Associations between Physical Activity and Health Parameters in Adolescent Pupils in Egypt A comprehensive physical activity promotion programme at elementary school: the effects on physical activity, physical fitness and psychosocial correlates of physical activity. Effects of Child Care Intervention on Physical Activity and Body Composition. A Fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: A pilot study A school-based physical activity program to improve health and fitness in children aged 6–13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785] Physical activity and psychosocial benefits among breast cancer patients. Physical Activity in Pediatric Cancer patients with solid tumors (PAPEC): trial rationale and design. A randomized trial to promote physical activity among breast cancer patients. Randomized trial of three strategies to promote physical activity in general practice. Maintenance of physical activity in breast cancer survivors after a randomized trial. Home-based physical activity intervention for breast cancer patients. Physical activity and skills intervention: SCORES cluster randomized controlled trial. Effects of physical activity on cancer survival: a systematic review. Effect of physical activity guidelines on physical function in older adults. Compliance with physical activity guidelines in a group of UK-based postal workers using an objective monitoring technique Objectively measured physical activity level and sedentary behavior in Norwegian children during a week in preschool☆ Kids Out; evaluation of a brief multimodal cluster randomized intervention integrated in health education lessons to increase physical activity and reduce sedentary behavior among eighth graders
Physical activity ( PA ) could be protective against  hypertension  , atherosclerosis , coronary heart disease and cardiovascular disease . This quantitative study assessed the association between a PA intervention and three anthropometric parameters ( weight , body mass index , body fat ) and four physiological parameters ( cholesterol level , systolic blood pressure , diastolic blood pressure , heart rate ) among secondary school pupils ( N = 160 ) in Egypt through the school term . The pupils were r and omised to an intervention group ( 80 pupils ) and controls ( 80 pupils ) . Measurements were obtained for all pupils twice : at baseline ; and then again after three months . The PA intervention programme comprised an ‘ afterschool ’ one hour of moderate exercise three times a week for three months . Both the controls and the intervention pupils attended the ‘ normal ’ exercise schedule provided by the school ; in addition , the intervention group attended afterschool PA programme from about 2–3 o’clock in the afternoon . At baseline , employing pupil ’s BMI , 27.5 % and 28.8 % of the intervention and control pupils respectively were classified as overweight . After three months , the percentage of overweight decreased to 12.5 % in the intervention pupils , while it increased to 37.3 % in the controls . At the end of the three months period , there were significant improvements across most anthropometric and physiological parameters of the intervention pupils when compared with the control children . The correlation coefficient of the improvements for the boys and the girls was 0.97 , indicating clearly that the intervention was having nearly the same beneficial effect for boys and girls . A moderate PA programme for a modest period of 3 months could be effective in maintaining or enhancing pupil ’s anthropometric and physiological parameters in comparison to the controls where there was deterioration in both parameters . Policy makers and secondary schools in Egypt might need to pay more attention to PA programmes conducted on school days , in order to motivate pupils to attend such programmes . There is also an urgent need to look at current PA systems within schools in Egypt in order to assess PA outside school times OBJECTIVE To evaluate the effects of a comprehensive physical activity ( PA ) promotion programme in elementary schools on children 's total PA levels , leisure-time PA , physical fitness and psychosocial correlates of PA . DESIGN A pre-test-post-test design over two school years . SETTING AND SUBJECTS Sixteen elementary schools ( 764 children , mean age : 11.2 + /- 0.7 years ) were r and omly assigned to the intervention condition ( n = 8) and the control condition ( n = 8) . The intervention included a health-related physical education programme , an extracurricular PA promotion programme and classroom-based PA