Physical exercise-related manifestations of long COVID: A systematic review and meta-analysis.

Objective: This study aims to systematically assess physical exercise-related symptoms of post-acute sequelae of SARS-CoV-2 infection (PASC or long COVID) in coronavirus disease 2019 (COVID-19) survivors. Methods: Eight databases were systematically searched on March 03, 2024. Original studies that compared physical exercise-related parameters measured by exercise testing between COVID-19 survivors who recovered from SARS-CoV-2 infection over 3 months and non-COVID-19 controls were included. A random-effects model was utilized to determine the mean differences (MDs) or standardized MDs in the meta-analysis. Results: A total of 40 studies with 6241 COVID-19 survivors were included. The 6-min walk test, maximal oxygen consumption (VO2max), and anaerobic threshold were impaired in COVID-19 survivors 3 months post-infection compared with non-COVID-19 controls in exercise testing, while VO2 were comparable between the two groups at rest. In contrast, no differences were observed in SpO2, heart rate, blood pressure, fatigue, and dyspnea between COVID-19 survivors and non-COVID-19 controls in exercise testing. Conclusion: The findings suggest an underestimation of the manifestations of PASC. COVID-19 survivors also harbor physical exercise-related symptoms of PASC that can be determined by the exercise testing and are distinct from those observed at rest. Exercise testing should be included while evaluating the symptoms of PASC in COVID-19 survivors.

"Still work?" Design and effect of interventions used to modify feeding problems in children with autism: A systematic review of studies employing group designs.

BACKGROUND: Feeding problems in children with autism jeopardize the well-being of both children with autism and their families. Mixed findings were reported from previous interventions, which were mostly evaluated by single subject research design (SSRD) studies. Moreover, feasibility assessment and social validity measurement were unaddressed by these SSRD studies. To fill this substantial knowledge gap, the present review systematically summarized and evaluated feeding interventions implemented in children with autism, which were assessed by studies employing group designs. METHOD: An extensive literature search in eight established online databases was conducted, and a total of 17 eligible studies published in 2009-2021 were included for further analysis. A descriptive account of the features of the investigations is provided, including assessment of study quality. RESULTS: A total of 449 children with autism and 203 parents/caregivers participated in the included studies. The multiple use of five strategic intervention components were highlighted in this review, including nutrition education/consultations, environmental modifications, sensory exposure, cognitive components, and behaviour interventions. The reviewed interventions showed a preliminarily positive effect for modifying feeding problems in children with autism. Furthermore, the evaluation based on the RE-AIM framework (reach, efficacy, adoption, implementation, and maintenance) demonstrated that an interdisciplinary multi-component intervention strategy may achieve high effectiveness and feasibility in improving feeding problems in a wide range of children with autism. CONCLUSIONS: This review found that interventions achieved and maintained a positive effect on modification of feeding problems in groups of children with autism. Information and gaps identified and summarized in the implementation process may assist both researchers and stakeholders to further support these vulnerable children.

Effectiveness of chatbots in increasing uptake, intention, and attitudes related to any type of vaccination: A systematic review and meta-analysis.

This systematic review and meta-analysis analyzed and summarized the growing literature on the effectiveness of chatbot-delivered interventions in increasing uptake, intention, and attitudes related to any type of vaccination. We identified randomized controlled studies (RCTs), quasi-experimental studies, and non-experimental studies from the following platforms: PubMed, Web of Science, MEDLINE, Global Health, APA PsycInfo, and EMBASE databases. A total of 12 eligible studies published from 2019 to 2023 were analyzed and summarized. In particular, one RCT showed that a chatbot-delivered tailored intervention was more effective than a chatbot-delivered non-tailored intervention in promoting seasonal influenza vaccine uptake among older adults (50.5% versus 35.3%, p = 0.002). Six RCTs were included in the meta-analysis to evaluate the effectiveness of chatbot interventions to improve vaccination attitudes and intentions. The pooled standard mean difference (SMD) of overall attitude change was 0.34 (95% confidence intervals [CI]: 0.13, 0.55, p = 0.001). We found a non-significant trivial effect of chatbot interventions on improving intentions of vaccination (SMD: 0.11, 95% CI: -0.13, 0.34, p = 0.38). However, further evidence is needed to draw a more precise conclusion. Additionally, study participants reported high satisfaction levels of using the chatbot and were likely to recommend it to others. The development of chatbots is still nascent and rooms for improvement exist.

