Effects of exergaming on motor skill competence, perceived competence, and physical activity in preschool children

Study on the relationship and related factors between physical fitness and health behavior of preschool children in southwest China

OBJECTIVE

To investigate the physical fitness level and health behavior status of preschool children in China, explore the relationship between physical fitness and health behavior, and further reveal the main factors affecting health behavior, to provide a reference for improving the physical fitness level of preschool children and maintaining healthy behavior.

METHODS

A total of 755 preschool children (394 boys and 361 girls, aged 4.52 ± 1.11 years) were selected from Chongqing and Liupanshui in China by cluster random sampling method for questionnaire survey and physical monitoring, and SPSS21.0 software was used to process and analyze the data.

RESULTS

(1) Heart rate (p = 0.015), protein content (p < 0.001), and time spent on the balance beam (p < 0.001) were significantly lower in boys than in girls, while BMI (p = 0.012), muscle mass (p < 0.001), and distance of standing long jump (p < 0.001) were significantly higher in boys than in girls. Meanwhile, systolic blood pressure (p = 0.004) and diastolic blood pressure (p = 0.001) of rural children were significantly higher than those of urban children, while BMI (p < 0.001) and sitting forward flexion (p = 0.019) were significantly lower than those of urban children. (2) The light-intensity physical activity (LPA) and moderate to vigorous physical activity (MVPA) of boys were significantly higher than that of girls (p < 0.001), and the MVPA of urban children was significantly higher than that of rural children (p = 0.001), and the former participated in sports classes more frequently (p < 0.001). (3) There was a significant correlation between physical activity (PA) and physical fitness indicators of preschoolers. Participating in sports interest classes was only significantly correlated with systolic blood pressure (r = 0.08) and sitting forward flexion (r = 0.09). (4) The PA level of preschool children was related to gender, household registration, kindergarten nature, age, residence environment, parental support, and participation degree. Participation in sports interest classes was related to gender, the nature of the kindergarten, household registration, age, and parent participation. Daily screen time was related to household registration, the nature of the kindergarten, the environment of residence, and the value perception of parents.

CONCLUSIONS

There were different degrees of correlation between preschool children's physical fitness and health behaviors, and children's health behaviors were closely related to gender, environment, parents, and other factors. Therefore, how to increase the protective factors of children's health behaviors and controlling the risk factors may be crucial to promoting the development of good health behaviors and improving the physical fitness of preschool children.

A 10-week play-based after-school program to improve coordinative abilities and physical fitness capabilities among adolescents: a randomized trial

The average levels of physical activity in children are below the ideal, which may influence children's health and motor competence levels. Therefore, this study aimed to assess the impact of a 10-week play-based after-school program on 50 twelve-year-old students' anthropometric characteristics (body height and body weight), coordinative abilities (flamingo balance test and T-test agility), and physical fitness (sit and reach, 20-m sprint test, SLJ, CMJ, and handgrip). After baseline assessments, the students were randomly divided into two groups: one participating in a play-based after-school program (experimental group) and the other attending regular PE classes (control group). No differences were noted between the sexes. Analysis revealed baseline differences between groups in body weight, agility T-test, and right-handgrip, with no significant sex differences. Following the intervention, the experimental group demonstrated improvements in the 20-m sprint test (F(1,46) = 11.03, p < 0.01), flamingo balance test (F(1,46) = 9.16, p = 0.004), SLJ (F(1,46) = 5.30, p = 0.03), agility T-test (F(1,46) = 28.30, p < 0.01), and right-handgrip (F(1,46) = 6.59, p < 0.01). In summary, the results suggested that a 10-week play-based after-school program enhances coordinative abilities and physical fitness in 12-year-old children. This underscores the potential advantages of integrating play-based physical activities into schools to promote holistic health and fitness in children.

Enhancing Physical Activity with Immersive Virtual Reality: A Systematic Review

The aim of this article is to review how immersive virtual reality-enhanced physical activity (IVR-PA) can be used to improve psychological, physiological, and performance outcomes linked to exercising and to compare it with non-immersive virtual reality-enhanced physical activity (nIVR-PA) and with traditional physical activity (TR-PA). We also aimed to explore the effectiveness of IVR-PA in promoting psychological well-being and engagement in physical activity. A systematic literature review (Prospero CRD42022330572) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. OVID (including Medline, Embase, GlobalHealth, and APA PsychInfo), Web of Science, and Sport Discuss were searched. The quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment. The search identified 26,548 titles. After screening, 20 studies (the total number of participants was 798) published between 2009 and 2023 were included in this systematic review. The quality of the studies was rated as weak (n = 9), moderate (n = 10), or strong (n = 1). Overall, the reviewed studies indicated that, compared with TR-PA and nIVR-PA, IVR-PA was associated with an increase in enjoyment of physical activity, a reduction in perceived exertion, and increased rates of self-efficacy, intrinsic motivation, and exercise intention. Furthermore, some studies showed higher muscular strength and aerobic increase after an IVR-PA intervention compared with TR-PA. The findings suggest that IVR-PA can improve psychological, physiological, and performance outcomes linked to exercising, as well as improving psychological well-being and engagement in physical activity. However, owing to the methodological limitations of the reviewed studies, further research is encouraged.

Effects of exergames on student physical education learning in the context of the artificial intelligence era: a meta-analysis

Whether the application of exergames in physical education (PE) courses can significantly improve student performance in PE learning is still controversial. This review explores the promoting effect of exergames on student PE learning and the conditions in which the effect of exergames can be maximized. Based on the PICOS method, two researchers independently searched the ProQuest database, EBSCO database, Web of Science (WoS) database, PubMed database, Chinese National Knowledge Infrastructure (CNKI) database, Wanfang database, and VIP database, evaluated the literature quality using the Cochrane system evaluation manual, and performed a meta-analysis of the included literature. A total of 16 randomized controlled trials involving 2962 subjects were included in this study. The meta-analysis showed that exergames effectively improved student performance in PE learning (SMD = 0.45, 95% CI: 0.27-0.63, P < 0.00001). Subgroup analysis indicated that better results could be achieved when exergames were introduced in small kindergarten classes and continued for 1-2 months.

Effectiveness of parent-based electronic health (eHealth) intervention on physical activity, dietary behaviors, and sleep in preschoolers: A systematic review

Background

The lifestyles of preschoolers have become physically inactive and sedentary, their eating habits unhealthy, and their sleep routines increasingly disturbed. Parental involvement appears crucial to combat the unhealthy lifestyle of preschoolers. Because of the recognized barriers to traditional face-to-face interventions, easy access and lower costs make electronic health (eHealth) interventions appealing. However, whether parent-based eHealth intervention may be harnessed to improve the aforementioned lifestyle behaviors of preschoolers is currently unclear, a gap that this systematic review intends to address. This study aims to systematically review the current literature concerning the effectiveness of parent-based eHealth intervention on the physical activity, dietary behaviors, and sleep of preschoolers.

Method

This systematic review conforms to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Six databases (EMBASE, PubMed, MEDLINE, Web of Science, SPORTDiscus, and PsycINFO) were retrieved for the period from January 2000 to December 2022. Studies were eligible if 1 they were quantitative study design; 2 eHealth interventions in which parents were the change agents targeted children aged 3-6 years; 3 interventions examined the effectiveness of eHealth or incorporated eHealth as one of the intervention modalities; 4 at least one variable included in either primary or secondary outcome had to concentrate on the physical activity, diet, and sleep of preschoolers; 5 publication type was limited to the English language and peer-reviewed journal articles; 6 study settings were confined to family- or parent-based ones. The risk of bias was assessed, based upon Version 2 of the Cochrane risk-of-tool for randomized trials (RoB2).

Results

Twelve studies were screened. No significant group-by-time improvement in physical activity was found in studies related to physical activity outcomes. Two studies reported a significant difference between groups concerning motor ability, with one study indicating improved object control with the other reporting improvement in both object control and locomotor skills. Of the studies related to dietary behavior outcomes, six studies reported a significant difference at the posttest compared to the control group, in terms of vegetable and fruit intake, sugar-sweetened drinks, reduced candy consumption, and improved non-core food. Three studies reported a significant difference between groups in sleep duration at the end of the posttest, with the result of one study limited to preference-only participants. None of the reviewed studies found a significant difference between groups for sleep problems.

Conclusion

Parent-based eHealth interventions were not significantly effective in improving physical activity and reducing sleep problems in preschoolers, but the majority of studies have found that this type of intervention significantly improves the dietary behaviors and sleep duration of preschoolers. High-quality, robustly designed studies to balance the intervention dosage and sequence are needed to investigate the effectiveness of parent-based eHealth intervention on physical activity, dietary behaviors, and sleep in preschoolers, particularly those raised in other cultural background, which may significantly impact their lifestyle.

Trial registration

International Prospective Register of Systematic Review (PROSPERO): CRD42023418861.

Functional physical training improves fitness and cognitive development in 4~5 years old children

Background

Development of physical and cognitive function is very critical in 4~5 years children. It has been addressed in this research if the 18 weeks of specific functional training with or without cognitive training can be effective on improving fitness and cognitive development in 4~5 years preschool children.

Methods

A total of 126 preschool children in the 4~5 age range were selected as participants and randomly assigned to one of four groups: the control group (C), the functional physical training group (P), the cognitive training group (CT), and the functional physical training combined with cognitive training group (PCT).

