Effects of health-related physical education on academic achievement: project SPARK

A Semester of Hatha Yoga Has Comparable Effects to Physical Education for Children in Terms of Physical Activity and Psychosocial Indicators

BACKGROUND/OBJECTIVES

As research on yoga with school children is growing, this study investigated the effects a semester of yoga versus physical education on children's physical activity and psychosocial indicators.

METHODS

Physical activity and psychosocial variables were assessed at Time 1 (January/February) and Time 2 (April/May) through self-report surveys (n = 157; 63% female, age: m = 10.38, sd = 0.81 years) for the intervention (Hatha yoga classes) and control groups (standard physical education classes). The intervention group was also observed regarding pedometer and System for Observing Fitness Instruction Time data.

RESULTS

The results revealed a trend towards an increase for the control and a decrease for the intervention group in stress levels. The pedometer results showed a trend towards an increasing number of steps/min. Skill practice had the greatest increase with time dedicated to that activity. The observation results revealed a significant difference in activity from Time 1 to Time 2. The major differences were decreases in sitting and being very active, and an increase in walking.

CONCLUSIONS

Given the observation data and our study design limitations, the study results showed similarities between Hatha yoga and physical education in terms of increasing physical activity levels and psychosocial variables; thus, yoga may be a viable alternative to children's physical education in this regard.

Effect of Extracurricular After-School Physical Activities on Academic Performance of Schoolchildren: A Cluster Randomized Clinical Trial

Importance

The beneficial effects of increasing outdoor physical activity time on children's myopia onset and physical well-being are widely acknowledged. However, in countries with competitive educational systems, such as China, parents and school administrators may be relatively reluctant to increase the extracurricular physical activity time for children due to concerns that this action will compromise children's academic performance.

Objective

To investigate whether additional extracurricular physical activity time after school compromises the academic performance of schoolchildren.

Design, Setting, and Participants

This cluster randomized clinical trial was conducted from October 2020 to June 2021 in Yudu, Jiangxi, China. Eligible children in grades 3 and 4 from 24 elementary schools were randomized to the intervention or control group. Primary analysis was conducted in the full sample using the intention-to-treat principle.

Interventions

The intervention group received 2 hours of after-school physical activity time outdoors on school days. The control group was free to arrange their after-school activity.

Main Outcomes and Measures

The primary outcome was the between-group mean difference in mathematics test scores at the end of 1 academic year, with a noninferiority margin of -3.3 points. Standardized mathematics tests, physical fitness assessments (in reference to the 2018 National Physical Fitness Survey Monitoring Programme in China), and cycloplegic autorefraction were performed at baseline and the end of 1 academic year. Myopia was defined as a cycloplegic spherical equivalent refraction of -0.5 diopters or less in either eye.

Results

A total of 2032 children (mean [SD] age, 9.22 [0.62] years; 1040 girls [51.2%]) from 24 schools were randomized to the intervention group (12 schools; 1012 children) or control group (12 schools; 1020 children). The mean (SD) mathematics score at the end of 1 academic year was 78.01 (17.56) points in the intervention group and 77.70 (17.29) points in the control group. The adjusted between-group mean difference was 0.65 points (95% CI, -2.85 to 4.15). The adjusted between-group mean difference in physical fitness score was 4.95 points (95% CI, 3.56-6.34; P < .001) and -1.90% (95% CI, -18.72% to 14.91%; P > .99) in myopia incidence.

Conclusions and Relevance

Results of this trial indicate that, compared with the control practice of free play after school, adding 2 hours of extracurricular physical activity outdoors after school was noninferior in academic performance and had superior efficacy in improving physical fitness.

Trial Registration

ClinicalTrials.gov Identifier: NCT04587765.

School-based physical activity interventions and language skills: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVES

School-based physical activity (PA) interventions have proven beneficial for improving cognitive performance and overall academic achievement, but their benefits on language skills remain unclear. We aimed to assess the effects of school-based PA interventions on language skills in children and adolescents.

DESIGN

Systematic review with meta-analysis.

METHODS

A systematic search was performed in PubMed, PsycINFO and Scopus until September 10th, 2022. We included randomized controlled trials (RCTs) that performed a school-based PA intervention in children/adolescents and that assessed language-related outcomes (i.e., reading, spelling, vocabulary, verbal fluency, comprehension and grammar) or language school grades. Random effect meta-analyses were conducted to pool study results.

RESULTS

Thirty-one studies (18,651 participants) were finally included. Significant benefits were observed for reading (standardized mean difference [SMD]: 0.15; 95% confidence interval [CI]: 0.08, 0.22), vocabulary (SMD: 0.71; 95%CI: 0.44, 0.97), and comprehension (SMD: 0.24; 95%CI: 0.09, 0.40), with a non-significant trend (p = 0.083) also observed for language school grades (SMD: 0.40; 95%CI: -0.05, 0.86). No significant benefits were observed for spelling or verbal fluency (both p > 0.05), and no meta-analysis could be performed for grammar skills. No consistent differences were observed between integrated (i.e., performing PA along with the academic content) and non-integrated PA interventions (e.g., extra physical education lessons).

CONCLUSIONS

School-based PA interventions appear as an effective strategy for improving different language-related skills, although further research is needed to determine how interventions' and participants' characteristics moderate these effects.

News of the Pedagogical Models in Physical Education-A Quick Review

In the last two decades, research has proliferated in the field of pedagogical models used in school Physical Education. The growth is so high that it is necessary to do a quick review to know which models currently exist and which are emerging. The objective of this work is to collect all the models or pedagogical approaches present in the scientific literature related to school Physical Education and to make known, to the scientific and academic community, its main purposes and characteristics. A quick review of the literature found in the Web of Science and Scopus databases has been carried out using "pedagogical model" and "Physical Education" as descriptors. The results revealed a total of 19 pedagogical approaches that record scientific evidence linked to their application in the classroom. It was detected that some models or approaches were more scientifically supported than others, as is the case for Cooperative Learning, Sports Education, or Teaching Games for Understanding, while others barely registered in international scientific literature. It was concluded that researchers need to work together with Physical Education teachers to analyze the effectiveness of all these approaches. School teachers are also encouraged to vary their pedagogical approach depending on the content they are working on and the positive effects they are looking for in the psychic, motor, affective-emotional, and social domains of the students. Finally, it is proposed to researchers who promote new models or approaches a greater clarity of these to facilitate their application in the field of school Physical Education, since some difficulty has been detected in the practical application of some approaches.

The Association Between Physical Activity and Mathematical Achievement Among Chinese Fourth Graders: A Moderated Moderated-Mediation Model

This study explored the association between out-of-school physical activity (PA) and mathematical achievement in relation to mathematical anxiety (MA), as well as the influence of parents’ support for their children’s physical activity on this association, to examine whether parental support for physical activity affects mental health and academic performance. Data were collected from the responses of 22,509 (52.9% boys) children in Grade 4 from six provinces across eastern, central, and western China who completed the mathematics component and the physical education and health component of the national-level education quality assessment. A moderated moderated-mediation model was tested using PROCESS v3.4 and SPSS v19.0, with socioeconomic status, school location, and body mass index as controlled variables. Out-of-school physical activity had a positive effect on children’s mathematical achievement, and math anxiety partially mediated this association. The indices of conditional moderated mediation through the parental support of both girls and boys were, respectively, significant, indicating that children can benefit from physical activity, and that increased perceived parental support for physical activity can alleviate their children’s math anxiety and improve their mathematics, regardless of gender. However, gender differences were observed in the influence of parental support for physical activity on anxiety: Although girls’ math anxiety levels were significantly higher, the anxiety levels of girls with high parental support were significantly lower than those of boys with low parental support.

