Zachary Pope

A meta-analysis of active video games on health outcomes among children and adolescents.

This meta‐analysis synthesizes current literature concerning the effects of active video games (AVGs) on children/adolescents’ health‐related outcomes. A total of 512 published studies on AVGs were located, and 35 articles were included based on the following criteria: (i) data‐based research articles published in English between 1985 and 2015; (ii) studied some types of AVGs and related outcomes among children/adolescents and (iii) had at least one comparison within each study. Data were extracted to conduct comparisons for outcome measures in three separate categories: AVGs and sedentary behaviours, AVGs and laboratory‐based exercise, and AVGs and field‐based physical activity. Effect size for each entry was calculated with the Comprehensive Meta‐Analysis software in 2015. Mean effect size (Hedges g) and standard deviation were calculated for each comparison. Compared with sedentary behaviours, AVGs had a large effect on health outcomes. The effect sizes for physiological outcomes were marginal when comparing AVGs with laboratory‐based exercises. The comparison between AVGs and field‐based physical activity had null to moderate effect sizes. AVGs could yield equivalent health benefits to children/adolescents as laboratory‐based exercise or field‐based physical activity. Therefore, AVGs can be a good alternative for sedentary behaviour and addition to traditional physical activity and sports in children/adolescents.

A systematic review of active video games on rehabilitative outcomes among older patients

Background Although current research supports the use of active video games (AVGs) in rehabilitation, the evidence has yet to be systematically reviewed or synthesized. The current project systematically reviewed literature, summarized findings, and evaluated the effectiveness of AVGs as a therapeutic tool in improving physical, psychological, and cognitive rehabilitative outcomes among older adults with chronic diseases. Methods Seven databases (Academic Search Complete, Communication & Mass Media Complete, ERIC, PsycINFO, PubMed, SPORTDiscus, and Medline) were searched for studies that evaluated the effectiveness of AVG-based rehabilitation among older patients. The initial search yielded 946 articles; after evaluating against inclusion criteria and removing duplicates, 19 studies of AVG-based rehabilitation remained. Results Most studies were quasi-experimental in design, with physical functioning the primary outcome investigated with regard to the use of AVGs in rehabilitation. Overall, 9 studies found significant improvements for all study outcomes, whereas 9 studies were mixed, with significant improvements on several study outcomes but no effects observed on other outcomes after AVG-based treatments. One study failed to find any benefits of AVG-based rehabilitation. Conclusion Findings indicate AVGs have potential in rehabilitation for older patients, with several randomized clinical trials reporting positive effects on rehabilitative outcomes. However, existing evidence is insufficient to support the advantages of AVGs over standard therapy. Given the limited number of studies and concerns with study design quality, more research is warranted to make more definitive conclusions regarding the ability of AVGs to improve rehabilitative outcomes in older patients.

Impact of exergaming on young children's school day energy expenditure and moderate-to-vigorous physical activity levels

