Lithuanian Sports University e-Journals
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S22: Tools and Methods for Physical Activity Interventions – Examples From Projects Among Older Adults and Patient Populations
Get PDFTargeted interventions for physical activity (PA) promotion require tools for identifying the individuals or groups who would benefit most from the PA intervention and understanding determinants of their behaviour. This symposium presents various tools and methods that have been applied to PA interventions among older adults and patient populations. Increasing knowledge of factors for successful PA interventions among these vulnerable groups enhances the sustainable development goals of ‘Good health and wellbeing (3)’ and ‘Reduced inequalities (10)’.
In the first presentation, we hear about the CDC’s STEADI Algorithm, which is a coordinated approach to fall prevention, including the identification of at-risk individuals and addressing risk factors. The speaker presents results from their study, which evaluated the integration of the STEADI Algorithm into Slovenia’s primary healthcare system and the results of the vAdBeCeDa movement programme.
In the second presentation, we learn about digital mobility outcomes (DMOs) to assess real-world mobility by targeting walking activity (amount, pattern) and gait (pace, rhythm, variability). The DMOs are developed in the European Mobilise-D project, for which participants were recruited from 17 sites in 10 countries. The speaker presents their results from the validation of the DMOs in patient populations.
The third presentation is about mobile health (mHealth) technologies in PA interventions. The speaker shows results of their systematic review and meta-analysis, in which they evaluated the effectiveness of various types of mHealth tools in improving physical health, quality of life, cognitive function, and mental wellbeing among community-dwelling older adults aged 65 and above.
The fourth presentation introduces how systems mapping can be applied to identify key determinants of participation in a PA programme. The speaker explains how various analytical methods are applied to produce a comprehensive view of the lived experiences and opinions of older adults across Wales on participation in the 60+ Active Leisure Scheme.
The symposium aims to provide the participants with new ideas on tools and methods to apply to interventions. There will be room for discussion and more specific questions. Moreover, the symposium offers possibilities to network and foster collaboration
Associations Between Motor Competence and Global Mental Health in Children and Adolescents: A Systematic Review and Meta-Analysis
Get PDFThe objective of this study was to investigate the associations between motor competence and global mental health in youth through longitudinal, cross-sectional, and experimental research designs. A systematic search was conducted across five electronic databases: CINAHL Complete, PubMed, PsycINFO, SCOPUS, and SPORTDiscus. To be eligible for inclusion, studies had to meet the following criteria: (1) peer reviewed and written in English, (2) published after 2014, (3) involving healthy, typically developing children and adolescents aged 5–19 years, (4) reporting quantitative associations between at least one aspect of motor competence and at least one subscale of global mental health, and (5) employing cross-sectional, longitudinal, or experimental designs. Titles, abstracts, and full texts were screened, data were extracted, and risk of bias was assessed by two independent researchers. The quality of the studies was evaluated using the National Heart, Lung, and Blood Institute (NHLBI) ‘Quality Assessment Tool for Observational Cohort and Cross-sectional Studies’ (2021). Meta-analysis was performed using structural equation modelling (R software), and funnel plots along with Egger’s regression test for asymmetry were conducted.
A total of 6,049 records were identified after removing duplicates. Seventeen studies were included in the systematic review, although two were excluded from the meta-analysis due to insufficient reporting of required results. The majority of the studies were cross-sectional (n = 14), with the population predominantly consisting of children (n = 13). Motor competence demonstrated a small but positive association with global mental health (effect size (ES) = 0.30; 95% confidence interval (CI) 0.20–0.40). This association was moderated by study design, age, type of motor competence assessment, risk of bias, domains of motor competence and mental health outcomes.
These findings indicate a small and positive association from motor competence to global mental health in youth. Future research should prioritise experimental study designs to better elucidate the underlying mechanisms of this relationship
Changes in Active Travel Among Adolescents in Active School Flag Between 2022–2024
Get PDFPurpose: Whole-of-school programmes to promote physical activity (PA) seldom focus on travel to and from school, yet active travel (AT) is an opportunity for being physically active. In Ireland, the Active School Flag (ASF) is a multi-tiered (try it out, certificate – school activities, flag – community activities) programme with the aim of promoting PA opportunities in the school and community. The purpose of this study was to examine the school-level changes in AT across three academic years during the ASF programme.
