Childhood aerobic fitness predicts cognitive performance one year later

Outdoor recess is associated with more positive attitudes toward physical activity among pre-adolescent students and their parents

Introduction

School day structure has the potential to increase students' physical activity (PA) levels and form positive attitudes about PA. Including various PA opportunities and free play possibilities in the school schedule, especially outdoor recess, can improve students' moderate-to-vigorous PA (MVPA) levels during school time. Therefore, the main aim of the study was to investigate students' and their parents' attitudes about outdoor recess and PA opportunities in schools with different recess opportunities.

Methods

Students from grades three to six (9-13-year-olds) and their parents responded to a questionnaire about the effect of outdoor recess and opportunities for PA during the school day. Schools were divided into three groups based on the recess opportunities during the school day: (1) "outdoor recess", (2) "outdoor recess on some days", (3) "indoor recess".

Results

Students and parents of the "outdoor recess" group had significantly more positive attitudes about outdoor recess and PA opportunities in school. Students of the "outdoor recess" group stated being significantly more active during their leisure-time compared to other groups. Parents of the "outdoor recess" group stated that the school has asked their opinion regarding PA opportunities during the school day significantly more compared to the other two groups.

Discussion

These findings emphasize the positive effect outdoor recess can have on students' PA beliefs and habits. Parents of the "outdoor recess" group also had more positive attitudes toward PA which is important as parents most likely convey their attitudes and beliefs to their children. In addition, involving and informing parents is critical when changing the school schedule and introducing new school culture, to make the changes last.

Association between BMI and health-related physical fitness in adolescents with hearing impairment in China: a cross-sectional study

Background

This cross-sectional study aimed to address a critical gap in the understanding of the association between body mass index (BMI) and physical fitness levels in adolescents with hearing impairment (HI) in China. This study investigated how different BMI levels impact the physical fitness index (PFI) of HI adolescents.

Methods

This study employed a physical fitness test for HI adolescents attending special education schools. The test included eight components: height, weight, 50-m sprint, standing long jump, sit and reach, endurance run, bent-knee sit-up (for girls), and pull-up (for boys). Test scores for each student were standardized by age and gender. Individual Z-scores were then calculated, and the sum of these Z-scores constituted the PFI. Logistic regression was used to analyze the relationship between BMI and PFI across different gender and age groups. Statistical significance was set at P < 0.05.

Results

The linear regression model showed an inverted U-shaped relationship between BMI and PFI. At the same BMI level, boys exhibited superior physical fitness compared to girls with the same BMI (P < 0.05). Statistically significant differences in PFI levels were observed between normal-weight and obese males, as well as between underweight and obese boys (P < 0.05). In the 13-15 and 16-18 age groups, the increase in BMI has a greater impact on boys PFI than on girls.

Conclusions

Adolescents with HI generally demonstrated good physical fitness. Compared to individuals with normal weight, those who were underweight, overweight, or obese exhibited lower levels of physical fitness. Future interventions should focus on adolescents with HI with abnormal BMI.

Cross-sectional association between frequency of vigorous physical activity and academic achievement in 214,808 adolescents

Background

This study explores the intricate link between vigorous physical activity and academic achievement in adolescents. By analyzing data from the Health Behaviour in School-aged Children (HBSC) survey, it seeks to understand how engaging in high-intensity physical activities influences academic achievement.

Methods

A comprehensive cross-sectional analysis was conducted on a vast dataset comprising 214,808 adolescents aged 11, 13, and 15 years. The frequency of vigorous physical activity was determined through self-reports, while academic achievement was assessed based on students' self-perceptions, reflecting their understanding of teachers' evaluations of their academic performance.

Results

Adolescents who reported engaging in vigorous physical activity daily were more likely to report higher academic achievement. This positive correlation was consistent across various demographic groups, including different age cohorts and both genders, indicating a universal benefit of regular vigorous physical activity on perceived academic success.

Conclusion

The findings of this study underscore the significant role that regular vigorous physical activity plays in the academic lives of adolescents. The correlation between daily vigorous physical activity and enhanced self-reported academic achievement suggests that encouraging high-intensity physical activities in schools could be a key strategy in boosting educational outcomes.

Longitudinal Associations of Body Fatness and Physical Fitness with Cognitive Skills in Preschoolers

A good cognitive status predicts academic, professional, and health outcomes. However, longitudinal data regarding the associations of body fatness, physical fitness, and cognition are relatively scarce and mixed. The purpose of this longitudinal study was to investigate whether body fatness, cardiorespiratory fitness (CRF), and muscular fitness (MF) in preschool are associated with cognitive skills in the first grade of school. A total of 133 South Estonian children whose age was 6-7 years were recruited from 13 kindergartens and again at 7-8 years after they had entered school. Body fat percentage (BF%), CRF, MF as the mean of z-scores of relative upper-limb strength, standing long jump results, and cognitive skills (verbal, conceptual, and perceptual) were studied. There were no associations between BF% and CRF in preschool with perceptual, conceptual, or verbal skills in school in boys and girls. In boys, a higher MF in preschool was associated with higher verbal skills (β = 0.293, p = 0.021) in school after adjustment for confounders. Cognitive skills at baseline seemed to be frequently associated with cognitive performance in school. In conclusion, higher MF in preschool was associated with better verbal skills in the first grade of school in boys but not in girls. Body fatness and cardiorespiratory fitness in preschool were not associated with cognitive skills in school.

Independent and joint associations of aerobic and muscle-strengthening exercise with mental health in adolescents: A cross-sectional analysis before and during COVID-19 using the 2015-2021 National Youth Risk Behavior Survey

PURPOSE

COVID-19 led to social isolation that may have compromised adolescent mental health. This study examined the independent and joint associations of aerobic physical activity (PA) and muscle-strengthening exercise (MSE) with mental health problems in adolescents.

METHODS

Participants were US adolescents who completed the 2015-2021 National Youth Risk Behavior Survey (N = 61,298; 45.7% female). Data were collected between 2015 and 2021 and analyzed in 2023. Outcomes were binary response items asking about feeling sad/hopeless, having difficulty concentrating, remembering, or making decisions, and having a suicidal ideation. Preventive exposure variables were items asking about frequencies of aerobic PA and MSE with responses dichotomized to align with recommendations. Independent and joint associations were examined using robust Poisson regression with covariates selected using double selection lasso. Structural equation models examined the associations treating PA and MSE as continuous predictors and poor mental health as a latent dependent variable.

RESULTS

Meeting either recommendation alone associated with a 4-10% lower prevalence of mental health problems (APR = 0.90-0.96, p < 0.05), and meeting both recommendations associated with a 15%-20% lower prevalence of mental health problems (APR = 0.80-0.85, p < 0.001). Although categorical joint associations were stronger in males (p < 0.05), multiplicative interactions were observed in females using continuous variables for PA and MSE (β = -0.09, p < 0.001).

CONCLUSION

Meeting aerobic PA and MSE recommendations associated with lower prevalence of mental health problems. Participation in MSE below recommended levels may be beneficial for females when combined with aerobic PA. Future research should examine these associations by acquiring contextual information and device-based assessments.