Background Although emerging research is demonstrating the potential health impact of exergaming, investigations have primarily been conducted in laboratory settings among small samples with short-term interventions. Information on the effectiveness of exergaming in underserved childrens objective physical activity (PA) in population-based settings is also scarce. Moreover, most empirical studies have only included 1 type of exergame in the intervention. Therefore, this studys purpose was to investigate the long-term impact of a multigame exergaming intervention among underserved children integrated within school curricula. Specifically, this study examined the effect of exergaming on childrens accelerometer-determined sedentary behavior (SB), light PA, moderate-to-vigorous PA (MVPA), and energy expenditure (EE) over 2 years as compared with regular physical education (PE) classes. Methods A total of 261 second- and third-grade children (134 girls, 127 boys; mean age 8.27 years) were recruited from 2 Texas elementary schools. Childrens pre-test 3-day SB, light PA, MVPA, and EE at school were assessed in the fall of 2012. Participants were assigned to 1 of 2 groups: (1) exergaming/PE group (125 min weekly of exergaming-based PA program) and (2) comparison group (125 min weekly of PE). PA (SB, light PA, and MVPA) and EE outcome variables were assessed again in 2013 (post-test) and 2014 (follow-up). Results Significant time effects were observed for SB (F(1, 162) = 25.0, p < 0.01, η2 = 0.14), light PA (F(1, 162) = 9.6, p < 0.01, η2 = 0.06), and MVPA (F(1, 162) = 6.2, p = 0.01, η2 = 0.04) but not for EE (F(1, 162) = 0.63, p > 0.05, η2 = 0.004). Subsequent pairwise comparisons revealed significant increases from pre- to post-test for light PA (p < 0.01), MVPA (p < 0.01), and EE (p = 0.02) with no changes in SB (p > 0.05). Conversely, significant decreases occurred in light PA (p < 0.01) from post-test to follow-up with no differences seen in MVPA (p = 0.08) and EE (p = 0.06) over the same time period. A significant increase was seen, however, for SB from post-test to follow-up. Conclusion Exergaming PE can have the same positive effect on childrens light PA, MVPA, and EE as regular PE. More research is necessary to discern how to promote long-term PA participation after conclusion of the intervention.

The Role of Youth Sports in Promoting Children's Physical Activity and Preventing Pediatric Obesity: A Systematic Review

ABSTRACT Youth sport participation plays an important role in promoting physical activity among children and may be a possible venue for the prevention of pediatric obesity. To design effective physical activity interventions, it is imperative to understand how different aspects of sport participation influence physical activity (PA). The purpose of this article is to present a comprehensive review of the impact of youth sport participation on childrens PA and obesity status. A total of 44 studies published up to January 2014 concerning youth sport participation, PA, and obesity status were identified. Inclusion criteria were studies comparing PA levels of sport participants to nonparticipants or those comparing PA levels in different sport types and settings. Studies with the outcome variables of obesity status (e.g., body mass index, fat percentage, waist circumference) were also included. Participation in youth sport was positively associated with childrens PA levels, and youth participating in sports were more likely to persist in their PA. However, the relationship between youth sport participation and obesity status was inconclusive. Educators and sports professionals should find ways to involve children in various sports settings and policies and help obese children engage more in sports.

Accelerometer-Determined Physical Activity and Clinical Low Back Pain Measures in Adolescents With Chronic or Subacute Recurrent Low Back Pain

STUDY DESIGN: Cross‐sectional. BACKGROUND: Although low back pain (LBP) occurs commonly in adolescence, little is known about the relationship between objectively measured physical activity and chronic LBP. OBJECTIVES: To assess the relationship between an objective physical activity measure (accelerometer) and standard clinical measures (pain intensity, disability, and quality of life) in a sample of adolescents with recurrent or chronic LBP. METHODS: The study included a subsample of 143 adolescents, 12 to 18 years of age, from a randomized clinical trial. Pearson correlations (r) and bivariate linear regression were used to assess the relationship between baseline measures of sedentary, light, and moderate‐to‐vigorous physical activity using accelerometers and clinical measures of LBP (pain intensity, disability, and quality of life). RESULTS: Participants spent an average of 610.5 minutes in sedentary activity, 97.6 minutes in light physical activity, and 35.6 minutes in moderate‐to‐vigorous physical activity per day. Physical activity was very weakly associated with clinical measures of LBP (r<0.13). None of the assessed correlations were statistically significant, and bivariate regression models showed that physical activity measures explained very little of the variability for clinical measures of LBP (R2<0.02). CONCLUSION: We found no important relationship between objectively measured physical activity and self‐reported LBP intensity, disability, or quality of life in adolescents with recurrent or chronic LBP. The parent randomized clinical trial was registered at ClinicalTrials. gov (NCT01096628).

