Health literacy mediates the relationships of cognitive and physical functions with health-related quality of life in older adults.

Background: Declining cognitive function (CF) and physical function (PF) relate to poorer health-related quality of life (HRQoL) in older adults. As health literacy (HL) facilitates health information utilization, it may mediate links between functionality and HRQoL appraisals. This study examined HL as an intermediary between joint CF and PF contributions and HRQoL in Hong Kong older adults. Methods: 490 older adults aged 50-80 years completed assessments from March to July 2021. Health Literacy Survey Questionnaire Short Form 12 questions (HLS-SF12), Montreal Cognitive Assessment (MoCA), Senior Fitness Test (SFT) and 12-Item Short-Form Health Survey version 2 (SF-12v2) were used to assess HL, CF, PF and HRQoL, respectively. Path analysis tested a model with HL mediating CF/PF predictors and HRQoL outcome. Results: Results for direct effects indicated that CF significantly associated with PF (ß = 0.115, SE = 0.012, p < 0.001), PF significantly connected to HL (ß = 0.101, SE = 0.022, p < 0.001), and HL significantly related to HRQoL (ß = 0.457, SE = 0.049, p < 0.001). Meanwhile, PF significantly linked to HRQoL directly (ß = 0.156, SE = 0.025, p < 0.001) as well as indirectly (ß = 0.046, 95% CI [0.028, 0.067]). Significant mediating effect of HL was found on the relationship of PF and HRQoL. Conclusion: Findings confirm CF and PF joint impacts on HL and HRQoL in older adults, elucidating HL's mediating role in translating functionality levels into HRQoL. Fostering enduring health knowledge access may thus buffer effects of age-related declines on well-being. Results can inform interventions leveraging this pathway to promote resilient trajectories.

Acute performance responses to repeated treadmill sprints in hypoxia with varying inspired oxygen fractions, exercise-to-recovery ratios and recovery modalities.

PURPOSE: For optimizing the quality of repeated-sprint training in hypoxia, the differences in the acute performance responses to a single session of repeated-sprint exercise with various (i) inspired oxygen fractions; (ii) exercise-to-recovery (E:R) ratios and (iii) recovery modalities were examined. METHODS: Ten male participants performed three sets, 5 × 5-s all-out treadmill sprints, E:R ratio of 1:5, passive recovery, in seven trials randomly. In four of the seven trials, hypoxic levels were set corresponding to sea level (SL1:5P), 1500 (1.5K1:5P), 2500 (2.5K1:5P), and 3500 m (3.5K1:5P), respectively. In a further two trials, the hypoxic level of 3.5K1:5P was maintained, while the E:R ratio was reduced to 1:4 (3.5K1:4P) and 1:3 (3.5K1:3P), respectively. In the last trial, the passive recovery mode of 3.5K1:5P was changed to active (3.5K1:5A). RESULTS: In comparison to SL1:5P, the averaged peak velocity (P-Vel), mean velocity (M-Vel), and velocity decrement score (Sdec) of the sprints, and the cumulative HR-based training impulse (cTRIMP) in 1.5K1:5P and 2.5K1:5P were well maintained. Minor decrement in the M-Vel was found in 3.5K1:5P. Conversely, lowered E:R ratio in 3.5K1:4P and 3.5K1:3P significantly reduced the P-Vel (≥ -2.3%, Cohen's d ≥ 0.43) and M-Vel (≥ -2.4%, ≥ 0.49), and in 3.5K1:3P altered the Sdec (107%, ≥ 0.96), and cTRIMP (-16%, 1.39), when compared to 3.5K1:5P. Furthermore, mild reductions in M-Vel (-2.6%, 0.5) was observed in 3.5K1:5A using the active recovery mode. Other variables did not change. CONCLUSION: The findings suggest that a 3.5K1:5P marginally maintained sea-level training loads, and as a result, could maximally optimize the training stress of hypoxia.

Physical and Sedentary Activity Patterns in Youths with Autism Spectrum Disorder.