The effect of different high-intensity interval training protocols on cardiometabolic and inflammatory markers in sedentary young women: A randomized controlled trial.

Few studies have reported the cardiovascular health effects of different high-intensity interval training (HIIT) protocols among sedentary young women. We investigated the impact of a traditional HIIT programme and a high-intensity circuit training (HICT) programme on lipid profiles and inflammatory cytokine levels in sedentary young women. Forty-two women were randomly assigned to HICT (body weight-based training), HIIT (cycling-based training), or control groups (n = 14 each). HICT and HIIT participants completed an 8-week training programme of three sessions per week. Total cholesterol (TC), triglyceride, high- and low-density lipoprotein, leptin, resistin, tumour necrosis factor-alpha (TNF-α), interleukin-8, and interferon-gamma levels were measured before and after the intervention. Post-intervention, TC and leptin were decreased in the HICT group. The HICT group also demonstrated increased lean mass, upper and lower limb strength, and balance, while the HIIT group displayed improved lower limb strength. Additionally, the control group showed significant increases in triglyceride levels, weight, body mass index, and fat mass. In conclusion, although both HICT and HIIT interventions showed improvements in cardiovascular health and physical fitness, participants in the HICT group experienced more health benefits.

Influences of mpox disease perceptions, sources and contents of information exposure on mpox vaccine uptake among gay, bisexual, and other men who have sex with men in Hong Kong, China.

BACKGROUND: Following the global mpox outbreak in 2022, multiple regions in Asia have been reporting ongoing mpox cases within high-risk groups, including gay, bisexual, and other men who have sex with men (GBMSM). An optimal level of vaccination rate is essential to prevent further mpox outbreaks. However, no existing studies have examined mpox vaccine uptake among GBMSM in East Asia. METHODS: A cross-sectional survey was conducted among a sample of 531 GBMSM in Hong Kong, China, between March and October 2023. The study used multivariable logistic regression models to investigate the associations between mpox-related disease perceptions, exposures to sources and contents of mpox-related information, and mpox vaccine uptake. RESULTS: The prevalence of mpox vaccine uptake among GBMSM in Hong Kong was 21.7%, with 7.7% completing one dose and 13.9% completing two doses. GBMSM who were younger or earning less monthly income were less likely to have been vaccinated. After adjusting for confounding variables, participants who perceived more negative impacts on their lives if they were to contract mpox, more severe symptoms, and a more coherent understanding of mpox were positively associated with mpox vaccine uptake. In addition, more frequent exposure to information through the following sources: TV, newspaper, radio and posters, government websites, news websites or apps, other people's social media, and communication over the phone or face-to-face was positively associated with mpox vaccine uptake. Finally, more frequent exposure to the following information contents: mpox statistics from other countries, the Hong Kong government's responses to mpox cases, negative information about patients with mpox, and information on prevention and treatment of mpox were positively associated with mpox vaccine uptake. CONCLUSIONS: This study provides timely and evidence-based implications to address health communication and messaging needs in promoting mpox vaccination among GBMSM in Hong Kong, relevant to regions with similar sociocultural contexts.

Effectiveness of tele-exercise training on physical fitness, functional capacity, and health-related quality of life in non-hospitalized individuals with COVID-19: The COFIT-HK study.

Background: The use of tele-exercise programs as an option for post-COVID-19 rehabilitation has been suggested, but its effectiveness in non-hospitalized individuals is not well understood. Objective: This study aimed to determine the effectiveness of an 8-week tele-exercise training program (COFIT-HK) on physical fitness, functional capacity, and health-related quality of life (HRQoL) in non-hospitalized post-COVID-19 individuals. Methods: Forty-one non-hospitalized individuals (age:47.4 ± 7.8 yrs) who had COVID-19 history were divided into two groups: the tele-exercise training group (TELE; n = 21) and the non-intervention control group (CON; n = 20). TELE engaged in online supervised multicomponent low-to-moderate intensity exercise training (including respiratory muscle, aerobic, and resistance training) three times per week, whereas CON received standardized educational leaflets based on World Health Organization (WHO) guidelines for post-COVID-19-related illness rehabilitation only. Various components of physical fitness, functional capacity, and HRQoL were assessed at baseline and after the 8-week intervention. Results: TELE showed significant improvements in handgrip strength, arm flexibility, functional lower extremity endurance, and HRQoL after the 8-week intervention (all p < 0.05, ES = 0.50-1.10). When comparing the groups, TELE demonstrated significantly greater improvements in both the physical and mental component summary scores of HRQoL compared to CON (both p < 0.05). Other outcomes did not reveal significant group differences. Conclusion: Our tele-exercise intervention was effective in improving physical fitness, functional capacity and HRQoL among non-hospitalized post-COVID-19 individuals. Further research is needed to explore the utility and limitations of tele-exercise programs for post-COVID-19 rehabilitation and beyond.