The effectiveness of school physical education on students' cognitive competence: a systematic review and meta-analysis

INTRODUCTION

School physical education plays an important role in improving the cognitive competencies of students. The theoretical background related to how school physical education positively influences students' cognitive domains has been consistently structured; however, there are few previous studies that have systematically analyzed how physical education interventions produce positive outcomes related to learners' cognitive competencies. The aim of the present study was to analyze the effectiveness of physical education interventions on students' cognitive competencies.

EVIDENCE ACQUISITION

The study involved searching for related quantitative research studies through electronic research databases including SPORTDiscus, ScienceDirect, and MEDLINE Patent Applications and conducting a screening process considering the purpose of the meta-analysis. The present study assessed for a risk of bias, extracted data, and conducted a meta-analysis to determine the effectiveness of physical education interventions.

EVIDENCE SYNTHESIS

According to the results of the meta-analysis, school physical education has a significant impact on students' cognitive competencies such as intelligence and academic achievement. In terms of the characteristics of the interventions, the effectiveness of aerobic exercise rooted in physical education was more significant than that of model-based physical education or traditional physical education.

CONCLUSIONS

Based on the results of the meta-analysis, the present study concluded that school physical education has a statistically significant impact on changing students' cognitive conditions; however, there is need for a follow-up study on how the contents of school physical education and the methods of teaching have distinct effects on students' cognitive competencies.

A Systematic Review of the Effects of Physical Activity on Specific Academic Skills of School Students

This systematic review examined the effects of distinct physical activity interventions on the academic achievement of school students based on an analysis of four distinct outcomes: mathematics, language, reading, and composite scores. This study was performed in accordance with the PRISMA guidelines and the QUORUM statement. A literature search was conducted using the PubMed-MEDLINE, Scopus, and Web of Science databases. Peer-reviewed studies published in English, Portuguese, and Spanish were considered. A random-effect meta-analysis was employed to determine the effect of interventions on academic performance. The effects between interventions and control groups were expressed as standardized mean differences. Thirty-one studies were included in the meta-analysis based on the inclusion and exclusion criteria. The exercise programs were not capable of significantly improving language, reading skills, and composite scores. Conversely, performance in math tests increased significantly after the interventions compared with the control groups. Regarding the overall effect, a significant improvement in academic achievement was detected after physical activity programs compared with controls. In conclusion, the positive effects of school-based physical education on academic performance are not uniform and may be higher for math skills. The implementation of evidence-based exercise programs in school settings emerges as a promising strategy to increase overall academic achievement in school-aged students.

Does Learning Through Movement Improve Academic Performance in Primary Schoolchildren? A Systematic Review

Physically active children have greater motor competence and a faster maturation compared with their sedentary peers. Recent research also suggests that physical activity during childhood may also promote cognitive development and therefore improve academic performance. The aim of this study was to understand if physically active academic lessons may improve academic achievement in primary schoolchildren. A systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted. The search was performed on the following database: PubMed, Web of Science, Scopus, Education Resources Information Center (ERIC), and PsycINFO (APA). Studies evaluating schoolchildren aged between 3 and 11 years taking part in educational contexts that include physical activity and natural environments evaluating physical fitness and/or educational outcomes were included. A total of 54 studies (for a total sample of 29,460 schoolchildren) were considered eligible and included in the qualitative synthesis. The Effective Public Health Practice Project risk-of-bias assessment revealed a moderate quality of the included studies with only two considered weeks. Despite differences in the retrieved protocols, physically active academic lessons improve the total time engaged in physical activity, motor skills, and/or academic performance. The results of this review suggest that learning through movement is an effective, low-cost, and enjoyable strategy for elementary schoolchildren.

Effects of physical education interventions on cognition and academic performance outcomes in children and adolescents: a systematic review and meta-analysis

OBJECTIVE

To determine the effects of interventions aimed at optimising the quantity and quality of physical education (PE) on cognition and academic performance in children and adolescents.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

Studies from electronic databases from inception to 3 January 2021 were identified.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Experimental studies that assessed the effect of quantity-based (ie, increasing the amount of curriculum time allocated to PE) or quality-based (ie, increasing students' participation in physical activity during PE) PE interventions, or both, on changes in cognition and/or academic performance in youth (aged 5-18 years) were included.

RESULTS

19 trials comprising 8676 youth (46.5% girls) were included. Individual quality-based PE interventions increased cognition performance (Hedges' g=0.38, 95% CI 0.15 to 0.60; I ²=83.70%), mainly in primary education settings (g=0.48, 95% CI 0.07 to 0.89; I ²=90.43%). Academic performance, principally mathematics-related skills, was also increased by quality-based PE interventions (g=0.15, 95% CI 0.06 to 0.24; I ²=41.75%). Among these interventions, teaching strategies favoured similar results, but without heterogeneity in the results (g=0.12, 95% CI 0.05 to 0.18; I ²=0%). In contrast, quantity-based PE interventions had a very small and non-significant effect on academic performance (g=0.09, 95% CI -0.05 to 0.24; Q=11.65; I ²=48.48%). Finally, there were no differences between the three PE interventions (ie, quantity, quality, and combined PE interventions) in regard to academic performance.

CONCLUSION

Improving the quality of PE classes may improve students' cognition and academic performance in children and adolescents. Importantly, allocating more time for PE does not seem to compromise this performance.

Effects of a Comprehensive School Health Program on Elementary Student Academic Achievement

BACKGROUND

Improving the academic achievement of youth in the United States is an area of interest and a critical indicator of the future success of the youth. The purpose of this study was to examine the impact of a comprehensive school physical activity and healthy eating program on 5th-grade students' academic achievement, specifically reading and math.

METHODS

Overall, 628 (intervention: 377, 54% girls; comparison: 251, 49% girls) 5th-grade children participated across the 6 schools in a year-long comprehensive health intervention, completing curriculum-based academic achievement measures at 2 time-points.

RESULTS

Results showed that even after controlling for class clustering, age, sex, race, and T1 reading and math variables, students' T2 reading and math achievement were significantly higher in the intervention group than the comparison group.

CONCLUSIONS

Comprehensive health programming can enhance the health and academic achievement of youth.

