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Rationale and methods for a randomized controlled trial of a movement-to-music video program for decreasing sedentary time among mother-child pairs

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Background: Measured objectively, under a quarter of adults and fewer than half of preschool children meet the criteria set in the aerobic physical activity recommendations of the Centers for Disease Control and Prevention. Moreover, adults reportedly are sedentary (seated or lying down) for most of their waking hours. Importantly, greater amounts of sedentary time on parents' part are associated with an increased risk of more sedentary time among their children. A randomized controlled trial targeting mother-child pairs has been designed, to examine whether a movement-to-music video program may be effective in reducing sedentary time and increasing physical activity in the home environment. Methods: Mother-child pairs (child age of 4-7 years) will be recruited from among NELLI lifestyle-modification study five-year follow-up cohort participants, encompassing 14 municipalities in Pirkanmaa region, Finland. Accelerometer and exercise diary data are to be collected for intervention and control groups at the first, second and eighth week after the baseline measurements. Background factors, physical activity, screen time, motivation to exercise, and self-reported height and weight, along with quality of life, will be assessed via questionnaires. After the baseline and first week measurements, the participants of the intervention group will receive a movement-to-music video program designed to reduce sedentary time and increase physical activity. Intervention group mother-child pairs will be instructed to exercise every other day while watching the video program over the next seven weeks. Information on experiences of the use of the movement-to-music video program will be collected 8 weeks after baseline. Effects of the intervention will be analyzed in line with the intention-to-treat principle through comparison of the changes in the main outcomes between intervention and control group participants. The study has received ethics approval from the Pirkanmaa Ethics Committee in Human Sciences. Discussion: The study will yield information on the effectiveness of movement-to-music video exercise in reducing sedentary behavior. Intervention-based methods have proven effective in increasing physical activity in home environments. Music may improve exercise adherence, which creates a possibility of achieving long-term health benefits. Trial registration: The study is registered at ClinicalTrials.gov, as NCT02270138. It was registered on October 2, 2014.
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S T U D Y P R O T O C O L Open Access
Rationale and methods for a randomized
controlled trial of a movement-to-music
video program for decreasing sedentary
time among mother-child pairs
Pipsa P. A. Tuominen
1,2*
, Pauliina Husu
1
, Jani Raitanen
1,3
and Riitta M. Luoto
1
Abstract
Background: Measured objectively, under a quarter of adults and fewer than half of preschool children meet the
criteria set in the aerobic physical activity recommendations of the Centers for Disease Control and Prevention.
Moreover, adults reportedly are sedentary (seated or lying down) for most of their waking hours. Importantly,
greater amounts of sedentary time on parentspart are associated with an increased risk of more sedentary time
among their children. A randomized controlled trial targeting mother-child pairs has been designed, to examine
whether a movement-to-music video program may be effective in reducing sedentary time and increasing physical
activity in the home environment.
Methods: Mother-child pairs (child age of 47 years) will be recruited from among NELLI lifestyle-modification
study five-year follow-up cohort participants, encompassing 14 municipalities in Pirkanmaa region, Finland.
Accelerometer and exercise diary data are to be collected for intervention and control groups at the first, second
and eighth week after the baseline measurements. Background factors, physical activity, screen time, motivation to
exercise, and self-reported height and weight, along with quality of life, will be assessed via questionnaires. After the
baseline and first week measurements, the participants of the intervention group will receive a movement-to-music video
program designed to reduce sedentary time and increase physical activity. Intervention group mother-child pairs will be
instructed to exercise every other day while watching the video program over the next seven weeks. Information on
experiences of the use of the movement-to-music video program will be collected 8 weeks after baseline. Effects of the
intervention will be analyzed in line with the intention-to-treat principle throughcomparisonofthechangesinthemain
outcomes between intervention and control group participants. The study has received ethics approval from the
Pirkanmaa Ethics Committee in Human Sciences.
Discussion: The study will yield information on the effectiveness of movement-to-music video exercise in reducing
sedentary behavior. Intervention-based methods have proven effective in increasing physical activity in home
environments. Music may improve exercise adherence, which creates a possibility of achieving long-term health
benefits.
Trial registration: The study is registered at ClinicalTrials.gov, as NCT02270138. It was registered on October 2, 2014.
Keywords: Sedentary behavior, Physical activity, Movement-to-music, Motivational music, Video
* Correspondence: pipsa.tuominen@uta.fi
Equal contributors
1
UKK Institute for Health Promotion Research, Tampere, Finland
2
Department of Health Sciences, Faculty of Sport and Health Sciences,
University of Jyväskylä, Jyväskylä, Finland
Full list of author information is available at the end of the article
© 2015 Tuominen et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Tuominen et al. BMC Public Health (2015) 15:1016
DOI 10.1186/s12889-015-2347-4
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Background
The risk of many chronic diseases, among them type 2
diabetes, obesity, breast cancer, and cardiovascular dis-
eases, along with all causes of mortality, grows in conse-
quence of increasing of sedentary behavior (SB) and
decreasing of physical activity (PA) [1, 2]. For our re-
search, we have slightly adapted the definitions from the
Sedentary Behavior Research Network [3] and Tremblay
et al. [4] thus:
Sedentary behavior is any waking behavior
characterized by energy expenditure 1.5 METs
while the participant is in a sitting or reclining
posture. Screen time (watching television, using a
computer, and playing video games or using other
screens) is included in SB.
Physical activity consists of meeting the established
guidelines for physical activity [5], usually reflected
in achievement of at least a certain threshold (see
below) number of minutes of moderate to vigorous
physical activity (MVPA) per day.
Physical inactivity consist of performing insufficient
amounts of MVPA i.e., not following the specified
physical activity guidelines.
The Centers for Disease Control and Prevention (CDC)
recommends that adults engage in at least 150 min of
moderate or 75 min of vigorous intensity activity, or an
equivalent combination of aerobic activities every week in
bouts of 10 or more minutes. In addition, muscle-
strengthening activities for all major muscle groups on
two or more days per week are recommended [5]. For
children, the recommendation includes at least 60 min of
aerobic activity per day and muscle and bone strengthen-
ing three or more days a week [5]. In addition, there are
guidelines for both adults and children to reduce SB by
minimizing their sitting, screen time, and motorized trans-
portation [610].
By objective measurements, under a quarter of adults
[11] and fewer than half of preschool children meet the
criteria set in the aerobic PA recommendations [12, 13].
