Lithuanian Sports University e-Journals
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How the Service Provider Influences the Continuation of Physical Activity for People With Hip and Knee Osteoarthritis
Full text linkPurpose: Osteoarthritis (OA) is the most common chronic condition in adults over 65 years old and affects over 528 million people worldwide (Vos et al., 2020). Physical activity plays a central role in managing OA-related pain, improving function, and supporting independent living. Structured programmes such as GLA:D® (Good Life with osteoArthritis from Denmark), which integrates exercise and education, have demonstrated significant short-term benefits (Baumbach et al., 2022). However, sustaining continued physical activity following the completion of these programmes remains a key challenge. Identifying the factors that support a successful transition from structured interventions to sustained, community-based activity is essential for fostering long-term self-management.
Methods: This presentation reports preliminary findings from a systematic review exploring the barriers to and facilitators of physical activity maintenance in individuals with hip and knee OA. Six electronic databases (APA PsycInfo, CINAHL Complete, Cochrane Library, Embase, MEDLINE via PubMed, and Web of Science) were systematically searched using comprehensive Boolean terms. This sub-analysis focuses specifically on qualitative studies exploring the perspectives of service providers, as well as patient-reported experiences relating to provider influence.
Results: Ten qualitative studies met inclusion criteria for this sub-analysis. Thematic analysis revealed several key themes across both patient and provider perspectives. From the patient viewpoint, three themes emerged: (1) Therapeutic alliance and person-centred education, highlighting the importance of trust and tailored information; (2) Ongoing support and accountability, referring to follow-up communication and provider encouragement; and (3) Collaborative goal-setting and empowerment, emphasising shared decision-making. From the provider perspective, three additional themes were identified: (1) Resource availability and constraints, such as limited access to resources; (2) Inclusive and supportive environments, such as attending local community-based classes; and (3) Promoting shared responsibility, where support is offered in a way that still promotes patient independence.
Conclusion: These preliminary findings provide insight into the multifaceted role of service providers in supporting the maintenance of physical activity for individuals with OA. Understanding both patient and provider perspectives is essential in designing sustainable, community-based models of care. This sub-analysis contributes to a broader systematic review that will further explore the factors hindering sustained physical activity
Implementing Sensor-Based Physical Activity Measurement in the Existing Infrastructure for the National Health Surveillance in The Netherlands
Full text linkPurpose: Several Dutch studies have examined the possibility to implement sensor-based measurement of physical activity (PA) as part of the existing national health surveillance infrastructure. These pilots have provided valuable knowledge, but reaching a representative sample of the general population, which is crucial for informing policy, remains a challenge. We investigated the differences between respondents at different stages of the data collection protocol in order to assess barriers and facilitators to participation and improve recruitment strategies for future large-scale surveillance efforts.
Methods: For this pilot, we used the existing infrastructure from the GGD Health Monitor (GEMON), which is a probability sample from the Dutch population and contains the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH). At the end of the GEMON, we asked respondents whether they would be willing to wear an accelerometer (activPAL) for seven consecutive full days. From those willing, we selected a subsample based on ethnicity, age, and income to wear the accelerometer. The primary goal was to compare key characteristics (e.g. demographics, health behaviours including PA, socioeconomic factors) of respondents to non-respondents in each stage of the data collection protocol. We performed univariate and multivariable regression analyses.
Results: Of 125,248 invited persons, 13,727 responded to the questionnaire. Of those, 6,655 persons agreed to wear the accelerometer. We selected 1,459 persons, of which 580 adults between 18–65 years old actually wore the accelerometer. For our primary outcome, we are currently running statistical analyses, and are able to present the results at the HEPA conference.
Conclusion: We expect interesting insights that will inform our advise to the Ministry of Health, Welfare and Sport of The Netherlands how to best implement sensor-based physical activity measurement in the existing national health surveillance infrastructure.
