State laws governing school physical education in relation to attendance and physical activity among students in the USA: A systematic review and meta-analysis

BackgroundThis study systematically synthesized and quantified the relationship linking state laws governing school physical education (PE) to PE attendance and physical activity (PA) in class and throughout the day and week among students in the USA.MethodsA keyword search was performed in PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Complete, and EconLit. Meta-analyses were performed to estimate the effects of state PE laws.ResultsA total of 17 studies were included in the review, and five contributed to the meta-analyses. A total of 8 studies used nationally representative school- or student-level data, three focused on multiple states, and the remaining six examined the PE laws of a single state. The presence and strength of state PE laws were positively associated with PE attendance and the frequency and duration of PA during PE classes and throughout the school day. Compared to those residing in states with weak or no PE laws, students in states with strong PE laws had an additional 0.2 days (95% confidence interval (95%CI): 0.1–0.4) of PE attendance per week and spent an additional 33.9 min (95%CI: 22.7–45.0) participating PE classes per week. State PE laws affected girls’ PA more than boys’. Different aspects of state PE laws tended to affect students’ PE attendance differently. Disparities in the implementation of state PE laws existed across schools.ConclusionFuture studies should adopt objective measures on PE and PA participation and examine the roles schools and districts play in mediating the effect of state PE laws on students’ PE attendance and PA.     

Exercise interventions for older adults: A systematic review of meta-analyses

Background:The evidence concerning which physical exercise characteristics are most effective for older adults is fragmented.We aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of metaanalyses of exercise interventions in older adults.Methods:We searched the Cochrane Database of Systematic Reviews,PsycInfo,MEDLINE,Embase,CINAHL,AMED,SPORTDiscus,and Web of Science for articles that met the following criteria:(1)meta-analyses that synthesized measures of improvement(e.g.,effect sizes)on any outcome identified in studies of exercise interventions;(2)participants in the studies meta-analyzed were adults aged 65+or had a mean age of 70+;(3)meta-analyses that included studies of any type of exercise,including its duration,frequency,intensity,and mode of delivery;(4)interventions that included multiple components(e.g.,exercise and cognitive stimulation),with effect sizes that were computed separately for the exercise component;and(5)meta-analyses that were published in any year or language.The characteristics of the reviews,of the interventions,and of the parameters improved through exercise were reported through narrative synthesis.Identification of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the reviews.The study included 56 meta-analyses that were heterogeneous in relation to population,sample size,settings,outcomes,and intervention characteristics.Results:The largest effect sizes for improvement were found for resistance training,meditative movement interventions,and exercise-based active videogames.Conclusion:The review identified important gaps in research,including a lack of studies investigating the benefits of group interventions,the characteristics of professionals delivering the interventions associated with better outcomes,and the impact of motivational strategies and of significant others(e.g.,carers)on intervention delivery and outcomes.     

Association between physical activity and digestive-system cancer: An updated systematic review and meta-analysis

BackgroundPhysical activity (PA) may have an impact on digestive-system cancer (DSC) by improving insulin sensitivity and anticancer immune function and by reducing the exposure of the digestive tract to carcinogens by stimulating gastrointestinal motility, thus reducing transit time. The current study aimed to determine the effect of PA on different types of DSC via a systematic review and meta-analysis.MethodsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched for relevant studies in PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. Using a random effects model, the relationship between PA and different types of DSC was analyzed.ResultsThe data used for meta-analysis were derived from 161 risk estimates in 47 studies involving 5,797,768 participants and 55,162 cases. We assessed the pooled associations between high vs. low PA levels and the risk of DSC (risk ratio (RR)  = 0.82, 95% confidence interval (95%CI): 0.79–0.85), colon cancer (RR = 0.81, 95%CI: 0.76–0.87), rectal cancer (RR = 0.88, 95%CI: 0.80–0.98), colorectal cancer (RR = 0.77, 95%CI: 0.69–0.85), gallbladder cancer (RR = 0.79, 95%CI: 0.64–0.98), gastric cancer (RR = 0.83, 95%CI: 0.76–0.91), liver cancer (RR = 0.73, 0.60–0.89), oropharyngeal cancer (RR = 0.79, 95%CI: 0.72–0.87), and pancreatic cancer (RR = 0.85, 95%CI: 0.78–0.93). The findings were comparable between case-control studies (RR = 0.73, 95%CI: 0.68–0.78) and prospective cohort studies (RR = 0.88, 95%CI: 0.80–0.91). The meta-analysis of 9 studies reporting low, moderate, and high PA levels, with 17 risk estimates, showed that compared to low PA, moderate PA may also reduce the risk of DSC (RR = 0.89, 95%CI: 0.80–1.00), while compared to moderate PA, high PA seemed to slightly increase the risk of DSC, although the results were not statistically significant (RR = 1.11, 95%CI: 0.94–1.32). In addition, limited evidence from 5 studies suggested that meeting the international PA guidelines might not significantly reduce the risk of DSC (RR = 0.96, 95%CI: 0.91–1.02).ConclusionCompared to previous research, this systematic review has provided more comprehensive information about the inverse relationship between PA and DSC risk. The updated evidence from the current meta-analysis indicates that a moderate-to-high PA level is a common protective factor that can significantly lower the overall risk of DSC. However, the reduction rate for specific cancers may vary. In addition, limited evidence suggests that meeting the international PA guidelines might not significantly reduce the risk of DSC. Thus, future studies must be conducted to determine the optimal dosage, frequency, intensity, and duration of PA required to reduce DSC risk effectively.     