education lessons . In the total sample , leisure-time PA , psychosocial correlates of PA and physical fitness were measured using a PA question naire and the Eurofit test battery . In a sub- sample , total PA levels were measured using an accelerometer . RESULTS According to accelerometer data , children 's moderate PA and moderate-to-vigorous PA ( MVPA ) levels decreased less in the intervention schools than in the control schools ( P < 0.01 ) . The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools . Children in the intervention schools reported significantly more moderate PA in leisure time than the controls ( P < 0.05 ) . No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found . CONCLUSIONS The comprehensive PA promotion programme was successful in preventing a decline in children 's  total activity levels . Furthermore , the intervention increased children 's PA engagement in leisure time . Therefore , implementation needs to be encouraged INTRODUCTION This study evaluated whether intervening with child care providers would increase physical activity ( PA )  and reduce adiposity in preschoolers . METHODS This was a two-arm , parallel group , cluster RCT whereby six child care centers were r and omly assigned in equal numbers to intervention ( n=40 children ) or control ( n=43 children ) . Participants were aged 3 - 5 years and attended licensed child care centers . Child care providers received two 3-hour train-the-trainer workshops and a training manual at program initiation aim ed at increasing structured and unstructured PA through active play . Control child care centers implemented their st and ard curriculum .  PA and sedentary behavior were measured by accelerometry , and body composition was measured using bioelectrical impedance at baseline and 6 months . Data were collected in 2011 - 2012 and analyzed in April 2015 . RESULTS Linear mixed-effects modeling showed that at 6 months , children in the intervention group demonstrated greater increases in minutes per preschool day spent in overall PA ( 22.5 minutes , 95 % CI=8.9 , 36.1 , p=0.002 ) , and light-intensity PA ( 16.1 minutes , 95 % CI=5.2 , 26.7 , p=0.004 ) , but changes between groups in moderate to vigorous PA did not differ . The intervention group showed greater reductions in body fat percentage ( -1.9 % , 95 % CI=-3.5 , -0.3 , p=0.023 ) and fat mass ( -0.3 kg , 95 % CI=-0.7 , -0.1 , p=0.018 ) , but groups did not differ on fat-free mass , BMI , or z- BMI . CONCLUSIONS Provider-led intervention in child care centers increased preschoolers '  PA and reduced adiposity , therefore may represent a viable approach to promoting PA and related health benefits in preschool-aged children . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT02293278 BACKGROUND Physical activity ( PA ) may be important for preventing chronic diseases for adolescent and young adult ( AYA ) childhood cancer survivors . R and omized controlled trials ( RCTs ) of PA interventions for AYA survivors are sparse , but necessary to determine effective programs for increasing PA among this population . Thus , we conducted a pilot RCT , testing the feasibility of a mobile health ( mHealth ) intervention to promote PA among AYA survivors . PROCEDURE We recruited 14- to 18-year-olds who were ≥1-year post cancer therapy from Seattle Children 's Hospital . The 10-week intervention consisted of a wearable PA-tracking device ( Fitbit Flex ) and a peer-based virtual support group ( Facebook group ) . Research staff helped set step goals and awarded badges weekly . Controls received usual care . Baseline assessment s occurred before r and omization and follow-up assessment s occurred during weeks 8 - 10 of the intervention period . Feasibility criteria are defined below . Qualitative interviews assessed acceptability . Exploratory outcomes included PA , quality of life , and motivation for PA . RESULTS All feasibility criteria were met : we recruited 60 survivors , intervention participants wore the Fitbit  on the majority ( 71.5 % ) of intervention days , and ≥90 % of all participants completed question naires . Qualitative data confirmed intervention acceptability . Exploratory analyses found no significant adjusted group differences for change in moderate-to-vigorous PA ( 4.4 vs. 5.0 min/day ; P = 0.92 ) or sedentary time ( -4.5 vs. 1.0 min/day ; P = 0.73 ) , comparing intervention subjects to controls . Some modest differences were found for select subscales of quality of life and motivation for PA . CONCLUSIONS This mHealth PA intervention was feasible and acceptable to AYA childhood cancer survivors and warrants a fully powered RCT Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure . A major contributing factor is physical inactivity which is closely linked to bone health , cardiovascular disease risk , fitness and psychological factors . The school seems to provide an excellent setting to enhance levels of  physical activity ( PA ) .  