Support/Funding Source: This research was funded by the National Institute for Public Health and the Environment, and the Ministry of Health, Welfare and Sport of The Netherlands
Narrative Review of Physical Activity Prescription Programmes: Towards a Harmonised PAP Framework in Belgium
Full text linkPurpose: Physical activity on prescription (PAP) programmes have demonstrated a positive impact on health, wellbeing, and physical activity levels. However, such programmes face both structural and organisational barriers. In Belgium, PAP programmes are implemented in various forms. In Flanders, a regional programme centred on physical activity counselling was established; whereas in Wallonia, multiple decentralised initiatives co-exist, with a primarily focus on adapted physical activity. In 2023, a national network was established to foster synergies among existing initiatives and enable stakeholders to gain a better understanding of the PAP ecosystem. One of the objectives of this network was to develop potential models for a harmonised PAP framework in Wallonia and, therefore, in Belgium.
Methods: A working group was formed based on the national network of PAP initiatives, and a non-systematic narrative review of PAP was carried out, focusing specifically on four prescription-based systems in Europe. Sources included peer-reviewed articles, grey literature, and policy documents retrieved through targeted searches. Key structural elements that could be further explored, refined, and operationalised within a working group were identified through expert consultation. Additionally, key areas where further research is needed to inform both practice and future programme development were also highlighted.
Results: When already well-documented or experienced in existing programmes, facilitating a capitalisation on current practices, some structural elements of PAP were prioritised to be explored and refined by the working group. These structural elements were: the categories of prescribed physical activity and their definitions, the prescribers, the beneficiaries; the physical activity professional, their roles and training. Gaps in the literature and further research specific to Wallonia context were also identified.
Conclusion: Despite the limitations of narrative reviews, this study serves as a rapid preliminary assessment that can facilitate the consolidation of expertise and the capitalisation on existing PAP initiatives. This initial overview provides a foundation for structuring existing PAP and for identifying future research directions that can enhance their practical implementation.
Support/Funding Source: This study was conducted in collaboration of the Expertise Centre in Health Promotion in Sciensano, funded by l\u27Agence pour une Vie de Qualité, Department Zorg and Vivalis
Promoting Physical Activity to Lower the Incidence of Major Non-Communicable Diseases – A Literature Review to Inform a Simulation Model for Policy Purposes
Full text linkPurpose: To predict the impact of physical activity (PA) policy in the Netherlands on health outcomes, quality of life, and costs, the Dutch National Institute for Public Health and the Environment developed a model incorporating PA effects across various health outcomes. For model input, we analysed recent literature on the association between PA and major non-communicable diseases.
Methods: For this review, we systematically searched PubMed and Embase from 2016 to 2025 for meta-analyses on the dose–response association between PA and incidence of type 2 diabetes, stroke, ischemic heart disease, congestive heart failure, breast cancer, colon cancer, and dementia. The meta-analyses: 1) preferably included prospective cohort studies, 2) reported a broad range and dispersion of PA levels, 3) expressed PA in MET-min/week, and 4) presented associations as hazard rate ratios (HRR) or relative risks (RR) versus inactivity. Eligible studies were appraised on methodological quality (low, moderate, high), sample size, data quality, generalisability to the Dutch population, and biological plausibility. Data from the highest-quality, most comparable study to the Dutch population was used to estimate the corresponding association in the model.
Results: Kyu et al. (2016) reported that higher total PA (<600 vs ≥8,000 MET-min/week) lowered the risk of type 2 diabetes (RR: 0.80 [0.70, 0.89]), stroke (RR: 0.80 [0.70, 0.90]), and ischemic heart disease (RR: 0.78 [0.72, 0.84]). Aune et al. (2021) found higher leisure-time PA (0 vs 2,100 MET-min/week) lowered the risk of congestive heart failure (RR: 0.71 [0.64, 0.77]). Matthews et al. (2020) found higher leisure-time PA (0 vs 1,800 MET-min/week) lowered the hazard for breast cancer (HRR: 0.86 [0.82, 0.90]) and colon cancer (HRR: 0.82 [0.77, 0.87]). Iso-Markku et al. (2022) found higher total PA (203.64 vs 4,989.09 MET-min/week) lowered the risk of dementia (RR: 0.64 [0.51, 0.81]). All associations were significant and had dose–response relationships, i.e. more PA lowered the risk for these non-communicable diseases.