Little is known about the patterns of sedentary behavior and physical activity (PA) within different school levels (i.e., primary school and secondary school) and on different day types (i.e., weekdays and weekend days) among youths with autism spectrum disorder (ASD). The sample was recruited from one city in Taiwan. A total of 68 male youths with ASD, aged 6-17 years, participated in the study. PA was assessed using an ActiGraph accelerometer, and sedentary behaviors (i.e., TV viewing, computer use, and reading time) were determined using a self-report log. The main findings were that (a) primary school youths with ASD were more active than secondary school youths with ASD on both weekdays and weekend days, but primary school youths with ASD also had more sedentary time than did secondary school youths with ASD on both weekdays and weekend days; (b) secondary school youths with ASD were more active but also more sedentary on weekdays compared with weekend days, but they had more screen use on weekend days compared with on weekdays. Future interventions are required to decrease sedentary behavior and increase PA to improve the health of these youths according to school level and day of the week.

Promoting Physical Activity in Group Home Settings: Staff Perspectives through a SWOT Analysis.

PURPOSE: The aim of the study was to investigate perceptions of staff about the promotion of physical activity (PA) in selected group residences of Hong Kong (HK), some of which had experienced a multi-component PA program. METHOD: Focus group interviews with nineteen staff members from four group homes (two of which received the program) were conducted. FINDINGS: A SWOT analysis provided important insights into residential staff views about key influences on the quality of PA programs for residents with intellectual disabilities (ID). Positive (strengths and opportunities) and negative (weaknesses and threats) influences were identified. They were associated with characteristics of residents, staff, and group residence. Increasing age and low motivation are impediments to PA engagement of adults with ID. Staff competence and prior unsuccessful experience in promoting PA are also implicated. CONCLUSION: The PA program quality is mediated by the quality of staff interpersonal interactions with their clients and their commitment in encouraging such adults with ID to join and persistent in PA as well as staff seeking external resources and support as well as using initiative to adapt PA promotion activities in their specific group residential context.

Physical Activity and Physical Fitness of Adults with Intellectual Disabilities in Group Homes in Hong Kong.

Adults with intellectual disabilities (ID) typically have a sedentary lifestyle and higher rates of overweight and obesity. This study describes the habitual daily physical activity (PA) and the health-related physical fitness (PF) of adults with mild and moderate ID who resided in four group homes and worked in sheltered workshops. We also assessed the contribution of PF variables towards PA levels and sedentary behavior of this population subgroup. Adults with mild and moderate ID (N = 114) were assessed on PF tests (percent body fat, waist and hip circumferences, 6-min walk (6MWT), arm curl, and sit and reach). PA and sedentary behavior on weekdays were determined using Actigraph accelerometers. Results showed these adults averaged 2% of their daily time (or 10 min) engaged in moderate-to-vigorous PA (MVPA) and 67% of the time (495 min) being sedentary. No significant differences between mild and moderate ID were found for any PA or PF variable. Linear multiple regression analyses showed 6MWT to be the only significant PF variable contributing to the variance of PA and sedentary behavior. In conclusion, adults with ID reside in group home have low PA and low fitness levels. Among fitness variables, the walking test (i.e., cardiovascular fitness) had the highest positive association with participants’ daily PA, MVPA, and negative association with sedentary behavior. Future intervention studies in promoting PA and fitness for adults with ID are warranted.

Physical Activity and Sedentary Time among Children with Disabilities at School.

PURPOSES: Physical activity (PA) is important for the development of children with disabilities, but rarely does this population meet the recommended standards. Schools are salient locations for PA, but little is known about how specific school settings affect the PA of children with diverse disabilities. We assessed PA and sedentary time (ST) of children with disabilities in three school settings (physical education, recess, lunchtime). METHODS: Participants included 259 children from 13 Hong Kong special schools for five primary disabilities: visual impairments, hearing impairments, physical disabilities, intellectual disabilities, and social development problems. Children wore accelerometers at school for 3 d, and the time (min and %) they engaged in moderate-to-vigorous PA (MVPA) and ST was extracted for each school setting by sex. Analyses included multiple linear mixed models to determine differences in MVPA and ST by sex across disability types, adjusting for body mass index, grade level, and duration in each setting. RESULTS: Overall, children spent 70% of their day at school being sedentary and accrued little MVPA (mean, 17 ± 4.2 min daily). Children with intellectual disabilities (severe) had especially low levels of MVPA. All three settings contributed significantly to both MVPA and ST, with recess contributing more to MVPA than physical education or lunchtime. CONCLUSIONS: This is the first study to examine MVPA and ST among different disability types at school using accelerometry. Given the low levels of PA, this population should receive priority in the development of cost-effective interventions to improve their PA opportunities.

Public Parks in Hong Kong: Characteristics of Physical Activity Areas and Their Users.

