Multiple short bouts of exercise are better than a single continuous bout for cardiometabolic health: a randomised crossover trial

Positive skill transfer in balance and speed control from balance bike to pedal bike in adults: A multiphase intervention study

BACKGROUND

Learning to cycle can be challenging for adults who did not acquire the necessary skills during childhood. Balance bikes have been used to teach children how to cycle, but it was unclear whether this approach could also be effective for adults.

PURPOSE

To address this, a multi-phase intervention study was conducted to investigate whether healthy adults could be taught to cycle independently through the use of a balance bike.

METHODS

In Phase 1, a case-control observational study was conducted in which 13 cyclists and 8 non-cyclists completed balance bike tests. Based on the findings, an 8-session intervention pre- and post-test study was conducted in Phase 2, using an 8 × 20-minute balance bike training programme to improve cycling postural stability and control. Another 11 non-cyclists completed the novel programme. The time taken to complete the balance bike tests was compared before and after the program, while their cycling confidence was recorded in each session. To assess the effectiveness of the programme, participants were invited to cycle on a pedal bike to evaluate their ability to cycle independently.

RESULTS

The results in Phase 1 showed that cyclists performed better on the balance bike than non-cyclists, with Bayes factor analyses providing evidence of this difference, BF01 = 0.228 in the 15 m sprint test and BF01 = 0.138 in the two-turn curved sprint test. The novel training programme in Phase 2 demonstrated remarkable effectiveness in improving their balance bike riding performance, as evidenced by the Bayes factor for completion times in the repeated measures being BF01 < 0.001. All participants were able to cycle independently with confidence after the programme.

CONCLUSIONS

This study sheds light on the idea that it's never too late for adults to learn how to ride a bike. It provides evidence that healthy adults can learn to ride independently with the help of a balance bike, a tool that's commonly used for teaching children. The study identifies five key principles for effective balance bike training in adults, including focusing on riding speed, gliding to turn, building cycling confidence, engaging high motor skills, and using a dual-task approach. Our evidence-based training programme offers a safe, enjoyable, and effective way for adults to develop the skills and confidence they need to ride, even if they've never ridden before.

Short-Term Impact of Exercise Fitness Testing in a Pediatric Metabolic and Obesity Clinic: Initiative to Improve Health Care Quality

This 2-phase pilot initiative determined whether (1) fitness testing could feasibly be implemented in pediatric practice, and (2) short-term changes in fitness and body mass index occur with Specific, Measurable, Attainable, Relevant, and Time-based (SMART) goals. Phase 1 (N = 580), clinic feasibility: evidence-based prognostic tests were successfully performed to measure cardiorespiratory fitness (CRF; 3-minute bench step), strength (handgrip dynamometry), and flexibility (sit-and-reach distance). Mean CRF percentile was 58.1 (worst >95 percentile, best <5 percentile), strength percentile was 73.5, and flexibility was 42.3 (worst <5 percentile, best >95 percentile). Phase 2, goal setting and follow-up: SMART fitness goals were developed. In phase 2, patients demonstrated 11.9% and 12.4% improvements in CRF and strength percentiles (P < .05) respectively. All patients who were assigned a strength goal improved handgrip strength. Body mass index percentile changes were not different by SMART goal target. Fitness testing was feasible and successfully improved CRF and strength in children at high risk of metabolic complications and future disability.

The Effects of Accumulated Versus Continuous Exercise on Postprandial Glycemia, Insulin, and Triglycerides in Adults with or Without Diabetes: A Systematic Review and Meta-Analysis

BACKGROUND

Postprandial dysmetabolism, an important cardiovascular disease risk factor, can be improved by exercise. Further systematic review and meta-analysis is needed to compare the effects of accumulated exercise with a single session of energy-matched continuous exercise on postprandial glucose (PPG), insulin, and triglycerides in adults with or without diabetes.

METHODS

Eight electronic databases were searched on August 28, 2020, and updated on April 27, 2021. Eligible studies were randomized, quasi-randomized, or non-randomized controlled or crossover trials that evaluated the acute or longitudinal effects of accumulated exercise compared with a single session of energy-matched continuous exercise on PPG, postprandial insulin, and triglycerides in diabetic and non-diabetic adults. Same-day and second-morning effects were assessed separately for acute intervention studies. Subgroup analyses were conducted based on the number of exercise bouts (2-3 bouts or frequent brief bouts (e.g., 1-6 min) throughout the day at 20-60-min intervals (known as physical activity [PA] breaks, ≥ 5 bouts)), exercise intensity, and populations. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Pooled effects were reported as standardized mean differences (SMD) and 95% CI using a random effects model.

RESULTS

Twenty-seven studies (635 participants) were included. A significant difference was found for same-day PPG control, which favored accumulated exercise over one bout of energy-matched continuous exercise (SMD - 0.36 [95%CI: (- 0.56, - 0.17)], P = 0.0002, I2 = 1%), specifically in accumulated exercise with PA breaks (SMD - 0.36 [95%CI: (- 0.64, - 0.08)], P = 0.01, I2 = 30%), low-moderate intensity exercise (SMD - 0.38 [(95%CI: (- 0.59, - 0.17)], P = 0.0005, I2 = 0%), and in non-diabetic populations (SMD - 0.36 [95%CI: (- 0.62, - 0.10)], P = 0.007, I2 = 16%). No differences were found for same-day postprandial insulin and triglycerides, and second-morning effects (postprandial or fasting glucose, insulin, and triglycerides) between different exercise patterns.

CONCLUSION

Compared with one session of continuous exercise, accumulated exercise-specifically in subgroups of PA breaks, low-moderate intensity exercises-produced greater acute effects on same-day PPG control for non-diabetic adults. There were no differences between continuous and accumulated patterns of exercise in terms of same-day postprandial insulin and triglycerides, and second-morning effects on all previously mentioned markers. The findings provide additional PA options for PPG control for individuals with limited time or exercise capacity to engage in PA in one session. Registration: PROSPERO (identification code: CRD42021251325).