The Influence of Motor Competence on Broader Aspects of Health: A Systematic Review of the Longitudinal Associations Between Motor Competence and Cognitive and Social-Emotional Outcomes

BACKGROUND

Motor competence has important developmental associations with aspects of physical health, but there has been no synthesis of longitudinal associations with cognitive and social-emotional health.

OBJECTIVES

The first aim was to present a conceptual model that positions motor competence as a mediator between physical activity and cognitive and social-emotional outcomes. The second aim was to synthesize the association of motor competence and cognitive and social-emotional development using longitudinal observational and experimental evidence, in particular to (i) identify the role of task, individual, and environmental characteristics in moderating the association between motor and cognitive and social-emotional outcomes and (ii) synthesize the strength of evidence pertaining to domain-specific relationships.

METHODS

This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses. Five electronic databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were systematically searched. Following study screening and risk-of-bias assessment by two authors, 49 eligible studies were identified for inclusion and grouped by study design. Evidence for domain-specific paths between motor competence and cognitive and social-emotional outcomes was synthesized by calculating the significant analyses in the hypothesized direction, divided by the total number of analyses for that path. These percentages were then collated for each domain outcome. This collated influence was classified as either no association (0-33%), written as '0', or indeterminate/inconsistent (34-59%), written as '?' If there were fewer than three studies in the domain, the strength of evidence was classified as insufficient (I).

RESULTS

Of the 49 studies, 35% were able to satisfy six or more of the seven risk-of-bias criteria. Longitudinal observational evidence about domain-specific and global associations of motor competence and cognitive and social-emotional development is indeterminate. The included studies also did not provide evidence for a consistent moderating role of age and sex. Some preliminary experimental evidence does support the role of motor competence in moderating the influence of cognitively enriched physical activity on cognitive outcomes, especially working memory and social-emotional skills. However, too few studies were appropriately designed to acknowledge the moderating role of contextual mechanisms.

CONCLUSIONS

Between-study heterogeneity means it was not possible to identify definitive domain- and construct-specific relationships between motor competence and cognitive and social-emotional outcomes. To further develop our understanding, it is important that researchers acknowledge the complexity of these relationships within rigorous study designs.

Effects of physical exercise on executive functions of individuals with schizophrenia spectrum disorders: Protocol for a systematic review and meta-analysis

INTRODUCTION

Executive functions are commonly impaired in individuals with schizophrenia spectrum disorders. Physical exercise has the potential for improving executive functions and can be easily implemented as a therapeutic method. However, there are only few systematic reviews of exercise effects in schizophrenia including cognitive outcomes, and no meta-analytical syntheses of effects on "cool" and "hot" executive functions. The purpose of this systematic review and meta-analysis will be to determine the effects of physical exercise on "cool" and "hot" executive functions of adults with schizophrenia spectrum disorders.

METHODS AND ANALYSIS

This protocol was guided by PRISMA-P guidelines. Studies will be searched using combinations of keywords and medical terms in the Web of Science, PubMed, Scopus, and EBSCO databases. Inclusion criteria will be determined as per PICOS approach. The risk of bias will be assessed using the Cochrane RoB2 tool. The certainty of evidence (per outcome) will be assessed using the GRADE method. The meta-analyses will be performed using the DerSimonian and Laird random effects model. Effect sizes (Hedges' g) with 95% confidence intervals will be calculated for each main outcome.

CONCLUSIONS

The results of this review may be useful for mental health professionals to design treatment plans for adults with schizophrenia spectrum disorders, offering potential benefits related to the quality of life and cognitive abilities of this population.

PROSPERO REGISTRATION NUMBER

CRD42023392295.

Martial arts, combat sports, and mental health in adults: A systematic review

Martial arts (MA) and combat sports (CS) are physical activities that may be associated with health-related outcomes. The aim of this systematic review was to synthesize and evaluate the available evidence on the relationship between MA and CS training and mental health of adult practitioners (≥18 years). CochraneLibrary, EBSCOhost, Web-of-Science, and Scopus databases were searched up to September 2022 for measures of self-related constructs, ill-being and well-being, cognition and brain structure/function, in adult MA/CS practitioners. Seventy cross-sectional and two longitudinal studies were retained and submitted to risk of bias assessments through an adapted version of the Cochrane Collaboration's Tool. Associations between MA/CS practice and self-related constructs were inconclusive for both consistency and strength of evidence. Limited evidence of significant associations emerged for sub-domains of ill-being (i.e., externalizing and internalizing emotion regulation), and well-being. In regard to cognitive and brain structural/functional variables, evidence of positive association with MA/CS practice was consistent with respect to perceptual and inhibition abilities but limited with respect to attention and memory. Evidence on negative associations of boxing with changes of brain structure integrity due to concussions was also inconclusive. Functional imaging techniques could shed light onto brain activation mechanisms underlying complex cognitive performance. In relation to moderators, mixed results were found for activity exposure, expertise, level of competitive engagement (which often covary with the length of training) and sex and type of MA/CS. The MA/CS' multifaceted nature may produce different, sometimes conflicting outcomes on mental health. Studies on MA/CS represent a flourishing research area needing extensive improvement in theoretical and practical approaches.

Associations of physical activity dose and movement quality with executive functions in socioeconomically disadvantaged children aged 5-6 years

BACKGROUND

Growing up in areas of high deprivation can negatively impact children's movement behaviours and cognitive development. Enhancing the quantity and quality of children's movement experiences is believed to enhance cognitive development. This study investigated the association of three different modes of movement assessment, movement proficiency and divergent movement ability (collectively understood as motor competence) and PA dose with executive function in a low socio-economic demographic. Demographics, motor competence, and a combination of motor competence and physical activity were hypothesized to be significantly predictor of executive functions.

METHOD

In this cross-sectional study, 360 children aged 5-6 years from deprived areas were assessed using three movement assessments: wrist-worn accelerometery for physical activity dose, Test of Gross Motor Development-3 for movement proficiency, and divergent movement assessment. Executive function, including inhibitory control, working memory, and cognitive flexibility, was measured using the NIH Toolbox on an iPad. Multiple linear regression models were designed to evaluate the independent and combined association of demographics, movement competence and physical activity variables with executive function.

RESULTS

The regression analysis, with demographic factors only, explained 12% of EF variance (r2 = 0.12 95%CI 0.06-0.18). In addition to this demographics the model with divergent movement explained 19% of EF variance (r2 = 0.19 95% CI = 0.12-0.28), the model with movement proficiency explained 16% of EF variance (r2 = 0.16 95% CI = 0.08-0.26) and the model with PA dose explained 13% of EF variance (r2 = 0.13 95% CI = 0.07-0.20). In these models both divergent movement and proficiency were significant predictors, whilst physical activity variables were not. The final models, combining motor competence and physical activity variables, explained 24% and 23% of EF variance (r2 = 0.24 CI = 0.14-0.33 and r2 = 0.23 CI = 0.14-0.32). In these models, motor competence variables were significant predictors, and only vigorous physical activity and Euclidean Norm Minus One emerged as significant PA dose predictors.

DISCUSSION

These findings emphasise that motor competence and physical activity variables better predict executive functions when they are combined. When considered individually both motor competence variables were significant predictors of executive function whilst physical activity variables were not. Importantly, among the two movement competence facets, divergent movement assessment exhibited the strongest association with executive function. Future interventions should consider how to facilitate both movement and cognitive development in children. Future interventions should consider both the interplay of movement quality and quantity and the importance of environments that invite children's exploratory movement behavior.

Effects of Cognitively Engaging Physical Activity on Preschool Children's Cognitive Outcomes

Research combining physical activity with the training of cognitive skills such as executive functions is emerging as a novel and fruitful intervention approach for children. Purpose: This study aimed to examine the impact of an intervention program including cognitively engaging physical activity on preschool children's cognitive outcomes and physical activity. Methods: Children (N = 144, 65 female; Mage = 4.41 years, SD = 0.61), randomly assigned to one of three groups: cognitively engaging physical activity (CPA; i.e., storytelling, cognitive activities, and motor tasks, n = 55), cognition (i.e., storytelling and cognitive activities without motor tasks, n = 48), or control (i.e., traditional storytelling, n = 41). Sessions lasted approximately 17 minutes, conducted twice a week, for 6 weeks. Children's executive function, self-regulation, and related outcomes (i.e., numeracy) were assessed at baseline and again-along with perceived enjoyment-at the end of the program. Accelerometers measured children's physical activity during each session. Teachers completed a logbook for each session, and two fidelity checks per preschool took place by the researcher. Main analyses used linear mixed models adjusted for covariates (age, sex) and clustering at the preschool level. Results: Results showed no significant group by time interaction for executive function, self-regulation, numeracy, enjoyment. During the sessions, children in the CPA group were more physically active than children in the cognition and control groups. Conclusion: While we did not find the expected amplified cognitive benefits, making storytelling more active has the potential to meet two needs (increase cognitive stimulation and physical activity levels) in one deed.

