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Campagna J, Czyszczon K, Little J, Selby C, Wick L, Ferreira D, Oriel K. The physical and psychosocial impact of a school-based running programme for adolescents with disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:181-192. [PMID: 37984471 DOI: 10.1111/jir.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 09/28/2023] [Accepted: 10/11/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Adolescents with disabilities have fewer opportunities to participate in community-based fitness programmes. The purpose of this study was to examine the impact of a school-based running programme at a local middle school in Lebanon, Pennsylvania, on fitness and quality of life (QoL) in children with physical and cognitive disabilities in a life-skills classroom. METHODS Nineteen adolescents with diagnosed disabilities including intellectual disability (ID), autism spectrum disorder and Down syndrome were recruited from three life-skills classrooms to participate in a school-based running programme. The programme was designed to be implemented two times/week for 6 weeks by classroom teachers/aides. Physical therapy faculty and students developed the programme and assisted with implementation. Each session lasted 30 min, consisting of a warm-up and cooldown, relay races, games and timed runs. Pre- and post-test measures included physiological cost index (PCI) and Paediatric Quality of Life Inventory™ (PedsQL™). Pre- and post-test data were compared using Wilcoxon signed rank tests. Each week participants also completed a training log to reflect on the activity for the day. RESULTS Participants demonstrated significant improvements in PCI (P = 0.028) and the PedsQL™ (P = 0.008) following the running programme. CONCLUSIONS Results of this study suggest that participation in a 6-week school-based running programme may improve fitness and QoL in adolescents with disabilities.
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Affiliation(s)
- J Campagna
- Student, Lebanon Valley College, Annville, PA, USA
| | - K Czyszczon
- Student, Lebanon Valley College, Annville, PA, USA
| | - J Little
- Student, Lebanon Valley College, Annville, PA, USA
| | - C Selby
- Student, Lebanon Valley College, Annville, PA, USA
| | - L Wick
- Student, Lebanon Valley College, Annville, PA, USA
| | - D Ferreira
- Department of Physical Education and Exercise Science, Lander University, Greenwood, SC, USA
| | - K Oriel
- Department of Physical Therapy, Lebanon Valley College, Annville, PA, USA
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Reyes-Amigo T, Ibarra-Mora J, Aguilar-Farías N, Gómez-Álvarez N, Carrasco-Beltrán H, Zapata-Lamana R, Hurtado-Almonácid J, Páez-Herrera J, Yañez-Sepulveda R, Cortés G, Rolle-Cáceres G, Bezerra A. An active break program (ACTIVA-MENTE) at elementary schools in Chile: study protocol for a pilot cluster randomized controlled trial. Front Public Health 2024; 11:1243592. [PMID: 38259740 PMCID: PMC10800631 DOI: 10.3389/fpubh.2023.1243592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Background Physical inactivity is prevalent in childhood. Schools can be an ideal context to promote the regular practice of physical activity since children spend there a large part of the day. In this sense, an emerging and current trend is active breaks at school. This article presents a study protocol that seeks to assess the feasibility and effectiveness of an intervention with active breaks (ACTIVA-MENTE program) in a school context on physical activity, on-task classroom behavior, and the physical activity enjoyment in schoolchildren. Methods The protocol includes children aged 10 to 11 years. Two groups will be randomized (intervention and control groups). The intervention group will use the active break program, ACTIVA-MENTE, which consists of the application of a 4-min, 30-s video with moderate to vigorous-intensity physical activity. These breaks will be taken 6 times a day in the classes for 6 weeks. The total physical activity will be measured with accelerometers (Actigraph wGT3X-BT), the on-task behavior through the Direct Behavior Rating Scale and the level of enjoyment through the Physical Activity Enjoyment Scale. Discussion Previous research reported that active breaks have positive results in physical activity levels. This study will be one of the few to design active breaks through videos without depending on the presence of a physical education teacher and it can also provide new findings on the effectiveness of an active break's structure (e.g., types of exercises and intensity) on the indicated outcomes. Expected results It is expected that the ACTIVA-MENTE program can be a suitable program for school settings, potentially increasing physical activity levels, and the commitment to the task, as well as be a pleasant moment for the students. Clinical trial registration Clinicaltrials.gov, identifier NCT05403996.
