Pancreatic Tuberculosis With Duodenal Fistula Presenting as Life-Threatening Gastrointestinal Bleeding.

Pancreatic tuberculosis (TB) warrants heightened suspicion in individuals with pancreatic lesions and risk factors such as HIV, organ transplantation, or pertinent immigration history. We present a 38-year-old man who presented with hemodynamically unstable gastrointestinal bleeding. He was found to have pancreatic TB complicated by a duodenal ulcer with fistula. Following 1 month of antitubercular therapy, he experienced complete resolution of symptoms, healing of the duodenal ulcer, closure of the fistulous tract, and a decrease in the size of the pancreatic lesion as observed on imaging. Our case highlights the importance of early diagnosis and treatment of pancreatic TB.

Effects of a multicomponent physical activity programme, Mobility-Fit, compared with a standard care lower limb strengthening programme, to promote safe mobility among older adults in care facilities: protocol for a cluster randomised controlled trial.

INTRODUCTION: Upper limb and core strength training is essential for older adults to safely perform daily activities. However, existing exercise programmes mainly focus on lower limb strength and are not designed or delivered to suit people with different functional capacities. This study describes the design of a two-arm cluster randomised controlled trial to examine the effects of a multicomponent physical activity (PA) programme, Mobility-Fit, on mobility and frailty in older adults living in care facilities. METHODS AND ANALYSIS: 160 older adults from 20 care facilities in Hong Kong will be recruited and randomised by care facilities (1:1) to an intervention or a control group. Participants in the intervention group will attend the Mobility-Fit programme, led by facility-based instructors, three times per week, 45 min per session, for 12 weeks, while the control group will participate in a standard care lower limb strengthening programme offered by the care facility. Participants will then be followed up for 9 months. Mobility-Fit comprises agility, postural coordination, balance and strength training, with suitable dosage based on participant's baseline physical and cognitive function. The primary outcomes encompass upper and lower limb strength, trunk stability, reaction time, mobility function and fall efficacy. Secondary outcomes comprise daily PA level and performance, frailty, cognitive function and quality of life. A repeated measures analysis of variance (ANOVA) and generalised estimating equation (GEE) will be used to examine changes in outcomes over time and between groups. Data will be analysed following the intention-to-treat principles. We will also evaluate programme implementation and health economics throughout the follow-up period. ETHICS AND DISSEMINATION: Ethical approval was acquired in November 2022 from the Joint CUHK-NTEC Clinical Research Ethics Committee in Hong Kong (CREC-2022-459). Informed consent will be obtained from participants. The results of the study will be disseminated through peer-reviewed articles, conference presentations and social media. TRIAL REGISTRATION NUMBER: ChiCTR2300072709.

The role of physical literacy and mindfulness on health-related quality of life among college students during the COVID-19 pandemic.

This study aimed to examine the role played by the physical literacy and mindfulness in the health-related quality of life (QoL) of college students. In early 2022, 24,236 college students from three universities in southern China were recruited in the study. R software and the lavvan package was utilized to build the structural equation model. The measurement model was composed of three latent factors (physical literacy, mindfulness, and quality of life) and 16 observed variables in total. The results of the measurement model indicated goodness fit with p > .05 in Chi-square result, and GFI = .92. In addition, the comparative fit index (.92), Tucker-Lewis index (.91), root-mean-square error of approximation (.07), and root of mean square residual (.11) were in accord with the cutoff model-fit criteria. The results confirm that physical literacy and mindfulness can play a significant and positive role in the structural equation model of quality of life. In addition, this study provides initial evidence that mindfulness and physical literacy could potentially buffer declines in student QoL during the COVID-19 pandemic. Moreover, this study is the first to develop a structural equation model of QoL with multiple indicators, making it a strong addition to existing research on QoL during a pandemic.

What is esports? A systematic scoping review and concept analysis of esports.

This study conducted a systematic scoping review to collect definitions and explanations of esports and its related concepts in the existing literature. A thematic coding approach was used to screen possible disagreements and issues between the different characteristics of esports as presented in the existing definitions. Based on a critical discussion, the results of the coding were combined with the objective facts of the current esports industry and theories from similar fields to reconstruct the construction of an esports definition. In addition, the relationship between esports and its related concepts was discussed based on the proposed esports definition structure. The proposed esports criteria can help avoid misunderstandings and confusion in future studies regarding the research subjects related to esports and propose standardized usage of relevant terms in the field of esports research.