Conclusion: We identified significant dose-dependent relationships between PA and non-communicable disease incidence from literature, providing risk estimates used to predict and model the impact of PA policies on such diseases.
Support/Funding Source: Funding was provided by the Dutch Ministry of Health, Welfare and Sport
Staff Perceptions on the Implementation and Delivery of the Active Education Beyond the School Day Programme in Wales, United Kingdom
Full text linkPurpose: Low levels of physical activity and high sedentary behaviour among children and young people remain a global public health concern, with youth in Wales (United Kingdom) reporting some of the lowest physical activity levels worldwide. Schools are recognised as critical environments for promoting health and wellbeing, both during and beyond the school day. Active education settings which involve access to sport and physical activity opportunities beyond the school day through the utilisation of school facilities are increasingly viewed as a strategy to address these challenges. This study aimed to explore staff perceptions of the implementation and delivery of a Sport Wales programme “Active Education Beyond the School Day” (AEBSD). Methods: A mixed-methods evaluation was conducted between March and September 2022, with 13 schools participating in the AEBSD programme. Structured interviews were conducted with 11 staff across eight schools, including school leaders, teachers, and sport development personnel. Data collection was guided by a co-developed questionnaire addressing six thematic areas. Closed responses were analysed descriptively, and open-text responses through qualitative content analysis.
Results: Staff reported multiple perceived benefits of the programme, including increased physical activity levels, enhanced student wellbeing, strengthened school-community partnerships, and greater inclusivity. Diverse activity offerings, late transport provision, and targeted engagement with specific groups, such as children with disabilities and LGBTQ+ students, were highlighted as important considerations. Challenges included delayed facility readiness, funding and budgeting issues, staffing constraints, and difficulties sustaining community engagement.
Conclusion: Despite the barriers identified, the AEBSD programme was perceived positively by school and local authority staff, demonstrating the potential for schools to function as community hubs for promoting physical activity and subsequently wellbeing. The programme fostered inclusive participation, improved community cohesion, and supported curriculum-linked educational outcomes. Addressing the reported barriers, particularly around funding timelines, staffing capacity and community coordination will be essential for sustaining and scaling up the programme. These findings contribute to the growing evidence base supporting extended school use and highlight key considerations for embedding active education models in policy and practice
Technology-Based Self-Directed Learning Model Adaptability for Physical Education in High School
Full text linkPurpose: The purpose of the study is to investigate the main factors of self-directed learning in online digital environments, combining them into a model for physical education (PE) and educational policy formation. According to WHO, physical education tends to decline from an early age. However, experiences in early childhood shape pupil’s engagement in physical activity (PA), smoothing their learning in the future, without sacrificing their natural ability to play in varied environments. The Lithuanian General Framework for Physical Education mentions that physical and health education is considered as a (pre)subject area of the curricula applied in educational institutions, which also introduces the use of digital technologies to develop PA. It is important that the model of technology-based self-directed learning helps to create the necessary environment for the learner and takes into account the most critical PE factors necessary for self-directed learning. Implementation of self-directed learning differs fundamentally at various levels of PE, such as elementary, high school, or higher education levels.
Methods: A qualitative study of empirical data collection, qualitative content analysis, qualitative (semi-structured interview) and quantitative research (sociological survey) will be carried out.
