Lithuanian Sports University e-Journals
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Achieving the Goal of Best Practice in Football Club Community Trusts: Co-Producing Interventions to Improve Young People’s Mental Health
Full text linkPurpose: Football Club Community Trusts (FCCTs) attached to professional football clubs in the United Kingdom use their sport brand to engage young people in physical activity and support mental health. These interventions have expanded nationwide, yet their feasibility and acceptability remain under-researched. Guided by the Medical Research Council and National Institute for Health and Care Research Framework for Developing and Evaluating Complex Interventions, this study explores stakeholders’ views to identify key features for successful delivery and areas for refinement.
Methods: This qualitative study examined the perspectives of staff and young people involved in mental health-focused interventions across five FCCTs in the English Football League. Semi-structured interviews were conducted with 17 staff members managing or delivering the interventions, and focus groups were held with 19 young participants. Stakeholders engaged in various interventions, such as MENTalk, Safety Nets, and the Premier League-funded Inspires programme. Reflexive thematic analysis was used to analyse the data.
Results: Staff and young people identified five key features of effective programmes: (1) the appeal of the professional club brand, (2) opportunities to play football, (3) using sports-based examples to teach mental health concepts, (4) relatable facilitators as role models, and (5) encouraging open discussions around mental health. Suggested refinements included (1) sustaining participant engagement and (2) increasing interactive activities.
Conclusion: This study provides insight into what makes mental health-focused FCCT interventions acceptable and engaging for young people. Stakeholders highlighted the importance of football-based delivery, relatable models, and open dialogue around mental health. These findings offer practical recommendations for enhancing the design and delivery of FCCT and similar sports-based programmes aimed at supporting young people’s mental wellbeing.
Support/Funding Source: The author received no financial support for this research
Association of Daily Step Count and Multiple Sclerosis: An Accelerometer-Based Prospective Cohort Study
Full text linkPurpose: To date, no study has examined the dose–response association between daily step count and the incidence of Multiple Sclerosis (MS), and no specific step-based guidelines exist for MS prevention. This study aimed to investigate the association between accelerometer-derived daily step count and MS incidence in a large population-based cohort from the United Kingdom (UK).
Methods: We used data from the UK Biobank cohort, including participants aged 40–79 years at baseline (2013–2015) who agreed to wear a wrist-worn triaxial accelerometer (Axivity AX3) for seven days. Daily step counts were estimated using the Verisense step-count algorithm implemented via the GGIR R-package. Incident MS cases were ascertained based on primary care and hospital inpatient data, as well as self-reported data. Cox proportional hazards models, with age as the timescale, were used to examine the association between step count and MS risk, adjusting for potential confounders. Daily step counts were analysed as a continuous variable (per 1,000 steps/day), in categories (<7,000; 7,000–10,000; ≥10,000), and using restricted cubic splines to assess potential non-linearity.
Results: Among 96,253 participants (mean age = 62.4 ± 7.8 years), 67 developed MS over a mean follow-up of 8.1 (±1.0) years. Participants recorded an average of 10,937 (±3,427) steps/day. A linear association was observed between daily steps and MS incidence (hazard ratio (HR) per 1,000 steps/day = 0.92; 95% confidence interval (CI) = 0.85, 0.99; p = 0.029). Participants in the highest category had a 62% lower incidence of MS compared to those in the lowest (HR = 0.38; 95% CI = 0.19, 0.74; p = 0.004). While the inclusion of splines did not statistically improve the model fit (p-non-linearity = 0.097), a plateau in the dose–response curve was observed around 12,000 steps/day when using three knots.
Conclusion: In this large prospective cohort study, higher daily step counts were associated with a reduced incidence of MS. The dose–response relationship also suggests that even a modest increase in daily activity (1,000 steps) may confer substantial benefits among individuals with less than 10,000 steps/day. These findings support the integration of step-based physical activity targets into public health strategies for MS prevention. Future guidelines may build upon this evidence to develop practical, step-oriented recommendations aimed at promoting neurological health.