Associations of timing of physical activity with all-cause and cause-specific mortality in a prospective cohort study.

There is a growing interest in the role of timing of daily behaviors in improving health. However, little is known about the optimal timing of physical activity to maximize health benefits. We perform a cohort study of 92,139 UK Biobank participants with valid accelerometer data and all-cause and cause-specific mortality outcomes, comprising over 7 years of median follow-up (638,825 person-years). Moderate-to-vigorous intensity physical activity (MVPA) at any time of day is associated with lower risks for all-cause, cardiovascular disease, and cancer mortality. In addition, compared with morning group (>50% of daily MVPA during 05:00-11:00), midday-afternoon (11:00-17:00) and mixed MVPA timing groups, but not evening group (17:00-24:00), have lower risks of all-cause and cardiovascular disease mortality. These protective associations are more pronounced among the elderly, males, less physically active participants, or those with preexisting cardiovascular diseases. Here, we show that MVPA timing may have the potential to improve public health.

Development, explanation, and presentation of the Physical Literacy Interventions Reporting Template (PLIRT).

BACKGROUND: The physical literacy (PL) concept integrates different personal (e.g., physical, cognitive, psychological/affective, social) determinants of physical activity and has received growing attention recently. Although practical efforts increasingly adopt PL as a guiding concept, latest evidence has shown that PL interventions often lack specification of important theoretical foundations and basic delivery information. Therefore, the goal of the present study was to develop an expert-based template that supports researchers and practitioners in planning and reporting PL interventions. METHODS: The development process was informed by Moher et al.'s guidance for the development of research reporting guidelines. We composed a group of ten distinguished experts on PL. In two face-to-face meetings, the group first discussed a literature-driven draft of reporting items. In the second stage, the experts anonymously voted and commented on the items in two rounds (each leading to revisions) until consensus was reached. RESULTS: The panel recommended that stakeholders of PL initiatives should tightly interlock interventional aspects with PL theory while ensuring consistency throughout all stages of intervention development. The Physical Literacy Interventions Reporting Template (PLIRT) encompasses a total of 14 items (two additional items for mixed-methods studies) in six different sections: title (one item), background and definition (three items), assessment (one item each for quantitative and qualitative studies), design and content (five items), evaluation (one item plus one item each for quantitative and qualitative studies), discussion and conclusion (two items). CONCLUSION: The PLIRT was designed to facilitate improved transparency and interpretability in reports on PL interventions. The template has the potential to close gaps between theory and practice, thereby contributing to more holistic interventions for the fields of physical education, sport, and health.

Associations Between Perceived Social Support, Perceived Competence, and Physical Activity in Hong Kong Children With Disabilities During the COVID-19 Pandemic.

This study aimed to examine the associations between perceived social support, perceived competence, and physical activity in children with physical and intellectual disabilities during the COVID-19 pandemic. During the third wave of the pandemic in Hong Kong (i.e., July through December 2020), 291 participants age 6-17 years from 27 special schools were included. After controlling for demographic variables, the total variance explained by perceived social support and perceived competence was 24%, F(2, 240) = 12.42, p < .001, with perceived competence having a stronger association with physical activity (ß = 0.29, p < .001) than perceived social support (ß = 0.07, p = .22). This study highlights two key facilitators for shaping physical activity involvement among children with disabilities during the COVID-19 pandemic.

The Associations Between Accelerometer-Measured Physical Activity Levels and Mental Health in Children and Adolescents with Intellectual Disabilities During the COVID-19 Pandemic.

To examine the associations between physical activity (PA) levels and mental health in children and adolescents with intellectual disabilities (IDs) during the COVID-19 pandemic, 117 participants aged between 6 and 17 years with IDs from 10 Hong Kong special schools were included. There were positive dose-response associations between PA (i.e., light PA, moderate PA, and vigorous PA) and mental health, and participants with higher levels of moderate-to-vigorous PA (MVPA) and self-concept (SC) had better social quality of life (QoL) than those with lower levels of MVPA and SC. Moreover, personal and environmental factors such as age, body mass index, school, sex, ID level, and parental education level influenced the PA levels and QoL in children and adolescents with IDs.

Exploring physical literacy in children aged 8 to 12 years old: a cross-cultural comparison between China and Greece.

