Xi'an Physical Education University

ObjectiveTo examine whether health-related physical fitness mediates the association between fundamental motor skills (FMS) and social functioning in school-age children with autism spectrum disorder (ASD).MethodsA total of 117 school-age children with ASD were recruited from special education schools. FMS were assessed using the Test of Gross Motor Development–3 (TGMD-3). Social functioning was evaluated using the Social Responsiveness Scale–2 (SRS-2), with higher scores indicating greater social impairment. Health-related physical fitness was assessed via body mass index, flexibility (sit-and-reach), muscular strength (handgrip), muscular power (standing long jump), balance (one-leg stance), and vital capacity. Pearson correlation analyses and structural equation modeling with bias-corrected bootstrapping (5,000 resamples) were conducted to test mediation effects.ResultsHigher FMS scores were associated with lower SRS-2 scores, indicating better social functioning (r = −0.312, p < 0.001). Several health-related physical fitness components, particularly handgrip strength and flexibility, were significantly associated with both FMS and social functioning. Structural equation modeling demonstrated a full mediation effect, whereby health-related physical fitness significantly transmitted the association between FMS and social functioning (indirect effect B = −2.111, 95% CI [−3.576, −1.189]), while the direct effect was not significant (B = −0.095, 95% CI [−1.193, 1.274]). Model fit indices indicated an excellent fit.ConclusionHealth-related physical fitness, especially muscular strength and flexibility, appears to be a key mechanism linking motor skill proficiency to social functioning in children with ASD. Interventions that integrate strength and mobility training with motor-skill practice may enhance social outcomes in this population.

Negative physical sensation (i.e., negative reactions to the physical sensations with exercise) refers to the perception and attitude toward one's own physical health and exercise capacity under a specific stressful situation. It is affected by potentially stressful situations, negative emotions, and avoidance coping strategies, and it has an important influence on individual behavior. In the stress situation, the avoidance strategy of cognition, emotion and behavior caused by emotional disorder is called experiential avoidance. Negative physical sensation and experiential avoidance, as negative cognitive and emotional regulation methods, play an important role in behavior orientation and emotional disorders. These factors may elucidate the underlying mechanisms contributing to the onset and perpetuation of sports anxiety. The present study investigates the role of negative physical sensation and experiential avoidance in anxiety during endurance exercise contexts, with a view to elucidating their underlying mechanisms. In order to this end, a study was conducted on 262 non-athlete college students from western China, who were subjected to endurance exercise anxiety scenarios. The survey encompassed acceptance and action, non-cognitive factors in adolescent competitive athletes, and sports behavior. Related statistics were analyzed and the mediating effect was tested by the nonparametric percentile bootstrap method of deviation correction. Taking exercise anxiety as dependent variables, the structural equation model (R=0.61, R2=0.38) was established, and the mediating effect was tested by the nonparametric percentile bootstrap method of deviation correction. A total of 262 college students participated in the survey. The average age of participants was 19.29years, with 170 females (64.9%) and 92 males (36.1%). The average BMI for female students was 21.59±4.33 (mean±standard deviation). The average BMI for male students was 22.22±4.21. The findings of the regression analysis suggest that endurance exercise behavior negatively predicts negative physical sensations (β=-0.48, p<0.001), negative physical sensation positively predicts experiential avoidance (β=0.34, p<0.001) and exercise anxiety (β=0.34, p<0.001), and experiential avoidance positively predicts exercise anxiety (β=0.25, p<0.001). Taking exercise anxiety as a dependent variable and endurance exercise behavior, negative physical sensations, and experiential avoidance as independent variables, a structural equation model (SEM) is established. And path analysis and structural equation modeling are used to examine mediating effects. The results indicate that the standard indirect effect value of Path 1 (endurance exercise→negative physical sensation→exercise anxiety) was β=-0.041, 95% CI=[-0.077, -0.018], accounting for 10.22% of the total indirect effect. Bootstrap 95% confidence interval did not contain 0, indicating that the mediating effect was significant. The standard indirect effect value of Path 2 (endurance exercise→negative physical sensation→experiential avoidance→exercise anxiety) was β=-0.178, 95% CI=[-0.259, -0.109], accounting for 44.39% of the total effect. Bootstrap 95% confidence interval did not contain 0, indicating that the mediating effect was significant. A substantial correlation was identified among endurance exercise, negative physical sensation, experiential avoidance, and exercise anxiety. Negative physical sensations and experiential avoidance significantly predict anxiety behaviors during endurance exercise. Furthermore, they have been shown to play mediating and chain-mediating roles between endurance exercise and exercise anxiety.