However , there is insufficient data from previous school-based intervention trials on how to enhance overall PA . It is also unknown whether an intervention aim ed at increasing PA is effective in improving the children 's health . The purpose of this paper is to outline the design of a school-based r and omized , controlled trial ( RCT ) aim ing to increase overall PA and to improve fitness and health in 6- to 13-year-old children . Methods / Design 15 schools were r and omized to the intervention ( n = 9 ) or the control ( n = 6 ) group , stratified by geographic region ( urban vs. rural ) and by age ( 1st and 5th grade ) . Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum . The intervention during one academic year consisted of : 1 . two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week , 2 . short PA breaks ( 2–5 min each ) during academic lessons , 3 . PA home work , and 4 . adaptation of recreational areas around the school . All children underwent  anthropometric measurements , blood pressure assessment , fitness testing , measurement of PA  and they filled out question naires . At least 70 % of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry . The primary endpoints of the study after one year were an increase in total PA by accelerometry , an increase in aerobic fitness measured by the 20 m shuttle run , a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health question naire in the intervention group compared to the control group . Secondary outcomes were overall fitness , differences in body composition including body fat distribution , cardiovascular risk factors , psychosocial health , bone mineral content and density of femur , lumbar spine and total body and food intake . Discussion Our preliminary data suggest that the children were representative of Swiss children with respect to sex , socio-demographic status , and body mass index . Short-term results can be expected by the beginning of 2007 . We hypothesized that our intervention will lead to an increase in PA , fitness and overall health . Based on our data , we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children OBJECTIVE Physical activity ( PA ) has been shown to provide health benefits for breast cancer patients . The effects of augmenting oncology healthcare provider ( HCP ) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a r and omized trial . Our goal in this secondary analysis was to examine the amount of PA ( min/week ) needed for psychosocial benefits among both groups . METHODS After receiving brief HCP advice to become physically active , 192 women ( age in years : mean = 60.0 , SD = 9.9 ) who had completed treatment for Stage 0-IV breast cancer were r and omized to  telephone counseling to support PA ( n = 106 ) or contact control ( n = 86 ) . Their PA , fatigue , physical functioning , and quality of life were assessed at baseline ( before receiving HCP advice ) , 3 , 6 , and 12 months . A non-r and omized design was used to examine the dose-response relationship between PA and psychosocial outcomes . RESULTS Exercising for at least 150 min/week at moderate intensity was associated with improved physical functioning ( b = 5.9 , SE = 2.9 , p = 0.04 ) and quality of life ( b = 3.6 , SE = 1.9 , p = 0.05 ) at 3 months . These relationships were not found at 6 and 12 months ( p 's > 0.05 ) . However , women who reported at least 150 min/week of PA at both 3 and 6 months had significantly reduced fatigue ( b = 1.3 , SE = 0.7 , p = 0.05 ) and improved physical functioning ( b = 3.1 , SE = 1.3 , p = 0.02 ) and quality of life ( b = 2.0 , SE = 0.9 , p = 0.02 ) compared with women who did not meet this criterion . CONCLUSION Women who exercised at recommended levels ( at least 150 min/week ) and sustained this level of activity for at least 6 months accrued psychosocial benefits BACKGROUND This r and omized controlled trial on Physical Activity in Pediatric Cancer ( PAPEC ) was design ed to assess the impact of an exercise program on pediatric cancer patients undergoing chemotherapy for solid tumors . METHODS AND DESIGN 60 pediatric patients of both sexes , aged 4 to 18 years and undergoing treatment for extracranial primary solid tumors will be recruited for this trial . Each