BACKGROUND: The concept of physical literacy (PL) has been advocated as a crucial determinant for increasing the quality and quantity of movement and physical activity (PA). Children's PL has been rarely compared across countries, although it has shown low levels in many countries. This study aimed to explore and compare children's PL from China and Greece. METHODS: A total of 327 Chinese (47.1% boys) and 295 Greek children (48.1% boys) aged 8 to 12 years participated in this study. Children's PL was objectively assessed by the Chinese and Greek version of the Canadian Assessment of Physical Literacy, 2nd edition, which consists of four domains: Daily Behavior, Physical Competence, Motivation and Confidence, and Knowledge. and Understanding. Univariate analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) on total PL and domain scores were conducted in both countries, respectively. RESULTS: MANOVA revealed significant differences in total PL and distribution scores between two countries (Pillais' trace = 0.260, F = 53.855, p < 0.001, η2 = 0.260), with Greek children scoring better than Chinese. Nevertheless, most children failed to present an adequate PL level as they were mostly in the "progressing" stage. The chi-square denoted that the distribution of Chinese and Greek participants across the CAPL-2 interpretive categories was statistically different for total PL (χ2 [3] = 18.726, p < 0.001, Cramer's V = 0.174), with more Greek children being classified as "achieving" and "excelling". CONCLUSIONS: The variance between Chinese and Greek children may be attributed to cultural differences in the context of PA, such as PE policies and settings. The relatively low level of PL shown in both countries echoes the global trend of the declining PA among children, with an increasing amount of their time spent in a sedentary lifestyle. These findings highlight the need to consider children's cultural factors and pedagogical strategies in terms of developing their PL. Future research is required to explore the impact of cultural background on PL development among children and appropriate strategies to migrate their influence.

Effects of a blended classroom-based intervention on aerobic fitness, motor skills, inhibition, and daytime sleepiness among Hong Kong children.

In response to the all-round development of primary school children, this study aimed to evaluate the effectiveness of a blended intervention program on children's health-related outcomes of aerobic fitness, motor skills, inhibition and daytime sleepiness in classroom settings. Three experimental conditions include: (1) the "Stand + Move" group combining sit-stand desks and physical activity (PA) recess, (2) "Move" group with PA recess only, and (3) Control group (CG; normal class schedule). A total of 64 primary school children (37.5% girls and 62.5% boys, M [SD] = 9.6 [0.61], BMI mean = 17.0 ± 3.0) participated in all assessments, including aerobic fitness, motor skills, inhibitory control, and daytime sleepiness. The baseline data collection starts from January 2019, with the intervention lasting for 13 weeks and followed by post-intervention and follow up tests conducted in July and October 2019. There was a significant interaction effect on aerobic fitness [F (2,76) = 10.62, p < 0.001, η2 = 0.22] after the intervention period, whereas no significant interaction was observed for other variables. Significant main effects were observed in aerobic fitness (pre - post: -11.75 and -7.22) for both experimental groups, with the blended group showing greater improvements immediately post the test, while motor skills only showed a significant increase at the three-month follow-up, with the greatest increase in the blended group (pre-follow-up: -2.50). For inhibition control and daytime sleepiness, better improvements were shown for the experimental groups than for the control group. The blended designed intervention, by incorporating multiple components as an innovative strategy to reconstruct children's traditional classroom environment in Hong Kong, has demonstrated improved physical and psychological development of school children. Clinical trial registration: ChiCTR, ChiCTR2000035038. Registered 29 July 2020 - Retrospectively registered. http://www.chictr.org.cn/hvshowproject.aspx?id=46038.

The Associations Among Physical Activity, Quality of Life, and Self-Concept in Children and Adolescents With Disabilities: A Moderated Mediation Model.