Active breaks: a strategy to counteract sedentary behaviors for Health Promoting Schools. A discussion on their implementation in Italy

Abstract

School Active Breaks are short bouts of physical activity (5-15 minutes) conducted by appropriately trained teachers and delivered during or between curricular lessons. They are a good strategy to counteract sedentary behaviors, and a growing body of evidence shows that they can represent also a tool to promote and improve health, school wellbeing and academic achievements. On 19 February 2022, the Working Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health organized an Awareness Day on the effectiveness, usefulness and feasibility of School Active Breaks, opened to teachers, educators, school leaders, pediatricians, personnel from Departments of Prevention and Public Health and Health Policy-makers. During the event, the testimonies about the experiences already carried out in Italy showed that School Active Breaks are an effective intervention that each school can easily include in its educational offer and apply in any context.

How divergent are children's divergent movements? The role of cognition and expertise in a class-randomized cross-over trial

This study aimed at investigating (1) the cognitive and motor predictors of divergent movement ability (DMA) in childhood and (2) the role of sport and enriched physical education (PE) experience. Participants were 165 fifth graders, aged 10-11 years, with different histories (onset and duration) of participation in enriched PE. They were assessed in cognitive/attentional and motor/sport skills and active play/sport habits at baseline, and six months later in DMA. Results of regression analyses showed an overall prediction of DMA by sport practice and a nuanced prediction of individual DMA indices (fluency, flexibility, originality) by decision making and spatial attention ability. Linear mixed models revealed better DMA in children exposed to enriched PE, with differential effects on DMA indices depending on its duration and earlier/later onset. The results identify novel cognitive determinants of children's DMA and suggest that sport practice and experience of designed enrichment in PE may benefit DMA.

Reinvest to Assess: Advancing Approaches to Motor Competence Measurement Across the Lifespan

Measurement of motor competence is a vital process to advancing knowledge in the field of motor development. As motor competence is being more widely linked to research in other academic domains (e.g., public health, neuroscience, behavioral health), it is imperative that measurement methodology and protocols are reproducible with high degrees of validity and reliability. When addressing the plethora of available assessments, mostly developed for youth populations, there are potential questions and concerns that need to be addressed and/or clarified. One of the most prominent issues is the lack of a lifespan measure of motor competence, which is at odds with the premise of the field of motor development-studying changes in motor behavior across the lifespan. We address six areas of concern in lifespan assessment which include: (1) lack of assessment feasibility for conducting research with large samples, (2) lack of accountability for cultural significance of skills assessed, (3) limited sensitivity and discriminatory capabilities of assessments, (4) developmental and ecological validity limitations, (5) a problematic definition of 'success' in skill performance, and (6) task complexity and adaptability limitations. It is important to critically analyze current assessment methodologies as it will help us to envision the development and application of potential new assessments through a more comprehensive lens. Ultimately, we propose that reinvesting in how we think about assessment will be highly beneficial for integrating motor development from a holistic perspective, impact scientific advancements in other developmental domains, and increase global and lifespan surveillance of motor competence.

The Effects of a Cognitively Challenging Physical Activity Intervention on School Children's Executive Functions and Motivational Regulations

This study examined the effects of a physical education intervention consisting of cognitively challenging physical activity games on school children's executive functions and motivational regulations. Ninety-nine fourth- and fifth-grade children participated in this two-group, repeated measures, quasi-experimental study with a cross-over design. Children's executive functions (measured with the design fluency and Stroop and flanker tests) and motivational regulations were measured pre- and post-intervention and one month later. At post-test, the experimental group children outperformed the waiting-list control group children in all design fluency test conditions and accuracy in the Stroop and flanker tests. Both groups improved from pre- to post-intervention their speed (reaction time) in the Stroop and flanker tests. The waiting-list control group children, after receiving the intervention, improved their performance in the executive function tests except for Stroop test accuracy and flanker test speed. The positive effects were reduced significantly one month after the end of the intervention but remained significantly higher compared to pre-intervention. No intervention effects were found for the motivational regulations. These results showed that the intervention had positive effects on children's executive functions and supported the new shift of designing physical activity programs for developing combinedly children's physical and cognitive development.

Understanding the Benefits of Brief Classroom-Based Physical Activity Interventions on Primary School-Aged Children's Enjoyment and Subjective Wellbeing: A Systematic Review

BACKGROUND

Engaging in classroom-based physical activity (PA) breaks may help increase children's subjective wellbeing and enjoyment of PA, important precursors for children to remain engaged in PA. We conducted a systematic review to investigate the effect of brief classroom-based PA interventions on primary school children's subjective wellbeing and enjoyment of PA.

METHODS

Databases were reviewed between the earliest date of records and April 2020. Eligibility criteria included peer-reviewed empirical quantitative or mixed methods studies reporting enjoyment of PA or wellbeing outcomes of participating in a brief classroom-based PA program. Fifteen papers were included. Interventions supported 7022 child participants enrolled at baseline and 6286 children analyzed in interventions across 148 schools.

RESULTS

Thirteen studies examined the effect of brief classroom-based PA interventions on subjective wellbeing. Four found a significant positive effect for children in the intervention group (specifically for children's self-efficacy in learning with video exercises, quality of life, and self-confidence). Eight studies examined the effect of brief classroom-based PA interventions on enjoyment of PA. Five studies reported a positive effect for children in the intervention group and only 1 study found a negative effect for 1 grade level of children in the intervention group. The remaining studies with wellbeing and/or enjoyment outcomes reported no significant effect.

CONCLUSIONS

Findings from these studies indicate that the integration of brief PA breaks may support PA enjoyment and specific self-beliefs and quality of life perceptions that contribute to children's subjective wellbeing. However, more research is needed to confirm this effect.

Effects of Baby Swimming on Motor and Cognitive Development: A Pilot Trial

Contact with water, even from birth, may be an important experience for child development. In this work, we aimed to investigate if baby swimming might influence infant development in motor and cognitive domains. We assigned infants to either a 10-week baby swimming intervention (n = 12; M age = 13 months (SD) = 7) or a control group (n = 15; M age = 22 months (SD) = 6). We assessed motor development with the Peabody Developmental Motor Scales (2nd edition, PDMS-2) and cognitive development with core tests of executive functions: delayed response for working memory, object retrieval for inhibition, and A-not-B for response shifting. Non-parametric analyses revealed that infants in the baby-swimming group improved in gross, fine, and total motor skills, and showed marginally better inhibition speed and shifting accuracy, with associated gains of shifting accuracy and fine and total motor skills. Even with in this small-sized convenience sample, this pilot study revealed promising benefits from baby swimming on motor development that warrant further study. This preliminary work paves the way for replication and illustrates what effect sizes may be expected in sufficiently powered well-designed follow-up research targeted to aid the joint development of motor and cognitive skills as early as infancy.

Giving Ideas Some Legs or Legs Some Ideas? Children's Motor Creativity Is Enhanced by Physical Activity Enrichment: Direct and Mediated Paths

Approaches to foster motor creativity differ according to whether creative movements are assumed to be enacted creative ideas, or solutions to emerging motor problems that arise from task and environmental constraints. The twofold aim of the current study was to investigate whether (1) an enriched physical education (PE) intervention delivered with a joint constraints-led and cognitive stimulation approach fosters motor creativity, and the responsiveness to the intervention is moderated by baseline motor and cognitive skills and sex; (2) the intervention may benefit motor creativity through gains in motor coordination, executive function, and creative thinking. Ninety-five children, aged 6-9 years, participated in a 6-month group randomized trial with specialist-led enriched PE vs. generalist-led conventional PE. Before and after the intervention, Bertsch's Test of Motor Creativity, Movement Assessment Battery for Children, Random Number Generation task and Torrance Test of Creative Thinking were administered. Linear mixed models were run accounting for the random effects of data clusters. Multiple mediation analysis was performed to assess whether motor coordination, executive function and creative thinking mediated any improvement of motor creativity. Results showed that (1) specialist-led enriched PE, compared to generalist-led conventional practice, elicited a more pronounced improvement in all motor creativity dimensions (fluency, flexibility, and originality) independently of baseline levels of motor and cognitive skills and sex; and (2) improved motor creativity was partially mediated by improved motor coordination and, as regards motor flexibility, also by improved inhibitory ability. In conclusion, enriching PE with tailored manipulations of constraints and variability may enhance the ability to create multiple and original task-pertinent movements both directly and through indirect paths. The results are discussed extending to motor creativity a theoretical framework that distinguishes different creativity modes. The intervention may have fostered the generation of creative movements directly through the exposure to variation in constraints, activating the sensorimotor 'flow' mode of creativity that bypasses higher-order cognition, but also indirectly through a systematic and conscious convergence on solutions, activating the 'deliberate' mode of creativity that relies on inhibition to reject common or task-inappropriate movement categories.

