Gareth Stratton

Comparison of energy expenditure in adolescents when playing new generation and sedentary computer games: cross sectional study

Objective To compare the energy expenditure of adolescents when playing sedentary and new generation active computer games. Design Cross sectional comparison of four computer games. Setting Research laboratories. Participants Six boys and five girls aged 13-15 years. Procedure Participants were fitted with a monitoring device validated to predict energy expenditure. They played four computer games for 15 minutes each. One of the games was sedentary (XBOX 360) and the other three were active (Wii Sports). Main outcome measure Predicted energy expenditure, compared using repeated measures analysis of variance. Results Mean (standard deviation) predicted energy expenditure when playing Wii Sports bowling (190.6 (22.2) kJ/kg/min), tennis (202.5 (31.5) kJ/kg/min), and boxing (198.1 (33.9) kJ/kg/min) was significantly greater than when playing sedentary games (125.5 (13.7) kJ/kg/min) (P<0.001). Predicted energy expenditure was at least 65.1 (95% confidence interval 47.3 to 82.9) kJ/kg/min greater when playing active rather than sedentary games. Conclusions Playing new generation active computer games uses significantly more energy than playing sedentary computer games but not as much energy as playing the sport itself. The energy used when playing active Wii Sports games was not of high enough intensity to contribute towards the recommended daily amount of exercise in children.

Physical Activity Levels of Children during School Playtime

School represents a suitable setting for intervention programmes aiming to promote physical activity to benefit health. During the school day, physical education and school playtime offer children regular opportunities to engage in physical activity. However, there is growing concern that, internationally, curricular time allocated to physical education is not meeting statutory guidelines. The effectiveness of the playground environment to promote physical activity has been considered as a complementary setting to physical education.Physical activity guidelines state that children should engage in at least 1 hour of moderate intensity physical activity a day. Currently no empirically tested guidelines exist for physical activity levels during playtime. However, studies cited in this article indicate that playtime can contribute between 5–40% of recommended daily physical activity levels when no interventions have been utilised.The limited school-based investigations that have been reported in the literature suggest that boys engage in more physical activity during playtime than girls. Studies that have implemented intervention strategies in order to promote physical activity levels indicate that playtime can substantially contribute towards daily optimal physical activity guidelines. Energy expenditure and physical activity levels have increased during playtime following the implementation of playtime-based interventions. In order to advance knowledge of children’s physical activity during playtime, a number of key issues for consideration in future research are detailed. Research on children’s use of playtime to be physically active and the extent of the contribution of playtime to daily physical activity guidelines is warranted.

The contribution of upper limb and total body movement to adolescents’ energy expenditure whilst playing Nintendo Wii

Little research documents the contribution of upper limb and total body movement to energy expenditure (EE) during active video gaming. To address this, EE, heart rate (HR), and, upper limb and total body movement were assessed in 11- to 17-year-old adolescents whilst playing three active (Nintendo Wii) and one sedentary (XBOX 360) video games. Non-dominant upper limb activity, EE and HR were significantly greater during Wii Sports boxing [mean 267.2 (SD 115.8) J kg−1 min−1; 136.7 (24.5) beats min−1] than tennis or bowling (P ≤ 0.044). For all active games hip activity best predicted EE (R2 ≥ 0.53), with two-measure models of HR and single-site activity data, and multi-site activity data, similarly explaining the variance in EE (R2 ≥ 0.64). The physiological cost of upper-body orientated active video games increased when movement of both upper limbs was encouraged. Improvements in EE explanatory power provide support for multi-site activity monitoring during unique, non-ambulatory activities.

Promoting children's physical activity in primary school: an intervention study using playground markings

The physical activity levels of 47, 5- to 7-year-old children were assessed before and after a school playground was painted with fluorescent markings. Children‘s physical activity was measured using heart rate telemetry during three playtimes before and after the markings were laid down. Children in the experimental and control groups spent 27 and 29 min, respectively, in moderate to vigorous physical activity (MVPA) before the intervention, increasing to 45 and 36 min, respectively, during the intervention period. MVPA, vigorous physical activity (VPA) and mean heart rate remained relatively stable in the control group compared to respective increases of 10 and 5% of playtime and 6 beats min - 1 in the experimental group during the intervention period. The ANCOVA analysis revealed significant interactions and main effects for the intervention for MVPA, VPA and mean heart rate. Conversely there were no main effect differences between groups. These results suggest that while playground markings had a significant and positive influence on childrens physical activity, factors other than playground markings may also influence childrens physically active play.