BackgroundChronic nonspecific low back pain (CNLBP) is a leading cause of disability, with diaphragm dysfunction implicated in impaired spinal stability. However, systematic evidence on targeted interventions remains limited.ObjectiveTo quantify the efficacy of diaphragm-focused interventions on pain and function in CNLBP.MethodsThe systematic review/meta-analysis followed PRISMA-Cochrane guidelines. Analyzed randomized controlled trials (RCTs) assessing diaphragmatic interventions (manual therapy, respiratory training, neuromuscular re-education). Databases were searched until February 2025. Random-effects models and subgroup analyses were applied.ResultsMeta-analysis of 7 RCTs (n = 283) showed diaphragmatic interventions significantly reduced pain (overall SMD = -1.11, 95%CI: -1.52--0.71, p < 0.01). Diaphragmatic training (SMD = -1.37) and manual therapy (SMD = -1.25) were most effective, while neuromuscular re-education was not significant (SMD = -0.62). For disability, overall SMD was -0.83（95%CI: -1.14--0.52, p < 0.01, with manual therapy showing the largest effect size (SMD = -1.30), followed by diaphragmatic training (SMD = -0.69) and neuromuscular re-education (SMD = -0.47). Excluding one 4-week DNS study eliminated heterogeneity and increased pain effect to SMD = -1.24. Evidence certainty was low (GRADE).ConclusionDiaphragm-targeted interventions improve short-to-midterm pain and function. Future high-quality RCTs are needed to confirm long-term efficacy and standardize protocols.

We have previously found that vitamin D and resistance exercise synergistically improve type 2 diabetes mellitus (T2DM)-related skeletal muscle atrophy. This study aims to investigate the effect of varying exercise intensity on synergistic effects of vitamin D and resistance exercise on their efficacy in improving T2DM-induced myopathy and to further elucidate the underlying mechanism. We compared the effects of vitamin D combined with low-, moderate-, and high-intensity resistance exercise on metabolic status and skeletal muscle function. Then, we explored the mechanism through lipidomic analysis in diabetic rats and verified in adults with T2DM. We found that combined intervention of vitamin D and medium-resistivity volume (MRV) exercise most effectively improved glucose metabolism and insulin sensitivity and increased muscular mass and strength, resulting to alleviated gastrocnemius muscle atrophy in diabetic rats. Vitamin D combined with MRV intervention increased expressions of vitamin D receptor, whereas lysophosphatidylcholine acyltransferase 3, activated p38 MAPK, and ERK1/2 signaling pathways suppressed inflammatory responses. Moreover, lipidomic analysis of gastrocnemius muscle indicated that lysophosphatidylcholine (LPC) 18:1 exhibited the most significant restoration after intervention. Notably, in adults with T2DM, reduced changes in plasma LPC 18:1 levels exhibited positive correlations with decreased appendicular skeletal muscle index, upper limb muscle mass, and thigh muscle mass. Our findings suggested that vitamin D combined with MRV intervention has more pronounced effect on improving T2DM-related skeletal muscle atrophy. Additionally, LPC 18:1 may be a key target for regulating skeletal muscle function through p38 MAPK/ERK and inflammatory signaling pathways. These results provide novel insights for the prevention and treatment of T2DM-related skeletal muscle atrophy through lifestyle modifications.

ObjectiveThis study aims to examine how residents’ perceptions of urban green space environments influence their physical activity levels. Specifically, it investigates the mediating role of perceived restorativeness and the moderating role of spatial accessibility.MethodsA cross-sectional survey was conducted with 307 residents in Chengdu, China. Structured questionnaires were used to measure perceived environmental quality, perceived restorativeness, spatial accessibility, and physical activity level. Confirmatory factor analysis (CFA) and model fit assessments were performed in AMOS 24.0 to evaluate the reliability and validity of the measurement model. Mediation and moderation analyses were subsequently conducted in SPSS 26.0 using the PROCESS macro to test the indirect and interaction effects.ResultsPerceived environmental quality was positively associated with residents’ physical activity levels (β = 0.707, p < 0.001). Perceived restorativeness partially mediated this relationship (β = 0.229, p < 0.001). Moreover, spatial accessibility significantly moderated the association (β = 0.185, p < 0.001), with a stronger relationship observed under higher accessibility conditions.ConclusionThis study highlights the roles of psychological and spatial factors in understanding urban green space–related physical activity. Enhancing environmental quality, accessibility, and restorative characteristics of green spaces may help create conditions that are more conducive to residents’ engagement in physical activity and overall well-being.

Modern technology has played a significant role in improving the analysis and training of swimming, providing more accurate results. Also, finding the best swimming technique is still complicated because there are conflicting standards and uncertainty among experts. This study builds a decision framework using hesitant bipolar fuzzy sets (HBFS) and the grey relational analysis (GRA) method to deal with expert hesitations and bipolar opinions. Freestyle, breaststroke, butterfly, backstroke, and sidestroke are tested against what they accomplish in terms of speed, energy they use, how smooth they look during execution, and the efficiency of their breathing. Based on the HBFS-GRA approach, the experts considered the butterfly stroke the most suitable technique. The new process increases objectivity and makes decisions in sports science less vague. This study also recognizes some challenges, including using experts’ subjective opinions, missing data, and the need to regularly update the analysis due to the quick development of sports technologies. In the future, the system could be enhanced by including data from wearable devices and discussion with artificial intelligence, as well as by adapting it to cover different sports disciplines. This research promotes using data and well-structured models to assess athlete performance.