Exercise Reshapes the Brain: Molecular, Cellular, and Structural Changes Associated with Cognitive Improvements

Physical exercise is well known as a non-pharmacological and holistic therapy believed to prevent and mitigate numerous neurological conditions and alleviate ageing-related cognitive decline. To do so, exercise affects the central nervous system (CNS) at different levels. It changes brain physiology and structure, promoting cognitive improvements, which ultimately improves quality of life. Most of these effects are mediated by neurotrophins release, enhanced adult hippocampal neurogenesis, attenuation of neuroinflammation, modulation of cerebral blood flow, and structural reorganisation, besides to promote social interaction with beneficial cognitive outcomes. In this review, we discuss, based on experimental and human research, how exercise impacts the brain structure and function and how these changes contribute to cognitive improvements. Understanding the mechanisms by which exercise affects the brain is essential to understand the brain plasticity following exercise, guiding therapeutic approaches to improve the quality of life, especially in obesity, ageing, neurodegenerative disorders, and following traumatic brain injury.

Physical activity interventions have a moderate effect in increasing physical activity in university students-a meta-analysis

INTRODUCTION

The transition to college is associated with changes in physical activity. This meta-analysis aims to quantify the effect of interventions on increasing physical activity in healthy university students.

METHODS

We conducted a literature search (up to 2/3/2020) to identify randomized controlled trials with healthy undergraduate or graduate students enrolled in a college degree program. Moderator analyses were conducted to examine the effects of intervention modality delivery (delivered in-person or remotely) and the type of outcome measure (self-report or objective measures).

RESULTS

18 publications were included. Interventions had a medium effect on physical activity (Cohen's d = 0.52). Moderator analyses revealed no differences.

CONCLUSION

Suggestions of how to improve the quality of physical activity intervention studies in college students are given. The moderate effect size of physical activity interventions in college students highlights the importance of developing and testing new interventions to promote physical activity in emerging adults.

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1998070 .

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.

Comparison Between Cardiorespiratory Fitness and Functions of Cognitive Control in Adolescents: A Tracking Study of 3 Years

PURPOSE

Compare tracking groups with cognitive control functions and plasma brain-derived neurotrophic factors concentrations from childhood to adolescence.

METHODS

This is a prospective study with 3 years of follow-up. At baseline, data from 394 individuals were collected (11.7 y), and data were obtained from 134 adolescents (14.9 y) at the 3-year follow-up. At both time points, anthropometric and maximal oxygen uptake data were collected. Cardiorespiratory fitness (CRF) groups were classified into high or low CRF. At follow-up, cognitive outcomes were collected via the Stroop and Corsi block test; plasma brain-derived neurotrophic factors concentrations were also analyzed.

RESULTS

Comparisons demonstrated that maintaining high CRF over 3 years results in shorter reaction time, better inhibitory control, and higher working memory values. Likewise, the group that moved from low to high CRF over 3 years presented better reaction time. Plasma brain-derived neurotrophic factors concentrations were higher for the group that increased its CRF over the 3 years in relation to the low-low group (90.58 pg·mL-1; P = .004). However, after scaling by an allometric approach, differences were only found for reaction time and working memory between high-high and high-low groups.

CONCLUSION

Maintaining high CRF over 3 years was positively related to reaction time and working memory in relation to adolescents that decreased their levels of CRF.

Impact of Overtraining on Cognitive Function in Endurance Athletes: A Systematic Review

BACKGROUND

Endurance sports require significant training loads to elicit the desired training effects on an athlete's body. However, if adequate recovery is not provided, overtraining may occur, with corresponding decrements in performance. As such, there is a need for measures that can be tracked, to monitor athlete adaptation to training loads, and provide early warning of possible maladaptation. The aim of this review was to determine if a relationship exists between overtraining and cognitive function in endurance athletes.

METHODS

A systematic search of AMED, MEDLINE, SPORTDiscus and APA PsycINFO was conducted. Eligibility criteria included original peer reviewed research, written in English, published between January 2000 and May 2022, and using human participants. Of the 221 articles screened, a total of seven studies met the inclusion criteria and were included in this review.

RESULTS

The findings of the review suggest that there is a relationship between overtraining and cognitive function with all seven studies finding that cognitive performance declined in response to athletes becoming overreached or overtrained. These studies found that reaction time (as measured by Stroop colour test) increased in response to both overreaching and overtraining.

CONCLUSIONS

Cognitive function tests such as the Stroop Colour Test could be included as part of a broader programme for monitoring athlete adaptation to training.

Effects of a Summer Physical Activity Program on Fitness and Cognitive Function among Children from Low Socioeconomic Households

During the summer months, school aged children experience a loss in academic gains made over the course of the school year, as well as engage in poorer health behaviors such as decreased physical activity and poor diet that can lead to excess weight gain. This study aimed to assess changes in body composition, fitness, and cognitive abilities in children from low-income households after a summer physical activity program and explored whether time spent in moderate to vigorous physical activity (MVPA) was related to these changes. Participant's (N = 77) body composition, aerobic fitness (i.e., PACER), and cognitive function (i.e., modified flanker task) were measured during week 1 and week 3. MVPA was collected via hip accelerometer worn during program hours. Paired t-tests and regression analyses were conducted to determine changes between week 1 and 3, whether participation was related to changes in fitness, adiposity, and cognitive function. T-tests revealed significant changes in PACER score (10.71 ± 7.72 to 13.301 ± 10.68; p < 0.001) and incongruent accuracy on the flanker task (65.94% ± 23.83 to 69.00% ± 21.89; p < 0.006), however no significant change in BMI-for-age percentile or body fat percentage was detected. Additionally, regression analyses revealed no significant relationship between change in MVPA or attendance, and changes in PACER, flanker task performance, BMI, or body fat percentage. Children that participated in a summer physical activity program targeted toward children affected by poverty exhibited significant improvements in cardiorespiratory fitness and cognitive abilities, and no changes in body composition.

Exploring the Relationship between Cardiorespiratory Fitness and Executive Functioning in Adults with ADHD

OBJECTIVE

Associations between measures of executive functioning (EF) and cardiorespiratory fitness (CRF) were examined for adults with and without ADHD.

METHOD

Measures of executive functioning including the Stroop task, Wisconsin Card Sorting task, and Operation Span Task were completed virtually (n = 36 ADHD; n = 36 Control). Participants completed the Six-Minute Walk Test to estimate CRF.

RESULTS

Mean performance measures of executive function did not differ by group. However, higher estimated CRF was associated with better Stroop task performance, and the association was strongest for individuals with ADHD.

CONCLUSION

In adults with ADHD, higher estimated CRF was associated with better inhibitory control, but not with other measures of executive functioning.

Exploring the Mediating Role of Executive Function in the Relationship between Aerobic Fitness and Academic Achievement in Adolescents

(1) Background: The performance of physical activity at a sufficient volume can result in improvements in fitness. Aerobic fitness is a particular aspect of fitness that has consistently been shown to be related to both cognitive performance and academic achievement. Cognitive performance, particularly executive function, is itself predictive of academic achievement. It has been hypothesized that the benefits of aerobic fitness for academic achievement are due to improvements in executive function. This study explores the mediating role of cognitive performance on the relationship between physical fitness and academic achievement in high-school-aged adolescents. (2) Methods: High school students (N = 283, 127 male, 156 females, mean age = 16.05 years, SD = 0.41) performed a shuttle run test to assess aerobic fitness and completed the Stroop Color, Stroop Word, and Stroop Color–Word tests to measure information processing and inhibition. They also completed the National Union Academic Achievement Assessment (NUAAA) as part of their high school requirements. (3) Results: Mediation analyses showed that inhibition (performance in the Stroop Color–Word test) fully mediated the relationship between aerobic fitness and both mathematics and Korean performance. (4) Conclusions: This cross-sectional investigation suggests an important mediating role of cognitive performance related to executive function in understanding the relationship between aerobic fitness and the academic achievement of high-school-aged adolescents. This suggests that enhancements in performance related to executive function, which are attributed to increases in aerobic fitness, could explain the observed benefits for academic attainment.