Corrigendum: Association between nutritional status, physical fitness and executive functions in preadolescents: a person-centered approach.

[This corrects the article DOI: 10.3389/fped.2022.966510.].

Effects of intermittent dieting with break periods on body composition and metabolic adaptation: a systematic review and meta-analysis.

CONTEXT: Intermittent dieting incorporated with break periods (INT-B) has recently been promoted as an alternative dietary approach for optimal weight management. OBJECTIVE: This study assessed the effectiveness of INT-B compared with that of conventional continuous energy restriction (CER) for improving body composition and attenuating metabolic adaptation. DATA SOURCES: A systematic search was conducted on 6 databases using all available records until July 2023. DATA EXTRACTION: The extracted data included the lead author, year of publication, population characteristics, intervention protocols, duration, and adherence. DATA ANALYSIS: Random-effects meta-analyses were conducted for within-group and between-group comparisons of anthropometric and metabolic outcomes. Subgroup moderator analysis was performed for the types of INT-B, intervention duration, and population characteristics. RESULTS: Of the 1469 records, 12 randomized trials (with 881 participants) were included. Within-group analyses demonstrated significant improvements in body mass, fat mass, body mass index, body fat percentage, and waist circumference following both INT-B and CER, with no significant group differences. However, resting metabolic rate (RMR) was significantly reduced following CER only. The compensatory reduction in RMR was significantly smaller following INT-B compared with CER, suggesting a lesser degree of metabolic adaptation. INT-B had a more significant effect on RMR retention in individuals with overweight/obesity compared with resistance-trained individuals. CONCLUSION: This review provides up-to-date evidence for INT-B as a viable dietary strategy to improve body composition and attenuate metabolic adaptation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023448959.

CircPRDM5 inhibits the proliferation, migration, invasion, and glucose metabolism of gastric cancer cells by reducing GCNT4 expression in a miR-485-3p-dependent manner.

Circular RNA (circRNA) plays a key part in the pathological process of gastric cancer (GC). The study is organized to analyze the function of circPRDM5 in GC cell tumor properties. Expression levels of circPRDM5, miR-485-3p, glucosaminyl (N-acetyl) transferase 4 (GCNT4), ki67, E-cadherin, N-cadherin, and hexokinase 2 (HK2) were analyzed by quantitative real-time polymerase chain reaction (PCR), Western blotting or immunohistochemistry assay. Cell proliferation was assessed by cell colony formation assay and 5-ethynyl-2'-deoxyuridine assay. Cell migration and invasion were investigated by transwell assay. Glycolysis was evaluated by the Seahorse XF Glycolysis Stress Test Kit. Dual-luciferase reporter assay and RNA pull-down assay were performed to identify the associations among circPRDM5, miR-485-3p, and GCNT4. Xenograft mouse model assay was conducted to determine the effects of circPRDM5 on tumor formation in vivo. CircPRDM5 and GCNT4 expression were downregulated, while miR-485-3p expression was upregulated in GC tissues and cells when compared with paracancerous tissues or human gastric epithelial cells. CircPRDM5 overexpression inhibited proliferation, migration, invasion, and glucose metabolism of GC cells; however, circPRDM5 depletion had the opposite effects. CircPRDM5 repressed tumor properties of GC cells in vivo. MiR-485-3p restoration relieved circPRDM5-induced effects in GC cells. GCNT4 overexpression remitted the promoting effects of miR-485-3p mimics on GC cell malignancy. CircPRDM5 acted as a sponge for miR-485-3p, and GCNT4 was identified as a target gene of miR-485-3p. Moreover, circPRDM5 regulated GCNT4 expression by interacting with miR-485-3p.CircPRDM5 acted as a miR-485-3p sponge to inhibit GC progression by increasing GCNT4 expression, proving a potential target for GC therapy.