Sports mega-event legacies and adult physical activity: A systematic literature review and research agenda

Sports mega-events, such as the Olympic and Paralympic Games, have the potential to inspire increases in population physical activity, yet investigations concerning such legacy outcomes have been inconclusive. This may be due to research design limitations or inconsistent leveraging of potential hosting benefits by event organizers. This systematic review aims to identify current knowledge about the capacity of sports mega-events to inspire increases in physical activity participation among adult populations and develop a research agenda to guide future legacy evaluations. Peer-reviewed, English-language studies published on or after the year 2000 were considered. Six academic databases and grey literature sources were searched, and articles were assessed for methodological quality. Reporting followed PRISMA conventions for systematic reviews. Nine studies were selected after quality evaluation, including previous reviews, quantitative and qualitative research. Most studies found no evidence for long-term physical activity outcomes associated with hosting sports mega-events, although limitations and gaps were identified. These included lack of longitudinal or cohort studies, limited differentiation of subpopulations, use of non-validated instruments, and lack of triangulation for qualitative findings. Only one cohort study from Japan identified sustainable and significant physical activity increases resulting from a previous sports mega-event. Considering theory, the commonly cited Demonstration Effect was reportedly an unreliable framework, although the Festival Effect and Social Ecological Model appear more promising for anticipating and explaining legacy effects. With less than two years until the Tokyo 2020 Olympiad, it is appropriate to commence high-quality legacy research drawing on lessons learned from previous studies.     

A critical review of national physical activity policies relating to children and young people in England

BackgroundThere has been an increasing focus on the importance of national policy to address population levels of physical inactivity. It has been suggested that the 4 cornerstones of policy comprise (1) national guidelines on physical activity (PA), (2) setting population goals and targets, (3) surveillance or health-monitoring systems, and (4) public education. The current study aimed to review the policy actions that have addressed each of these elements for children and youth in England and to identify areas of progress and remaining challenges.MethodsA literature search was undertaken to identify past and present documents relevant to PA policy for children and youth in England. Each document was analyzed to identify content relevant to the 4 cornerstones of policy.ResultsPhysical activity guidelines (Cornerstone 1) for children and youth have been in place since 1998 and reviewed periodically. Physical activity targets (Cornerstone 2) have focussed on the provision of opportunities for PA, mainly through physical education in schools rather than in relation to the proportion of children meeting recommended PA levels. There has been much surveillance (Cornerstone 3) of children''s PA, but this has been undertaken infrequently over time and with varying inclusions of differing domains of activity. There has been only 1 campaign (Cornerstone 4) that targeted children and their intermediaries, Change4Life, which was an obesity campaign focussing on dietary behavior in combination with PA. Most recently, a government infographic supporting the PA guidelines for children and young people was developed, but details of its dissemination and usage are unknown.ConclusionThere have been many developments in national PA policy in England targeted to children and young people. The area of most significant progress is national PA guidelines. Establishing prevalence targets, streamlining surveillance systems, and investing in public education with supportive policies, environments, and opportunities would strengthen national policy efforts to increase PA and reduce sedentary behavior.     

