Health-Related Quality of Life, Physical Function, Fatigue, and Disease Activity in Children with Established Polyarticular Juvenile Idiopathic Arthritis The Relationship Between Physical Activity Levels and Pain in Children with Juvenile Idiopathic Arthritis Reliability of exercise testing and functional activity questionnaires in children with juvenile arthritis. The effects of vigorous exercise training on physical function in children with arthritis: a randomized, controlled, single-blinded trial. Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK) A policy-driven multifaceted approach for early childhood physical fitness promotion: impacts on body composition and physical fitness in young Chinese children Aquatic fitness training for children with juvenile idiopathic arthritis. Leisure-time physical activity of 13-year-old adolescents. Perceived social and physical environmental correlates of physical activity in older adolescents and the moderating effect of self-efficacy. Pilot study of fitness training and exercise testing in polyarticular childhood arthritis. Connecting Children to Recreational Activities: Results of a Cluster Randomized Trial Evaluating the effects of the Lunchtime Enjoyment Activity and Play (LEAP) school playground intervention on children’s quality of life, enjoyment and participation in physical activity Enjoyment mediates effects of a school-based physical-activity intervention. Measuring health status in early juvenile idiopathic arthritis: determinants and responsiveness of the child health questionnaire. The effect of adult participation in a school-based family intervention to improve Children's diet and physical activity: the Child and Adolescent Trial for Cardiovascular Health. Physical, social and productive leisure activities, cognitive decline and interaction with APOE-epsilon 4 genotype in Chinese older adults. An active video game intervention does not improve physical activity and sedentary time of children at-risk for developmental coordination disorder: a crossover randomized trial.
Objective . To compare child  self-report and parent/proxy report of health-related quality of life ( HRQOL ) , disability , and fatigue in children with active polyarticular juvenile idiopathic arthritis ( JIA ) to that of children with inactive polyarticular JIA and to previous data from healthy controls . Methods . Cross-sectional survey of children with polyarticular JIA diagnosed and treated between 2000 to 2006 and their parent/proxy . The Childhood Health Assessment Question naire , Pediatric Quality of Life Inventory ( PedsQL ) Generic Core Scales , PedsQL Rheumatology Module , and PedsQL Multidimensional Fatigue Scale were administered . Disease activity data were collected from the physician clinic notes . Comparisons were performed with t tests . Correlations between patient and parent/proxy reports were measured with Pearson correlation coefficients . Results . Sixty children and /or their parents/proxies participated ( 79 % response rate ) . Disease activity status was available for 52 , and 32 met criteria for inactive disease ( 62 % ) . Participants reported lower scores on the PedsQL Generic Core Scales ( range 2.54–9.13 points lower ) and the PedsQL Rheumatology Module ( range 2.46–6.96 points lower ) than those with inactive disease . Participants also reported lower scores on the PedsQL Multidimensional Fatigue Scale than did healthy controls , regardless of disease activity status ( range 0.06–9.2 points lower ) . Conclusion . Although children in this cohort with polyarticular JIA and inactive disease reported HRQOL scores similar to those of healthy controls , children with polyarticular JIA and their parents/proxies tended to report more fatigue than controls , regardless of disease activity . Application of these measures prospect ively to larger cohorts of children with JIA is needed to assess these differences Objective . Pain and reduced physical activity levels are common in children with juvenile idiopathic arthritis ( JIA ) . Currently , there is no consensus about the role of physical activity in managing pain in JIA . The purpose of our study was to assess the relationship between physical activity level and pain in children ages 11 to 18 years with JIA . Methods . A r and om sample of 50 patients with JIA were approached by mailed question naires . Physical activity was determined using the Physical Activity Question naire ( PAQ ) .  