Methods: Second-level students in ASF schools were asked to complete an online survey every autumn for three years. Target recruitment rates were >50% of students throughout the school. Travel to and from school was asked independently and combined for analyses. PA was measured using self-report of behaviour in the last week. The year of survey was a predictor for a logistic regression model, where travel by car and 2022 were the reference categories after controlling for individual characteristics (gender and age) and physical activity. Odds ratio (OR) and 95% confidence interval (CI), for each school and as a pooled sample, determined statistically significant changes.
Results: There were 21 schools involved in ASF in 2022, 2023, and 2024, with students (n = 30,143) who completed surveys. Half of all the students (50%) reported to AT, although the range among schools was between 25%–77%. No statistically significant changes over the three years for the pooled sample were found. However, statistically significant changes were found in 10 of the schools (5 increased AT in 2024 with range of OR = 1.4 (CI = 1.1–1.7) – 1.9 (CI = 1.2–3.0), 3 decreased AT in 2024 with range of OR = 0.5 (CI = 0.3–0.8) – 0.7 (CI = 0.5–0.9) since 2022) after adjusting for gender, age and physical activity level).
Conclusion: AT was not changed in the majority of ASF schools, although there were increases in some and decreases in others. These results emphasise the potential for the ASF to encourage more AT as part of the school and community programme. The lessons from schools that have changed may be useful for future recommendations to increase A
Efficacy of a Multicomponent Exercise Programme for People With Chronic Musculoskeletal Pain – Preliminary Results
Get PDFPurpose: Exercise is a core component of chronic musculoskeletal (CMS) pain management and is widely supported by clinical guidelines. Despite this, many individuals with CMS pain struggle to maintain physical activity (PA) in daily life. This study explored the feasibility and preliminary effects of a supervised, individualised, patient-centred multicomponent exercise programme on disability, physical capacity, and engagement in PA.
Methods: A 16-session exercise programme was delivered, consisting of warm-up, functional exercises, and breath-centred yoga with relaxation. Exercises were graded throughout the sessions. Assessments were conducted at the first and last session using the Oswestry Disability Index (ODI), the ATEMPT questionnaire (to assess exercise adherence), and the Senior Fitness Test (SFT) battery. Given the small sample size and lack of control group, findings are reported descriptively, with focus on clinical relevance.
Results: Forty-nine participants (mean age: 53.4 ± 8.6 years) attended an average of 12.5 sessions, reflecting a high adherence rate (78%). The mean ODI score decreased from 39.4 ± 17.5 to 34.8 ± 17.6 (mean change: 4.6 points). While statistically significant (p = .002), the change did not reach the commonly accepted threshold for clinical relevance (6–10 points). The 30-second chair-stand test showed improvement (mean increase: 1.6 repetitions; p < .001), suggesting a gain in lower limb strength. ATEMPT scores also improved (mean change: 5.6 points; p < .001), though without a control group, these changes should be interpreted cautiously. Importantly, over 80% of participants completed at least 75% of the sessions, indicating strong engagement.
Conclusion: Although the functional and self-reported outcomes showed modest improvements, the results fall short of demonstrating clinically meaningful change in disability and must be interpreted within the limitations of the study design. Nonetheless, the high adherence and acceptability of the programme suggest its potential as a feasible intervention to support active living in people with CMS pain. Future research should include a control group, longer follow-up, and larger sample size to assess efficacy and sustainability more robustly.
Support/Funding Source: This study was funded by the European Union (NextGenerationEU) and the Republic of Slovenia, Ministry of Health, under the Recovery and Resilience Pla
Engaging Populations With Long-Term Conditions: Insights From ExWell Community-Based Physical Activity Programmes in Ireland
Get PDFPurpose: Long-term conditions (LTCs) impact quality of life. As life expectancy increases, ensuring individuals lead fulfilling lives whilst supporting sustainable healthcare systems is essential. Extensive evidence demonstrates exercise rehabilitation efficacy in LTC management. In Ireland, accessibility to community-based services for LTC management is growing. ExWell, a community-based physical activity (PA) programme for populations with LTC reaches 5,000 individuals weekly across 50 centres nationwide. Despite such extensive participation, participants’ demographic profiles remain unclear. This study aims to examine demographic characteristics of ExWell participants and identify potentially underserved populations.