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network

OBJECTIVES

(1) To develop reference values for health-related fitness in European children and adolescents aged 6-18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries.

METHODS

This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method.

RESULTS

A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu).

CONCLUSION

This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

Adherence to Screen Time and Physical Activity Guidelines is Associated with Executive Function in US Toddlers Participating in the STRONG Kids 2 Birth Cohort Study

OBJECTIVE

To test the hypothesis that healthy weight status and adherence to American Academy of Pediatrics (AAP) guidelines for diet and physical activity would extend to greater executive function (EF) at age 24 months.

STUDY DESIGN

Parents of 24-month-old children from the STRONG Kids 2 cohort study (n = 352) completed the Behavioral Rating Inventory of Executive Function for Preschoolers (BRIEF-P) and reported physical activities, diet, and screen time. Toddlers met AAP guidelines if they consumed at least 5 servings of fruits and vegetables, were physically active, refrained from sugar-sweetened beverages, and limited daily screen time to <60 minutes. Relationships between EF, 24-month weight status, and meeting AAP guidelines were tested independent of child sex, ethnicity, socioeconomic status, weight status at birth, and maternal pregnancy weight status.

RESULTS

Weight-for-length z-score had no effect on EF. Toddlers meeting the screen time guideline had greater EF (β, -0.125; 95% CI, 0.234 to -0.008), inhibitory self-control (β, -0.142; 95% CI, -0.248 to -0.029), and emergent metacognition (β, -0.111; 95% CI, -0.221 to 0.002), indicated by lower BRIEF-P scores. Those with more minutes of screen time had poorer overall EF (β, 0.257; 95% CI, 0.118-0.384), inhibitory self-control (β, 0.231; 95% CI, 0.099-0.354), cognitive flexibility (β, 0.217; 95% CI, 0.082-0.342), and emergent metacognition (β, 0.257; 95% CI, 0.120-0.381). Daily physical activity was associated with greater emergent metacognition (β, -0.116; 95% CI, -0.225 to -0.005).

CONCLUSIONS

Meeting AAP guidelines for physical activity and screen time was related to greater EF in a demographically homogenous sample of toddlers. Future randomized control trials and more diverse samples are needed to confirm the directionality of this relationship.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, NCT03341858.

Association between cardiorrespiratory fitness and cognitive control: is somatic maturity an important mediator?

BACKGROUND

Recently some articles presented information related to the possible effect of maturity over the cognitive control and cardiorespiratory fitness, however little is known about the real effects of maturity in the relation of these variables. In this sense, the purpose of this study was to examine the potential mediating role of somatic maturity on the association between cardiorespiratory fitness (CRF) and cognitive control.

METHODS

This three-year longitudinal research comprises two data collection groups: a baseline conducted in 2016 with 394 adolescents (aged 11.7 ± 0.6 years) and a follow-up in 2019 with 134 adolescents (aged 14.9 ± 0.7 years). Anthropometry data, 20-m shuttle run test and peak height velocity (PHV) to determine the maximum oxygen uptake (VO_2max) and somatic maturity, respectively, were collected at both sampling times. In parallel, the Sociodemographic and cognitive control function variables were included in the follow-up to evaluate the inhibitory control (by the Stroop test) and the visuo-spatial working memory (by the Corsi block-tapping test). Associations between CRF and cognitive functions were computed by multiple linear regression, with mediation as a function of PHV.

RESULTS

CRF exhibited transversal associations with reaction time in congruent (β = -0.004; p = 0.001) and incongruent (β = -0.005; p = 0.004) stimulus-responses. Meanwhile, the variation in VO_2max over the three year-study had a significant impact on the reaction time of congruent (β = -0.006; p = 0.001) and incongruent (β = -0.006; p = 0.012) responses at follow-up. However, PHV did not show a significant association with the cognitive functions, indicating no mediating role.

CONCLUSIONS

Although the associations between CRF and the cognitive functions exhibited great transversal and longitudinal impacts, somatic maturity did not affect the cognitive control functions, associating exclusively with CRF.

The Effect of Leisure Time Sport on Executive Functions in Danish 1st Grade Children

Physical inactivity can influence children’s executive functions with severe impact on wellbeing and academic learning. The objective is to study the effect of leisure time sport on executive functions in Danish 1st grade children, and secondary to explore if socio-economy is a confounder for associations between leisure time sport and executive functions. This study is a sub-study nested within a cluster-randomized controlled trial with two arms (ClinicalTrials.gov, NCT02488460). 505 children from twelve schools, mean age 7.2 ± 0.3 years participated. Outcomes for executive function were “Modified Eriksen Flanker/Reverse Flanker Task” and “Behavior Rating Inventory of Executive Function” (BRIEF-P). Parents used SMS-tracking to register their children’s leisure time sport. Multivariate analyzes was performed using mixed linear regression, with adjustment for highest parental education, sex, municipality, and school-type. We found that leisure time sport seems to significantly improve working memory (WM) with nearly 20%, and furthermore it seems to be a significant predictor of ‘Initiate’ (the ability to begin an activity, to generate ideas, responses or problem-solving strategies). Socio-economy was not found to be a confounder. This study lends support to the hypothesis that leisure time sport is related to working memory capacity in children.

Changes in Hippocampus and Amygdala Volume with Hypoxic Stress Related to Cardiorespiratory Fitness under a High-Altitude Environment

The morphology of the hippocampus and amygdala can be significantly affected by a long-term hypoxia-induced inflammatory response. Cardiorespiratory fitness (CRF) has a significant effect on the neuroplasticity of the hippocampus and amygdala by countering inflammation. However, the role of CRF is still largely unclear at high altitudes. Here, we investigated brain limbic volumes in participants who had experienced long-term hypoxia exposure in Tibet (3680 m), utilizing high-resolution structural images to allow the segmentation of the hippocampus and amygdala into their constituent substructures. We recruited a total of 48 participants (48 males; aged = 20.92 ± 1.03 years) to undergo a structural 3T MRI, and the levels of maximal oxygen uptake (VO_2max) were measured using a cardiorespiratory function test. Inflammatory biomarkers were also collected. The participants were divided into two groups according to the levels of median VO_2max, and the analysis showed that the morphological indexes of subfields of the hippocampus and amygdala of the lower CRF group were decreased when compared with the higher CRF group. Furthermore, the multiple linear regression analysis showed that there was a higher association with inflammatory factors in the lower CRF group than that in the higher CRF group. This study suggested a significant association of CRF with hippocampus and amygdala volume, which may be related to hypoxic stress in high-altitude environments. A better CRF reduced physiological stress and a decrease in the inflammatory response was observed, which may be related to the increased oxygen transport capacity of the body.