Results

The results revealed significant pre/post differences in body height and weight among all four groups of children. Furthermore, there was no significant difference in physical fitness between the C group and the CT group after the intervention. However, the children in the P group and the PCT group showed significant improvements in three indicators including standing long jump, continuous jump, and 10-meter shuttle running. Additionally, the children in P group, CT group, and the PCT group demonstrated significant improvement in simple reaction time, attention, and spatial memory. No significant cognitive improvement was found in C group.

Conclusion

Functional physical training with or without cognitive intervention can promote both physical fitness and cognitive development in children aged 4~5 years. Cognitive training alone can significantly improve cognitive function but not physical. Therefore, functional physical training can be used alone to improve the physical and cognitive abilities for aged 4~5 years old children.

Motion-based technology to support motor skills screening in developing children: A scoping review

BACKGROUND

Acquiring motor skills is fundamental for children's development since it is linked to cognitive development. However, access to early detection of motor development delays is limited.

AIM

This review explores the use and potential of motion-based technology (MBT) as a complement to support and increase access to motor screening in developing children.

METHODS

Six databases were searched following the PRISMA guidelines to search, select, and assess relevant works where MBT recognised the execution of children's motor skills.

RESULTS

164 studies were analysed to understand the type of MBT used, the motor skills detected, the purpose of using MBT and the age group targeted.

CONCLUSIONS

There is a gap in the literature aiming to integrate MBT in motor skills development screening and assessment processes. Depth sensors are the prevailing technology offering the largest detection range for children from age 2. Nonetheless, the motor skills detected by MBT represent about half of the motor skills usually observed to screen and assess motor development. Overall, research in this field is underexplored. The use of multimodal approaches, combining various motion-based sensors, may support professionals in the health domain and increase access to early detection programmes.

Intensity of a Physical Exercise Programme Executed through Immersive Virtual Reality

Evidence suggests that moderate to vigorous physical activity (MVPA) is necessary for health benefits. Immersive virtual reality is a technology that uses images, sounds, and tactile sensations from a simulated world to encourage healthy behaviours and physical activity. The aims of this research are (1) to determine the duration and intensity of physical activity performed through immersive virtual reality; (2) to determine differences in physical activity intensity according to gender.

METHODS

A nonprobabilistic convenience sample composed of 39 university students of physical education pedagogy, who performed, through immersive virtual reality, a physical activity programme composed of three levels that progressively increased in complexity. Physical activity intensity was measured using accelerometers.

RESULTS

Of the three levels, the most complex was not the one that produced the most minutes of MVPA. The three levels added up to 08:53 min of MVPA. No significant differences were found when comparing them by sex.

CONCLUSIONS

The results of this study suggest that an exercise programme delivered through immersive virtual reality generates MVPA levels, with no major differences between sexes. Further research is needed to confirm the contribution of immersive virtual reality to physical activity.

Screen time and preschool children: Promoting health and development in a digital world

COVID-19 transformed the family media environment and spurred research on the effects of screen media exposure and use on young children. This update of a 2017 CPS statement re-examines the potential benefits and risks of screen media in children younger than 5 years, with focus on developmental, psychosocial, and physical health. Four evidence-based principles-minimizing, mitigating, mindfully using, and modelling healthy use of screens-continue to guide children's early experience with a rapidly changing media landscape. Knowing how young children learn and develop informs best practice for health care providers and early years professionals (e.g., early childhood educators, child care providers). Anticipatory guidance should now include child and family screen use in (and beyond) pandemic conditions.

Physical Activity in Immersive Virtual Reality: A Scoping Review

Physical activity has benefits for health, but many adolescents are inactive. However, video games such as Immersive Virtual Reality (IVR) have grown in popularity as a leisure activity among young people, allowing them to manipulate objects in virtual environments increasing the practice of physical activity. The evidence indicates that the interest in physical activity through IVR is greater than in traditional methods, and different experiences have been reported. However, few studies indicate the sample evaluated, the effects found, or the IVR instruments used. Due to this, is the aim of this study is to identify the publications referring to IVR and physical activity, characterize them, and present the obtained main findings. For this, the guidelines described in the PRISMA-ScR for scoping reviews were applied. After the use of the inclusion and exclusion criteria, eight articles were included. Results show evidence regarding physiological outcomes, perceptual variables, interest and enjoyment, and psychological effects regarding physical activity through IVR. Additionally, the use of different devices and their prescriptions are explored. It is concluded that there is interest from the scientific community for the practice of physical activity through IVR, as well as for its application for the maintenance of active habits. This is important as it positions IVR as a method that can be a more experiential and effective way to develop and maintain a healthy lifestyle.

Active Video Game Interventions Targeting Physical Activity Behaviors: Systematic Review and Meta-analysis

BACKGROUND

Research on digital games designed to increase physical activity (PA), also known as exergames or active video games (AVGs), has proliferated over the past 2 decades. As a result, reviews of literature in this field can become outdated, revealing the need for updated high-quality reviews that identify overarching insights. Furthermore, given the significant heterogeneity in AVG research, study inclusion criteria may significantly influence conclusions. To the best of our knowledge, no prior systematic review or meta-analysis has specifically focused on studies of longitudinal AVG interventions targeting increases in PA behaviors.

OBJECTIVE

The aim of this study was to obtain insights into when and why longitudinal AVG interventions are more or less successful for sustained increases in PA, especially for public health.

METHODS

Six databases (PubMed, PsycINFO, SPORTDiscus, MEDLINE, Web of Science, and Google Scholar) were reviewed until December 31, 2020. This protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, randomized controlled trials had to prominently (>50% of intervention) feature AVG technology, involve repeated AVG exposure, and target changes in PA behavior. Experimental designs had to include ≥2 within- or between-participant conditions with ≥10 participants per condition.

RESULTS

A total of 25 studies published in English between 1996 and 2020 were identified, with 19 studies providing sufficient data for inclusion in the meta-analysis. Our findings indicated that AVG interventions had a moderately positive effect, thereby increasing overall PA (Hedges g=0.525, 95% CI 0.322-0.728). Our analysis showed substantial heterogeneity (I²=87.7%; Q=154.1). The main findings were consistent across all subgroup analyses. The comparison between PA assessment type groups showed a moderate effect for objective measures (Hedges g=0.586, 95% CI 0.321-0.852) and a small effect for subjective measures (Hedges g=0.301, 95% CI 0.049-0.554) but no significant difference between the groups (P=.13). The platform subgroup analysis indicated a moderate effect for stepping devices (Hedges g=0.303, 95% CI 0.110-0.496), combination of handheld and body-sensing devices (Hedges g=0.512, 95% CI 0.288-0.736), and other devices (Hedges g=0.694, 95% CI 0.350-1.039). The type of control group showed a wide range of effects sizes, ranging from a small effect size (Hedges g=0.370, 95% CI 0.212-0.527) for the passive control group (nothing) to a moderate effect size for the conventional PA intervention group (Hedges g=0.693, 95% CI 0.107-1.279) and ultimately to a large effect size for sedentary game as control groups (Hedges g=0.932, 95% CI 0.043-1.821). There was no significant difference among the groups (P=.29).

CONCLUSIONS

AVGs represent a promising tool for PA promotion among the general population and clinical subpopulations. However, significant variabilities in AVG quality, study design, and impact were also detected. Suggestions for improving AVG interventions and related research will be discussed.

TRIAL REGISTRATION

PROSPERO CRD42020204191; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204191.

Effectiveness of interventions using apps to improve physical activity, sedentary behavior and diet: An umbrella review

Technology has been recently found to be an effective tool to deliver public health interventions [1]. More specifically, the effects of interventions using apps to improve health have been targeted lately [2]. The goal of the present study was to conduct a systematic review of systematic reviews to summarize the scientific evidence. Three research questions were formulated to guide the research: RQ1. Are interventions using apps effective to improve PA? RQ2. Are interventions using apps effective to improve sedentary behavior? RQ3. Are interventions using apps effective to improve diet? This review of reviews was registered with PROSPERO (CRD42022345909). Systematic reviews were included following the PICOTS framework (population, intervention, comparator, outcomes, time and setting). In addition, reviews with several research objectives were included only when they comprised more than two-thirds of the studies analyzing one or more of the objectives of this review. As a result, 12 systematic reviews were selected for data extraction. Findings uncovered that apps could be effective to improve individuals' PA, sedentary behavior and diet. However, elements like the intervention components, the context/environment/setting, the length of the intervention or the population targeted should be carefully considered in future studies.

Effects of different physical activity interventions on children with attention-deficit/hyperactivity disorder: A network meta-analysis of randomized controlled trials

Background

Previous studies have shown that physical activity interventions positively affect core symptoms and executive functioning in children with attention-deficit/hyperactivity disorder (ADHD). However, comparisons between different physical activity interventions still need to be made. This study is the first to analyze the effects of 10 different types of physical activity on children with ADHD through a network meta-analysis.

Methods

PubMed, Embase, Web of Science, and Cochrane Library databases were searched for randomized controlled trials on the effects of physical activity interventions on children with ADHD. The search time frame was from database creation to October 2022. Two investigators independently performed literature screening, extraction, and quality assessment. Network meta-analysis was performed with Stata 15.1.