Behaviours that prompt primary school teachers to adopt and implement physically active learning: a meta synthesis of qualitative evidence

BACKGROUND

Physically active learning (PAL) - integration of movement within delivery of academic content - is a core component of many whole-of-school physical activity approaches. Yet, PAL intervention methods and strategies vary and frequently are not sustained beyond formal programmes. To improve PAL training, a more comprehensive understanding of the behavioural and psychological processes that influence teachers' adoption and implementation of PAL is required. To address this, we conducted a meta-synthesis to synthesise key stakeholders' knowledge of facilitators and barriers to teachers' implementing PAL in schools to improve teacher-focussed PAL interventions in primary (elementary) schools.

METHODOLOGY

We conducted a meta-synthesis using a five-stage thematic synthesis approach to; develop a research purpose and aim, identify relevant articles, appraise studies for quality, develop descriptive themes and interpret and synthesise the literature. In the final stage, 14 domains from the Theoretical Domain Framework (TDF) were then aligned to the final analytical themes and subthemes.

RESULTS

We identified seven themes and 31 sub-themes from 25 eligible papers. Four themes summarised teacher-level factors: PAL benefits, teachers' beliefs about own capabilities, PAL teacher training, PAL delivery. One theme encompassed teacher and school-level factors: resources. Two themes reflected school and external factors that influence teachers' PAL behaviour: whole-school approach, external factors. Ten (of 14) TDF domains aligned with main themes and sub-themes: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, Beliefs about Consequences, Reinforcement, Goals, Environmental Context and Resources, Social influences and Emotion.

CONCLUSIONS

Our synthesis illustrates the inherent complexity required to change and sustain teachers' PAL behaviours. Initially, teachers must receive the training, resources and support to develop the capability to implement and adapt PAL. The PAL training programme should progress as teachers' build their experience and capability; content should be 'refreshed' and become more challenging over time. Subsequently, it is imperative to engage all levels of the school community for PAL to be fully integrated into a broader school system. Adequate resources, strong leadership and governance, an engaged activated community and political will are necessary to achieve this, and may not currently exist in most schools.

Fostering Holistic Development with a Designed Multisport Intervention in Physical Education: A Class-Randomized Cross-Over Trial

Physical education (PE) is acknowledged as a relevant context for holistic child and youth development promotion. However, interventional research mostly builds on individual theories focused on specific outcome domains. This study presents a multisport enriched PE intervention that capitalizes on the intersection of different theory-based approaches to motor, cognitive and socio-emotional skills development promotion. With a cross-over design, 181 fifth graders, coming from a past class-randomized trial of enriched or traditional PE in their 1st–3rd grade, were stratified (based on their previous PE experience) and class-randomized to multisport enriched PE or control group. They completed pre-post assessments in motor and sport skills, cool (inhibition, working memory) and hot (decision making) executive functions, prosocial (empathy, cooperation) and antisocial (quick-temperedness, disruptiveness) behaviors. Children in the enriched PE group showed advantages in motor and prosocial skills after the intervention, which were linked by a mediation path, and an interactive effect of past and actual PE experience on decision making but no differential effects on other variables. The results suggest that a PE intervention designed with an integrative theory base, although not allowing disentangling the contribution of individual components to its efficacy, may help pursue benefits in motor and non-motor domains relevant to whole-child development.

Exploring Potential Benefits of Accumulated Multicomponent-Training in Non-Active Older Adults: From Physical Fitness to Mental Health

The present study aimed to analyze the impact of a multicomponent training (MCT) program in a group of non-active older adults, comparing two different dose distributions. Twenty-four individuals, assigned to two groups, completed 15 weeks of MCT (2 days/week). The continuous group (CMCT; n = 14, 9 females; 71.07 ± 5.09 years) trained for 60 min/session in the morning. The accumulated group (AMCT; n = 10, 5 females; 72.70 ± 3.59 years) performed the same exercises, volume, and intensity, but the training was distributed twice per day (30 min in the morning; 30 more in the afternoon). Bonferroni post hoc comparisons revealed significant (p < 0.001) and similar large improvements in both groups in lower limb strength (five times sit-to-stand test: CMCT, 12.55 ± 2.83 vs. 9.44 ± 1.72 s; AMCT, 10.37 ± 2.35 vs. 7.46 ± 1.75 s). In addition, there were large gains in preferred walking speed and instrumental daily life activities, which were higher for CMCT and AMCT, respectively (in this order: 1.00 ± 0.18 vs. 1.44 ± 0.26 m/s and 1.09 ± 0.80 vs. 1.58 ± 0.18 m/s; 33.07 ± 2.88 vs. 36.57 ± 1.65 points and 32.80 ± 1.93 vs. 36.80 ± 0.92 points); improvements in cardiorespiratory fitness, now moderate for CMCT (474.14 ± 93.60 vs. 529.64 ± 82.76 m) and large for AMCT (515.10 ± 20.24 vs. 589.60 ± 40.38 m); and medium and similar enhancements in agility in both groups (TUG test: CMCT: 7.49 ± 1.11 vs. 6.77 ± 1.16 s; AMCT: 6.84 ± 1.01 vs. 6.18 ± 0.62 s). None of the protocols had an impact on the executive function, whereas health-related quality of life showed a trend to significance in the whole sample only (EQindex overall sample, p = 0.062; d = 0.48 CMCT; d = 0.34 AMCT). Regardless of the type of dose distribution, starting multicomponent training improves physical function in non-active older adults, but does not improve cognitive function at mid-term. Because both forms of MCT showed similar compliance, slightly positive differences in accumulated strategies may indicate some benefits related to breaking afternoon sedentary behaviors, which deserves further research in longer and larger interventions. The mixed nature of MCT suggests accumulative group interventions may be a promising approach to address sedentary aging.

Breaking up classroom sitting time with cognitively engaging physical activity: Behavioural and brain responses

INTRODUCTION

Classroom-based active breaks are a feasible and effective way to reduce and break up sitting time, and to potentially benefit physical health in school children. However, the effect of active breaks on children's cognitive functions and brain activity remains unclear.

OBJECTIVE

We investigated the impact of an active break intervention on typically developing children's cognitive functions and brain activity, sitting/standing/stepping, on-task behaviour, and enjoyment.

METHODS

Up to 141 children, aged between 6 and 8 years (46% girls), were included, although about half of them completed two of the assessments (n = 77, working memory; n = 67, dorsolateral prefrontal cortex haemodynamic response). Classrooms from two consenting schools were randomly allocated to a six-week simple or cognitively engaging active break intervention. Classrooms from another school acted as a control group. The main analyses used linear mixed models, clustered at the class level and adjusted for sex and age, to investigate the effects of the interventions on response inhibition, lapses of attention, working memory, event-related brain haemodynamic response (dorsolateral prefrontal cortex). The mediating effects of sitting/standing/stepping on cognition/brain activity were also explored. To test intervention fidelity, we investigated differences by group on the change values in children's sitting, standing, and moving patterns during class/school time using linear mixed models. Generalized linear mixed models clustered at the individual level were used to examine on-task behaviour data. For the intervention groups only, we also assessed children's perceived enjoyment, physical exertion and mental exertion related to the active breaks and compared the results using independent t-tests.

RESULTS

There was a significantly greater positive change in the proportion of deoxygenated haemoglobin in the left dorsolateral prefrontal cortex of children assigned to cognitively engaging active breaks compared to the control group (B = 1.53 × 10-07, 95% CI [0.17 × 10-07, 2.90 × 10-07]), which under the same cognitive performance is suggestive of improved neural efficiency. Mixed models showed no significant effects on response inhibition, lapses of attention, working memory. The mediation analysis revealed that the active breaks positively affected response inhibition via a change in sitting and standing time. The sitting, standing, and moving patterns and on-task behaviour were positively affected by the active breaks at end of trial, but not at mid-trial. Children in both intervention groups showed similarly high levels of enjoyment of active breaks.