Social Cognitive Beliefs Predicting ChildrenâÂÂs Physical Activity andCardiovascular Fitness in Physical Education

Purpose: This study examined the predictive utility of children’s self-efficacy, outcome expectancy, and satisfaction on their perceived persistence/effort, physical activity (PA) levels, and cardiovascular fitness. Method: Participants were 307 sixth through eighth grade students enrolled in a 90-minute physical education class on alternate days. Participants completed questionnaires assessing self-efficacy, outcome expectancy, satisfaction, and perceived persistence/effort during the second to last week of the school year. During the last week of school the Progressive Aerobic Cardiovascular Endurance Run (PACER) test was administered and in-class PA levels were measured via pedometers (Yamax Digi-Walker SW-701). Multiple regression analyses were used to determine how self-efficacy, outcome expectancy, and satisfaction predicted children’s persistence/effort, PA levels, and cardiovascular fitness. Results: Correlation analysis indicated all variables were significantly associated with one another (rs = .17 to . 59, ps < .01) while regression analyses showed outcome expectancy (s = .36, p <.01) and satisfaction (s = .34, p <. 01) were significant predictors for persistence/effort, accounting for 25.48% and 9.54% of the variance, respectively. Further, children’s self-efficacy (s = .28, p <.01), satisfaction (s = .18, p <.01), and outcome expectancy (s = .13, p <.05) significantly predicted their in-class PA levels, and explained 20.14%, 2.72% and 1.00% of the variance, respectively. Finally, self-efficacy (s = .35, p <.01) was the only significant predictor for cardiovascular fitness accounting for 12.16% of the variance. Conclusion: Results indicate that children who perceive the benefits of physical education, enjoy the sense of satisfaction physical education provides, and have higher self-efficacy persist and put forth greater effort during class while also displaying higher in-class PA levels and better cardiovascular fitness.

Feasibility of smartphone application and social media intervention on breast cancer survivors’ health outcomes

Breast cancer survivors are at risk for poor health, with physical activity a possible treatment. Little research has examined how technology might promote breast cancer survivor physical activity or health. The aim of this study is to investigate the feasibility of employing a commercially available mobile health application- and social media-based health education intervention to improve breast cancer survivor physical activity or health.Ten breast cancer survivors (X̅ age = 45.80 ± 10.23 years; X̅ weight = 79.51 ± 20.85 kg) participated in this 10-week single-group pilot study from 2015 to 2016. Participants downloaded the MapMyFitness application, documented all physical activity with MapMyFitness, and were enrolled in a Social Cognitive Theory-based, Facebook-delivered health education intervention. Objectively measured physical activity, weight or body composition, cardiovascular fitness, psychosocial constructs, and quality of life indices were measured at baseline and 10 weeks. Intervention use and acceptability was evaluated during and following the intervention. Descriptive statistics were calculated for all study outcomes, with qualitative analyses performed regarding use and acceptability.At postintervention, average daily moderate-to-vigorous physical activity and steps increased by 2.6 min and 1,657, respectively, with notable decreases in weight (2.4 kg) and body fat percentage (2.3%). Physical activity-related social support and ability to engage in social roles or activity demonstrated the greatest improvements among all psychosocial and quality of life indices, respectively. Participants enjoyed the feedback and tracking features of MapMyFitness, with most finding the Facebook component helpful. All participants recommended the intervention for future use.Physical activity interventions combining commercially available mobile health applications and theoretically based social media-delivered health interventions may promote certain physiological, psychosocial, and quality of life outcomes among breast cancer survivors. Larger samples and randomized studies are warranted.