Association between fundamental motor skills and physical activity in the early years: A systematic review and meta-analysis

BackgroundPhysical activity (PA) in the early years is associated with a range of positive health outcomes. Fundamental motor skill (FMS) competence is associated with PA and is theorized to be driven by PA in the early years and vice versa in mid to late childhood. However, to date, no studies have meta-analyzed the association between PA and FMS in the early years.MethodsSix electronic databases were searched for articles published up to April 2019. Cross-sectional and longitudinal studies were included if they targeted children (ages 3–6 year) as the population of the study and assessed the association between objectively measured PA and FMS. Total FMS, total physical activity (TPA), and moderate-to-vigorous physical activity (MVPA) data were meta-analyzed using a random effects model.ResultsWe identified 24,815 titles and abstracts. In total, 19 studies met the inclusion criteria, including 14 cross-sectional and 4 longitudinal studies, as well as 1 study with cross-sectional and longitudinal analysis. There was a significant but small positive association between FMS and MVPA (r = 0.20, 95% confidence interval (CI): 0.13–0.26) and TPA (r = 0.20, 95%CI: 0.12–0.28). Findings from longitudinal studies revealed that PA drives FMS in early childhood. Mediation was explored in 1 study, which found that perceived motor competence did not mediate the association between FMS and PA.ConclusionUsing a meta-analysis, this study is the first to show a positive association between FMS, MVPA, and TPA in the early years of childhood, suggesting that the association begins at an early age. Limited evidence from longitudinal studies supports the theory that PA drives FMS in the early years of childhood. More evidence is needed from large studies to track PA and FMS until mid to late childhood and to explore the mediators of this association.     

Correlates of physical activity in youth: a review of quantitative systematic reviews

To increase young people's physical activity (PA) levels it is important to understand the correlates of PA in children and adolescents. We sought to identify factors associated with children's and adolescents’ PA by reviewing systematic quantitative reviews of non-intervention research. Systematic reviews examining associations between quantitatively measured variables and PA in young people (< 19 years) from 2000–2010 were identified using electronic and manual searches. Nine systematic reviews were identified. Demographic/biological correlates of PA were age and gender. Psychological correlates of PA were positive motivation, positive body image and the existence of barriers to PA. Behavioural correlates of PA were previous PA, sport participation, smoking, and sedentary behaviour. Social/cultural correlates of PA were parental influence and social support, and environmental correlates of PA were access to facilities, distance from home to school, time spent outside, and local crime. The evidence is suggestive of a number of different types of correlates of PA for children and adolescents. Beyond age and gender, though, most are likely to have only small or small-to-moderate effects in isolation and may work best in interaction with other influences. Psychologists must look to social, organisational and community-level correlates in addition to individual correlates.     

Fundamental motor skills: A systematic review of terminology

The three aims of this systematic review are to describe: (1) use of the term fundamental motor/movement skills (FMS) in published articles; (2) the quality of definitions; and (3) relative use of process- and product- oriented assessments to measure FMS. The inclusion criteria included: (a) peer-reviewed article, (b) printed in English, (c) published between January 2000 and 31 December 2015, (d) presence of either the term “fundamental motor or movement skill” in the title and/or abstract, and (e) FMS were a measured outcome. There has been an increase in the number of publications on FMS in recent years, with the majority of studies conducted in Australia (n = 41, 33%). Approximately 24% of studies (n = 30) did not provide any explicit definition of FMS. A majority of studies reported the use of process-oriented measures (n = 98, 79%) compared to product-oriented measures (n = 23, 19%), and few studies used both (n = 6, 5%). We recommend that researchers provide: (1) an operational definition of FMS that states FMS are the “building blocks” (or similar terminology) of more advanced, complex movements; (2) specific categories of skills that compose FMS; and (3) at least one specific example of a FMS.     

Relationship between school rhythm and physical activity in adolescents: the HELENA study

The aim was to assess the relationship between school rhythm and physical activity (PA) in adolescents. The study included 2024 adolescents (12.5–17.4 years). Participants wore an accelerometer for 7 days. A short school rhythm was defined as a short time at school with short recesses and less time in teaching per day (Group 1). A long school rhythm was defined as a longer time at school with more time in teaching and recess (Group 2). Adolescents in Group 1 performed less moderate to vigorous PA (MVPA) than those in Group 2 per week (P < .0001), especially during school days (recess: 3.9 ± 4.0 vs. 9.8 ± 7.9 min · day^?1; P < .0001; teaching hours: 14.5 ± 9.8 vs. 19.1 ± 12.0 min · day^?1; P < .0001). Adolescents in Group 1 were less likely to meet the PA recommendations than were adolescents in Group 2: 30.7% vs. 34.1% (P < .0001). During school days, the percentage of adolescents who spent more than 2 h · day^?1 in sedentary activities was greater in the Group 1 (P < .001). Our results suggest that leisure-time out-of-school hours is used mainly for sedentary activities, and that school time provides a good opportunity for promoting PA.     