CONCLUSION

Cognitively engaging active breaks may improve brain efficiency in the dorsolateral prefrontal cortex, the neural substrate of executive functions, as well as response inhibition, via effects partially mediated by the change in sitting/stepping time. Active breaks can effectively reduce sitting and increase standing/stepping and improve on-task behaviour, but the regular implementation of these activities might require time for teachers to become familiar with. Further research is needed to confirm what type of active break best facilitates cognition.

Early Drop-Out from Sports and Strategic Learning Skills: A Cross-Country Study in Italian and Spanish Students

The search for overarching factors involved in both sport and broader lifestyle and achievement domains may help to understand the early drop-out phenomenon. This study aimed to analyze the association between early sport drop-out and strategic learning skills, checking for the individual and joint role of nationality, school type, gender, age and sport habits. Six hundred and fourteen Italian and Spanish students aged 14–18 years completed two self-assessment questionnaires concerning physical activity, sports habits and learning strategies. Outcomes were analyzed with frequency analysis. Higher affective–motivational strategic learning skills were associated with lower drop-out rates in Italian but not Spanish students. In high schools with an enhanced sports curriculum, drop-out rates were negligible compared to other Italian and Spanish curricula. A lack of persistence in the same sport type was significantly associated with a higher drop-out rate in males but not in female students, who had overall higher drop-out rates. This study suggests that overarching personal skills, cultural characteristics and sports habits may independently and jointly contribute to sport drop-out. Specifically, affective–motivational learning skills may play a key role in sport persistence and in strategies tailored to drop-out prevention.

Effects of classroom-based active breaks on cognition, sitting and on-task behaviour in children with intellectual disability: a pilot study

BACKGROUND

Classroom-based active breaks can help typically developing children reduce sitting, increase physical activity and improve cognitive functions and on-task behaviour. Yet, this strategy has not been tested in children with intellectual disability (ID) - a population who are insufficiently active. This study aimed to investigate the effects of a 5-week active breaks intervention on cognitive functions and on-task behaviour in schoolchildren with ID.

METHODS

Twenty-four children, aged between 8 and 12 years (37.5% girls), were recruited. Children's cognitive functions (response inhibition, lapses of attention, interference and working memory) were measured at baseline and end of trial using computer-based tests. Sitting, standing and movement patterns were assessed with inclinometers, and on-task behaviour was directly observed in the classroom before and after active breaks, at baseline, mid-trial and end of trial. Linear mixed models were used to investigate the intervention effects on cognitive functions and sedentary patterns; generalised linear mixed models were used to analyse on-task behaviour data.

RESULTS

A significant time × group interaction was found for working memory favouring the intervention (B = 11.56, 95% confidence interval [1.92, 21.21]). No significant effects were found in relation to the other measures of children's cognition or on-task behaviour. Stepping time and bouts of sitting were positively affected.

CONCLUSIONS

Classroom-based active breaks can increase physical activity and reduce sedentary behaviour in children with ID and might also benefit their working memory. Further research is required to clarify the effects on cognition and to investigate whether this strategy has other benefits in this population.

Parents about parenting dual career athletes: A systematic literature review

OBJECTIVES

To establish the scientific literature on the parents' view as supporters of dual career (DC) athletes, and to highlight practical implications for the development of education programmes to empower parents in this role.

METHOD

ology: The systematic literature review included four electronic databases, from which 438 articles published in English between 1999 and 2019 were retrieved.

RESULTS

A total of 14 studies achieved the eligibility criteria (i.e., focus on DC, involving parents as participants) for inclusion. Results show that the 14 studies included in the review were characterised by sample sizes <15 to >50 parents of individual and/or team sports athletes, involving data collection based on interviews, semi-structured interviews focus groups, questionnaires and a survey. A thematic synthesis highlighted a two primary constructs: the individual level and the inter-individual level, respectively. The individual level comprised two main themes: Approach to both Sport and Education, and Stressors and Coping, which included five aspects of parenting. The inter-individual level presented three themes: Relationship with the Athlete; Relationship with the Sport Environment and Relationship with the Academic Environment.

CONCLUSIONS

Findings highlighted a relevant parental role in supporting DC athletes and partial information on parental support strategies. In conclusions, the limited sample size and typology of sports, and the partial representativeness of countries have impacted the global application of the main findings. Furthermore, the need of an educational programme for parents and the need of regular parents-athlete-teacher/coach engagement were considered crucial to facilitate successful parental interventions at academic and/or sports levels and to limit the potential negative effects of DC parenting.

Understanding the educational needs of parenting athletes involved in sport and education: The parents' view

BACKGROUND

Despite the fact that an educational programme for parents of youth tennis players has been launched recently, there is a need to empower parents of athletes in sustaining the combination of education and sport careers (i.e., dual career) of their talented and elite athletes across sports. The aim of this study was to explore the parents' view of their role as dual career supporters and their need for educational support in this area.

METHODS

In total, 115 parents (F = 49, M = 66) of athletes (14-23 yrs) engaged in full time academic education (high school/university) and competitive (e.g., National, International) sports (individual = 12, team = 9) in five European Member States (e.g., France, Ireland, Italy, Portugal, Slovenia) took part in national workshops. The workshops involved discussing five themes and agreeing statements relevant to assist parents supporting their children as dual career athletes: 1) the athletes' needs; 2) the sports environment; 3) the academic environment; 4) dual career-related policies and services; 5) The educational methods for parenting dual career athletes.

RESULTS

A final list of 80 agreed statements were identified: 25 statements mainly related to the sports entourage; 23 to information on dual career-related policies and services; 22 to the athletes' needs; 17 to the academic entourage, and 8 to the relevant educational resources to parenting dual career athletes, respectively.

CONCLUSIONS

This cross-national qualitative research synthesized the parents' perspectives about their needs and the most relevant content of an educational programme for parenting dual career athletes. The findings of this research will help influence the formulation of effective education strategies on parenting dual career athletes to ensure an optimal supportive environment for the successful combination of high-level sport and education careers.

Effects of a 4-month judo program on gait performance in older adults

BACKGROUND

Falls prevention is a critical goal of training program for older individuals. This study explored the effects of a judo program on gait performance in older adults.

METHODS

Pre- and post-intervention (15 weeks, 1-hr session, twice a week) step length (cm), gait cycle time (s), speed (m·s-1) and cadence (step·min-1) mean values (AVG) and coefficients of variation (CV) were assessed in a judo (JG: N.=16 novice judoka; age=69.3±3.9 years) and a control (CG: N.=14 healthy older adults; age=70.1±4.5 years) group. Two 3 (motor complexity: flat, corridor, hurdling) ×2 (group: JG, CG) ×2 (time: pre, post) MANOVAs with repeated measures were applied to ascertain differences in gait parameters.

RESULTS

A significant Time×Motor Complexity×Group interaction was found for AVG and CV. For AVG, JG showed improvements for flat and hurdling conditions in step length (flat: ∆=+2.6%, d=0.4; hurdling: ∆=+3.2%, d=0.4), gait cycle (flat: ∆=-4.3%, d=0.4; hurdling: ∆=-4.0%, d=0.5), speed (flat: ∆=+6.6%, d=0.7; hurdling: ∆=+6.7%, d=0.6) and cadence (flat: ∆=4.3%, d=0.4; hurdling: ∆=3.9%, d=0.5). For CV, JG improved step length for flat (∆=-20.9%, d=0.6) and hurdling (∆=-16.3%, d=0.8) conditions, whereas CG showed a deterioration in the step length for the corridor condition (∆=+22.3%, d=0.7).

CONCLUSIONS

The findings demonstrated the effectiveness of an adapted judo program for improving gait performance in older individuals, suggesting a potential protective effect for fall risk.

Fostering Self-Control Development With a Designed Intervention in Physical Education: A Two-Year Class-Randomized Trial

This study evaluated whether a theory-based intervention in physical education (PE) designed to train self-control may positively impact children's quick-temperedness and disruptiveness and whether changes in executive functions (EFs) may be a correlate or antecedent of such effects. One hundred and sixteen children aged 8-9 years participated in a 2-year intervention and completed three assessments at baseline, 6- and 18-month follow-ups in quick-temperedness and disruptiveness, hot and cool EFs. After the intervention, children in the intervention group showed lower quick-temperedness and disruptiveness and improvement in hot EF. Changes over the intervention period were moderately associated and showed marginal evidence of causal ordering, suggesting that designed PE may benefit self-control through a possible linkage to hot EF improvement.