Effectiveness of Combined Smartwatch and Social Media Intervention on Breast Cancer Survivor Health Outcomes: A 10-Week Pilot Randomized Trial

Physical activity (PA) among breast cancer survivors (BCS) can improve this population’s health and quality of life (QoL). This study evaluated the effectiveness of a combined smartwatch- and social media-based health education intervention on BCS’s health outcomes. Thirty BCS (X¯age = 52.6 ± 9.3 years; X¯Wt = 80.2 ± 19.6 kg) participated in this 10-week, 2-arm randomized trial, with BCS randomized into: (1) experimental group (n = 16): received Polar M400 smartwatches for daily PA tracking and joined a Facebook group wherein Social Cognitive Theory-related PA tips were provided twice weekly; and (2) comparison group (n = 14): only joined separate, but content-identical Facebook group. Outcomes included PA, physiological, psychosocial, and QoL variables. Specifically, PA and energy expenditure (EE) was assessed by ActiGraph GT3X+ accelerometers while physiological, psychosocial, and QoL were examined via validated instruments at baseline and post-intervention. No baseline group differences were observed for any variable. Ten BCS dropped out of the study (experimental: 4; comparison: 6). Compared to completers, dropouts differed significantly on several outcomes. Thus, a per-protocol analysis was performed, revealing significant group differences for changes in social support (t = −2.1, p = 0.05) and barriers (t = −2.2, p = 0.04). Interestingly, the comparison group demonstrated improvements for both variables while the intervention group demonstrated slightly decreased social support and no change in barriers. Notably, both groups demonstrated similarly increased daily light PA, moderate-to-vigorous PA, EE, and steps of 7.7 min, 5.1 min, 25.1 kcals, and 339 steps, respectively, over time. Despite extensive user training, several experimental BCS found the Polar M400 use difficult—possibly decreasing intervention adherence. Future interventions should utilize simpler smartwatches to promote PA among middle-aged clinical/non-clinical populations.

Virtual Reality Exercise for Anxiety and Depression: A Preliminary Review of Current Research in an Emerging Field

Objective: Although current evidence supports the use of virtual reality (VR) in the treatment of mental disorders, it is unknown whether VR exercise would be beneficial to mental health. This review synthesized literature concerning the effect of VR exercise on anxiety and depression among various populations. Methods: Ten electronic databases were searched for studies on this topic from January 2000 through October 2017. Studies were eligible if the article: (1) was peer-reviewed; (2) was published in English; and (3) used quantitative measures in assessing anxiety- and depression-related outcomes. Results: A total of five empirical studies met the eligibility criteria. These studies included two randomized clinical trials, one control trial, and two cross-sectional studies. Four studies reported significant improvements in anxiety- and depression-related measures following VR exercise, including reduced tiredness and tension, in addition to increased energy and enjoyment. Nonetheless, one study failed to support the effectiveness of VR exercise over traditional exercise alone on depressive symptoms. Conclusions: Findings favor VR exercise in alleviating anxiety and depression symptomology. However, existing evidence is insufficient to support the advantages of VR exercise as a standalone treatment over traditional therapy in the alleviation of anxiety and depression given the paucity of studies, small sample sizes, and lack of high-quality research designs. Future studies may build upon these limitations to discern the optimal manner by which to employ VR exercise in clinical settings.

Acculturation and Adherence to Physical Activity Recommendations Among Chinese American and Non-Hispanic White Breast Cancer Survivors

Chinese American breast cancer survivors’ adherence to recommended physical activity (PA) guidelines has been understudied. This study investigated their PA adherence by acculturation level (vs. non-Hispanic White (NHW) survivors). One hundred ninety five Chinese and 202 NHW breast cancer survivors (stage 0–III) responded to a cross-sectional survey including a self-reported PA questionnaire. PA adherence referred to meeting PA recommendations for cancer survivors. Acculturation among Chinese was defined by proxies of U.S. residency, English proficiency, and interview language. Logistic regression was performed to examine factors associated with PA adherence. More-acculturated Chinese survivors’ PA adherence rate was 76%. Less-acculturated Chinese survivors’ adherence rate (60%) was significantly lower than that of NHWs (80%) (OR 0.38, 95%CI 0.19, 0.75). Less-acculturated Chinese survivors were also less likely to engage in vigorous-intensity PA than NHWs (p < 0.01). Future research on less-acculturated Chinese survivors’ motivation for PA to promote their adherence is needed.