Pain measures included the Numerical Rating Scale ( pain severity ) , SUPER-KIDZ body diagram ( number of painful areas ) , and the Child Activities Limitations Inventory-21 ( pain interference ) . Generalized linear models were used to assess the relationship between physical activity and pain , as well as the roles of sex and age . Results . The response rate was 84 % . Thirty-four respondents completed the question naire package . The median age was 15 years . The mean PAQ score was 2.16/5 . Physical activity declines with increasing age in youth with JIA ( r = 0.53 , p = 0.0014 ) . Lower physical activity is associated with greater pain interference ( r = 0.39 , p = 0.0217 ) and more severe pain ( r = 0.35 , p = 0.0422 ) . Conclusion . Children with JIA report significantly less activity than healthy children based on PAQ scores , with physical activity declining throughout adolescence . Physical activity is inversely related to pain interference and severity in children with JIA . Our findings suggest that physical activity interventions may play an important role in the management of pain in JIA OBJECTIVE To determine the reliability of formal exercise testing and the reliability of functional and activity question naires in children with juvenile idiopathic arthritis ( JIA ) . METHODS Children with JIA of any subtype ages 8 - 16 years who were recruited to a r and omized trial comparing different exercise therapies participated in 2 preintervention sessions of exercise testing 2 - 6 weeks apart . Exercise testing included 1 ) submaximal oxygen uptake ( VO(2submax ) ) , 2 ) peak VO(2 ) ( VO(2peak ) ) , and 3 ) anaerobic power using modified Wingate tests ( W(ant ) ) . Two physical function question naires ( the Childhood Health Assessment Question naire [ C-HAQ ] and Revised Activity Scale for Kids [ ASK ] ) and 1 daily physical activity question naire ( the Habitual Activity Estimation Scale [ HAES ] ) were also completed at these times . Test-retest reliability was assessed using type 3 , intrarater intraclass correlation coefficient ( ICC(3,1 ) ) and Bl and and Altman plots were used to determine limits of agreement . RESULTS Data were available for 74 patients ( 58 girls ) .  VO(2submax ) , VO(2peak ) , and W(ant ) demonstrated high reliability ( ICC(3,1 ) 0.82 , 0.91 , and 0.94 , respectively ) . C-HAQ and ASK question naires also had very high reliability ( ICC(3,1 ) 0.82 and 0.91 , respectively ) . The HAES demonstrated low reliability for total activity score ( ICC(3,1 ) 0.15 ) and moderate reliability when the number of very active hours was analyzed separately ( ICC(3,1 ) 0.59 ) . CONCLUSION Results of this investigation suggest that exercise testing and functional question naires in children with JIA are consistent and reliable . Reliability of the HAES total score was poor , but moderate when the very active hours subscale score was used OBJECTIVE To examine the effectiveness of high-intensity aerobic training compared with low-intensity training in terms of energy cost of locomotion , peak oxygen uptake , peak power , and self-reported physical function in children with juvenile idiopathic arthritis ( JIA ) . METHODS Eighty children with JIA , ages 8 - 16 years , were enrolled in a r and omized , single-blind controlled trial . Both groups participated in a 12-week , 3-times-weekly training program consisting of high-intensity aerobics in the experimental group and qigong in the control group . Subjects underwent exercise testing measuring submaximal oxygen uptake at 3 km/hour ( VO(2submax ) ) as the primary outcome , maximal oxygen uptake , and peak power at the beginning and end of the program . Physical function was measured using the Child Health Assessment Question naire ( C-HAQ ) . RESULTS The exercise program was well tolerated in both groups . There was no difference in VO(2submax ) or any other exercise testing measures between the groups through the study period and no indication of improvement . Both groups showed significant improvements in C-HAQ with no difference between the groups . Adherence was higher in the control group than the experimental group . CONCLUSION Our findings suggest that activity programs with or without an aerobic training component are safe and may result in an important improvement in physical function . The intensity of aerobic training did not seem to provide any additional benefits , but higher adherence in the qigong program may suggest that less intensive regimens are easier for children with JIA to comply with , and provide a degree of benefit equivalent to more intensive programs Introduction Many children fail to meet international guideline recommendations for health-related activity ( ≥60 minutes/day of moderate-to-vigorous physical activity [ MVPA ] ) , and intervention studies to date have reported negligible effects . Objective Explore the associations of organized leisure-time sport participation with overall physical activity levels and health-related physical activity guideline concordance . Methods This prospect i ve cohort study was nested in the Childhood Health , Activity , and Motor Performance School Study Denmark . Study participants were a representative sample of 1124 primary school students .  