A Preliminary Investigation of the Relationship between Motivation for Physical Activity and Emotional and Behavioural Difficulties in Children Aged 8-12 Years: The Role of Autonomous Motivation

While motivation for physical activity (PA) and PA participation have been linked, research on the relationship between motivation for PA and mental health outcomes is scant, with studies involving children largely underrepresented. Grounded in self-determination theory, this cross-sectional study aimed to determine whether autonomous motivation versus external motivation (a form of controlled motivation) for PA is associated with fewer emotional and behavioural difficulties and higher levels of PA in children. A sample of 87 children (aged 8–12 years) were recruited from five primary schools in Victoria, Australia. An adapted version of the Behavioural Regulation in Exercise Questionnaire (BREQ) was used to measure motivation for PA and structured parent-report questions were used to assess moderate-to-vigorous PA (MVPA) levels. Parents also completed the Strengths and Difficulties Questionnaire (SDQ) to measure children’s emotional and behavioural difficulties. Children’s autonomous motivation was associated with fewer emotional and behavioural difficulties (β = −0.25, p = 0.038) and higher levels of MVPA (β = 0.24, p = 0.014). These results indicate autonomous motivation is associated with improved mental health outcomes and higher levels of PA in children. Thus, PA interventions that promote autonomous motivation may enhance children’s mental health compared to interventions that promote mainly controlled forms of motivation.

Physical Literacy - A Journey of Individual Enrichment: An Ecological Dynamics Rationale for Enhancing Performance and Physical Activity in All

Internationally, governments, health and exercise practitioners are struggling with the threat posed by physical inactivity leading to worsening outcomes in health and life expectancy and the associated high economic costs. To meet this challenge it is important to enhance the quality, and quantity, of participation in sports and physical activity throughout the life course to sustain healthy and active lifestyles. This paper supports the need to develop a physically literate population, who meaningfully engage in play and physical activity through the development of functional movement skills in enriched environments. This is a shift away from reductionist approaches to physical activity engagement and maintenance to an ecological dynamics approach that focuses on enrichment to support functional movement skill learning and development. This is an embedded approach to physical literacy that allows learners the space and time to "explore-discover" (ecological psychology) within environments that will lead to a concomitant self-organization of highly intricate network of co-dependent sub-systems (anatomical, respiratory, circulatory, nervous, and perceptual-cognitive) resulting in functional movement solutions for the performance task and enduring positive adaptations to subsystems supporting the physical literacy journey across the life course. "Explore-discover adapt" is at the heart of two contemporary learner-centered pedagogies: Non-linear Pedagogy (NLP) and the Athletic Skills Model (ASM). Both emphasize the importance of enrichment experiences from an early age, and throughout life course, and both appreciate the inherent complexity involved in the learning process and the importance of designing a rich and varied range of athletic, participatory experiences that will support the embedded development of physical literacy leading to ongoing physical activity for all. The final part of this paper will demonstrate the potential of an ecological dynamics approach for supporting the concept of physical literacy by providing a roadmap for a reliable and valid measurement of physical literacy when considered from both an ecological dynamics perspective and the phenomenology understanding of physical literacy.

Skill Acquisition Methods Fostering Physical Literacy in Early-Physical Education (SAMPLE-PE): Rationale and Study Protocol for a Cluster Randomized Controlled Trial in 5-6-Year-Old Children From Deprived Areas of North West England

BACKGROUND

There is a need for interdisciplinary research to better understand how pedagogical approaches in primary physical education (PE) can support the linked development of physical, cognitive and affective aspects of physical literacy and physical activity behaviors in young children living in deprived areas. The Skill Acquisition Methods fostering Physical Literacy in Early-Physical Education (SAMPLE-PE) study aims to examine the efficacy of two different pedagogies for PE, underpinned by theories of motor learning, to foster physical literacy.

METHODS

SAMPLE-PE will be evaluated through a cluster-randomized controlled trial targeting 5-6 year old children from schools located in areas of high deprivation in Merseyside, North-West England. Schools will be randomly allocated to one of three conditions: Linear Pedagogy, Non-linear Pedagogy, or Control. Non-linear and Linear Pedagogy intervention primary schools will receive a PE curriculum delivered by trained coaches over 15 weeks, while control schools will follow their usual practice. Data will be collected at baseline (T0), immediately post-intervention (T1), and 6 months after the intervention has finished (T2). Children's movement competence is the primary outcome in this trial. Secondary outcomes include physical activity, perceived competence, motivation, executive functions, and self-regulation. An extensive process evaluation will also examine implementation factors such as intervention context, reach, dose, fidelity and acceptability.

DISCUSSION

The SAMPLE-PE project will enable better understanding surrounding how to operationalise physical literacy through enrichment of PE practices in early PE. The study will provide robust scientific evidence regarding the efficacy of underpinning PE pedagogy with theories of motor learning to promote the development of physical literacy.

TRIAL REGISTRATION

Retrospectively registered on 5th September 2018 at ClinicalTrials.gov, a resource provided by the U.S. National Library of Medicine (Identifier: NCT03551366).

Autonomic Stress Response and Perceived Effort Jointly Inform on Dual Tasking in Aging

The study investigated, through neuroendocrinological, subjective and behavioral assessments, how aging individuals cope with locomotor-cognitive dual-tasking and whether physical activity habits influence the acute response to locomotor-cognitive performance. Seventy-nine healthy participants aged 55–85 years were assessed on locomotor (gait speed, stride length) and cognitive (working memory) performances under single- and dual-task (ST, DT) conditions, and habitual physical activity (daily steps). Rating of perceived exertion (RPE) was assessed immediately after performance. Salivary α-amylase (sAA) was measured prior, immediately and 5 min after performance. Gait and working memory variables, the area under the curve of sAA (AUC) and DT–ST differences (DT effects) were computed. AUC was higher when the ST or DT performance involved a locomotor component and showed a pre-to-post increment after DT only, whereas RPE was higher when performance involved a cognitive component. Daily steps neither predicted sAA, nor RPE. Associations between DT effects on sAA, RPE and performance emerged in high-active participants only. In aging individuals, DT walking elicits an autonomic stress response presumably led by the challenge to share resources relying upon common neural substrates. This autonomic response seems tuned to gait performance and subjective evaluation of effort in those more accustomed to walking.

Exercise, sports, and performance arts benefit cognition via a common process

Exercise training is widely promoted as a method to enhance both physical health and cognitive function. Although routine exercise engenders physiological adaptations to the body and brain, its effects on mental processing are uncertain. Our review of the experimental evidence reveals that acknowledging the role of skill acquisition may help clarify the exercise-cognition relation. Instructional methods that optimize physical and mental challenge provide the conditions necessary to produce long-term changes in the way individuals process information, make decisions, select movements, and experience the consequences of actions. Main conclusions drawn by intersecting theory-based research on the linkages between chronic exercise and cognitive function and research on the associations of both sport and performance arts with cognitive function are as follows: (1) Exercise may be but one of many types of movement activities that can benefit cognition; (2) the process of skill acquisition provides a parsimonious explanation for outcomes across exercise, sport, and performing art studies; (3) the allocation of mental resources required during skill acquisition, independently from or interactively with the level of physical energy expenditure, is essential for reaping the largest cognitive benefits; and (4) cognitive benefits obtained via skill-acquisition interventions are enduring. This review also highlights issues that call for future research to provide convergent evidence for the relation between skill training and cognition; the inclusion of outcome measures other than executive functions; and a naturalistic translational approach to complement controlled experiments in chronic exercise and cognition and skill learning research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Effects of a Judo Training on Functional Fitness, Anthropometric, and Psychological Variables in Old Novice Practitioners

This study aimed to investigate the effects of a 4-month judo training (1 hr session, biweekly) on physical and mental health of older adults (69.7 ± 4.2 years). Participants (N = 30) were assigned to a judo novice practitioners group (n = 16) or a control group (n = 14), which did not receive any training. Before and after the program, they underwent anthropometric (body mass index and waist and hip circumferences); functional fitness (upper and lower body flexibility and strength, coordination); and psychological assessments (perceived physical and mental health, body image, and fear of falling). The judo group showed reductions of waist circumference (Δ = -1%, d = 0.2) and improvements for lower and upper body flexibility (Δ = +69%, d = 0.4 and Δ = +126%, d = 0.5, respectively) and strength (Δ = +12%, d = 0.6 and Δ = +31%, d = 1.6, respectively). The control group showed a decline in lower body strength (Δ = -12%, d = 0.8). Psychological variables did not reveal statistically significant effects. Judo seems beneficial for improving anthropometric and functional fitness variables, relevant aspects of successful aging.