participant will be r and omly assigned ( with blocking on sex ) to either an intervention or control ( normal care ) group . The intervention group will participate in combined inpatient physical training ( aerobic + strength ) for the duration of neoadjuvant chemotherapy . The intervention will include 3 weekly 60 - 70 min exercise sessions in the child 's room or in a pediatric gym at the hospital , depending on the child 's health state . In both groups , determination of several primary ( cardio-respiratory fitness , muscle strength , functional capacity , physical activity levels , body weight and quality of life ) and secondary outcomes [ immune function and inflammatory profile ( blood levels of 47 cytokines ) ] will be made at the following time points : ( i ) before the exercise intervention ( immediately after diagnosis and before treatment onset ) ; ( ii ) after the exercise intervention ( upon termination of neoadjuvant chemotherapy ) ; and ( iii ) after a detraining period ( 2 months after the intervention ) . DISCUSSION The PAPEC trial will provide relevant new information on biological mechanisms and inform on the potential clinical use of exercise during pediatric cancer treatment as a simple way to prevent future long-term treatment effects and improve the general health state of pediatric cancer patients OBJECTIVE  Physical activity ( PA ) has been shown to provide health benefits for breast cancer patients . The effects of augmenting oncology health care provider ( HCP ) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a r and omized trial . METHODS After receiving brief HCP advice to become physically active , 192 women ( age in years : M = 60.0 , SD = 9.9 ) who had completed treatment for Stage 0-IV breast cancer were r and omized to telephone counseling to support PA ( n = 106 ) or contact control ( n = 86 ) . Their PA , motivational readiness , fatigue , and physical functioning were assessed at baseline ( before receiving HCP advice ) , 3 , 6 , and 12 months . RESULTS Telephone counseling produced significant effects on the primary outcome of moderate-intensity PA of about 30 min/week at both 3 months ( 95 % CI = 0.44 , 57.32 ) and 6 months ( 95 % CI = 3.06 , 61.26 ) . Intervention participants were also more than twice as likely as control participants to report improvements in achieving PA guidelines of at least 150 min/week at 3 ( OR = 2.43 , 95 % CI = 1.18 , 4.98 ) and 6 months ( OR = 2.11 , 95 % CI = 1.00 - 4.48 ) . Telephone counseling was significantly more effective than contact control in increasing motivational readiness for PA at all follow-ups ( ORs = 3.93 - 6.28 , all ps < .003 ) . No between-groups differences were found for fatigue , while differential improvements in physical functioning did not remain significant past 3 months ( p = .01 ) . CONCLUSION HCP advice plus telephone counseling improved PA among breast cancer patients at 3 and 6 months and also differentially improved patients ' motivational readiness at all follow-ups , suggesting the potential for exercise promotion in cancer follow-up care OBJECTIVE To evaluate three strategies for promoting physical activity ( PA ) in a primary care setting . METHOD Data were collected between 2002 and 2004 from 136 patients attending two general practice s in Brisbane , Australia . Inactive patients ( 50 - 70 years ) were r and omly allocated to one of three hierarchical intervention groups : the general practitioner ( GP ) group received ' brief ' advice ; the GP+ES group also received behavior change advice from an exercise scientist ( ES ) ; and the GP+ES+P group also received a pedometer .  Self-reported PA and its determinants were measured at baseline and weeks 12 and 24 . Cardio-respiratory variables were measured at baseline and week 12 . RESULTS Overall , mean PA time increased by 84 and 128 min/week at weeks 12 and 24 ( p<.01 ) with no significant group differences . Small improvements in blood pressure and post-exercise heart rate were observed . At week 24 , the GP+ES+P group were more likely to report meeting PA guidelines than the GP group ( OR=2.39 95 % CI : 1.01 , 5.64 ) . CONCLUSION PA levels can be increased in mid- to older-age adults , either by brief advice from motivated GPs alone , or from collaboration between GPs and ESs . The most intense intervention ( GP+ES+P ) showed the most promising results PURPOSE The purpose of this study was to examine the longer-term effects of pedometers and print material s on changes in physical activity ( PA ) and health-related quality of life ( HRQoL ) in breast cancer survivors who participated