Organized leisure-time sport participation was reported via text messaging and physical activity was objective ly measured over seven days with accelerometry . Associations between sport participation and physical activity level were explored with multilevel mixed-effects regression models and reported with beta coefficients ( b ) and adjusted odds ratios ( aOR ) . Results Participants were 53 % female , with mean(SD ) age = 8.4(1.4 ) years . Boys were more active than girls ( p<0.001 ) , and physical activity levels and guideline concordance decreased with age ( p<0.001 ) . Soccer participation at any frequency was associated with greater overall MVPA ( b[95 % CI ] = 0.66[0.20,1.13 ] to 2.44[1.44,3.44 ] ) . Depending on participation frequency , this equates to 5–20 minutes more MVPA on the average day and 3 to 15 fold increased odds of achieving recommended levels of health-related physical activity ( aOR[95%CI ] = 3.04[1.49,6.19 ] to 14.49[1.97,106.56 ] ) . Similar associations were identified among children playing h and ball at least twice per week . Relationships with other sports ( gymnastics , basketball , volleyball ) were inconsistent . Conclusions Many children , particularly girls and those in higher grade levels do not adhere to health-related physical activity recommendations . Organized leisure-time sport participation may be a viable strategy to increase overall health-related physical activity levels and international guideline concordance in children Background The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade . This study tested the effectiveness of a multifaceted intervention that integrated childcare center , families , and community to promote healthy growth and physical fitness in preschool Chinese children . Methods This 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group . The participants were 357 children ( mean age = 4.5 year ) enrolled in three grade levels in two childcare centers in Beijing , China . The intervention included : 1 ) childcare center intervention ( physical activity policy changes , teacher training , physical education curriculum and food services training ) , 2 ) family intervention ( parent education , internet website for support , and family events ) , and 3 ) community intervention ( playground renovation and community health promotion events ) . The study outcome measures included body composition ( percent body fat , fat mass , and muscle mass ) , Body Mass Index ( BMI ) and BMI z-score and physical fitness scores in 20-meter agility run ( 20M-AR ) , broad jump for distance ( BJ ) , timed 10-jumps , tennis ball throwing ( TBT ) , sit and reach ( SR ) , balance beam walk ( BBW ) , 20-meter crawl ( 20M-C ) ) , 30-meter sprint ( 30M-S ) ) from a norm referenced test . Measures of process evaluation included monitoring of children ’s physical activity ( activity time and intensity ) and food preparation records , and fidelity of intervention protocol implementation . Results Children in the intervention center significantly lowered their body fat percent ( −1.2 % , p < 0.0001 ) , fat mass ( −0.55 kg , p < 0.0001 ) , and body weight ( 0.36 kg , p < 0.02 ) and increased muscle mass ( 0.48 kg , p < 0.0001 ) , compared to children in the control center . They also improved all measures of physical fitness except timed 10-jumps ( 20M-AR : −0.74 seconds , p < 0.0001 ; BJ : 8.09 cm , p < 0.0001 ; TBT : 0.52 meters , p < 0.006 ; SR : 0.88 cm , p < 0.03 ; BBW : −2.02 seconds , p < 0.0001 ; 30M-S : −0.45 seconds , p < 0.02 ; 20M-C : −3.36 seconds , p < 0.0001 ) . Process evaluation data showed that the intervention protocol was implemented with high fidelity . Conclusions The study demonstrated that a policy-driven multi-faceted intervention can improve preschool children ’s body composition and physical fitness . Program efficacy should be tested in a r and omized trial . Trial registration ChiCTR-ONRC-14004143 OBJECTIVE To evaluate the effects of an aquatic training programme for JIA patients . METHODS Fifty-four patients with JIA ( age range 5 to 13 yr ) participated in this