How Older Adults Cope with Cognitive Complexity and Environmental Constraints during Dual-Task Walking: The Role of Executive Function Involvement

This cross-sectional study investigated the interactive dual-task (DT) effects of executive function demands and environmental constraints on older adults' walking and the moderating role of habitual physical activity (PA). Locomotor performance under different environmental constraints (flat versus obstructed walking) and cognitive performance with different executive function involvement (backward counting versus random number generation) were assessed under single-task (ST) and DT conditions in 135 participants (mean age 68.1 ± 8.4). The weekly number of daily steps was measured. Reciprocal DT effects of walking on cognitive performance and of the cognitive task on gait performance were computed and submitted to analyses of covariance with age, PA level, and cognitive functioning as covariates, followed by linear regressions with PA level as predictor. Cognitive task demands and environmental constraints individually and jointly affected gait variability (p = 0.033, ηp2 = 0.08) and executive function performance (p = 0.009, ηp2 = 0.09). Physical activity level predicted a low but significant percentage of variance of DT effects on gait only in flat walking (R2 = 0.04, p = 0.027). Results suggest that older individuals may adopt variable task prioritization in dual tasking depending on the type of executive function involvement and the environmental constraints on walking. Their DT ability was slightly affected by habitual PA.

Associations of Class-Time Sitting, Stepping and Sit-to-Stand Transitions with Cognitive Functions and Brain Activity in Children

Previous research showed that children’s physical activity is positively related to executive functions, whilst screen time shows negative associations. However, it is unclear how school-based sitting time and transitions from sitting to standing relate to cognition. We investigated the relationship between class time sitting/stepping/sit-to-stand transitions and cognitive functions in Grade 1–2 children. Overall, 149 children (7.7 ± 0.6 years old, 54% boys) participated. Measures included class time sitting/stepping/sit-to-stand transitions and: (i) response inhibition (i.e., response time and accuracy); (ii) lapses of attention; (iii) working memory; and (iv) brain activity (cortical haemodynamic response). Linear mixed-models, adjusting for age, sex, and clustering at the classroom level, found that more sitting time was associated with higher lapses of attention (β = 0.12, p < 0.05). Children who stepped more had quicker inhibition response time (β = −0.95, p < 0.01); however, they were less accurate in their responses (β = −0.30, p < 0.05) and this was also observed with sit-to-stand transitions (β = −0.26, p < 0.05). No associations were found with brain activity. In conclusion, reducing and breaking up sitting may help keep children focused, but the evidence regarding response inhibition is unclear.

Feasibility of breaking up sitting time in mainstream and special schools with a cognitively challenging motor task

BACKGROUND

Children spend ≤70% of the school day sitting in class. Classroom-based active breaks can benefit children's physical health, but if the breaks are cognitively demanding (i.e., combine physical exertion and mental engagement), they may also improve focus and cognitive functions. Teachers and students play a crucial role in the successful implementation of active breaks, and their perspectives are critical to the feasibility of these strategies. The aim of this study was to assess the feasibility of implementing a cognitively challenging motor task as an active break in mainstream and special primary schools.

METHODS

A total of 5 teachers in 2 mainstream schools and 7 teachers in 1 special school (attended by children with neurodevelopmental disorders) attended a 20-min training on how to implement a 4-min cognitively challenging active break, before conducting a feasibility trial (twice a day for 1 week). To understand individual perceptions, one-on-one semistructured interviews were conducted before and after the trial with teachers, and focus group interviews were conducted with typically developing children after the trial. Questions were based on a predefined framework for feasibility studies. All interviews were audio recorded, transcribed and analyzed in NVivo 11 using a framework approach. A total of 12 teachers (11 females; 7 between 20 and 34years old) and 34 children (16 girls; 9.3 ± 1.7years, mean ± SD) participated in the interviews.

RESULTS

In mainstream schools, teachers viewed the cognitively challenging motor task as appropriate and potentially beneficial for children's health and focus. Children reported enjoying the active breaks. Teachers in special schools viewed the task as complex and potentially frustrating for children. In both school types, children's disruptive behavior and lack of time were seen as the main potential barriers to implementation. The use of music, videos, visual cards, and support staff were noted as potential facilitators.

CONCLUSION

The cognitively challenging motor task was a feasible way to interrupt children's sitting time and promote physical activity in mainstream schools, but required changes in special schools. Further research could investigate the effectiveness of these types of task interruptions on children's physical and cognitive health.

Chronic participation in externally paced, but not self-paced sports is associated with the modulation of domain-general cognition

The present study investigated the role of chronic sport participation in the modulation of vigilance and inhibitory control. We also aimed to disentangle the relative contribution of different types of sport expertise and sport-related fitness to the exercise-cognition relationship. Three groups of young adults differing in their chronic sport expertise (externally-paced sports, n = 22, self-paced sports, n = 22, non-athletes, n = 22) took part in the study. Participants completed a cardiovascular fitness test, a hand-eye coordination test and two different types of vigilance tasks: (1) Psychomotor Vigilance Task (PVT) and (2) Oddball Task, which were designed to gain insight into the cognitive processes involved in sustaining attention over time and allocating selective attention by exerting inhibitory control, respectively. No differences were found in PVT performance between the two athlete groups and between self-paced sports athletes and non-athletes, whereas athletes from externally-paced sports outperformed non-athletes. Crucially, athletes from externally-paced sports also differed from those of self-paced sports and non-athletes in the Oddball task, showing less omission and commission errors. The sport expertise effect was independent of participant's cardiovascular fitness while hand-eye coordination modulated vigilance and inhibitory control performance. Our findings add novel empirical evidence to the role of expertise in cognitively demanding sports as an important factor in the relationship between exercise and cognition.

Abstract P3-11-04: A model to predict high-risk Oncotype DX scores as defined by the TailorX trial: A report from the National Cancer Data Base

Background: Results from the TailorX clinical trial demonstrated a survival benefit of chemotherapy in those with high-risk (&gt;25) Oncotype DX scores as well as in some patients ≤50yo with intermediate (16-25) scores. The objective of this study was to develop a model that could predict a high-risk Oncotype DX score based on tumor features alone.

Methods: From 2010-2015, 84,549 breast cancer patients with Oncotype DX scores were selected from the National Cancer Data Base. Seven pathologic variables including age, estrogen and progesterone receptor status, histologic subtype, lymphovascular invasion (LVI), grade, and tumor size were used to predict high-risk (&gt;25) Oncotype DX scores using logistic regression. A similar analysis was performed on women ≤50yo to predict low (&lt;15) and intermediate (16-25) scores. Nomograms were created for models using bootstrap estimation method of the model coefficients. Cutoffs with at least 80% positive predictive value (PPV) were chosen to classify patients into high or low-risk Oncotype DX score groups. Accuracy of these predictions were developed in a training set and validated in a testing set.

Results: For patients &gt;50yo, 6,658 (15.1%) of patients had high-risk Oncotype DX scores. The model yielded a moderately strong C-index of 0.80 for Oncotype DX score of &gt;25. For women ≤50yo, 2,044 (13.5%) were high-risk, 5,760 (38.1%) were intermediate-risk and 7,316 (48.4%) were low-risk. The C-index for women ≤50yo was 0.81 for prediction of Oncotype DX score of &gt;25. C-indexes for intermediate and low risk scores were not strong enough to use for prediction (0.54 and 0.67). Estrogen receptor status, progesterone receptor status and grade were the strongest independent predictors of high-risk Oncotype DX scores in women &gt;50yo and ≤50yo. Age was not a good predictor of high-risk scores in women &gt;50yo. When our nomogram was used in the training set, the PPV of a high-risk Oncotype score was 80% with a negative predictive value (NPV) of 87%, sensitivity of 19% and specificity of 99%. In the testing set, PPV was 81%, with a NPV of 87%, sensitivity of 19% and specificity of 99%.

Conclusion: A model incorporating tumor factors can predict a high-risk Oncotype DX score as defined by the recent TailorX trial in all age groups. The model is of limited value in predicting intermediate-risk Oncotype DX scores in women of age ≤50. In resource-constrained healthcare systems, such a model can help identify high risk patients who would benefit from adjuvant chemotherapy without incurring the cost of an Oncotype DX test.