Methods: Data were collected at ExWell inductions, where participants, referred by healthcare professionals, engaged in exercise classes. Five hundred twenty-eight participants aged 22–93 years (mean age 70.5 ± 9.93 yrs.) were recruited. A 20-item questionnaire was distributed, capturing demographics, self-rated health (EQ-5D), mental wellbeing (WEMWBS, UCLA Loneliness Scale), and healthcare utilisation. Data were analysed using IBM SPSS version 29.0.1.0 (2023).
Results: Two-thirds of participants were female (63.7%, n = 337). Participant ethnicity was 96.8% White. According to Ireland’s Central Statistics Office’s (CSO) 2024 census, 25% of the general population are aged 60–75 years, this aligns with 54.1% of ExWell’s study sample falling within this age bracket. Participants reported a diverse range of LTCs, with high prevalence of cardiovascular (74.7%) and musculoskeletal (66%), which corresponds with 2020 TILDA (The Irish Longitudinal Study on Ageing) data on disease prevalence in this cohort. Most (98.2%) of participants presented with multimorbidity, comparable with TILDA data stating over three-quarters of adults >58 years-old have ≥2 LTCs. Females reported significantly higher numbers of LTC than males (3.71 ± 1.9, 3.26 ± 1.7, p < 0.05). Males rated life satisfaction significantly higher than females (6.97 ± 2.4, 6.44 ± 2.5, p < 0.05). Spearman’s rank correlation showed a moderate negative correlation between number of LTCs and self-rated health (p = –.323, p < .001).
Conclusion: Preliminary findings highlight that men, broader ethnic groups, and younger individuals with LTC may be under-represented. Demographic profiles of this sample align with corresponding CSO and TILDA data. Follow-up research will explore barriers potentially preventing underrepresented populations from engaging in ExWell. These findings may suggest the need to adapt strategies for promoting PA engagement amongst individuals with LTC, potentially enhancing programme sustainability.
Support/Funding Source: SETU Co-Fund and Carlow Sports Partnership
Implementing Physical Activity on Prescription (FaR) in Primary Care: A Scalable Model for Sustainable Health Promotion
Get PDFPurpose: Physical activity on prescription (FaR) is a structured, evidence-based intervention aimed at increasing physical activity among patients through individualised prescriptions provided by healthcare professionals. With support from approximately 60 scientific publications and inclusion in Sweden’s 2024 national guidelines for unhealthy lifestyle habits, FaR is a recommended tool in health care. Several strategies have been tested to implement FaR in Region Stockholm’s primary care system, including staff training and support materials. However, uptake remains inconsistent across services, leading to unequal care. The aim of this project was to develop and implement a new, scalable model to integrate FaR as a routine component of primary care practice.
Project Description: To develop the implementation model, a comprehensive approach was undertaken to integrate FaR as a routine component of primary care practice. The model is based on previously identified, evidence-informed implementation strategies and is designed to support long-term sustainability. The innovation lies in combining multiple evidence-informed implementation strategies in a practical, real-world context. Key components include:
• A digital e-learning course
• Development of local routines
• Ongoing education and supervision
• Structured follow-up using electronic health records
• Implementation support via a digital platform
The model is being tested in Region Stockholm through a project (2023–2025) involving 50–75 primary healthcare units annually. Evaluation includes:
• Number of FaR prescriptions, measured at baseline, 3- and 6-months post-intervention
• Interviews with unit managers to explore perception of the implementation model
• Questionnaires to assess staff experience
Preliminary results show increased use of FaR and high acceptability among staff. Many report that the model is easy to apply and fits well into routine care. Dissemination efforts aim to scale up the model at both regional and national levels.
Conclusion: This implementation model shows promise as a feasible and scalable approach for integrating FaR into primary care. It contributes to improved clinical routines and supports healthcare professionals in promoting physical activity among patients. By strengthening the use of FaR, the model may lead to improved population health and offers a replicable framework for other regions or countries aiming to implement evidence-based physical activity interventions in healthcare
Improving Health, Physical Fitness, and Academic Performance Through Active Learning
Get PDFPurpose: This study aimed to improve physical fitness, health, and academic performance in primary school children through implementation of a daily 45-minute school-based physical activity (PA) intervention integrated into regular classroom learning. In addition to standard physical education lessons, academic content was delivered using physically active teaching methods and adapted educational materials. The study was conducted within the ‘Health and Academic Performance with Happy Children’ ERASMUS+ project and on the background of the Norwegian ‘Health Oriented Pedagogical Project’ (HOPP).