Results: This project offers innovative research, as self-directed learning is a new and promising educational paradigm. It is also complex due to the nature of the research object, crucial to identify challenges in the real-time application of technology in self-directed learning to enhance learners’ abilities and independence. Additionally, it is expected to foster dialogue between learners, PE teachers, and technology developers in order to address didactic learning issues. A technology-enhanced self-directed learning model will be developed to support PE in policy-making. It will help create an optimal environment for pupils in grades 9–12 while considering key PE factors essential for self-directed learning.
Conclusion: The project will have a positive impact on the approach to technology-based self-directed learning, raising physical education level and will bring significant changes to the professional growth of the project participants themselves.
Support/Funding Source: This research is co-funded by the European Union (the project “Breakthrough in Educational Research” No 10-044-P-0001) under the 1st April 2025 Agreement with the Research Council of Lithuania (RCOL)). 
The Effect of Repeated Short-Duration Hot and Cold-Water Immersions on Glucose Tolerance and Insulin Response: A Pilot Study
Full text linkPurpose: The prevalence of diabetes is increasing annually. Consequently, preventive measures, including thermal stimuli, are gaining significant attention. However, no research has addressed the combined use of cold and hot stimuli as a strategy for metabolic health promotion. Thus, the main aim of this study was to determine if interventions consisting of a brief whole-body immersion in hot water (HWI) and cold water (CWI) on alternating days over a 16-day period can improve glucose tolerance and insulin sensitivity.
Methods: Male (n = 4) and female (n = 3) non-obese subjects completed sixteen 5-minute daily sessions, consisting of eight whole-body hot immersions in 45°C water and eight whole-body cold immersions in 14°C water, in an alternating order on separate days.
Glucose and insulin release in response to a 2-hour standard (75 g oral glucose load) were assessed before, 48 hours after, and two weeks after the end of the cold and hot interventions. The areas under the curves of glucose and insulin were calculated using the trapezoidal rule during a standardised 2 h oral glucose load test. Additionally, insulin sensitivity was assessed using the Matsuda index.
Results: After repeated short-duration HWI and CWI, the glucose area under the curve (AUC) significantly decreased (p < 0.05) and remained lower after two weeks (p < 0.05). Meanwhile, no effect on insulin AUC or insulin sensitivity, as indicated by the maintained Matsuda index, was observed.
Conclusion: Repeated short-duration alternating hot and cold-water immersions improved glucose tolerance through insulin-independent mechanisms. These findings suggest that this intervention may serve as a viable alternative for metabolic health promotion in individuals unable to engage in physical activity programmes.
Support/Funding Source: This work was supported by the Research Council of Lithuania (Grant Number S-PAD-22-9)
Understanding the Role of Disability Identity in Physical Activity and Sport Among People With Physical Disabilities
Full text linkPurpose: The research aimed to determine disability identity, athletic identity, and sports motivation of physically disabled people participating in physical activity and sports and to evaluate the influence of disability identity on physically disabled people’s athletic identity and sports motivation according to the level of participation in physical activity and sports.
Hypothesis: A positive disability identity can lead to a higher athletic identity and greater motivation to participate in physical activity and sports.
Methods: The Personal Disability Identity (PDI) scale including subscales of Self-Worth and Personal Meaning was used to assess self-concept as a person with a disability. Athletic identity was evaluated by the multidimensional Athletic Identity Measurement Scale to assess the social identity, exclusivity, and negative affectivity of the physically disabled. Sport Motivation Scale (SMS-II) including subscales of Intrinsic Regulation, Integrated Regulation, Identified Regulation, Introjected Regulation, External Regulation, and Non-Regulation was used to evaluate the reasons why physically disabled people are practising sports. The data were collected from 102 people with physical disabilities.
Results: Findings indicated that scores on disability self-worth and personal meaning, athletic identity and sports motivation were significantly related (p < 0.005) after accounting for demographic and disability characteristics.
Conclusion: The findings of the research on the relationship between positive adjustment among people with disabilities, their athletic identity and sports motivation contribute to the emerging literature on the predictive role of disability identity and the benefits of physical activity and sports in positive life outcomes among adults with physical disabilities.