PHYSICAL ACTIVITY, PHYSICAL FITNESS AND ACADEMIC ACHIEVEMENT IN ADOLESCENTS: A SYSTEMATIC REVIEW

ABSTRACT Objective: To synthesize the evidence available in the literature on the relationship between the components of physical activity, physical fitness and academic achievement in adolescents. Methods: The review followed the methodological procedures described by PRISMA and was carried out in the Lilacs, Medline, SciELO, PubMed, Web of Science and Science Direct databases. Quantitative empirical studies published as of 2006 were included. The following descriptors and keywords were used: “Motor activity”, “Physical fitness”, “Physical activity”, “Educational status”, “Academic achievement”, “Academic performance”, and their equivalents in Portuguese and Spanish. Results: The most widely investigated variable was physical fitness (45.5%) followed by physical activity (40.9%), whereas only three studies (13.6%) investigated both. Conclusion: Physical activity and physical fitness are positively associated with the academic achievement of adolescents. In more than 80% of studies the association was considered strong. The physical fitness component most frequently associated with academic achievement was cardiorespiratory fitness. Level of evidence II; Systematic review.

Effects of a Physical Education Intervention on Academic Performance: A Cluster Randomised Controlled Trial

Background: We investigated the effects of three different interventions on academic performance in students enrolled in the first year of high school. Methods: This was a cluster randomised controlled trial conducted with 1200 students enrolled in the first year of high school. Schools were randomly assigned to: 1. Doubling physical education (PE) classes (3:20 h of PE/week); 2. workshop with the PE teachers; 3. workshop with the PE teachers and doubling the PE classes; and 4. control group (1:40 h of PE/week). We assured that the schools within the groups were equal regarding: The structural condition of the sports court; number of PE teachers; number of school classes; and the average number of students per classroom. Results: Overall, the intervention was not effective in improving the students’ academic performance. However, the subgroup analysis showed that the workshop intervention group increased the academic performance of students who had failed an academic year (from 16 years of age), compared to their peers in the doubling the PE classes (1.3 points on average) and the control groups (1.4 points on average). Conclusions: Enhancing the pedagogical skills of the teachers is a promising approach in improving the academic performance of students who failed an academic year.

Attentiveness and Fidgeting While Using a Stand-Biased Desk in Elementary School Children

Standing desks are a viable option to decrease sedentary time in the classroom. However, it is important that standing desks are not detrimental to classroom behavior or learning. The purpose of this study was to evaluate the impact of stand-biased desks on fidgeting and attentiveness. Ninety-seven students in grades 3, 4, and 6 (ages 8–12 years) volunteered to participate in this study. The intervention employed a within-classroom crossover design, with teacher-determined allocation for seating within each classroom and included the replacement of one-half of the traditional sitting desks with stand-biased desks. Direct observation of student’s attentive and fidgeting behaviors occurred at three assessment periods, at baseline when all students were in a sitting desk condition and at the end of each nine-week intervention. Stand-biased desks did not influence fidgeting behavior, but did have an impact on attentive behavior. Students that were less attentive at baseline had a 40–80% increase incidence rate in non-attentive behavior while in the traditional desk as compared to the stand-biased desk after the intervention. While fidgeting and non-attentive episodes (p = 0.034) were significantly related, the type of desk did not significantly moderate this relationship (p = 0.810). Standing desks can be incorporated into the classroom without negatively influencing classroom behavior.

Association between the school environment and children's body mass index in Terengganu: A cross sectional study

With the on-going interest in implementing school policies to address the problem of childhood obesity in Malaysia, there is urgent need for information about the association between school environment and children’s weight status. This study aims to investigate the association between school environmental factors (physical, economic, political and sociocultural) with BMI of school children in Terengganu. The school environment factors were assessed using a set of validated whole-school environmental mapping questionnaires, consisting of 76 criteria with four domains; physical environment (41 criteria), economic environment (nine criteria), political environment (nine criteria) and sociocultural environment (17 criteria). This involved face-to-face interview sessions with 32 teachers from 16 schools (eight rural and eight urban). In addition, 400 school children aged between 9 and 11 years of the selected schools were assessed for BMI (WHO 2007 reference chart), dietary intake (food frequency questionnaire (FFQ)) and physical activity level (physical activity questionnaire for children (PAQ-C)). Multiple regression was used to examine the association between school environment factors and BMI of the school children. Seven school environment criteria were found to be associated with BMI of school children when it was adjusted for calorie intake and physical activity level. About 33.4% of the variation in BMI of school children was explained by health professional involvement, simple exercise before class, encouragement to walk/ride bicycle to/from school, no high-calorie food sold, healthy options of foods and drinks at tuck shop, availability of policy on physical activity and training teacher as a role model. Policy makers should make urgent actions to address the obesogenic features of school environments. It should strive towards setting up healthy school environment and improving school curricula to promote healthy behaviours among the school children.

Assessing Maternal Support for Physical Activity in Latina Adolescents

Objectives: We developed a comprehensive measure to evaluate 11 domains of maternal social support for physical activity (PA) among Latina adolescents. Methods: The 26-item questionnaire included a version for mothers to rate how often they engaged in behaviors supporting their daughters' PA, and a version for daughters to rate how often their mothers engaged in the same behaviors. Bivariate correlations examined associations between mother-daughter perceived support for daughter's moderate-to-vigorous PA (MVPA), and associations between daughter's perceived support for PA and current MVPA. Results: Twenty-one Latina adolescents, which included 20 adolescent-mother dyads, enrolled in the study. Mother-daughter ratings of support showed significant positive correlations for reminders (r = .573, p = .01), watching daughters' sports (r = .566, p = .01), limit-setting (r = .564, p = .01), encouragement (r = .561, p = .01), transportation (r = .544, p = .02). We found statistically significant associations between MVPA and daughters' ratings of their mothers valuing (r = .544, p = .02) and facilitating PA (r = .48, p = .05). Conclusions: Mothers accurately perceive several supportive behaviors for PA given to daughters, but only daughters' perception of received support predicts their MVPA.

The Effect of Strengthened Physical Education on Academic Achievements in High School Students: A Quasi-Experiment in China

Objectives: Evidence of school-based physical activity (PA) on academic performance in children and adolescents was inconsistent, especially in high school students who face a high academic burden. In this study, we tested the efficacy of a strengthened physical education (PE) program on academic outcomes in Shanghai. Methods: A quasi-experimental design was conducted to investigate the effect of strengthened PE on academic scores by calculating the grade-cohort difference before and after the intervention. PE curriculum switched from traditional short duration (40 minutes) general fitness training to long duration (90 minutes) specialized sports (e.g., football, aerobics). A total of 460 high school students (236 pre-intervention and 224 post-intervention) were enrolled in grade 10 and followed for two and three semesters. The academic outcome was assessed by district-standardized test scores. A difference-in-difference approach was employed. Results: After two semesters, the standardized Chinese language scores and English language scores for the post intervention group were increased by 0.61 SD (95% confidence interval (CI): 0.44, 0.78, p < 0.001) and 0.28 SD (95% CI: 0.09, 0.47, p = 0.01). However, the standardized math scores for the post intervention group were decreased in girls. After three semesters, standardized Chinese language scores for the post intervention group were increased by 0.27 SD (95% CI: 0.06, 0.48, p = 0.01). Math scores and English language scores decreased by 0.18 SD (95% CI: −0.36, −0.01, p = 0.04) and 0.23 SD (95% CI: −0.38, −0.09, p = 0.00), respectively. Conclusion: A school-based physical education program had mixed effects on academic scores in high school students.

