Stephen HS Wong | The Chinese University of Hong Kong (original) (raw)

Papers by Stephen HS Wong

Background A considerable number of published reviews have addressed the effects of physical exer... more Background A considerable number of published reviews have addressed the effects of physical exercise on mental health, cognitive function, or attention-deficit hyperactivity (ADHD) symptoms as outcomes in children and adolescents with ADHD. Their findings have often conflicted, therefore, there is an urgent need to synthesise a hierarchy of the evidence and examine the credibility of previous meta-analyses. To establish the robustness of these findings, we conducted an additional meta-analysis on a number of individual studies that were not covered in previous reviews but were suitable for inclusion in our own study. Methods Three reviewers independently searched Web of Science, Psych INFO, Embase, Cochrane Library, PubMed, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for meta-analyses published between database inceptions to December 1, 2022. The individual studies were also screened from 1 January 2015 to 1 December 2022. We included meta-analyses and eligible individual studies that addressed the effects of exercise on at least one outcome of mental health, cognitive function, or ADHD symptoms in children and adolescents with ADHD. We excluded systematic reviews and articles that lacked sufficient data for a meaningful second analysis. The effect estimates (Hedges' g), 95% confidence interval (95% CI), 95% prediction interval (95% PI), small study effects, and excess significance bias were calculated. Finally, we categorised the meta-analyses based on the credibility of the evidence criteria and their quality using a Measurement Tool to Assess Systematic Reviews 2 checklist. This umbrella review was registered with PROSPERO, CRD42022361331. Findings Of 181 listed review articles and 60 individual papers, 10 reviews and 12 individual articles were included in the meta-analyses. This yielded 37 meta-analyses based on 106 study estimates. Evidence was highly suggestive for the effectiveness of exercise (class II) for improving inattention (G = 0.92, 95% CI: 0.44-1.39, 95%), inhibitory control (G = 0.82, 95% CI: 0.52-1.13), and cognitive flexibility (G = 0.52, 95% CI: 0.32-0.72). However, evidence for the effectiveness of exercise on emotional, social, and working memory outcomes was weak, and these results were not significant for hyperactivity and behavioural functioning. Interpretation Improvement of cognitive flexibility, inhibitory control, and inattention in children and adolescents with ADHD was highly suggested by exercise interventions. However, results were weak for other outcomes (emotional functioning, social functioning, and working memory). Further high-quality randomised controlled trials are, therefore, warranted to determine the effectiveness of exercise on weak outcomes.

Low physical fitness in childhood is linked with poor health now and in later life. This study es... more Low physical fitness in childhood is linked with poor health now and in later life. This study estimated temporal trends in physical fitness for Hong Kong children aged 6-12 years from 2003-04 to 2015-16. Objectively measured body size and physical fitness data for 27,513 children were obtained from four population-representative surveys of Hong Kong primary school students. Temporal trends in means were estimated by population-weighted linear regression. Trends in distributional characteristics were visually described. Overall, there was a small increase in mean height (effect size (ES) = 0.20 (95%CI: 0.13, 0.28)), with a negligible increase (ES < 0.2) in mean body mass. When adjusted for trends in age, gender, and body size, there was a small decline in sit-and-reach performance (ES =-0.43 (95%CI: −0.43, −0.42)), a small improvement in 9-min run/walk performance (9-to-12-year-olds, ES = 0.26 (95%CI: 0.26, 0.27)), with negligible declines in handgrip strength, 6-min run/walk (6-to 8-year-olds), and sit-ups performance. Temporal trends were not always uniform across the population distribution, with declines in run/walk, sit-ups, and sit-and-reach performance generally largest in children with low fitness. Increased national health promotion strategies that address culturally specific factors are encouraged to further improve the existing trends, especially for children with low fitness.

To conduct a systematic review and meta-analysis of the association between children and adolesce... more To conduct a systematic review and meta-analysis of the association between children and adolescents with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) and ocular characteristics. Systematic review with meta-analysis. Six databases (PubMed, Scopus, APA PsycInfo, Embase, EBSCOhost, and Cochrane library) were selected for a systematic literature search from database inception to July 2022. The observational studies assessing and reporting at least one outcome regarding ocular characteristics in children and adolescents with ADHD or ASD aged 6-17 were included. Studies in languages other than English, studies of adult or elderly human populations, and animal studies were excluded. The results were analyzed following the PRISMA guideline 2020. The findings of 15 studies, including 433 participants with ADHD, 253 participants with ASD, and 514 participants with typical development (TD), revealed that there were no significant differences in retinal nerve fiber layer, ganglion cell complex, and macular thickness between the ADHD group and the TD group. In subgroup analysis, significant differences in inferior ganglion cell (MD = − 3.19; 95% CI = [− 6.06, − 0.31], p = 0.03) and nasal macular thickness (MD = 5.88; 95% CI = [− 0.01, 11.76], p = 0.05) were detected between the ADHD group and the TD group. A significant difference in pupillary light reflex (PLR) was also observed between the ASD group and the TD group (MD = 29.7; 95% CI = [18.79, 40.63], p < 0.001). Existing evidence suggests a possible association between children and adolescents with ADHD or ASD and ocular characteristics. Given the limited number of studies, further research on a larger cohort is necessary to claim a possible diagnosis of ADHD or ASD through ocular characteristics.