Structured physical exercise interventions and children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta-analysis.

BACKGROUND: The efficacy of structured physical exercise (SPE) has been examined in empirical studies to treat attention deficit hyperactivity disorder (ADHD). This review aimed (i) to systematically review and quantify the effects of SPE on ADHD symptomology and executive function (primary outcomes) and on physical health, physical fitness and mental health issues (secondary outcomes) in children/adolescents with ADHD; (ii) to evaluate the study quality and explore moderation of the effects of SPE; and (iii) to summarize the design of SPE interventions. METHODS: An extensive literature search in the databases of PubMed, Web of Science and EBSCOhost was conducted to identify eligible intervention studies for meta-analysis. A descriptive account of the features of the studies is provided, including assessment of risk/quality (ROB-2/ROBINS-I). Standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated with random effects models to compare post-intervention effects. RESULTS: A total of 18 studies were included in the review. The majority of the studies examined the effects of SPE lasting for 3-12 weeks. Assessment of bias/quality indicated half of the included studies as high quality. The meta-analysis (pooled n = 627) revealed that SPE had a positive effect on primary and secondary outcomes, that is, inattention (SMD = -1.79), executive function (SMD = 2.19), physical fitness (SMD = 1.39) and mental health issues (SMD = -0.89). Subgroup analysis showed that long-term practice of SPE, featured/tailored SPE, non-Chinese participants, taking methylphenidate and study with low quality had larger effects. CONCLUSIONS: There is emerging evidence that SPE is a promising option to enhance symptom management and physical/mental health in children/adolescents with ADHD.

A scoping review of physical activity-based interventions for obesity management in children and adolescents during the COVID-19 pandemic.

Overweight and obesity have emerged as global health issues among children and adolescents. Restrictions related to the COVID-19 pandemic have aggravated the threat of paediatric obesity due to the prevalent reduction in physical activity (PA) in children and adolescents. However, this has also created an opportunity for healthcare professionals to explore new strategies to address this persistent problem. A systematically conducted scoping review was performed on 15 online databases to summarise and analyse the design, efficacy, and feasibility of PA-based weight management interventions for children and adolescents during the pandemic. Finally, we reviewed 23 eligible studies that were published between 2021 and 2023. The included interventions were presented to 1938 children and adolescents and 355 parents using a virtual or virtually blended face-to-face approach during the pandemic. The intervention design included a basic PA programme with three optional components (nutritional education, sociopsychological counselling, and medication consultations). Implementation generally resulted in favourable changes in body mass index (BMI) and/or body size or composition (primary outcomes), as well as health behaviours, physical health or fitness, and individual well-being (secondary outcomes). A longer duration of exposure to the intervention, female sex, and older age were associated with a higher efficacy of the included interventions. Moreover, the interventions showed high feasibility, with medium-high participant attendance, high acceptance/satisfaction in both children and adolescents and their parents and teachers, and strong participant engagement. This may be related to the high accessibility of health information, timely social support, and enhanced self-efficacy. In conclusion, both the virtual and blended delivery of well-planned weight management interventions during the pandemic show promise for the treatment and control of paediatric obesity. The lessons learned from the pandemic may help improve the design of future interventions and inform the proper integration of new technologies that have emerged in the post-pandemic world.

Association of Sedentary Lifestyle with Risk of Acute and Post-Acute COVID-19 Sequelae: A Retrospective Cohort Study.