Objectives: This study aimed to examine a moderated mediation model of the associations among physical activity (PA), quality of life (QoL), and self-concept (SC) in children and adolescents with physical disabilities (PDs) and intellectual disabilities (IDs). Materials and Methods: A total of 288 children and adolescents with PDs and IDs, aged between 6 and 17 years, were recruited from 16 special schools in Hong Kong. PA, QoL, and SC were measured using the Physical Activity Questionnaire for Older Children (PAQ-C), Paediatric Quality of Life Inventory (PedsQL), and Physical Self-Description Questionnaire Short Form, respectively. Mediation (i.e., PA, QoL, and SC) and moderation analyses (i.e., age, sex, and parental education level) were conducted by structural equation modelling (SEM) using the M plus and PROCESS macro for SPSS. Results: Physical activity (PA) was positively associated with SC (PDs: ß = 0.373; IDs: ß = 0.343), and SC significantly mediated the associations between PA and QoL in children and adolescents with PDs (parent proxy-report QoL: ß = 0.114; self-report QoL: ß = 0.141) and IDs (self-report QoL: ß = 0.204). The mediating effects of SC accounted for 16 and 15% of the total effects of PA on QoL (parent proxy-report and self-report) respectively, in participants with PDs, and 8 and 4%, respectively, in those with IDs. Males and participants with higher parental education levels reported stronger associations among PA, QoL, and SC than their counterparts. Conclusion: This study supports mediating and moderating effects on the associations among PA, QoL, and SC in children and adolescents with PDs and IDs. Future researchers should consider PA intervention in mental health services and provide tailor-made PA programmes based on personal and environmental factors for children and adolescents with disabilities.

Operationally defining physical literacy in Chinese culture: Results of a meta-narrative synthesis and the Panel's recommendations.

Purpose: The definition of physical literacy (PL) needs to be explored by researchers from educational, public health, and sports organisations in Chinese culture; an adequate definition and theoretical framework of PL can then be embraced within different contexts and according to cultural influences. Methods: This meta-narrative synthesis of literature in this area included a series of planning, search, mapping, appraisal, synthesis, and recommendation phases. The literature was translated into English and circulated among international experts to seek suggestions. A total of 74 articles were included in the PL definition synthesis and 28 were included for philosophical synthesis in this study. Results: Based on three rounds of discussions, the final agreement was reached among panel members regarding the defining statements and practical and theoretical models of PL in Chinese culture. According to consensus, PL is the integration of physical, perceptual, cognitive, psychological, and behavioural capabilities, echoing with the need for an active, healthy, and fulfilling lifestyle, which involves continuous positive interactions with the environment and embodied engagement in physical activities for life. The framework addressed five domains (physical, sensory-perceptual, cognitive, psychological, and behavioural) and one important overlapping factor (dynamic environment). A further explanation was provided in the defining statement to assist in understanding the concept. Conclusion: It is suggested that the cultural interpretation and historical background of PL in Chinese discourse should be addressed and respected. The development of a specific cultural definition statement of PL in one country could provide implications for PL researchers worldwide.

Psychometric Validation of Senior Perceived Physical Literacy Instrument.

Aim: To validate the Senior Perceived Physical Literacy Instrument (SPPLI). Methods: In the pilot study, we refined the Perceived Physical Literacy Instrument (PPLI, Cronbach's α = 0.94, initially designed for adults) into SPPLI using internal reliability, content validity, and construct validity results. A total of 341 older adults recruited from community centers in Southern Taiwan participated in the study. A principle component analysis (PCA) identified three components of SPPLI. Results: Eleven items were captured from the 18-item PPLI as the SPPLI (Cronbach's α = 0.90). SPPLI exhibits three components: attitude toward physical activity, physical activity ability, and sociality around physical activity. Significant differences were discovered in physical activity ability by educational attainment (p < 0.05) and in all three components by stage of exercise (maintenance vs. non-maintenance) (p < 0.05). The SPPLI possesses proper reliability and validity to assess physical literacy among older adults. Conclusions: This instrument is suggested for physical literacy assessments in physical activity programs to assess the needs of older adults and/or the effectiveness of an intervention program that aims to improve the attitude, ability, and sociality of physical activity.

Validation of a Speech Database for Assessing College Students' Physical Competence under the Concept of Physical Literacy.

This study developed a speech database for assessing one of the elements of physical literacy-physical competence. Thirty-one healthy and native Cantonese speakers were instructed to read a material aloud after various exercises. The speech database contained four types of speech, which were collected at rest and after three exercises of the Canadian Assessment of Physical Literacy 2nd Edition. To show the possibility of detecting each exercise state, a support vector machine (SVM) was trained on the acoustic features. Two speech feature sets, the extended Geneva Minimalistic Acoustic Parameter Set (eGeMAPS) and Computational Paralinguistics Challenge (ComParE), were utilized to perform speech signal processing. The results showed that the two stage four-class SVM were better than the stage one. The performances of both feature sets could achieve 70% accuracy (unweighted average recall (UAR)) in the three-class model after five-fold cross-validation. The UAR result of the resting and vigorous state on the two-class model running with the ComParE feature set was 97%, and the UAR of the resting and moderate state was 74%. This study introduced the process of constructing a speech database and a method that can achieve the short-time automatic classification of physical states. Future work on this corpus, including the prediction of the physical competence of young people, comparison of speech features with other age groups and further spectral analysis, are suggested.

