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Use of an open-loop system to increase physical activity
Roemmich JN, Lobarinas CL, Barkley JE, White TM, Paluch R, Epstein LH
Pediatric Exercise Science 2012 Aug;24(3):384-398
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

This study evaluated the effectiveness of an open-loop system that reinforces physical activity with TV watching to increase children's physical activity. Nonoverweight, sedentary boys and girls (8 to 12 y) were randomized to a group that received feedback of activity counts plus reinforcement for physical activity by providing access to television (F+R, n = 20); or to feedback, no reinforcement (feedback, n = 20) or no feedback, no reinforcement control (control, n = 21) groups. Children wore an accelerometer with a count display for 4-months with a 1-year follow-up. F+R reduced TV by 68 min/day and TV time was lower than the feedback (p < 0.005) and control (p < 0.002) groups. TV time of F+R remained 31 min lower (p < 0.02) than baseline at 1-year. F+R had a 44% increase in physical activity, which was greater than the feedback (p < 0.04) and control (p < 0.01) groups. An open-loop system decreases TV viewing and increases physical activity of children for 4-months. TV of the F+R group remained lower at 12 months, suggesting a reduction in screen-time habits.

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