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Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34–36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise. [ABSTRACT FROM AUTHOR]

• Moderate to vigorous levels of physical activity were independently associated with a lower incidence of mild cognitive impairment. • Handgrip strength was associated a lower hazard for incident mild cognitive impairment and dementia. • Handgrip strength partly mediated the association between moderate to vigorous levels of physical activity and mild cognitive impairment. We analyzed the mediating role of handgrip strength in the association between moderate to vigorous physical activity and incident mild cognitive impairment and dementia. We used prospective data from 14 European countries participating in the Survey of Health, Ageing, and Retirement in Europe. 19,686 participants free of dementia and mild cognitive impairment (64.9 ± 8.7 years) were followed up for a mean of 10.2 years. Moderate to vigorous physical activity was self-reported, and handgrip strength was assessed with a dynamometer. Mild cognitive impairment was defined as 1.5 standard deviations below the mean of the standardized global cognition score, while dementia was determined by physician diagnosis. Gender, age, country, education, presence of chronic diseases, depressive symptoms, limitations in activities of daily living, body mass index, and baseline cognitive levels were used as covariates. Cox proportional hazards as well as mediation models were used. Moderate to vigorous physical activity for at least 1 day per week was independently associated with lower incident mild cognitive impairment (HR: 0.85; 95%CI: 0.74–0.98). A 10 % increase in handgrip strength was associated a 6 % lower hazard for incident mild cognitive impairment (0.94; 0.92–0.97) and 5 % lower hazard for incident dementia (0.95; 0.93–0.98). Handgrip strength partly mediated the association of moderate to vigorous physical activity with mild cognitive impairment (Coefficient: 0.03; 95%CI: 0.01–0.05; 17.9 %). Physical activity is independently associated with a lower incidence of mild cognitive impairment. [ABSTRACT FROM AUTHOR]

To propose a response criterion for analyzing the intervention success by verifying patient outcomes after a multidisciplinary obesity treatment program in Brazilian children and adolescents. Obese children and adolescents (n = 103) completed a 16-week multidisciplinary intervention (IG) and were compared to the control group (CG) (n = 66). A cluster of parameters (e.g. total domain of HRQoL; BMI z-score; cardiorespiratory fitness; body mass; waist circumference; fat mass; lean mass) were measured pre and post-intervention, and the sum of the median percentage variation and the percentile 25 and 75 were used from IG and CG to determine the responsiveness to the program. We are proposing four ranges in which children and adolescents may be classified after the intervention: (1) CG percentile 50 values or lower are considered non-responsive to the intervention, (2) values greater than CG percentile 50 but lower than IG percentile 50 are considered slightly responsive, (3) values greater than IG percentile 50 but lower than IG percentile 75 were considered as moderately responsive, and (4) values greater than IG percentile 75 were considered very responsive.Conclusions: This criterion may serve as a complementary tool that can be employed to monitor the response to this model of multidisciplinary intervention. What is Known: • The effectiveness of multidisciplinary obesity interventions is usually determined by comparing changes in selected outcomes in the intervention versus versus control group. • There is no consensus about what should be assessed before and after the intervention program, which makes difficult to compare different programs and to determine their rate of responsiveness. What is New: • This study proposes a response criteria to pediatric obesity interventions following a similar model compared to ours based on key variables that presents low cost and high applicability in different settings. [ABSTRACT FROM AUTHOR]