Public parks, salient locations for engaging populations in health promoting physical activity, are especially important in high-density cities. We used the System for Observing Physical Activity in Communities (SOPARC) to conduct the first-ever surveillance study of nine public parks in Hong Kong (288 observation sessions during 36 weekdays and 36 weekend days) and observed 28,585 visitors in 262 diverse areas/facilities. Parks were widely used throughout the day on weekdays and weekend days and across summer and autumn; visitor rates were among the highest seen in 24 SOPARC studies. In contrast to other studies where teens and children dominated park use, most visitors (71%) were adults and seniors. More males (61%) than females used the parks, and they dominated areas designed for sports. Over 60% of visitors were observed engaging in moderate-to-vigorous physical activity, a rate higher than other SOPARC studies. Facilities with user fees were less accessible than non-fee areas, but they provided relatively more supervised and organized activities. Assessing parks by age, gender, and physical activity can provide useful information relative to population health. This study not only provides information useful to local administrators for planning and programming park facilities relative to physical activity, but it also provides a baseline for comparison by other high-density cities.

Design and methods of a multi-component physical activity program for adults with intellectual disabilities living in group homes.

Adults with intellectual disabilities (ID) often live a sedentary lifestyle and have higher rates of overweight and obesity. The purpose of this report is to describe the design and methods of a multi-component physical activity (PA) intervention program that aims to increase PA levels in adults with ID who live in group homes. The study employed a multi-component delayed treatment control group design involving adults with ID who lived in two group homes. Interventions included 30 exercise sessions in groups over a 10-week period and three educational lessons based on social cognitive theory that aimed to improve self-efficacy and social support for PA in the participants. In addition, staff training in exercise and advice on institutional PA policies were provided to the caregivers working in the group homes. Outcome measures on three aspects were collected: (1) physical fitness, (2) PA as assessed by an ActiGraph accelerometer, and (3) self-efficacy and social support for PA. Our major objective was to develop the intervention protocol, and the successful completion of this study will provide valuable evidence on how to promote active lifestyles in adults with ID.

Difference in children's gross motor skills between two types of preschools.

The purpose of this study was to assess the influence of preschool type (public vs private) on motor skill performance in 239 (121 boys, 118 girls) preschool children ages 3 to 6.5 yr. Preschoolers were tested on 12 fundamental motor skills from the Test of Gross Motor Development-Second Edition and 11 anthropometrics (body height, weight, Body Mass Index, waist and hip girths, and body segment lengths). Analysis of variance controlled for anthropometrics and age indicated that children from private preschools performed better on locomotor skills than those from public preschools. However, no difference was found in object control skills. The results suggest that performance of locomotor skills by preschool children is affected by their schools' physical environment.

Increased sensations of intensity of breathlessness impairs maintenance of intense intermittent exercise.

To identify the reserve of an individual's tolerance of the sensation of breathlessness and metabolic stress in maintaining intense intermittent exercise at exhaustion under conditions of normal breathing, the contribution of the effect of modest inspiratory load on these two responses to the change in the exercise sustainability (Ex(sus)) were examined. Seven men repeatedly performed 12 s exercise at 160% maximal aerobic power output followed by passive recovery for 18 s under normal and ventilatory muscle loaded (VML) breathing conditions until exhaustion. In the VML trial, ventilatory muscle work at exhaustion was double that of the normal control. The control Ex(sus) was reduced [mean (SEM)] [31.7 (6.6)%] while the slope of the time course for the rating of the perceived magnitude of breathing effort (RPMBE/Time), which reflected the intensity of breathlessness, was increased [164.8 (32.2)%] from control and the RPMBE at exhaustion was higher than corresponding control value [144.4 (21.8)%]. Moreover, increases in plasma ammonia and uric acid concentrations, which indicated metabolic stress, were increased [168.1 (28.0)% and 251.7 (57.4)%, respectively], with no change in total oxygen uptake from control when the control exercise was repeated with an identical duration of VML exercise. It was found that the reduction in Ex(sus) in the VML trial was correlated to the increase in their sensations of the intensity of breathlessness (RPMBE/Time: r=0.81; RPMBE at exhaustion: r=0.97, P<0.05). The reduction in Ex(sus), however, was not correlated to the increase in metabolite concentrations. These findings implied that there was no substantial reserve of tolerance of the sensation of breathlessness relative to that of metabolic stress in subjects maintaining intense intermittent exercise at exhaustion under normal conditions of breathing.