Gymnastik- och idrottshögskolan, GIH

PURPOSE: The transition phase between childhood and adolescence is critical, given the observation of increased mental health issues during this period, coupled with the absence of efficient intervention tools. This study aims to examine a possible effect of physical activity on mental health symptoms in adolescents during this transitional age.

METHODS: We used data from a large-scale population-based Swedish twin sample of 14,083 individuals to investigate cross-sectional and longitudinal associations between physical activity and mental health problems during childhood and adolescence. We examine different aspects of mental health symptoms, including internalizing and externalizing symptoms. We applied generalized estimating equations to investigate the associations and explored potential familial confounding using within-twin pair analysis.

RESULTS: We found high physical activity intensity and frequency to be associated with better mental health throughout childhood and adolescence, cross-sectionally and longitudinally. Compared to those who reported low, those reporting high physical activity intensity and frequency in both childhood and/or adolescence had significantly lower symptoms of mental health at age 15. This association was statistically significant for both internalizing and externalizing symptoms. The within-twin pair analysis showed that familial confounding factors can largely explain the association with the externalizing scale, but not the internalizing scale.

DISCUSSION: Physical activity in childhood and adolescence may play an essential role in reducing the risk of developing mental health problems, especially internalizing symptoms. Implementing acceptable, low-risk, and cost-effective interventions to promote physical activity could effectively safeguard young individuals from these symptoms.

AIM: Investigate the longitudinal relationship between physical activity, organised physical activity, fitness, screen time and academic performance among Swedish adolescents.

METHODS: Data from 1139 adolescents at age 13, included vigorous physical activity (accelerometry), fitness (submaximal ergometer test), screen time and organised physical activity participation (self-reported) and academic performance (math and Swedish grades at ages 13 and 16 from registry). Academic performance at age 16 was categorised as A-D (higher grades or pass) or E, F (fail or at-risk of failing). Multilevel logistic regression models were used to examine the relationships while adjusting for gender, parental education, parental country of birth and academic performance at age 13.

RESULTS: Higher fitness at age 13 was associated with increased odds of receiving A-D at age 16 (OR: 1.04 per mL, 99% CI 1.00, 1.07, p = 0.003). High screen time during weekdays was associated with reduced odds (OR: 0.40, 99% CI 0.20, 0.81, p = 0.001) compared to low screen time.

CONCLUSION: Academic performance at the end of compulsory school (age 16) was related to fitness and screen time 3 years earlier. These findings create a paradigm for future randomised controlled trials to explore how influencing these factors might affect academic performance.

BACKGROUND: Understanding psychological responses to acute exercise, defined as a single bout of physical exercise, in clinical populations is essential for developing tailored interventions that account for the psychological benefits and challenges of exercise. Given its effectiveness in reducing symptoms in various psychological disorders, exercise should be further explored in Exhaustion Disorder ICD-10-SE: F43.8A (ED), characterized by persistent exhaustion following long-term psychosocial stress. Currently, no studies address the psychological responses to acute exercise in ED patients.

AIMS: This study aims to (1) compare the psychological responses to acute exercise between ED patients and healthy controls and (2) assess response differences between low and moderate exercise intensities.

METHODS: We conducted a two-armed cross-over trial comparing ED patients (n = 30) and healthy controls (n = 30). Participants completed a 22-min exercise at low or moderate intensity on a cycle ergometer, on separate occasions, in randomized order. The primary outcome was perceived fatigue (POMS); secondary outcomes included feelings of energy, anxiety, stress, exertion, and psychological discomfort, measured before, during, and up to 24 h post-exercise. Exercise effects were assessed using repeated measures analysis of variance.

RESULTS: ED patients reported higher levels of exertion, psychological discomfort, fatigue, anxiety, and stress but lower energy throughout the trial compared to controls. Unlike controls, the ED group showed significant fatigue and stress reductions post-exercise (p < 0.05). Additionally, ED patients showed a more elevated energy after moderate-intensity exercise compared to controls (p < 0.05). Both groups experienced anxiety reductions post-exercise, with no group interactions over time. No differences were observed between pre- and 6 or 24 h post-exercise in any variables. The only intensity effect (p < 0.05) in the ED patients was a more pronounced energy decline 30 min after moderate-intensity exercise.

CONCLUSIONS: A 22-min exercise session was perceived as more strenuous by patients with exhaustion disorder (ED) and generated greater improvements in feelings of fatigue, energy, and stress compared to healthy individuals without delayed negative effects. These findings highlight the specific psychological responses in ED to exercise and can inform intervention design tailored specifically to this population.