Increasing daily physical activity (PA) is a practical way to decrease the risk of cardiometaboli... more Increasing daily physical activity (PA) is a practical way to decrease the risk of cardiometabolic diseases, while the studies on exercise intensity remain limited. The purpose of the present study was to compare the effects of increasing light PA (LPA) or moderate-to-vigorous PA (MVPA) for 12 weeks on cardiometabolic markers in Chinese adults with obesity. Fifty-three adults were randomly assigned to the 1) control group, 2) LPA group, and 3) MVPA group in free-living settings. The intervention effects on body composition, cardiorespiratory fitness, and cardiometabolic biomarkers were analysed using a generalized estimated equation model adjusted for baseline values and potential confounders. Compared with the control group, the MVPA group showed improvements in body composition, lipids, C-peptide, monocyte chemoattractant protein-1 (MCP-1), interleukin-8, leptin, and E-selectin. A favourable change in triglycerides and E-selectin were observed in the LPA group when compared to the control group. Lastly, improvements in waist circumference, C-reactive protein, and MCP-1 were observed in the MVPA group when compared to those in the LPA group. Although increasing both LPA and MVPA improved certain cardiometabolic biomarkers, the latter may have more benefits. These findings imply that MVPA may reduce cardiometabolic disease risk more effectively than LPA, especially in Chinese adults with obesity.

ABSTRACTObjectivesThe coronavirus disease 2019 (COVID-19) pandemic continues to pose profound cha... more ABSTRACTObjectivesThe coronavirus disease 2019 (COVID-19) pandemic continues to pose profound challenges on society. Governments around the world have managed to mitigate its spread through strategies including social distancing; however, this may result in the adoption of sedentary lifestyle. This study aimed to investigate: 1) physical activity (PA) levels, sedentary behavior (SB) and sleep among young adults during COVID-19 epidemic, and 2) the change in these behaviors before and during the pandemic.MethodsA total of 631 young adults (38.8% males) participated in the cross-sectional study and completed an online survey that included five components: general information, COVID-19 related issues, PA, SB, and sleep. For longitudinal study, PA, SB, and sleep data collected from 70 participants before and during COVID-19 pandemic were analyzed.ResultsParticipants reported engaging in low PA, high SB and long sleep duration during COVID-19 pandemic. Females had greater concern for COV...

Journal of Exercise Science & Fitness, 2019

International Journal of Environmental Research and Public Health, 2022

We conducted a systematic review and meta-analysis comparing motor control, isometric, and isoton... more We conducted a systematic review and meta-analysis comparing motor control, isometric, and isotonic trunk training intervention for pain, disability, and re-injury risk reduction in chronic low back pain patients. The EMBASE, MEDLINE, CENTRAL, PsycINFO, SPORTDiscus, and CINAHL databases were searched from inception until 25 February 2021 for chronic low back pain intervention based on any trunk training. Outcomes include the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ) for disability, the Numerical Pain Rating Scale (NPRS) for pain, and the Sorensen Test (ST) for future risk of re-injury. Isometric training was superior to the control with a mean difference (MD) = −1.66, 95% confidence interval (CI) [−2.30, −1.01] in pain reduction; MD = −7.94, 95% CI [−10.29, −5.59] in ODI; MD = −3.21, 95% CI [−4.83, −1.60] in RMDQ; and MD = 56.35 s, 95% CI [51.81 s, 60.90 s] in ST. Motor control was superior to the control with a MD = −2.44, 95% CI [−3.10, −1.7...

European Journal of Applied Physiology

PURPOSE To investigate sports compression garment (CG)-induced recovery hemodynamics and their po... more PURPOSE To investigate sports compression garment (CG)-induced recovery hemodynamics and their potential impact on subsequent cycling performance. METHODS In a randomized crossover design, 13 physically active men (20.9 ± 1.4 years; 65.9 ± 7.8 kg; 173.3 ± 4.8 cm; peak power output 254.2 ± 27.2 W) underwent 2 experimental trials. During each experimental trial, the subjects performed 20-min fatiguing preload cycling followed by 60-min passive recovery wearing either a sports CG (28.6 ± 9.4 mmHg) or gymnastic pants (CON). A 5-min all-out cycling performance test was subsequently conducted and power output and cadence were recorded. Cardiac output (CO) and stroke volume (SV) were measured using Doppler ultrasound (USCOM®). Heart rate (HR), blood lactate [BLa-], ratings of perceived exertion (RPE), leg muscle soreness (LMS), mean arterial pressure (MAP) and systemic vascular resistance (SVR) were monitored at 5, 15, 30, 45, 60 min during passive recovery. RESULTS During the subsequent 5-min all-out cycling performance test, power output (215.2 ± 24.0 vs. 210.8 ± 21.5 W, CG vs. CON) and cadence (72.5 ± 3.8 vs. 71.2 ± 4.8 rpm, CG vs. CON) were higher in CG than CON (P < 0.05). SV was higher at 15, 30 and 45 min (P < 0.05), CO was higher at 5 and 45 min (P < 0.05), HR was lower at 15 and 30 min (P < 0.05) and [BLa-] was lower at 5 and 15 min (P < 0.05) during passive recovery, while LMS was lower at all time-points (P < 0.05) compared with CON. CONCLUSION Sports CG improves subsequent cycling performance by enhancing hemodynamic responses and attenuating perceived muscle soreness during passive recovery in physically active men.

The fbcus of this paper is on the glycemic index (GI) that provides effectual information on plan... more The fbcus of this paper is on the glycemic index (GI) that provides effectual information on planning nutritional strategies fbr carbohydrate (CHO) supplementation in exercise. Related research has suggested that the GI can be used as a reference guide for the selection of an idea] CHO supplernent in sports nutrition. Recentiy, the manipulation ot' GI of CHO supplernentation in optirnizing athletic performance has provided an exciting new research area in sports nutrition. There is a growing evidence to support the use of the GI in planning the nutritional strategies for CHO supplementation in sports, The optirnum CHO availability for exercise has been demonstrated by manipulating the GI of CHO. Research has shown that a low GI CHO-rich meal is a suitablc CHO source befbre prolonged exercise in order to promote the availability of the sustained CHO. In contrast, a high GI CHO-rich meal appears to be beneficial for glycogen storage after the exercise by prometing greater glucose ...

