Compensation or displacement of physical activity in children and adolescents—A systematic review of empirical studies
Abstract Background: Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one and multiple days. Objectives: This systematic review provides an overview of studies that analyze changes in (overall) physical activity, which are assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents.Methods: A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. Results: A total of 77 peer-reviewed articles were included that analyze compensatory mechanisms with multiple methodological approaches. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward indication of compensation. Quality assessment of the included studies revealed high quality (mean = 0.866).Conclusion: This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration can be observed.