Search Results (233)

Background/Objectives: Chronic musculoskeletal pain (CMSKP) affects up to 40% of adolescents and leads to substantial disability, reduced quality of life, and long-term health risks. Physical activity is central to treatment, but adherence to moderate-to-vigorous physical activity (MVPA) is inconsistent. We evaluated higher-resilience constructs—self-efficacy, pain acceptance, motivational stage, and affect—and hypothesized that higher resilience would be associated with greater objectively measured physical activity, better daily functioning, and higher quality of life in adolescents with CMSKP. Methods: Forty-three adolescents (13–18 years) with CMSKP completed measures of physical activity-specific self-efficacy, acceptance (AFQ-Y), motivational stage (PSOCQ-A), and affect (PANAS-C). Participants wore activPAL monitors to assess MVPA, light activity, and sedentary time. Physical function endurance was measured by the six-minute walk test (6MWT) and the Functional Disability Inventory (FDI); quality of life by the Pediatric Quality of Life Inventory (PedsQL). Spearman’s correlations assessed associations among resilience variables, physical activity metrics, 6MWT distance, FDI, and PedsQL. Results: MVPA was correlated positively with 6MWT distance (ρ = 0.48, p = 0.002) and negatively with FDI scores (ρ = −0.56, p < 0.001). Self-efficacy related to higher MVPA (ρ = 0.41, p = 0.009), better endurance (ρ = 0.36, p = 0.017), and lower disability (ρ = −0.38, p = 0.013). Acceptance was correlated with PedsQL total (ρ = 0.45, p = 0.004); motivation (specifically maintenance) scores were correlated with higher quality of life (ρ = 0.33, p = 0.027). Light activity and sedentary time were not significantly linked to functional or psychosocial outcomes. In a step-wise regression, only physical activity self-efficacy for ambulation at school predicted MVPA, B = 1.56, p = 0.008. Conclusions: Resilience constructs—including self-efficacy, acceptance, and readiness to change—were meaningfully associated with MVPA, daily functioning, and quality of life, and may have implications for treatment development. Full article

Background: Foot morphology plays a central role in musculoskeletal development during childhood. Variations in the medial longitudinal arch may influence walking mechanics, and excess body weight can further affect plantar structure and gait. Objective: This study examined the relationship between foot type, body mass index (BMI), and gait function in school-aged children, with particular focus on gait symmetry as a sensitive marker. Methods: Ninety-eight children aged 8–16 years were evaluated. Foot type was classified using a pressure platform, and gait was assessed with a wearable sensor. Outcomes included gait symmetry, walking speed, cadence, Timed Up and Go (TUG), and Six-Minute Walk Distance (6MWD). Results: Mixed bilateral foot patterns were observed in 46 of the 98 participants (47%). Significant associations were found between foot type, BMI, and gait symmetry (p < 0.01), while other mobility measures (speed, cadence, TUG, 6MWD) remained stable across groups. Children with normal bilateral feet showed the best gait symmetry, whereas mixed patterns had the lowest. Conclusions: Gait symmetry is a sensitive indicator of functional imbalance in schoolchildren and is strongly influenced by both foot morphology and body weight. Incorporating plantar assessment and BMI monitoring into routine pediatric evaluations may help clinicians identify children at risk for long-term musculoskeletal problems at an early stage. Full article

This study presents the first comprehensive spatial accessibility assessment of essential urban services in Belgrade, Republic of Serbia, conducted entirely with open-source tools and data. The analysis focused on six facility categories: primary healthcare centers, public pharmacies, primary and secondary schools, libraries, and green markets. Spatial accessibility was modelled using OpenRouteService (ORS) isochrones for walking travel times of 5, 10, and 15 min, combined with population data from the Global Human Settlement Layer (GHSL). Results indicate that 79% of residents live within a 15-min walk of a healthcare facility, 74% of a pharmacy, 89% of an elementary school, 52% of a high school, 60% of a library, and 62% of a green market. Central administrative units such as Vračar, Zvezdara, and Stari Grad demonstrated nearly complete service coverage, while peripheral areas, including Resnik, Jajinci, and Višnjica, exhibited substantial accessibility deficits, often coinciding with lower-income zones. The developed workflow provides a transparent, replicable approach for identifying underserved neighborhoods and prioritizing investments in public infrastructure. This research emphasizes the role of spatial accessibility analysis in advancing Sustainable Development Goals (SDGs), contributing to the creation of more inclusive, walkable, and sustainable urban environments, while on the other hand, it offers practical insights for improving urban equity, guiding policy formulation, and supporting necessary planning decisions. Subsequent research will focus on alternative facilities, other cities such as Novi Sad and Niš, and the disparity between urban and rural populations. Full article