in a 3-month behavior change intervention . METHODS Breast cancer survivors ( N = 377 ) were r and omly assigned to receive either ( a ) a st and ard public health recommendation for PA ( SR ) , ( b ) previously developed breast cancer-specific PA print material s ( PM ) , ( c ) a step pedometer ( PED ) , or ( d ) a combination of the two ( COM ) . The primary endpoint was self-reported moderate/vigorous PA minutes per week at 6-month follow-up after the initial 3-month intervention period . RESULTS Seventy-one percent ( 266/377 ) of participants completed the 6-month follow-up assessment . According to intention-to-treat linear mixed-model analyses , self-reported moderate to vigorous PA increased by 9 min x wk(-1 ) in the SR group compared with 39 min x wk(-1 ) in the PM group ( mean difference = 30 min x wk(-1 ) ; 95 % CI = -44 to 104 ; P = 0.425 ) , 69 min x wk(-1 ) in the PED group ( mean difference = 60 min x wk(-1 ) ; 95 % CI = -13 to 132 ; P = 0.107 ) , and 56 min x wk(-1 ) in the COM group ( mean difference = 47 min x wk(-1 ) ; 95 % CI = -26 to 119 ; P = 0.210 ) . The same pattern was observed for self-reported , brisk walking . No differences were found for HRQoL or fatigue . CONCLUSION ( S ) Breast cancer-specific PM and PED did not maintain significantly higher PA or HRQoL at 6-month follow-up in breast cancer survivors , but the magnitude of the effect on PA ( 30 - 60 min x wk(-1 ) ) was consistent with the immediate postintervention effect observed at the 3-month postintervention time point . Issues of power result ing from additional loss to follow-up may account for the failure to achieve statistical significance . Additional research with larger sample sizes and more complete follow-up is warranted PURPOSE The efficacy of a home-based physical activity ( PA ) intervention for early-stage breast cancer patients was evaluated in a r and omized controlled trial . PATIENTS AND METHODS Eighty-six sedentary women ( mean age , 53.14 years ; st and ard deviation , 9.70 years ) who had completed treatment for stage 0 to II breast cancer were r and omly assigned to a PA or contact control group . Participants in the PA group received 12 weeks of PA counseling ( based on the Transtheoretical Model ) delivered via telephone , as well as weekly exercise tip sheets . Assessment s were conducted at baseline , after treatment ( 12 weeks ) , and 6 and 9 month after baseline follow-ups . The post-treatment outcomes are reported here . RESULTS Analyses showed that , after treatment , the PA group reported significantly more total minutes of PA , more minutes of moderate-intensity PA , and higher energy expenditure per week than controls . The PA group also out-performed controls on a field test of fitness . Changes in PA were not reflected in objective activity monitoring . The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines . No significant group differences were found in body mass index and percent body fat . Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group . There was a positive trend in intervention effects on overall mood and body esteem . CONCLUSION The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients . The success of a home-based PA intervention has important implication s for promoting recovery in this population PURPOSE  Physical activity ( PA  ) declines dramatically during adolescence , and activity levels are consistently lower among children living in low-income communities . Competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against the decline in PA typically observed during adolescence . The purpose of this study was to evaluate the effect of a 12-month multicomponent PA and FMS intervention on children attending primary schools in low-income communities . METHODS The Supporting Children 's Outcomes using Rewards , Exercise , and Skills intervention was evaluated using a cluster r and omized controlled trial . The sample included 25 classes from eight primary schools located in low-income communities . Participants were 460 children ( 54.1 % girls ) age 8.5 ± 0.6 yr . Primary outcomes were objective ly measured PA ( ActiGraph GT3X and GT3X+ accelerometers ) , FMS competency ( Test of Gross Motor Development 2 , six locomotor and six object control skills ) , and cardiorespiratory fitness ( 20-m multistage fitness test ) assessed at baseline , midprogram ( 6-months ) , and at posttest ( 12 months ) . Linear mixed models , adjusted for sex , age , body mass index z-score , socioeconomic status , ethnicity , and school class as a r and om factor , were used to assess the effect of the