Effects of Motor versus Cardiovascular Exercise Training on Children’s Working Memory

A classroom-based intervention targeting working memory, attention and language skills in 4-5 year olds (RECALL): study protocol for a cluster randomised feasibility trial

BACKGROUND

There is international recognition of the need for creative, classroom-based interventions to support children at risk of low academic achievement and well-being, due to poor attention and language skills on school entry. Working memory (WM) is a cognitive skill that is strongly associated with attention and language skills. There has been speculation that WM training, embedded within typical educational activities, may improve children's WM skills and produce transfer effects to real-world skills such as attention and language. However, little is known about the effectiveness of this approach.'Recall to Enhance Children's Attention, Language and Learning' (RECALL) is a novel, 6-week, classroom-based intervention targeting WM, attention and language skills in 4-5 year olds. RECALL was co-produced with health professionals, teachers and parents. This protocol describes the rationale, methods and analysis plan for a proposed cluster randomised feasibility trial of this RECALL programme.

METHODS

This is a three-arm, cluster randomised feasibility trial comparing RECALL to an existing programme (active control), and no-intervention (education as usual). We will recruit six schools in socially disadvantaged areas in one region of the UK. Two schools will be randomly allocated to each arm of the trial. In each school, one class of children (ages 4-5 years) of approx. 30 children will be involved in this study. Ten children in each class will be sampled purposefully for outcome measurement including: standardised assessments of WM, language and attention skills; teacher ratings of attention; and parent ratings of functional communication skills. These will be administered at baseline and 1-week post-intervention in order to test the acceptability of the measures. A process evaluation using semi-structured interviews with participants will explore the acceptability of RECALL and the procedures employed in this trial.

DISCUSSION

This feasibility study will explore the acceptability of RECALL to the health professionals and teachers who will deliver it and inform the optimal design of the programme. The inclusion of an active control group and the blinding of outcomes assessors enhance rigour in this study. The findings will determine whether this study can be scaled-up into a definitive cluster randomised trial to evaluate the effectiveness of RECALL.

TRIAL REGISTRATION

ISRCTN13633886. Registered 7 Sept 2018.

Effects of Exercise on Cognitive Performance in Children and Adolescents with ADHD: Potential Mechanisms and Evidence-based Recommendations

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with a complex symptomatology, and core symptoms as well as functional impairment often persist into adulthood. Recent investigations estimate the worldwide prevalence of ADHD in children and adolescents to be ~7%, which is a substantial increase compared to a decade ago. Conventional treatment most often includes pharmacotherapy with central nervous stimulants, but the number of non-responders and adverse effects call for treatment alternatives. Exercise has been suggested as a safe and low-cost adjunctive therapy for ADHD and is reported to be accompanied by positive effects on several aspects of cognitive functions in the general child population. Here we review existing evidence that exercise affects cognitive functions in children with and without ADHD and present likely neurophysiological mechanisms of action. We find well-described associations between physical activity and ADHD, as well as causal evidence in the form of small to moderate beneficial effects following acute aerobic exercise on executive functions in children with ADHD. Despite large heterogeneity, meta-analyses find small positive effects of exercise in population-based control (PBC) children, and our extracted effect sizes from long-term interventions suggest consistent positive effects in children and adolescents with ADHD. Paucity of studies probing the effect of different exercise parameters impedes finite conclusions in this regard. Large-scale clinical trials with appropriately timed exercise are needed. In summary, the existing preliminary evidence suggests that exercise can improve cognitive performance intimately linked to ADHD presentations in children with and without an ADHD diagnosis. Based on the findings from both PBC and ADHD children, we cautiously provide recommendations for parameters of exercise.

Interventions targeting working memory in 4-11 year olds within their everyday contexts: A systematic review