study and were r and omized into an experimental ( n = 27 ) and a control ( n = 27 ) group . The children in the experimental group received a training programme consisting of a 1 h per week supervised training programme in a local pool of approximately 20 sessions . Effects were analysed on the following domains : functional ability , health-related quality of life , joint status and physical fitness . RESULTS Although all measures improved more in the experimental group than the control group , none of the differences was statistically significant . CONCLUSIONS The current research found no significant effect of an aquatic fitness training programme in children with JIA . Since there were no signs of worsening in health status , one can conclude that this was a safe exercise programme The leisure-time physical activity  of 13-year-old Finnish adolescents was assessed in the prospect i ve STRIP study . A self-administered question naire ( N=565 ) was used . The leisure-time physical activity index ( PAI ; MET h/week ) was calculated on the basis of reported exercise intensity , duration and frequency ( N=558 ; 53 % boys ) . The participants were divided into Sedentary , Moderately Active and Active groups by PAI tertiles . A sub population ( N=197 ) also used a heart rate monitor ( 3 days , > /=8 h/day ) to assess the time spent on different activity intensities . The median male PAI was 31.3 ( inter-quartile range ( IQR ) 44.2 ) MET h/week and female 19.5 ( IQR 26.3 ) MET h/week ( P=0.0002 ) . The cutoff points of the PAI tertiles were similar for the Active girls ( 31.3 MET h/week ) and boys ( 32.6 MET h/week ) , but for the Sedentary boys it was 19.5 MET h/week and only 5.0 MET h/week for the Sedentary girls . High self-reported leisure-time physical activity associated poorly with time spent on moderate or vigorous exercise measured by heart rate monitoring . Active mothers had more often Active daughters or sons . In conclusion , the amount of leisure-time physical activity of one-third of 13-year-old girls is extremely low . Sedentary adolescents , especially girls , should therefore be put into focus for active efforts to increase their leisure-time physical activity . Parental models may be important OBJECTIVE To determine if perceptions of the social and physical environment are associated with active transport and leisure-time sports among Belgian youth and to investigate if this relationship is moderated by self-efficacy . METHODS In February-May 2008 , 1445 adolescents ( 17.4+/-0.6 yrs ) were recruited in 20 r and omly selected Belgian schools .  Physical activity , psychosocial , and environmental factors were assessed using vali date d question naires . Moderated multilevel regression analysis was used to examine the association between physical activity and possible correlates . RESULTS Social environmental variables  ( modeling and social support ) were positively associated with active transportation and leisure-time sports ( p<0.05 ) . Higher l and use mix diversity , higher street connectivity , more attractive environments , better access to recreational facilities , and higher emotional satisfaction with the neighborhood were associated with more active transportation ( p<0.05 ) . Higher perceived safety from traffic , better access to recreational facilities , more physical activity equipment at home , and fewer electronic devices in the bedroom were associated with more leisure-time sports ( p<0.05 ) . Lower perceived safety and poorer access to ( recreational ) facilities were only associated with lower active transport among youth with lower self-efficacy ( p<0.05 ) . CONCLUSION Creating more supportive environments could have the potential to affect the physical activity levels of Belgian adolescents with both high and low self-efficacy OBJECTIVE To 1 ) assess the safety and feasibility of laboratory-based exercise testing in juvenile idiopathic arthritis ( JIA ) , 2 ) test the safety and feasibility of a 3-month exercise program in JIA , 3 ) assess pain during exercise in JIA , 4 ) compare ratings of perceived effort ( RPE ) with heart rate ( HR ) achieved , and 5 ) estimate the training effect on metabolic efficiency of gait as measured by submaximal exercise testing . METHODS Nine children with JIA were enrolled in a 12-week circuit training program involving pool , stationary bicycle , treadmill , and Fitball . They underwent formal exercise testing before and after the program , underwent a full joint assessment , were administered the Childhood Health Assessment Question naire and Juvenile Arthritis