intervention . RESULTS At midprogram , there were no significant intervention effects for any of the outcomes . At posttest ( study 's primary time point ) , there were intervention effects for daily moderate-to-vigorous PA ( MVPA ) ( adjusted mean difference , 12.7 min·d of MVPA ; 95 % confidence interval ( CI ) , 5.0 - 20.5 ) , overall FMS competency ( 4.9 units ; 95 % CI , -0.04 to 9.8 ) , and cardiorespiratory fitness ( 5.4 laps ; 95 % CI , 2.3 - 8.6 ) . CONCLUSIONS A school-based multicomponent PA and FMS intervention maintained daily MVPA , improved overall FMS competency , and increased cardiorespiratory fitness among children attending primary schools in low-income communities PURPOSE Physical activity ( PA ) has been suggested to help increase the survival of individuals with cancer . The objective of this review was to systematic ally evaluate and summarize the available evidence investigating the effect of PA on the survival of individuals with cancer . METHODS Electronic data bases ( CINAHL , EMBASE , and MEDLINE ) were systematic ally search ed for r and omized controlled trials and cohort studies . Selected studies were assessed by two independent investigators for method ological quality , using the PEDro scale . RESULTS Ten prospect i ve cohort studies met the inclusion criteria . Quality - assessment scores averaged 5/10 on the PEDro scale , with two articles obtaining a score of 6/10 . The majority of studies found that individuals participating in higher levels of physical activity had a reduced risk of cancer-related mortality . This trend was observed specifically for breast , colon , and colorectal cancers . On average , it appears that engaging in higher levels of metabolic equivalent hours per week may help to improve survival rates among individuals diagnosed with cancer . CONCLUSION Patients diagnosed with cancer demonstrated a trend toward increased survival with greater levels of PA . However , because only prospect i ve cohort studies were included in the study , the conclusions drawn should be regarded with caution OBJECTIVES To determine whether elderly people who meet national guidelines have higher physical function ( PF ) scores than those who do not and the effect on functional trajectory when physical activity ( PA ) levels change from above to below this threshold , or vice versa . DESIGN Pooled data . SETTING Two 6-month r and omized controlled trials aim ed at increasing PA in adults . PARTICIPANTS Adults aged 65 to 94 ( N=357 ) . INTERVENTION PA counseling over the telephone and through mailed material s. MEASUREMENTS  Self-reported PA  dichotomized at 150 minutes/week and PF using the Medical Outcomes Study 36-item Short Form Question naire PF subscale . RESULTS At baseline , individuals reporting 150 minutes or more of moderate PA/week had mean PF scores that were 20.3 points higher than those who did not ( P<.001 ) . Change in PA minutes from above threshold to below threshold or from below threshold to above threshold from baseline to 6 months result ed in an average change in PF of -11.18 ( P<.001 ) and + 5.10 ( P=.05 ) , respectively . CONCLUSION These findings suggest that PA is an important predictor of functional status . Older sedentary adults can improve PF by meeting recommended PA levels . Conversely , dropping below recommended PA levels has a deleterious effect on PF . Given the importance of PF in maintenance of independence and quality of life in older adults , adherence to recommended PA guidelines should be endorsed Compliance with physical activity ( PA ) recommendations was assessed using objective PA monitoring of ambulatory activity , in two healthy groups of individuals with active and sedentary occupations . The study showed generally low compliance with the guidelines ( 53 % with 10,000 steps a day ; 10 % with 30 min of moderate activity a day ; and 1 % with 30 min of moderate activity a day in bouts of at least 10 min ( ACSM ) ) . Adherence to guidelines decreased as more rigorous conditions were applied to the PA data . Use of an objective monitor revealed that health enhancing bouts of activity were performed in periods of approximately 1-min duration , which may be due to unavoidable environmental interruptions . These bouts of activity are much shorter than those advocated in the ACSM guidelines , raising questions regarding how actual behaviour , based on objective monitoring , can be reconciled with guidelines based on self-reported PA Although many studies have reported on  physical activity ( PA ) levels using accelerometers , a thorough description of the PA