Methods: A non-randomised controlled intervention study was conducted in Graz, Austria, involving 475 children from three public primary schools – two intervention schools and one control school. Baseline and follow-up assessments were conducted over two academic years. Physical fitness measures included endurance, hand and leg strength, coordination, balance, and flexibility. Anthropometric data (e.g. weight, height, leg length, waist, hip, and thigh circumferences), health parameters, subcutaneous adipose tissue (via ultrasound), and urine samples were collected. Cognitive abilities, including executive function, language, and mathematics skills, were also assessed.
Results: At baseline, a high prevalence of overweight and obesity (>32% in two schools) was observed, with significant disparities in physical fitness and health indicators linked to parental socio-economic status (SES). While for changes in strength and coordination the results were inconclusive, the intervention led to significant and sustained improvements in endurance, independent of SES. Endurance increased significantly from baseline to both follow-ups in the two intervention schools compared to the control school (F(4, 546) = 18.39, p < 0.001). Notably, in children who improved their endurance, the intervention led also to a greater improvement in executive functions (F(2, 145) = 3.745, p = 0.026).
Conclusion: This integrated physical activity intervention demonstrated measurable benefits on children’s physical health, fitness, and cognitive performance already after one academic year. Implementing physical activity into the school curriculum offers an inclusive, cost-effective, and sustainable strategy for health promotion and academic enhancement. Early interventions are crucial to ensure equitable access for children across all socio-economic backgrounds and abilities
Make a Move: Implementing the Get Finland Moving Programme
Get PDFPurpose: The “Get Finland Moving” programme aims to enhance physical activity across all age groups. It promotes physical activity through a cross-ministerial collaboration with a phenomenon-oriented approach. The programme spans the years 2024–2027.
Description: The programme focuses on creating societal frameworks that encourage daily physical activity and inspire behavioural changes. The measures are categorised in five key areas: 1) Physically active operational cultures; 2) Physical activity counselling; 3) Conditions for physical activity; 4) Physical activity competencies; and 4) Incentivising taxation. Thus far, the programme has driven initiatives such as:
• Submission of a proposal to Parliament to amend the Basic Education Act, emphasising that pre-primary and basic education must promote a physically active lifestyle.
• Enhanced lifestyle and physical activity counselling within municipalities and public healthcare.
• Assessment of international models for taxing physical activity and sports, with the aim of preparing a national study on taxation’s role in encouraging physical activity.
• Integration of physical activity and functional capacity promotion into conscription call-ups.
• Support for municipalities in renovating and developing nearby recreational areas.
• Inclusion of a ball in the maternity package and distribution of brochures in child health clinics highlighting the importance of physical activity in early childhood and family settings.
• A ball will be included in the maternity package, along with a brochure designed to initiate discussions at child health clinics about the importance of physical activity in early childhood and family life.
The programme is systematically monitored and evaluated according to a monitoring model, in which each measure is tracked using implementation, process, output, and impact indicators. To date, the most significant challenges have arisen in the implementation of work life-related and tax-related measures.
Conclusion: The programme has successfully advanced cross-ministerial collaboration and garnered strong political support. The cross-sectoral implementation approach has been made possible by the fact that different ministries are responsible for various measures, and the programme’s funding is allocated to different ministries. The ‘Make a Move’ communication campaign further empowers individuals and communities by showcasing the accessibility, benefits, and importance of incorporating physical activity into daily life
Mixed-Method Study Analysing Lessons Learned From ACTIVE-AGE@home: BRIDGE Recruitment Model to Engage Frail Older Adults in Intervention Trials
Get PDFPurpose: Multicomponent physical activity programmes can prevent frailty in older adults but remain underutilised. To increase adoption, healthcare policy must prioritise research on preventive strategies. Although randomised controlled trials (RCTs) and clinical trials (CTs) are essential, recruitment challenges often lead to underpowered studies, wasted resources, and unexpected costs. Transparent and comprehensive reporting on recruitment is rare. This study aimed to develop effective strategies for engaging frail older adults in trials by analysing recruitment efforts and outcomes from the ACTIVE-AGE@home trial.