Get moving! A comparison of ideas about body,health and physical activity in materials produced for health education in the Danish Primary School

In the debate over health, one political message has become more and more dominant in western societies over the past decade: Get moving! The logic seems to be that physical activity per se equals better health and that the more physical activity, the better one's health. This logic has, among other things, induced an increased political focus on educational settings and physical education (PE) as a central place for promoting health by increasing physical activity. Today PE is often explicitly identified with health in contemporary school curricula, and this means that PE teachers unavoidably encounter contemporary perceptions of health and physical activity in their professional practice. Taking as its starting point four different teaching resources produced for health education in the Danish Primary School, this article presents four different health cultures and their recommendations for physical activity as a health-promoting practice. The aim is to challenge current perceptions of health and the related recommendations for physical activity in providing a springboard for health communicators and PE teachers to reflect on the health cultures they encounter and maybe to consider how these aligns their own preferred health culture.     

The global physical inactivity pandemic: an analysis of knowledge production

In July 2012, The Lancet announced a pandemic of physical inactivity and a global call to action to effect change. The worldwide pandemic is said to be claiming millions of lives every year. Asserting that physical inactivity is pandemic is an important moment. Given the purported scale and significance of physical inactivity around the world, this research examines how the pandemic is rhetorically constructed and how various solutions are proposed. We apply a governmentality perspective to examine the continuity, coherence and appropriateness of ideas about physical activity. The analysis demonstrates that within The Lancet, there is disunity about what is known about physical activity, problematic claims of ‘abnormality’ and contradictions in the proposed deployment of a systems approach to solve the problem. The article concludes by suggesting that as knowledge produced about physical activity grows, scholars need to beware of nostalgic conceptions of physical activity, account for the immense diversity of lived experiences which do not abide by idealistic recommendations and consider more rigorously contentious claims about physical activity programme effects.     

From evidence to policy: reflections on emerging themes in health-enhancing physical activity

Based on a detailed reading of the six preceding papers, in conjunction with a reflection on the socio-political forces shaping lifestyles in the UK at the turn of the millennium, we come to four interrelated conclusions. First, sport and exercise science needs to move beyond evidence-based practice to evidence-based policy. Second, sport and exercise science needs to make health-enhancing physical activity a political issue at both national and local level. Third, transport, not health policy, may be the key to promoting health-enhancing physical activity. And, fourth, young people deserve our special attention. In reaching these four interrelated conclusions, we attempt both to shape evidence based policy and future research agendas in exercise science. To achieve an international perspective, we also present a short case note from Australia.     

Sport event legacy: A systematic quantitative review of literature

The study of sport event legacies has grown rapidly since 2000 across a number of disciplines related to planning and hosting large-scale sport events. However, to date, there have been limited attempts to systematically review and synthesise extant sport event legacy research, reflect on existing knowledge, and identify key gaps for future research. In this article, the authors reviewed the state of sport event legacy research through a systematic quantitative review of 305 original, peer-reviewed research articles published in English language journals between 2000 and 2016. Results demonstrate that a small group of academics concentrated in particular countries are driving the publication of studies on sport event legacy in predominately specialised sport and event journals. There is a clear research interest in legacy outcomes realised through hosting sport events in areas of public life, politics, and culture, as well as mass participation sport. The authors identify key areas for future research and make recommendations for empirical research designs to progress scholarship and better inform policy and practice pertaining to sport event legacy.     

Influences of volitional and forced intentions on physical activity and effort within the theory of planned behaviour

Abstract

In the present study, we examined the utility of volitional and forced intentions in predicting participation in physical activities and effort within the theory of planned behaviour. Four hundred and forty-four participants (184 males, 260 females) aged 19.1 ± 3.3 years (mean ± s) completed self-report measures of intentions, attitudes, subjective norms, perceived behavioural control, volitional intentions, forced intentions, and past behaviour in a physical activity context. Six weeks later, they completed self-report measures of physical activity behaviour and effort. Results indicated that volitional intentions and forced intentions contributed to the prediction of effort over and above intentions, attitudes, subjective norms, perceptions of control, past behaviour, and the product terms of attitudes×intentions and subjective norms×intentions. Volitional intentions and forced intentions did not predict participation in physical activities over and above effort. We concluded that volitional intentions and forced intentions assist in the explanation of effort in the context of physical activity behaviour.     