Support/Funding Source: The research was conducted using the author’s resources, without any financial support from external sources
Advancing Healthcare by Integrating Physical Activity and Nutritional Health Through Expert Collaboration, Strategic Partnerships, and Knowledge Enhancement
Full text link“Get Finland Moving” programme (2024–2027) is part of the government’s goal to increase physical activity across all age groups in Finland. One of the programme’s initiatives is the promotion of physical activity and nutrition among professionals. This Liira initiative covers the entire country and aims to develop effective and high-quality physical activity counselling and nutritional health services, based on the idea that regular exercise and a healthy diet significantly improve wellbeing.
The initiative seeks to support strategic choices, strengthen collaborative structures, implement impactful operational models, and enhance professionals’ expertise through nationwide training. This includes, among other things, referring individuals who engage in insufficient physical activity from healthcare services to physical activity counselling through official referrals.
Competence Mapping and Training Development: In 2024, the Ministry of Social Affairs and Health conducted a comprehensive training needs survey targeting regional healthcare services and municipal physical activity services – an unprecedented survey for this target group. Key development areas identified include:
· Functional and high-quality service chains
· Seamless collaboration between physical activity and nutrition (e.g. dietitian referrals to exercise counselling)
· Motivation and behaviour change
· Promotion of healthy lifestyles
· Effectiveness of exercise counselling
A nationwide training tour in 2025 will enhance professionals’ expertise, increase the visibility of physical activity and nutrition in healthcare, and strengthen cooperation. Within two years, the vision is to integrate standardised and high-quality supplementary training in physical activity and nutrition into all healthcare education programmes in Finland, supporting professional collaboration.
Implementation and Evaluation: New operating models will be actively implemented and disseminated nationwide through strong ministerial communication and networking. The effectiveness of the measure will be evaluated as part of the “Get Finland Moving” programme throughout the government term
Are Physical Activity and Health Conditions Associated With Mental Health in Individuals With Prediabetes or Type 2 Diabetes? A Longitudinal Study
Full text linkPurpose: Individuals with type 2 diabetes face an elevated risk of comorbidity which is linked to poor mental health such as low quality of life and symptoms of depression and anxiety. Physical activity is related to a reduced risk of mental health symptoms in the general population. How physical activity along with various health conditions affect mental health in prediabetes or type 2 diabetes is less studied. This study examined the associations of physical activity, health conditions, gender, and age with mental health over time in individuals with prediabetes or type 2 diabetes.
Methods: Data of 59 participants was used. Mental health was assessed at baseline, two years, and after 5–9 years using the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the EQ-5D Visual Analogue Scale measuring health-related quality of life. Physical activity, measured via accelerometers at baseline, was dichotomised as active (reaching WHO guidelines of ≥150 min/week of moderate-to-vigorous activity) or inactive. Health conditions at baseline included multimorbidity (having >2 comorbidities), duration of type 2 diabetes (>5 years), and BMI (≥30 kg/m²). Generalised estimating equations were applied for statistical analyses.
Findings: The participants, 57% male, had a mean (standard deviation) age of 64.6 years (7.8) and BMI 29.4 (3.8) at baseline. Being inactive and having multimorbidity were not statistically significantly associated with any examined mental health variable across time. However, duration of type 2 diabetes and being female were associated with symptoms of anxiety and perceived stress, and high BMI was associated with symptoms of depression and lower quality of life.
Conclusion: In this sample, duration of type 2 diabetes, high BMI, and female gender were risk factors for mental health symptoms over 5–9 years, while physical activity and multimorbidity were not. These findings underscore the complex interplay between physical activity, health conditions, demographics, and mental health among individuals with prediabetes or type 2 diabetes. The knowledge is valuable in clinical practice to identify risk groups for mental health symptoms, and to person-centre support for physical activity.
Support/Funding Source: This work was supported by the Sophiahemmet Foundation and The Swedish Diabetes Foundation