BACKGROUND: Evidence suggests that coronavirus disease 2019 (COVID-19) survivors could experience COVID-19 sequelae. Although various risk factors for COVID-19 sequelae have been identified, little is known about whether a sedentary lifestyle is an independent risk factor. METHODS: In this retrospective cohort study, 4850 participants self-reported their COVID-19 sequelae symptoms between June and August 2022. A sedentary lifestyle included physical inactivity (<150 min/week of moderate-to-vigorous intensity physical activity) and prolonged sedentary behavior (≥10 h/day) before the fifth COVID-19 wave was recorded. Logistic regression analysis was performed to determine the relationships between sedentary lifestyle and risk of acute and post-acute (lasting ≥2 months) COVID-19 sequelae. RESULTS: A total of 1443 COVID-19 survivors and 2962 non-COVID-19 controls were included. Of the COVID-19 survivors, >80% and >40% self-reported acute and post-acute COVID-19 sequelae, respectively. In the post-acute phase, COVID-19 survivors who were physically inactive had a 37% lower risk of insomnia, whereas those with prolonged sedentary behavior had 25%, 67%, and 117% higher risks of at least one symptom, dizziness, and "pins and needles" sensation, respectively. For the acute phase, prolonged sedentary behavior was associated with a higher risk of fatigue, "brain fog," dyspnea, muscle pain, joint pain, dizziness, and "pins and needles" sensation. Notably, sedentary behavior, rather than physical inactivity, was correlated with a higher risk of severe post-COVID-19 sequelae in both acute and post-acute phases. CONCLUSIONS: Prolonged sedentary behavior was independently associated with a higher risk of both acute and post-acute COVID-19 sequelae, whereas physical inactivity played contradictory roles in COVID-19 sequelae.

Functional threshold power and the (manufactured) critical power controversy.

We read with concern yet another communication from Dotan regarding the critical power (CP) concept which contains a litany of factual errors, false statements, and dated physiological interpretations. Space does not permit us to rebut every incorrect point made about our work (Wong et al., 2022) and the wider field in which it sits, but we will address what we consider to be some of the more egregious errors in his letter. We would first note, however, that our paper was not actually focused on the critical power concept.

Acute Physiological and Perceptual Responses to Whole-Body High-Intensity Interval Training Compared with Equipment-Based Interval and Continuous Training.

Low-volume, time-efficient high-intensity interval training (HIIT), which involves whole-body (WB) callisthenics exercises, has gained worldwide popularity in recent years. However, the physiological and perceptual impact of WB-HIIT in comparison to specialised, equipment-based training is relatively less studied. This study compared the acute physiological and perceptual responses to a single session of WB-HIIT, ergometer-based HIIT (ERG-HIIT) and conventional moderate-intensity continuous training (MICT). Fourteen physically inactive adults (age: 28.4 ± 6.5 years, VO2peak: 31.0 ± 6.2 mL· kg-1· min-1) underwent three main trials (WB-HIIT: 12 x 30-s high-intensity callisthenics workout; ERG: HIIT: 12 x 30-s high-intensity cycling bouts; MICT: 30-min cycling at 50% peak power output) in a randomized cross-over order 3-7 days apart. The mean session heart rate (HR) and perceived exertion were comparable across all three protocols (p > 0.05). WB-HIIT attained a similar peak HR (87.4 ± 9.4 %HRmax) as that of ERG-HIIT (83.0 ± 8.6 %HRmax), and significantly greater than that of MICT (78.7 ± 5.5 %HRmax, p = 0.001). However, WB-HIIT induced significantly higher blood lactate levels (7.2 ± 1.8 mmol/L) compared to both ERG-HIIT (5.1 ± 1.3 mmol/L, p < 0.05) and MICT (3.1 ± 1.5 mmol/L, p < 0.001). The participants reported higher self-efficacy and greater enjoyment with WB-HIIT compared to MICT (p < 0.05). The mean HR and perceived exertion responses to WB-HIIT are comparable to those of equipment-based HIIT and MICT; however, WB-HIIT results in greater metabolic strain than both other modalities. Despite this, the overall perceptual responses to WB-HIIT are positive, suggesting that it could be a viable exercise alternative, especially for individuals with limited exercise time and restricted access to facilities and equipment.

Examining the Impact of Physical Activity on Sleep Quality in Children With ADHD.

OBJECTIVE: Sleep problems have been commonly observed in children with attention deficit hyperactivity disorder (ADHD). The aim of current study was to investigate the impact of physical activity on sleep quality in young adolescent with attention deficit hyperactivity disorder. METHOD: A total of 33 children diagnosed with attention deficit hyperactivity disorder (mean age = 10.12 years) were randomized into intervention group and control group respectively. Mention the intervention detail here. Four specific sleep parameters, including sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset, were assessed before and after the intervention period in both groups. RESULTS: Results revealed the significant improvements in sleep efficiency, sleep onset latency and wake after sleep onset in the intervention group but not in the control group. CONCLUSION: Current findings highlight the benefits of PA on enhancing sleep quality among children with ADHD.