Loneliness and physical activity: A systematic review

This article aims to provide an overview of the current state of research on the relationship between loneliness and physical activity (PA). A systematic literature search was conducted to identify all empirical studies assessing this relationship. A total of 37 studies stemming from 36 publications met the inclusion criteria. Study analyses comprised an individual consideration of each study and a systematic summarization of the studies. The majority of eligible studies focused on adolescent or elderly populations. Direct negative associations between PA and loneliness were found in half of the 24 cross-sectional studies. Of the seven identified longitudinal studies, one found a direct negative influence of PA on loneliness. Four longitudinal studies found evidence for a reverse influence, namely of loneliness on PA. Five intervention studies found PA to reduce loneliness. Two of the cross-sectional studies and one of the intervention studies found social support and social competence to moderate or to mediate the relationship between PA and loneliness. The findings indicate that PA can contribute to a decrease in loneliness. However, studies also indicate that any beneficial effect is dependent upon the quality of relationships present during physical activity. Additionally, loneliness itself might reduce the probability of being physically active.     

24 h Accelerometry: impact of sleep-screening methods on estimates of sedentary behaviour and physical activity while awake

Although accelerometers can assess sleep and activity over 24 h, sleep data must be removed before physical activity and sedentary time can be examined appropriately. We compared the effect of 6 different sleep-scoring rules on physical activity and sedentary time. Activity and sleep were obtained by accelerometry (ActiGraph GT3X) over 7 days in 291 children (51.3% overweight or obese) aged 4–8.9 years. Three methods removed sleep using individualised time filters and two methods applied standard time filters to remove sleep each day (9 pm–6 am, 12 am–6 am). The final method did not remove sleep but simply defined non-wear as at least 60 min of consecutive zeros over the 24-h period. Different methods of removing sleep from 24-h data markedly affect estimates of sedentary time, yielding values ranging from 556 to 1145 min/day. Estimates of non-wear time (33–193 min), wear time (736–1337 min) and counts per minute (384–658) also showed considerable variation. By contrast, estimates of moderate-to-vigorous activity (MVPA) were similar, varying by less than 1 min/day. Different scoring methods to remove sleep from 24-h accelerometry data do not affect measures of MVPA, whereas estimates of counts per minute and sedentary time depend considerably on which technique is used.     

Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan

ABSTRACT

High-intensity-interval-training (HIIT) has been suggested to have beneficial effects in multiple populations across individual systematic reviews, although there is a lack of clarity in the totality of the evidence whether HIIT is effective and safe across different populations and outcomes. The aim of this meta-review was to establish the benefits, safety and adherence of HIIT interventions across all populations from systematic reviews and meta-analyses. Major databases were searched for systematic reviews (with/without meta-analyses) of randomised & non-randomised trials that compared HIIT to a control. Thirty-three systematic reviews (including 25 meta-analyses) were retrieved encompassing healthy subjects and people with physical health complications. Evidence suggested HIIT improved cardiorespiratory fitness, anthropometric measures, blood glucose and glycaemic control, arterial compliance and vascular function, cardiac function, heart rate, some inflammatory markers, exercise capacity and muscle mass, versus non-active controls. Compared to active controls, HIIT improved cardiorespiratory fitness, some inflammatory markers and muscle structure. Improvements in anxiety and depression were seen compared to pre-training. Additionally, no acute injuries were reported, and mean adherence rates surpassed 80% in most systematic reviews. Thus, HIIT is associated with multiple benefits. Further large-scale high-quality studies are needed to reaffirm and expand these findings.

