Academic-Based and Aerobic-Only Movement Breaks: Are There Differential Effects on Physical Activity and Achievement?

Feasibility of student-designed, peer-led classroom physical activity breaks in graduate school

Objective: We evaluated the feasibility of Pitt Moves, a classroom-based, peer-led physical activity break (PAB) intervention developed by graduate students to improve mood, focus, and boredom among students. Participants: One hundred and thirty-two graduate-level students in 10 courses during an academic semester. Methods: Process evaluation with a formative focus involving document review, surveys, and interviews with students and facilitators. Results: Eighty-four percent of eligible students participated in ≥1 of 65 PABs. Participants said Pitt Moves provided a mental break, promoted community building, and increased their physical activity. They recommended increasing accessibility. Organizers' time was a constraint in running this program. Conclusion: Pitt Moves was feasible based on successful recruitment of participants, delivery of PABs as planned, and participant acceptability. A formal study should evaluate whether Pitt Moves can improve mood, focus, and boredom among graduate students. Organizational encouragement and audiovisuals could enhance marketing and program implementation.

The Use of Wearable Activity Trackers in Schools to Promote Child and Adolescent Physical Activity: A Descriptive Content Analysis of School Staff's Perspectives

BACKGROUND

The school environment is an ideal setting for promoting physical activity (PA). Wearable activity trackers (wearables) have previously been implemented, in research, as intervention tools within the school-environment. However, the large-scale use and acceptance of wearables, in schools, is unknown.

METHODS

This study distributed a cross-sectional survey to school staff to investigate the prevalence of child and adolescent wearable use in schools, including when and how they are used, and school staff's willingness to use them in the future (as implemented by school staff). This survey consisted of between 13 and 22 items, including closed-ended and open-ended questions. Closed-ended responses were displayed descriptively (wearable prevalence and characteristics), and open-ended qualitative responses were categorised using descriptive content analysis (how wearables are used).

RESULTS

1087 school staff provided valid responses. Of those, 896 (82.4%) had never used a wearable as a teaching or support tool for their students, and 120 (11%) currently used- and 71 (6.5%) had previously used- a wearable as a teaching or support tool for their students. When wearables were used, school staff implemented their use regularly and during physical education lessons or throughout the entire school day. Wearables were used to monitor or increase student's PA levels, or for student and staff educational purposes (e.g., academic learning, movement breaks). Most school staff were willing to use a wearable as a teaching or support tool to promote student's PA, and/or learning about PA, in the future.

CONCLUSIONS

This study is the first study to explore the widescale use and acceptance of children and adolescents using wearables in the school-setting. Findings may inform the development of future school-based interventions and public health initiatives for physical activity promotion, using wearables.

Associations Between Physical Fitness, Objectively Measured Physical Activity and Academic Performance

There is evidence that physical activity (PA) can improve the academic performance. We recruited healthy adolescent girls, aged 11–12 years, and measured their PA with the accelerometer ActiGraph GT3X for the consecutive 5 days. Physical fitness (PF) was measured with eight motoric tests and three anthropometry measures. Academic performance (AP) was assessed for the six academic narrated school subjects. The results revealed that the girls were more physically active during the week days and less active at weekend (557 vs. 516 counts/min). Physical education grade shows the highest overall correlations with the results of the PF test battery (r = 0.53–0.95, p < 0.01). Nevertheless, correlations surprisingly decrease for the combined daily PA (r = 0.45), especially the weekend PA (r = 0.28). Grade point average and PF correlated moderately (r = 0.43-0.64), while they were moderate to high for PA (r = 0.59–0.87). Many questions arose after the completion of the present study and several new topics opened up, such as the question of how parental education affects the duration of PA and AP of the children and the influence of the place of residence AP of the children.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18

BACKGROUND

Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school.

OBJECTIVES

The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information.

SELECTION CRITERIA

Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update.  DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type.

MAIN RESULTS

Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias.  Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events.

AUTHORS' CONCLUSIONS

Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.