Evaluation of an Intervention to Increase Physical Activity in Low-Income, Urban Middle Schools

BACKGROUND

Physical education (PE) can provide opportunities to engage in daily moderate-to-vigorous physical activity (MVPA), but MVPA levels in many classes are low. This study examines MVPA during middle school PE lessons before and after receiving the SPARK (Sports, Play, and Active Recreation for Kids) program.

METHODS

Sixteen schools were enrolled in the study. PE teachers at eight schools received the intervention. PE lessons at all schools (N = 561) were observed over 2 years. Hierarchical linear regression models examined the effect of the intervention on the amount and consistency of MVPA and sedentary behavior.

RESULTS

An average of 13.7% of observed class time was spent in MVPA (approximately 5 minutes of a 60-minute class), compared to 27.5% of time spent sedentary. There was no evidence that the curriculum resulted in increased MVPA or consistent MVPA, or that it decreased sedentary behavior. Findings also suggested that contextual factors may contribute to physical activity levels in PE.

CONCLUSIONS

Mixed evaluation findings of the SPARK middle school curriculum demonstrate that an out-of-the-box curriculum does not have the same results in all contexts. Implications for school health are described based upon findings. Further research is needed to identify effective strategies to increase MVPA for adolescents both in and outside of PE.

Physical Activity and Academic Performance: The Mediating Effect of Self-Esteem and Depression

An important step to enhance the academic efficiency of students is increasing their physical activity. For this reason, it is necessary to see to what extent physical activity is related to the academic performance of the students and what might mediate this. A major objective of the study is to explore self-esteem and depression as mediators between physical activity and academic performance. On the basis of informed consent to participate in the study, 358 participants have been selected from Universities in Pakistan, and they were asked about their physical activity, depression during their study and self-esteem through self-report. Participants self-reported their self-esteem, level of depression and their physical activity through standardized measures; the Rosenberg Self-esteem scale (1965), the University stress scale (2016), and the short form of the International Physical Activity questionnaire (2003), respectively. Academic performance had been measured as the cumulative grade point average (CGPA) of the last two consecutive semesters. Self-esteem and depression were found to be significant mediators between physical activity and academic performance. The total effect of physical activity on academic performance was significant but smaller than the total indirect effect through mediators. Though total indirect effect is the combination of the effect of self-esteem and depression, but the larger contribution is of self-esteem which has been found to be the strongest mediator between physical activity and academic performance. The study has implications for future research, both in terms of testing the model and testing psychological constructs. Also, the study emphasizes that the importance of physical activity has to be kept in mind while designing a curriculum of an educational institution in order to foster sustainable development.

"You Only Teach PE and It Doesn't Really Matter": Middle School PE Teachers' Perspectives on Intervention Efforts to Increase Physical Activity

Physical education (PE) is a frequent site of public health intervention to promote physical activity (PA); however, intervention research frequently overlooks the perspective of PE teachers. The purpose of this qualitative study was to explore teachers' experiences with and perceptions of a PA curriculum intervention. Six findings within three categories were identified and described in detail. In-depth one-on-one semistructured interviews were conducted with nine PE teachers from eight middle schools in Los Angeles. Feeling underappreciated and having a "muddled mission" within PE were driving factors in teacher morale and practice. Teachers had positive experiences with the curriculum, but significant barriers remained and limited the potential for PA during PE classes. PE teachers are pulled in multiple directions and perceive a lack of necessary support systems to achieve student health goals. Interventions aimed at leveraging PE as a site of PA promotion must incorporate the perspectives of PE teachers.

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

OBJECTIVE

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

DESIGN

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

DATA SOURCES

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

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

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

RESULTS

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

CONCLUSION

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

PROSPERO REGISTRATION NUMBER

CRD42017082505.

Effects of a Sports-Oriented Primary School on Students' Physical Literacy and Cognitive Performance

As only a small group of children fulfil the guidelines for physical activity, interventions are necessary to promote active lifestyles. We examined the effects of a sports-oriented primary school (N = 79) in comparison to a regular primary school (N = 90) on students' physical literacy and cognitive performance. To evaluate the implementation of the sports-oriented school curriculum a process evaluation was conducted, in which the school curriculum was analysed and guideline-based interviews were carried out with the schoolteachers and the school director. To measure students' physical literacy and cognitive performance several tests were used. Small positive effects of the sports-oriented primary school on students' physical literacy were shown in standing long jump and attitudes towards physical activity. There were no differences between the groups regarding cognitive performance. This study provides the first insights on how a sports-oriented school can promote students' physical literacy in the future. The results are in line with previous research that shows that when children spend more time in physical education and overall physical activities at school, no negative consequences result for their cognitive performance. In future, long-term evaluations of the effects of sports-oriented schools are required to receive valid results on the effects on students.

Effects of Perinatal Factors on Body Mass Index and Physical Fitness of School-age Children

Objective

To examine the effects of various maternal and neonatal perinatal factors on the child’s body mass index (BMI) and physical fitness at school-age.

Methods

Data from two registries, the SLOfit database (a national surveillance system of children’s motor and physical development) and Slovenian National Perinatal Information System (NPIS) were analysed. Perinatal data for 2,929 children born in 2008 were linked to results of SLOfit testing of these children in 2016. Linear regression analysis was used to assess the potential relationship between several perinatal factors (very preterm birth, birth mass, maternal age, hypertensive disorders of pregnancy, gestational diabetes, parity, plurality, maternal pre-pregnancy BMI, mode of delivery, presentation, Apgar score at 5 minutes, and admission to a neonatal intensive care unit (NICU)) and child’s BMI or child’s physical fitness index (PFI) at the age of eight years. We also included child’s school grade and maternal educational level in the analysis. A p value <0.05 was considered statistically significant.

Results

Children born to mothers with lower pre-pregnancy BMI and higher education had lower BMI and higher PFI (p<0.001) at school-age. Physical fitness was also inversely associated with nulliparity (p<0.001) and NICU admission (p=0.020).

Conclusions

Among all perinatal factors studied, higher maternal education and lower pre-pregnancy BMI seem to be the most significant determinants of child’s BMI and physical fitness at school-age.

Association of School-Based Physical Activity Opportunities, Socioeconomic Status, and Third-Grade Reading

BACKGROUND

Socioeconomic status (SES) is the most accurate predictor of academic performance in US schools. Third-grade reading is highly predictive of high school graduation. Chronic physical activity (PA) is shown to improve cognition and academic performance. We hypothesized that school-based PA opportunities (recess and physical education) would moderate the negative association between SES and third-grade reading.

METHODS

Schools serving third-grade students were surveyed (N = 1279) for minutes/week of PA opportunities. Allotted weekly PA time and achievement data from participating schools (N = 784) were recorded and analyzed. To test the moderator hypothesis, moderated multiple regression analysis was conducted.

RESULTS

The interaction of PA opportunities and SES explained a significant increase in variance in third-grade reading (b = .053, p < .001), thus moderating the relationship between SES and third-grade reading. Further analysis showed that schools offering greater than 225 minutes/week of PA opportunities experienced a greater (+5%) moderating effect.