Abbreviations: ACSM: American College of Sports Medicine; BMI: Body Mass Index; BNP: Brain Natriuretic Peptide; BP: Blood Pressure; CAD: Coronary Artery Disease; CHD: Coronary Heart Disease; COPD: Chronic Obstructive Pulmonary Disease; CRP: c- reactive Protein; CVD: Cardiovascular Disease; DBP: Diastolic Blood Pressure; ES: Effect Size; FAS: Reduced Fatty Acid Synthase; FATP-1: Reduced Fatty Acid Transport Protein 1; FMD: Flow Mediated Dilation; Hs-CRP: High-sensitivity c- reactive Protein; HDL: High Density Lipoprotein; HIIT: High-Intensity Interval Training; HOMA: Homoeostatic Model Assessment; HR: Heart Rate; HTx: Heart Transplant Recipients; IL-6: Interleukin-6; LDL: Low Density Lipoprotein; LV: Left Ventricular; LVEF: Left Ventricular Ejection Fraction; MD: Mean Difference; MetS: Metabolic Syndrome; MPO: Myeloperoxidase; MICT: Moderate-Intensity Continuous Training; NO: Nitric Oxide; NRCT: Non-Randomised Controlled Trial; PA: Physical Activity; PAI-1: Plasminogen-activator-inhibitor-1; QoL: Quality of Life; RCT: Randomised Controlled Trial; RoB: Risk of Bias; RPP: Rate Pressure Product; RT: Resistance Training; SBP: Systolic Blood Pressure; SD: Standardised Difference; SMD: Standardised Mean Difference; TAU: Treatment-As-Usual; T2DM: Type 2 Diabetes Mellitus; TC: Total Cholesterol; TG: Triglycerides; TNF-alfa: Tumour Necrosis Factor alpha; UMD: Unstandardised Mean Difference; WC: Waist Circumference; WHR: Waist-to-Hip Ratio; WMD: Weighted Mean Difference

Key points:

• HIIT may improve cardiorespiratory fitness, cardiovascular function, anthropometric variables, exercise capacity, muscular structure and function, and anxiety and depression severity in healthy individuals and those with physical health disorders.

• Additionally, HIIT appears to be safe and does not seem to be associated with acute injuries or serious cardiovascular events.

     

Organisational factors and non-accidental violence in sport: A systematic review

The objective of the current systematic review was to investigate the organisational factors that enable and motivate non-accidental violence towards athletes in the sport context. The authors identified and reviewed 43 qualitative studies investigating psychological, physical, and sexual abuse of athletes, and developed a framework of organisational factors (i.e., structural, social, and stress factors) related to non-accidental violence. Athletes were the key informants, yet some studies included athletes’ entourages. The authors independently coded the findings sections of the primary research, using the developed framework. Organisational tolerance for abuse and conformity to dominant values within sports were related to all three types of non-accidental violence. Power imbalance appeared as a relevant factor in both psychological and sexual abuse, while isolation was also relevant in sexual abuse. Believing that non-accidental violence had instrumental effects appeared related to both psychological and physical abuse, whereas a winner-take-all reward system was related to physical abuse. Based on this systematic review, the authors proposed an integrated perspective of the organisational factors driving non-accidental violence in sport and conclude by proposing a whole-of-system approach to the prevention and management of non-accidental violence.     

Changing the individual to promote health-enhancing physical activity: the difficulties of producing evidence and translating it into practice

This paper presents conclusions from recent systematic reviews and highlights individually targeted interventions that are effective at increasing physical activity. It discusses the limitations of currently available evidence, considers what factors lead to these limitations and what barriers exist in terms of implementing the evidence as part of local and national policy and practice. Barriers present themselves in terms of getting evidence into practice and in terms of ensuring that practice informs the evidence base. These barriers include difficulties in conducting systematic reviews, disaggregating knowledge from complex interventions, making local adaptations to existing evidence, the lack of an evaluation culture, ethical and pragmatic difficulties in designing interventions, selecting appropriate outcome measures, poor designs and implementation of evidence and, finally, a recognition that policy making is not only based on the available evidence. New and more integrated approaches to evaluation and to practice are needed.     

Participation in sports in childhood and adolescence and physical activity in adulthood: A systematic review

ABSTRACT

The aim of this study was to systematically review the literature to verify the association between participation in sports (PS) in childhood and adolescence and physical activity (PA) in adulthood. A systematic search was conducted in the following databases: Medline (PUBMED), Web of Science, Scopus, and SPORTDiscus, LILACS and SciELO. All steps of the process followed the recommendations of the PRISMA FlowDiagram. After all the steps of the process, 29 articles were included for analysis. In general, only three of the studies analyzed found no relation between PS in childhood and adolescence and PA in adulthood. However, a positive relationship was found to be weak in only 7% of the studies, a moderate relation in 62% of the studies, and a strong relation in 21%. It was found that higher weekly frequencies of PS; persistence of at least three years of PS and, finally, the highest level of practice and/or competition reached were related to higher levels of PA in adulthood. Thus, it can be concluded that there is a positive association considered moderate to strong between PS in childhood and adolescence and PA in adulthood.