A Sustainable Swedish School Intervention with Extra Aerobic Exercise—Its Organization and Effects on Physical Fitness and Academic Achievement

A large majority of Swedish children do not reach the recommended daily activity level. Some, but not all, studies show that extra physical activity may have positive effects on children’s school performance, physical fitness and health. The present purpose was to offer pupils from the 7th to the 8th grade extra aerobic exercise led by physical education teachers and to evaluate the effects on aerobic fitness, muscle strength, school grades and health. The hypothesis was that extra aerobic exercise would improve physical fitness, school grades and health. In the two-year project, 122 pupils aged 13–14 years from three schools constituted an aerobic group with 30 min extra exercise sessions (≥70% maximal heart rate) twice weekly. A control group of 26 pupils was included. All 148 pupils also had regular 60 min physical education lessons (2/week). A moderate to large significant effect size (via partial eta-squared) of the interaction effect for the aerobic group compared to the control group over time was generally seen for aerobic fitness, the muscle strength test with push-ups, school grades in Swedish, English and physical education, and in average school grade for four school subjects combined, thus also including mathematics. Within the aerobic group, significant improvements were also shown for aerobic fitness, endurance and strength of abdominal and leg muscles, and the total physical test index during the two-year project. The control group showed no corresponding improvement in these parameters. Improvements in school grades were generally seen among both sexes in the aerobic group, whereas improvements in physical capacity were distinctly more pronounced among boys and seldom among girls. A similar pattern with significant improvement in several school grades was noted in all three intervention schools, although one of the schools had a distinctly larger proportion of children who immigrated to Sweden. The aerobic group showed significantly higher ratings (with a small to moderate effect size) on several questions about physical self-perception than the control group at the end of the 8th grade. This teacher-led school intervention generated a sustainable project with improvements in physical fitness and school grades. The project might act as an inspiration for other schools to increase physical activity to improve physical fitness and possibly school grades.

Combined Motor and Cognitive Rehabilitation: The Impact on Motor Performance in Patients with Mild Cognitive Impairment. Systematic Review and Meta-Analysis

Mild cognitive impairment (MCI), a neurodegenerative disease leading to Alzheimer's disease or dementia, is often associated with physical complaints. Combined physical and cognitive training (PCT) has been investigated to see the effects on cognitive function, but its impact on motor functions and activities of daily living has not been explored yet. The combination of physical and cognitive training may be a valuable non-pharmacological intervention that could preserve motor function and quality of life (QoL). We aimed, therefore, to analyze if combined PCT is effective at improving motor performance in patients with an MCI. A systematic electronic literature search and a meta-analysis were conducted. The following criteria were compulsory for inclusion in the study: (1) randomized controlled trial design; (2) combined PCT compared to motor training alone or no intervention; (3) motor outcomes as a study's end point. Nine articles met the inclusion criteria. Results showed that PCT significantly enhances balance compared to motor training alone (SMD 0.56; 95% CI 0.07 to 1.06; I2 = 59%; 160 participants), whereas a significant improvement was found for mobility in the PCT group when compared to no intervention (MD -1.80; 95% CI -2.70 to -0.90; I2 = 0%; 81 participants). However, there is no evidence that people with MCI experience an increase in gait speed and QoL at the end of their practice sessions. Further investigation with larger samples and a longer period of monitoring after intervention should be undertaken.

Independent and combined associations between multiple lifestyle behaviours and academic grades of inner urban and peri-urban high school students: a cross-sectional study in Chongqing, China

OBJECTIVES

This study aims to assess the independent and combined associations between multiple lifestyle behaviours and academic grades of inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs).

DESIGN

A cross-sectional study was conducted.

PARTICIPANTS

There are 1481 high school students (49.9% boys) in this study, who were enrolled from one inner urban and two peri-urban schools in Chongqing, China.

OUTCOME MEASURES

Academic grades were assessed based on the students' self-reported grade ranking in the last cumulative examination.

RESULTS

In IUHSSs and PUHSSs, high frequency of sugar-sweetened beverage consumption was unlikely to obtain high academic grades (OR 0.56, 95% CI 0.32 to 0.99 and 0.63, 95% CI 0.42 to 0.96), respectively). Among IUHSSs, meeting the recommendations for weekday screen time and egg consumption (OR 1.57, 95% CI 1.06 to 2.34 and 1.60, 95% CI 1.04 to 2.47, respectively) and high frequency of fruit consumption (1.67, 95% CI 1.11 to 2.50) were significantly associated with high academic grades; meeting the recommendation for weekday sleep duration was unlikely to obtain high academic grades (0.46, 95% CI 0.21 to 0.98). Among PUHSSs, meeting the recommendations for weekend sleep duration (1.40, 95% CI 1.02 to 1.93) and eating dinner regularly (1.55, 95% CI 1.01 to 2.37) had significant associations with high academic grades. No significant associations were found between physical activity and academic grades in both IUHSSs and PUHSSs (p>0.05). Moreover, IUHSSs with 9-13 healthy lifestyle behaviours were 3.25 times more likely to achieve high academic grades than IUHSSs with 1-6 healthy lifestyle behaviours (3.25, 95% CI 1.96 to 5.40). No significant associations were found in the combined associations between multiple lifestyle behaviours and academic grades among PUHSSs (p>0.05).

CONCLUSIONS

Correlations were observed between lifestyle behaviours and academic grades among high school students, and cumulative associations between multiple healthy lifestyle behaviours and academic outcomes appear to be stronger than the independent associations. These findings are particularly applicable to IUHSSs.

Implementation of a Physical Activity Program Protocol in Schoolchildren: Effects on the Endocrine Adipose Tissue and Cognitive Functions

Practicing exercise is one of the best strategies to promote well-being and quality of life, however physical activity in schoolchildren and adolescents is developed in an unpredictable, intermittent way and in short periods. There are relatively few intervention studies investigating the role of physical activity in schoolchildren endocrine function of adipose tissue and cognitive function. One hundred and three boys, divided into two groups: control (n = 51, did not perform additional physical activity) and exercise (n = 52, performed vigorous physical activity after the regular school classes). The exercise group, developed a 6 months physical activity protocol delivered by the physical education teacher during the second semester of the academic course (6 months). Body composition measurements, adherence to the Mediterranean diet, nutritional intake, hematological and biochemical parameters, endocrine function of the adipose tissue and biomarkers of brain molecular function were assessed at enrolment and after 6 months of intervention. No statistically significant differences between both groups were found for age, height and bone mass. Weight and BMI was lower in the exercise group compared to the control group, increasing lean mass and reducing fat mass. 58.68% of children in the exercise group showed high adherence to the Mediterranean Diet compared to 46.32% of the control group. The exercise group was more concerned about their diet consumed more fiber, vitamin B1, B2, B6, B12, D, Niacin, Folic acid, Fe, Zn, Se and Cu. Triglycerides levels and HDL-cholesterol were higher in the exercise group at the end of the study. Leptin, MCP-1, lipocalin-2, adipsin and PAI-1 levels were lower in the exercise group at the end of the exercise protocol. In contrast, adiponectin and osteocrin markedly increased in the exercise group. Moreover, marked increases were recorded in healthy brain state biomarkers (NGF, BDNF, and irisin) in the exercise group, which could have a positive impact on academic performance. Taken together, all the findings reported are consistent with many benefits of the exercise protocol on adipose tissue and brain molecular function, demonstrating the usefulness of early interventions based on physical activity in children to reduce risk factors related to sedentary lifestyle.

Effect of exercise on inhibitory control in adolescents is dose-dependent

Adolescence is an important stage for brain maturation. To investigate the effect of different exercise doses on inhibitory control in adolescents aged 12 to 14-year old, an after-school exercise program was offered 5 days per week for 12 weeks during a school semester. Thirsty-four adolescents (17 boys) from the first six classes were randomly divided into low-dose exercise group (LE group, one 30-min aerobic exercise bout per day, n ​= ​16) and high-dose exercise group (HE group, two 30-min aerobic exercise bouts per day, n ​= ​18), while 23 adolescents (10 boys) in the control group (CON, zero 30-min exercise bout, n ​= ​23) were from the last two classes. All the participants in different classes received the same physical education with the same contents, duration, and intensity at class. All the participants completed flanker tests and cardiorespiratory tests before and after exercise intervention. The HE group showed more significant improvements on inhibitory control and V˙O2peak than CON (p ​< ​0.05). Changes in physical activity (PA) were significantly correlated with changes in interference scores (Spearman rho ​= ​-0.30, p ​< ​0.05), V˙O2peak (Spearman rho ​= ​0.31, p ​< ​0.05), and BF percentage (Spearman rho ​= ​-0.32, p ​< ​0.05). This study demonstrated that effect of exercise on inhibitory control in adolescents is dose-dependent, which highlights the need to focus on the exercise dose in daily life for improving cognition among adolescents.