Citation Format: Pesce C, Kuchta K, Wang E, Yao K, El-Tamer M. A model to predict high-risk Oncotype DX scores as defined by the TailorX trial: A report from the National Cancer Data Base [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-11-04.

Embodied time: Time production in advanced Quadrato and Aikido practitioners

Over the last few years, several studies have investigated the possible effects of mindfulness meditation on time perception. Mindfulness meditation has been linked to both longer time production (TP) and increased bodily perception, and bodily processes are in turn thought to lie at the core of human time perception. Nevertheless, the connection between mindful movements (MMs; i.e., specific types of mind-body coordination-demanding physical activity) and time perception has been ignored. Consequently, in the current study we examined the effect of MMs on TP. A mixed observational study design was adopted to investigate whether (1) the extensive practice of MMs is associated with longer TP and interlimb coordination efficiency, and (2) there is a relationship between these two variables. Thirty-four healthy adults volunteered, including 11 Aikido and nine advanced Quadrato Motor Training (aQMT) practitioners, and 14 physically non-active controls. Practitioners of aQMT had significantly longer produced durations in contrast to the Aikido and control groups. In addition, longer produced duration was associated with increased coordination efficiency. In conclusion, the current results are in line with previous studies linking embodied time and mindful meditation, and suggest the importance of incorporating movement meditation, especially in the context of time estimation and the self.

Effects of physical activity interventions on cognitive and academic performance in children and adolescents: a novel combination of a systematic review and recommendations from an expert panel

OBJECTIVE

To summarise the current evidence on the effects of physical activity (PA) interventions on cognitive and academic performance in children, and formulate research priorities and recommendations.

DESIGN

Systematic review (following PRISMA guidelines) with a methodological quality assessment and an international expert panel. We based the evaluation of the consistency of the scientific evidence on the findings reported in studies rated as of high methodological quality.

DATA SOURCES

PubMed, PsycINFO, Cochrane Central, Web of Science, ERIC, and SPORTDiscus.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

PA-intervention studies in children with at least one cognitive or academic performance assessment.

RESULTS

Eleven (19%) of 58 included intervention studies received a high-quality rating for methodological quality: four assessed effects of PA interventions on cognitive performance, six assessed effects on academic performance, and one on both. All high-quality studies contrasted the effects of additional/adapted PA activities with regular curriculum activities. For cognitive performance 10 of 21 (48%) constructs analysed showed statistically significant beneficial intervention effects of PA, while for academic performance, 15 of 25 (60%) analyses found a significant beneficial effect of PA. Across all five studies assessing PA effects on mathematics, beneficial effects were reported in six out of seven (86%) outcomes. Experts put forward 46 research questions. The most pressing research priority cluster concerned the causality of the relationship between PA and cognitive/academic performance. The remaining clusters pertained to PA characteristics, moderators and mechanisms governing the 'PA-performance' relationship and miscellaneous topics.

CONCLUSION

There is currently inconclusive evidence for the beneficial effects of PA interventions on cognitive and overall academic performance in children. We conclude that there is strong evidence for beneficial effects of PA on maths performance.The expert panel confirmed that more 'high-quality' research is warranted. By prioritising the most important research questions and formulating recommendations we aim to guide researchers in generating high-quality evidence. Our recommendations focus on adequate control groups and sample size, the use of valid and reliable measurement instruments for physical activity and cognitive performance, measurement of compliance and data analysis.

PROSPERO REGISTRATION NUMBER

CRD42017082505.

Academic Achievement and Physical Activity: A Meta-analysis

CONTEXT

The effect of physical activity (PA) on different areas of academic achievement and classroom behaviors and how different characteristics of PA interventions could modify the effect remain unclear.

OBJECTIVE

The objective was twofold: (1) to assess the effect of PA interventions on academic achievement and classroom behaviors in childhood and (2) to determine the characteristics of individuals and PA programs that enhance academic performance.

DATA SOURCES

We identified studies from the database inception to October 16, 2016.

STUDY SELECTION

We selected intervention studies aimed at examining the effect of exercise on academic achievement and classroom behaviors at developmental age.

DATA EXTRACTION

Random-effects models were used to calculate pooled effect size for all primary outcomes (language- and mathematics-related skills, reading, composite score, and time in on-task behavior). Positive values represent a direct relationship between PA programs and academic achievement scores or on-task behaviors.

RESULTS

A total of 26 studies (10 205 children, aged from 4 to 13) were included. Pooled effect size (95% confidence interval) estimates were as follows: (1) 0.16 (-0.06 to 0.37) for language-related skills; (2) 0.21 (0.09 to 0.33) for mathematics-related skills; (3) 0.13 (0.02 to 0.24) for reading; (4) 0.26 (0.07 to 0.45) for composite scores; and (5) 0.77 (0.22 to 1.32) for time in on-task behaviors.

LIMITATIONS

Limitations included the variety of tools used to measure academic achievement and the limited number of studies that reported the effect of after-school PA interventions.

CONCLUSIONS

PA, especially physical education, improves classroom behaviors and benefits several aspects of academic achievement, especially mathematics-related skills, reading, and composite scores in youth.

From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis

BACKGROUND

Evidence-based guidelines published by health authorities for the promotion of health-enhancing physical activity (PA), continue to be implemented unsuccessfully and demonstrate a gap between evidence and policies. This review synthesizes evidence on factors influencing delivery, adoption and implementation of PA promotion guidelines within different policy sectors (e.g., health, transport, urban planning, sport, education).

METHODS

Published literature was initially searched using PubMed, EBSCO, Google Scholar and continued through an iterative snowball technique. The literature review spanned the period 2002-2017. The realist synthesis approach was adopted to review the content of 39 included studies. An initial programme theory with a four-step chain from evidence emersion to implementation of guidelines was tested.

RESULTS

The synthesis furthers our understanding of the link between PA guidelines delivery and the actions of professionals responsible for implementation within health services, school departments and municipalities. The main mechanisms identified for guidance implementation were scientific legitimation, enforcement, feasibility, familiarity with concepts and PA habits. Threats emerged to the successful implementation of PA guidelines at national/local jurisdictional levels.

CONCLUSIONS

The way PA guidelines are developed may influence their adoption by policy-makers and professionals. Useful lessons emerged that may inform synergies between policymaking and professional practices, promoting win-win multisectoral strategies.

The Effect of Physical Activity Interventions on Children's Cognition and Metacognition: A Systematic Review and Meta-Analysis

OBJECTIVE

The objective was twofold: to assess the effect of physical activity (PA) interventions on children's and adolescents' cognition and metacognition; and to determine the characteristics of individuals and PA programs that enhance the development of cognitive and metacognitive functions.

METHOD

We systematically searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, and PsycINFO databases from their inception to October 16, 2016. Intervention studies aimed at examining the exercise-cognition interaction at a developmental age were included in this systematic review and meta-analysis. Random-effects models were used to calculate pooled effect size (ES) values and their corresponding 95% CIs. Subgroup analyses were conducted to examine the effect of participants' and PA programs' characteristics.

RESULTS

A total of 36 studies were included in this systematic review and meta-analysis. Pooled ES estimations were as follows: nonexecutive cognitive functions 0.23 (95% CI = 0.09-0.37); core executive functions 0.20 (95% CI = 0.10-0.30), including working memory (0.14 [95% CI = 0.00-0.27]), selective attention-inhibition (0.26 [95% CI = 0.10-0.41]), and cognitive flexibility (0.11 [95% CI = -0.10 to 0.32]); and metacognition 0.23 (95% CI = 0.13-0.32), including higher-level executive functions (0.19 [95% CI = 0.06-0.31]) and cognitive life skills (0.30 [95% CI = 0.15-0.45]).

CONCLUSION

PA benefits several domains of cognition and metacognition in youth. Curricular physical education interventions and programs aimed at increasing daily PA seem to be the most effective.

