Shijie Liu

The purpose of this systematic review was to synthesise the evidence for the association of adherence to the 24-h movement guidelines with academic-related outcomes in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. PubMed, PsycINFO, Scopus, WOS, SPORTDiscus, and EMBASE were searched from their inception to 12 December 2023. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the risk of bias of included studies. In total, 4326 records were identified through database searches; 10 articles met the inclusion criteria and were included in this systematic review. There were eight cross-sectional studies and two longitudinal studies; the main academic-related outcomes were academic achievement and cognitive function. A small association between adherence to all three recommendations and academic achievement (k = 5, r = 0.17, 95% CI = 0.10–0.24, I² = 49%) was found compared to those who did not adhere to any recommendations.    Conclusion: Findings from this systematic review and meta-analysis reveal a small association between adherence to all three recommendations and greater academic achievement in children and adolescents. Nevertheless, it is imperative to underscore the need for more studies to establish robust evidence underpinning this relationship.    Trial registration: PROSPERO (CRD42021295403). What is Known: • Regular physical activity, reduced screen time, and optimal sleep duration are independently associated with improved academic-related outcomes in children and adolescents. • The associations between adherence to the 24-h movement guidelines and academic-related outcomes in children and adolescents have not been quantitatively synthesised. What is New: • There is a small but positive association between adherence to all three recommendations of the 24-h movement guidelines and greater academic achievement in children and adolescents. • Further well-designed research is needed to focus on academic achievement, cognitive function and classroom behaviours in young individuals.

In the context of exercise psychology, the mediating relationship between peer support, self-efficacy and self-regulation, and adolescents’ exercise adherence was to be explored. Methods: A questionnaire was distributed among 2200 teenagers from twelve middle schools in Shanghai. The “process” program in SPSS and the bootstrap method were applied to construct and analyze the direct and indirect effects of peer support on adolescents’ exercise adherence. Results: Peer support directly affected adolescents’ exercise adherence (β = 0.135, p < 0.001, effect size of 59%) and self-efficacy (β = 0.493, p < 0.001, effect size accounted for 42%), and self-regulation (β = −0.184, p < 0.001, effect size of 11%) influenced exercise adherence indirectly. In addition, self-efficacy and self-regulation could impose a chain-mediated effect on peer support and exercise adherence (effect size of 6%). Conclusion: Peer support could promote adolescents’ exercise adherence. Self-efficacy and self-regulation are mediating factors of peer support on exercise adherence in teenagers, self-regulation as well as self-efficacy-imposed chain-mediating effects on peer support and adolescents’ exercise adherence.

Background and aims: Mobile phone addiction (MPA) has recently aroused much attention due to its high incidence and considerable health hazards. Although some existing studies have documented that physical activity is negatively associated with MPA, it is little known about the potential effects underlying this relation. The aim of this study was to investigate the relationship between physical activity and MPA among undergraduates in China, and to further examine the moderating effect of exercise type in the relation between them.Methods: By the quota sampling, a total of 650 participants engaged in this survey and completed relevant measurements including physical activity rating scale-3 (PARS-3) and mobile phone addiction tendency scale (MPATS).Results: Gender (β= 0.271,P< 0.05) and major (β= −0.169,P< 0.05) could significantly predict MPA, respectively, and physical activity was an imperative protective factor to decrease MPA (β= −0.266,P< 0.001). While the physical activity level enhanced from none exercise to medium exercise, an optimum dose-response relationship would emerge between physical activity and MPA (F_(3,604)= 4.799,P< 0.01). Most important, the relation between physical activity and MPA can be moderated by exercise type. Especially in terms of aerobic endurance exercise, the higher level of physical activity the undergraduates performed, the lower degree of MPA would be suffered by them (β= −0.266,P< 0.001).Discussion: These findings could be conducive to better understand the positive and potential effects of physical activity on the intervention in MPA, and served as a persuasive evidence that as for university students, actively engaging in aerobic endurance exercise with the medium activity level would be a practicable exercise strategy to deal with MPA in daily lifestyle behavior.