BMC Public Health, 2021

Background The physical activity-environment relationship has been infrequently investigated in C... more Background The physical activity-environment relationship has been infrequently investigated in Chinese children. Reliable and valid environmental measures specific to the age group and the local context are crucial for better understanding this relationship. The purposes of this study were to adapt the Neighborhood Environment Walkability Scale for youth (NEWS-Y) for Chinese children (termed NEWS-CC), and to examine the reliability and factorial validity of the NEWS-CC. Methods The development of the NEWS-CC involved the translation of the NEWS-Y to Chinese and the addition of nine new items capturing Hong Kong specific environmental attributes which were generated in our previous study. A total of 953 Hong Kong children aged 9–14 years volunteered to complete the NEWS-CC twice with 7–14 days apart. Confirmatory factor analysis (CFA) was performed to examine the factorial validity of the NEWS-CC. Test-retest reliability of subscales and individual items in the NEWS-CC was examined ...

Sports Medicine

Both chronic and acute exercise interventions have reported positive effects on executive functio... more Both chronic and acute exercise interventions have reported positive effects on executive functions (EFs) in general populations. However, data on changes in EFs in children and adolescents with autism spectrum disorder (ASD) in response to exercise interventions are still unclear. This systematic review and meta-analysis aimed to synthesize available empirical studies concerning the effects of exercise interventions on EFs in children and adolescents with ASD. In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the electronic databases CINAHL Complete (via EBSCOhost), SPORTDiscus with Full Text (via EBSCOhost), MEDLINE (via EBSCOhost), Web of Science, ProQuest, and Education Resources Information Center (ERIC; via EBSCOhost) were searched from inception to January 2021. Two authors independently extracted data and conducted a risk-of-bias analysis using the Physiotherapy Evidence Database scale. Randomized controlled trials/quasi-experimental designs that used acute or chronic exercise interventions and assessed EFs through neurocognitive tasks or questionnaires among children and adolescents with ASD were included. In total, 259 articles were identified, of which 15 full texts were independently assessed for eligibility by two authors. In total, 14 articles underwent systematic review, and seven were selected for meta-analysis. Overall, chronic exercise interventions had a small to moderate positive effect on overall EFs in children and adolescents with ASD (g = 0.342; 95% confidence interval [CI] 0.084–0.600; p < 0.01). Regarding domain-specific EFs, chronic exercise interventions had a small to moderate positive effect on cognitive flexibility (g = 0.312; 95% CI 0.053–0.570; p < 0.01) and inhibitory control (g = 0.492; 95% CI 0.188–0.796; p < 0.01). However, our review found a non-significant effect size (g = 0.212; 95% CI − 0.088 to 0.512) on working memory. Chronic exercise interventions appear to have beneficial effects on overall EFs in children and adolescents with ASD, particularly in relation to cognitive flexibility and inhibitory control.

Frontiers in Physiology

Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to... more Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to plasma glucose (PG) measurements during postprandial rest and different walking conditions in overweight/obese young adults.Methods: Data of 40 overweight/obese participants from two randomized crossover studies were pooled into four trials: (1) sitting (SIT, n = 40); (2) walking continuously for 30 min initiated 20 min before individual postprandial glucose peak (PPGP) (20iP + CONT, n = 40); (3) walking continuously for 30 min initiated at PPGP (iP + CONT, n = 20); and (4) accumulated walking for 30 min initiated 20 min before PPGP (20iP + ACCU, n = 20). Paired FGM and PG were measured 4 h following breakfast.Results: The overall mean absolute relative difference (MARD) between PG and FGM readings was 16.4 ± 8.6% for SIT, 16.2 ± 4.7% for 20iP + CONT, 16.7 ± 12.2% for iP + CONT, and 19.1 ± 6.8% for 20iP + ACCU. The Bland–Altman analysis showed a bias of −1.03 mmol⋅L–1 in SIT, −0.89 mmol...

International Journal of Behavioral Nutrition and Physical Activity

Background Previous studies found that exercise interventions have positive effects on executive ... more Background Previous studies found that exercise interventions have positive effects on executive functions of the general population. However, studies seldom target executive functions of children and adolescents with attention-deficit hyperactivity disorder (ADHD). This study aimed to synthesise empirical studies regarding the effects of exercise interventions on executive functions of children and adolescents with ADHD. Methods A systematic search of the relevant literature was conducted in March 2020 through six electronic databases: CINAHL Complete, Eric, MEDLINE, PsychINFO, SPORTDiscus with Full Text, and Web of Science. Randomised controlled trials/quasi-experimental designs that applied exercise interventions and assessed executive functions through neurocognitive tasks among children and adolescents with ADHD were included. Altogether, 314 studies were identified, from which 31 full texts were independently assessed by two authors for eligibility. Finally, 21 studies underwe...