Results

A total of 31 studies were included, and the results indicated that perceptual-motor training was the most effective in terms of motor ability and working memory (SUCRA = 82.7 and 73.3%, respectively). For attention problems and cognitive flexibility, aquatic exercise was the most effective (SUCRA = 80.9 and 86.6%, respectively). For social problems, horsemanship was the most effective (SUCRA = 79.4%). For inhibition switching, cognitive-motor training was the most effective (SUCRA = 83.5%).

Conclusion

Our study revealed that aquatic exercise and perceptual-motor training had a superior overall performance. However, the effects of various physical activity interventions on different indicators in children with ADHD can vary depending on the individual and the intervention's validity. To ensure an appropriate physical activity intervention is selected, it is important to assess the severity of symptoms exhibited by children with ADHD beforehand.

A Skill Acquisition Perspective on the Impact of Exergaming Technology on Foundational Movement Skill Development in Children 3-12 Years: A Systematic Review and Meta-analysis

BACKGROUND

Sedentary, digital screen time in children represents a major concern due to its detrimental effect on children's development. Nowadays, however, advances in technology allow children to actively interact with a digital screen using their whole body (e.g., exergaming), providing potential for movement learning. Exergaming technology may prove valuable in supporting children's development of foundational movement skills (FMS).

OBJECTIVE

To examine the impact of exergaming technology on the development of FMS in children 3-12 years through a skill acquisition lens.

METHODS

Systematic review and meta-analysis were conducted following the PRISMA guidelines. Web of Science, PubMed, PsycINFO and SPORTDiscus databases were searched between 2007 and 2022. Studies were eligible if they conducted an exergaming intervention to improve FMS in typically developing children aged three to twelve with a control group, using a baseline and post-intervention assessment design. FMS outcomes were pooled with a random effects model.

RESULTS

Nine trials (4 RCTs, 2 cluster RCTs and 3 non-randomized trials) of varying methodological quality (2 had low, 6 had some concerns, and 1 had a high risk of bias) were included, with a total of 783 participants. FMS outcome measures across studies comprised object control skills, locomotor skills, coordination, agility, balance and balance-related skills. The meta-analysis included showed a small positive effect in favor of the exergaming intervention (r = 0.24 [95% confidence interval: 0.11-0.36]).

CONCLUSION

Our results indicate that screen-based technology that requires an active engagement of the child can promote the development of FMS. Considering that FMS are the foundation of a child's physical, mental, health and academic development, this finding could lead to a reshaping of the perception of digital screen-based technology and the role this should play in children's lives. We speculate that the observed benefits most likely depend upon the quality of information-movement coupling specificity and the motor learning strategies built into the exergame and/or the intervention design. We do not believe this is dependent on the type of FMS being performed or the amount of practice. We recommend therefore that future research should examine how practitioners (school teachers, coaches and parents) can facilitate the interaction between a child and exergaming technology.

Psychometric Parameters of the Intrinsic Motivation Inventory Adapted to Physical Education in a Sample of Active Adults from Austria

Introduction. Intrinsic motivation is essential for establishing life-long positive behaviors. In Physical Education (PE), this variable may have a significant impact on students’ choice of adhering to an active lifestyle both in the short and long term. Many tools have been developed for the assessment of intrinsic motivation, among which the Intrinsic Motivation Inventory (IMI) was built based on the Self-Determination Theory. The aim of this study is to examine a version of the IMI adapted to PE (IMI-PE). Methods. A total of 660 customers of a Sports Service Center responded to the IMI-PE and 39 individuals carried out a test–retest of the tool within two weeks. Results. The initial model including the original pool of items showed low indexes of goodness of fit. However, the removal of item 6, 8, 13, and 14 led to excellent parameters for the four-factor model (CFI = 0.96, and SRMR = 0.0420). Internal consistency and reliability analyses confirmed the robustness of such model. The final IMI-PE, comprising 14 items distributed into four factors, represents a robust assessment tool for the analysis of intrinsic motivation in PE.

Examining Relationships among Chinese Preschool Children's Meeting 24-Hour Movement Guidelines and Fundamental Movement Skills

Background: Few studies have investigated associations between meeting 24-Hour Movement Guidelines and preschool children’s fundamental movement skills (FMS). This study aimed to investigate the associations between Chinese preschoolers meeting various combinations of the Guidelines and FMS, as well as examining gender differences across those outcomes. Methods: A total of 322 preschool children (181 boys and 141 girls) aged 3−6 years old were recruited from five early-childhood education and care services in China. Children’s 7-day physical activity (PA) was assessed using accelerometry, and screen time (ST) and sleep duration were reported by their parents. FMS were assessed by Test of Gross Motor Development 3. Descriptive statistics and gender differences in children’s meeting the Guidelines and FMS were calculated using t-tests for continuous variables and Chi-square tests for categorical variables. Results: Most preschoolers met the sleep and ST guidelines, but only 22.3% met the PA guidelines; 4% of preschoolers did not meet any of the recommendations, while 9.3% met all three recommendations. Boys reported significantly higher compliance with all combined recommendations. There were positive associations between meeting the PA guidelines and both locomotor (β = 0.49; p < 0.001) and object control skills (β = 0.21; p < 0.001). A significantly positive relationship was identified between meeting PA + sleep guidelines and locomotor skills (β = −0.16; p = 0.02). A significantly negative association was observed between preschoolers’ meeting sleep + ST guidelines and locomotor skills (β = 0.31; p = 0.001). Conclusion: Few preschoolers met all three movement behavior guidelines. The findings suggest that PA levels, especially MVPA, are important for the promotion of FMS. Meanwhile, the impacts of ST and sleep on motor development cannot be neglected.

Comparative Effectiveness of Physical Activity Intervention Programs on Motor Skills in Children and Adolescents: A Systematic Review and Network Meta-Analysis

Objective: To evaluate how different physical activity (PA) interventions (traditional, exergaming, and teacher/parent education) impacted children's motor skills (object control, locomotor, and gross motor). Design: Systematic review and network meta-analysis. Data sources: PubMed, Medline, Scopus, Web of Science, EMBASE, and PsycINFO. Eligibility criteria: (1) Participants comprised 1708 children 3-12 years; (2) PA or exercise-based interventions were investigated; (3) only studies using a Test of Gross Motor Skills assessment were included; (4) RCT were chosen as the study design to assess the impact of PA interventions on children's motor skills; and (5) culture-based PA studies with English language only were included. Data were analyzed using a Bayesian network meta-analysis. Results: The results were reported as standardized mean differences (SMDs) with associated 95% credible intervals (CrIs). For object control, aerobic intervention (SMD 6.90, 95% Crl 1.39 to 13.50); for locomotor, exergaming intervention (SMD 12.50, 95% Crl 0.28 to 24.50); and for gross motor, aerobic intervention (SMD 7.49, 95% Crl 0.11 to 15.70) were the most effective treatments. Conclusion: Children's FMSs have been improved through different PA interventions. Among them, aerobic interventions seem to be the most effective intervention in enhancing object control skills and overall gross motor skills.

Effects of Chinese Martial Arts on Motor Skills in Children between 5 and 6 Years of Age: A Randomized Controlled Trial

Children’s motor skills can be fully developed only by the appropriate stimulation of physical activities and the environment, and the poor development of motor skills greatly increases the risk of cognitive impairment, obesity, and movement coordination disorder. This study aimed to examine the effects of Chinese martial arts on the motor skills of preschool children aged 5−6 years through a randomized controlled trial. A total of 87 children aged 5−6 years served as participants in a martial arts sensory teaching group (MAST, n = 29), a martial arts traditional teaching group (MATT, n = 29), and a free activity group (FA, n = 29). The interventions were conducted twice weekly for a total of 10 weeks, with each session lasting 30 min. Children’s motor skills were assessed before and after the intervention using the Movement Assessment Battery for Children (MABC-2). The results indicated that the balance index scores in the MAST (p < 0.001) and MATT (p = 0.014) groups were significantly higher than those in the FA and that the MAST score was significantly higher than the MATT (p = 0.004). Meanwhile, the MAST was significantly higher in total scores on motor skills when compared to the FA (p = 0.039), and the MAST showed significantly higher scores on manual dexterity when compared to both the MATT (p = 0.021) and FA (p = 0.011). Chinese martial arts can significantly improve the balance ability of preschool children, and the MAST method was found to be better than that of the MATT. Meanwhile, the MAST had good potential for the development of preschool children’s manual dexterity and their overall level of motor skills.

The role of physical activity promoting thinking skills and emotional behavior of preschool children

Objectives

Physical activity is critical, not only for the normal growth and development of children, but also for emotional and social behavior. The purpose of the article is to determine the relationship between physical education and social and emotional development of preschool children.

Methods

The study involved 366 children (188 boys and 178 girls) at the ages of 5 (N = 191) and 6 (N = 174), who study in public kindergartens in Beijing (China). Within 3 months, additional physical education and fitness classes were held. Before and after the study, a test was conducted: Ages & Stages Questionnaires: Social-Emotional (ASQ:SE), which was completed by the parents. The research process did not affect the performance or development of children participants.

Results

As a result of the study, the main regularities of the influence of physical education on social and emotional behavior of children were established. Based on the results of the study, it was determined that there is a positive correlation between age, physical education, and social-emotional behavior (r +—= 0.668).