Classroom-based physical activity and math performance: Integrated physical activity or not?

AIM

This 8-week intervention examined the effect of two different types of classroom-based physical activity on math performance in elementary school children.

METHODS

Students in 4th and 5th grade (N = 560; 32 classes, 9-11 years old) from six schools were assigned to integrated physical activity (Move for Thought [M4T], n = 221), activity break (AB; n = 134) and a control group (n = 205; usual instruction) for eight weeks. Students completed a standardised math test before and after the intervention. Programme fidelity was measured with a teacher daily log, recording the duration and frequency of the physical activity sessions. Linear mixed models were used for the analyses. Grade and gender were explored as moderators.

RESULTS

Move for Thought group outperformed AB (p < 0.001, d = 0.44) and control groups (p = 0.013, d = 0.38). However, subgroup analyses showed that these effects were evident only in Grade 4. No gender differences were found. Intervention fidelity showed that the classroom-based physical activities (M4T and AB) were used about every other day, with higher implementation among 4th graders.

CONCLUSION

This study indicated that integrating physical activity with mathematics has stronger effects on mathematics than activity breaks and traditional instruction.

The Walking Classroom: Measuring the Impact of Physical Activity on Student Cognitive Performance and Mood

BACKGROUND

The Walking Classroom is an education program that provides students with an opportunity to accumulate physical activity without losing instructional time.

METHOD

This research tests Kuczala's application of kinesthetic learning theory through measuring knowledge retention, postactivity information processing, and mood in students who engage in a short bout of physical activity while listening to Walking Classroom podcasts about language arts, science, and history, and those who remain seated during a podcast, compared with baseline levels. Students from 9 high-poverty fourth- and fifth-grade classrooms (n = 319) in a North Carolina county comprised the sample.

RESULTS

Utilizing multivariate analysis of covariance, the results demonstrate significantly higher levels of learning while walking compared with learning while sitting. Measures of mood utilizing the 10-item version of the Positive and Negative Affect Scale also demonstrated a significant effect in predicted directions.

CONCLUSION

The results support that coupling physical activity with instruction leads to increased performance and mood for elementary school students.

Longitudinal Associations between Physical Fitness and Academic Achievement in Youth

INTRODUCTION

Data from clinical trials have justified the promotion of fitness as a means to enhance facets of cognitive control and academic achievement in youth. However, such associations, when tested under real-world conditions, are equivocal. The purpose of this study, therefore, was to evaluate longitudinal associations between aerobic capacity (AC), weight status, and academic achievement within a large urban county.

METHODS

Longitudinal data were obtained from a sample of third, fifth, and seventh grade students in schools within an urban county in Georgia. Data on body mass index (BMI) were available from 11,639 students; AC data from 5735 students. Data on both indicators were obtained through the established FitnessGram assessment battery with 2-yr changes calculated using standardized Z scores. Academic achievement data were available from three subjects (math, science, and reading) for third, fifth, and seventh grade students, and 2-yr changes were computed using changes in Z scores for each test. Data were analyzed using generalized logistic models to test associations between change in BMI and AC in relation to changes in academic achievement.

RESULTS

Positive associations were observed between improvements in weight status and academic achievement for the fifth grade boys and girls ([reading] odds ratio [OR], 1.47; 95% confidence interval [CI], 1.25-1.72; [science] OR, 1.22; 95% CI, 1.04-1.42). Maintaining weight status was associated with improved scores in the third grade ([math] OR, 1.16; 95% CI, 1.012-1.327; [reading] OR, 1.47; 95% CI, 1.25-1.72) and fifth grade cohorts (math OR, 1.20; 95% CI, 1.00.1.43). For AC, no significant associations were found for any age cohort.

CONCLUSIONS

Modest associations between improvements in weight status, AC, and academic achievement are noteworthy, despite the lack of statistical significance for AC. The results provide a robust evaluation of associations between fitness and academic achievement.