It has been suggested that diverse interventions applied within children's everyday contexts have the potential to improve working memory (WM) and produce transfer to real-world skills but little is known about the effectiveness of these approaches. This review aims to examine systematically the effectiveness of non-computerised interventions with 4-11 year olds to identify: (i) their effects on WM; (ii) whether benefits extend to near- and far-transfer measures; (iii) if gains are sustained over time; (iv) the active ingredients; and (v) the optimum dosage. Searches were conducted across 12 electronic databases using consistent keywords. Papers were screened by title and abstract (n = 6212) and judged against pre-defined eligibility criteria (n = 63). Eighteen papers were included in the review. They used a range of non-computerised WM intervention approaches that included: (i) adapting the environment to reduce WM loads; (ii) direct WM training with and without strategy instruction; and (iii) training skills which may indirectly impact on WM (physical activity, phonological awareness, fantastical play and inhibition). Both direct training on WM tasks and practicing certain skills that may impact indirectly on WM (physical activity, fantastical play and inhibition) produced improvements on WM tasks, with some benefits for near-transfer activities. The common ingredient across effective interventions was the executive-loaded nature of the trained task i.e., training on a task that taps into attentional and processing resources under executive control and not just the storage of information. Few studies reported dosage effects, measured far-transfer effects (n = 4), or tested the durability of gains over time (n = 4). The lack of a clear theoretical framework in many of the included studies resulted in ambiguous predictions about training and transfer effects, and inadequate use of outcome measures. Methodological issues also constrain the strength of the evidence, including: small samples sizes; an absence of blinding of participant and outcome assessors; and lack of active control groups. Further well-designed and controlled studies with clear theoretical underpinnings are required to expand and enhance the evidence base. The heterogeneity of the interventions and of the study designs (randomised and non-randomised) in the included papers limited the synthesis of evidence across studies. However, this diversity enabled the identification of key ingredients, notably the training of executive-loaded WM tasks, which can help inform novel approaches to WM intervention in everyday contexts.

Boost your brain, while having a break! The effects of long-term cognitively engaging physical activity breaks on children's executive functions and academic achievement

Classroom-based physical activity (PA) is gaining attention in terms of its potential to enhance children's cognitive functions, but it remains unclear as to which specific modality of PA affects cognitive functions most. The aim of the study was to examine the effects of qualitatively different PA breaks on children's cognitive outcomes. Children (N = 142) aged between 7 and 9 years were allocated to a 20-week classroom-based PA program, with either high physical exertion and high cognitive engagement (combo group), high physical exertion and low cognitive engagement (aerobic group), or low physical exertion and high cognitive engagement (cognition group). Executive functions (updating, inhibition, shifting) and academic achievement (mathematics, spelling, reading) were measured pre- and post-intervention. Results showed that the combo group profited the most displaying enhanced shifting and mathematic performance. The cognition group profited only in terms of enhanced mathematic performance, whereas the aerobic group remained unaffected. These results suggest that the inclusion of cognitively engaging PA breaks seem to be a promising way to enhance school children's cognitive functions.

Improving Cognitive Performance of 9-12 Years Old Children: Just Dance? A Randomized Controlled Trial

Exercise is assumed to have positive effects on children's cognitive performance. However, given the inconclusive evidence for the long-term effects of exercise, it is difficult to advice schools on what specific exercise programs can improve children's cognitive performance. In particular, little is known about the effects of small exercise programs that may be feasible in daily school practice. Therefore, we assessed the effects of a 9-weeks program consisting of daily exercise breaks on children's cognitive performance, aerobic fitness and physical activity levels. We conducted a cluster-randomized controlled trial in 21 classes of eight Dutch primary schools. A total of 512 children aged 9-12 years participated. The exercise intervention had a duration of 9 weeks and consisted of a daily 10-min classroom-based exercise break of moderate to vigorous intensity. Before and after the intervention, we used four cognitive tasks (i.e., the Attention Network Test, Stroop test, d2 test of attention and Fluency task) to measure children's cognitive performance in domains of selective attention, inhibition and memory retrieval. In addition, we measured aerobic fitness with a Shuttle Run test and physical activity during school hours by accelerometers. We analyzed data using mixed models, adjusting for baseline scores, class and school. After 9 weeks, there were no intervention effects on children's cognitive performance or aerobic fitness. Children in the intervention group spent 2.9 min more of their school hours in moderate to vigorous physical activity as compared to the children in the control group. In conclusion, daily 10-min exercise breaks in the classroom did not improve, nor deteriorate cognitive performance in children. The exercise breaks had no effect on children's fitness, and resulted in 2.9 min more time spent in moderate to vigorous physical activity during school hours. Daily exercise breaks can be implemented in the classroom to promote children's physical activity during school time, without adverse effect on their cognitive performance.