The Effect of Physical Activity Intervention on Motor Proficiency in Children and Adolescents with ADHD: A Systematic Review and Meta-analysis.

Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed neurodevelopmental disorder in children and adolescents. The objective of this review was to synthesize empirical studies that investigated the effects of physical activity (PA) on motor proficiency in this population. A systematic review and meta-analysis were conducted following the cochrane guidelines for systematic reviews. In May 2022, a systematic search of eight electronic databases retrieved 476 results, which were screened independently by two reviewers. Based on the inclusion and exclusion criteria, 12 studies were selected for systematic review, and 10 were included in the meta-analysis. A beneficial effect of PA on overall motor proficiency (SMD = 1.12; 95% CI [0.63 to 1.61]; p < 0.05) was observed. Similar positive effects were found for motor proficiency composites, including object control, fine manual control, and body coordination. These results indicate that PA improves the motor proficiency of children and adolescents with ADHD.

Environmental Correlates of Physical Activity and Screen-Time in Youth with Autism Spectrum Disorder: A Seven-Country Observational Study.

This cross-sectional observational study sought to examine the environmental correlates of physical activity and screen-time among youth with autism spectrum disorder (ASD). Parents of youth with ASD (n = 1,165) from seven countries/regions provided responses to an online survey form measuring environmental correlates (i.e., physical activity neighborhood environment, social network, social trust and cohesion, bedroom media, social home environment) and outcomes (i.e., physical activity, screen-time). Multiple linear regression analyses were conducted to determine environmental predictors of the outcomes. Physical activity neighborhood environment (B = 0.15, p = 0.047), social network (B = 0.16, p = 0.02), and social home environment (B = 1.07, p < 0.001) were significantly associated with physical activity, whereas social trust and cohesion and bedroom media were not. Further, social trust and cohesion (B = -0.14, p = 0.001), bedroom media (B = 0.10, p = 0.001), and social home environment (B = -0.16, p < 0.001) were significantly associated with screen-time while neighborhood environment and social network were not. The identified environmental attributes of physical activity and screen-time behaviors should be targeted for health promotion among youth with ASD.

Effects of accumulated versus continuous individualized exercise on postprandial glycemia in young adults with obesity.

Background: Elevated postprandial glucose (PPG) is an independent risk factor for cardiovascular disease. Post-meal exercise effectively reduces PPG concentrations. However, the effect of accumulated versus continuous post-meal exercise on PPG control remains unclear. This study aimed to investigate the effects of individualized accumulated or continuous exercise on PPG in young adults with obesity.Twenty young adults with obesity (11 males) completed three 4-h randomized crossover trials with 6-14-day washout periods: (1) sitting (SIT), (2) one 30-min walking bout (CONT), and (3) three 10-min walking bouts separated by 20-min resting (ACCU). Walking was initiated 20 min before individual PPG peak after breakfast, which was predetermined by continuous glucose monitoring. Blood samples were collected at 15-30 min intervals, and the 24-h glucose was monitored via continuous glucose monitoring.Results: The 4-h PPG incremental area under the curve (iAUC) was 12.1%±30.9% and 21.5%±21.5% smaller after CONT (P = 0.022) and ACCU (P < 0.001), respectively, than after SIT. PPG concentrations were lower during CONT at 30-60 min and during ACCU at 30-105 min after breakfast than during SIT (all P < 0.05). The 4-h plasma insulin and C-peptide iAUC, and mean amplitude of glycemic excursions were lower after CONT and ACCU than after SIT (all P < 0.05).Conclusions: Both continuous and accumulated exercises reduced PPG, insulin, and C-peptide concentrations and improved glucose fluctuations. Accumulated exercise maintained lower PPG concentrations for a longer time than continuous exercise in young adults with obesity.Clinical Trial Information: Clinical trial registration No. ChiCTR 2000035064, URL: http://www.chictr.org.cn/showproj.aspx?proj=56584; (registered July 29, 2020).

Both continuous and accumulated walking lowered post-meal glucose, insulin and C-peptide levels and improved glucose fluctuation.Postprandial glucose was kept lower for a longer time in accumulated than continuous walking.Accumulated post-meal exercise (e.g. three 10-min bouts of walking) could be recommended as a feasible and practical alternative protocol for postprandial glucose control, especially for those who have difficulty performing sufficient exercise in one session.