A Randomized Controlled Trial of a Blended Physical Literacy Intervention to Support Physical Activity and Health of Primary School Children.

BACKGROUND: The concept of physical literacy (PL) has been advocated as the need to create environments fostering sustainable engagement in PA. This study adopted ecological approach to evaluate the effectiveness of a blended PL intervention embedded into the school day to support children's PA and health. METHOD: Designed as a three-arm randomized controlled trial, a total of 79 participants (59.5% girls) were randomly assigned to: the "Quantity + Quality" blended PL group combining sit-stand desks and play-based recess (SSPlay), the "Quality" group with play-based recess only (Play) or the control group. The intervention lasted for 13 weeks, and all the variables were collected at baseline, post-intervention and 3-month follow-up. RESULTS: SSPlay and Play group significantly improved on two of the embodied PL domains, Physical Competence (- 2.96 vs - 5.15, p < 0.05) and Knowledge and Understanding (- 2.35 vs - 2.00, p < 0.05), total errors of cognitive flexibility (24.00 vs 12.92, p < 0.05), and this difference was maintained at follow-up (p < 0.05). Whilst there was no interaction effect between groups, and time effects were found for PA and planning from baseline to post-intervention. CONCLUSION: This was the first to adopt an ecological approach as an innovative strategy to provide the emergence of PA for children in Hong Kong. The blended intervention design that embedded both quantity and quality of PA into children's school day has shown promise in supporting children's all round development. PL intervention where environments are designed to increase the "Quantity + Quality" of children's everyday interactions has led to improvements in PA and health outcomes, which may provide insights for future studies to adopt cost-friendly and feasible measures for promoting children's PA in the school settings. TRIAL REGISTRATION: ChiCTR, ChiCTR2000035038. Registered 29 July 2020-Retrospectively registered. http://www.chictr.org.cn/hvshowproject.aspx?id=46038 .

Exploring the Level of Physical Fitness on Physical Activity and Physical Literacy Among Chinese University Students: A Cross-Sectional Study.

Physical literacy (PL) has received considerable attention in the field of physical education and physical activity (PA) worldwide. According to recent studies, the level of physical fitness (PF) among Chinese university students is gradually decreasing. This study aims to examine the impact of the PF level (fit/unfit) on PA and PL, as well as the relationships among PF, PA, and PL, in Chinese university students. Participants comprised 798 university students (390 men; mean age, 19.2 ± 1.2 years) in Chongqing, China. Participants completed the tests of vital capacity, cardiorespiratory fitness, muscular strength, and flexibility, according to the National Physical Fitness Measurement Standards Manual (NPFMSM), as well as questionnaires on PA (time spent performing PA at various intensities) and PL. The independent t-tests were conducted to examine sex differences in the evaluated variables, and the Pearson's correlation between each PF test and PL attributes and PA was calculated according to sex. In addition, the independent t-tests were conducted to determine whether the PF level had an effect on PL attributes and PA at various intensities. Significant sex differences were found in the PF domains of vital capacity, muscular strength, and aerobic fitness, with higher scores in men than in women (all p-values < 0.05), but not in the PF domain of flexibility and total PL score. Furthermore, the PF domains of muscular strength and aerobic fitness were significantly and positively correlated with the PL attributes of confidence and physical competence in both men and women, while the PF domains of vital capacity and aerobic fitness were significantly and positively correlated with the PL attribute of motivation in men. In addition, PL was significantly and positively associated with cardiorespiratory fitness, vital capacity, muscular strength, and flexibility among participants in the fit group. These findings support advocating for increased participation in PA in university students and using PL as a tool to improve PF components.

The associations between psychological needs, health-related quality of life and subjective well-being among Chinese older people: A cross-sectional study.

The present study investigated the associations between the three psychological needs (autonomy, competence and relatedness) derived from the Self-determination Theory and well-being [health-related quality of life (HRQOL) and subjective well-being (SWB)] among older people in Hong Kong SAR, China. A cross-sectional study was conducted from May to August 2018 in Hong Kong. A total of 230 participants aged 60-year-old or above were recruited from eight community service centres. Results from adjusted regression analysis showed that, among the three psychological needs, competence and relatedness were positively associated with SWB, while relatedness was positively associated with physical health domain of HRQOL. The three psychological needs had no significant associations with mental health domain of HRQOL. Interventions to improve HRQOL and SWB should promote older people's sense of competence and relatedness. Longitudinal studies are warranted to clarify the causal relationships and look at other physical, mental and social health outcomes.