Functional Status Index , and were assessed for overall quality of life and health-related quality of life . A visual analog scale was used to assess pain during testing and training , and the Borg scale was used to measure RPE . RESULTS Children with JIA were able to participate in exercise testing without any significant problems . Children with severe hip disease dropped out of the exercise program due to  pain  during the exercise sessions and worsened arthritis symptoms . Target HR was achieved and correlated with RPE in the bicycle and treadmill sessions . Submaximal exercise testing showed an improvement with a small to moderate effect size . CONCLUSION This study suggests that it is safe , feasible , and acceptable for children with arthritis , in the absence of severe hip involvement , to participate in formal exercise testing and structured fitness programs Purpose . Identify if outreach support increases school-aged children 's  participation in recreational activities . Design . Cluster r and omized trial . Setting . Sixteen schools in economically vulnerable neighborhoods were r and omized to either an intervention or control group . Subjects . Children in grade s 3 to 5 and their families were invited to participate . Intervention . Children in intervention schools were assigned a “ connector ” ( outreach worker ) to facilitate participation in recreation activities . Measures . The Children 's Assessment of Participation and Enjoyment ( CAPE ) was the primary measure at baseline , middle , and end of 1 year . Demographics , body mass index , child physical and psychosocial health , coordination , and self-esteem were measured . Analysis . A generalized linear model was used to test differences between intervention and control groups . Results . Three hundred and sixty children enrolled , and 306 ( 85 % ) completed the study . A greater proportion of children in the intervention group compared with the control group increased participation in physical activity ( 21 % vs. 10 % , p = .02 ) . Children who increased their activity were more likely to have higher levels of contact with the connectors ( 31 % vs. 8 % , p = .001 ) . Study limitations included ( I ) 29 % of eligible families participated , ( 2 ) first use of the CAPE instrument as a longitudinal measure , and ( 3 ) connectors were not blinded to group assignment . Conclusion . Children living in vulnerable neighborhoods benefit from outreach workers to connect them with physical activity programs Background An emerging public health strategy is to enhance children ’s opportunities to be physically active during school break periods . The aim of this study was to evaluate the effects of the Lunchtime Enjoyment Activity and Play ( LEAP ) school playground intervention on primary school children ’s  quality of life ( QOL ) , enjoyment and participation in physical activity ( PA ) . Methods This study consisted of a movable/recycled material s intervention that included baseline , a 7-week post-test and an 8-month follow-up data collection phase . Children within an intervention school ( n = 123 ) and a matched control school ( n = 152 ) aged 5-to-12-years-old were recruited for the study . Children ’s PA was measured using a combination of pedometers and direct observation ( SOPLAY ) . Quality of life , enjoyment of PA and enjoyment of lunchtime activities were assessed in the 8 - 12 year children . A multi-level mixed effect linear regression model was applied in STATA ( version 12.0 ) using the xtmixed comm and to fit linear mixed models to each of the variables to examine whether there was a significant difference ( p < 0.05 ) between the intervention and control school at the three time points ( pre , post and follow-up ) . Results Significant overall interaction effects ( group × time ) were identified for children ’s mean steps and distance ( pedometers ) in the intervention school compared to the control school . Intervention school children also spent significantly higher proportions within specified target areas engaged in higher PA intensities in comparison to the control school at both the 7-week post-test and 8-month follow-up . A short-term treatment effect was revealed after 7-weeks for children ’s physical health scale QOL , enjoyment of PA and enjoyment of intra-personal play activities . Conclusions Examining the effects of this school playground intervention over a school year suggested that the introduction of movable/recycled material s can have a significant , positive long-term intervention effect on children ’s PA . The implication s from this