Children's physical activity levels during school recess: a quasi-experimental intervention study

BackgroundRecess provides a daily opportunity for children to engage in moderate-to-vigorous (MVPA) and vigorous physical activity (VPA). Limited research has investigated the effects of recess-based interventions on physical activity using large sample sizes whilst investigating variables that may influence the intervention effect. The aim of the study was to investigate the short-term effects of a playground markings and physical structures intervention on recess physical activity. A secondary aim was to investigate the effects of covariates on the intervention.Methods150 boys and 147 girls were randomly selected from 26 elementary schools to wear uni-axial accelerometers that quantified physical activity every 5 seconds during recess. Fifteen schools located in deprived areas in one large urban city in England received funding through a national initiative to redesign the playground environment. Eleven schools served as matched socioeconomic controls. Data were collected at baseline and 6-weeks following playground intervention. Recess MVPA and VPA levels adjusted for pupil- and school-level covariates (baseline physical activity, age, gender, recess length, body mass index) were analysed using multilevel analyses.ResultsPositive but non-significant intervention effects were found for MVPA and VPA when confounding variables were added to the model. Gender was a significant predictor of recess physical activity, with boys engaging in more MVPA and VPA than girls. Significant interactions for MVPA revealed that the intervention effect was stronger for younger elementary aged school children compared to older children, and the intervention effect increased as daily recess duration increased.ConclusionThe playground redesign intervention resulted in small but non-significant increases in childrens recess physical activity when school and pupil level variables were added to the analyses. Changing the playground environment produced a stronger intervention effect for younger children, and longer daily recess duration enabled children to engage in more MVPA following the intervention. This study concludes that the process of increasing recess physical activity is complex when school and pupil-level covariates are considered, though they should be taken into account when investigating the effects of playground intervention studies on childrens physical activity during recess.

The Contribution of Secondary School Physical Education to Lifetime Physical Activity

The promotion of lifetime participation in physical activity is a major goal of physical education, which this study considered in the context of curricular and extracurricular opportunities. Questionnaires focusing on PE provision were completed by 51 heads of physical education (HoPE). Results showed that team games predominated over lifetime activities in Key Stages 3 and 4 (p < .01), while lifetime activities were more prominent during extra-curricular time (p< .01). Female HoPE offered more lifetime activities than team games as part of their curricular (p < .01) and extracurricular provision. In contrast, male HoPE provided most opportunities for team games (p < .01). Schools place a significant emphasis on team games, often at the expense of lifetime activities. Physical educators must recognize which activities have the greatest carry-over value into adult life, and aim to provide more opportunities for allstudents to experience these activities.

Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep1

Leaders from the Canadian Society for Exercise Physiology convened representatives of national organizations, content experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children and youth aged 5-17 years respect the natural and intuitive integration of movement behaviours across the whole day (24-h period). The development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument and systematic reviews of evidence informing the guidelines were assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Four systematic reviews (physical activity, sedentary behaviour, sleep, integrated behaviours) examining the relationships between and among movement behaviours and several health indicators were completed and interpreted by expert consensus. Complementary compositional analyses were performed using Canadian Health Measures Survey data to examine the relationships between movement behaviours and health indicators. A stakeholder survey was employed (n = 590) and 28 focus groups/stakeholder interviews (n = 104) were completed to gather feedback on draft guidelines. Following an introductory preamble, the guidelines provide evidence-informed recommendations for a healthy day (24 h), comprising a combination of sleep, sedentary behaviours, light-, moderate-, and vigorous-intensity physical activity. Proactive dissemination, promotion, implementation, and evaluation plans have been prepared in an effort to optimize uptake and activation of the new guidelines. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed.