Understanding the dose of ambient PM_2.5 inhaled by middle school students during active commuting between home and school is essential for optimizing their travel routes and reducing associated health risks. However, accurately modeling this remains challenging due to the difficulty of measuring ambient PM_2.5 concentrations along commuting routes at a population scale. In this study, we overcome this limitation by employing spatiotemporally dense observations of on-road ambient PM_2.5 concentrations collected through a massive mobile monitoring fleet consisting of around 200 continuously operating taxis installed with air quality monitoring instruments. Leveraging these rich on-road PM_2.5 observations combined with a GIS-terrain-based PM_2.5 dosage modeling approach, we (1) assess middle school students’ PM_2.5 dosages during morning (7:00 am–8:00 am) home–school walking commuting along the shortest-distance route; (2) examine the feasibility of identifying an alternative route for each student that minimizes PM_2.5 dosages during commuting; (3) investigate the trade-off between the relative reduction in PM_2.5 dosage and the relative increase in route length when opting for the alternative lowest-dosage route; and (4) examine whether exposure inequalities exist among students of different family socioeconomic statuses (SES) during their home–school commutes. The results show that (1) 18.8–57.6% of the students can reduce the dose of PM_2.5 by walking along an alternative lowest-dose route; (2) an alternative lowest-dose route could be found by walking along a parallel, less-polluted local road or walking on the less-trafficked side of the street; (3) seeking an alternative lowest-dose route offers a favorable trade-off between effectiveness and cost; and (4) exposure inequities do exist in a portion of students’ walking commutes and those students from higher-SES are more likely to experience higher exposure risks. The findings in our study could offer valuable insights into commuter exposure and inspire future research. Full article

Background: Childhood overweight and obesity are increasing public health concerns globally, with a high prevalence in Chile, particularly in rural areas. Excess weight may impair physical fitness, affecting children’s overall health and development. Objectives: This study aimed to compare the physical fitness of schoolchildren with normal weight (NW) and overweight/obesity (OW/OB) from a rural school in Maule, Chile. Methods: A total of 87 students (boys and girls, aged 9–14 years) were evaluated and classified into NW and OW/OB groups based on their body mass index. Physical fitness was assessed using the 6 min walk test (6MWT) for cardiovascular endurance, handgrip strength (HGS) and squat jump (SJ) for muscular strength, 20 m sprint for speed, and 4 × 10 m shuttle run for agility. Results: Significant differences were found between groups in most physical fitness components. The NW group covered 11.13% more distance in the 6MWT than the OW/OB group (p < 0.001; d = 1.28). NW children also performed better in the 20 m sprint (p = 0.023; d = 1.02) and the 4 × 10 m shuttle run (p < 0.001; d = 0.72). SJ was higher in the NW group (p = 0.004; d = 0.45). No significant differences were found in HGS (p = 0.893; d = 0.01). Conclusions: Children with normal weight demonstrated better physical fitness compared to their overweight or obese peers. These findings support the need for targeted strategies to prevent overweight and obesity in rural schoolchildren to improve physical health and functional capacities. Full article