Journal of Strength and Conditioning Research

Lee, DCW, Ali, A, Sheridan, S, Chan, DKC, and Wong, SHS. Wearing compression garment enhances cen... more Lee, DCW, Ali, A, Sheridan, S, Chan, DKC, and Wong, SHS. Wearing compression garment enhances central hemodynamics? a systematic review and meta-analysis . J Strength Cond Res XX(X): 000-000, 2020-Compression garments (CG) are believed to enhance exercise performance and recovery by improving central hemodynamic responses. However, evidence is inconclusive. We performed a systematic review and meta-analysis to determine the effect of wearing CG at rest or after a physiological challenge on central hemodynamic responses, including cardiac output, stroke volume (SV), heart rate (HR), systolic blood pressure, diastolic blood pressure (DBP), and systemic vascular resistance in healthy individuals. The English language searches of the electronic databases SPORTDiscus, MEDLINE, and Web of Science were conducted from November 2018-February 2019. The studies involved were limited to the following: (a) original articles; (b) randomized controlled trials; (c) monitoring of central hemodynamic responses (either at rest or after a physiological challenge: maximal exercise or orthostatic challenge); and (d) healthy individuals. Of the 786 studies identified, 12 were included in the systematic review and meta-analysis. Meta-analysis was performed by the restricted maximum likelihood method. The results indicated that the effect size (ES) of wearing CG on improving central hemodynamic responses was large overall (Hedges' g = 0.55) and was large in SV (Hedges' g = 1.09) and HR (Hedges' g = 0.65). Subgroup analysis showed that the ESs in "post-physiological challenge" was large in overall (Hedges' g = 0.98), SV (Hedges' g = 1.78), HR (Hedges' g = 1.10), and DBP (Hedges' g = 0.75). Their ESs in "at rest" were not significant in all central hemodynamic responses, apart from a significant medium ES observed in SV (Hedges' g = 0.44). Healthy individuals who wear CG have marked improvement in central hemodynamic responses, particularly after a physiological challenge. More pronounced effects of CG are observed in increasing SV and reducing HR.

International Journal of Sports Medicine

This study evaluated the morphological changes of the lower limb and associated hemodynamic respo... more This study evaluated the morphological changes of the lower limb and associated hemodynamic responses to different lower-body compression pressures (COMPs) in physically active, healthy individuals at rest. Each of the 32 participants underwent three trials with three different degrees of lower-body compression applied: “Low” (2.2±1.4 mmHg), “Medium” (12.9±3.9 mmHg), and “High” (28.8±8.3 mmHg). In each COMP, a cross-sectional area of leg muscles (CSAmuscle), subcutaneous fat (CSAfat), superficial vessels (SupV), deep arteries (DA), and deep veins (DV) at the calf, knee, and thigh levels were measured using magnetic resonance imaging (MRI). Additionally, blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) were measured using Doppler ultrasound (USCOM®). With High COMP, calf CSAmuscle and SupV were smaller (p<0.01), whereas DA and DV were larger (p<0.05). Calf CSAfat, however, was similar among all COMPs. There we...

Journal of Physical Activity and Health

Background: The Global Matrix 3.0 brings together the Report Card grades for 10 physical activity... more Background: The Global Matrix 3.0 brings together the Report Card grades for 10 physical activity indicators for children and youth from 49 countries. This study describes and compares the Global Matrix 3.0 findings among 10 countries with high Human Development Index. Methods: Report Cards on physical activity indicators were developed by each country following a harmonized process. Countries informed their Report Cards with the best and most recent evidence available. Indicators were graded using a common grading rubric and benchmarks established by the Active Healthy Kids Global Alliance. A database of grades from the countries was compiled, and letter grades were converted to numerical equivalents. Descriptive statistics and scores for groups of indicators were calculated, and correlation analyses were conducted. Results: Grades for the 10 countries clustered around “D” ranging from “F” to “B+.” Active Transportation had the highest average grade (“C”), whereas Overall Physical ...

Journal of Physical Activity and Health

Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key... more Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI...

Journal of science and medicine in sport, Jan 15, 2017

While previous studies have demonstrated an ergogenic effect of sport compression garments in exe... more While previous studies have demonstrated an ergogenic effect of sport compression garments in exercise performance and recovery, the possible underlying mechanisms remain unclear. Claims for improved venous return from wearing sport compression garments with a low compression pressure remain unproven. The aim of this study was to determine the pressure profile exerted by low-pressure sports compression tights, and to investigate using a non-invasive Doppler ultrasound cardiac output monitor (USCOM), whether the compression applied will influence haemodynamic responses during an orthostatic challenge. A randomized-crossover design. Thirty-three healthy participants (18 male and 15 female) underwent two trials, each consisting of lying supine and 70° head-up tilt wearing either a low-pressure sports compression tights (CT) or track pants (CON). Stroke volume (SV) and cardiac output (CO) were measured non-invasively using USCOM; heart rate (HR) and non-invasive blood pressure were meas...

Frontiers in physiology, 2017

This study compared the effect of alpha-lactalbumin and whey protein on muscle damage, muscle pai... more This study compared the effect of alpha-lactalbumin and whey protein on muscle damage, muscle pain, and mood states during short term recovery following strenuous prolonged exercise. In a two-stage crossover counterbalanced design, 12 endurance male runners were recruited (age: 30.4 ± 2.8 year, height: 172.7 ± 5.6 cm, body mass: 66.7 ± 6.5 kg, VO2max: 58.0 ± 6.9 ml/kg(-)/min), ran for 90 min at 70% VO2max, and followed by a 4-h recovery. Two treatments (carbohydrate+alpha-lactalbumin, CA; carbohydrate+whey protein isolate, CW) were applied during the main trials. During the first 2-h of recovery, CHO was served at the rate of 0.66 g/kg/h and PRO at 0.34 g/kg/h every 30 min. Creatine kinase (CK), interleukin-6 (IL-6), salivary cortisol, rating of muscle pain, pressure pain threshold (PPT), and mood states were evaluated before (Pre-ex), immediately (Post-ex0), 2 h (Post-ex2h) and 4 h (Post-ex4h) after exercise. 24 h after exercise (Post-ex24h), CK and IL-6, muscle pain, and PPT were ...