A Randomized Controlled Trial on the Effects of Aerobic and Coordinative Training on Neural Correlates of Inhibitory Control in Children

Whereas aerobic training has found to be beneficial for inhibitory control, less is known on the efficiency of other exercise types in children. The present study compared the effects of aerobic and coordinative training on behavioral and neurophysiological measures of inhibitory control. Forty-five children were randomly assigned (1:1:1 ratio) to groups performing aerobic training, coordinative training or assisted homework sessions over 10 weeks. Before and after intervention, all participants completed a Flanker task. The P300 component of event-related potentials elicited from the task was recorded via electroencephalography. Additionally, aerobic fitness and gross-motor skills were assessed using 20 m Shuttle Run and Heidelberg Gross-Motor Test, respectively. Statistical analyses revealed no time by group interactions for the P300 component (amplitude, latency), p = 0.976, η² = 0.007, and behavioral performance (reaction time, accuracy), p = 0.570, η² = 0.045. In contrast, there was a significant group-difference in pre- to post-test changes in aerobic fitness, p = 0.008, η² = 0.246, with greater improvements following aerobic and coordinative training compared to assisted homework sessions. In conclusion, no differences regarding the efficiency of aerobic and coordinative training for the enhancement of inhibitory control were found as both exercise programs failed to elicit changes in speed and accuracy of stimulus evaluation and the allocation of attentional resources.

Impact of a multicomponent physical activity intervention on cognitive performance: The MOVI-KIDS study

INTRODUCTION

This study examined the impact of a multicomponent physical activity (PA) intervention (MOVI-KIDS) on improving cognition in schoolchildren. This paper also analyzed the mediator role of motor fitness between MOVI-KIDS and cognition.

METHODS

Propensity score analysis of data from a cluster randomized controlled trial (MOVI-KIDS study). This analysis including 240 5-7 years old children from nine schools in the provinces of Cuenca and Ciudad Real, Spain. MOVI-KIDS program consisted of: (a) three weekly after-school sessions of recreational non-competitive PA lasting 60 minutes during one academic year, (b) educational materials for parents and teachers, and (c) school playground modifications. Changes in cognition (logical reasoning, verbal factor, numerical factor, spatial factor, and general intelligence) were measured. A propensity score cross-cluster matching procedure and mediation analysis (Hayes's PROCESS macro) were conducted.

RESULTS

All cognitive variables pre-post mean changes were significantly higher (P ≤ 0.05) in children from intervention schools than those from control schools (effect size ranged from 0.33 to 1.48). The effect of the intervention on the spatial factor and general intelligence was partially mediated by motor fitness (indirect effect = 0.92, 95% CI: 0.36; 1.65; and indirect effect = 1.21, 95% CI: 0.06; 2.62, respectively).

CONCLUSIONS

This study shows that a one-school-year multicomponent intervention consisting of a recreational non-competitive PA program, educational materials for parents and teachers, and school playground modifications improved the cognition of first-grade children. Further, our results suggest that the effect of the intervention on cognition was mediated by changes in motor fitness.

A Non-linear Relationship Between Selective Attention and Associated ERP Markers Across the Lifespan

The ability to selectively attend to task-relevant information increases throughout childhood and decreases in older age. Here, we intended to investigate these opposing developmental trajectories, to assess whether gains and losses early and late in life are associated with similar or different electrophysiological changes, and to get a better understanding about the development in middle-adulthood. We (re-)analyzed behavioral and electrophysiological data of 211 participants, who performed a colored Flanker task while their Electroencephalography (EEG) was recorded. Participants were subdivided into six groups depending on their age, ranging from 8 to 83 years. We analyzed response speed and accuracy as well as the event replated potential (ERP) components P1 and N1, associated with visual processing and attention, N2 as marker of interference suppression and cognitive control, and P3 as a marker of cognitive updating and stimulus categorization. Response speed and accuracy were low early and later in life, with peak performance in young adults. Similarly, ERP latencies of all components and P1 and N1 amplitudes followed a u-shape pattern with shortest latencies and smallest amplitudes occurring in middle-age. N2 amplitudes were larger in children, and for incongruent stimuli in adults middle-aged and older. P3 amplitudes showed a parietal-to-frontal shift with age. Further, group-wise regression analyses suggested that children’s performance depended on cognitive processing speed, while older adults’ performance depended on cognitive resources. Together these results imply that different mechanisms restrict performance early and late in life and suggest a non-linear relationship between electrophysiological markers and performance in the Flanker task across the lifespan.