Could Physical Fitness Be Considered as a Protective Social Factor Associated with Bridging the Cognitive Gap Related to School Vulnerability in Adolescents? The Cogni-Action Project

The first aim was to compare differences between school vulnerability groups, fitness levels, and their combination in adolescent cognitive performance. The second aim was to determine the mediation role of fitness in the association between school vulnerability and cognitive performance. A total of 912 Chilean adolescents aged 10–14 years participated in this study. The school vulnerability index (SVI) assigned by the Chilean Government was categorized into high-, mid-, or low-SVI. Adolescents were classified as fit or unfit according to their global fitness z-score computed from their cardiorespiratory (CRF), muscular (MF), and speed/agility fitness (SAF) adjusted for age and sex. A global cognitive score was estimated through eight tasks based on a neurocognitive battery. Covariance and mediation analyses were performed, adjusted for sex, schools, body mass index, and peak high velocity. Independent analyses showed that the higher SVI, the lower the cognitive performance (F_(6,905) = 18.5; p < 0.001). Conversely, fit adolescents presented a higher cognitive performance than their unfit peers (F_(5,906) = 8.93; p < 0.001). The combined analysis found cognitive differences between fit and unfit adolescents in both the high- and mid-SVI levels (Cohen’s d = 0.32). No differences were found between fit participants belonging to higher SVI groups and unfit participants belonging to lower SVI groups. Mediation percentages of 9.0%, 5.6%, 7.1%, and 2.8% were observed for the global fitness score, CRF, MF, and SAF, respectively. The mediation effect was significant between low- with mid-high-SVI levels but not between mid- and high-SVI levels. These findings suggest that an adequate physical fitness level should be deemed a protective social factor associated with bridging the cognitive gap linked to school vulnerability in adolescents. This favourable influence seems to be most significant in adolescents belonging to a more adverse social background.

Health-Related Fitness Levels among Title I Elementary School Students

Over the past few decades, studies have emphasized improving children’s health by increasing health-related fitness levels. Despite the known benefits of health-related fitness in youth, studies have also highlighted a lack of physical activity opportunities for children living in low-income households. The purpose of this study was to investigate the health-related fitness levels of students attending Title I (low-income) elementary schools. A total of 77 elementary students (50.6% female; M_age = 10.0, SD = 0.827) from two Title I elementary schools in the western United States completed the FitnessGram assessments of aerobic capacity, muscular strength and endurance, and flexibility. Descriptive statistics were used to identify the number of students in the Healthy Fitness Zone (HFZ) based upon the FitnessGram HFZ Performance Standards. Less than 17% of students achieved the HFZ for aerobic capacity and only 31.2% achieved the HFZ for upper body strength and endurance. Students performed better for abdominal strength and endurance and flexibility with 55.8% and 68.8% achieving the HFZ, respectively. The results of this study offer insights into the health-related fitness levels of a unique population, students attending Title I schools. School health professionals, including physical education teachers, need to be aware of existing disparities and make efforts to systematically intervene.

Dose-Response Effects of Acute Aerobic Exercise Intensity on Inhibitory Control in Children With Attention Deficit/Hyperactivity Disorder

The present study aimed to examine whether the effect of acute aerobic exercise on inhibitory control of children with attention-deficit/hyperactivity disorder (ADHD) is moderated by exercise intensity. Using a within-subjects design, 25 children with ADHD completed a flanker task with concurrent collection of electroencephalography (EEG) data after three different intensities of treadmill running. The results showed that low- and moderate-intensity exercises resulted in shorter reaction times (RTs) relative to vigorous-intensity exercise during the incompatible condition of the flanker task regardless of task congruency. A P3 congruency effect was observed following low- and vigorous-intensity exercises but not after moderate-intensity exercise. The mean alpha power, a measure of cortical arousal, increased following low- and moderate-intensity exercises but decreased following vigorous-intensity exercise. In addition, the change in arousal level after moderate-intensity exercise was negatively correlated with RT during incompatible flanker tasks. The current findings suggest that children with ADHD have better inhibitory control following both low- and moderate-intensity exercises relative to vigorous aerobic exercise, which could be characterized by an optimal state of cortical arousal.

Comparison of the effects of open- and closed-skill exercise on cognition and peripheral proteins: A cross-sectional study

Previous research indicates that different exercise modes might create different effects on cognition and peripheral protein signals. This study aimed to compare the effects of long-term participation in an open and closed-skill exercise on cognitive functions and Brain-derived neurotrophic factor and Cathepsin B levels. 18 fencers, 18 swimmers, 18 sedentary controls between 18–25 years old participated in the study. Participants performed visuospatial working memory, verbal fluency and selective attention tasks. Blood samples were tested for Brain-derived neurotrophic factor and Cathepsin B using ELISA. The results showed that fencers performed superiorly on some part of visuospatial working memory, verbal fluency, and selective attention tasks than swimmers and sedentary controls. Athlete groups showed higher scores on some subtests of visuospatial working memory and selective attention tasks than sedentary controls. The basal serum Brain-derived neurotrophic factor level was not significant between the groups, but Cathepsin B was higher in fencers than swimmers and sedentary controls. The peripheric protein signal response to acute exercise was significantly higher in athletes, particularly in the open-skill group for Cathepsin B. Our research provided noteworthy results that more cognitively challenging exercise may provide more benefits for some aspects of cognition. Since our findings suggest that open-skill exercise improves specific types of executive-control functioning, this exercise mode might be included in training programs to support cognition and prevent cognitive impairment.

How are academic achievement and inhibitory control associated with physical fitness, soil-transmitted helminth infections, food insecurity and stunting among South African primary schoolchildren?

BACKGROUND

Cardiovascular fitness has been associated with both executive function and academic achievement in multiple cohort studies including children and adolescents. However, research is scarce among children from low- and middle-income countries. Hence, this paper focuses on South African primary schoolchildren living in marginalized areas and examines if academic achievement and inhibitory control can be explained by children's age, socioeconomic status, soil-transmitted helminth infections, food insecurity, stunting, grip strength, and cardiorespiratory fitness.

METHODS

The sample of this cross-sectional study consisted of 1277 children (48% girls, mean age: 8.3 years). Data were assessed via questionnaires, stool samples, anthropometric measurements, 20 m shuttle run test, grip strength test, Flanker task, and school grades. Data were analysed with mixed linear regression models with random intercepts for school classes, separately for boys and girls.

RESULTS

Higher socioeconomic status was most closely associated with academic achievement among boys (p < 0.05), whereas higher levels of cardiorespiratory fitness and not being stunted explained most variance in academic achievement in girls (p < 0.05). Higher age turned out to be associated with better performance in the Flanker task (p < 0.01). Additionally, in boys, higher grip strength was associated with better information processing and inhibitory control of attention (p < 0.01), whereas in girls, higher cardiorespiratory fitness levels were positively associated with these cognitive abilities (p < 0.05).