Medicine & Science in Sports & Exercise

Background A considerable number of published reviews have addressed the effects of physical exer... more Background A considerable number of published reviews have addressed the effects of physical exercise on mental health, cognitive function, or attention-deficit hyperactivity (ADHD) symptoms as outcomes in children and adolescents with ADHD. Their findings have often conflicted, therefore, there is an urgent need to synthesise a hierarchy of the evidence and examine the credibility of previous meta-analyses. To establish the robustness of these findings, we conducted an additional meta-analysis on a number of individual studies that were not covered in previous reviews but were suitable for inclusion in our own study. Methods Three reviewers independently searched Web of Science, Psych INFO, Embase, Cochrane Library, PubMed, SPORTDiscus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for meta-analyses published between database inceptions to December 1, 2022. The individual studies were also screened from 1 January 2015 to 1 December 2022. We included meta-analyses and eligible individual studies that addressed the effects of exercise on at least one outcome of mental health, cognitive function, or ADHD symptoms in children and adolescents with ADHD. We excluded systematic reviews and articles that lacked sufficient data for a meaningful second analysis. The effect estimates (Hedges' g), 95% confidence interval (95% CI), 95% prediction interval (95% PI), small study effects, and excess significance bias were calculated. Finally, we categorised the meta-analyses based on the credibility of the evidence criteria and their quality using a Measurement Tool to Assess Systematic Reviews 2 checklist. This umbrella review was registered with PROSPERO, CRD42022361331. Findings Of 181 listed review articles and 60 individual papers, 10 reviews and 12 individual articles were included in the meta-analyses. This yielded 37 meta-analyses based on 106 study estimates. Evidence was highly suggestive for the effectiveness of exercise (class II) for improving inattention (G = 0.92, 95% CI: 0.44-1.39, 95%), inhibitory control (G = 0.82, 95% CI: 0.52-1.13), and cognitive flexibility (G = 0.52, 95% CI: 0.32-0.72). However, evidence for the effectiveness of exercise on emotional, social, and working memory outcomes was weak, and these results were not significant for hyperactivity and behavioural functioning. Interpretation Improvement of cognitive flexibility, inhibitory control, and inattention in children and adolescents with ADHD was highly suggested by exercise interventions. However, results were weak for other outcomes (emotional functioning, social functioning, and working memory). Further high-quality randomised controlled trials are, therefore, warranted to determine the effectiveness of exercise on weak outcomes.

Low physical fitness in childhood is linked with poor health now and in later life. This study es... more Low physical fitness in childhood is linked with poor health now and in later life. This study estimated temporal trends in physical fitness for Hong Kong children aged 6-12 years from 2003-04 to 2015-16. Objectively measured body size and physical fitness data for 27,513 children were obtained from four population-representative surveys of Hong Kong primary school students. Temporal trends in means were estimated by population-weighted linear regression. Trends in distributional characteristics were visually described. Overall, there was a small increase in mean height (effect size (ES) = 0.20 (95%CI: 0.13, 0.28)), with a negligible increase (ES < 0.2) in mean body mass. When adjusted for trends in age, gender, and body size, there was a small decline in sit-and-reach performance (ES =-0.43 (95%CI: −0.43, −0.42)), a small improvement in 9-min run/walk performance (9-to-12-year-olds, ES = 0.26 (95%CI: 0.26, 0.27)), with negligible declines in handgrip strength, 6-min run/walk (6-to 8-year-olds), and sit-ups performance. Temporal trends were not always uniform across the population distribution, with declines in run/walk, sit-ups, and sit-and-reach performance generally largest in children with low fitness. Increased national health promotion strategies that address culturally specific factors are encouraged to further improve the existing trends, especially for children with low fitness.

To conduct a systematic review and meta-analysis of the association between children and adolesce... more To conduct a systematic review and meta-analysis of the association between children and adolescents with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) and ocular characteristics. Systematic review with meta-analysis. Six databases (PubMed, Scopus, APA PsycInfo, Embase, EBSCOhost, and Cochrane library) were selected for a systematic literature search from database inception to July 2022. The observational studies assessing and reporting at least one outcome regarding ocular characteristics in children and adolescents with ADHD or ASD aged 6-17 were included. Studies in languages other than English, studies of adult or elderly human populations, and animal studies were excluded. The results were analyzed following the PRISMA guideline 2020. The findings of 15 studies, including 433 participants with ADHD, 253 participants with ASD, and 514 participants with typical development (TD), revealed that there were no significant differences in retinal nerve fiber layer, ganglion cell complex, and macular thickness between the ADHD group and the TD group. In subgroup analysis, significant differences in inferior ganglion cell (MD = − 3.19; 95% CI = [− 6.06, − 0.31], p = 0.03) and nasal macular thickness (MD = 5.88; 95% CI = [− 0.01, 11.76], p = 0.05) were detected between the ADHD group and the TD group. A significant difference in pupillary light reflex (PLR) was also observed between the ASD group and the TD group (MD = 29.7; 95% CI = [18.79, 40.63], p < 0.001). Existing evidence suggests a possible association between children and adolescents with ADHD or ASD and ocular characteristics. Given the limited number of studies, further research on a larger cohort is necessary to claim a possible diagnosis of ADHD or ASD through ocular characteristics.