Effects of Different Types of Exercise Training on the Cortisol Awakening Response in Children

Context: Due to great variability of the hypothalamus-pituitary-adrenal (HPA)-axis, research has to produce better-controlled findings to make a more meaningful statement regarding the effect of exercise training (ET) on the cortisol awakening response (CAR), especially in children. Objective: The aim of the study was to investigate the effects of different ET interventions on the CAR in children. Design and setting: We conducted a short-term training study for 10 weeks in primary schools in Westphalia, Germany. Participants: 71 children (9-10 years old) were randomly assigned to a cardiovascular exercise group (n = 27), a motor exercise group (n = 23), or a control group (n = 21). Intervention: An experienced instructor trained the children in an after-school setting in 45 min sessions, three times a week over the course of 10 weeks. Main outcome measure: CAR (0, +30 min) was assessed on 2 schooldays one week apart before and after the 10-week intervention. A Shuttle Run Test was performed to determine the cardiovascular fitness. Motor fitness was assessed using the Heidelberg Gross Motor Test. Results: Children who enhanced their cardiovascular fitness over the course of the intervention showed an increased CAR after the intervention time (B = 0.213), whereas children who underwent a motor exercise intervention and at the same time gained in motor fitness exhibited a decreased CAR after intervention (B = -0.188). Conclusions: It has been speculated that other neurobiological pathways are activated by different exercise interventions. The extent to which these ET effects on CAR can be applied in clinical settings needs further investigation. Précis: The 10-weeks longitudinal effects of cardiovascular vs. motor exercise interventions (three times a week) on CAR in children show that these interventions exert different effects on hypothalamus-pituitary-adrenal (HPA) axis activity.

A Narrative Review of School-Based Physical Activity for Enhancing Cognition and Learning: The Importance of Relevancy and Integration

Engaging in regular physical activity can have substantial cognitive and academic benefits for children, and is generally promoted for its beneficial effects on children's physical and mental health. Although embodied cognition research has convincingly shown the integral relationship of the human body and mind, in schools physical activity and cognitive activity are typically treated as unrelated processes. Consequently, most physical activities used are neither sufficiently relevant for nor fully integrated into the learning tasks. In reviewing the literature regarding the integration of physical activity into education to promote cognition and learning, two main lines of research emerged: exercise and cognition research vs. embodied cognition research. In this narrative review, we describe these two separately evolved schools of thought, highlighting their differences and commonalities. In categorising the existing studies on a 2 × 2 matrix, concerning the two main categories of relevance for and integration into the learning task, it becomes clear where the different foci lie, and how both lines of research could profit from learning from each other. Finally, a new instructional model that integrates task-relevant physical activities into the cognitive/learning task is proposed to inform both further research and educational practice.

Interrater Reliability of a Field-Based Preschool Movement Skills Assessment

OBJECTIVE

To determine the interrater reliability of the Preschool Movement Assessment (PMA), a unique field-based assessment tool for use by early childhood professionals in preschool settings.

METHODS

A total of 123 preschool children, aged 3-5years, were assessed by 6 trained raters using the PMA tool in an intervention. Interrater agreement on individual items of the PMA was determined using the kappa (κ) and intraclass correlation coefficient statistics.

RESULTS

Weighted κ values were 0.82-0.96, indicating excellent agreement for all constructs of the PMA. The 95% confidence intervals indicated that all weighted κ's were statistically significant. The intraclass correlation coefficient for the PMA total score was 0.97.

CONCLUSIONS AND IMPLICATIONS

After additional developmental research, the tool might serve to establish and support a minimum level of functional movements that should be attained before a child enters grade school.

Competitive achievement may be predicted by executive functions in junior tennis players: An 18-month follow-up study

This study evaluates whether high levels of executive function predict competition results 18 months later in junior tennis players. Forty junior tennis players (20 girls, 20 boys; 9-15 years old) who regularly participate in prefecture tennis tournaments were recruited. All participants underwent executive function evaluations (the Design Fluency Task) in July 2015 and their prefecture junior rankings in August 2015 and February 2017 were recorded. As a result, after controlling for age and gender, the future ranking (February 2017) was significantly predicted by performance in the Design Fluency Task (β = -.30, p = .02; ΔR² = .08), whereas the prediction for August 2015 rank as the baseline was not significant (β = -.19, p = .17; ΔR² = .03). After controlling for age, gender, and ranking in the baseline, the change in ranking was significantly predicted by performance in the Design Fluency Task (β = -.14, p = .02; ΔR² = .02). This suggests that childhood executive function may play a significant role in success later in life. This study highlights how executive function predicts future success in a specific sport; as such, supporting the development of executive function may contribute to higher competition results.