TRIAL REGISTRATION: The study was retrospectively registered on 05/30/2024 at Clinical Trials.gov, with trial registration number 2022-04943-01.

Introduction: There is an association between physical activity and both health and academic performance. However, there is still a lack of consensus on how to engage adolescents in physical activity interventions in secondary schools. One approach to better understand the activities and strategies supporting effective implementation is to involve school staff and adolescents in the early stages of planning and preparing for interventions. Therefore, the aim of this study is to explore how multiple stakeholders, including school staff, students, and experts, perceive the barriers and facilitators for implementing a school-based intervention that extends the school day with additional physical activity in Sweden.

Material and methods: This inductive explorative qualitative study involved 16 participants. Three focus groups with school staff, including principals (n = 3), teachers (n = 6), and students (n = 4), and three interviews with experts were conducted. The planned intervention and its components were presented to the participants in the focus group and interviews to discuss them based on their previous experiences and thoughts of implementing physical activities or health promotion programmes in their schools or with adolescents. Data were analysed using qualitative content analysis.

Results: Three categories emerged: (1) “types of activities offered”, highlighting the importance of designing activities that are fun, inclusive and unusual; (2) “integration of the activities into school curriculum” to promote sustainability of the intervention and incorporate physical activity throughout the school day and across school subjects, and (3) “Management support and funding” referring to the funded time and facilities that teachers leading the activities need to facilitate implementation.

Conclusions: Before implementing extra physical activity in a school setting, it is important to understand what activities enhance students' motivation and the type of support teachers need from the school principal and administration. This includes funding for teachers' time, appropriate scheduling of the activities, and access to facilities.

It remains unknown whether dietary nitrate and breakfast may enhance working memory (WM) performance by augmenting physiological mechanisms and subjective psychological well-being. We performed a 3-arm randomised within-subject crossover study, with pretest-posttest comparisons, to test whether nitrate consumption via breakfast with a beetroot juice shot or regular breakfast compared to no breakfast improved WM (measured with n-back tests) and cognitive task-related changes in prefrontal cortical haemodynamic response (oxygenated- and deoxygenated-haemoglobin derived from functional near-infrared spectroscopy). In addition, effects on peripheral vascular function and self-reported psychological factors were assessed. In 60 adolescents (13-15 years old; 66% girls), WM improved in all conditions, with no intervention effects. Intervention effects were seen for oxygenated-haemoglobin changes, such that it increased after the breakfast with a nitrate shot during the WM tests and decreased after the regular breakfast. Thus, different neurophysiological mechanisms may be at play to preserve WM in adolescents depending on their breakfast composition. The trial was registered in the ISRCTN registry (ISRCTN16596056) on 21/02/2022.

Earlier research proposes that a school’s social environment among staff functions as an important facilitator for physical activity policy/curriculum dissemination, such as support among colleagues, physical activity ideas shared between teachers, as well as having individuals as ‘agents of change’. It is often proclaimed that physical education teachers inhabit these ‘agentic’ roles concerning physical activity and health promotion targeting youth during the school day. Despite this, little seems to have been researched concerning the agentic roles of physical educators and other school staff and their social networks within the school organization. Consequently, this study aims to explore relations among school staff regarding daily physical activity promotion in a Swedish secondary school from a social network perspective.  

This case study applied a convergent mixed method design with an emergent approach, where the qualitative ethnographic data and quantitative survey data were collected around the same time. Data was collected during one full school year from school staff at one secondary school (students aged 12-16 years, grades 7-9) in a larger urban area in Sweden. The sample included all staff within the school that interacts with secondary students, which involves school management, staff and teachers who are responsible for secondary students at some point during the school day, involved in student health or are engaged in physical activity, as well as physical education and health teachers. Our empirical material consists of field notes (180 hours of fieldwork), transcriptions from interviews (12 staff), as well as survey nomination data (23 participants). Qualitative data has been analyzed through a reflexive thematic analysis, and survey data through a social network analysis, and then further combined in an integrated analysis.  

Preliminary results of the current study show that the school staff’s social networks are characterized in different ways within close everyday-discussion colleague networks, peer networks concerning physical activity, and advisory networks regarding physical activity. In the everyday discussions among staff on topics regarding secondary students, physical education teachers are positioned as isolated islands in the networks. While physical education teachers hold a somewhat key role relating to discussions about physical activity, these discussions also go through other, and sometimes more influential, agents. Conflictingly, the physical education teachers still picture themselves as physical activity ambassadors for students’ daily physical activity. This picture is also shared by other school staff. At this school, the results shed light on important issues concerning how the social (network) context among school staff helps promote and inhibit physical activities for the students. 