Background: Both physical activity (PA) and TV-viewing are associated with depressive symptoms, but the combined association with depressive symptoms is unclear. Therefore, our aim was to analyze the joint association of PA and TV-viewing with depressive symptoms among a large cohort of adults.Methods: We used data from the Brazilian National Survey, conducted in 2013 with 59,401 adults [≥18 years (34,282 women)]. Information regarding exposures (TV-viewing and leisure PA), outcome (depressive symptoms) and covariates (chronological age, race, educational status, employment status, tobacco smoking, alcohol consumption) were self-reported. Body mass index was estimated through the assessment of body mass and stature. Logistic regression models were used.Results: Engaging in >5 hours of TV viewing was associated with elevated depressive symptoms [13.1% (CI95%: 11.6%-14.7%) vs. 7.4% (95%CI:7.0%-7.8%)]. However, this association was nullified when people met guidelines and engaged in >150 min of PA per week. Specifically, among men [Active: OR = 1.16 (95%CI: 0.58-2.32) vs. Inactive: OR = 3.63 (95%CI: 2.43-5.42)] and women [Active: OR=1.30 (95%CI: 0.80-2.11) vs. Inactive: OR = 1.84 (95%CI: 1.43-2.36)].Conclusion: Whilst TV viewing is associated with increased depressive symptoms, meeting recommended physical activity levels reduces the association between TV-viewing and depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Our aim was to examine associations between depression and time spent in TV viewing in a representative sample of Brazilian adults.Methods: Data from the Brazilian National Health Survey (Pesquisa Nacional de Saúde - PNS in Portuguese) (n =60,202; ≥18 years) were used. Time spent TV viewing (h/day) was elicited via interview. Depression was evaluated through the Patient Health Questionnaire-9. Chronological age, educational status, employment status, alcohol use, tobacco smoking and body mass index were covariates. Descriptive statistics (mean and 95% confidence interval) and adjusted logistic regression models were applied.Results: Five or more hours as well as less than 1 h of TV viewing was associated with increased depression (men: <1 h OR = 1.89, 95%CI = 1.40-2.54; ≥5 h OR = 2.69, 95%CI = 1.88-3.83; women: <1 h OR = 1.50, 95%CI = 1.25-1.81; ≥5 h OR = 1.65, 95%CI = 1.35-2.03) when compared to 2-2.99 h of TV viewing.Conclusion: More than 5 h/day seems to be associated with a higher risk for depression among Brazilian adults (except for older adults). Less than 1 h TV viewing might be a measure-of-proxy for a lower socio-economic status, which is a known risk factor for depression. [ABSTRACT FROM AUTHOR]

Hip muscle weakness and altered hip biomechanics during walking are often observed in people with femoroacetabular impingement syndrome, although little is known about biomechanics during higher impact tasks. The aim of our study was to explore relationships between hip muscle strength and hip biomechanics during running in people with femoroacetabular impingement syndrome, including exploring sex as an effect-modifier of this relationship. Forty-two adults with unilateral femoroacetabular impingement syndrome (20 females; age 18-50 years; alpha angle ≥60°) completed assessments of hip muscle strength and hip biomechanics during running. Strength was assessed using a hand-held dynamometer for the hip flexors, extensors, abductors, adductors, internal rotators, and external rotators. Hip biomechanics were assessed during overground running (3–3.5 m/s) using three-dimensional motion capture and a force plate. Linear models assessed the relationships between hip strength and hip biomechanics of the symptomatic limb, controlling for body mass and running velocity along with an interaction term (strength*sex). A significant negative relationship was observed between hip external rotator strength and hip frontal plane range of motion (i.e., excursion), independent of sex (estimate = −0.039, 95%CI −0.071 to −0.008, P = 0.02). Four sex-specific interactions were observed, with a significant positive relationship between hip external rotator strength and peak hip extension moment in women (estimate = −0.413, 95%CI −0.713 to −0.114, P = 0.01) but not in men. We found significant relationships between hip external rotator strength and stance phase running biomechanics, providing further understanding on two impaired physical measures that may inform exercise-based management strategies in femoroacetabular impingement syndrome. • Hip weakness and altered movement exist with femoroacetabular impingement syndrome. • Associations between muscle strength and running biomechanics were explored. • Stronger hip external rotators were associated with less hip frontal plane motion. • Significant sex-specific interactions were observed in some associations. • Our results may help to inform exercise-based management strategies. [ABSTRACT FROM AUTHOR]