CONCLUSION

School-based PA opportunities positively moderate the relationship between SES and third-grade reading, and lowest SES schools experience greater moderating effects. Future research should consider PA opportunities as a moderator of the SES-academic achievement relationship, and school policy makers should consider the influence that PA opportunities have on student achievement at varying SES levels.

The Physical Activity Environment and Academic Achievement in Massachusetts Schoolchildren

BACKGROUND

A supportive school-based physical activity environment (PAE) is integral to children's physical activity behaviors, but less understood is its association with academic achievement. We aimed to assess the association between PAE and academic performance and whether a stronger relationship exists in lower-income schools (LIS) compared to middle-income schools (MIS).

METHODS

Schoolchildren (grades 3rd to 5th) were recruited from 17 Massachusetts public schools. Schools were classified based on geographic characteristics and free/reduced-price lunch (FRPL) eligibility (LIS = 7, Median FRPL = 86%; MIS = 10, Median FRPL = 20%). PAE was measured using a 10-item survey. Mixed-effects logistic regression models were used to examine associations between PAE and scoring Advanced/Proficient on standardized Math and English Language Arts (ELA) tests.

RESULTS

Demographic characteristics differed between LIS (N = 278, 5% non-Hispanic white) and MIS (N = 297, 73% non-Hispanic white). In LIS, PAE was associated with Math (odds ratio = 5.40, 95% CI = 2.52-11.54 p < .001), but not ELA test scores (p > .05). There was no relationship between PAE and MIS test scores (p > .05). Schooltime moderate-to-vigorous physical activity was not associated with test scores (p > .05).

CONCLUSIONS

A beneficial relationship exists between a high-PAE and test scores among LIS children, suggesting that the PAE may be associated with a more supportive environment and may be more fundamentally important for lower-income students.

Academic Achievement and Physical Activity: A Meta-analysis

CONTEXT

The effect of physical activity (PA) on different areas of academic achievement and classroom behaviors and how different characteristics of PA interventions could modify the effect remain unclear.

OBJECTIVE

The objective was twofold: (1) to assess the effect of PA interventions on academic achievement and classroom behaviors in childhood and (2) to determine the characteristics of individuals and PA programs that enhance academic performance.

DATA SOURCES

We identified studies from the database inception to October 16, 2016.

STUDY SELECTION

We selected intervention studies aimed at examining the effect of exercise on academic achievement and classroom behaviors at developmental age.

DATA EXTRACTION

Random-effects models were used to calculate pooled effect size for all primary outcomes (language- and mathematics-related skills, reading, composite score, and time in on-task behavior). Positive values represent a direct relationship between PA programs and academic achievement scores or on-task behaviors.

RESULTS

A total of 26 studies (10 205 children, aged from 4 to 13) were included. Pooled effect size (95% confidence interval) estimates were as follows: (1) 0.16 (-0.06 to 0.37) for language-related skills; (2) 0.21 (0.09 to 0.33) for mathematics-related skills; (3) 0.13 (0.02 to 0.24) for reading; (4) 0.26 (0.07 to 0.45) for composite scores; and (5) 0.77 (0.22 to 1.32) for time in on-task behaviors.

LIMITATIONS

Limitations included the variety of tools used to measure academic achievement and the limited number of studies that reported the effect of after-school PA interventions.

CONCLUSIONS

PA, especially physical education, improves classroom behaviors and benefits several aspects of academic achievement, especially mathematics-related skills, reading, and composite scores in youth.

Physically active Chilean school kids perform better in language and mathematics

We examined the association between the engagement in regular physical activity (PA) and the academic performance (AP) of school-age children from Santiago Metropolitan Region. In a random sample of 1271 students (13.3 ± 2.3 years old) we measured regular PA, accounting for hours of weekly scheduled exercise, and AP, using national standardized tests scores in Language and Mathematics. Bivariate and multivariate regression analyses were used to model the relation between academic and health-related behaviors. Two outcomes were considered: (i) sufficiency according to the Ministry of Education and (ii) discretionary sufficiency (tests z-scores ≥50th percentile). About 80% of students were poorly engaged in scheduled exercise (<2 h per week). Devoting more than 4 h per week to scheduled exercise significantly increased the odds of reaching the official and discretionary sufficiency in both Language and Mathematics. Moderate engagement (2-4 h per week) just improved the odds of reaching the discretionary sufficiency standard. These results confirm the poor engagement in regular exercise at the school level. School kids with the highest allocation of time to scheduled exercise have better AP in Language and Mathematics. Our findings support the notion that academic and health-related behaviors are linked and, similarly, that school health programs may have positive effects on educational outcomes.

Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review

BACKGROUND

The relationship among physical activity (PA), fitness, cognitive function, and academic achievement in children is receiving considerable attention. The utility of PA to improve cognition and academic achievement is promising but uncertain; thus, this position stand will provide clarity from the available science.

OBJECTIVE

The purpose of this study was to answer the following questions: 1) among children age 5-13 yr, do PA and physical fitness influence cognition, learning, brain structure, and brain function? 2) Among children age 5-13 yr, do PA, physical education (PE), and sports programs influence standardized achievement test performance and concentration/attention?

STUDY ELIGIBILITY CRITERIA

This study used primary source articles published in English in peer-reviewed journals. Articles that presented data on, PA, fitness, or PE/sport participation and cognition, learning, brain function/structure, academic achievement, or concentration/attention were included.

DATA SOURCES

Two separate searches were performed to identify studies that focused on 1) cognition, learning, brain structure, and brain function and 2) standardized achievement test performance and concentration/attention. PubMed, ERIC, PsychInfo, SportDiscus, Scopus, Web of Science, Academic Search Premier, and Embase were searched (January 1990-September 2014) for studies that met inclusion criteria. Sixty-four studies met inclusion criteria for the first search (cognition/learning/brain), and 73 studies met inclusion criteria for the second search (academic achievement/concentration).

STUDY APPRAISAL AND SYNTHESIS METHODS

Articles were grouped by study design as cross-sectional, longitudinal, acute, or intervention trials. Considerable heterogeneity existed for several important study parameters; therefore, results were synthesized and presented by study design.

RESULTS

A majority of the research supports the view that physical fitness, single bouts of PA, and PA interventions benefit children's cognitive functioning. Limited evidence was available concerning the effects of PA on learning, with only one cross-sectional study meeting the inclusion criteria. Evidence indicates that PA has a relationship to areas of the brain that support complex cognitive processes during laboratory tasks. Although favorable results have been obtained from cross-sectional and longitudinal studies related to academic achievement, the results obtained from controlled experiments evaluating the benefits of PA on academic performance are mixed, and additional, well-designed studies are needed.

LIMITATIONS

Limitations in evidence meeting inclusion criteria for this review include lack of randomized controlled trials, limited studies that are adequately powered, lack of information on participant characteristics, failure to blind for outcome measures, proximity of PA to measurement outcomes, and lack of accountability for known confounders. Therefore, many studies were ranked as high risk for bias because of multiple design limitations.