pattern in preschool children during their stay in the preschool , is lacking in the current literature . Furthermore , there remains a lack of underst and ing of the PA level and pattern in children in the lower end of the PA continuum . The first aim of this study was therefore to describe the PA pattern during a week-long stay in a preschool in all children born in 2011 ( either three or four-year-olds ) attending public preschools in a municipality in Norway . The second aim was to describe the PA level and pattern of the children who are the least physically active . This cross-sectional study included baseline data from 95 % of children ( N = 111 ) participating in a r and omized controlled physical activity intervention ( Active Kindergarten – Active Children study ) . The participants wore an Actigraph accelerometer , in week 39 in 2015 , from when they arrived at the preschool on Monday morning and throughout their stay of five consecutive days . The amount of moderate- to vigorous-intensity PA ( MVPA ) per day ranged from 16 min to 116 min , and sedentary time ranged from 2.7 h to 6.5 h per day in the least and most sedentary child , respectively . The least physically active 25 % of children were less active throughout the entire day , and only a few of them managed to achieve the recommended level of MVPA on any weekday . The physical activity levels and patterns among the least active children described in this study may help to inform interventions targeting this group Background Most Finnish adolescents are not sufficiently physically active . Health education ( HE ) provides beneficial starting point for physical activity ( PA ) promotion in schools . This study evaluates an intervention integrated into three HE lessons to increase  PA and reduce sedentary behavior ( SB )  among eighth grade rs . Methods All public secondary schools in Tampere , Finl and participated and were r and omized to intervention ( INT , n = 7 ) and comparison group ( COM , n = 7 ) . In INT ( 690 students , 36 classes ) the teachers ( n = 14 ) implemented behavioral theory-driven content during three HE lessons . In COM ( 860 students , 41 classes ) the teachers ( n = 14 ) carried out st and ard lessons . The evaluation was based on RE- AIM : Effectiveness was assessed from baseline to 4 weeks ( Follow-up 1 ) and Maintenance from 4 weeks to 7 months ( Follow-up 2 ) with change in students ’ PA and SB and related psychosocial and parental factors . Methods included question naire , accelerometer  and  activity diary . Linear mixed models with baseline adjustments and r and om effect correction were used to compare the difference in change between INT and COM . Data on Reach , Adoption and Implementation were collected during the process . Results Intervention effects were only seen in the self-reported data favoring INT in the weekly number of days with at least 1 h of brisk leisure PA ( 0.3 [ 95%CI 0.1 to 0.6 ] ) , proportion of students meeting PA recommendations ( 4.1 [ 95%CI 2.5 to 5.7 ] ) , proportion of students reporting that their family sets limitations for screen time ( 5.4 [ 95%CI 3.3 to 7.4 ] ) and in the number of days on which the students intended to do leisure PA in the following week ( 0.3 [ 95%CI 0.1 to 0.6 ] ) . The effects on PA were still beneficial for INT at Follow-up 2 . The intervention reached 96 % of the students , was adopted in all 7 schools and was implemented by 13/14 teachers in 35/36 classes . Conclusions The intervention was feasible and had small favorable effects on students ’ self-reported PA , intention to do PA and family norm in screen time . The effects on PA persisted until Follow-up 2 . It is likely that for greater impacts the HE lessons should have been supported with other actions without compromising feasibility . Trial registration NCT01633918 ( June 27th , 2012 )
Results Overall , exercise intolerance is prevalent in pediatric chronic disease .
Background Physical activity ( PA ) is associated with a diverse range of health benefits .
International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits .
However , current guidelines are intended for healthy children , and thus may not be applicable to children with a chronic disease .
Specifically , the dose of PA and disease specific exercise considerations are not included in these guidelines , leaving such children with few , if any , evidence -based informed suggestions pertaining to PA .
Thus , the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases : respiratory , congenital heart , metabolic , systemic inflammatory/autoimmune , and cancer .