Furthermore, adults seem to be sedentary (sitting or lying
down) most of their waking hours [11]. In addition, larger
amounts of sedentary time on the part of their parents
(such as watching TV) are associated with increased risk
of higher sedentary time for children [14, 15]. Lifestyle in-
terventions (such as promoting PA) targeted at both par-
ents and children, aimed at parentsparticipation in
sports, and addressing PA level, along with considering
the availability of media in the home and being involved
in organized activities, may generate reduction in seden-
tary time and a PA increase among children [16].
In the context of PA and exercise, the benefits of
music have been studied mainly for therapeutic purposes
and in research involving athletes and other habitual ex-
ercisers. According to these studies, listening to music
can influence exercise intensity, perceived exertion, and
general mood, and can help to extend workout duration
[17, 18]. Only a few studies have examined the ergogenic
effect of motivational music and video interventions in
combination. As music does, video watching has poten-
tial to shift attention from internal stimuli to external
cues [19], and motivational music with video strengthens
the positive effects of audiovisual interventions [19, 20].
Increasing PA and decreasing SB represents an oppor-
tunity to prevent health problems caused by inactivity
and bring long-term health benefits. Screen time is usu-
ally quite sedentary in nature, accordingly, the use of
music and video together should be able to yield added
benefit for increasing PA.
An experimental study entitled Movement-to-music
video program for decreasing sedentary time among
mothers and children(Moving Sound) has been prepared
with the aim of reducing sedentariness by introducing mo-
tivating movement-to-music video programs for mother-
child pairs. To our knowledge, changes in SB or PA have
not been studied previously in relation to a movement-to-
music video program in the home environment.
This article describes the rationale behind the home-
based movement-to-music video program for decreasing
sedentary time while increasing mother-child pairsPA
and the methods employed.
Methods
Design and ethics issues
A randomized controlled trial (RCT) is being used, with a
parallel design involving one intervention and one control
group of mother-child pairs. Mothers and children in the
intervention group will receive a movement-to-music
DVD and be instructed to exercise with it every other day.
The target is to reduce SB and increase PA, in other
words, sit less and be more active.
In the study, SB and PA are objectively assessed by
means of an accelerometer in the first, second and
eighth week of the intervention period. The accelerome-
ters are attached to a flexible belt, which all women and
children will be instructed to wear around their hips.
The instructions specify using the accelerometers for 14
consecutive days (two weeks) during the participants
waking hours at the beginning of the study and for seven
days (one week) over the last week of the intervention.
The accelerometers are to be removed before the partici-
pants go to bed and for showers, bathing, swimming,
and other water activities. Measurements from acceler-
ometers have been used in earlier studies for both adults
and children, and they have been found to be a safe and
reliable way to show changes in SB and PA [21]. There
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are no physical risks with the measurements in this
study.
The information on the mothersbackground, motiv-
ation, and current health behavior comes from question-
naire data. The questionnaires are identical to those
used in the Lifestyle, counseling, and exercise in mater-
nity care (NELLI) five-year follow-up project.
Use of the movement-to-music video program as
instructed (1030 min every other day) will amount to
less than half of adultsand about 1015 % of childrens
PA guideline totals. The reason for this is to reduce risk
of musculoskeletal injury and other complications.
Moreover, when the movement-to-music video program
is used in line with the instruction, there is no significant
overall physical overload risk either. It is also assumed
that adherence to the video protocol will be better with
a short bouts of exercise compared to longer, although
the evidence is contradictory [22].
Participation in the research is completely voluntary.
Recruited mothers will give written informed consent
for participation in the study on their and their childs
behalf. The persons recruited have the right to refuse to
participate or to withdraw at any time from the study
without explaining the reason.
This research project will be carried out in accordance
with good scientific practice, with respect to ethics issues
also. The UKK Institute for Health Promotion Research,
based in Tampere, Finland, owns the data and is respon-
sible for its storage and use.
The Pirkanmaa Ethics Committee in Human Sciences
has issued a favorable statement on the Moving Sound
study (statement 23/2014).
Inclusion and exclusion criteria
Mothers and children are eligible for inclusion if they
meet the following criteria: child included in the original
NELLI cohort, child age of 47 years, the possibility of
using a DVD player or the content behind a YouTube-
link, and ability to perform PA and use the accelerom-
eter as instructed. Mothers and children who because of
medical factors (for example, chronic diseases, musculo-
skeletal or bone disorders, need for special rehabilitation,
or trauma) are unable to perform PA will be excluded.
Eligibility and willingness to participate in the research
will be assessed via interviews of the participants during
the personal contact of sampling for the NELLI study.
Recruitment of the study population and randomization
Participants (i.e., mother-child pairs) in the Moving
Sound study are being recruited from the cohort of the
NELLI five-year follow-up study, which is based on the
original cohort from the NELLI study (n= 837). The fo-
cuses of the NELLI work have been prevention of type 2
diabetes, metabolic syndrome, and obesity. The protocol
and methods of the original NELLI study have been re-
ported upon in detail previously [23].
All NELLI follow-up study participants will be of-
fered an opportunity to be part of the Moving Sound
study. Mother-child pairs are being invited from 14
municipalities in the Pirkanmaa area, in south-western
Finland, via an information letter and phone call. We
expect to recruit 3040 % of the original NELLI co-
hort (again, n= 837), for 251335 mother-child pairs,
in all. This expectation is based on figures from the
original NELLI study, wherein 640 women agreed to
participate and 399 women completed the interven-
tion [24, 25]. Possible reasons for dropping out at this
stage could include participants being unable to be
reached or unwilling to take part in the study. Esti-
mate of sample size and randomization for the study
are shown in Fig. 1.
For the randomization, there was not an appointment
order list and the total number of participants was un-
known. Randomization was performed for blocks of
four participants, in a 2:2 ratio: two mother-child pairs
in the intervention group for two pairs of control par-
ticipants. In practical terms, four random numbers
were generated, and the pairs associated with the two
largest were assigned to the experimental group and
the two lowest to the control group. For allocation of
participants, an appointment order list for the NELLI
five-year follow-up study is being used. Mothers are
randomized to the intervention or control group by
means of sealed envelopes in the contact for sampling
for the NELLI study.
The recruitment started in November 2014 and will
continue until December 2015. Because season-to-season
changes in Finland are large (with cold and snowy winters,
rain in the spring and fall, and a warm summer), seasonal
differences in PA levels may present themselves [26, 27].
Though the intervention takes place in the home, we have
paid attention to this effect by performing the intervention
throughout the year.
Power calculations
On the basis of the Moving Sound pilot study, it is as-
sumed that the mean sedentary (i.e., sitting or lying
down) time will be 7 h 40 min per day at baseline. It is
also assumed that the reduction in sedentary time in the
intervention group at the end of the study will be
around 6 % while the control groups figure remains un-
changed. Differences of groupwise means are tested via
T-tests. Power calculations for the study (see Table 1)
show that if the significance level is 0.05 (α= 0.05) and
the power of the study is to be 80 % (β= 0.80), effect size
varies from 0.357 to 0.500 and approximately 63124
mother-child pairs per group are needed.