Background: Prolonged sedentary behavior and associated obesity are recognized risk factors for poor health across the lifespan. Globally, data show that many children and adolescents aged 5 to 17 significantly increased their sedentary behaviors during the COVID-19 pandemic, failing to meet recommended physical activity levels and reporting increased smartphone use. While mobile devices and video games have been traditionally linked to physical inactivity, formats like exergaming, which combine gameplay with gross motor activity, offer potential to promote physical activity. However, many digital health tools for children are developed without incorporating feedback from key stakeholders and end-users (e.g., children, teachers, and guardians). Therefore, this paper, within the Walk around the Earth (E-Walk) project, describes a prospective study that aims (1) to identify the most influential factors or characteristics affecting engagement with and usability of a mobile application promoting physical activity among primary school students; (2) to develop a mobile application for children based on the identified factors and characteristics. Methods: This project will use a group concept mapping approach to identify the most influential features/factors/characteristics affecting engagement with and usability of an app. By involving primary stakeholders (e.g., children, teachers, guardians, and physical activity experts), the project seeks to align the app’s features with primary end-user needs and motivations. Following the app’s development, its effectiveness in increasing physical activity levels and reducing sedentary behaviors will be evaluated through a mixed-method design, incorporating anthropometric data, validated physical activity questionnaires (Physical Activity Questionnaire for Older Children (PAQ-C) and International Physical Activity Questionnaire (IPAQ)), and engagement metrics. Conclusions: The E-Walk project integrates participatory design with educational content and activity-based challenges, representing a multidimensional strategy for promoting health and learning in primary school students. Ultimately, this study contributes to the development of user-informed digital interventions that support sustainable behavioral changes, in line with broader goals of child well-being and digital health promotion. Full article

In the context of today’s neoliberal governance of schooling, the psychological, emotional, cultural, and spiritual costs of internalized racism remain unaddressed. However, when Youth of Color embody internalized racial oppression (IRO), they become “psychologically homeless,” which affects their wellbeing in devastating ways. This article advances an anti-racist research agenda in education, suggesting that education researchers’ implementation of “healing methodologies” in school is key to tackling issues of IRO. To this end, this paper advocates for education researchers to embrace, incorporate, and combine art-based and walking approaches into participatory “healing methodologies” to provide students with embodied practices that can support them in exploring, reconciling, and repairing hidden injuries while re-establishing inner strength and equilibrium for wellbeing and body restoration. Full article

Background/Objectives: Lack of objective evidence exists regarding changes in physical function and impact on daily functioning in paediatric post-COVID-19 condition (PPCC). This study aimed to assess exercise capacity, fatigue, and peripheral and respiratory muscle strength in PPCC patients compared with healthy controls. Additionally, the impact of PPCC on domains of daily life was evaluated. Methods: A cross-sectional study was performed. Study variables: exercise capacity (6 min walk test, 6MWT), inspiratory muscle strength (maximal inspiratory pressure, PImax), handgrip strength (handheld dynamometer, HHD), quadriceps femoris muscle thickness (QF MT), rectus femoris muscle thickness (RF MT), rectus femoris cross-sectional area (RF CSA), rectus femoris echo-intensity (RF EI), fatigue (Paediatric Functional Assessment of Chronic Illness Therapy-Fatigue, pedsFACIT-F), and physical activity (Assessment of Physical Activity Levels Questionnaire, APALQ). Results: A total of 115 PPCC patients and 227 healthy controls were included. The PPCC group had lower 6MWT (509.00 ± 86.12, p < 0.001), PImax (68.71 ± 26.23, p < 0.001), HHD (82.84 ± 29.09, p < 0.001), APALQ (7.94 ± 3.14, p < 0.001), pedsFACIT-F (24.51 ± 11.01, p < 0.001), QF MT mid-thigh (33.21 ± 7.99, p = 0.011), and higher RF EI (p < 0.001) vs. controls. Only 37.63% of the PPCC group resumed previous sports, 43.48% were unable to attend school full-time and 28.7% could not participate in after-school activities. Conclusions: Paediatric post-COVID-19 condition patients exhibited significant impairments in terms of physical function, with a high impact on daily functioning. This knowledge is necessary to provide targeted therapeutic interventions. Full article

A growing body of scientific literature emphasizes the role of the built environment in shaping commuting behavior among adolescents. However, the comparison of the built environment on adolescents’ route choice remains underexplored. A total of 317 Spanish adolescents participated in the study, of whom 67 adolescents provided a valid GPS-identified walking route between home and school (54.5% girls; mean age = 14.4 ± 0.7 years). Built environment variables—including residential density, number of intersections, land use mix, number of services, number of visible services from the route, street width, walkability, park area, elevation gain, elevation loss, and topographic cost—were measured using 3.28.8 QGIS software. A paired-sample analysis was performed using the Wilcoxon signed-rank test and the sign test to compare the actual route with the shortest available route. The results showed a deviation of 63.96%. Comparisons between the actual routes and the shortest ones revealed a statistically significant difference in the number of intersections (p = 0.009) and topography cost (p = 0.050). Likewise, a significant trend was found with the residential density (p = 0.080). These findings suggest that in this case study, the built environment plays an important role in adolescents’ decision-making when choosing routes for commuting to school. Some urban planning and design recommendations were given to address the results from a school built-environment-oriented approach. Full article