Thinking While Moving or Moving While Thinking - Concepts of Motor-Cognitive Training for Cognitive Performance Enhancement

The demographic change in industrial countries, with increasingly sedentary lifestyles, has a negative impact on mental health. Normal and pathological aging leads to cognitive deficits. This development poses major challenges on national health systems. Therefore, it is necessary to develop efficient cognitive enhancement strategies. The combination of regular physical exercise with cognitive stimulation seems especially suited to increase an individual's cognitive reserve, i.e., his/her resistance to degenerative processes of the brain. Here, we outline insufficiently explored fields in exercise-cognition research and provide a classification approach for different motor-cognitive training regimens. We suggest to classify motor-cognitive training in two categories, (I) sequential motor-cognitive training (the motor and cognitive training are conducted time separated) and (II) simultaneous motor-cognitive training (motor and cognitive training are conducted sequentially). In addition, simultaneous motor-cognitive training may be distinguished based on the specific characteristics of the cognitive task. If successfully solving the cognitive task is not a relevant prerequisite to complete the motor-cognitive task, we would consider this type of training as (IIa) motor-cognitive training with additional cognitive task. In contrast, in ecologically more valid (IIb) motor cognitive training with incorporated cognitive task, the cognitive tasks are a relevant prerequisite to solve the motor-cognitive task. We speculate that incorporating cognitive tasks into motor tasks, rather than separate training of mental and physical functions, is the most promising approach to efficiently enhance cognitive reserve. Further research investigating the influence of motor(-cognitive) exercises with different quantitative and qualitative characteristics on cognitive performance is urgently needed.

Effects of physical activity interventions on cognitive and academic performance in children and adolescents: a novel combination of a systematic review and recommendations from an expert panel

OBJECTIVE

To summarise the current evidence on the effects of physical activity (PA) interventions on cognitive and academic performance in children, and formulate research priorities and recommendations.

DESIGN

Systematic review (following PRISMA guidelines) with a methodological quality assessment and an international expert panel. We based the evaluation of the consistency of the scientific evidence on the findings reported in studies rated as of high methodological quality.

DATA SOURCES

PubMed, PsycINFO, Cochrane Central, Web of Science, ERIC, and SPORTDiscus.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

PA-intervention studies in children with at least one cognitive or academic performance assessment.

RESULTS

Eleven (19%) of 58 included intervention studies received a high-quality rating for methodological quality: four assessed effects of PA interventions on cognitive performance, six assessed effects on academic performance, and one on both. All high-quality studies contrasted the effects of additional/adapted PA activities with regular curriculum activities. For cognitive performance 10 of 21 (48%) constructs analysed showed statistically significant beneficial intervention effects of PA, while for academic performance, 15 of 25 (60%) analyses found a significant beneficial effect of PA. Across all five studies assessing PA effects on mathematics, beneficial effects were reported in six out of seven (86%) outcomes. Experts put forward 46 research questions. The most pressing research priority cluster concerned the causality of the relationship between PA and cognitive/academic performance. The remaining clusters pertained to PA characteristics, moderators and mechanisms governing the 'PA-performance' relationship and miscellaneous topics.

CONCLUSION

There is currently inconclusive evidence for the beneficial effects of PA interventions on cognitive and overall academic performance in children. We conclude that there is strong evidence for beneficial effects of PA on maths performance.The expert panel confirmed that more 'high-quality' research is warranted. By prioritising the most important research questions and formulating recommendations we aim to guide researchers in generating high-quality evidence. Our recommendations focus on adequate control groups and sample size, the use of valid and reliable measurement instruments for physical activity and cognitive performance, measurement of compliance and data analysis.

PROSPERO REGISTRATION NUMBER

CRD42017082505.

The impact of an exercise training intervention on cortisol levels and post-traumatic stress disorder in juveniles from an Ugandan refugee settlement: study protocol for a randomized control trial

Background

Latest research demonstrates a significant improvement in stress-related symptoms in psychological disorders as a result of exercise training (ET). Controlled clinical trials further validate the significance of ET by demonstrating lower salivary cortisol levels in patients with post-traumatic stress disorder (PTSD) after intervention. A significant change in cortisol and dehydroepiandrosterone (DHEA) levels can already be found after an 8–12-week ET program. The proposed study aims to investigate the impact of an 8-week ET on PTSD symptoms and changes in cortisol levels in a juvenile refugee sample from the Democratic Republic of the Congo (DRC) at an Ugandan refugee settlement. It is the first to implement an ET intervention in a resource-poor, post-conflict setting.

