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      Sport-2-Stay-Fit study: Health effects of after-school sport participation in children and adolescents with a chronic disease or physical disability

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          Abstract

          Background

          Children and adolescents with a chronic disease or physical disability have lower fitness levels compared to their non-disabled peers. Low physical fitness is associated with reduced physical activity, increased cardiovascular diseases, and lower levels of both cognitive and psychosocial functioning. Moreover, children and adolescents with a chronic disease or physical disability participate less in both recreational and competitive sports. A variety of intervention studies have shown positive, but only temporary, effects of training programs. Next to issues related to the chronic condition itself, various personal and environmental factors play a key role in determining the extent to which they participate in sports or physical activities. Due to these barriers, sport participation in the immediate after-school hours seems to be a feasible solution to get these children and adolescents physical active structurally. To investigate if an after school sport program can sustain the positive effects of an intervention, a standardized interval training will be given to improve physical fitness levels. High-intensity Interval Training (HIT) is superior to moderate-intensity continuous training in improving physical fitness in patients with chronic diseases. Therefore, the Sport-2-Stay-Fit study will investigate whether after school sport participation can increase the sustainability of a HIT program in children and adolescents with a chronic disease or physical disability.

          Methods

          The Sport-2-Stay-Fit study is a clinical controlled trial. A total of 74 children and adolescents in the age of 6–19 years with a chronic disease or physical disability will be included. This could be either a cardiovascular, pulmonary, metabolic, musculoskeletal or neuromuscular disorder. Both children and adolescents who are ambulatory or propelling a manual wheelchair will be included. All participants will follow a HIT program of eight weeks to improve their physical fitness level. Thereafter, the intervention group will participate in sport after school for six months, while the control group receives assessment only. Measurements will take place before the HIT, directly after, as well as, six months later. The primary objective is anaerobic fitness. Secondary objectives are agility, aerobic fitness, strength, physical activity, cardiovascular health, cognitive functioning, and psychosocial functioning.

          Discussion

          If effective, after school sport participation following a standardized interval training could be implemented on schools for special education to get children and adolescents with a chronic disease or physical disability active on a structural basis.

          Trial registration

          This trial is registered at the Dutch Trial Register # NTR4698.

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          Most cited references72

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          Physical fitness and all-cause mortality. A prospective study of healthy men and women.

          We studied physical fitness and risk of all-cause and cause-specific mortality in 10,224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110,482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (slope, -4.5). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years (slope, -5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.
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            Physical activity and performance at school: a systematic review of the literature including a methodological quality assessment.

            To describe the prospective relationship between physical activity and academic performance. Prospective studies were identified from searches in PubMed, PsycINFO, Cochrane Central, and Sportdiscus from 1990 through 2010. We screened the titles and abstracts for eligibility, rated the methodological quality of the studies, and extracted data. Studies had to report at least 1 physical activity or physical fitness measurement during childhood or adolescence. Studies had to report at least 1 academic performance or cognition measure during childhood or adolescence. We identified 10 observational and 4 intervention studies. The quality score of the studies ranged from 22% to 75%. Two studies were scored as high quality. Methodological quality scores were particularly low for the reliability and validity of the measurement instruments. Based on the results of the best-evidence synthesis, we found evidence of a significant longitudinal positive relationship between physical activity and academic performance. Participation in physical activity is positively related to academic performance in children. Because we found only 2 high-quality studies, future high-quality studies are needed to confirm our findings. These studies should thoroughly examine the dose-response relationship between physical activity and academic performance as well as explanatory mechanisms for this relationship.
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              Exercise and Children's Intelligence, Cognition, and Academic Achievement.

              Studies that examine the effects of exercise on children's intelligence, cognition, or academic achievement were reviewed and results were discussed in light of (a) contemporary cognitive theory development directed toward exercise, (b) recent research demonstrating the salutary effects of exercise on adults' cognitive functioning, and (c) studies conducted with animals that have linked physical activity to changes in neurological development and behavior. Similar to adults, exercise facilitates children's executive function (i.e., processes required to select, organize, and properly initiate goal-directed actions). Exercise may prove to be a simple, yet important, method of enhancing those aspects of children's mental functioning central to cognitive development.
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                Author and article information

                Contributors
                m.zwinkels@dehoogstraat.nl
                o.verschuren@dehoogstraat.nl
                kristel.lankhorst@hu.nl
                karin.vanderende-kastelijn@hu.nl
                Janke.degroot@hu.nl
                F.J.G.Backx@umcutrecht.nl
                J.M.A.Visser-Meily@umcutrecht.nl
                +31 (0)88 7554030 , t.takken@umcutrecht.nl
                Journal
                BMC Sports Sci Med Rehabil
                BMC Sports Sci Med Rehabil
                BMC Sports Science, Medicine and Rehabilitation
                BioMed Central (London )
                2052-1847
                6 October 2015
                6 October 2015
                2015
                : 7
                : 22
                Affiliations
                [ ]Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands
                [ ]Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands
                [ ]Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
                [ ]Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, the Netherlands
                [ ]Child Development and Exercise Center, University Medical Center Utrecht, Wilhelmina Children’s Hospital, P.O. Box 85090, 3508 AB Utrecht, the Netherlands
                Article
                16
                10.1186/s13102-015-0016-7
                4594646
                25973205
                25cd4f3c-5fc3-4dcf-9e64-c2ee214676e5
                © Zwinkels et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 August 2015
                : 23 September 2015
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2015

                children,adolescents,physical fitness,health,chronic disease,physical disability,interval training,exercise,sport participation

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