CONCLUSIONS

The present systematic review found evidence to suggest that there are positive associations among PA, fitness, cognition, and academic achievement. However, the findings are inconsistent, and the effects of numerous elements of PA on cognition remain to be explored, such as type, amount, frequency, and timing. Many questions remain regarding how to best incorporate PA within schools, such as activity breaks versus active lessons in relation to improved academic achievement. Regardless, the literature suggests no indication that increases in PA negatively affect cognition or academic achievement and PA is important for growth and development and general health. On the basis of the evidence available, the authors concluded that PA has a positive influence on cognition as well as brain structure and function; however, more research is necessary to determine mechanisms and long-term effect as well as strategies to translate laboratory findings to the school environment. Therefore, the evidence category rating is B. The literature suggests that PA and PE have a neutral effect on academic achievement. Thus, because of the limitations in the literature and the current information available, the evidence category rating for academic achievement is C.

Effects of Active Videogame and Sports, Play, and Active Recreation for Kids Physical Education on Children's Health-Related Fitness and Enjoyment

OBJECTIVE

The purpose of the study was to compare the effects of a Kinect active videogame (AVG) and the Sports, Play, and Active Recreation for Kids (SPARK) intervention in improving children's health-related fitness and physical activity (PA) enjoyment.

MATERIALS AND METHODS

A total of 65 students from both third and fourth grade in a rural elementary school participated in the study. The third graders (N = 29, mean age = 9.1 years, 10 boys, mean body mass index [BMI] = 20.1) were assigned to a SPARK physical education group, while the fourth graders (N = 36, mean age = 10.2 years, 15 boys, mean BMI = 20.3) were enrolled in the Kinect AVG group. The intervention lasted for 6 weeks, with each week including three practice sessions (∼40 minutes per session). All participants were measured on their health-related fitness by testing their performance in the 15-m Progressive Aerobic Cardiovascular Endurance Run (PACER), curl-ups, and push-ups both before and after the interventions. Participants' PA enjoyment was measured immediately after the first and last session's practice. Various ANCOVA tests were conducted to analyze the intervention effects on the changes of health-related fitness performances and enjoyment while controlling for baseline values, gender, and BMI. Various MANOVA tests were used to examine the intervention effects on PA levels during three practice sessions.

RESULTS

Participants in AVG group had greater improvement in 15-m PACER test (P < 0.001), as well as PA enjoyment (P < 0.05), than those in SPARK group. The AVG group generated higher light PA and lower sedentary time for three (P < 0.05 to P < 0.001) and two sessions (P < 0.05 and P < 0.001), respectively. In addition, the AVG group accumulated higher moderate-to-vigorous physical activity (MVPA) for the first session (P < 0.01), while the SPARK group generated higher MVPA for the third session (P < 0.001). No MVPA difference was found between groups for another session.

CONCLUSION

A 6-week (40 minutes × 3 times/week) program using AVG could be an effective strategy in improving children's cardiorespiratory fitness while maintaining PA enjoyment.

Factors associated with good self-rated health in European adolescents: a population-based cross-sectional study

OBJECTIVES

The aim of the present study was to investigate self-reported health status and associated factors.

METHODS

In this cross-sectional study, the participants were 6501 adolescents (52% females) aged 14-19 years from three European countries: Croatia, Lithuania and Serbia. Self-rated health was assessed by using one item question: "How would you perceive your health?" The answers were arranged along a 5-point Likert-type scale: (1) very poor, (2) poor, (3) fair, (4) good and (5) excellent. The outcome was binarized as "good" (fair, good and excellent) and "poor" health (very poor and poor). Potential factors associated with self-rated health included demographic (age, gender, socioeconomic status and body-mass index), social (social capital) and lifestyle (physical activity and psychological distress) variables.

RESULTS

In both univariate and multivariate models, being older, being a boy, having higher level of family, neighbourhood and school social capital, participating in moderate-to-vigorous physical activity more frequently and having low psychological distress were associated with good self-rated health.

CONCLUSIONS

Our findings suggest strong associations between social and lifestyle factors and self-rated health. Other explanatory variables will require future research.

School and Neighborhood Predictors of Physical Fitness in Elementary School Students

BACKGROUND

We assessed the associations of 5 school and 7 neighborhood variables with fifth-grade students achieving Healthy Fitness Zone (HFZ) or Needs Improvement-Health Risk (NI-HR) on aerobic capacity (AC) and body composition (BC) physical fitness components of the state-mandated FITNESSGRAM^® physical fitness test.

METHODS

Data for outcome (physical fitness) and predictor (school and neighborhood) variables were extracted from various databases (eg, Data Quest, Walk Score^® ) for 160 schools located in San Diego, California. Predictor variables that were at least moderately correlated (|r| ≥ .30) with ≥1 outcome variables in univariate analyses were retained for ordinary least squares regression analyses.

RESULTS

The mean percentages of students achieving HFZ AC (65.7%) and BC (63.5%) were similar (t = 1.13, p = .26), while those for NI-HR zones were significantly different (AC = 6.0% vs BC = 18.6%; t = 12.60, p < .001). Correlations were greater in magnitude for school than neighborhood demographics and stronger for BC than AC. The school variables free/reduced-price lunch (negative) and math achievement (positive) predicted fitness scores. Among neighborhood variables, percent Hispanic predicted failure of meeting the HFZ BC criterion.

CONCLUSIONS

Creating school and neighborhood environments conducive to promoting physical activity and improving fitness is warranted.

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

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

Lifestyle use of drugs by healthy people for enhancing cognition, creativity, motivation and pleasure

Today, there is continued, and in some cases growing, availability of not only psychoactive substances, including treatments for mental health disorders such as cognitive enhancers, which can enhance or restore brain function, but also 'recreational' drugs such as novel psychoactive substances (NPS). The use of psychoactive drugs has both benefits and risks: whilst new drugs to treat cognitive symptoms in neuropsychiatric or neurodegenerative disorders could have great benefits for many patient groups, the increasing ease of accessibility to recreational NPS and the increasing lifestyle use of cognitive enhancers by healthy people means that the effective management of psychoactive substances will be an issue of increasing importance. Clearly, the potential benefits of cognitive enhancers are large and increasingly relevant, particularly as the population ages, and for this reason, we should continue to devote resources to the development of cognitive enhancers as treatments for neurodegenerative diseases and psychiatric disorders, including Alzheimer's disease, attention deficit hyperactivity disorder and schizophrenia. However, the increasing use of cognitive enhancers by healthy individuals raises safety, ethical and regulatory concerns, which should not be ignored. Similarly, understanding the short- and long-term consequences of the use of NPS, as well as better understanding the motivations and profiles of users could promote more effective prevention and harm reduction measures. Linked Articles This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc.

The health Oriented pedagogical project (HOPP) - a controlled longitudinal school-based physical activity intervention program

BACKGROUND

The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables.

METHODS

The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance.

DISCUSSION

HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention.

TRIAL REGISTRATION

The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 ) as of June 20th - 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.

Acute Exercise Improves Motor Memory Consolidation in Preadolescent Children

Objective: The ability to acquire new motor skills is essential both during childhood and later in life. Recent studies have demonstrated that an acute bout of exercise can improve motor memory consolidation in adults. The objective of the present study was to investigate whether acute exercise protocols following motor skill practice in a school setting can also improve long-term retention of motor memory in preadolescent children.

