comprehensive comparison between available cut-points for different attachment and acceleration metrics in children. Furthermore, our data clearly show that it is not possible (and probably will never be) to know the prevalence of meeting the PA guidelines based on accelerometer data since apparent differences range from almost zero to nearly everyone meeting the guidelines.

Cortical thickness and surface area are thought to be genetically unrelated and shaped by independent neurobiological events suggesting that they should be considered separately in morphometric analyses. Although the developmental trajectories of cortical thickness and surface area may differ across brain regions and ages, there is no consensus regarding the relationships of physical fitness with cortical thickness and surface area as well as for its subsequent influence on intelligence. Thus, this study examines: (i) the associations of physical fitness components (i.e., cardiorespiratory fitness, speed-agility and muscular fitness) with overall and regional cortical thickness and surface area; (ii) whether body composition indicators (i.e., body mass index, fat-free mass index and fat mass index) mediate these associations; and (iii) the association of physical fitness and cortical thickness with intelligence in overweight/obese children. A total of 101 overweight/obese children aged 8–11 years were recruited in Granada, Spain. The physical fitness components were assessed following the ALPHA health-related fitness test battery. T1-weighted images were acquired with a 3.0 Tesla Siemens Magnetom Tim Trio system. We used FreeSurfer software version 5.3.0 to assess cortical thickness (mm) and surface area (mm2). The main results showed that cardiorespiratory fitness and speed-agility were related to overall cortical thickness (β = 0.321 and β = 0.302, respectively; both P 0.05). The associations of cardiorespiratory fitness and speed-agility with overall cortical thickness were mediated by fat mass index (56.86% & 62.28%, respectively). In conclusion, cardiorespiratory fitness and speed-agility, but not muscular fitness, are associated with overall cortical thickness, and in turn, thicker brain cortex is associated with higher intelligence in overweight/obese children. Yet, none of the three physical fitness components were related to surface area. Importantly, adiposity may hinder the benefits of cardiorespiratory fitness and speed-agility on cortical thickness. Understanding individual differences in brain morphology may have important implications for educators and policy makers who aim to determine policies and interventions to maximize academic learning and occupational success later in life.