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The interventions
The mothers and children will wear the accelerometer
on an elastic belt on their hips for the first 14 days (two
weeks) and last seven days (during week 8; see Fig. 2).
Both groups will complete an exercise diary during
weeks 1, 2, and 8. The intervention group will fill in
questionnaires at baseline and after two and eight weeks,
with the control group doing so at baseline and after the
full eight weeks.
In addition, the intervention (i.e., movement-to-music)
group will receive the DVD and YouTube-link to videos
by e-mail or cell phone, in line with their choice between
these, at the end of the first week. The DVD is the pre-
ferred option, because of the larger image and better
sound when it is played through a television set. The
YouTube-link is intended as an alternative to be used,
for example, during trips or if the DVD breaks. Mothers
in the movement-to-music group will be instructed to
watch the program on the DVD or on the Internet every
other day with their 47-year-old child. The mothers
and children will be instructed to move to the video and
report their exercise in the structured diaries. Mothers
will also use the Brunel Music Rating Inventory-2
(BMRI-2) to assess the motivational quality of the music
used in the movement-to-music video [28, 29].
Outcome measurements and pre-testing
Outcomes
The main objective of the study is to decrease SB and
increase PA among the mothers and their children by
means of the movement-to-music video program.
NELLI 5-years follow up,
n = 837 to be invited
Enrollment in Moving Sound study
Expected to get involved: 30–40%,
assessed for eligibility (n = 251–335)
Possible reasons for dropping out
- Unable to be contacted
- Having moved away from area
- Declining to participate
- Dropping out for other reasons
Assigned to control group
(accelerometer): expected
sample size n = 63–124
Assigned to intervention group
(accelerometer + movement-
to-music program): expected
sample size n = 63–124
Excluded
- Not meeting inclusion criteria
- Declining to participate
- Other reasons
Randomized (n = 130–260)
2 + 2 mother-child pairs
Original NELLI
control cluster
Original NELLI
intervention cluster
Excluded
- Not meeting inclusion criteria
- Declining to participate
- Other reasons
Lost to follow-up or
discontinued intervention
Lost to follow-up or
discontinued intervention
Analysis
Excluded
from analysis
with reasons
Fig. 1 Flow chart, estimates for sample size, and randomization for the study
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The primary outcomes of the study are SB and PA,
which will be assessed objectively by means of the accel-
erometer and further examined via the exercise diaries
and questionnaires. Measurements will be performed in
the first, second and eighth weeks of the intervention.
For inclusion in the analysis, accelerometer data for at
least four days per week and measurement time of more
than 10 h per day will be needed. Participants using the
accelerometer on fewer than four days per week will be
excluded. Any participants whose measurement time for
a given day is over 20 h will be considered to have slept
with the accelerometer. To avoid possible bias in SB
time, the recording time for them will be capped at 20 h,
with the deduction coming from their lying-down time.
The measurement discriminates among the time spent
in a sitting or reclining posture, standing still, and PA.
The daily amount of standing-up (breaks in sedentary
time) will be calculated from the number of lying/sitting
periods that end with standing. Lying, sitting, and stand-
ing time, along with light, moderate, and vigorous PA
time during waking hours, will be analyzed both in mi-
nutes and as a proportion of the measurement time (at
least 10 h per day). In the analysis, moderate and vigor-
ous activity might be combined as MVPA if vigorous PA
covers a very small proportion of the total measurement
time.
Secondary outcomes of the study include the quantity
of self-reported sitting and screen time among mothers
and children, motivation to exercise, and the motiv-
ational quality of the music and movement-to-music
video. Additional secondary outcomes are mothers
weight and quality of life, depression, anxiety, perceived
health, and work ability assessed by a questionnaire.
The specific aim is to study the effectiveness of the
intervention by comparing accelerometer use alone with
a combination of accelerometer and movement-to-music
video program for mother-child pairs.
Accelerometer measures and pre-test
The main aim with the project is to reduce sedentariness
among mothers and their children. The accelerometers
continuously measures tri-axial acceleration caused by
any movement and permit precise assessment of individ-
ualsPA and SB both. Data on PA and SB will be col-
lected in raw mode via a tri-axial accelerometer (Hookie
AM 20, Traxmeet Ltd, of Espoo, Finland). The data will
be analyzed as the mean signal amplitude deviation
(MAD) of resultant acceleration for each epoch [21].
The choice of algorithms for use in the study is based
on pilot studies conducted at the UKK Institute.
The resultant, which indicates the magnitude of the
acceleration, is calculated for every measured sample. It
Table 1 Power calculations for the primary outcome of the study
Primary aim: decrease participantssedentariness by using movement-to-music video material
Sedentary time
(mean 7 h 40 min, α= 0.05)
Intervention:
Accelerometer and DVD group
Control:
Accelerometer group
Number of participants
(mother + child pair)
needed per group
Reduction of sedentary time power effect size Mean SD Mean SD
5.4 % β= 0.80 0.357 435 min 70 min 460 min 70 min 124
5.4 % β= 0.80 0.385 435 min 65 min 460 min 65 min 107
5.4 % β= 0.80 0.417 435 min 60 min 460 min 60 min 91
6.5 % β= 0.80 0.429 430 min 70 min 460 min 70 min 86
6.5 % β= 0.80 0.462 430 min 65 min 460 min 65 min 74
6.5 % β= 0.80 0.500 430 min 60 min 460 min 60 min 63
α= significance level, β= power of the test
Week 1 Week 2 Weeks 3-7 Week 8
Intervention group:
Accelerometer +
exercise diary
Control group:
Accelerometer +
exercise diary
Intervention group :
Accelerometer +
exercise diary +
DVD +
questionnaire
Control group:
Accelerometer +
exercise diary +
questionnaire
Intervention group:
DVD
Control group:
No intervention
Intervention group :
Accelerometer +
exercise diary +
DVD +
questionnaire
Control group:
Accelerometer +
exercise diary +
questionnaire
Fig. 2 Intervention for eight weeks
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is possible to determine with high accuracy whether the
participant is standing, sitting, or lying down by applying
the information from the three measurement axes of the
accelerometer. Walking is used as a reference. While the
body orientation during walking is upright and the dir-
ection of Earths gravity vector is constant, the vertical
position (angle) of the accelerometer can be identified
during normal walking. This known position (i.e., the
angle of the accelerometer) can then be compared to
other positions for purposes of recognizing different
body postures. The number of instances of standing-up
can be calculated from the number of lying/sitting pe-
riods ending with a clear vertical acceleration. In stan-
dardized conditions, standing can be distinguished from
sitting or lying with 100 % accuracy, and sitting from
lying with 95 % accuracy [Vähä-Ypyä et al., unpublished
manuscript].