Increasing daily physical activity (PA) is a practical way to decrease the risk of cardiometaboli... more Increasing daily physical activity (PA) is a practical way to decrease the risk of cardiometabolic diseases, while the studies on exercise intensity remain limited. The purpose of the present study was to compare the effects of increasing light PA (LPA) or moderate-to-vigorous PA (MVPA) for 12 weeks on cardiometabolic markers in Chinese adults with obesity. Fifty-three adults were randomly assigned to the 1) control group, 2) LPA group, and 3) MVPA group in free-living settings. The intervention effects on body composition, cardiorespiratory fitness, and cardiometabolic biomarkers were analysed using a generalized estimated equation model adjusted for baseline values and potential confounders. Compared with the control group, the MVPA group showed improvements in body composition, lipids, C-peptide, monocyte chemoattractant protein-1 (MCP-1), interleukin-8, leptin, and E-selectin. A favourable change in triglycerides and E-selectin were observed in the LPA group when compared to the control group. Lastly, improvements in waist circumference, C-reactive protein, and MCP-1 were observed in the MVPA group when compared to those in the LPA group. Although increasing both LPA and MVPA improved certain cardiometabolic biomarkers, the latter may have more benefits. These findings imply that MVPA may reduce cardiometabolic disease risk more effectively than LPA, especially in Chinese adults with obesity.

ABSTRACTObjectivesThe coronavirus disease 2019 (COVID-19) pandemic continues to pose profound cha... more ABSTRACTObjectivesThe coronavirus disease 2019 (COVID-19) pandemic continues to pose profound challenges on society. Governments around the world have managed to mitigate its spread through strategies including social distancing; however, this may result in the adoption of sedentary lifestyle. This study aimed to investigate: 1) physical activity (PA) levels, sedentary behavior (SB) and sleep among young adults during COVID-19 epidemic, and 2) the change in these behaviors before and during the pandemic.MethodsA total of 631 young adults (38.8% males) participated in the cross-sectional study and completed an online survey that included five components: general information, COVID-19 related issues, PA, SB, and sleep. For longitudinal study, PA, SB, and sleep data collected from 70 participants before and during COVID-19 pandemic were analyzed.ResultsParticipants reported engaging in low PA, high SB and long sleep duration during COVID-19 pandemic. Females had greater concern for COV...

Journal of Exercise Science & Fitness, 2019

International Journal of Environmental Research and Public Health, 2022

We conducted a systematic review and meta-analysis comparing motor control, isometric, and isoton... more We conducted a systematic review and meta-analysis comparing motor control, isometric, and isotonic trunk training intervention for pain, disability, and re-injury risk reduction in chronic low back pain patients. The EMBASE, MEDLINE, CENTRAL, PsycINFO, SPORTDiscus, and CINAHL databases were searched from inception until 25 February 2021 for chronic low back pain intervention based on any trunk training. Outcomes include the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ) for disability, the Numerical Pain Rating Scale (NPRS) for pain, and the Sorensen Test (ST) for future risk of re-injury. Isometric training was superior to the control with a mean difference (MD) = −1.66, 95% confidence interval (CI) [−2.30, −1.01] in pain reduction; MD = −7.94, 95% CI [−10.29, −5.59] in ODI; MD = −3.21, 95% CI [−4.83, −1.60] in RMDQ; and MD = 56.35 s, 95% CI [51.81 s, 60.90 s] in ST. Motor control was superior to the control with a MD = −2.44, 95% CI [−3.10, −1.7...

European Journal of Applied Physiology

PURPOSE To investigate sports compression garment (CG)-induced recovery hemodynamics and their po... more PURPOSE To investigate sports compression garment (CG)-induced recovery hemodynamics and their potential impact on subsequent cycling performance. METHODS In a randomized crossover design, 13 physically active men (20.9 ± 1.4 years; 65.9 ± 7.8 kg; 173.3 ± 4.8 cm; peak power output 254.2 ± 27.2 W) underwent 2 experimental trials. During each experimental trial, the subjects performed 20-min fatiguing preload cycling followed by 60-min passive recovery wearing either a sports CG (28.6 ± 9.4 mmHg) or gymnastic pants (CON). A 5-min all-out cycling performance test was subsequently conducted and power output and cadence were recorded. Cardiac output (CO) and stroke volume (SV) were measured using Doppler ultrasound (USCOM®). Heart rate (HR), blood lactate [BLa-], ratings of perceived exertion (RPE), leg muscle soreness (LMS), mean arterial pressure (MAP) and systemic vascular resistance (SVR) were monitored at 5, 15, 30, 45, 60 min during passive recovery. RESULTS During the subsequent 5-min all-out cycling performance test, power output (215.2 ± 24.0 vs. 210.8 ± 21.5 W, CG vs. CON) and cadence (72.5 ± 3.8 vs. 71.2 ± 4.8 rpm, CG vs. CON) were higher in CG than CON (P < 0.05). SV was higher at 15, 30 and 45 min (P < 0.05), CO was higher at 5 and 45 min (P < 0.05), HR was lower at 15 and 30 min (P < 0.05) and [BLa-] was lower at 5 and 15 min (P < 0.05) during passive recovery, while LMS was lower at all time-points (P < 0.05) compared with CON. CONCLUSION Sports CG improves subsequent cycling performance by enhancing hemodynamic responses and attenuating perceived muscle soreness during passive recovery in physically active men.

The fbcus of this paper is on the glycemic index (GI) that provides effectual information on plan... more The fbcus of this paper is on the glycemic index (GI) that provides effectual information on planning nutritional strategies fbr carbohydrate (CHO) supplementation in exercise. Related research has suggested that the GI can be used as a reference guide for the selection of an idea] CHO supplernent in sports nutrition. Recentiy, the manipulation ot' GI of CHO supplernentation in optirnizing athletic performance has provided an exciting new research area in sports nutrition. There is a growing evidence to support the use of the GI in planning the nutritional strategies for CHO supplementation in sports, The optirnum CHO availability for exercise has been demonstrated by manipulating the GI of CHO. Research has shown that a low GI CHO-rich meal is a suitablc CHO source befbre prolonged exercise in order to promote the availability of the sustained CHO. In contrast, a high GI CHO-rich meal appears to be beneficial for glycogen storage after the exercise by prometing greater glucose ...