Methods/design

In a randomized controlled trial, 198 adolescent participants aged 13–16 years from the DRC who, suffer from PTSD, will be investigated. The participants are based at the Nakivale refugee settlement, an official refugee camp in Uganda, Africa, which is among the largest in the world. The participants will be randomized into an Exercise Training (ET) group with a maximum heart rate (HR_max) of > 60%, an Alternative Intervention (AI) group with low-level exercises, and a Waiting-list Control (WC) group. After the 8-week interventional phase, changes in cortisol awakening response (CAR) and DHEA in the ET group that correspond to an improvement in PTSD symptoms are expected that remain at follow-up after 3 months.

Discussion

To date, there is no controlled and reliable longitudinal study examining the effects of an ET program on symptom severity in individuals with PTSD that can be explained with a harmonization of cortisol secretion. The presented study design introduces an intervention that can be implemented with little expenditure. It aims to provide a promising low-threshold and cost-effective treatment approach for the application in resource-poor settings.

Trial registration

German Trials Register, ID: DRKS00014280. Registered prospectively on 15 March 2018.

Electronic supplementary material

The online version of this article (10.1186/s13063-018-2753-x) contains supplementary material, which is available to authorized users.

Mediating effects of motor performance, cardiorespiratory fitness, physical activity, and sedentary behaviour on the associations of adiposity and other cardiometabolic risk factors with academic achievement in children

We investigated the associations of cardiometabolic risk factors with academic achievement and whether motor performance, cardiorespiratory fitness, physical activity, or sedentary behaviour mediated these associations. Altogether 175 children 6-8 years-of-age participated in the study. We assessed body fat percentage (BF%), waist circumference, insulin, glucose, triglycerides, HDL cholesterol, and systolic and diastolic blood pressure, leptin, alanine aminotransferase, and gamma-glutamyltransferase (GGT). Reading fluency, reading comprehension, and arithmetic skills were assessed using standardized tests. Speed/agility, balance, and manual dexterity test results were used to calculate motor performance score and physical activity was assessed by combined heart rate and movement sensor and cardiorespiratory fitness by maximal cycle ergometer test. In boys, BF% was inversely associated with reading fluency (β = -0.262, P = 0.007) and reading comprehension (β = -0.216, P = 0.025). Motor performance mediated these associations. Leptin was inversely related to reading fluency (β = -0.272, P = 0.006) and reading comprehension (β = -0.287, P = 0.003). The inverse association of leptin with reading fluency was mediated by motor performance. In girls, GGT was inversely associated with reading fluency independent of confounders (β = -0.325, P = 0.007). The inverse association of BF% with academic achievement among boys was largely explained by motor performance. Leptin in boys and GGT in girls were inversely associated with academic achievement independent of confounding factors.

Executive Function, Behavioral Self-Regulation, and School Related Well-Being Did Not Mediate the Effect of School-Based Physical Activity on Academic Performance in Numeracy in 10-Year-Old Children. The Active Smarter Kids (ASK) Study

Inconsistent findings exist for the effect of school-based physical activity interventions on academic performance. The Active Smarter Kids (ASK) study revealed a favorable intervention effect of school-based physical activity on academic performance in numeracy in a subsample of 10-year-old elementary schoolchildren performing poorer at baseline in numeracy. Aiming to explain this finding, we investigated the mediating effects of executive function, behavioral self-regulation, and school related well-being in the relation between the physical activity intervention and child's performance in numeracy. An ANCOVA model with latent variable structural equation modeling was estimated using data from 360 children (the lower third in academic performance in numeracy at baseline). The model consisted of the three latent factors as mediators; executive function, behavioral self-regulation, and school related well-being. We found no mediating effects of executive function, behavioral self-regulation or school related well-being in the relationship between the ASK intervention and academic performance in numeracy (p ≥ 0.256). Our results suggest that the effect of the intervention on performance in numeracy in the present sample is not explained by change in executive function, behavioral self-regulation, or school related well-being. We suggest this finding mainly could be explained by the lack of effect of the intervention on the mediators, which might be due to an insufficient dose of physical activity. Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494.

Improved cognitive performance in preadolescent Danish children after the school-based physical activity programme "FIFA 11 for Health" for Europe - A cluster-randomised controlled trial

OBJECTIVE

Recent studies have shown promising effects of physical activity on cognitive function, but there is a need to investigate this link in real-life settings such as schools. Hence, the objective of the present pilot study was to investigate whether the school-based physical activity programme "FIFA 11 for Health" for Europe could improve cognitive performance in preadolescent Danish children.