Method: A mixed-method study was conducted to evaluate recruitment strategies at three levels: macro (broad-scale), meso (community-level), and micro (individual-level). Quantitative analysis assessed the effectiveness of these strategies, while qualitative data – field notes documenting researchers’ recruitment experiences – were analysed using thematic analysis (TA) following Braun and Clarke’s approach. Both a deductive TA, guided by the TIBaR model (Trust, Incentives, Barriers, and Responsiveness), and an inductive approach were employed to explore motivations for long-term engagement, adherence, and maintenance.
Results: Over six months, researchers contacted 49 macro-, 112 meso-, and 1,001 micro-level recruitment partners. Of these, 30 meso- and 44 micro-level partners referred frail older adults. Micro-level referrals were most effective, yielding 23 eligible participants, compared to six via meso-level. Thematic analysis identified four key themes: 1) Be appealing – Make the study unique, accessible, and approachable. 2) Foster reciprocal relationships – Build trust and shared ownership with recruitment partners. 3) Understand identity – Consider the identities of both recruitment partners and potential participants. 4) Gear trial requirements – Align study design with recruitment realities and identity needs.
Conclusion: Micro-level strategies, particularly personal contact and warm referrals through local healthcare and welfare professionals, are critical for recruiting frail older adults. Macro- and meso-level strategies should support these efforts. The BRIDGE model emerged from this analysis, offering a reflective tool balancing recruitment, identity, and trial demands. As rigid RCT designs present recruitment barriers, more flexible trial designs should be explored. Transparent reporting of both successes and challenges is essential to improve future intervention research.
Support/Funding Source: This work is supported by Research Foundation Flanders, under Applied Biomedical Research with a Primary Social finality (Grant Number: T002322N)
Moderate-to-Vigorous Physical Activity and Its Association With Psychological Distress and Sleep Quality Among Lithuanian School-Aged Adolescents: A Cross-Sectional Study
Get PDFPurpose: To determine how typical daily time spent in moderate-to-vigorous physical activity (MVPA) relates to psychological distress and sleep quality in Lithuanian school-aged adolescents (11–18 years).
Background: Roughly 81% of adolescents worldwide fall short of the World Health Organization (WHO) guideline of ≥60 min MVPA per day. A recent umbrella meta-analysis reports medium protective effects of physical activity on adolescent mental health. Emerging evidence also links MVPA to better sleep, which subsequently predicts lower anxiety and depressive symptoms. Large Baltic studies that integrate validated mental health and sleep metrics are lacking. This study addresses that gap.
Methods: The cross-sectional epidemiological study included 4,925 school-aged pupils from 11 to 18 years (mean 14.08 ± 2.21). There were 49.1% boys and 50.1% girls. Physical activity was evaluated by asking how long per day adolescents are usually active at moderate-to-vigorous intensity (1 = almost not active; 4 = ≥1 h). Psychological distress was measured with the six-item Kessler scale (Cronbach α = .897). Sleep quality was rated on a 5-point Likert scale (1 = very bad; 5 = very good). Age and gender were covariates.
Results: Fifteen-point-four percent of participants accumulated ≥60 min of MVPA per day, more boys (19%) than girls (11%). In a linear regression analysis, higher physical activity significantly predicted lower psychological distress (std β = .089; ∆R2 = .007), and sleep quality (β = .094; ∆R2 = .008), and lower psychological distress predicted better sleep quality (β = .401; ∆R2 = .142) controlling for age and gender. Psychological distress mediated the physical activity – sleep quality relationship (CSIE = .053 [.0419–.0644]).
Conclusion: Engaging in at least one hour of MVPA per day is directly associated with reduced psychological distress and better sleep among Lithuanian school-aged adolescents. Moreover, MVPA is indirectly associated with sleep quality by reducing psychological distress. Although causality cannot be inferred from this cross-sectional design, embedding daily MVPA sessions into the school timetable represents a low-cost, scalable strategy to improve student wellbeing; longitudinal and intervention studies are needed to confirm these relationships