Conclusion

Gender differences are not statistically significant when it comes to physical activity’s effect on social and emotional behavior (p-value = 0.004). The results can be applied to programs for the prevention of psychosocial and social-emotional development delays of children in kindergartens.

The COVID-19 Pandemic and Overall Wellbeing: Mediating Role of Virtual Reality Fitness for Physical-Psychological Health and Physical Activity

Background

Virtual reality applications are made for various objectives such as business, entertainment, education, and healthcare. Anxiety, phobias, distress, disordered eating, drug addiction, panic disorder, post-traumatic stress disorder, schizophrenia, bipolar disorder, psychosis, depression, and autism spectrum disorders may benefit from virtual reality-based approaches. The 2019 coronavirus (COVID-19) pandemic has impacted the way we live, enjoy, study, sport, and socialize significantly. Virtual reality fitness technology gained much attention during the COVID-19 preventive measures time.

Objective

The present study explores the role of virtual reality fitness in improving overall wellbeing during the COVID-19 pandemic home isolation period in terms of physical-psychological health and physical activity.

Methods

A total of 2300 individuals were recruited using the snowball sampling technique to participate in the study. The primary data were collected using an anonymous web-based survey. SPSS-23 and Smart-PLS 3.2.9 software were used to analyze the data.

Results

The direct path coefficient analysis of the study constructs show that virtual reality fitness has (preventive measures -> virtual reality fitness -> overall wellbeing, preventive measures -> virtual reality fitness -> physical exercise, and preventive measures -> virtual reality fitness -> physical health) profound effects on the research participants’ mental and physical wellbeing of the study participants while indirect mediation analysis shows that virtual reality fitness has (preventive measures -> virtual reality fitness ->overall wellbeing, preventive measures -> virtual reality fitness -> physical exercise, preventive measures -> virtual reality fitness ->physical health) significant impacts.

Conclusion

Our study results concluded that house exercises through virtual reality fitness are a good substitute for public gyms and private group fitness programs during the first pandemic wave for physical-psychological and overall wellbeing. Virtual reality fitness technology can alleviate many of the challenges brought on by the epidemic, resulting in increased utilization.

Usability and Effects of a Combined Physical and Cognitive Intervention Based on Active Video Games for Preschool Children

Executive functions (EFs) are essential for early childhood development, and effective programs to improve EFs in preschool education are becoming increasingly crucial. There is rising evidence that combined physical-cognitive intervention training utilizing active video games (exergames) could be a viable strategy to improve EFs. However, there is a shortage of empirical evidence on the application of this approach in preschool education. The effectiveness of exergame intervention training in preschools must be evaluated. This study conducted a randomized controlled trial to assess the effects of exergames intervention training on preschool children's EFs. A total of 48 participants aged 4-5 years were enrolled; 24 were randomly allocated to receive exergames physical activity training, and the remaining 24 received conventional physical activity training. After a four-week intervention, the children who received the exergames intervention training exhibited considerably greater gains in all three EFs tasks than children who received the conventional physical activity program. Follow-up interviews revealed that the children accepted the exergames well. The results demonstrate the viability of incorporating exergames into preschool education to improve children's EFs, supporting prior findings and offering more empirical evidence from early childhood research.

Active video game on children and adolescents' physical activity and weight management: A network meta-analysis

We synthesized evidence on the effectiveness of active video games (AVGs) versus no AVG-applied comparators on various physical activity (PA) levels and weight management outcomes in children and adolescents. We analyzed the comparative evidence on different sub-categories of AVGs and ranking the best option. An overview of systematic reviews (SRs) and network meta-analysis (NMA) (PROSPERO: CRD42021248499) was employed. A search for relevant literature published in English was conducted in six electronic databases from their inception until April 2021. SRs consisting of randomized control trials (RCTs) and satisfying our PICOS inclusion criteria were included. RCTs included were a comparison of groups among children and adolescents between 6 and 21, where groups with AVG interventions were compared with groups without them. Direct head-to-head pairwise meta-analyses were conducted using weighted mean difference between the two groups, and the comparative effectiveness of different sub-categories of AVGs was analyzed indirectly using NMA. Overall, 17 SRs were identified from the 6036 screened citations. Of these, 350 citations were retrieved, and 12 RCTs were finally included. Compared with no AVG group, AVG groups were shown to be more effective in achieving vigorous, moderate-to-vigorous, and moderate PA levels, and decreased BMI and body fat. NMA showed that rhythmic dance games had the highest probability of being the most effective sub-category for reducing BMI. AVGs are effective in attaining vigorous, moderate to vigorous, and moderate PA levels, and reducing BMI and body fat among children and adolescents. Dance appears to be the best option for reducing BMI among AVG subcategories.

Effects of cognitive-motor dual task training on cognitive and physical performance in healthy children and adolescents: A scoping review

Simultaneous dual- or multitasking training has been used in manifold ways to improve cognitive-motor performance in different age groups. Dual task (DT) training is assumed to improve both, single task (ST) motor and cognitive performance, but particularly, performance under dual tasking conditions. Further, DT interventions have been shown to be beneficial for motor skill learning and cognitive performance as well as academic achievements in children and adolescents. The aim of this scoping review was to summarize current evidence on different cognitive-motor interventions that practice motor and cognitive performance simultaneously in children and adolescents and to identify training regimes that are most effective to improve cognitive or motor performance in this target group.

METHODS

Four electronic databases were searched (Pubmed, MEDLINE, Web of Science and APA Psycinfo) until May 2021. Following the PRISMA guidelines, title, abstract, and full-text screening as well as quality assessment was done by two independent reviewers. Studies were eligible if they (1) were published in English or German language, (2) accessible as a full-text version, (3) included at least one group of children or adolescents with a mean age of 4 to 21 years, (4) used dual-tasks as part of the intervention, (5) conducted one or more training sessions, and (6) reported at least one cognitive or motor outcome. The main outcome measures were cognitive and motor as well as cognitive-motor DT performance. Due to the heterogeneity in the characteristics of the included studies, we designed this review as a scoping review.

RESULTS

Seven studies met the inclusion criteria (n = 543, age four to 14 years, 47.1% female). One study reported two intervention experiments. Studies differed in sample size (20-189) as well as in type of training (specific or general DT training) and dose (frequency: one session/week to 110 sessions within 22 weeks). Overall, task-specific improvements in physical and cognitive functions were found, but not consistently across all interventions. Two interventions out of five interventions that measured motor performance demonstrated improvement in that domain, especially in balance. Three out of five interventions that measured cognitive functions found improved cognition. Only one study examined DT performance post training but failed to gain significant improvements in comparison to a control group. Studies only occasionally integrated training principles like individualization or progression in the design of their intervention.

DISCUSSION

The results indicate that DT training interventions may improve physical and/or cognitive functions in children and adolescents. Best practice recommendations for training regimes cannot be derived as outcomes differed a lot and were not systematically assessed across studies. Future studies should integrate more principles of training monitoring and aspects like individualization and progression to provide ideal training control and achieve better DT training results. Further, more high-quality trials are needed that adhere to the previous concepts.

PSYCINFO CLASSIFICATION

2340 Cognitive Processes 2820 Cognitive & Perceptual Development. 3720 Sports.

Integrating Regular Exergaming Sessions in the ExerCube into a School Setting Increases Physical Fitness in Elementary School Children: A Randomized Controlled Trial

This study aimed to investigate the effects of a school-based exergame intervention on anthropometric parameters and physical fitness. Fifty-eight students (10.4 ± 0.8 years; 48% girls) were randomized into an intervention (IG) and a control (CG) group. Both groups participated in regular physical education classes during the three-month intervention period. The IG additionally received a 20-minute exergame intervention twice per week. At baseline and following the intervention period, body mass index (BMI) and waist-to-height ratio (WHtR) were assessed. Furthermore, a sprint test (ST), a countermovement jump test (CMJ), and a shuttle run test (SRT) were performed. Due to prescribed quarantine measures, only 34 students (18 IG; 16 CG) were included in the final analysis. A significant group−time interaction was determined in CMJ performance (p < 0.001; η2 = 0.403), with a significant increase (+2.6 ± 2.4 cm; p < 0.001; η2 = 0.315) in the IG and a significant decrease (−2.0 ± 3.1 cm; p = 0.009; η2 = 0.190) in the CG. Furthermore, ST performance significantly improved in the IG (−0.03 ± 0.08 s; p = 0.012; η2 = 0.180) but not in the CG (0.13 ± 0.16 s; p = 0.460; η2 = 0.017), revealing significant interaction effects (p = 0.02; η2 = 0.157). Significant group−time interaction was observed for the SRT (p = 0.046; η2 = 0.122), with a significant increase (+87.8 ± 98.9 m; p = 0.028; η2 = 0.147) in the IG and no changes (−29.4 ± 219.7 m; p = 0.485; η2 = 0.016) in the CG. Concerning BMI (p = 0.157; η2 = 0.063) and WHtR (p = 0.063; η2 = 0.114), no significant interaction effects were detected. School-based exergaming is a suitable tool to influence students’ physical fitness positively.