Active school transportation (AST), including walking or cycling to school, is common among children and youth in India. However, rising air pollution and public health advisories may encourage parents to restrict outdoor activities. The role of parental restrictions on children’s and youths’ participation in AST remains largely unexplored. This study examines how parental restrictions on outdoor activity influence children’s and youths’ engagement in AST. We surveyed children and youth aged 5 to 17 from 41 schools across 28 urban and rural locations in five Indian states, collecting data on AST, parental restrictions, perceptions of air pollution, sociodemographic factors, and school distance. Data were analyzed using multiple logistic regression models, adjusted and unadjusted for children’s and youths’ perceptions of air pollution, segregated by age, gender, and location. Reported parental restrictions due to air pollution were associated with lower odds of engaging in AST overall (OR = 0.625, 95% CI = 0.400–0.971), for ages 5–12 (OR = 0.460, 95% CI = 0.208–0.985, and in urban areas (OR = 0.433, 95% CI = 0.198–0.881). Adjusting for children’s and youths’ air pollution perceptions, these associations persisted in overall and urban analyses. Living over 2 kilometres from school also lowered odds of AST participation (p < 0.05 across all models). The interplay between AST, air pollution, and parental restrictions is self-reinforcing: air pollution can trigger parents to restrict child and youth mobility and reduce AST and, in turn, lower AST may contribute to worsening air quality because of increased motorized transport. Integrated policies are required to simultaneously mitigate pollution and enhance active transportation infrastructure. Full article

Background/Objectives: Civic engagement may be a critical determinant of prognostic outcomes in persons with diabetes. Persons with diabetes are at increased risk for mobility impairment. Little research has explored the role of mobility difficulties in voting participation among persons with diabetes. Methods: To examine whether mobility difficulties influence voting participation in U.S. local elections among persons with diabetes, data was obtained from the 2022 National Health Interview Survey for persons with diabetes (n = 1398). The independent variable was mobility difficulties, defined as difficulty walking or climbing stairs. The dependent variable, voting participation, was assessed by an indication as to whether respondents voted in the last local elections. Weighted logistic regression assessed the influence of mobility difficulties on voting participation adjusting for potentially influential covariates among persons with diabetes. Results: Among persons with diabetes, less than one fifth (18.8%) voted in the last local election and half (48.9%) reported difficulties walking or climbing stairs. In models adjusting for covariates, persons with diabetes who indicated they had difficulties in walking or climbing stairs were significantly less likely to indicate they had voted in the last local election in comparison with those without mobility difficulties (adjusted odds ratio (AOR) = 0.638, 95% confidence interval (CI) = (0.443, 0.918)). Persons with diabetes who were female, married, had graduated from college or technical school, or rated their health as good/very good were significantly more likely to report having voted in a local election. Conclusions: Initiatives are needed to foster voting participation among persons with diabetes and mobility difficulties. Full article

Children’s physical and mental wellbeing is declining, partly due to reduced independent mobility and lack of engaging public environments. This study explores a co-design approach in which children actively participated in a series of design workshops focused on improving school routes through sensory engagement and imagination. Using sensory walks, students mapped positive and negative experiences in their everyday surroundings. Through hands-on creative exercises and the integration of AI and VR tools, they developed design proposals envisioning safer, more enjoyable, and inclusive mobility environments. The findings reveal that while children are highly capable of generating creative and context-sensitive ideas, they are less accustomed to reflecting on sensory input beyond vision. The results underscore the importance of designing urban spaces that prioritize safety, playfulness, and multisensory richness, with particular emphasis on nature and emotional connection. Full article