Gymnastik- och idrottshögskolan (GIH) har sedan 2017 arbetat i en serie forskningsstudier finansierade av Stiftelsen för kunskaps- och kompetensutveckling, KKS. Studierna har fokuserat på både barn, vuxna och äldre. Sedan 2021 finns vid GIH ett forskningscentrum med fokus på fysisk aktivitet och hjärnhälsa, det vill säga goda kognitiva funktioner och god psykisk hälsa, kallat E-PABS (Center of Excellence in Physical Activity, Healthy Brain Functions and Sustainability). Forskningen inom E-PABS täcker många ämnesområden och innefattar epidemiologi, beteendeförändring, kognitiv neurovetenskap, fysiologi och molekylär biokemi.

Denna rapport bygger på studier inom projektet ”Fysisk aktivitet och hälsosamma hjärnfunktioner hos skolungdomar”, som genomfördes under 2017–2023. Projektet hade tre delar, en epidemiologisk, en fysiologisk och en etnografisk del som tillsammans syftade till att svara på frågorna ”Vilket är sambandet mellan fysisk aktivitet, stillasittande beteende, kost och hälsosamma hjärnfunktioner hos barn och ungdomar, och hur kan fysisk aktivitet som främjar sunda hjärnfunktioner långsiktigt hållbart implementeras i skolor?”

Objectives

Is physical exercise beneficial or can it have adverse effects for patients with stress-induced exhaustion disorder? Previous studies confirm exercise benefits in various mental disorders but its impact on exhaustion disorder - a clinical condition resulting from chronic psychosocial stress - requires further exploration to enhance intervention strategies.

This study aims to evaluate the immediate effects of acute exercise on mental health variables fatigue, energy, anxiety, stress, perceived exertion, and psychological discomfort, and compare these effects in patients with exhaustion disorder to healthy controls across two exercise intensities.

Methods

To determine the acute exercise effects, we conducted an experimental trial with patients with exhaustion disorder (n = 30) and healthy control participants (n = 30). At two different occasions they performed 22-minute sessions of cycling at either low or moderate intensity. We assessed the mental health variables before, during, and after exercise.

Results

Acute exercise significantly reduced fatigue, anxiety, and stress while increasing energy in patients immediately after exercising, with sustained benefits thirty minutes later except for energy. The patients reported higher levels of exertion and discomfort than controls throughout the exercise. There were intensity effects in energy and exertion, with moderate intensity inducing higher levels.

Conclusions

Short bouts of exercise can have immediate beneficial mental health effects for patients with exhaustion disorder, regardless of intensity. They experience more exertion and discomfort during exercise, suggesting they face more challenges in physical activities. Further research should aim to optimize protocols and manage barriers to enhance the feasibility of long-term exercise interventions.

INTRODUCTION AND AIM: Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents' experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden.

METHODS: Researchers' engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis.

RESULTS: The analysis resulted in three main themes and seven sub-themes representing different aspects of the program's meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls' physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences.

CONCLUSIONS: The program's activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.

OBJECTIVE: Specific information for whom and when cardiorespiratory fitness (CRF) is associated with depression risk is lacking. We aimed to study the association between adulthood CRF and incident depression, long-term sickness absence, and disability pension due to depression, as well as examine moderation of sex, age, education, and occupation on associations.

METHODS: A large prospective cohort study follows participants over time with Swedish occupational health screenings data. The study includes 330,247 individuals (aged 16-79 years, 46% women) without a depression diagnosis at baseline. CRF was estimated from a submaximal cycle test.

RESULTS: CRF was associated beneficially from low to higher levels with incident depression and long-term sickness absence due to depression. Further, CRF at high levels (≥46 ml/min/kg) was associated with a decreased risk of receiving disability pension due to depression. The associations remained after adjustment for age and sex, but not lifestyle-related factors and co-morbidity. Participants with moderate and high CRF had 16% and 21%, respectively, lower risk for incident depression, and participants with high CRF had 11% lower risk for long-term sickness absence due to depression. Associations between higher CRF and the outcomes were mainly evident in men, younger participants, and individuals with low education.

CONCLUSION: In a large sample of adults without a depression diagnosis at baseline, higher CRF was shown to be beneficially related to the risk of incident depression and, to some extent, long-term sickness absence due to depression. If causal, targeted interventions focusing on increasing CRF in these sub-groups should be prioritized.