Effects of Exergaming on College Students' Situational Interest, Self-Efficacy, and Motion Sickness

Objective: Given the low levels of physical activity (PA) among U.S. college students, the use of exergaming as a supplement to traditional exercise may promote higher levels of motivation and PA. Therefore, this study’s purpose was to examine the effect of two different exergames on college students’ situational interest (SI), self-efficacy (SE), and equilibrium change (EQC) compared to traditional treadmill walking. Methods: Sixty college students (30 female; Mage = 23.6 ± 4.1 years; MBMI = 23.9 ± 4.0 kg/m2) participated in three separate 20 min exercise sessions: (1) Xbox 360 Kinect Just Dance; (2) Xbox 360 Kinect Reflex Ridge; and (3) traditional treadmill walking at 4.0 mph. Participants’ SI, SE, and EQC were measured after each session using a series of validated surveys. Results: A mixed model analysis of covariance (ANCOVA) with repeated measures evaluated mean differences between exercise sessions for all outcomes. Significant main effects were observed between the three exercise sessions (all p < 0.01). Specifically, Just Dance and Reflex Ridge sessions yielded significantly higher SI scores than treadmill exercise, F (10, 49) = 54.61, p < 0.01, η2 = 0.92. In addition, participants experienced significantly lower EQC in Reflex Ridge than in treadmill exercise, F (2, 58) = 4.26, p = 0.02, η2 = 0.13. No differences were identified for SE. Conclusion: The integration of exergaming into traditional exercise routines may help to promote higher levels of SI but not SE amongst college students. RR exergaming also demonstrated low EQC as compared to traditional exercise. Experimental study designs are warranted to provide additional evidence on the efficacy of exergaming.

Digital Intervention Strategies for Increasing Physical Activity Among Preschoolers: Systematic Review

Background

Digital interventions are increasingly used to improve health behaviors. Improved access and lower costs (relative to in-person interventions) make such interventions appealing. Specifically, digital platforms may be a promising approach for increasing physical activity (PA) in young children.

Objective

The goal of this systematic review was three-pronged: (1) to determine the quality of studies using digital PA intervention strategies with preschool-aged children (ie, 3 to 5 years old); (2) to assess the efficacy of digital interventions and approaches designed to improve PA in preschool-aged children; and (3) to examine theoretical application and implementation outcomes with current approaches to digital PA interventions.

Methods

This review identified and summarized studies on digitally supported interventions for promoting PA in preschool-aged children. We generated 3 lists of relevant search terms that included technology-related terms, PA-related terms, and weight-related terms. The search included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Study selection was led by a single author and verified by a second; the same 2 authors assessed study quality using a standardized tool, and 3 authors completed data extraction on PA outcomes, theory application, and implementation outcomes.

Results

In total, 601 studies were identified; 8 met the inclusion criteria. For study quality, only 2 studies received an overall rating of strong quality and low risk of bias. All but 1 study had a small sample size (<100). Positive and significant changes in child PA outcomes were reported in only 2 studies with weak overall quality, both of which used child-directed approaches. In total, 5 studies applied a behavioral theory for designing the intervention; no patterns of effectiveness were identified based on the application of theory. Finally, no studies reported on the implementation outcomes of adoption, cost, penetration, or sustainability; 1 study did not assess any implementation outcomes, and no single study reported on more than 2 implementation outcomes. Studies measured the implementation outcome of acceptability most frequently (n=4), and researchers assessed fidelity in 3 studies.

Conclusions

The interventions with a significant effect on PA used child-centered activities; parent-directed digital interventions alone were ineffective for improving PA. Future research with rigorous designs, monitoring of implementation outcomes, and testing of the contributions of digital components will advance understanding of the effectiveness of digital interventions for increasing PA in children.

Functional Training Focused on Motor Development Enhances Gross Motor, Physical Fitness, and Sensory Integration in 5-6-Year-Old Healthy Chinese Children

OBJECTIVE

Physical inactivity and sensory integration dysfunction are public health concerns among Chinese preschool children. The purpose of this study was to determine the efficacy of a novel functional training program focused on motor development for healthy children aged 5 to 6 years.

METHODS

A total of 101 healthy children aged 5 to 6 years in Tianjin were randomly assigned to the experimental group (N = 51), which received 12-week functional training featuring essential motor skills, whilst the control group (N = 50) continued with their kindergarten-based physical education curriculum. Test of Gross Motor Development-2, national physical fitness measurement, and sensory integration were evaluated before and after the intervention. Children's height, body weight, and the corresponding pre-intervention test scores were utilized as covariates to compare the post-intervention outcomes between the groups.

RESULTS

After the intervention, the experimental group scored considerably higher (P < 0.01) on the locomotor composite score, object control composite score, and overall gross motor score than the control group; the experimental group scored higher (P < 0.05) on the run, gallop, leap, stationary dribble, kick, striking a stationary ball, overhand throw, and underhand roll motor skill tests than the control group; the experimental group performed considerably better (P < 0.01) on the balance beam walking test and sit-and-reach test than the control group; and, the experimental group performed considerably better (P < 0.01) on the vestibular function, tactile defensiveness, and proprioception than the control group.

CONCLUSION

A 12-week functional training focused on motor development effectively enhanced gross motor, physical fitness, and sensory integration in 5-6-year-old healthy Chinese children.

The Dilemma of Analyzing Physical Activity and Sedentary Behavior with Wrist Accelerometer Data: Challenges and Opportunities

Physical behaviors (e.g., physical activity and sedentary behavior) have been the focus among many researchers in the biomedical and behavioral science fields. The recent shift from hip- to wrist-worn accelerometers in these fields has signaled the need to develop novel approaches to process raw acceleration data of physical activity and sedentary behavior. However, there is currently no consensus regarding the best practices for analyzing wrist-worn accelerometer data to accurately predict individuals' energy expenditure and the times spent in different intensities of free-living physical activity and sedentary behavior. To this end, accurately analyzing and interpreting wrist-worn accelerometer data has become a major challenge facing many clinicians and researchers. In response, this paper attempts to review different methodologies for analyzing wrist-worn accelerometer data and offer cutting edge, yet appropriate analysis plans for wrist-worn accelerometer data in the assessment of physical behavior. In this paper, we first discuss the fundamentals of wrist-worn accelerometer data, followed by various methods of processing these data (e.g., cut points, steps per minute, machine learning), and then we discuss the opportunities, challenges, and directions for future studies in this area of inquiry. This is the most comprehensive review paper to date regarding the analysis and interpretation of free-living physical activity data derived from wrist-worn accelerometers, aiming to help establish a blueprint for processing wrist-derived accelerometer data.

Investigating Relationships between Preschool Children's Perceived Competence, Motor Skills, and Physical Activity: A Cross-Lagged Panel Model

Background: Motor skill competence (MSC) and perceived competence (PC) are primary correlates that are linked with physical activity (PA) participation, yet there is limited evidence of the mutual longitudinal or temporal associations between these variables in preschoolers. Therefore, this study’s purpose was to examine the bidirectional relationships between MSC and PA, MSC and PC, and PC and PA in preschoolers over time. Methods: The final sample were 61 preschoolers (M_age = 4.45 years, ranging from 4 to 5) from two underserved schools. MSC was assessed using the Test of Gross Motor Development, Second Edition (TGMD-2). PC was assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children. PA was assessed using ActiGraph GT9X Link accelerometers during three consecutive school days. All assessments of MSC, PC, and PA were measured in identical conditions at schools at the baseline (T1) and the end of the eighth week (T2). We employed a cross-lagged model approach to understand the bidirectional relationships between MSC, PC, and PA. Results: The results showed that T1 MSC significantly predicted T2 MSC (p < 0.01) and T1 MSC significantly predicted T2 PA only in girls (p = 0.03). Additionally, a cross-lagged effect of T1 MSC and T2 PC was only observed in boys (p = 0.03). Lastly, a significant association for T1 moderate-to-vigorous physical activity (MVPA) and T2 PC was only observed in girls (p = 0.04). Conclusions: Bidirectional relationships between the variables were not observed in preschoolers. However, significant gender differences were observed in each cross-lagged model.

Protocol for a quasi-experimental study examining the effect of a ball skills intervention on four domains of preschooler development

Background:

Preschooler inactivity and insufficient motor development have serious long-term consequences. The Chinese Ministry of Education launched a nationwide football-focused pilot project aimed at kindergartens in 2019 and issued the policy “Notice on the Establishment of National Football Kindergartens” in 2020. However, the impact of fundamental movement skills (FMS) interventions on other aspects of child development is unclear.

Aim:

This study will evaluate the effects of ball skills physical education projects on the development of Chinese preschoolers’ physical, motor, cognitive, and social competencies and examine the influencing factors.

Method:

This is a quasi-experimental study evaluating how well the “Hello Sunshine” curriculum project promotes children’s development over 10 weeks. The trial will be conducted from September 2021 to November 2021 in 12 classes from 3 kindergartens with a total of 249 children aged 4 to 6 years in Haikou, China. Pre- and posttest analyses will include tests on participants’ physical fitness, FMS, cognitive self-regulation, and emotional competence. Participants’ background information will be collected through questionnaires answered by parents and teachers. The intervention will focus on game-based basic ball skills.

Findings:

If this intervention provides evidence that these skills improve children’s multidimensional development, it will support the promotion of similar programs in China. We will also outline the social-ecological factors affecting the intervention’s results, providing further information for improving pedagogical methods related to preschool ball skills.

Effects of Active Video Games on Health-Related Physical Fitness and Motor Competence in Children and Adolescents With Overweight or Obesity: Systematic Review and Meta-Analysis

Background

Childhood obesity is one of the most important public health problems. Active video games (AVGs) have been proposed as an attractive alternative to increase energy expenditure and are being investigated to determine their effectiveness against childhood obesity.