PA will be divided into three intensity categories by
metabolic equivalent (MET): light, moderate, and vigor-
ous. The classification was validated with simultaneous
measurements of acceleration and oxygen consumption
[30]. Light PA has been defined as activity corresponding
to 1.52.9 METs, moderate activity as 3.05.9 METs and
vigorous activity more than 6 METs [4, 5, 30].
Accelerometers were pre-tested with eleven 29-year-
old children. The children engaged in free movement,
play, and games on a test track field for one hour for de-
termination of how scurrying-type movements appear in
the readings. Another test, on a running track, tested
speeds ranging from slow walking to participantsmax-
imum rate of running. In addition, accelerometers were
piloted in free-living conditions with 10 children aged
47 for one week. In these tests, the acceleration signal
behaved as expected, in other words, the MAD-value
was higher for younger (smaller) children at the same
speed and different activity intensities could be identified
from the data.
The movement-to-music DVDs production and pre-testing
In spring 2014, three distinct movement-to-music video
programs were prepared, by the Sibelius-Academy
music-education students in course specifically on chil-
drens music programs. The music was composed and
arranged with lyrics. Further video programs were pro-
duced for the study specifically as part of a training
course on childrens music and videos. Two of the videos
last about 10 min each, including two songs and their
movement instructions. There are three songs in all, be-
cause the title song, Mutaveijarit(or The Mud
Mates) is part of both tracks (see Table 2). The third
video includes all songs, with movements but without
any verbal instructions, and it lasts about 12 min.
To rate the motivational qualities of the three songs, a
panel of eight physiotherapists (all female and comparable
to the adult intervention participants in age, race, and cul-
tural background) assessed each song by using the BMRI-
2 [28, 29]. Another reason for pre-testing was to find out
the influence of visual stimuli on the responses to the
music. The BMRI-2 was translated into Finnish by investi-
gators involved in the present study.
Each song was rated with a one number from 1
(Strongly disagree) and 7 (Strongly agree) for six
statements about how much the characteristic features
of the music would motivate a person during exercise.
The range of total scores is 642, with scores below 24
indicating low motivational quality or an oudeterous
(neutral) nature, those in the middle range (2435)
representing moderate motivation, and scores over 35
denoting highly motivating material [28].
The members of the video group (n= 4, mean age
41 years, SD 16.2 years) first watched the DVD and
assessed all three songs separately, using the BMRI-2.
Then they listened to the music only (without video)
and rated the motivational quality of each song. The
music group (n= 4, mean age 42.8 years, SD 15.8 years)
assessed the motivational qualities of the songs first,
then watched the DVD and appraised the music and
video content together. In addition, both groups moved
to the DVD and rated the motivational qualities of the
music during movement. Music and video together re-
ceived higher motivation ratings than did the music
alone, from both groups (see Table 2).
The movement program
The exercises in the videos are based on PA recommen-
dations [5] and include exercises to improve or maintain
aerobic fitness, muscle strength, balance, and coordin-
ation (including motor and rhythm coordination) [31].
All three songs begin with the Mud Mates getting up
from a sofa. Each song has its own movements, which
are performed to the beat of the music. The videos serve
to encourage and motivate mother and child to exercise
together and allow them to choose suitable movements
for themselves from one to three variations.
The first song, Mutaveijarit, is accompanied by move-
ments to improve aerobic fitness (walking, jumping, step-
ping, and shaking ones whole body), postural balance
(standing on one leg), and motor coordination (pelvic and
midriff control, and agility). The second song, Karibialai-
nen kala, involves movements to improve dynamic bal-
ance (moving the center of gravity to the edge of the area
of support) and motor coordination (Caribbean dance
movements such as swaying from side to side and making
stepping motions). The third song, Kuravelli,entails
movements to improve muscle strength (squats and
lunges) and aerobic fitness (walking, jumping, and the side
gallop). The last song, Mutaveijarit,(thesameasthe
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first) combines movement elements from all three previ-
ous songs.
Data collection
The baseline data collection (with body-weight and
questionnaire-based measurement) will take place dur-
ing the personal contact of sampling for the NELLI
study. Information on the accelerometer-based measure-
ments will be supplied to participants at the same time.
The timing of the data collection related to these mea-
surements, the exercise diaries, and the questionnaires is
described in detail in Table 3.
The measurements and exercise diaries
Objective measurement of the SB and PA of the mothers
and children will be conducted in the first, second and
eighth weeks of the intervention via accelerometer use
during waking hours. The mothersbody weight will be
measured at baseline.
Participants will be instructed to complete exercise
diaries for the time for which they wear the accelerome-
ters. The mothers will be asked to indicate their working
hours and actual exercise, such as walking, jogging, run-
ning, swimming, biking, gym workouts, and dancing in
the diaries. Start and end time of the exercise are to be
Table 2 Details of the music used for the movement-to-music DVD
Name of song Music, lyrics, and arrangement Music genre Tempo (bpm
a
) Motivational quality of the video vs.
music group (BMRI-2
b
)
Video 1: Mutaveijarit ja karibialainen kala (10 minutes)
MutaveijaritEeva-Leena Pokela and Mutaveijarit Childrens rock 94 34.6 vs. 33.7
Karibialainen kalaAili Järvelä Childrens Latin 128 34.0 vs. 31.9
Video 2: Kuraa ja mutaa (10 minutes)
KuravelliMiia Reko and Mutaveijarit Childrens folk 124 32.5 vs. 31.4
MutaveijaritEeva-Leena Pokela and Mutaveijarit Childrens rock 94
Video 3: Mutaveijarit kooste (12 minutes)
Mutaveijarit,Karibialainen kala,Kuravelli, and againMutaveijarit
a
Beats per minute
b
Brunel Music Rating Inventory-2 (max. 42 points)
Table 3 Moving Sound data collection and measurements at baseline and the 1st, 2nd, and 8th week after baseline measurement
Data collection Baseline 1st week 2nd week 8th week
Measurements and exercise diaries
Accelerometer measurements X X X
Exercise diaries X X X
Weight X
Questionnaires
Background questions X
Weight X X
a
X
Earlier physical activity (LTPA) X
Current physical activity and sitting time X X
a
X
Motivation to exercise (EIS and TPB) X X
a
X
Quality of life (15 D) X
Depression (BDI) X
Anxiety (SAI) X
Work ability X
Perceived health X
Mother's musical background X
a
Motivational quality of the music X
a
Other motivation-related factors X
a
X
a
Experiences of use of the video X
a
X
a
Perceived changes in PA X
a
X
a
a
Intervention group
Tuominen et al. BMC Public Health (2015) 15:1016 Page 7 of 11
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
filled in. Also, the participants will be instructed to as-
sess the perceived exertion their exercise involves nu-
merically: 1 = light PA, with no shortness of breath or
sweating at all; 2 = moderate PA, with some shortness of
breath or sweating; and 3 = vigorous PA, indicating
heavy breathing or increased sweating. If more than one
type of exercise is performed in the course of a day, the
participants are to include all of these in the diaries.