METHODS

The pilot study used an 11-week cluster-randomised intervention study design. School classes were randomly assigned to either a control group (CG) (n = 93 children, age = 11.8, s = 0.2 years), which performed the obligatory daily school-based physical activity (5 × 45 minutes per week); or an intervention group (IG) (n = 838 children, age = 11.9, s = 0.4 years), which substituted 2 × 45 minutes per week of the daily school physical activity with the "FIFA 11 for Health" for Europe programme. The programme combines small-sided football games, drills and health education. Cognitive performance was evaluated at baseline and follow-up.

RESULTS

The IG improved their cognitive performance compared to the CG for psychomotor function (56, s_x^- = 22 ms, p < .001), attention (39, s_x^- = 17 ms, p = .012) and working memory (79, s_x^- = 35 ms, p = .020).

CONCLUSION

This pilot study provides evidence that the school-based physical activity programme "FIFA 11 for Health" for Europe can improve cognitive performance in preadolescent Danish schoolchildren. Future studies should attempt to disentangle the effects of "FIFA 11 for Health" for Europe on cognitive performance by investigating the characteristics of the programme's physical activity.

The Effect of Physical Activity Interventions on Children's Cognition and Metacognition: A Systematic Review and Meta-Analysis

OBJECTIVE

The objective was twofold: to assess the effect of physical activity (PA) interventions on children's and adolescents' cognition and metacognition; and to determine the characteristics of individuals and PA programs that enhance the development of cognitive and metacognitive functions.

METHOD

We systematically searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, and PsycINFO databases from their inception to October 16, 2016. Intervention studies aimed at examining the exercise-cognition interaction at a developmental age were included in this systematic review and meta-analysis. Random-effects models were used to calculate pooled effect size (ES) values and their corresponding 95% CIs. Subgroup analyses were conducted to examine the effect of participants' and PA programs' characteristics.

RESULTS

A total of 36 studies were included in this systematic review and meta-analysis. Pooled ES estimations were as follows: nonexecutive cognitive functions 0.23 (95% CI = 0.09-0.37); core executive functions 0.20 (95% CI = 0.10-0.30), including working memory (0.14 [95% CI = 0.00-0.27]), selective attention-inhibition (0.26 [95% CI = 0.10-0.41]), and cognitive flexibility (0.11 [95% CI = -0.10 to 0.32]); and metacognition 0.23 (95% CI = 0.13-0.32), including higher-level executive functions (0.19 [95% CI = 0.06-0.31]) and cognitive life skills (0.30 [95% CI = 0.15-0.45]).

CONCLUSION

PA benefits several domains of cognition and metacognition in youth. Curricular physical education interventions and programs aimed at increasing daily PA seem to be the most effective.

Disentangling the relationship between children's motor ability, executive function and academic achievement

Even though positive relations between children's motor ability and their academic achievement are frequently reported, the underlying mechanisms are still unclear. Executive function has indeed been proposed, but hardly tested as a potential mediator. The aim of the present study was therefore to examine the mediating role of executive function in the relationship between motor ability and academic achievement, also investigating the individual contribution of specific motor abilities to the hypothesized mediated linkage to academic achievement. At intervals of ten weeks, 236 children aged between 10 and 12 years were tested in terms of their motor ability (t1: cardiovascular endurance, muscular strength, motor coordination), core executive functions (t2: updating, inhibition, shifting), and academic achievement (t3: mathematics, reading, spelling). Structural equation modelling revealed executive function to be a mediator in the relation between motor ability and academic achievement, represented by a significant indirect effect. In separate analyses, each of the three motor abilities were positively related to children's academic achievement. However, only in the case of children's motor coordination, the mediation by executive function accounted for a significance percentage of variance of academic achievement data. The results provide evidence in support of models that conceive executive function as a mechanism explaining the relationship that links children's physical activity-related outcomes to academic achievement and strengthen the advocacy for quality physical activity not merely focused on health-related physical fitness outcomes, but also on motor skill development and learning.

No Long-Term Effect of Physical Activity Intervention on Working Memory or Arithmetic in Preadolescents

We investigate if increased physical activity (PA) leads to enhanced working memory capacity and arithmetic performance, in a 2-year school-based intervention in preadolescent children (age 6–13). The active school (n = 228) increased PA (aimed at increasing cardiovascular fitness) from 2 to 5 days a week while the control school (n = 242) remained at 2 days. Twice a year, participants performed tests of arithmetic as well as verbal and spatial working memory. They also rated stress with a questionnaire at the start and at the end of the intervention. There was no beneficial development of working memory or arithmetic for the active school as compared to the control school. Furthermore, subgroup analyses revealed no favorable intervention effect for high/low baseline fitness, cognition or grit. Unexpectedly, a significant increase in self-rated stress was detected for the active school and this effect was driven by girls rather than boys and by the younger rather than older children. These results indicate that longtime high intensity PA does not lead to a beneficial development of working memory or arithmetic in preadolescent children.