Objective

The aim of this study is to summarize the existing research and draw conclusions about the effects of AVGs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity.

Methods

The search strategy was applied to PubMed, MEDLINE, Web of Science, and SPORTDiscus, including randomized and nonrandomized controlled trials investigating the effects of AVG programs on health-related physical fitness and motor competence in children and adolescents with overweight and obesity. To measure the risk of bias in randomized and nonrandomized controlled trials, 2 different quality assessment tools were used. In total, 15 articles met the inclusion criteria, and the variables of interest were BMI, body fat percentage, cardiorespiratory fitness (CRF), waist circumference, fat-free mass, muscular fitness, and motor competence. A meta-analysis was performed.

Results

Positive effects were found for BMI and body fat percentage, favoring the AVG group compared with a control group with no intervention (mean difference −0.209; 95% CI −0.388 to −0.031 vs mean difference −0.879; 95% CI −1.138 to −0.602). Positive effects seem to be observed for CRF. The effects of AVG interventions on muscular fitness, fat-free mass, waist circumference, and motor competence are unclear.

Conclusions

AVG programs showed positive effects on BMI, body fat percentage, and CRF. AVG could be a good strategy to combat childhood obesity.

Application of an Online Combination Exercise Intervention to Improve Physical and Mental Health in Obese Children: A Single Arm Longitudinal Study

Introduction: Childhood obesity has become a global public health concern in the past decade. The purpose of this study was to explore the effectiveness of an online combination exercise intervention in improving the physical and mental health of obese children.

Methods: This study adopted a one-group pre-test and post-test research design. A total of 28 obese children from 6 elementary schools in Heze City, Shandong Province, China, were recruited. All participants received an 8-week online combination exercise intervention and were tested at a three-month follow-up. Participants were tested and surveyed regarding their demographic, feasibility, and obesity indicators using mental health and quality of life questionnaires. The data were statistically analyzed using a one-way analysis of variance with repeated measures.

Results: A total of 26 obese children (Mean_age = 10.15 years) completed the study. The retention rate was 92.9% for the entire trial (two obese children withdrew due to their inability to exercise) and no adverse events were reported. In addition, the obese children completed 25/32 (78.1%) of the online courses. After 8 weeks of the intervention, the changes in the body fat percentage of the obese children [mean difference (MD) = –3.126, p < 0.001, Cohen’s d = –1.777], thinking dimension score (MD = 1.654, p < 0.001, Cohen’s d = 0.603), total quality of life score (MD = 6.385, p < 0.05, Cohen’s d = 0.610), and work attitude dimension score (MD = 1.346, p < 0.001, Cohen’s d = 0.744) showed significant differences compared to the baseline. However, no significant differences were identified between the post-intervention and three-month follow-up measurements (p > 0.05), and we assumed that the intervention effect was maintained three months after the intervention.

Conclusion: An online combination exercise intervention is a safe and feasible option to improve the mental health and quality of life of obese children and may have long-term health benefits.

Bidirectional Relationships among Children's Perceived Competence, Motor Skill Competence, Physical Activity, and Cardiorespiratory Fitness across One School Year

Purpose

The bidirectional associations among children's motor skill competence (MSC), perceived competence (PC), physical activity (PA), and cardiorespiratory fitness (CRF) over time remain unanswered. This study is aimed at discerning the bidirectional relationships among elementary school children's MSC, PC, PA and, CRF over the course of one school year.

Methods

A total of 261 second and third grade children (127 boys, 134 girls; mean_age = 8.27 years; BMI = 18.22 ± 3.71) were recruited from two Texas elementary schools. Approximately 73.56% of participants were White American. Children's baseline data were assessed in September/October in 2012 (Time1), and identical assessments were conducted in April/May in 2013 (Time2). MSC was assessed using product-oriented skill tests (e.g., throw, kick, and jump). PC was assessed via the Pictorial Scale of Perceived Competence for Children. Minutes spent in moderate-to-vigorous PA (MVPA) was assessed using ActiGraph GT3X+ accelerometers for five days, and CRF was assessed by the PACER test. Six age- and body mass index-adjusted cross-lagged panel models were used to test the relationships between the variables.

Results

We observed that T1 MSC significantly predicted T2 MSC (β = 0.59; p < 0.01), T2 CRF (β = 0.28; p < 0.01), and T2 MVPA (β = 0.18; p < 0.01). Children's CRF was a positive predictor for T2 CRF (β = 0.56; p < 0.01) and T2 MSC (β = 0.13; p < 0.05) Additionally, T1 MVPA significantly predicted T2 MVPA (β = 0.30; p < 0.01) and T2 PC (β = −0.14; p < 0.05).

Conclusion

Findings suggested a fully bidirectional relationship between elementary children's MSC and CRF. Other bidirectional relationships among the variables were only partially supported. Educators and health professionals need to emphasize the importance of developing both MSC and CRF to maintain physical health over time.

Effectiveness of Smartphone-Based Physical Activity Interventions on Individuals' Health Outcomes: A Systematic Review

Design

A systematic review. Data Sources. 114 studies were gathered using the following search descriptors: (“mobile phone” OR “smartphone” OR “cell phone” OR “mobile device” OR “mobile apps” OR “mHealth”) AND (“exercise” OR “physical activity” OR “physical fitness” OR “motor activity”) AND (“physiological outcomes” OR “weight outcomes” OR “psychological outcomes” OR “health” OR “health behavior”). Seven databases were used including databases such as Academic Search Premier and PubMed. PRISMA guidelines were followed in this review. Eligibility Criteria for Selecting Studies. The 20 articles included in this review met the following inclusion criteria: (1) randomized and controlled trials, (2) involving an outcome variable measured by accelerometer, and (3) intervention enforced by a smartphone application.

Results

Overall, 56% of the studies reviewed in this paper resulted in successful interventions. Of the 19 articles that examined the first individual health outcome of physical and physiological outcomes, 11 interventions resulted in a positive effect on one of the following parameters: MVPA/step count, sedentary behavior, cardiorespiratory fitness, and blood pressure. Six interventions examined the effects on the second individual health outcome, weight-related outcomes. Five of these interventions observed significant positive effects from mobile application interventions on weight and waist circumference. Six articles evaluated the effectiveness of smartphone-based physical activity interventions on the third and final individual health outcome, psychological outcomes, with four resulting in significant positive outcomes in self-efficacy, life enjoyment/satisfaction, and intrinsic PA motivation.

Conclusion

The findings in this review suggest that mobile application physical activity interventions, compared to unguided exercise activities, can effectively improve certain health outcomes for individuals such as physical/physiological and weight-related outcomes. It was found that research in the area of effectiveness of mobile application interventions on specific psychosocial health outcomes such as self-efficacy, life enjoyment, and intrinsic PA motivation is limited. Thus, the effect of mobile health applications remains unclear for psychosocial outcomes. Due to this limitation, more research is warranted to confirm the findings of this review.

Changes in Chinese Adults' Physical Activity Behavior and Determinants before and during the COVID-19 Pandemic

Purpose: To investigate the changes in Chinese adults’ physical activity (PA) behavior and determinants before and during the COVID-19 pandemic. Method: A total of 1028 adults (aged 19–59 years) were recruited from 127 urban and rural neighborhoods in China using stratified three-stage probability sampling. Data collection was conducted in December 2019 and July 2020. Results: Compared with the data before the pandemic, individuals’ weekly moderate-to-vigorous-intensity PA (MVPA) decreased significantly from 139 min to 120 min, seven months after the outbreak (p = 0.01), with female and rural populations displaying a more significant decrease (p = 0.02). Overall, 13.7% of participants met the PA guidelines (World Health Organization) both before and during the pandemic, while 21.8% met the guidelines only before the pandemic and 18.1% increased their PA and met the PA guidelines during the pandemic. A total of 46.4% did not meet the PA guidelines before or during the pandemic. Determinants of PA behavior change before and during the pandemic included sports skills, self-determined motivation and support from sports organizations. Conclusions: The Chinese adults’ PA levels decreased significantly from before to during the COVID-19 pandemic, particularly among the female population. It is suggested that the enhancement of self-determined motivation, improvement of sport skills, and support from sports organizations might be effective in facilitating individuals’ engagement in PA during the pandemic.

The Effects of Active Video Games on Health-Related Physical Fitness and Motor Competence in Children and Adolescents with Healthy Weight: A Systematic Review and Meta-Analysis

(1) Background: Poor levels of physical fitness and motor skills are problems for today’s children. Active video games (AVG) could be an attractive strategy to help address them. The aim was to investigate the effects of AVG on health-related physical fitness and motor competence in children and adolescents with healthy weight. (2) Methods: Randomized and non-randomized controlled trials investigating the effects of AVG programs on health-related physical fitness and motor competence were included. Two different quality assessment tools were used to measure the risk of bias. Twenty articles met the inclusion criteria and the variables of interest were body mass index (BMI), body fat, cardiorespiratory fitness (CRF), muscular fitness and motor competence. (3) Results: AVG interventions seem to have benefits in BMI when lasting longer than 18 weeks (SMD, −0.590; 95% IC, −1.071, −0.108) and in CRF (SMD, 0.438; 95% IC, 0.022, 0.855). AVG seems to be a promising tool to improve muscular fitness and motor competence but the effects are still unclear due to the lack of evidence. (4) Conclusions: AVG seem to be an effective tool for improving some components of health-related physical fitness and motor competence in healthy-weight children and adolescents, but the effect on some fitness components needs further research. Therefore, AVG may be included as a strategy to improve health.