Methods: Seventy-seven pre-adolescent children (age 10.5 ± 0.75 (SD)) participated in the study. Prior to the main experiment age, BMI, fitness status and general physical activity level was assessed in all children and they were then randomly allocated to three groups. All children practiced a visuomotor tracking task followed by 20 min of rest (CON), high intensity intermittent floorball (FLB) or running (RUN) with comparable exercise intensity and duration for exercise groups. Delayed retention of motor memory was assessed 1 h, 24 h and 7 days after motor skill acquisition.

Results: During skill acquisition, motor performance improved significantly to the immediate retention test with no differences between groups. One hour following skill acquisition, motor performance decreased significantly for RUN. Twenty-four hours following skill acquisition there was a tendency towards improved performance for FLB but no significant effects. Seven days after motor practice however, both FLB and RUN performed better when compared to their immediate retention test indicating significant offline gains. This effect was not observed for CON. In contrast, 7 days after motor practice, retention of motor memory was significantly better for FLB and RUN compared to CON. No differences were observed when comparing FLB and RUN.

Conclusions: Acute intense intermittent exercise performed immediately after motor skill acquisition facilitates long-term motor memory in pre-adolescent children, presumably by promoting memory consolidation. The results also demonstrate that the effects can be accomplished in a school setting. The positive effect of both a team game (i.e., FLB) and running indicates that the observed memory improvements are determined to a larger extent by physiological factors rather than the types of movements performed during the exercise protocol.

Three Effective Ways to Nurture Our Brain

Abstract. A growing body of research suggests that physical activity, healthy eating, and music can, either directly or indirectly, have positive effects on our brain and cognition. More specifically, exercising and eating seem to enhance cognitive abilities, such as memory, creativity, and perception. They also improve academic performance and play a protective role from many degenerative diseases, including Alzheimer’s disease. Concerning music, research has shown that there exists a general positive relation between music aptitude and cognitive functioning. Furthermore, the presence of music seems to create a positive mood and a higher arousal, which translates into better performance in many cognitive tasks. This literature review provides an overview of the major empirical findings in this domain. Studies on both healthy and clinical individuals are reviewed and discussed. We conclude with suggestions for educators, policymakers, people in helping professions, and any others interested in making informed decisions about possible ways to nurture their own brain or the brain of the people they are trying to help. We also provide suggestions for additional research on this important topic.

Study protocol: the Fueling Learning through Exercise (FLEX) study - a randomized controlled trial of the impact of school-based physical activity programs on children's physical activity, cognitive function, and academic achievement

BACKGROUND

Physical activity (PA) is critical to preventing childhood obesity and contributes to children's overall physical and cognitive health, yet fewer than half of all children achieve the recommended 60 min per day of moderate-to-vigorous physical activity (MVPA). Schools are an ideal setting to meeting PA guidelines, but competing demands and limited resources have impacted PA opportunities. The Fueling Learning through Exercise (FLEX) Study is a randomized controlled trial that will evaluate the impact of two innovative school-based PA programs on children's MVPA, cognitive function, and academic outcomes.

METHODS

Twenty-four public elementary schools from low-income, ethnically diverse communities around Massachusetts were recruited and randomized to receive either 100 Mile Club® (walking/running program) or Just Move™ (classroom-based PA program) intervention, or control. Schoolchildren (grades 3-4, approximately 50 per school) were recruited to participate in evaluation. Primary outcome measures include PA via 7-day accelerometry (Actigraph GT3X+ and wGT3X-BT), cognitive assessments, and academic achievement via state standardized test scores. Additional measures include height and weight, surveys assessing psycho-social factors related to PA, and dietary intake. School-level surveys assess PA infrastructure and resources and intervention implementation. Data are collected at baseline, mid-point (5-6 months post-baseline), and post-intervention (approximately 1.5 years post-baseline). Demographic data were collected by parents/caregivers at baseline. Mixed-effect models will test the short- and long-term effects of both programs on minutes spent in MVPA, as well as secondary outcomes including cognitive and academic outcomes.

DISCUSSION

The FLEX study will evaluate strategies for increasing children's MVPA through two innovative, low-cost, school-based PA programs as well as their impact on children's cognitive functioning and academic success. Demonstration of a relationship between school-based MVPA with neutral or improved, rather than diminished, academic outcomes in a naturalistic environment has the potential to positively influence investment in school PA programs and initiatives.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02810834 . Registered May 11, 2015. (Retrospectively registered).

Effect of Active Videogames on Underserved Children's Classroom Behaviors, Effort, and Fitness

OBJECTIVE

The purpose of this study was to examine the effect of active videogames (AVGs) on underserved minority children's on-task classroom behavior, academic effort, and fitness.

MATERIALS AND METHODS

A one group pre- and posttest repeated measures design was used. In Fall 2013, 95 fourth grade children (57 boys, 38 girls; 96% of minority) from three classes at an underserved urban elementary school participated in teacher-supervised AVG activities (e.g., Wii Sports, Xbox Just Dance). Specifically, students participated in a 50-minute weekly AVG program at school for 6 weeks. Children's academic effort was evaluated by classroom teachers using a validated scale that assessed activity, attention, conduct, and social/emotional behavior. Moreover, children's classroom behavior was observed immediately before and after each AVG session by trained researchers. Finally, cardiovascular fitness was also measured.

RESULTS

A paired t-test was used to assess teacher-rated student effort, while one-way (gender) analysis of variance (ANOVA) with repeated measures was performed to analyze children's on-task classroom behavior. There was a significant effect on children's effort between the first (mean = 3.24, SD = 0.75) and last week (mean = 3.41, SD = 0.73) assessments, t = 2.42, P = 0.02. In addition, there was a significant effect on classroom behavior, F = 33.103, P < 0.01. In detail, children scored significantly higher on on-task behavior during the post-AVG observation (mean = 81.4, SD = 12.3) than seen during the pre-AVG observation (mean = 69.8, SD = 14.9). However, no main effect was indicated for gender, F = 0.39, P = 0.54. No significant improvement in cardiovascular fitness was observed, although slight improvements were seen.

CONCLUSION

Offering an AVG program at school could improve underserved minority children's classroom on-task behavior and academic effort. Future studies may include a control group to further confirm the effectiveness of AVG activities. Practical implications for educators and other stakeholders are provided.

The search for healthy schools: A multilevel latent class analysis of schools and their students

The objective of this study was to establish and investigate a taxonomy of school health among high school students in Ontario, Canada. Data analyzed were based on 3358 9th–12th graders attending 103 high schools who participated in the 2011 Ontario Student Drug Use and Health Survey. Based on 10 health-related indicators, multilevel latent class analysis was used to extract 4 student-level latent classes and 3 school-level latent classes. Unhealthy schools (19% of schools) had the lowest proportion of healthy students (39%) and the highest proportion of substance-using (31%) and unhealthy (18%) students. Healthy schools (66%) contained the highest proportion of healthy students (56%) and smaller proportions of substance-using (22%) and unhealthy students (8%). Distressed schools (15%) were similar to healthy schools in terms of the proportions of healthy and unhealthy students. Distressed schools, however, were characterized by having the largest proportion of distressed students (35%) and the lowest proportion of substance-using students (4%). Meaningful categories of schools with respect to healthy environments can be identified and these categories could be used for focusing interventions and evaluating school health programs.