simple , low-cost intervention provide impetus for schools to consider introducing the concept of a movable/recycled material s intervention on a wider scale within primary school setting s . Trial registration Australian and New Zeal and Clinical Trials Registration Number : ACTRN12613001155785 PURPOSE The study evaluated whether targeted changes in factors influencing enjoyment of physical education ( PE ) , physical activity enjoyment , and self-efficacy beliefs about participating in physical activity mediated the effect of the Lifestyle Education for Activity Program ( LEAP ) intervention on participation in physical activity . METHODS High schools ( N=24 ) paired on enrollment size , racial composition , urban or rural location , and class structure were r and omized into control ( N=12 ) or experimental ( N=12 ) groups . Of the 4044 girls enrolled and eligible , 2087 ( 51.6 % ) participated in the measurement component of the study . There were 1038 girls in the control group and 1049 girls in the experimental group . INTERVENTION LEAP was a comprehensive school-based intervention emphasizing changes in instruction and school environment design ed to increase physical activity among black and white adolescent girls . It was organized according to the Coordinated School Health Program and included a PE component with core objectives of promoting enjoyment of PE , physical activity enjoyment , and self-efficacy . RESULTS Latent variable structural equation modeling indicated that : 1 ) the intervention had direct , positive effects on physical activity and factors influencing enjoyment of PE , which subsequently explained the effects of increased physical activity enjoyment and self-efficacy on increased physical activity ; and 2 ) an additional , indirect effect of physical activity enjoyment on physical activity operated by an influence on self-efficacy . CONCLUSIONS Increases in enjoyment partially mediated the positive effect of the LEAP intervention . To our knowledge , we have provided the first experimental evidence from a r and omized controlled trial linking increased enjoyment with increased physical activity among black and white adolescent girls OBJECTIVE To assess the determinants and responsiveness of the Norwegian version of the Child Health Question naire ( CHQ ) in patients with early juvenile idiopathic arthritis ( JIA ) and to compare health status in patients and controls . METHODS A total of 116 children ( median age 8.4 yrs ) with JIA and < 2.5 years of disease duration ( median 11.0 mo ) were examined by a pediatric rheumatologist and reassessed after a median of 10.0 months . Physical and psychosocial health were assessed by means of the CHQ , which provides summary scores for physical and psychosocial health , the Childhood Health Assessment Question naire ( CHAQ ) , and the Child Behavior Checklist ( CBCL , n = 32 ) . Matched controls ( n = 116 ) , r and omly selected from the general population , completed the CHQ at baseline . RESULTS The patients with JIA had poorer physical health and slightly impaired psychosocial health compared with the controls [ 41.2 + /- 13.6 vs 55.2 + /- 7.3 ( p < 0.001 ) and 51.0 + /- 7.5 vs 54.1 + /- 5.7 ( p = 0.002 ) , respectively ] . The most important determinants of the CHQ physical summary score were the child 's pain , morning stiffness , the CHAQ disability index , erythrocyte sedimentation rate ( ESR ) , overall well-being , and physician 's global assessment of disease activity . The psychosocial summary score correlated with the CBCL level of internalizing , externalizing , and total behavior problems . The st and ardized response mean for the physical summary score was large ( 0.96 ) for those who improved , and moderate ( -0.60 ) for those who became worse . CONCLUSION The CHQ discriminated between patients with early JIA and controls . The most important determinants of the CHQ physical summary score were the child 's pain , morning stiffness , CHAQ , ESR , overall well-being , and physician 's global assessment of disease activity . The CHQ was sensitive to clinical changes in children with JIA UNLABELLED BACKGROUND . There are strong theoretical reasons for including a family component with a school-based intervention aim ed at eating , activity , and smoking behaviors , but the empirical findings to date are limited and show mixed results . The overall CATCH family intervention added only knowledge and attitudinal effects , but no additional behavioral outcomes . This study provides a dose analysis of the family component of the CATCH study by assessing the