Mothers are asked to record the childs exercise time at
daycare or school and at home, and the time spent in
PA, in the childrens diaries.
Questionnaires
Information on participantsbackground, PA, screen
time, motivation to exercise, and self-reported height
and weight, along with information on quality of life, will
be collected at the baseline by means of the same ques-
tionnaires used for the NELLI five-year follow-up study
(based on original and one-year follow-up questionnaires
for the NELLI cohort). At two weeks after baseline, in-
formation on PA, screen time, self-reported weight, mu-
sical background, and motivation to exercise by means
of a movement-to-music video program will be collected
for the intervention group. At the eighth week after
baseline, information on PA, screen time, motivation to
exercise, and (self-reported) weight will be collected
from all participants. Information on motivation to exer-
cise by using the movement-to-music video program will
be collected from the intervention group. Information
on the childrens PA and screen time will be collected at
baseline and the second and eighth week after baseline
via questionnaires.
The information on participantsbackground includes
data on socioeconomic status, smoking, and height and
weight. The participants of the intervention group will
be asked for information on the mothers musical
background.
Mothersearlier PA will be examined at baseline via a
leisure-time physical activity (LTPA) questionnaire, ad-
dressing the amount, duration, and intensity of PA within
a typical week over the previous year. The validity and re-
liability of these questions have been examined previously
[32]. The questionnaire on participantscurrent PA and
time spent in a sitting position in various contexts (on
both weekdays and weekends) is the same as that utilized
in the national Health 2011 Survey [33] and FINRISKI
2011 Study [34] in Finland, intended to ascertain how fully
people meet the PA recommendations and how much
they tend to sit. The questionnaire on the childstypical
exercise and screen time is based on the same question-
naire used in the Finnish project on health monitoring
among children and young people (LATE) [35], with a
protocol reported upon earlier [36]. There are separate
questions on outside activities, exercises, and screen time.
Both weekdays and weekends are covered. Responses to
questionnaire items on current PA and on time spent in a
sitting position and screen time will be examined at base-
line and after week 8 for all participants, as will the figures
for just after the second week for the intervention group.
The instrument examining motivation to exercise is
based on the Finnish version [37] of the Enjoyment in
Sport (EIS) questionnaire [38] and also addresses some
factors motivating exercise [39]. Investigators involved in
the present study modified the questions to be appropri-
ate for exercising with children, for example, the state-
ment I like exercisingwas changed to I like exercising
with a child.Motivation and intention to encourage the
child to perform PA will be examined by means of a
short version of a theory of planned behavior (TPB)
questionnaire [40]. In the first phase, this questionnaire
was developed on the basis of the TPB manual instruc-
tions at University of Jyväskylä, Finland. In the second
phase, it was pre-tested for clarity of language and suit-
ability for the local culture by five experts in various
relevant fields (physical education, exercise physiology,
kinesiology, and health science). In the third phase,
items with low reliability indices were excluded on the
basis of pilot data collection from around 100 parents of
47-year-old children [41]. The final version of the TPB
short form used in the present study is composed of ele-
ments on behavior, intention, attitudes to the behavior,
and perceived control over the behavior. Motivation
questions will be evaluated at baseline and after the
eighth week for all participants and, in addition, for the
intervention group after week 2.
The relationship between SB or PA and quality of life,
depression, and anxiety is also of interest. Assessments
of quality of life, depression, anxiety, and work ability
will be performed via Finnish versions of the validated
indicator. Quality of life will be assessed via the 15D in-
strument [42], depression via Becks Depression Inven-
tory (BDI) [43], and anxiety by means of the State
Anxiety Inventory (SAI) [44]. A visual analogue scale
(VAS) will be used in the assessment of perceived health
and an 11-point Likert scale for work ability. The 15D
has 15 separate items: ability to be physically active, vi-
sion, hearing, breathing, sleeping, eating, communicat-
ing, elimination, normal functions, mental health, signs
and symptoms, depression, anxiety, vitality, and sexual-
ity. The BDI, in turn, is based on 21 distinct items for
measuring the severity of depression in terms of a list of
four statements. The SAI, a sub-scale of the State-Trait
Anxiety Inventory (STAI), has 20 items for assessing
how I feel right nowon a four-point scale (not at all
–“
somewhat”–“moderately so”–“very much so). Ten
of the 20 statements typify presence and the other 10
absence of anxiety. Perceived health is an important fac-
tor when one wishes to predict functional capacity and
Tuominen et al. BMC Public Health (2015) 15:1016 Page 8 of 11
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
health [45], and it will be measured via a VAS. Perceived
work ability at the moment, relative to lifetime best, will
be evaluated on an 11-point Likert scale, where 0 = total
disability and, 10 = work ability at its best ever. Perceived
deficiency of work ability in midlife is associated with ac-
celerated weakening in health and functioning in later
life [46]. Quality of life, depression, anxiety, perceived
health, and work ability assessment will be evaluated for
all participants at baseline.
In addition, there is a questionnaire for subgroup ana-
lysis, made up of questions for the intervention group.
The items on mothers musical background include
questions about prior singing, playing of an instrument,
dancing, and listening to music. The questionnaire on
the motivational quality of the music is based on the
BMRI-2. In this, the music will be rated on a scale of 1
(for strong disagreement) to 7 (for strong agreement) with
each of six statements about how much the characteristic
features of the music would motivate a person during ex-
ercise [29]. Experiences of use of the movement-to-music
video program, factors (other than music) motivating
exercise, and perceived changes in PA will be assessed via
a questionnaire that was developed by investigators work-
ing on the present study. Participants will rate their expe-
riences of use of the video on a scale of 1 (Hard)to3
(Easy). Factors motivating exercise (the videoscharac-
ters, movements, and ambience and exercising with the
child) will be rated on a scale of 1 (for Strongly disagree)
to 7 (for Strongly agree). Perceived changes in PA will be
rated between 1 (Much less than earlier)and5(Much
more than earlier). In addition, participants will be asked
about their actual activity while watching the video, in-
cluding how well they performed the exercises in accord-
ance with the video instructions, and about perceived
personal shortcomings in physical fitness during comple-
tion of the video exercises. The questionnaires for sub-
groups were pre-tested by a group of eight physiotherapists
and piloted in a separate pilot study. Items on mothers
musical background and BMRI-2 scores will be evaluated
after second week, other questions after weeks 2 and 8.