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Multi-level latent class analysis to identify student and school latent classes

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School-level latent classes include healthy, unhealthy, and distressed schools

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Importance of school environment as well as student health-related behaviours.

Effectiveness of a School-Based Physical Activity Intervention on Cognitive Performance in Danish Adolescents: LCoMotion-Learning, Cognition and Motion - A Cluster Randomized Controlled Trial

Background

Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12–14 years old adolescents.

Methods

A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD) age: 12.9 (0.6) years) completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects). The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness.

Results

No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p’s>0.05) or mathematics skills (p>0.05). An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4–38.6) and body-mass index in boys (-0.22 kg/m² (95% CI: -0.39–0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0–9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p’s>0.05).

Conclusions

No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared to a control group, but low implementation fidelity precludes interpretation of the causal relationship.

Trial Registration

www.ClinicalTrials.gov NCT02012881

Impact of an active educational video game on children's motivation, science knowledge, and physical activity

BACKGROUND

Active educational video games (AVGs) appear to have a positive effect on elementary school students' motivation leading to enhanced learning outcomes. The purpose of this study was to identify the effectiveness of an AVG on elementary school students' science knowledge learning, physical activity (PA) level, and interest-based motivation.

METHODS

In this randomized controlled study, 53 elementary school students were assigned to an experimental condition or a comparison condition. The experimental condition provided an AVG learning environment, whereas the comparison condition was based on sedentary educational video games.

RESULTS

The results of repeated measures analysis of variance (ANOVA) on the knowledge test showed that students in both groups performed better on the post-test than they did on the pre-test (p < 0.001, η ² = 0.486), and their post-test scores did not differ significantly. The experimental condition provided a more active environment since the students' average heart rates (HRs) were in the Target-Heart-Rate-Zone (HR = 134 bpm), which was significantly higher than the average HR (103 bpm) from the comparison condition (t = 7.212, p < 0.001). Students in the experimental condition perceived a higher level of situational interest than their counterparts in the comparison group (p < 0.01, and η ² = 0.301).

CONCLUSION

These results suggest that AVGs benefit children more in terms of PA and motivation than traditional video games by providing an enjoyable learning experience and sufficient PA.

Health in Adapted Youth Sports Study (HAYS): health effects of sports participation in children and adolescents with a chronic disease or physical disability

Background

In typically developing children, participation in sports has been proven to be positively correlated to both physical and psychosocial health outcomes. In children and adolescents with a physical disability or chronic disease participation in both recreational and competitive sports is often reduced, while for this population an active lifestyle may be even more important in reaching optimal levels of physical and psychosocial health. Therefore, the aim of the Health in Adapted Youth Sports (HAYS) Study is to determine both negative and positive effects of sports on children and adolescents with a chronic disease or physical disability.

Methods

In this cross-sectional study differences will be compared in regards to physical and psychosocial health, cognitive functioning, school performance, daily physical activity and injuries between children and adolescents with a chronic disease or physical disability who participate in sports and those who do not. Children and adolescents, both ambulatory and wheelchair dependent, in the age of 10–19 years with a physical disability or chronic disease will be included. “Sports” is defined as participation in an organized sport at least two times a week for a duration of 3 months or more prior to the assessment. Parametric and non-parametric statistics will be used to determine the differences between the two groups.

Discussion

This study provides insight in the effects of sports participation in relation to health, psychosocial functioning, physical activity and school performance in children and adolescents (10–19 years) with a chronic disease or physical disability. Results will guide healthcare professionals working with these children to better guide this population in reaching optimal levels of health and physical activity levels.

Sport-2-Stay-Fit study: Health effects of after-school sport participation in children and adolescents with a chronic disease or physical disability

BACKGROUND

Children and adolescents with a chronic disease or physical disability have lower fitness levels compared to their non-disabled peers. Low physical fitness is associated with reduced physical activity, increased cardiovascular diseases, and lower levels of both cognitive and psychosocial functioning. Moreover, children and adolescents with a chronic disease or physical disability participate less in both recreational and competitive sports. A variety of intervention studies have shown positive, but only temporary, effects of training programs. Next to issues related to the chronic condition itself, various personal and environmental factors play a key role in determining the extent to which they participate in sports or physical activities. Due to these barriers, sport participation in the immediate after-school hours seems to be a feasible solution to get these children and adolescents physical active structurally. To investigate if an after school sport program can sustain the positive effects of an intervention, a standardized interval training will be given to improve physical fitness levels. High-intensity Interval Training (HIT) is superior to moderate-intensity continuous training in improving physical fitness in patients with chronic diseases. Therefore, the Sport-2-Stay-Fit study will investigate whether after school sport participation can increase the sustainability of a HIT program in children and adolescents with a chronic disease or physical disability.

METHODS

The Sport-2-Stay-Fit study is a clinical controlled trial. A total of 74 children and adolescents in the age of 6-19 years with a chronic disease or physical disability will be included. This could be either a cardiovascular, pulmonary, metabolic, musculoskeletal or neuromuscular disorder. Both children and adolescents who are ambulatory or propelling a manual wheelchair will be included. All participants will follow a HIT program of eight weeks to improve their physical fitness level. Thereafter, the intervention group will participate in sport after school for six months, while the control group receives assessment only. Measurements will take place before the HIT, directly after, as well as, six months later. The primary objective is anaerobic fitness. Secondary objectives are agility, aerobic fitness, strength, physical activity, cardiovascular health, cognitive functioning, and psychosocial functioning.

DISCUSSION

If effective, after school sport participation following a standardized interval training could be implemented on schools for special education to get children and adolescents with a chronic disease or physical disability active on a structural basis.

TRIAL REGISTRATION

This trial is registered at the Dutch Trial Register #NTR4698.

The Effect of Stand-biased Desks on Academic Engagement: An Exploratory Study

BACKGROUND

Schools have been suggested as a viable avenue to combat childhood obesity. School administrators are sometimes faced with the conflicting demands of improving the health of their students and maintaining academic performance. Dynamic furniture such as stand-biased desks may be one way to address both academic and health demands placed on schools to prevent childhood obesity.

METHOD

Classrooms with stand-biased desks were compared to classrooms using traditional seated desks in 2^nd,3^rd, and 4^th grades. The academic engagement of 282 participants was observed in the fall and spring during one academic year. The engagement of the treatment classrooms was compared to the engagement of the control classrooms.

RESULTS

Both groups showed general increases in their academic engagement over time. Stand-biased desks do not seem to result in adverse effects on academic engagement when used in elementary classrooms.

CONCLUSION

The data suggests promising results for the use of stand-biased desks in elementary school classrooms. The results suggest that stand-biased desks can be introduced in the classroom to combat childhood obesity through increasing energy expenditure without affecting academic engagement.