Problematic smartphone use (PSU) has become a prevalent issue worldwide. Previous studies suggest that physical exercising may effectively reduce smartphone users’ addiction levels. Comparisons and further evaluations on the long-term effects of different types of exercise-based interventions on treating PSU remain to be investigated. Objective. We investigated if group-based basketball and Baduanjin exercise (a type of Qigong) would reduce PSU and improve the mental health of college students and whether such effects would be sustained. A twelve-week experiment was conducted, where 96 eligible Chinese college students with PSU were randomly assigned to two intervention arms (i.e., basketball and Baduanjin exercises) and a control arm. Outcome measures, including PSU (measured by the Mobile Phone Addiction Index in Chinese (MPAI)) and mental health indices for anxiety (measured by Self-Rating Anxiety Scale (SRAS)), loneliness (measured by the short-form of the UCLA Loneliness Scale (UCLA-LS)), inadequacy (measured by the revised Janis and Field’s Feelings of Inadequacy Scale (FIS)), and stress (measured by the Chinese version of Perceived Stress Scale (CPSS)) were collected at the baseline, the end of week 12, and the two-month follow-up. A Generalized Estimating Equations (GEE) model for longitudinal data was utilized in analyses. Results. Both exercise interventions demonstrated significant effects on decreasing PSU (basketball: ; Baduanjin: ), feelings of anxiety (basketball: ; Baduanjin: ), loneliness (basketball: ; Baduanjin: ), inadequacy (basketball: ; Baduanjin: ), and perceived stress (basketball: ; Baduanjin: ), at the end of interventions. At two months after interventions, both exercise interventions demonstrated significant effects on decreasing PSU (basketball: ; Baduanjin: ), feelings of anxiety (basketball: ; Baduanjin: ), loneliness (basketball: ; Baduanjin: ), and inadequacy (basketball: ; Baduanjin: <svg...

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson’s patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = −0.61, p < 0.001), TUG (SMD = −1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = −1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I² = 81%) and depression (I² = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG (I² = 29%), Balance (I² = 16%) and QoL (I² = 35%), it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson’s disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

Objectives: Mind–body exercise has been generally recognized as a beneficial strategy to improve mental health in those with Chronic Obstructive Pulmonary Disease (COPD). However, to date, no attempt has been made to collate this literature. The aim of the present study was to systematically analyze the effects of mind–body exercise for COPD patients with anxiety and depression and provide scientific evidence-based exercise prescription. Methods: both Chinese and English databases (PubMed, the Cochrane Library, EMBASE, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Wanfang, Baidu Scholar) were used as sources of data to search randomized controlled trials (RCT) relating to mind–body exercise in COPD patients with anxiety and depression that were published between January 1982 to June 2019. 13 eligible RCT studies were finally used for meta-analysis. Results: Mind–body exercise (tai chi, health qigong, yoga) had significant benefits on COPD patients with anxiety (SMD = −0.76, 95% CI −0.91 to −0.60, p = 0.04, I² = 47.4%) and depression (SMD = −0.86, 95% CI −1.14 to −0.58, p = 0.000, I² = 71.4%). Sub-group analysis indicated that, for anxiety, 30–60 min exercise session for 24 weeks of health qigong or yoga had a significant effect on patients with COPD who are more than 70 years and have more than a 10-year disease course. For depression, 2–3 times a week, 30–60 min each time of health qigong had a significant effect on patients with COPD patients who are more than 70 years old and have less than a 10-year disease course. Conclusions: Mind–body exercise could reduce levels of anxiety and depression in those with COPD. More robust RCT are required on this topic.

Background: With the emergence of electronic products, smartphones have become an indispensable tool in our daily life. On the other hand, smartphone addiction has become a public health issue. To help reduce smartphone addiction, cost-effective interventions such as exercise are encouraged. Purpose: We therefore performed a systematic review and meta-analysis evaluating existing literature on the rehabilitative effects of exercise interventions for individuals with a smartphone addiction. Methods: We searched PubMed, Web of Science, Scopus, CNKI, and Wanfang from inception to September 2019. Nine eligible randomized controlled trials (RCT) were finally included for meta-analysis (SMD represents the magnitude of effect of exercise) and their methodological quality were assessed using the PEDro scale. Results: We found significant positive effects of exercise interventions (Taichi, basketball, badminton, dance, run, and bicycle) on reducing the total score (SMD = −1.30, 95% CI −1.53 to −1.07, p < 0.005, I² = 62%) of smartphone addiction level and its four subscales (withdrawal symptom: SMD = −1.40, 95% CI −1.73 to −1.07, p < 0.001, I² = 81%; highlight behavior: SMD = −1.95, 95% CI −2.99 to −1.66, p < 0.001, I² = 79%; social comfort: SMD = −0.99, 95% CI −1.18 to −0.81, p = 0.27, I² = 21%; mood change: SMD = −0.50, 95% CI 0.31 to 0.69, p = 0.25, I² = 25%). Furthermore, we found that individuals with severe addiction level (SMD = −1.19, I² = 0%, 95%CI:−1.19 to −0.98) benefited more from exercise engagement, as compared to those with mild to moderate addiction levels (SMD = − 0.98, I² = 50%, 95%CI:−1.31 to −0.66); individuals with smartphone addiction who participated in exercise programs of 12 weeks and above showed significantly greater reduction on the total score (SMD = −1.70, I² = 31.2%, 95% CI −2.04 to −1.36, p = 0.03), as compared to those who participated in less than 12 weeks of exercise intervention (SMD = −1.18, I² = 0%, 95% CI−1.35 to −1.02, p < 0.00001). In addition, individuals with smartphone addiction who participated in exercise of closed motor skills showed significantly greater reduction on the total score (SMD = −1.22, I² = 0 %, 95% CI −1.41 to −1.02, p = 0.56), as compared to those who participated in exercise of open motor skills (SMD = −1.17, I² = 44%, 95% CI−1.47 to −0.0.87, p = 0.03). Conclusions: Exercise interventions may have positive effects on treating smartphone addiction and longer intervention durations may produce greater intervention effects.

Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge’s g = −0.64, 95% CI −0.90 to −0.37, p < 0.001), Roland–Morris Disability Questionnaire (RMDQ) (Hedge’s g = −0.41, 95% CI −0.79 to −0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge’s g = −0.96, 95% CI −1.42 to −0.50, p < 0.001), and cognitive function (Hedge’s g = −0.62, 95% CI −0.85 to −0.39, p < 0.001). In a meta-regression analysis, age (β = 0.01, p = 0.02) and total exercise time (β = −0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge’s g = −0.87, 95% CI −1.38 to −0.36, p < 0.001) and Qigong (Hedge’s g = −0.54, 95% CI −0.86 to −0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1–2 times/week (Hedge’s g = −0.53, 95% CI −0.98 to −0.07, p = 0.02) and 3–4 times/week (Hedge’s g = −0.78, 95% CI −1.15 to −0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge’s g = −0.54, 95% CI −1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status.

Background: The improvement of living standards has led to increases in the prevalence of hypokinetic diseases. In particular, multifactorial complex diseases, such as metabolic syndrome, are becoming more prevalent. Currently, developing effective methods to combat or prevent metabolic syndrome is of critical public health importance. Thus, we conducted a systematic review to evaluate the existing literature regarding the effects of Wuqinxi exercise on reducing risk factors related to metabolic syndrome. Methods: Both English- and Chinese-language databases were searched for randomized controlled trials investigating the effects of Wuqinxi on these outcomes. Meanwhile, we extracted usable data for computing pooled effect size estimates, along with the random-effects model. Results: The synthesized results showed positive effects of Wuqinxi exercise on systolic blood pressure (SBP, SMD = 0.62, 95% CI 0.38 to 0.85, p < 0.001, I² = 24.06%), diastolic blood pressure (DBP, SMD = 0.62, 95% CI 0.22 to 1.00, p < 0.001, I² = 61.28%), total plasma cholesterol (TC, SMD = 0.88, 95% CI 0.41 to 1.36, p < 0.001, I² = 78.71%), triglyceride (TG, SMD = 0.87, 95% CI 0.49 to 1.24, p < 0.001, I² = 67.22%), low-density lipoprotein cholesterol (LDL-C, SMD = 1.24, 95% CI 0.76 to 1.72, p < 0.001, I² = 78.27%), and high-density lipoprotein cholesterol (HDL, SMD = 0.95, 95% CI 0.43 to 1.46, p < 0.001, I² = 82.27%). In addition, regression results showed that longer-duration Wuqinxi intervention significantly improved DBP (β = 0.00016, Q = 5.72, df = 1, p = 0.02), TC (β = −0.00010, Q = 9.03, df = 1, p = 0.01), TG (β = 0.00012, Q = 6.23, df = 1, p = 0.01), and LDL (β = 0.00011, Q = 5.52, df = 1, p = 0.02). Conclusions: Wuqinxi may be an effective intervention to alleviate the cardiovascular disease risk factors of metabolic syndrome.

Objective: The purpose of this study was to investigate the effects of Tai Chi (TC) on arterial stiffness, physical function of lower-limb, and cognitive ability in adults aged over 60. Methods: This study was a prospective and randomized 12-week intervention trial with three repeated measurements (baseline, 6, and 12 weeks). Sixty healthy adults who met the inclusion criteria were randomly allocated into three training conditions (TC-24, TC-42, and TC-56) matched by gender, with 20 participants (10 males, 10 females) in each of the three groups. We measured the following health outcomes, including markers of atherosclerosis, physical function (leg power, and static and dynamic balance) of lower-limb, and cognitive ability. Results: When all three TC groups (p < 0.05) have showed significant improvements on these outcomes but overall cognitive ability at 6 or 12 weeks training period, TC-56 appears to have superior effects on arterial stiffness and static/dynamic balance in the present study. Conclusions: Study results of the present study add to growing body of evidence regarding therapeutic TC for health promotion and disease prevention in aging population. Future studies should further determine whether TC-42 and TC-56 are beneficial for other non-Chinese populations, with rigorous research design and follow-up assessment.