The Acute Effects of Exercise Intensity on Inhibitory Cognitive Control in Adolescents

Adolescence is an important stage for brain maturation. There are many studies of exercise-cognition relations, but there is still a lack of knowledge about the impact of combining different intensities of exercise on adolescents' cognitive responses. The main objective of this study was to analyze the effect of three physical education sessions (based on Zumba dance) of different intensities (no exercise, predominantly light intensity, and predominantly vigorous intensity) on the inhibition response (measured with the Stroop test) in adolescents. Forty-four adolescent students (age 16.39 ± 0.68) completed a Stroop test before and after the three different physical education sessions. The results show than the predominantly vigorous session represented the strongest stimulus to increase cognitive inhibitory control. This means that the cognitive effect of exercise can be conditioned by exercise intensity and implies the need to control exercise intensity in physical educational programs for adolescents.

The relationship between motor performance and parent-rated executive functioning in 3- to 5-year-old children: What is the role of confounding variables?

It is generally agreed that motor performance and executive functioning (EF) are intertwined. As the literature on this issue concerning preschool children is scarce, we examined the relationship between motor performance and parent-rated EF in a sample of 3- to 5-year-old children with different levels of motor skill proficiency, while controlling for age, gender, socio-economic status (SES), and attention-deficit-hyperactivity disorder (ADHD) symptomatology. EF was reported by parents of 153 children (mean age 4years 1months, SD 8months; 75 male) by means of the Behaviour Rating Inventory of Executive Function-Preschool version (BRIEF-P). Parent-reported ADHD symptoms were assessed using the Hyperactivity-Inattention subscale of the Strengths and Difficulties Questionnaire3-4. In addition, the children performed the Movement Assessment Battery for Children-2 (MABC-2). Several weak to moderate relationships were found between the MABC-2 Total Score and the EF subscales. Once other variables such as age, gender, SES, and ADHD symptomatology were taken into account, the only BRIEF-P subscale that was associated with the MABC-2 Total Score was the Working Memory subscale. Compared to their typically developing peers, children who are at risk for motor coordination difficulties (⩽the 16th percentile on the MABC-2) performed poorly on the Working Memory subscale, which confirms the results of the regression analyses. The at risk group also performed significantly worse on the Planning/Organize subscale, however. This is one of the first studies investigating the relationship between motor performance and parent-rated EF in such a young age group. It shows that the relationship between motor performance and EF in young children is complex and may be influenced by the presence of confounding variables such as ADHD symptomatology.

More than one road leads to Rome: A narrative review and meta-analysis of physical activity intervention effects on cognition in youth

A growing body of research indicates that physical activity (PA) positively impacts cognitive function in youth. However, not all forms of PA benefit cognition equally. The purpose of this review was to determine the effect of different types of chronic PA interventions on cognition in children and adolescents. A systematic search of electronic databases and examination of the reference lists of relevant studies resulted in the identification of 28 studies. Seven categories of PA were identified, based on all possible combinations of three types of PA (aerobic, motor skill, cognitively engaging), and four comparison groups (no treatment, academic, traditional physical education, aerobic). Effect sizes were calculated based on means and SDs at the post-test using Hedge's g formula, which includes a correction for small sample bias. Each study was only entered once in each intervention-comparator category. Full data were provided from 21 studies (28 effect sizes; n=2042 intervention; n=2002 comparison group). Overall, chronic PA interventions had a significant small-to-moderate effect on cognition (0.46). Moderate significant positive effects were identified when PA interventions were compared to no treatment (0.86) or academic content (0.57). A non-significant effect was noted when PA interventions were compared to traditional physical education (0.09) or aerobic group (0.80). However, high heterogeneity in pooled effect sizes suggests that important differences in the qualitative characteristics of the PA intervention and comparison interventions may exist. Effect sizes based on comparisons between different types of PA interventions and comparison groups are discussed in order to identify possible directions for future investigations. We conclude that chronic PA interventions have a positive impact on cognitive function in youth, but more systematic research is needed in this area.