BMC Public Health, 2021

Background The physical activity-environment relationship has been infrequently investigated in C... more Background The physical activity-environment relationship has been infrequently investigated in Chinese children. Reliable and valid environmental measures specific to the age group and the local context are crucial for better understanding this relationship. The purposes of this study were to adapt the Neighborhood Environment Walkability Scale for youth (NEWS-Y) for Chinese children (termed NEWS-CC), and to examine the reliability and factorial validity of the NEWS-CC. Methods The development of the NEWS-CC involved the translation of the NEWS-Y to Chinese and the addition of nine new items capturing Hong Kong specific environmental attributes which were generated in our previous study. A total of 953 Hong Kong children aged 9–14 years volunteered to complete the NEWS-CC twice with 7–14 days apart. Confirmatory factor analysis (CFA) was performed to examine the factorial validity of the NEWS-CC. Test-retest reliability of subscales and individual items in the NEWS-CC was examined ...

Sports Medicine

Both chronic and acute exercise interventions have reported positive effects on executive functio... more Both chronic and acute exercise interventions have reported positive effects on executive functions (EFs) in general populations. However, data on changes in EFs in children and adolescents with autism spectrum disorder (ASD) in response to exercise interventions are still unclear. This systematic review and meta-analysis aimed to synthesize available empirical studies concerning the effects of exercise interventions on EFs in children and adolescents with ASD. In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the electronic databases CINAHL Complete (via EBSCOhost), SPORTDiscus with Full Text (via EBSCOhost), MEDLINE (via EBSCOhost), Web of Science, ProQuest, and Education Resources Information Center (ERIC; via EBSCOhost) were searched from inception to January 2021. Two authors independently extracted data and conducted a risk-of-bias analysis using the Physiotherapy Evidence Database scale. Randomized controlled trials/quasi-experimental designs that used acute or chronic exercise interventions and assessed EFs through neurocognitive tasks or questionnaires among children and adolescents with ASD were included. In total, 259 articles were identified, of which 15 full texts were independently assessed for eligibility by two authors. In total, 14 articles underwent systematic review, and seven were selected for meta-analysis. Overall, chronic exercise interventions had a small to moderate positive effect on overall EFs in children and adolescents with ASD (g = 0.342; 95% confidence interval [CI] 0.084–0.600; p < 0.01). Regarding domain-specific EFs, chronic exercise interventions had a small to moderate positive effect on cognitive flexibility (g = 0.312; 95% CI 0.053–0.570; p < 0.01) and inhibitory control (g = 0.492; 95% CI 0.188–0.796; p < 0.01). However, our review found a non-significant effect size (g = 0.212; 95% CI − 0.088 to 0.512) on working memory. Chronic exercise interventions appear to have beneficial effects on overall EFs in children and adolescents with ASD, particularly in relation to cognitive flexibility and inhibitory control.

Frontiers in Physiology

Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to... more Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to plasma glucose (PG) measurements during postprandial rest and different walking conditions in overweight/obese young adults.Methods: Data of 40 overweight/obese participants from two randomized crossover studies were pooled into four trials: (1) sitting (SIT, n = 40); (2) walking continuously for 30 min initiated 20 min before individual postprandial glucose peak (PPGP) (20iP + CONT, n = 40); (3) walking continuously for 30 min initiated at PPGP (iP + CONT, n = 20); and (4) accumulated walking for 30 min initiated 20 min before PPGP (20iP + ACCU, n = 20). Paired FGM and PG were measured 4 h following breakfast.Results: The overall mean absolute relative difference (MARD) between PG and FGM readings was 16.4 ± 8.6% for SIT, 16.2 ± 4.7% for 20iP + CONT, 16.7 ± 12.2% for iP + CONT, and 19.1 ± 6.8% for 20iP + ACCU. The Bland–Altman analysis showed a bias of −1.03 mmol⋅L–1 in SIT, −0.89 mmol...

International Journal of Behavioral Nutrition and Physical Activity

Background Previous studies found that exercise interventions have positive effects on executive ... more Background Previous studies found that exercise interventions have positive effects on executive functions of the general population. However, studies seldom target executive functions of children and adolescents with attention-deficit hyperactivity disorder (ADHD). This study aimed to synthesise empirical studies regarding the effects of exercise interventions on executive functions of children and adolescents with ADHD. Methods A systematic search of the relevant literature was conducted in March 2020 through six electronic databases: CINAHL Complete, Eric, MEDLINE, PsychINFO, SPORTDiscus with Full Text, and Web of Science. Randomised controlled trials/quasi-experimental designs that applied exercise interventions and assessed executive functions through neurocognitive tasks among children and adolescents with ADHD were included. Altogether, 314 studies were identified, from which 31 full texts were independently assessed by two authors for eligibility. Finally, 21 studies underwe...