Support/Funding Source: Luxembourg Institute of Health funding
Development and Validation of a Physical Education Curriculum Quality Assessment Tool: The Global Observatory for Physical Education Curriculum Assessment Tool (GoPE!-CA)
Full text linkPurpose: Although the existence of national physical education (PE) curriculum is being identified by the GoPE! for 218 countries, we do not know the characteristics of physical education (PE) curricula. This study aims to develop and validate the Global Physical Education Curriculum Assessment Tool (GoPE!-CA) to allow characterisation and comparison of PE curricula worldwide.
Methods: The study adopts a multiphase approach. The first study involves a scoping review to identify the dimensions and indicators that must compose a quality PE curriculum. Following PRISMA-ScR guidelines and the European Physical Education Observatory as starting point, the review will search for the key characteristics of a PE curriculum. A search for published articles, books, and reports regarding curriculum in PE will be conducted to identify characteristics that should complement the EuPEO’s framework. A search for articles and reports regarding curriculum development in other school subjects will then identify critical aspects that may enrich the PE curriculum. The second study will engage a panel of global PE experts composed by GoPE! network members, using a Delphi methodology, to refine the items through consensus. Data will undergo qualitative content and concordance analyses. Finalised indicators will form the GoPE!-CA framework. A pilot and third study will be conducted to test the tool’s reliability with a sample of PE curricula from diverse regions and socio-economic contexts. Finally, the tool will be applied to curricula from over 100 countries, collected by the GoPE!. For the third and fourth studies, countries’ curricula will be clustered according to region and policy framing status. Content and quality scores will be synthesised and the outcomes will support the development of a hierarchically structured global database of curriculum quality.
Results: The expected outcomes include a validated, globally applicable PE curriculum quality assessment tool, allowing inter-country comparability.
Conclusion: The GoPE!-CA will offer valuable evidence to enhance the quality and comparability of PE curricula globally, aligning education policy with best practices in teaching PE and will inform the second set of GoPE! Country Cards with a measurable indicator to assess PE curriculum quality.
Support/Funding Source: Foundation for Science and Technology (FCT) scholarship (Reference ID: 2024.00810.BD)
Development of National Physical Activity and Sedentary Behaviour Guidelines for Specific Populations in Ireland – Pregnant and Postpartum Women and People Living With Chronic Conditions
Full text linkPurpose: Reflective of a need for inclusive public health guidance that acknowledges capability, complexity, and the need for equity in physical activity promotion, the aim of this work was to address gaps in national guidance and develop tailored national physical activity and sedentary behaviour guidelines for specific populations in Ireland (pregnant and postpartum women, and people living with chronic conditions). These guidelines accompany the updated National Physical Activity and Sedentary Behaviour Guidelines for Ireland (“Every Move Counts”) which were launched in 2024. The first of their kind in Ireland, they represent an innovative step towards delivering inclusive, evidence-informed recommendations that recognise the unique needs, risks, and opportunities of these populations, supporting a more equitable approach to physical activity promotion across the life course.
Policy Description: The guidelines were developed using a structured evidence-informed approach, incorporating international best practice, a review of the evidence following the WHO’s 2020 guidelines expansion, stakeholder consultation, and iterative expert input. The same methodology was applied to both guideline sets through separate but parallel development processes to ensure population-specific relevance while maintaining consistency in tone, structure, and messaging.
Stakeholder engagement was central, with consultation involving healthcare professionals, public health stakeholders, academics, advocacy groups, and individuals with lived experience. Development included the drafting of guidelines and accompanying health messaging, followed by surveys to assess perceived clarity, relevance, inclusivity, and feasibility with healthcare professionals and target populations. Feedback was synthesised through stakeholder consultation meetings and expert panels, enabling refinement while preserving public health scope and safety considerations.
Ireland’s Health Service Executive (HSE) commissioned this work, and dissemination will be led by the HSE through healthcare, community, and policy channels, with messaging tailored for healthcare and exercise professionals, policy makers, and the public.