Transcriptome and proteome analysis reveal new insight into proximal and distal responses of wheat to foliar infection by Xanthomonas translucens

The molecular details of local plant response against Xanthomonas translucens infection is largely unknown. Moreover, there is no knowledge about effects of the pathogen on the root's transcriptome and proteome. Therefore, we investigated the global gene and protein expression changes both in leaves and roots of wheat (Triticum aestivum) 24 h post leaf infection of X. translucens. This simultaneous analysis allowed us to obtain insight into possible metabolic rearrangements in above- and belowground tissues and to identify common responses as well as specific alterations. At the site of infection, we observed the implication of various components of the recognition, signaling, and amplification mechanisms in plant response to the pathogen. Moreover, data indicate a massive down-regulation of photosynthesis and confirm the chloroplast as crucial signaling hub during pathogen attack. Notably, roots responded as well to foliar attack and their response significantly differed from that locally triggered in infected leaves. Data indicate that roots as a site of energy production and synthesis of various secondary metabolites may actively influence the composition and colonisation level of root-associated microbes. Finally, our results emphasize the accumulation of jasmonic acid, pipecolic acid and/or the downstream mediator of hydrogen peroxide as long distal signals from infected leaves to roots.

Disentangling the relationship between children's motor ability, executive function and academic achievement

Even though positive relations between children's motor ability and their academic achievement are frequently reported, the underlying mechanisms are still unclear. Executive function has indeed been proposed, but hardly tested as a potential mediator. The aim of the present study was therefore to examine the mediating role of executive function in the relationship between motor ability and academic achievement, also investigating the individual contribution of specific motor abilities to the hypothesized mediated linkage to academic achievement. At intervals of ten weeks, 236 children aged between 10 and 12 years were tested in terms of their motor ability (t1: cardiovascular endurance, muscular strength, motor coordination), core executive functions (t2: updating, inhibition, shifting), and academic achievement (t3: mathematics, reading, spelling). Structural equation modelling revealed executive function to be a mediator in the relation between motor ability and academic achievement, represented by a significant indirect effect. In separate analyses, each of the three motor abilities were positively related to children's academic achievement. However, only in the case of children's motor coordination, the mediation by executive function accounted for a significance percentage of variance of academic achievement data. The results provide evidence in support of models that conceive executive function as a mechanism explaining the relationship that links children's physical activity-related outcomes to academic achievement and strengthen the advocacy for quality physical activity not merely focused on health-related physical fitness outcomes, but also on motor skill development and learning.

Psychological determinants of physical activity across the life course: A "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella systematic literature review

Low levels of physical activity (PA) are reported to contribute to the occurrence of non-communicable diseases over the life course. Although psychological factors have been identified as an important category concerning PA behavior, knowledge on psychological determinants of PA is still inconclusive. Therefore, the aim of this umbrella systematic literature review (SLR) was to summarize and synthesize the scientific evidence on psychological determinants of PA behavior across the life course. A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January 2004 to April 2016. SLRs and meta-analyses (MAs) of observational studies investigating the association of psychological variables and PA were considered eligible. Extracted data were evaluated based on importance of determinants, strength of evidence, and methodological quality. The full protocol is available from PROSPERO (Record ID: CRD42015010616). Twenty reviews (14 SLRs and 6 MAs), mostly of moderate methodological quality, were found eligible. Convincing evidence was found for self-efficacy (positive association with PA) in children and adolescents, and stress (negative association with PA) regardless of age. Most of the evidence revealing an association between psychological determinants and PA is probable and limited, mainly due to differences in the definition of PA and of psychological determinants across reviews. Thus, scholars are urged to reach a consensus on clear definitions of relevant psychological determinants of PA, subsuming cultural biases and allowing the possibility to obtain clear interpretations and generalizability of findings. Finally, most psychological determinants should be considered within a larger framework of other multi-level determinants that may interact or mediate some of the effects.

Behavioral determinants of physical activity across the life course: a "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella systematic literature review

Background

Low levels of physical activity (PA) are a global concern and increasing PA engagement is becoming a priority in current public health policies. Despite the large number of studies and reviews available, the evidence regarding the behavioral determinants of PA is still inconclusive. Thus, the aim of this umbrella systematic literature review (SLR) was to summarize the evidence on the behavioral determinants of PA across the life course.

Methods

A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January, 2004 to April, 2016. SLRs and meta-analyses (MAs) of observational studies that investigated the behavioral determinants of PA were considered eligible. The extracted data were assessed based on the importance of the determinants, the strength of evidence, and the methodological quality. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42015010616).

Results

Seventeen reviews on 35 behavioral determinants of PA were eligible for this umbrella SLR. Regardless of age, the most investigated determinants were those related with ‘screen use’ and ‘smoking’. For youth, probable positive evidence emerged for ‘previous PA’ and ‘independent mobility and active transport’ among children and adolescents. For the adult population, ‘transition to university’ and ‘pregnancy/having a child’ showed probable negative associations.

Conclusions

Although the majority of the evidence was limited and most of the determinants were not associated with PA, this umbrella SLR provided a comprehensive overview of the associations between behavioral determinants and PA. Youth should be physically active in the early years and increase active transportation to/from school, independent mobility, and ‘free-range activities’ without adult supervision, whilst adult PA behaviors are mostly influenced by the life events. Finally, more research is needed that incorporates prospective study designs, standardized definitions of PA, objective measurement methods of PA assessment, and the use of interactionist and mediational approaches for the evaluation of different behavioral determinants influencing PA behaviors.

Steps to Health in Cognitive Aging: Effects of Physical Activity on Spatial Attention and Executive Control in the Elderly

The purpose of this study was to investigate whether physical activity (PA) habits may positively impact performance of the orienting and executive control networks in community-dwelling aging individuals and diabetics, who are at risk of cognitive dysfunction. To this aim, we tested cross-sectionally whether age, ranging from late middle-age to old adulthood, and PA level independently or interactively predict different facets of the attentional performance. Hundred and thirty female and male individuals and 22 adults with type 2 diabetes aged 55–84 years were recruited and their daily PA (steps) was objectively measured by means of armband monitors. Participants performed a multifunctional attentional go/no-go reaction time (RT) task in which spatial attention was cued by means of informative direct cues of different sizes followed by compound stimuli with local and global target features. The performance efficiency of the orienting networks was estimated by computing RT differences between validly and invalidly cued trials, that of the executive control networks by computing local switch costs that are RT differences between switch and non-switch trials in mixed blocks of global and local target trials. In regression analyses performed on the data of non-diabetic elderlies, overall RTs and orienting effects resulted jointly predicted by age and steps. Age predicted overall RTs in low-active individuals, but orienting effects and response errors in high-active individuals. Switch costs were predicted by age only, with larger costs at older age. In the analysis conducted with the 22 diabetics and 22 matched non-diabetic elderlies, diabetic status and daily steps predicted longer and shorter RTs, respectively. Results suggest that high PA levels exert beneficial, but differentiated effects on processing speed and attentional networks performance in aging individuals that partially counteract the detrimental effects of advancing age and diabetic status. In conclusion, adequate levels of overall PA may positively impinge on brain efficiency and attentional control and should be therefore promoted by actions that support lifelong PA participation and impact the built environment to render it more conducive to PA.

The Body Fat-Cognition Relationship in Healthy Older Individuals: Does Gynoid vs Android Distribution Matter?

OBJECTIVE

To examine the relationship between regional and whole body fat accumulation and core cognitive executive functions.

DESIGN

Cross-sectional study.

SETTINGS AND PARTICIPANTS

78 healthy men and women aged between 65 and 75 years recruited through consumer's database.

MEASUREMENTS

DXA measured percentage total body fat, android, gynoid distribution and android/gynoid ratio; inhibition and working memory updating through Random Number Generation test and cognitive flexibility by Trail Making test. First-order partial correlations between regional body fat and cognitive executive function were computed partialling out the effects of whole body fat. Moderation analysis was performed to verify the effect of gender on the body fat-cognition relationship.

RESULTS

Results showed a differentiated pattern of fat-cognition relationship depending on fat localization and type of cognitive function. Statistically significant relationships were observed between working memory updating and: android fat (r = -0.232; p = 0.042), gynoid fat (r = 0.333; p = 0.003) and android/gynoid ratio (r = -0.272; p = 0.017). Separating genders, the only significant relationship was observed in females between working memory updating and gynoid fat (r = 0.280; p = 0.045). In spite of gender differences in both working memory updating and gynoid body fat levels, moderation analysis did not show an effect of gender on the relationship between gynoid fat and working memory updating.

CONCLUSIONS

Results suggest a protective effect of gynoid body fat and a deleterious effect of android body fat. Although excessive body fat increases the risk of developing CDV, metabolic and cognitive problems, maintaining a certain proportion of gynoid fat may help prevent cognitive decline, particularly in older women. Guidelines for optimal body composition maintenance for the elderly should not target indiscriminate weight loss, but weight maintenance through body fat/lean mass control based on non-pharmacological tools such as physical exercise, known to have protective effects against CVD risk factors and age-related cognitive deterioration.