effect of the level of adult participation . METHOD This secondary analysis included students who attended a CATCH family intervention school during all 3 years of the study . The extent of the adult-child interaction , the key aspect of the CATCH family intervention , was measured by the number of activity packets that an adult household member completed with the child . Multiple regression analysis was used to assess the association of adult participation with the child 's knowledge , attitudes , and behaviors related to diet and physical activity . RESULTS Statistically significant results suggested that dose effects were found for knowledge and attitudes related to diet and physical activity . These effects were more pronounced for minority and male students . CONCLUSIONS These results suggest that dose response of a family intervention has been shown in the acquisition of positive knowledge and attitudes toward health habit changes . The methodology of dose response can be applied to other health promotion projects BACKGROUND We evaluated the combined and differential effects of physical , social and productive activities on  cognitive decline  and whether they were modified by the presence of the APOE-epsilon 4 allele . METHODS In a prospect i ve cohort study of 1635 community-dwelling Chinese older adults aged 55 or older participating in the ongoing Singapore Longitudinal Aging Study , physical , social and productive leisure activities were assessed at baseline , and cognitive decline ( at least one point drop ) in MMSE scores between baseline and follow-up after one year . RESULTS Cognitive decline was observed in 30 % of the respondents . Controlling for age , gender , education and other risk factors , odds ratios ( ORs ) were significantly reduced in those with medium ( OR : 0.60 , 95 % CI : 0.45 - 0.79 ) and high activity levels ( OR : 0.62 , 95 % CI : 0.46 - 0.84 ) . A stronger association was shown for productive activity ( OR = 0.36 ) , than for physical ( OR = 0.78 ) and social activities ( OR = 0.85 ) . These associations showed statistically significant interactions with APOE genotype , being more pronounced in those with the APOE-epsilon 4 allele . CONCLUSION Increased leisure activity  , especially productive activities  more than  physical or social activities  , was associated with a lowered risk of cognitive decline . APOE-epsilon 4 genotype individuals appeared to be more vulnerable to the effects of low and high levels of leisure activities BACKGROUND Children with developmental coordination disorder ( DCD ) are highly inactive and sedentary . The purpose of this study was to assess the impact of a home-based active video game intervention on objective ly measured physical activity and sedentary behaviour in children at risk for DCD . METHODS In a crossover r and omized clinical trial , 21 children ( mean age 11.0 , SD 1.0 ; n = 11 girls ) in Perth , Western Australia participated in two 16-week periods : no active video games ( AVGs ) control period and AVGs intervention period . Two active input consoles were provided to participants along with a selection of non-violent AVGs for participants to play at home . Participants wore accelerometers at baseline and following each period to determine minutes of sedentary , light , moderate and vigorous times in addition to self-reported types of activities in a diary . Linear mixed models , adjusted for the order of periods , compared physical activity and sedentary time during the last week of each period . RESULTS There were no significant differences between the intervention and control periods in time spent in sedentary ( decrease of -1.0 min/day during the intervention period , 95%CI -12.1 , 10.1 ) , light ( increase of 2.2 min/day , 95%CI -8.8 , 13.2 ) , moderate ( decrease of 0.7 min/day , 95%CI -4.6 , 3.3 ) or vigorous ( decrease of -0.6 min/day , 95%CI -1.6 , 0.4 ) . CONCLUSIONS Among children at risk for DCD , participating in this AVG intervention did not improve objective ly measured physical activity and sedentary time
Results suggest that youth with JIA participated less in both  social and physical leisure activities  as compared to healthy peers , and those with JIA did not meet national recommendations for physical activity .
Characterization of leisure activity remains limited and mostly focused on physical activity in JIA .
UNLABELLED The aim of this systematic review is to describe participation in social and physical leisure activities among children and adolescents with JIA , as well as identify potential determinants of leisure participation .