Conclusion: These guidelines provide a critical addition to national policy infrastructure by promoting the benefits of physical activity in a safe, inclusive, and empowering way for groups historically underrepresented in physical activity policy. The process demonstrates a model for inclusive, evidence-informed guideline development and contributes to global efforts to enhance physical activity guidance for diverse populations through practical, stakeholder-informed approaches
Evaluating the Physiological Effects of Eccentric Exercises in Adults and Older Adults With Cardiovascular Disease: A Narrative Review
Full text linkIntroduction: Eccentric (ECC) exercise is a unique method in the rehabilitation field due to its lower metabolic demands and greater power output. It is considered a safe tool for participants and patients with low exercise tolerance. Cardiovascular disease (CVD), a leading cause of global mortality, continues to rise. During the rehabilitation phase, ECC exercise may be especially beneficial for CVD patients because of its reduced demands on the cardiorespiratory system. This narrative review aims to evaluate the physiological effects of ECC exercises in adults and older adults with CVD and to explore which ECC modalities are feasible and safe for this population.
Methods: A literature search was carried out in PubMed, Web of Science, and Scopus databases to identify relevant studies investigating the acute and chronic effects of ECC exercise interventions in CVD patients.
Results: The review analysed 13 studies involving 362 predominantly male participants with CVD, focusing on ECC exercise, mainly ECC cycling, with varying intensities and settings. Findings showed that ECC exercise is generally safe, with low heart rate (HR) and perceived exertion even at increasing workloads. Chronic ECC training led to improved cardiac function, reduced HR, and enhanced functional capacity, such as better performance in the 6-minute walk test and stair descent, despite lower oxygen consumption. While some studies reported no significant changes in V̇O2peak or vascular function, overall results support ECC training as a feasible and effective modality for cardiovascular rehabilitation.
Discussion: ECC exercise has shown notable advantages for individuals with CVD, offering higher power output with reduced cardiovascular strain compared to concentric (CON) training. Despite some variability in HR responses – likely due to differences in training intensity and adaptation over time – ECC consistently results in lower V̇O2 consumption, making it metabolically efficient and well-suited for CVD patients. Studies also highlight ECC’s positive impact on functional capacity, strength, and mobility, particularly in frail older adults, without increasing thrombotic risk. These findings support ECC as a safe and effective rehabilitation modality for improving both cardiovascular tolerance and physical function in at-risk populations
Exercise for Improving ADL in Frail Older Adults: Therapeutic Validity and Adherence Show No Effect on Outcomes – A Meta-Analysis
Full text linkPurpose: Frailty in older adults impairs activities of daily living (ADL). While exercise interventions improve factors like muscle strength and physical function, their direct impact on ADL is unclear. This review aims to assess the effectiveness of exercise on ADL and identify the most beneficial exercise interventions.
Methods: A systematic search in five databases included randomised controlled trials on frail adults (60+) comparing exercise interventions to usual care, with ADL as an outcome. Methodological quality was assessed using the Cochrane Risk of Bias (ROB) tool. Meta-analyses were performed using random effects models, with heterogeneity assessed by the I² index. Subgroup analyses were conducted based on ADL-measurement tool, ROB, therapeutic validity (i.e. whether the intervention conformed to exercise recommendations for frequency, intensity, volume, and duration), adherence, and the combination of therapeutic validity and adherence.
Results: Out of 5,975 records, 24 papers (20 studies) met inclusion criteria. Two studies had high ROB. Exercise improved ADL (standardised mean difference = 0.59) but heterogeneity was high (I² = 83%), partly explained by measurement tool and ROB. Studies with low ROB (n = 2) showed low heterogeneity (I² = 0%). Studies assessing performance-based ADL using the Physical Performance Test (n = 3) and studies assessing ADL via the KATZ index (n = 2) also demonstrated low heterogeneity (I² = 0%). Higher therapeutic validity and/or adherence did not necessarily lead to greater ADL improvements. Notably, interventions with high therapeutic validity showed lower adherence, suggesting that higher exercise demands reduce adherence.