Statistical methods
The effects of the intervention will be analyzed in line
with the intention-to-treat principle through comparison
of the changes in the main outcomes between interven-
tion and control group participants. Level of PA, seden-
tary time, and body weight will be compared between
the intervention and control group. All differences in
the afore-mentioned outcomes between groups will be
examined via linear regression. If the assumptions of lin-
ear regression are violated, ordinal or logistic regression
analysis will be used. Non-parametric methods (specific-
ally, the Mann-Whitney U-test) will also be used to de-
scribe differences between groups if needed. Subgroup
analysis within the intervention group will be conducted
with the mothers motivation to exercise with the
movement-to-music video program and her musical
background as covariates. The intervention group will
be split into two classes on the basis of these (dummy)
variables. These variables will be used to explain differ-
ences in exercise activity between mothers in the inter-
vention group. A significance level of 0.05 will be used
for all analysis.
Discussion
The study under way is unique in executing an interven-
tion for mothers and their children at the same time and
focusing the intervention on reduction of SB and in-
creasing of PA in the home environment. This is a new
way to approach inactivity. The Moving Sound interven-
tion has been designed for evaluation of the practical
implementation of PA measurement and motivational
music programs in combination. Given the well-known
positive effects of music on mood, improvements are
expected also with respect to exercise adherence [17].
For the intervention group, we have designed a pattern
by which mothers and children can exercise together.
This is promising, since PA interventions targeted at
both adults and children have been shown to be highly
effective in producing positive changes in sedentary time
and levels of PA [16].
There are a few challenges in this trial. The first chal-
lenge involves the new data collection for the NELLI
five-year follow-up study and Moving Sound sub-study.
This has to do with response rate. Therefore, additional
effort will be undertaken to increase participation, by
such means as utilization of social media (a closed Face-
book group), a small sports-related gift (such as a jump
rope or Frisbee) for the child, and provision of feedback
on the results. Another risk anticipated in the data col-
lection involves the ability of hip-worn accelerometer to
measure all movements during movement-to-music
video use. The program features many shaking move-
ments and jiggling of the hands and/or leg, and there
might be individual differences on performance of these
movements. Thus, it is unclear how all these kinds of
movements can be detected by a hip-worn Hookie accel-
erometer. However, the accelerometer is able to detect
overall PA and sedentary behavior [21] which is the
main target of the study.
In conclusion, the use of music and video material to-
gether could be of added benefit for reducing SB and in-
creasing PA for those mothers who have difficulties in
exercising outside the home with young children. The
intervention represents a possibility of achieving long-
term health benefits by moving at home. Therefore, the
study should show one way to improve activity level and
thereby prevent otherwise forthcoming health problems.
Tuominen et al. BMC Public Health (2015) 15:1016 Page 9 of 11
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Abbreviations
BDI: Becks depression inventory; BMRI-2: Brunel music rating inventory-2;
CDC: Centers for disease control and prevention; EIS: Enjoyment in Sport
(a questionnaire); LATE: The project for Finnish health monitoring among
children and young people; LTPA: Leisure-time physical activity; MAD: Mean
amplitude deviation; MET: Metabolic equivalent; Moving Sound: The
movement-to-music video program study; MVPA: Moderate to vigorous
physical activity; NELLI: A project on lifestyle, counseling, and exercise in
maternity care; PA: Physical activity; RCT: Randomized controlled trial;
SAI: State anxiety inventory; SB: Sedentary behavior; STAI: State-trait anxiety
inventory; TPB: Theory of planned behavior; VAS: Visual analogue scale.
Competing interests
The authors declare that they have no competing interests.
Authorscontributions
RL originated the idea of the study, and RL, PH and PPAT performed the studys
initial design. RL is responsible for the NELLI five-year follow-up study. PH and
PPAT designed the measurements of physical activity (using accelerometers and
questionnaires). PPAT is responsible for the Moving Sound study in collaboration
with RL, who was in charge of the DVD order from the Sibelius Academy. JR is
responsible for the statistical analyses. PPAT prepared the first version of the
manuscript.Allauthors(PPAT,PH,JR,and RML) were involved in its revision for
content and have given final approval of the version to be published. All authors
read and approved the final manuscript.
Authorsinformation
Not applicable.
Acknowledgements
The trial was funded via an Academy of Finland research grant (no. 277079) and
competitive research funding from Pirkanmaa Hospital District for Riitta Luoto
and the research group for four yearstime (2014-2017). Professor Minna
Huotilainen, PhD (Cognitive science), and Laura Sokka, MSc (psychology), from
the Finnish Institute for Occupational Health and Arto Laukkanen, MSc (sport and
exercise medicine), of the University of Jyväskylä are acknowledged for their
assistance and support related to motivation questions in the planning of the
study. Lecturer Eeva-Leena Pokela, vice-head of music education, and lecturer
Soili Perkiö, both from the Sibelius Academy, prepared the movement-to-music
video for this study in collaboration with their students. Important advice in the
course of the project was provided by: the University of Jyväskyläs Professor
Urho Kujala, MD, PhD (Sports and Exercise Medicine), and the UKK Institutes
Henri Vähä-Ypyä, MSc (Engineering, Accelerometer Data). Mrs. Ulla Hakala, Mrs.
Taru Helenius, Mrs. Sirke Rasinperä, and Mrs. Ulla Honkanen, all from the UKK
Institute laboratory, participated in the data collection. Physiotherapists from
Rauhaniemi Hospital are acknowledged for their participation in pre-testing of
the video and questionnaire material. The Moving Sound pilot work was
performed in the Kangasala area. Language of the current manuscript was edited
by a professional language editor Anu Planting.
Author details
1
UKK Institute for Health Promotion Research, Tampere, Finland.
2
Department of Health Sciences, Faculty of Sport and Health Sciences,
University of Jyväskylä, Jyväskylä, Finland.
3
School of Health Sciences,
University of Tampere, Tampere, Finland.