Associations between children's socioeconomic status, weight status, and sex, with screen-based sedentary behaviours and sport participation

OBJECTIVE The objective was to study associations between socioeconomic status (SES), weight status, and sex, with childrens participation in sedentary behaviours and sport. METHODS Children (aged 9-10 years; n = 6,337) completed a questionnaire to establish how long they spent in sedentary behaviours and sport participation during week days and weekend days. Height and weight were measured to calculate body mass index. Associations between dependent and independent variables were investigated using hierarchical loglinear analysis. RESULTS A significantly greater proportion of boys than girls spent > or = 1 h per weekday and weekend day watching television (TV) (p < 0.001), playing video games (p < 0.001), and participating in sport (p < 0.001). TV viewing and video gaming for > or = 1 h per day were inversely associated with SES (p = 0.001), whilst the greatest proportion of children participating in sport for > or = 1 h were in the highest SES quartile (p < 0.001). Overweight girls were more likely than normal weight girls to use the internet for > or = 1 h per weekend day (p < 0.001). CONCLUSIONS Relatively more lower SES children spent time in sedentary behaviours than sport participation. Weight status was not consistently associated with sedentary behaviours. Proportionately more boys than girls watched TV, played video games, and participated in sport, suggesting that boys find time for sedentary behaviours and physical activity. Efforts should be made to address inequalities in the prevalence of sedentary behaviours and sport participation for all children regardless of SES, weight status, or sex.

Cardiorespiratory fitness and body mass index of 9-11-year-old English children: A serial cross-sectional study from 1998 to 2004

Objective:To examine the changes over time in cardiorespiratory fitness and body mass index (BMI) of children.Design:Serial cross-sectional, population-based study.Setting:Primary schools in Liverpool, UK.Participants:A total of 15 621 children (50% boys), representing 74% of eligible 9–11-year olds in the annual school cohorts between 1998/9 and 2003/4, who took part in a 20m multi-stage shuttle run test (20mMST).Main outcome measures:Weight, height, BMI (kg/m2) and obesity using the International Obesity Taskforce definition.Results:Median (95% confidence interval) 20mMST score (number of runs) fell in boys from 48.9 (47.9–49.9) in 1998/9 to 38.1 (36.8–39.4) in 2003/4, and in girls from 35.8 (35.0–36.6) to 28.1 (27.2–29.1) over the same period. Fitness scores fell across all strata of BMI (P<0.001). Moreover, BMI increased over the same 6-year period even among children in fittest third of 20mMST.Conclusion:In a series of uniform cross-sectional assessments of school-aged children, BMI increased whereas cardiorespiratory fitness levels decreased within a 6-year period. Even among lean children, fitness scores decreased. Public health measures to reduce obesity, such as increasing physical activity, may help raise fitness levels among all children – not just the overweight or obese.

Biological risk indicators for recurrent non-specific low back pain in adolescents

Objectives: A matched case-control study was carried out to evaluate biological risk indicators for recurrent non-specific low back pain in adolescents. Methods: Adolescents with recurrent non-specific low back pain (symptomatic; n  =  28; mean (SD) age 14.9 (0.7) years) and matched controls (asymptomatic; n  =  28; age 14.9 (0.7) years) with no history of non-specific low back pain participated. Measures of stature, mass, sitting height, sexual maturity (Tanner self assessment), lateral flexion of the spine, lumbar sagittal plane mobility (modified Schöber), hip range of motion (Leighton flexometer), back and hamstring flexibility (sit and reach), and trunk muscle endurance (number of sit ups) were performed using standardised procedures with established reliability. Backward stepwise logistic regression analysis was performed, with the presence/absence of recurrent low back pain as the dependent variable and the biological measures as the independent variables. Results: Hip range of motion, trunk muscle endurance, lumbar sagittal plane mobility, and lateral flexion of the spine were identified as significant risk indicators of recurrent low back pain (p<0.05). Follow up analysis indicated that symptomatic subjects had significantly reduced lateral flexion of the spine, lumbar sagittal plane mobility, and trunk muscle endurance (p<0.05). Conclusions: Hip range of motion, abdominal muscle endurance, lumbar flexibility, and lateral flexion of the spine were risk indicators for recurrent non-specific low back pain in a group of adolescents. These risk indicators identify the potential for exercise as a primary or secondary prevention method.