CONCLUSIONS

Academic performance has been shown to be compromised in schoolchildren living in marginalised areas, compared to schoolchildren in less disadvantaged parts of South Africa. The present study suggests that cardiorespiratory fitness and grip strength are two potentially modifiable factors that are associated with children's academic achievement and cognitive performance, and that should be targeted in future school-based interventions.

Development of cardiorespiratory fitness standards for working memory using receiver operating curves in 15-year-old adolescents

BACKGROUND

Working memory performance is associated with better academic achievements in children and adolescents, and it is positively related to CRF. However, what level of cardiorespiratory fitness (CRF) discriminates higher working memory performance is not known. The purpose of this study was to identify CRF thresholds linked to working memory in adolescents.

METHODS

Data of 141 adolescents (53.2 % girls) were collected (14.9 years) from a cross-sectional study during the year 2019. CRF was assessed by the 20-m shuttle run test, and maximal oxygen uptake was calculated using the Mahar´s equation. Working memory was evaluated by the Corsi blocks test and performance was classified by percentiles. Receiver operating characteristic (ROC) curve analysis was used to identify CRF thresholds.

RESULTS

The ROC analysis indicated that CRF could be used to discriminate working memory in adolescents. CRF thresholds of ≥45.03 ml.kg- 1.min- 1for boys and ≥36.63 ml.kg- 1.min- 1for girls were found to be indicative of "normal" working memory performance.

CONCLUSIONS

CRF could discriminate low and normal working memory performance in 14-16- year-old adolescents. These thresholds could allow for earlier identification and intervention of low working memory performance using CRF.

Preschool physical activity and fitness predicts conceptual, verbal and perceptual skills at school

This study investigated longitudinal relationships between physical activity (PA), fitness and cognitive performance at early years. In total, 147 children at the age of 6.6 and 7.6 years participated in the study. PA and sedentary behaviour (SB) were registered with accelerometer. Skinfold thickness measurements were used to assess body composition. Children's cardiorespiratory fitness (CRF), muscular strength and speed-agility fitness was assessed using PREFIT fitness test battery and static balance by EUROFIT test battery. Cognitive skills were measured with modified Boehm-3 test. Linear regression analyses showed that PA at the age of 6.6 years was positively, while SB was negatively associated with the conceptual skills at the age of 7.6 years after adjusting for confounders. Positive associations were observed between CRF, lower-limbs strength relative to fat-free mass, static balance at the age of 6.6 years with perceptual skills at 7.6 years in unadjusted analysis. PA and fitness were not associated with verbal abilities. Physically active lifestyle and CRF, relative explosive strength of the lower limbs, balance at 6.6 years in kindergarten predict conceptual and perceptual skills, but does not predict verbal abilities 1 year later at first grade in school. SB affects negatively conceptual skills.

Cardiovascular fitness and executive functioning in primary school-aged children

Previous research in children has shown that higher cardiovascular fitness is related to better executive functioning. However, the available literature is hampered by methodological limitations. The present study investigates the relationship between cardiovascular fitness and executive functioning in a large sample of healthy children (N = 814). Cardiovascular fitness was assessed with estimated VO2Max from 20 m Shuttle Run Test performance. Executive functioning was assessed using a set of computerized neurocognitive tasks aimed at executive functions (working memory, motor inhibition, interference control) and lower-level neurocognitive functions (information processing and attention). Dependent measures derived from the neurocognitive tests were subjected to principal component analysis. Mixed model analyses tested the relation between cardiovascular fitness and neurocognitive functioning components. Results showed that children with higher cardiovascular fitness performed better on the neurocognitive function components Information Processing and Control, Visuospatial Working Memory and Attention Efficiency. The following measures contained in these components contributed to the observed relations: information processing measures, visuospatial working memory, and speed of alerting attention. No relationship was found between cardiovascular fitness and the other components: Verbal Working Memory, Attention Accuracy, and Interference Control. The present study suggests that there is a relationship between cardiovascular fitness and a specific set of executive functions and lower level neurocognitive functions. These findings highlight the importance of cardiovascular fitness for the overall health of school-aged children.

The Impact of Vigorous Cycling Exercise on Visual Attention: A Study With the BR8 Wireless Dry EEG System

Many studies have reported that exercise can influence cognitive performance. But advancing our understanding of the interrelations between psychology and physiology in sports neuroscience requires the study of real-time brain dynamics during exercise in the field. Electroencephalography (EEG) is one of the most powerful brain imaging technologies. However, the limited portability and long preparation time of traditional wet-sensor systems largely limits their use to laboratory settings. Wireless dry-sensor systems are emerging with much greater potential for practical application in sports. Hence, in this paper, we use the BR8 wireless dry-sensor EEG system to measure P300 brain dynamics while cycling at various intensities. The preparation time was mostly less than 2 min as BR8 system’s dry sensors were able to attain the required skin-sensor interface impedance, enabling its operation without any skin preparation or application of conductive gel. Ten participants performed four sessions of a 3 min rapid serial visual presentation (RSVP) task while resting and while cycling. These four sessions were pre-CE (RSVP only), low-CE (RSVP in 40–50% of max heart rate), vigorous-CE (RSVP in 71–85% of max heart rate) and post-CE (RSVP only). The recorded brain signals demonstrate that the P300 amplitudes, observed at the Pz channel, for the target and non-target responses were significantly different in all four sessions. The results also show decreased reaction times to the visual attention task during vigorous exercise, enriching our understanding of the ways in which exercise can enhance cognitive performance. Even though only a single channel was evaluated in this study, the quality and reliability of the measurement using these dry sensor-based EEG systems is clearly demonstrated by our results. Further, the smooth implementation of the experiment with a dry system and the success of the data analysis demonstrate that wireless dry EEG devices can open avenues for real-time measurement of cognitive functions in athletes outside the laboratory.

Cardiorespiratory and muscular fitness associations with older adolescent cognitive control

BACKGROUND

Participation in physical activity supports greater cardiorespiratory fitness (CRF), a correlate of cognitive control. However, the relationship between muscular fitness (MF) and cognitive control is less clear. The present study investigated the differential relationship of CRF and MF with cognitive control in older adolescents.

METHODS

This cross-sectional study involved students (15-17 years old, n = 541, 43% female) from 20 secondary schools who completed tests of inhibition (modified flanker task), working memory (n-back task), CRF (Progressive Aerobic Cardiovascular Endurance Run), and MF (standing long jump and push-up test). Multilevel analyses tested the association between CRF or MF and cognitive outcomes while accounting for the influence of the other fitness variable and relevant demographic factors.

RESULTS

CRF predicted response accuracy during incongruent flanker trials, the condition requiring greater inhibition. For the working memory task, CRF predicted greater target accuracy and greater d' scores on the 1-back task, requiring lesser amounts of working memory. In the 2-back task, which requires greater amounts of working memory, CRF also predicted greater target and non-target accuracy and d' scores. Comparatively, MF did not predict any cognitive outcomes after adjustment for CRF.

CONCLUSION

CRF was selectively related to better performance during task conditions that require greater amounts of inhibition and working memory. This finding suggests that CRF, but not MF, may benefit cognitive control in older adolescents. This selective influence of CRF on older adolescents' cognition highlights the value of aerobic physical activity.

Association between brain morphometry and aerobic fitness level and sex in healthy emerging adults

OBJECTIVE

Aerobic fitness may be beneficial for neuroanatomical structure. However, few have investigated this in emerging adults while also accounting for potential sex differences. Here we examine aerobic fitness level, sex, and their interaction in relation to cortical thickness, surface area, and volume.