Evaluation of school-based interventions of active breaks in primary schools: A systematic review and meta-analysis

OBJECTIVES

To provide a systematic review of studies that investigated the effects of Active Break (AB) school-based interventions on Physical Activity (PA) levels, classroom behavior, cognitive functions, and academic performance in primary school children.

DESIGN

Systematic review and meta-analysis.

METHODS

Searches of electronic databases and grey literature, with no time restriction and up to April 2019, resulted in 22 intervention studies meeting the inclusion criteria. Quality assessment of the studies was performed in accordance with the Cochrane Tool for Quality Assessment for RCTs and the STROBE tool for observational studies.

RESULTS

Four AB related outcomes were analyzed: (i) AB interventions had a significant effect in increasing PA levels in primary school children, both in terms of increased moderate to vigorous PA and step count. The meta-analysis seems to confirm this trend, showing a statistically significant result for the step count (p<0.00001, CI95% -0.71,1.21) (random model I²=0%). (ii) Regarding classroom behavior, time spent on task (TOT) during lessons significantly increased in each of the included studies. On the other hand, the effects on (iii) cognitive functions (attention components, working memory, executive functions) and (iv) academic achievements (mathematics, reading) were not conclusive.

CONCLUSIONS

Positive effects were found for PA levels and classroom behavior, while the conflicting results for cognitive functions and academic achievements suggest that the effect could be more evident with curriculum focused active breaks and active lessons that integrate ABs with key learning aspects and cognitive engagement.

Integrating Juggling with Math Lessons: A Randomized Controlled Trial Assessing Effects of Physically Active Learning on Maths Performance and Enjoyment in Primary School Children

There are tentative indications that physical activity (PA) during school time can be beneficial for children's academic performance. So far, most studies have focused on the effects of moderate-to-vigorous PA, for example, in the form of energizers or extra physical education lessons. Little is known about the effects of physically active learning, in which PA is integrated with the academic content of the lessons, especially in preadolescent children. Moreover, there is a lack of knowledge regarding the enjoyment of physically active learning in this age group. Therefore, the aim of the current study was to assess the effects of integrating juggling with math practice in primary school children, on (1) multiplication memorization performance and (2) enjoyment during the math lessons. We conducted a cluster randomized controlled trial, in which 312 children (mean age 10.4 years) from nine Dutch primary schools participated. Fourteen classes were randomly assigned to either a group that learned juggling whilst practicing multiplication tables (intervention group), or to a group that practiced the same multiplication tables while sedentary (control group). Both interventions had a duration of 5 weeks and consisted of 20 short lessons (4 lessons per week, 5 to 8 min). We used mixed-model analyses to examine the effect of the intervention on multiplication memorization performance. Group (control or intervention) was used as the fixed factor, and class and school as random intercepts. Analyses were adjusted for pretest multiplication performance, age, gender, general motor skill level, physical activity behavior (PAQ-C), and academic math performance. No significant intervention effect on multiplication performance were observed. However, the math-juggling program significantly increased enjoyment of children during the math lessons. We can conclude that the intervention did not improve, but neither deteriorated children's math performance. The increased enjoyment in the math-juggling group can serve as an important starting point for structurally incorporating physical activities in the classroom setting.

School Health Policy Implementation: Facilitators and Challenges

Schools are uniquely positioned to impact student health and academic outcomes through health and wellness policies. The purpose of this study was to describe factors influencing implementation of school health and wellness policies, specifically those focused on physical activity and nutrition. In-depth, stakeholder interviews were conducted with key informants at eight Chicago Public Schools (K-eighth grade). Data were analyzed using summative content analysis. Two themes were identified, facilitators and challenges to policy implementation. Facilitators included district support and motivation (internal and external). Challenges included limited school nurse availability, breaking tradition and budget. The external community and wellness team composition fell within both themes. Specific strategies are suggested to build upon policy implementation facilitators and overcome challenges. While school nurses play an integral role in student health and wellness, further research is needed to understand school nurse impact on student health and academic outcomes through school health policy.

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

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