Effect of a 6-Week Physical Education Intervention on Motor Competence in Pre-School Children with Developmental Coordination Disorder

The objective of this research was to analyze the impact of an intervention program performed by a specialist in physical education (PE) to contribute to the development of motor competence (MC) in pre-school children with motor development problems. The sample consisted of 28 children (12 from the intervention group and 16 from the control group) aged between 4.1 and 5.9 years (mean = 4.71 ± 0.54) who were in the fifth and sixth grades of pre-school education in two schools from Lugo, Spain. The Movement Assessment Battery for Children-2 (MABC-2) was used for data collection. The data revealed that, in the pre- and post-test intervention groups, there are statistically significant differences in manual dexterity (p < 0.001; d = 2.63), aiming and catching (p < 0.002; d = 1.13), balance (p < 0.001; d = 1.68), total test score (p < 0.001; d = 3.30) and total percentile score (p < 0.001; d = 1.88). Between the control and intervention post-test groups, significant differences were found in manual dexterity (p = 0.015; η²&nbsp;= 0.22), aiming and catching (p = 0.003; η²&nbsp;= 0.32), balance (p = 0.050; η² = 0.15), total test score (p < 0.001; η² = 0.47) and total percentile score (p < 0.001; η² = 0.48). Based on the results obtained, a specific MC program implemented by a PE specialist contributed to the improvement of manual dexterity, aiming and catching and balance, as well as a better percentile in the general MC of pre-school children diagnosed with motor skill problems.

Relationships between College Students' Sedentary Behavior, Sleep Quality, and Body Mass Index

PURPOSE

Sedentary behavior (SB), sleep efficiency (SE), sleep duration (SD), and body mass index (BMI) are crucial determinants of an individual's health. However, empirical evidence regarding associations between these factors in young adults living in China remains unknown. Therefore, the purpose of this study was to examine the relationships between accelerometer-measured SB, SE, SD, and BMI in Chinese college students.

METHODS

Two-hundred and twenty college students (115 females, Meanage = 20.29 years, SD = 2.37) were recruited from a south-central Chinese university. Participants' SB (daily % time spent in SB), SE (number of minutes of sleep duration/number of minutes in bed), and SD were assessed via wrist-worn ActiGraph GT9X Link accelerometers for one week. Body weight was measured using a digital weight scale, height was measured using a stadiometer, and BMI was calculated as weight (kg)/height (m2).

RESULTS

Participants' average time spent in SB was 76.52% (SD = 10.03), SE was 84.12% (SD = 4.79), and BMI was 20.67 kg/m2 (SD = 3.12), respectively. Regression analyses indicated that SB (β = -0.17, p = 0.01) and BMI (β = -0.20, p < 0.01) negatively predicted SE. In addition, BMI negatively predicted SD (β = -0.22, p < 0.01).

CONCLUSION

Prolonged SB (e.g., screen viewing, smartphone use, and computer playing) and higher BMI may link to shorter sleep duration and lower sleep efficiency in Chinese young adults. Future randomized controlled trials are needed to further confirm these findings. Given that increased BMI status and SB may relate to adverse health outcomes, more population-based intervention strategies seeking to lower BMI and reduce SB (e.g., nutrition education and physical activity promotion) are needed in this population.

Additional Exergames to Regular Tennis Training Improves Cognitive-Motor Functions of Children but May Temporarily Affect Tennis Technique: A Single-Blind Randomized Controlled Trial

This study evaluated the effects of an exergame program (TennisVirtua-4, Playstation Kinect) combined with traditional tennis training on autonomic regulation, tennis technique, gross motor skills, clinical reaction time, and cognitive inhibitory control in children. Sixty-three children were randomized into four groups (1st - two exergame and two regular trainings sessions/week, 2nd - one exergame and one regular training sessions/week, 3rd - two regular trainings sessions/week, and 4th - one regular training session/week) and compared at baseline, 6-month immediately post intervention and at 1-year follow-up post intervention. At 6-month post intervention the combined exergame and regular training sessions revealed: higher breathing frequency, heart rate (all ps ≤ 0.001) and lower skin conductance levels (p = 0.001) during exergaming; additional benefits in the point of contact and kinetic chain elements of the tennis forehand and backhand technique (all ps ≤ 0.001); negative impact on the shot preparation and the follow-through elements (all ps ≤ 0.017); higher ball skills (as part of the gross motor skills) (p < 0.001); higher percentages of clinical reaction time improvement (1st -9.7% vs 3rd group -7.4% and 2nd -6.6% vs 4th group -4.4%, all ps ≤ 0.003) and cognitive inhibitory control improvement in both congruent (1st -20.5% vs 3rd group -18.4% and 2nd -11.5% vs 4th group -9.6%, all ps ≤ 0.05) and incongruent (1st group -19.1% vs 3rd group -12.5% and 2nd group -11.4% vs 4th group -6.5%, all ps ≤ 0.001) trials. The 1-year follow-up test showed no differences in the tennis technique, clinical reaction time and cognitive inhibitory control improvement between groups with the same number of trainings per week. The findings support exergaming as an additional training tool, aimed to improve important cognitive-motor tennis skills by adding dynamics to the standardized training process. Caution should be placed to planning this training, e.g., in a mesocycle, since exergaming might decrease the improvement of specific tennis technique parts of the trainees. (ClinicalTrials.gov; ID: NCT03946436).

Effects of Interactive Videogames on Postural Control and Risk of Fall Outcomes in Frail and Pre-frail Older Adults: A Systematic Review and Meta-Analysis

Background: Interactive videogames (IVGs) have been used to reduce risk of falls in the older adult and improve postural control (PC) outcomes. Objective: To systematically review trials that examine whether IVGs training is effective in improving PC and managing falls in frail and pre-frail older adults. Data Sources: Four databases were searched, Scopus, Web of science, PubMed, and MEDLINE, from January 2007 to March 2019. Eligibility Criteria: Frail and pre-frail older adults aged 65+. Interventions were any Nintendo^® Wii™ training. The outcome measures were PC and risk of falls as measured by any validated outcome measure. Studies Appraisal Method: The PEDro (Physiotherapy Evidence Database) scale and Cochrane risk-of-bias tool were used by two independent authors. Results: Eleven papers were included, involving 388 participants, with a mean age of 79 ± 5.7 years. The mean duration of IVGs sessions was 8.8 ± 3.8 weeks, the mean total number of sessions was 20 ± 11.1 session, and the mean length of training was 44 ± 15.7 minutes. Meta-Analysis: IVGs achieved better results compared with traditional exercises and control on the Berg Balance Scale (mean difference [MD] 2.80; 95% confidence interval [CI] 1.21 to 4.39; P < 0.001; I² = 16%), as well as in the short term on Timed Up and Go (MD -1.23; 95% CI -2.37 to -0.09; P = 0.03; I² = 0%). Limitation: Definitive judgement could not be made due to the variability in training, training duration and outcomes measurement. Conclusion: IVGs is a promising modality that has a positive effect on PC but not on the outcome of falls, so it should be prescribed with caution among frail older adults. Systematic Review Registration: PROSPERO registration number: CRD42019129611.

Small-Groups Versus Full-Class Exergaming on Urban Minority Adolescents' Physical Activity, Enjoyment, and Self-Efficacy

BACKGROUND

The effects of school-based exergaming interventions on adolescents' physical activity (PA) and psychosocial outcomes have been mixed. Researchers speculate this may be attributed to design issues. Therefore, this study examined differences in urban minority adolescents' PA, enjoyment, and self-efficacy during small-groups and full-class exergaming.

METHODS

Forty-seven urban minority adolescents (83% black; X¯age=11.8+1.3 y) completed two 15-minute exergaming sessions on the Xbox One Kinect Just Dance: (1) small groups (n = 3-4) and (2) full class (n = 23-24). Participants' time in sedentary behavior, light PA, and moderate to vigorous PA and steps were retrieved from ActiGraph GT3X+ accelerometers with enjoyment and self-efficacy assessed using validated surveys.

RESULTS

Participants spent significantly more time in sedentary behavior (5.9 [5.2] min vs 3.5 [2.7] min, respectively: P < .001, d = 0.57) and less time in moderate-to-vigorous PA (2.1 [2.8] min vs 5.5 [2.2] min, respectively: P < .001, d = 0.85) during the full-class versus the small-groups session. Moreover, small-groups exergaming resulted in significantly higher steps than the full-class exergaming (504.2 [132.1] vs 387.8 [122.1], respectively: P = .01, d = 0.50) and significantly greater enjoyment (3.5 [1.1] vs 3.2 [1.0], respectively: P = .02, d = 0.37). There were no significant differences between sessions for time in light PA and self-efficacy.

CONCLUSIONS

Small-groups exergaming appears ideal for promoting enjoyable PA at higher intensities and lower sedentary time in underserved minority adolescents.