METHOD

Sixty-three young adults between the ages of 16-26 were balanced for sex and demonstrated a wide range of aerobic fitness levels. Exclusion criteria included left-handedness, past-year independent Axis-I disorders, major medical/neurologic disorders, prenatal medical issues, prenatal alcohol/illicit drug exposure, or excessive substance use. Participants completed an MRI scan and a graded exercise test to volitional fatigue (VO2 max). Data analyses were run in Freesurfer and data was corrected for multiple comparisons with Monte Carlo simulations at .05.

RESULTS

Males demonstrated higher VO2 values. Higher VO2 values were statistically independently related to thinner lateral occipital, superior parietal, cuneus, precuneus, and inferior parietal regions, smaller lateral occipital volume, and larger inferior parietal surface area. Compared to females, males had larger volume in rostral anterior cingulate, lateral occipital, and superior frontal regions, and greater surface area in fusiform, inferior parietal, rostral and caudal anterior cingulate, and superior parietal regions. VO2*Sex interactions revealed higher-fit females had higher inferior parietal, paracentral, and supramarginal surface area, while lower-fit males showed larger surface area in these same regions.

CONCLUSIONS

Individuals with higher aerobic fitness performance had thinner cortices, lower volume, and larger surface area in sensorimotor regions than lower fit individuals, perhaps suggesting earlier neuromaturation in higher fit individuals. Larger surface area was associated with higher-fit females and lower-fit males. Thus both sex and aerobic fitness are important in shaping brain health in emerging adults.

Associations of cardiorespiratory fitness, adiposity, and arterial stiffness with cognition in youth

Purpose

To investigate the associations of cardiorespiratory fitness, adiposity, and arterial stiffness with cognition in 16‐ to 19‐year‐old adolescents.

Methods

Fifty four adolescents (35 girls; 19 boys) participated in the study. Peak oxygen uptake (V̇O_2peak) and peak power output (W_max) were measured by the maximal ramp test on a cycle ergometer and ventilatory threshold (VT) was determined with ventilation equivalents. Lean mass (LM) and body fat percentage (BF%) were measured using a bioelectrical impedance analysis. Aortic pulse wave velocity (PWVao) and augmentation index (AIx%) were measured by a non‐invasive oscillometric device. Working memory, short term memory, visual learning and memory, paired‐associate learning, attention, reaction time, and executive function were assessed by CogState tests.

Results

V̇O_2peak/LM (β = 0.36 p = .011) and W_max/LM (β = 0.30 p = .020) were positively associated with working memory. W_max/LM was also positively associated with visual learning (β = 0.37, p = .009). V̇O₂ at VT/LM was positively associated with working memory (β = 0.30 p = .016), visual learning (β = 0.31 p = .026), and associated learning (β = −0.27 p = .040). V̇O₂ at VT as % of V̇O_2peak, BF%, PWVao, and AIx% were not associated with cognition.

Conclusion

Cardiorespiratory fitness was related to better cognitive function, while BF% and arterial stiffness were not associated with cognition in adolescents.

Exercise and Academic Performance Among Children With Attention-Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Randomized Controlled Trial

PURPOSE

To examine effects of a 10-week after-school physical activity (PA) program on academic performance of 6- to 12-year-old African American children with behavior problems.

METHODS

Participants were randomized to PA (n = 19) or sedentary attention control (n = 16) programs. Academic records, curriculum-based measures, and classroom observations were obtained at baseline, postintervention, and/or follow-up. Mixed models tested group × time interactions on academic records and curriculum-based measures. One-way analysis of variance or Kruskal-Wallis tested for differences in postintervention classroom observations.

RESULTS

Intent-to-treat analyses demonstrated a moderate effect within groups from baseline to postintervention on disciplinary referrals (PA: d = -0.47; attention control: d = -0.36) and a null moderate effect on academic assessments (PA: d = 0.11 to 0.36; attention control: d = 0.05 to 0.40). No significant group × time interactions emerged on direct academic assessments (all Ps ≥ .05, d = -0.23 to 0.26) or academic records (all Ps ≥ .05, d = -0.28 to 0.16). Classroom observations revealed that intervention participants were off-task due to moving at twice the rate of comparative classmates (F = 15.74, P < .001) and were off-task due to talking 33% more often (F = 1.39, P = .257).

CONCLUSION

Academic outcome improvements were small within and between groups and did not sustain at follow-up. Academic benefits of after-school PA programs for children with attention-deficit hyperactivity disorder and/or disruptive behavior disorders were smaller than neurobiological, behavioral, and cognitive outcomes as previously reported.

Aerobic fitness and academic achievement: A systematic review and meta-analysis

This study aims to quantify the association between aerobic fitness and academic achievement, and determine how different aerobic fitness tests and individual demographic characteristics may modify this association. It includes 41 cross-sectional and 7 longitudinal studies focusing on children and adolescents, from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database and Web of Science. Pooled effect sizes (ES) were estimated for the association between aerobic fitness and specific domains of academic achievement. Subgroup analyses and meta-regressions were based on aerobic fitness tests and demographic characteristics. The ES for the association between aerobic fitness with language/reading-skills, mathematics-related skills and composite scores, were 0.23 (95% CI: 0.12; 0.34); 0.27 (95% CI: 0.19; 0.36) and 0.28 (95% CI: 0.12; 0.45), respectively. Subgroup analyses by aerobic fitness test modified these associations; additionally, analyses by sex or age showed differences between boys and girls as well as between children and adolescents. Finally, meta-regressions revealed a slight effect of body mass index on these associations. Cardiorespiratory fitness is positively associated with academic achievement. Associations were dependent on demographic and aerobic fitness test characteristics, being stronger in boys than in girls, and in children than in adolescents.Systematic review registration: PROSPERO CRD42017069677.

Longitudinal Associations of Fitness, Motor Competence, and Adiposity with Cognition

PURPOSE

The purpose of this study was to investigate the longitudinal associations of cardiorespiratory fitness (CRF), motor competence (MC), and body fat percentage (BF%) with cognition in children.

METHODS

Altogether, 371 children (188 boys and 183 girls) 6-9 yr of age at baseline participated in this 2-yr follow-up study. We assessed CRF by maximal cycle ergometer test, computed the MC score from the z-scores of the 50-m shuttle run, static balance, and box and block test results, measured BF% by dual-energy x-ray absorptiometry, and assessed cognition using the Raven's Coloured Progressive Matrices (RCPM) score. The associations were studied by linear regression analysis and repeated-measures ANCOVA.

RESULTS

In boys, a higher MC score (β = -0.161, 95% confidence interval [CI] = -0.314 to -0.009), a shorter 50-m shuttle run test duration (β = 0.152, 95% CI = 0.007-0.296), and a higher number of cubes moved in the Box and block test (β = -0.161, 95% CI = -0.309 to -0.013) at baseline were associated with a smaller increase in the RCPM score during follow-up. These associations were largely explained by the RCPM score at baseline. However, boys in the highest third (mean difference = 2.5, 95% CI for difference = 0.66-4.33) and the middle third (mean difference = 2.1, 95% CI for difference = 0.39-3.82) of the MC score at baseline had a higher RCPM score over the 2-yr follow-up than boys in the lowest third. CRF, MC, or adiposity was not associated with the RCPM score in girls. Changes in CRF, MC, or BF% were not associated with changes in cognition.

CONCLUSIONS

Higher MC at baseline predicted better cognition during the first two school years in boys but not in girls. CRF or adiposity was not associated with cognition in boys or girls.