Conclusion: Exercise may enhance ADL in frail older adults, but high heterogeneity limits firm conclusions. Performance-based ADL assessments, which mimic daily tasks, may better detect exercise-related improvements. Unexpectedly, higher therapeutic validity and/or adherence do not yield greater effects. Moreover, therapeutic validity appears to be inversely related to adherence. Effective interventions should therefore include a gradual progression to balance therapeutic validity with adherence. A deeper understanding of the underlying mechanisms is needed.
Support/Funding Source: This study was funded by the Research Foundation – Flanders (FWO)
Exploring the Barriers and Motivations for Physical Activity Among Saudi Adults: A Qualitative Approach
Full text linkPurpose: Although it is well known that physical activity provides numerous health benefits and enhances wellbeing, there is substantial evidence indicating that Saudi adults do not achieve public health guidelines. Therefore, recognising and addressing the barriers and enhancing motivations to indoor and outdoor physical activity is essential for promoting greater opportunities to engage in physical activity. The purpose of this study is to explore in depth the factors influencing indoor and outdoor physical activity among Saudi adults.
Methods: A total of 22 Saudis (16 Saudi women and 6 Saudi men; ranged in age from 20 to 65 years, with an average age of 30 ± 10.1 years) took part in semi-structured interviews. The participants were conveniently recruited from different regions of Saudi Arabia to represent a variety of regional perspectives. The interview guide was based on the Socioecological Model of the determinants of physical activity to cover individual, interpersonal, environmental, and policy factors. All interviews were conducted in Arabic; thus, the first author transcribed all interviews in Arabic and then translated them to English. Both deductive and inductive approaches of qualitative content analysis were used for data analysis.
Results: Data were coded into four main categories based on the Socioecological Model of the determinants of physical activity (individual, interpersonal, environmental, and policy). Then, 11 sub-categories related to barriers and eight sub-categories related to motivators were generated. These results show that physical activity behaviour of participants was negatively influenced by societal and environmental factors, including discouragement, poor facilities, and unsafe areas, with women particularly affected. On the other hand, personal and societal motivations, such as improving health, enhancing mood, and being part of active communities were identified as key motivators for engaging in physical activity.
Conclusion: To increase physical activity levels in Saudi adults, interventions and policy modifications aimed at overcoming participation barriers and enhancing motivators are essential. Emphasis should be placed on overcoming societal and environmental barriers and enhancing personal and societal motivations
Intersectoral Cooperation for Sustainability: Implementing the Whole-School Approach as a National Certification Model for Promoting Physical Activity in Polish Schools
Full text linkPurpose: This project aims to strengthen whole-school physical activity (PA) promotion in Poland by developing and implementing a national school-certification framework. It addresses multiple public health challenges and supports SDG17 – Partnerships for a More Active World. The initiative targets primary and secondary schools and is inspired by the WHO’s Promoting Physical Activity Through Schools: A Toolkit. The framework supports schools in adopting a self-tailored, systems-based approach to embedding PA into daily routines, school culture, and the environment. A key innovation lies in the assumption that every school possesses the potential for PA development, and in the use of a ‘comply or explain’ methodology that encourages schools to critically assess and design their development.
Project Description: The project was developed under the nationwide ‘WF z AWF’ (PE with the University of Physical Education) multisectoral participatory initiative, involving interdisciplinary experts, school representatives, and governmental stakeholders.
Development: The framework, aligned with the WHO Toolkit, was co-created with input from educators, health professionals, policymakers, parents, and school leaders. Its evaluation criteria reflect WHO action areas such as quality PE, active travel, leadership, school culture, inclusion, and community engagement.
Implementation: Schools participate voluntarily, documenting existing PA efforts and planning future improvements. They use digital self-assessment tools and attend support workshops. A national database of best practices enables peer learning and inspires scalable, systemic change. Over 100 schools are expected to join the first phase.