Metabolism and Health Impacts of Dietary Sugars

Consumption of excessive amounts of added sugars and their effects on human health has been a major concern in the last several decades. Epidemiological data suggest that the incidence of metabolic disorders, such as obesity, nonalcoholic fatty liver disease, cardiovascular disease and diabetes, has increased due to chronic surplus consumption of these sugars. While many of these sugars have been isolated and studied for centuries, their health impacts and exact underlying mechanisms are still unclear. In this review, we discuss the pathophysiological role of 6 major simple sugars present in the human diet and the biochemical and molecular pathways related to their metabolism by different organs and gut microbiota, with a focus on the most recent investigations.

Promoting physical activity and health in Hong Kong primary school children through a blended physical literacy intervention: protocol and baseline characteristics of the "Stand+Move" randomized controlled trial.

BACKGROUND: Children predominantly remain sedentary in a traditional classroom. This study aimed to demonstrate the design and baseline characteristics of a three-armed intervention program that targeted enhancements in children's physical literacy (PL), physical activity (PA), sleep, and executive functions by constructing an active classroom environment in primary schools. The blended approach involved organized PA participation during recess combined with changes to the classroom environment in response to the emphasis on nurturing children's PL in Hong Kong. METHODS: This blended "Stand + Move" intervention adopted a randomized controlled trial design to investigate its effectiveness in improving health-related aspects. Three groups were compared: (1) PA recess intervention, (2) blended (sit-stand desks and PA recess) experimental, and (3) control groups. In this 13-week intervention (from March to September 2019), 76 students (59.2% girls) were recruited and randomly assigned to the three groups. The primary outcomes were children's PL and PA. The secondary outcomes were children's sleep and executive functions. RESULTS: Baseline data were evaluated. The mean age was 9.6 years [standard deviation = 0.61, range 9.0-12.0]. There were no significant differences between trial arms at baseline concerning any of the outcomes (all P = 0.06-0.89). Overall, 22.4% met the recommended PA guidelines, 36.8% met the sleep guidelines, and 10.5% met both guidelines. Three aspects of executive functions were evaluated: inhibition, executive control, and planning. Over half of the participants reported satisfaction with their perceived sleep quality. CONCLUSIONS: The designed intervention is regarded as an innovative strategy that incorporates sit-stand desks and PA breaks to reconstruct children's traditional classroom environment. The baseline results suggest that intervention was satisfactory in reducing students' sitting time and increasing their PA engagement. We demonstrated the benefits of this intervention on children's PL, various sleep patterns, and executive functions. As expected, the designed intervention changes made to the classroom improved children's health behaviors, as well as the support from stakeholders at schools and the children's families. Our results also provided the desired evidence for policy reforms in teaching and learning strategies. TRIAL REGISTRATION: ChiCTR ChiCTR2000035038 . Registered on July 29, 2020-retrospectively registered.

The association between physical activity and mental health in children with special educational needs: A systematic review.

The association between physical activity (PA) and mental health in typically developing children has been amply documented, but little is known about the corresponding association in children with special educational needs (SEN). This systematic review aimed to synthesize the evidence for the association between PA and mental health in children with SEN. A systematic literature search of five databases (PsycINFO, SPORTDiscus, PubMed, Web of Science, and CINAHL) was conducted, and the publication year was between October 2010 and February 2021. Two researchers performed abstract and full text screening and extracted the data independently. Inclusion and exclusion criteria followed the PICOS framework, and the quality of eligible studies was assessed using the McMaster critical review form. Eighteen studies that met the inclusion criteria and had quality ratings ≥ 60% were included in this review. PA was positively associated with overall psychological well-being and its subtypes (including enjoyment, self-worth, self-competence, mental wellness, and quality of life), and negatively associated with anxiety and fatigue. Body composition, age, and sex were moderators of the association. The findings of this review indicated that PA was consistently associated with mental health in children with SEN. These associations were the most powerful when PA was conducted in unstructured types such as free play and recess activities. Structured types including physical education classes were more strongly related to mental health than overall PA (combined structured and unstructured types). Future PA interventions are needed to promote mental health in children with SEN.