Sleep problems are common among children and adolescents; however, the potential role of exercise in mitigating these issues is often overlooked. To examine the relationship between exercise interventions and sleep parameters in children and adolescents.The review adhered to the PRISMA 2020 guidelines. A comprehensive literature search was conducted on 8 databases from inception to February 2025. Randomised controlled trials of children and adolescents aged 6-18 years who applied exercise interventions and reported at least one sleep parameter were included. Data include participant characteristics, intervention details, and sleep parameter. Evidence quality graded by GRADE.27 studies were used for meta-analysis. The results of the studies showed that exercise had a significant effect on sleep quality (standardized mean difference [SMD] =-1.06; 95% CI=-1.76 to -0.36), sleep efficiency (SMD=-2.17; 95% CI=-3.69 to -0.65), sleep duration (SMD=-0.70; 95% CI=-1.27 to -0.13), wake after sleep onset (SMD=-0.53; 95% CI=-0.91 to -0.15), sleep anxiety (SMD=-0.54; 95% CI=-0.98 to -0.10), sleep resistance (SMD=-0.33; 95% CI=-0.75 to -0.10), sleep latency (SMD=-1.05; 95% CI=-3.29 to 1.19), parasomnias (SMD=-0.67; 95% CI=-1.74 to 0.40), sleep onset delay (SMD=-0.30; 95% CI=-0.60 to -0.00), sleep-disordered breathing (SMD=-0.19; 95% CI=-0.50 to 0.13), and daytime dysfunction (SMD=-0.30; 95% CI=- 0.72 to 0.11) had an effect, but not on total sleep time (SMD = 0.02; 95% CI=-0.23 to 0.27).The findings emphasize the role of exercise in sleep among children and adolescents. Exercise interventions balancing effectiveness and efficiency may serve as an additional approach to sleep issues beyond sleep hygiene education.

When searching for innovative means of fostering enthusiasm for sports and physical activity, the world has been increasingly diverting its gaze toward virtual reality (VR). This study aims to examine the impact of the VR instructional approach on students’ Aerobics engagement and motivation levels. The study involved 112 students from Qingdao Huanghai University, divided into two groups of equal sizes: 56 students assigned to using the VR app, and 56 students exposed to the traditional teaching method. The results show that the VR-based intervention had significant positive effects on both the level of Aerobics engagement and the level of Aerobics motivation. The present findings can be used to develop engaging physical education programs and sports courses. Future research will examine the long-term effects of VR on physical activity and sports performance and will compare these effects against other teaching methods.

IntroductionIn recent years, non-invasive brain stimulation (NIBS) interventions for attention-deficit/hyperactivity disorder (ADHD) have received increasing attention. However, which of the various NIBS methods is more effective in improving cognitive functions and core symptoms in patients with ADHD remains unclear.MethodsRandomized controlled trials (RCTs) on NIBS in patients with ADHD were searched. Standardized mean differences (SMDs) for cognitive functions and core symptoms changes were pooled in Bayesian network meta-analyses.ResultAfter reviewing 3,976 retrieved citations, a total of 37 RCTs (N = 1,615 participants) were included. This NMA provides evidence that none of the NIBS interventions significantly improved inhibitory control compared to sham controls. However, a statistically significant difference was observed between anodal transcranial direct current stimulation (tDCS) over the left DLPFC plus cathodal tDCS over the right supraorbital area 1.5 mA (SMD = −0.87, 95% CI: −1.80 to −0.07) and High-definition anodal transcranial direct current stimulation over the vertex 0.25 mA (SMD = −1.04, 95% CI: −2.09 to 0.00). In terms of working memory, anodal tDCS over the left DLPFC plus cathodal tDCS over the right DLPFC (SMD = 0.95, 95% CI: 0.05–1.84) and anodal tDCS over the right inferior frontal cortex (rIFC) plus cathodal tDCS over the right supraorbital area (SMD = 0.86, 95% CI: 0.28–1.45) were associated with significant improvements compared to sham stimulation. For cognitive flexibility, only anodal tDCS over the left DLPFC plus cathodal tDCS over the right supraorbital area (SMD = −0.76, 95% CI: −1.31 to −0.21) demonstrated a statistically significant benefit relative to sham. Regarding inattention, both transcranial pulse stimulation (SMD = −2.62, 95% CI: −6.35 to 1.12) and transcranial alternating current stimulation 10 Hz (SMD = −2.35, 95% CI: −5.00 to 0.30) showed favorable trends in comparison with sham; however, these differences did not reach statistical significance, though they approached the threshold. Finally, no NIBS intervention was found to significantly improve hypersensitivity or impulsivity when compared to sham stimulation.ConclusionThe dual-tDCS and a-tDCS may be considered among the preferred NIBS interventions for improving cognitive function in ADHD. Specifically, anodal tDCS over the left DLPFC plus cathodal tDCS over the right supraorbital area improved cognitive flexibility; while anodal tDCS over the left DLPFC plus cathodal tDCS over the right DLPFC enhanced working memory; both dual-tDCS and a-tDCS demonstrated superior efficacy relative to repetitive transcranial magnetic stimulation (rTMS) for inhibitory control; further research is needed to investigate TPS for improving attention and impulsivity.