Evaluation: Ongoing quantitative and qualitative measures of effectiveness include school readiness, implementation progress, and stakeholder feedback. The framework is currently being scaled, with plans for long-term monitoring and policy integration.
Dissemination: Results and exemplary practices are shared via open access platforms, professional networks, and national events to encourage wider uptake.
Conclusion: This WHO-aligned certification framework provides a scalable strategy to embed health-enhancing PA in schools. By emphasising teacher-led innovation and reflective practice over externally imposed standards, it supports locally relevant change and long-term sustainability. It contributes to intersectoral collaboration, teacher development, and whole-school transformation – providing a European model for translating global PA policy into national action
Knowledge on Children’s Play Behaviour During Recess to Be Used for Designing Sustained Playable Schoolyards for All Children
Full text linkChildren’s outdoor free play is declining, which correlates with decreases in physical activity and mental wellbeing. Given the substantial amount of time children spend in school environments, understanding the dynamics of play in the schoolyard is crucial. This study aims to identify and describe prevalent play behaviour in the schoolyard environment for pupils in first to third school year (6–9-year-olds) during break time, and to propose a typology based on these findings. In five Danish schools, observations were conducted during a total of 710 min of break time, supplemented by 12 go-along group interviews involving 57 (32 girls) pupils in first to third school year. The transcripts and field notes were analysed using thematic analysis and Gibson’s theory of affordance. Five distinct types of play behaviour were identified: Rule-Bound Game Players, Imaginative Play Creators, Physical Skill Masters, Dialogue Dazzlers, and Nature Explorers. Children of the different play types perceive the schoolyard environment differently and, thus, the schoolyard affords different play behaviour. The findings suggest that the schoolyard should offer open areas, sport facilities, loose open-ended structures, a great variety of playground structures, nature-based areas, and secluded spaces to benefit all play types. The findings will offer valuable insights for practitioners tasked with designing schoolyards to build sustainable schoolyards that cater for varied play types
Physical Activity as a Predictor of Adolescents’ Subjective Health Assessment
Full text linkPurpose: Regular physical activity (PA) is a key protective factor for health in youths. The WHO recommends that adolescents do at least an average of 60 minutes per day of moderate-to-vigorous physical activity (MVPA) and incorporate vigorous-intensity aerobic activities (VPA) at least three days a week. This study aims to explore and to examine association between physical activity and self-rated health assessment in adolescents in Lithuania for two decades.
Methods: Data were collected during the six national Health Behaviour in School-aged Children (HBCS) surveys in Lithuania during 2002–2022 (n = 42,260). Students were from 5th, 7th, 9th grades (11-to-15-years-old). The self-reported paper-pencil questionnaires were used to examine indicators such as self-rated health, MVPA and VPA, gender, grade, and family affluence (FAS). Multivariate logistic regressions were performed, adjusting by gender, grade, and FAS. Data analysis was conducted using univariate and multivariate logistic regression. Fair and poor self-rated health and physical inactivity were the respective reference groups.
Results: Analysing the dynamics of MVPA for the period of 2002–2022, a consistently changing situation was observed, VPA among boys remained relatively stable, while rates among girls gradually improved. Boys were consistently more likely to have sufficient daily MVPA and VPA at least four days a week compared to girls; similarly, 5th grade students and adolescents from the higher FAS group were more physically active (p < 0.05). The multivariate analysis showed that during the period of 2002–2022, VPA at least four days a week always was a significant predictor for good and excellent self-rated health assessment (odds ratio (OR) = 1.35–1.72), while daily MVPA was not such a relevant factor (2010 and 2018 became non-significant, p > 0.05).
Conclusion: These results highlight the increasing importance of vigorous-intensity aerobic physical activities in assessing adolescent health.
Support/Funding Source: Supported by the Health Research Institute of the Faculty of Public Health, Lithuanian University of Health Sciences