Water treadmill (WT) exercise is used for horses’ rehabilitation and training. Given that each training needs to be individualized for each horse, the goal is to assess whether infrared thermography (IRT) can serve as a non-invasive tool for daily monitoring of individual training and rehabilitation progress in horses undergoing WT exercise. Fifteen Polish Warmblood school horses were subjected to five WT sessions: dry treadmill, fetlock-depth water, fetlock-depth water with artificial river (AR), carpal-depth water, and carpal-depth water with AR. IRT images, collected pre- and post-exercise, were analyzed for the mean temperature (Tmean) and maximal temperature (Tmax) across 14 regions of interest (ROIs) representing the body surface overlying specific superficial muscles. While on a dry treadmill, Tmean and Tmax increased post-exercise in all ROIs; wetting of the hair coat limited surface temperature analysis in ROIs annotated on limbs. Tmax over the m. brachiocephalicus, m. trapezius pars cervicalis, m. triceps brachii, and m. semitendinosus increased during walking in carpal-depth water, which therefore may be suggested as an indirect indicator of increased activity related to forelimb protraction and flexion–extension of the limb joints. Tmax over the m. latissimus dorsi and m. longissimus increased during carpal-depth WT exercise with active AR mode, which may be suggested as an indicator of increased workload including vertical displacement of the trunk. Full article

Background/Objectives: Obesity in adolescence is associated with a deterioration in cognitive functions, with significant implications for psychophysical well-being and academic performance. Recent studies highlight the importance of integrated interventions that combine nutrition education and physical activity to promote the overall health of students. The present study aims to evaluate the efficacy of an integrated intervention based on nutritional education and conscious body movement in improving cognitive functions, perceived well-being and nutritional knowledge in lower secondary school students with indicators of overweight and obesity. Methods: A quasi-experimental design with randomization at the class level was adopted, involving 60 students divided into an experimental group and control group. The intervention was divided into twelve weeks of activities, divided between nutritional education modules and physical activity courses. Standardized tests for the assessment of cognitive functions (Digit Span Forward, Digit Span Backward, Stroop Test, Trail Making Test B), motor tests (6-Minute Walk Test, Sit and Reach Test) and a food knowledge questionnaire were administered before and after the intervention. Results: The experimental group showed significant improvements compared to the control group in all cognitive, motor, and nutritional knowledge measures, indicating the effectiveness of the integrated intervention in promoting cognitive and physical well-being. Conclusions: The findings support the role of school as a generative environment of integrated well-being, suggesting the need to develop and implement curricular programs that integrate nutrition education and physical activity to counteract the negative effects of obesity on cognitive function in adolescents. Full article

Background and objectives: Neurosurgical intervention on the newborn’s developing brain is a risk factor for neurodevelopmental disorders (NDDs). These patients necessarily require regular, coordinated follow-up. The ventricular subgaleal shunt (VSGS) technique has been used since 2013 at Rouen University Hospital. Like any change in practice, this technique must be evaluated. In this paper, we describe the population of patients with hydrocephalus treated by VSGS, the complications associated with the procedure, and the outcome of these patients at two and six years old. Methods: This study was an observational, descriptive, retrospective, single-center study. Children included were those less than three months old with hydrocephalus treated by VSGS at Rouen University Hospital from January 2013 to December 2023. Data were anonymized and collected using EDSaN software. A descriptive analysis was performed. Results: Thirty-two patients were included in our study. Of these, 22 (69%) were born prematurely; 16 (50%) of these 22 had postnatal intraventricular hemorrhage (IVH) requiring treatment with VSGS. A total of three patients (13.6%) died within the first year of life; twenty-four patients (75%) required definitive shunting. Twenty-two patients were over 2 years old in our study. Only 10 of them acquired the ability to walk (45%). Cerebral palsy was present in 10 (45%) patients. Fifteen patients were over 6 years old; thirteen (87%) attended school, but six (40%) had special needs (the need of an assistant, or part-time schedule). In our study, only 24 patients (82%) were followed by a pediatrician trained in neurodevelopment at Rouen University Hospital, and 27 (93%) were followed by a neurosurgeon. Conclusions: This study describes all patients with hydrocephalus treated by VSGS at Rouen University Hospital between January 2013 and December 2023, as well as their complications and their neurological outcomes. The follow-up of these children at risk of NDDs is essential. Full article