Journal of Strength and Conditioning Research

Lee, DCW, Ali, A, Sheridan, S, Chan, DKC, and Wong, SHS. Wearing compression garment enhances cen... more Lee, DCW, Ali, A, Sheridan, S, Chan, DKC, and Wong, SHS. Wearing compression garment enhances central hemodynamics? a systematic review and meta-analysis . J Strength Cond Res XX(X): 000-000, 2020-Compression garments (CG) are believed to enhance exercise performance and recovery by improving central hemodynamic responses. However, evidence is inconclusive. We performed a systematic review and meta-analysis to determine the effect of wearing CG at rest or after a physiological challenge on central hemodynamic responses, including cardiac output, stroke volume (SV), heart rate (HR), systolic blood pressure, diastolic blood pressure (DBP), and systemic vascular resistance in healthy individuals. The English language searches of the electronic databases SPORTDiscus, MEDLINE, and Web of Science were conducted from November 2018-February 2019. The studies involved were limited to the following: (a) original articles; (b) randomized controlled trials; (c) monitoring of central hemodynamic responses (either at rest or after a physiological challenge: maximal exercise or orthostatic challenge); and (d) healthy individuals. Of the 786 studies identified, 12 were included in the systematic review and meta-analysis. Meta-analysis was performed by the restricted maximum likelihood method. The results indicated that the effect size (ES) of wearing CG on improving central hemodynamic responses was large overall (Hedges' g = 0.55) and was large in SV (Hedges' g = 1.09) and HR (Hedges' g = 0.65). Subgroup analysis showed that the ESs in "post-physiological challenge" was large in overall (Hedges' g = 0.98), SV (Hedges' g = 1.78), HR (Hedges' g = 1.10), and DBP (Hedges' g = 0.75). Their ESs in "at rest" were not significant in all central hemodynamic responses, apart from a significant medium ES observed in SV (Hedges' g = 0.44). Healthy individuals who wear CG have marked improvement in central hemodynamic responses, particularly after a physiological challenge. More pronounced effects of CG are observed in increasing SV and reducing HR.

International Journal of Sports Medicine

This study evaluated the morphological changes of the lower limb and associated hemodynamic respo... more This study evaluated the morphological changes of the lower limb and associated hemodynamic responses to different lower-body compression pressures (COMPs) in physically active, healthy individuals at rest. Each of the 32 participants underwent three trials with three different degrees of lower-body compression applied: “Low” (2.2±1.4 mmHg), “Medium” (12.9±3.9 mmHg), and “High” (28.8±8.3 mmHg). In each COMP, a cross-sectional area of leg muscles (CSAmuscle), subcutaneous fat (CSAfat), superficial vessels (SupV), deep arteries (DA), and deep veins (DV) at the calf, knee, and thigh levels were measured using magnetic resonance imaging (MRI). Additionally, blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) were measured using Doppler ultrasound (USCOM®). With High COMP, calf CSAmuscle and SupV were smaller (p<0.01), whereas DA and DV were larger (p<0.05). Calf CSAfat, however, was similar among all COMPs. There we...

Journal of Physical Activity and Health

Background: The Global Matrix 3.0 brings together the Report Card grades for 10 physical activity... more Background: The Global Matrix 3.0 brings together the Report Card grades for 10 physical activity indicators for children and youth from 49 countries. This study describes and compares the Global Matrix 3.0 findings among 10 countries with high Human Development Index. Methods: Report Cards on physical activity indicators were developed by each country following a harmonized process. Countries informed their Report Cards with the best and most recent evidence available. Indicators were graded using a common grading rubric and benchmarks established by the Active Healthy Kids Global Alliance. A database of grades from the countries was compiled, and letter grades were converted to numerical equivalents. Descriptive statistics and scores for groups of indicators were calculated, and correlation analyses were conducted. Results: Grades for the 10 countries clustered around “D” ranging from “F” to “B+.” Active Transportation had the highest average grade (“C”), whereas Overall Physical ...

Journal of Physical Activity and Health

Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key... more Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI...

Journal of science and medicine in sport, Jan 15, 2017

While previous studies have demonstrated an ergogenic effect of sport compression garments in exe... more While previous studies have demonstrated an ergogenic effect of sport compression garments in exercise performance and recovery, the possible underlying mechanisms remain unclear. Claims for improved venous return from wearing sport compression garments with a low compression pressure remain unproven. The aim of this study was to determine the pressure profile exerted by low-pressure sports compression tights, and to investigate using a non-invasive Doppler ultrasound cardiac output monitor (USCOM), whether the compression applied will influence haemodynamic responses during an orthostatic challenge. A randomized-crossover design. Thirty-three healthy participants (18 male and 15 female) underwent two trials, each consisting of lying supine and 70° head-up tilt wearing either a low-pressure sports compression tights (CT) or track pants (CON). Stroke volume (SV) and cardiac output (CO) were measured non-invasively using USCOM; heart rate (HR) and non-invasive blood pressure were meas...

Frontiers in physiology, 2017

This study compared the effect of alpha-lactalbumin and whey protein on muscle damage, muscle pai... more This study compared the effect of alpha-lactalbumin and whey protein on muscle damage, muscle pain, and mood states during short term recovery following strenuous prolonged exercise. In a two-stage crossover counterbalanced design, 12 endurance male runners were recruited (age: 30.4 ± 2.8 year, height: 172.7 ± 5.6 cm, body mass: 66.7 ± 6.5 kg, VO2max: 58.0 ± 6.9 ml/kg(-)/min), ran for 90 min at 70% VO2max, and followed by a 4-h recovery. Two treatments (carbohydrate+alpha-lactalbumin, CA; carbohydrate+whey protein isolate, CW) were applied during the main trials. During the first 2-h of recovery, CHO was served at the rate of 0.66 g/kg/h and PRO at 0.34 g/kg/h every 30 min. Creatine kinase (CK), interleukin-6 (IL-6), salivary cortisol, rating of muscle pain, pressure pain threshold (PPT), and mood states were evaluated before (Pre-ex), immediately (Post-ex0), 2 h (Post-ex2h) and 4 h (Post-ex4h) after exercise. 24 h after exercise (Post-ex24h), CK and IL-6, muscle pain, and PPT were ...

Medicine & Science in Sports & Exercise