Effects of Physical Activity on Children's Motor Skill Development: A Systematic Review of Randomized Controlled Trials

Objective

This systematic review synthesized current randomized controlled trials (RCTs) examining casual evidence regarding the effects of traditional and exergaming-based physical activity (PA) interventions on motor skill development in typically developed children (i.e., those aged 6-12 years).

Methods

We adhered to the PRISMA-P statement and searched electronic databases (Medline, PsycInfo, Web of Science, PubMed, ERIC, Scopus, and SportDiscus) from inception through July 2020. We screened for peer reviewed RCTs published in English between 2000 and 2020 examining the effect of PA on motor skill development in healthy children.

Results

A total of 25 RCTs were included, 20 (80%) of which reported significant improvements in children's motor skill performance. Specifically, 18 studies examined traditional PA interventions and 7 studies examined exergaming-based PA interventions, 83% and 71% of which observed statistically significant improvements in children's motor skill development, respectively.

Conclusions

Findings support the causal evidence regarding the effects of PA on motor skill development in children. Notable limitations of this review included heterogeneity of measurement protocols and assessment tools used to test children's motor skills across studies, a wide range of PA intervention dose across studies, and the lack of power analyses and long-term follow-up assessments in individual studies to discern appropriate sample sizes and long-term effectiveness, respectively. To further strengthen the evidence in this emerging field, we advocate for future RCTs to employ a priori power analyses, long-term follow-up measurements, and more exergaming-based interventions to allow for comparisons with traditional PA interventions, to explore the dose response and moderating relationships between PA and motor skill development in childhood, and to utilize homogenous assessment instruments to allow for more rigorous, quantitative syntheses.

The Effects of Physical Activity and Exergaming on Motor Skills and Executive Functions in Children with Autism Spectrum Disorder

Objective: This study aims at investigating the effects of two types of interventions, Sports, Play and Active Recreation for Kids (SPARK) and exergaming (Kinect), on motor skills (MS) and executive functions (EF) in children with autism spectrum disorder (ASD). Materials and Methods: Sixty children, aged 6-10 years were randomly assigned to SPARK (n = 20), Kinect (n = 20), or a control group (n = 20). Children's MS and EF were assessed before and after the intervention. The SPARK and Kinect groups participated in an 8-week intervention; the control group received treatment as usual. Intention-to-treat repeated-measures ANOVA was used to examine the effects of the intervention. Results: For MS, a significant group X time interaction was observed for aiming and catching skills [F(2, 53) = 4.12, P < 0.05]; the SPARK group improved significantly from pre- to post-test compared with the other groups. For EF, a main effect of group was found for correct responses [F(2, 53) = 5.43, P < 0.01]. The Kinect group showed more correct responses than the SPARK and control groups. A main effect of time was significant for conceptual responses [F(1, 53) = 10.61, P < 0.01] and perseverative errors [F(1, 53) = 14.31, P < 0.01]. Conclusion: This study suggests that structured physical activity (PA) interventions that target specific MS improve motor function in children with ASD and exergaming could be effective for improving EF. Future research is needed to untangle the interaction between the type of exercise, traditional PA versus exergaming, and the dose associated with improvements in MS and EF in children with ASD.

A Follow-Up Study of Motor Skill Development and Its Determinants in Preschool Children from Middle-Income Family

We tracked the motor skill development of young children aged 3–6 years and investigated the influence of middle-income home environment on the development of motor skill. 268 children were selected from kindergartens in Beijing. The Test of Gross Motor Development (TGMD) tool was used to test the development of locomotor and object-control skills (LS and OS), and a survey of children's behaviour and home environment was conducted. During the follow-up, the LS and OS of children aged 3–6 years continued to grow, with an annual growth rate of 20% and 30%. Five LS indicators and two OS indicators were significantly higher in the 3–4-year group than in the 4–5 and 5–6-year groups (p < 0.01). The age-sex trend model showed that girls' locomotor skill developed at a significantly higher rate than that of boys (β = 6.3004 and 4.6782, p < 0.001). Three-year-old boys performed significantly better than girls on object-control motor skill (p < 0.05). Factors affecting the rate of children's motor skill development in middle-income families included the frequency of playing with friends (β = 0.133, p = 0.032) and the frequency of bicycling, skateboarding, dancing, running, and jumping (β = 0.041, p = 0.042). Family income, parents' education level, and family activity area did not significantly affect the growth rate of motor skills. For middle-income families, the improvement of material environment at home like more playing spaces and toys did not speed up the motor development, while more opportunities to play with friends and engage in a variety of sports activities could promote children's motor skill development.

Hedonic and Utilitarian Motivations of Home Motion-Sensing Game Play Behavior in China: An Empirical Study

As an important branch of video games and the integration of emerging motion-sensing technology, home motion-sensing games cannot only bring hedonic entertainment but also promote utilitarian benefits including exercise and social interaction for people to improve their physical and psychological health. As one of the most populous countries in the world, China has the largest number of households in the world but quite a low home game penetration rate due to the 13 year game industry winter for international enterprises. Whether Chinese customers have the intention of using motion-sensing games to improve their health status in the home environment will directly determine the commercial potential of the relevant industry in the Chinese market. In order to understand the motives of users and explore the market possibility and prospects of the game industry, this study adopts empirical research and structural equation modeling to construct a motivation model of Chinese consumers toward motion-sensing gameplay behavior in the household environment. We distributed 515 questionnaires to conduct a survey; 427 valid responses have been received, and 203 data, which meet the inclusion criteria of the required game experience, have been analyzed by SPSS25.0 and AMOS25.0. A structural equation model for the gameplay motivation has been constructed. The result shows that the three functional motivators, exercise (Path efficient = 0.40, p < 0.01), entertainment (Path efficient = 0.27, p < 0.01), and social interaction (Path efficient = 0.36, p < 0.01) of home motion-sensing games have a significantly positive impact on the user's intention to play. Furthermore, the diversity and the time-and-place flexibility variables exert an important positive influence on the users' gameplay behavior through their effects on the three main functional motive variables. To sum up, (1) exercise, (2) entertainment, and (3) social interaction are the main functional motivations of the Chinese consumers' gameplay behaviors; (4) diversity and (5) time-and-place flexibility are the two main attribute motivators. The acceptance of Chinese users for home motion-sensing games remains positive and high. The motion-sensing game industry has broad market prospects in China through its potential in promoting consumer's wellness and health in the home environment.

Sweat, Sit, Sleep: A Compositional Analysis of 24-hr Movement Behaviors and Body Mass Index among Children with Autism Spectrum Disorder

This study (a) examined the daily composition of 24-hr movement behaviors in children with ASD using objective measures, and (b) applied compositional analysis to examine the associations of the time spent in moderate-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep duration (SD) with body mass index (BMI), relative to the time spent in the other movement behaviors in a sample of children (aged 7-19 years) with ASD. Time spent in MVPA, LPA, SB, and SD were measured using accelerometers over a 7-day period. BMI was calculated from measured height and weight. Participants (n = 46) spent 40% of time in LPA (M = 9.6 hr), 30.6% (M = 7.34 hr) in SB, 24.9% (M = 5.98 hr) asleep, and 4.5% (M = 64.8 min) in MVPA. Reallocating 30 min from LPA to SD decreased BMI by 0.471 kg/m² (P = 0.003). Reallocating 30 min from MVPA to SD decreased BMI by 0.658 kg/m² (P = 0.051). Reallocation of 60 min in equal proportions from SB, MVPA, and SD to LPA increased BMI by 0.418 kg/m² (P = 0.021), and reallocation of 60 min in equal proportions from LPA, MVPA, and SD to SB increased BMI by 0.295 kg/m² (P = 0.052). Finally, reallocation of 60 min in equal proportions from SB, LPA, and MVPA to SD decreased BMI by -0.845 kg/m² (P = 0.001). LAY SUMMARY: Data was collected on time spent in light physical activity (LPA), moderate-vigorous physical activity (MVPA), sedentary behavior (SB), and sleep in 46 children with autism. The sample had insufficient sleep (a mean of 6 hr/night). We showed that replacing 30 min of LPA or MVPA with sleep decreased BMI. Also, moving 60 min to LPA or SB from the remaining movement behaviors (i.e., 20 min from each) increased BMI, and moving 60 min to sleep from the remaining behaviors decreased BMI.

Effect of Active Video Games on Healthy Children's Fundamental Motor Skills and Physical Fitness: A Systematic Review

Objective: The present study aimed to synthesize the most updated literature regarding the casual evidence of the effects of active video games (AVGs) on fundamental motor skills (FMS; locomotor skills and object control skills) and physical fitness among healthy children. Methods: Electronic databases were searched through October 2020. Peer-reviewed randomized control trials (RCTs) and quasi-experimental designs examining the effectiveness of AVGs on FMS and physical fitness development among healthy children (3-12 years) were screened. Results: A total of nine RCTs and one quasi-experimental study were included. Of the five studies examining the effect of AVGs on FMS, two reported significant improvements, while three reported no significant improvements in motor skills development as compared to control. Of the five studies assessing the effects of AVGs on physical fitness, four reported significant improvements in physical fitness such as balance, agility, and speed, whereas one reported significant improvements in skill-related executive function, but not in physical competence. Conclusions: Overall, the current available evidence supports AVGs as an effective means to improve physical fitness, such as balance, postural stability, and agility, among healthy children. However, the findings of AVGs on healthy children's object control and locomotor skills remain inconclusive.