Received: 17 March 2015 Accepted: 24 September 2015
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... Mother-child dyads for the Moving Sound RCT (n = 228) were recruited between November 2014 and January 2016 from the cohort of NELLI: Pregnancy as a window to the future health of mothers and children, a seven-year follow-up of a gestational lifestyle intervention in the Pirkanmaa area of Finland [20,22]. Participants in the current study were mother-child dyads (n = 108) who had acceptable accelerometer measurements (having at least four measurement days during both the baseline and the final intervention week and at least 10 h per day) and who answered the questions about mothers' enjoyment of exercising with their child at both the beginning and the end of the intervention. ...
... Mother-child dyads in the intervention group (n = 50) were instructed to use the movement-to-music video program DVD every other day from the beginning of Week 2 to the end of Week 8. The program was based on PA recommendations from 2008 and included three separate exercise programs, each lasting 10 min [22]. In brief, the music (children's rock, Latin, and folk) and videos for the program were produced by the music education students from Sibelius Academy and pretested for the motivational qualities by a panel of female physiotherapists. ...
... Mothers' enjoyment was the primary outcome of the present study, and it was measured using the Finnish version [23] of the Enjoyment in Sport (EIS) questionnaire [11] before the baseline week and after the study period (Week 8). Questions were modified to be appropriate for exercising with children; for example, the statement "I like exercising" was changed to "I like exercising with a child" [22]. The EIS questionnaire included four statements for liking, enjoying, having fun, and happy playing, each one rated with a number from 1 (strongly disagree) to 5 (strongly agree) [11,23]. ...
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Background Parental support and participation in physical activity (PA) with children and parents’ acting as a role model for less sedentary behaviors (SB) are critical factors for children’s healthier lifestyle. The purpose of the study was to assess the relationship between mothers’ enjoyment and participants’ sedentary behavior (SB) and physical activity (PA) as a secondary analysis of a randomized controlled trial (RCT) using data from Moving Sound RCT in the Pirkanmaa area of Finland. Methods The participants were 108 mother–child dyads (child age 5–7 years) who completed the eight-week exercise intervention using a movement-to-music video program in their homes. Mothers’ enjoyment was examined using a modified version of the enjoyment in sport questionnaire. The proportion of SB, standing, light PA, moderate-to-vigorous PA, and Total PA were derived from accelerometers at baseline and during the final week of the intervention. Analyses were performed using linear mixed-effect models for (1) intervention and control groups, (2) groups based on mothers’ enjoyment. Results The results highlighted that mothers’ enjoyment of exercise with their children was overall high. Although there was no difference between the intervention and control groups, mothers in the intervention group increased their enjoyment during the intervention (p = 0.007). With mothers’ higher enjoyment at baseline, children’s light PA increased (p < 0.001), and with mothers’ lower enjoyment, children’s SB increased (p = 0.010). Further, if mothers’ enjoyment decreased during the study, their own LPA increased (p = 0.049), and their children’s SB increased (p = 0.013). If mothers’ enjoyment remained stable, children’s light PA (p = 0.002) and Total PA (p = 0.034) increased. Conclusions In this RCT, no differences were found between the intervention and control groups or groups based on mothers’ enjoyment, possibly due to the low power of the study. However, mothers’ enjoyment of exercise with their children increased within the intervention group, and mothers’ enjoyment influenced children’s SB and PA. For future studies, it would be essential to focus on children’s enjoyment and factors behind the behavior change. Trial registration The study is registered at ClinicalTrials.gov, registration number NTC02270138, on October 2, 2014.
... The current study is a subgroup analysis of an intervention group in randomized controlled trial (RCT) called Moving Sound [24,25], in where the main outcomes were children's and their mothers' sedentary time and PA during eight weeks' period. The participants of the Moving Sound study were recruited between November 2014 and January 2016 from the cohort of NELLI: Pregnancy as a window to the future health of mothers and children, the 7-year follow-up of a gestational lifestyle intervention in the Pirkanmaa area, Finland (ISRCTN33885819; http://www.controlled-trials.com/). ...
... In addition, every movement had one to three variations. The detailed contents of video program have been previously described by Tuominen et al. (2015). ...
... We suggest that if the video would have been more interesting and more engaging for older children, the possibility of having a higher participation rate until the end would have been greater. However, video was carefully pretested both with professional physiotherapists [25] and mother-child pairs [31]. ...
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Objectives: The purpose of this study was to examine whether mothers' musical background has an effect on their own and their children's sedentary behavior (SB) and physical activity (PA). The aim was also to assess children's and their mothers' exercise adherence when using movement-to-music video program. Design: Sub-group analysis of an intervention group in a randomized controlled trial (ISRCTN33885819). Method: Seventy-one mother-child-pairs were divided into two categories based on mothers' musical background. Each pair performed 8 weeks exercise intervention using movement-to-music video program. SB and PA were assessed objectively by accelerometer, and exercise activity, fidelity, and enjoyment were assessed via exercise diaries and questionnaires. Logistic regression model was used to analyze associations in the main outcomes between the groups. Results: Those children whose mothers had musical background (MB) had greater probability to increase their light PA during the intervention, but not moderate-to-vigorous PA compared to those children whose mothers did not have musical background (NMB). SB increased in both groups. Mothers in the NMB group had greater probability to increase their light and moderate-to-vigorous PA and decrease their SB than mothers in the MB group. However, exercise adherence decreased considerably in all groups. Completeness, fidelity, and enjoyment were higher among the NMB group compared to the MB group. Conclusions: The present results showed that mothers without musical background were more interested in movement-to-music exercises, as well as their children. For further studies it would be important to evaluate an effect of children's own music-based activities on their SB and PA.
... As per the instructions, the videos could be used individually or consecutively in order to allow the mother and child to choose the suitable amount of exercise for themselves. The contents of video program have been previously described by Tuominen et al. (2015) [43]. ...
... As per the instructions, the videos could be used individually or consecutively in order to allow the mother and child to choose the suitable amount of exercise for themselves. The contents of video program have been previously described by Tuominen et al. (2015) [43]. ...
... The average reduction in sedentary time in the intervention group at the end of the study was assumed to be around 6%, while the control group would remain unchanged. Power calculations for the study have been reported earlier by Tuominen et al. (2015). Briefly, differences in groupwise means were tested via t-tests. ...