Cardiorespiratory fitness and health-related quality of life in adolescents: A longitudinal analysis from the LabMed Physical Activity Study

OBJECTIVE

The purpose of this study was to examine the longitudinal associations between cardiorespiratory fitness and health-related quality of life (HRQoL) in a sample of adolescents, and to determine whether changes in cardiorespiratory fitness were associated with HRQoL over a 2-year follow-up.

METHODS

This is a longitudinal analysis with 571 Portuguese adolescents (274 boys and 297 girls) aged 12-18 years. HRQoL was measured with the Kidscreen-10 questionnaire; the 20 m shuttle-run was used to estimate cardiorespiratory fitness; socioeconomic status was assessed with the Family Affluence Scale; and pubertal stage was assessed with Tanner stages. Linear regression and analysis of covariance (ancovas) were used to examine the associations between cardiorespiratory fitness and HRQoL.

RESULTS

HRQoL decreased over a 2-year period both in boys and girls (P < .05). Moreover, girls at baseline and at follow-up reported significantly lower HRQoL values than boys (between subjects P < .001). After adjustments for potential confounders, regression analyses showed significant cross-sectional associations between cardiorespiratory fitness and HRQoL both at baseline (B = 0.095; P = .023) and at follow-up (B = 0.090; P = .012). ancova showed that adolescents whose cardiorespiratory fitness decreased over time exhibited lower scores of HRQoL at follow-up, compared to those with persistent high cardiorespiratory fitness; this held after adjustments for age, sex, socioeconomic status, and pubertal stage.

CONCLUSIONS

Changes in cardiorespiratory fitness during adolescence were associated with HRQoL over a 2-year period. This study suggests that improving cardiorespiratory fitness could be an important strategy in improving the HRQoL of adolescents.

Validation of Cardiorespiratory Fitness Measurements in Adolescents

Cardiorespiratory fitness (CRF) is an important indicator of adolescent cardiovascular well-being and future cardiometabolic health but not always feasible to measure. The purpose of this study was to estimate the concurrent validity of the non-exercise test (NET) for adolescents against the Progressive Aerobic Capacity Endurance Run (PACER^®) and direct measures of VO_2max as well as to examine the concurrent validity of the PACER^® with a portable metabolic system (K4b^2™). Forty-six adolescents (12-17 years) completed the NET prior to performing the PACER^® while wearing the K4b^2™. The obtained VO_2max values were compared using linear regression, intra-class correlation (ICC), and Bland-Altman plots, and α was set at 0.05. The VO_2max acquired directly from the K4b^2™ was significantly correlated to the VO_2max indirectly estimated from the NET (r = 0.73, p < 0.001, r² = 0.53, ICC = 0.67). PACER^® results were significantly related to the VO_2max estimates from the NET (r = 0.81, p < 0.001, r² = 0.65, ICC = 0.72). Direct measures from the K4b^2™ were significantly correlated to the VO_2max estimates from the PACER^® (r = 0.87, p < 0.001, r² = 0.75, ICC = 0.93). The NET is a valid measure of CRF in adolescents and can be used when an exercise test is not feasible.

Increased flanker task and forward digit span performance in caudate-nucleus-dependent response strategies

One of two memory systems can be used to navigate in a new environment. Hippocampus-dependent spatial strategy consists of creating a cognitive map of an environment and caudate nucleus-dependent response strategy consists of memorizing a rigid sequence of turns. Spontaneous use of the response strategy is associated with greater activity and grey matter within the caudate nucleus while the spatial strategy is associated with greater activity and grey matter in the hippocampus. The caudate nucleus is involved in executive functions such as working memory, cognitive control and certain aspects of attention such as attentional disengaging. This study therefore aimed to investigate whether response learners would display better performance on tests of executive and attention functioning compared to spatial learners. Fifty participants completed the 4/8 virtual maze to assess navigational strategy, the forward and backward visual digit span and the Attention Network Test - Revised to assess both attention disengagement and cognitive control. Results revealed that response learners showed significantly higher working memory capacity, more efficient attention disengagement and better cognitive control. Results suggest that response learners, who putatively display more grey matter and activity in the caudate nucleus, are associated with better working memory span, cognitive control and attentional disengagement.

The Influence of Classroom Physical Activity Participation and Time on Task on Academic Achievement

Objectives

Determine the impact of classroom-based physically active lessons on time-on-task. Secondarily, determine the relationship of time-on-task with academic achievement controlling for key demographic variables.

Methods

Seventeen elementary schools were cluster randomized to receive classroom physical activity (A+PAAC, N=9) or control (i.e., no physical activity, N=8) for a 3-year trial. Teachers were trained to deliver physically active lessons with moderate-to-vigorous intensity targeting 100 minutes per week. Outcome measures included academic achievement (Weschler Individual Achievement Test-III), administered at baseline and repeated each spring for 3 years, time spent in moderate-to-vigorous physical activity (MVPA), and time spent on task (TOT) pre- and post-physical activity. Multilevel modeling was utilized to estimate the impacts of percent time spent in MVPA and percent TOT post-lesson on academic achievement and the change in these impacts over 3 years, accounting for dependency among observations and covariates including age, gender, race, free or reduced lunch, BMI, and fitness.

Results

A greater percentage of time performing MVPA were each significantly associated with higher math scores (p=.034) and spelling scores (p<.001), but not reading scores. Academic achievement was not associated with TOT.

Conclusion

Findings suggest that a greater percentage of time spent participating in MVPA results in higher math scores and spelling scores, but not reading scores, independent of TOT. Future studies should continue to evaluate the influence of physically active classroom lessons on time spent on task and its impact on academic achievement. Furthermore, strategies are needed to maximize impact and to determine the sustainability of physical activity's effect on classroom behavior and academic achievement.

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.

School-based physical activity intervention for older adolescents: rationale and study protocol for the Burn 2 Learn cluster randomised controlled trial

INTRODUCTION

This trial aims to investigate the impact of a school-based physical activity programme, involving high-intensity interval training (HIIT), on the physical, mental and cognitive health of senior school students.

METHODS AND ANALYSIS

The Burn 2 Learn (B2L) intervention will be evaluated using a two-arm parallel group cluster randomised controlled trial with allocation occurring at the school level (to treatment or wait-list control). Schools will be recruited in two cohorts from New South Wales, Australia. The trial will aim to recruit ~720 senior school students (aged 16-18 years) from 20 secondary schools (ie, 10 schools per cohort). A range of implementation strategies will be provided to teachers (eg, training, equipment and support) to facilitate the delivery of HIIT sessions during scheduled classes. In phase I and II (3 months each), teachers will facilitate the delivery of at least two HIIT sessions/week during lesson-time. In phase III (6 months), students will be encouraged to complete sessions outside of lesson-time (teachers may continue to facilitate the delivery of B2L sessions during lesson-time). Study outcomes will be assessed at baseline, 6 months (primary end point) and 12 months. Cardiorespiratory fitness (shuttle run test) is the primary outcome. Secondary outcomes include: vigorous physical activity, muscular fitness, cognition and mental health. A subsample of students will (i) provide hair samples to determine their accumulated exposure to stressful events and (ii) undergo multimodal MRI to examine brain structure and function. A process evaluation will be conducted (ie, recruitment, retention, attendance and programme satisfaction).

ETHICS AND DISSEMINATION

This study has received approval from the University of Newcastle (H-2016-0424) and the NSW Department of Education (SERAP: 2017116) human research ethics committees.

TRIAL REGISTRATION NUMBER

ACTRN12618000293268; Pre-results.