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Regular physical activity (PA) and the avoidance of prolonged sitting are essential for children’s healthy growth, and for the physical and mental wellbeing of both children and adults. In the context of exercise, music may promote behavioral change through increased exercise adherence and participation. The purpose of this study was to determine whether a movement-to-music video program could reduce sedentary behavior (SB) and increase PA in mother-child pairs in the home environment. A randomized controlled trial was conducted in the Pirkanmaa region, Finland, in 2014–2016. The participants consisted of 228 mother-child pairs (child age 5–7 years). The primary outcomes of interest were tri-axial accelerometer-derived SB and PA, which were measured in weeks one (baseline), two, and eight in both the intervention and control groups. Further, the mothers and children in the intervention group used a movement-to-music video program from the beginning of week two to the end of week eight. Secondary outcomes included self-reported screen time. The statistical methods employed comprised an intention-to-treat and linear mixed effects model design. No statistically significant differences between groups were found in primary or secondary outcomes. Among the children in the control group, light PA decreased significantly over time and screen time increased from 89 (standard deviation, SD 37) to 99 (SD 41) min/d. Among mothers and children in the intervention group, no statistical differences were found. In supplementary analysis, the children who stayed at home instead of attending daycare/preschool had on average 25 (95% confidence interval, CI 19–30) min/d more sedentary time and 11 (95% CI 8–14) min/d less moderate-to-vigorous PA than those who were at daycare/preschool. The higher body mass index of mothers was related with 5 (95% CI 2–7) min/d more sedentary time and 1 (95% CI 0–2) min/d less moderate-to-vigorous PA. The movement-to-music video program did not change the objectively measured SB or PA of the mother-child pairs. However, mothers and children seemed to be more sedentary at home, and therefore interventions for decreasing SB and increasing PA should be targeted in the home environment.
... Instructions were provided, to allow the mother and child to choose suitable movements for themselves from one to three variations. The details of use of this video-based movement program have been reported upon previously (Tuominen et al. 2015). ...
... With these conditions, it should also be possible to estimate whether changes in SB and PA occur in the long run and thereby judge the intervention's effectiveness in relation to the PA recommendations. The need for a study with a larger sample size and longer follow-up time will be in met in ongoing Moving Sound study (Tuominen et al. 2015), registered at Clini-calTrials.gov with ID NCT02270138. ...
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Measured objectively, less than a quarter of adults and under half of preschool children in Finland meet the physical activity recommendations. Moreover, higher sedentary time among parents (such as watching television) is associated with higher sedentary time of their children. The study introduces an intervention based on reducing sedentary behavior among mothers and their children. It utilizes a combination of music and exercise via a motivation-targeting movement-to-music video program in the home environment. Data were collected in summer 2014 from Finland’s Pirkanmaa region. Each mother–child pair (n = 24, child age: 4–7 years) was assigned to the intervention and control group. Both groups used an accelerometer and completed physical activity diaries for two consecutive weeks (14 days) during waking hours. In addition, the intervention group was instructed to use the movement-to-music video program during the second week. Differences between groups were expected in analysis of sedentary time and physical activity between weeks 1 and 2. The parameters assessed were sedentary time (i.e., lying down or sitting), standing still, and time spent in physical activity. Less sedentary time was revealed in week 2 than in week 1 among both intervention group mothers (56.6 vs. 53.3 %) and for intervention group children (49.5 vs. 46.0 %). The opposite was true of control group mothers (52.1 vs. 52.4 %) and children (46.7 vs. 49.8 %). Within-group differences in mothers’ sedentary time correlated moderately with the children’s sedentary time (Spearman’s r = 0.56). All groups exhibited slightly more standing in the second week than in week 1. Both sets of intervention participants also engaged in more light physical activity in week 2, with the opposite evident for the two control sets. In all groups, except the control children, the proportion of moderate to vigorous physical activity was higher in the second week than the first. The use of music and video content together may yield added benefits in efforts to reduce sedentary behavior and increase physical activity among mothers and their children in the home environment.
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Background: Early childhood provides a window of opportunity for the promotion of physical activity. Given the limited effectiveness of interventions to date, new approaches are needed. Socio-ecological models suggest that involving parents as intervention targets may be effective in fostering healthier lifestyles in children. This study describes the effectiveness of a family-focused 'Active Play' intervention in decreasing sedentary time and increasing total physical activity in preschool children. Method: Seventy-seven families were recruited from 8 randomly selected SureStart children's centres in the North West of England. Centres were randomly assigned to either an intervention (n = 4) or a comparison group (n = 4). Parents and children in the intervention group received a 10-week active play programme delivered by trained active play professionals; this included an activity and educational component. Families in the comparison group were asked to maintain their usual routine. Each participating parent and child wore a uni-axial accelerometer for 7 days at baseline and post-test. Week and weekend day sedentary time and total physical activity adjusted for child-and home-level covariates were analysed using multilevel analyses.
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Our recent study of three accelerometer brands in various ambulatory activities showed that the mean amplitude deviation (MAD) of the resultant acceleration signal performed best in separating different intensity levels and provided excellent agreement between the three devices. The objective of this study was to derive a regression model that estimates oxygen consumption (VO2) from MAD values and validate the MAD-based cut-points for light, moderate and vigorous locomotion against VO2 within a wide range of speeds. 29 participants performed a pace-conducted non-stop test on a 200 m long indoor track. The initial speed was 0.6 m/s and it was increased by 0.4 m/s every 2.5 minutes until volitional exhaustion. The participants could freely decide whether they preferred to walk or run. During the test they carried a hip-mounted tri-axial accelerometer and mobile metabolic analyzer. The MAD was calculated from the raw acceleration data and compared to directly measured incident VO2. Cut-point between light and moderate activity was set to 3.0 metabolic equivalent (MET, 1 MET = 3.5 ml · kg-1 · min-1) and between moderate and vigorous activity to 6.0 MET as per standard use. The MAD and VO2 showed a very strong association. Within individuals, the range of r values was from 0.927 to 0.991 providing the mean r = 0.969. The optimal MAD cut-point for 3.0 MET was 91 mg (milligravity) and 414 mg for 6.0 MET. The present study showed that the MAD is a valid method in terms of the VO2 within a wide range of ambulatory activities from slow walking to fast running. Being a device-independent trait, the MAD facilitates directly comparable, accurate results on the intensity of physical activity with all accelerometers providing tri-axial raw data.
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Background: There is a paucity of work addressing the distractive, affect-enhancing, and motivational influences of music and video in combination during exercise. Purpose: We examined the effects of music and music-and-video on a range of psychological and psychophysical variables during treadmill running at intensities above and below ventilatory threshold (VT). Methods: Participants (N = 24) exercised at 10 % of maximal capacity below VT and 10 % above under music-only, music-and-video, and control conditions. Results: There was a condition × intensity × time interaction for perceived activation and state motivation, and an intensity × time interaction for state attention, perceived exertion (RPE), and affective valence. The music-and-video condition elicited the highest levels of dissociation, lowest RPE, and most positive affective responses regardless of exercise intensity. Conclusions: Attentional manipulations influence psychological and psychophysical variables at exercise intensities above and below VT, and this effect is enhanced by the combined presentation of auditory and visual stimuli.