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Affiliation(s)
- Tomás Reyes-Amigo
- Physical Activity Sciences Observatory (OCAF), Department of Physical Activity Sciences, Universidad de Playa Ancha, Valparaíso, Chile
| | - Jessica Ibarra-Mora
- Physical Education, Universidad Metropolitana de las Ciencias de la Educación, Ñuñoa, Chile
| | - Nicolás Aguilar-Farías
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Nicolás Gómez-Álvarez
- Physical Activity, Health and Education Research Group (AFSYE), Physical Education Pedagogy, Universidad Adventista de Chile, Chillán, Chile
| | - Hernaldo Carrasco-Beltrán
- Physical Activity Sciences Observatory (OCAF), Department of Physical Activity Sciences, Universidad de Playa Ancha, Valparaíso, Chile
| | | | - Juan Hurtado-Almonácid
- Physical Education School, Pontificia Universidad Católica de Valparaísio, Viña del Mar, Chile
| | - Jacqueline Páez-Herrera
- Physical Education School, Pontificia Universidad Católica de Valparaísio, Viña del Mar, Chile
| | | | - Guillermo Cortés
- School of Education, Universidad Viña del Mar, Viña del Mar, Chile
| | - Grissel Rolle-Cáceres
- Faculty of Education and Social Sciences, Universidad Andrés Bello, Viña del Mar, Chile
| | - Andréa Bezerra
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, Universidade do Porto, Porto, Portugal
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Wang J, Zhao X, Bi Y, Jiang S, Sun Y, Lang J, Han C. Executive function elevated by long term high-intensity physical activity and the regulation role of beta-band activity in human frontal region. Cogn Neurodyn 2023; 17:1463-1472. [PMID: 37974584 PMCID: PMC10640436 DOI: 10.1007/s11571-022-09905-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/19/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
The importance of physical activity (PA) to people's health has become a consensus around the world, and regular long-term PA has been accepted as an alternative preventive measure for many chronic medical conditions. Although the daily PA have several benefits for the public, the systematic research on its effect in human physiology, cognition and cerebral nerve level is not fully studied. Hence, in this study, we aim to investigate this question in several specific aspects: basal heart rate, executive function, and neural oscillatory activity in the brain. A total of 146 subjects participated in this study and they were divided into two groups. One group (SG) is the long-term training (more than 8 years) subjects in soccer (n = 31), and the other group (CG) is a normal control group (n = 115). The heart rate was monitored with a portable equipment. Besides, 24 subjects (14 in SG and 10 in CG) participated the Go/No-Go task and EEG recording before and after exercise fatigue task. In the physiology level, we found that in the non-training time, the heart rate in CG group is significantly higher than that of the SG group (P < 0.001). In the cognition level, we found that the SG group has a faster reaction time that that of CG group (P < 0.01), while for the accuracy, two groups did show significant difference. In the neural level in the brain, we found a significant abnormal increased beta-band (around 25 Hz) activity in CG group after the exercise fatigue task immediately. Long-term high-intensity physical activity reduces basal heart rate, improves executive function, and improve the central tolerance of the body under the stimulation of fatigue and stress. These benefits of long-term activity could be used as a manual to guide people's healthy life.
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Affiliation(s)
- Junxiang Wang
- College of P.E. and Sports, Beijing Normal University, Beijing, 100875 China
| | - Xudong Zhao
- College of P.E. and Sports, Beijing Normal University, Beijing, 100875 China
| | - Yan Bi
- College of P.E. and Sports, Beijing Normal University, Beijing, 100875 China
| | - Shan Jiang
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, 999077 China
| | - Yinghua Sun
- College of P.E. and Sports, Beijing Normal University, Beijing, 100875 China
| | - Jian Lang
- College of P.E. and Sports, Beijing Normal University, Beijing, 100875 China
| | - Chuanliang Han
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
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Zhang D, Shi L, Zhu X, Chen S, Liu Y. Effects of intervention integrating physical literacy into active school recesses on physical fitness and academic achievement in Chinese children. J Exerc Sci Fit 2023; 21:376-384. [PMID: 37927355 PMCID: PMC10624586 DOI: 10.1016/j.jesf.2023.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 09/19/2023] [Accepted: 09/27/2023] [Indexed: 11/07/2023] Open
Abstract
Background/Objective The aim of this study was to examine the effects of school-based intervention integrating physical literacy (PL) into active school recesses (ASR) on physical fitness (i.e., body composition, 20-m shuttle run, 50-m run, rope skipping, sit and reach, handgrip) and academic achievement (i.e., academic result of Chinese and Mathematics) in Chinese children. Methods A total of 357 children (mean age: 7.8 ± 0.7 years; boys: 50.4%) were recruited from two schools and these two schools were randomly assigned as the intervention group (IG) and the control group (CG), respectively. The IG consisted of 155 children (mean age: 7.9 ± 0.7 years, boys: 51.0%), and 202 children (mean age: 7.8 ± 0.7 years; boys: 50%) were allocated to the CG. Children in the IG received a 10-week intervention integrating PL that was conducted during ASR. In the CG, children's regular school activity was remained during the intervention period. Generalized estimating equation was performed to compare the levels of physical fitness and academic achievement between the IG and the CG after intervention. Results Regarding physical fitness, there was a significant group × time interaction on 20-m shuttle run (β = -3.89, 95% CI [-5.08; -2.71], p < 0.001) and handgrip (β = -0.70, 95% CI [-1.20; -0.20], p = 0.006). After intervention, children in the IG had a greater increase than the CG (p < 0.001) in terms of 20-m shuttle run and handgrip. In addition, the post-test analysis indicated that performance of children in the IG was significantly greater than those in the CG (20-m shuttle run: p < 0.001, handgrip: p = 0.002). There was a significant group × time interaction on academic result of Chinese (β = -1.21, 95% CI [-1.91; -0.56], p = 0.001) and academic result of Mathematics (β = 16.71, 95% CI [15.14; 18.143], p < 0.001). Statistically significant positive difference in post-test was observed in academic result of Mathematics between the IG and the CG (p = 0.012). Conclusion The results of this intervention study indicate that intervention integrating PL into ASR could bring a promising effect on physical fitness and academic achievement in children. It is recommended that future studies are necessary to assess the effects of ASR-based PL intervention on physical and cognitive outcomes using a wide range of sample.
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Affiliation(s)
- Danqing Zhang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Lijuan Shi
- Shanghai Teacher Education Institute, Shanghai, China
| | - Xiaoling Zhu
- Education Institute of Yangpu District Shanghai, Shanghai, China
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
- Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai, China
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James J, Pringle A, Mourton S, Roscoe CMP. The Effects of Physical Activity on Academic Performance in School-Aged Children: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1019. [PMID: 37371251 DOI: 10.3390/children10061019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Schools offer a unique environment to influence children's physical activity (PA) levels positively. This study aims to systematically review the evidence surrounding how PA affects academic performance by analysing how the frequency, intensity, time, and type of PA mediate academic performance outcomes. This review was conducted using the PRISMA framework. Keyword searches were conducted in Science Direct, PubMed, and SPORTDiscus. Children that were obese, typically developing, typical weight, disabled, with a developmental disability, from a low socio-economic background, or an ethnic minority were included. A total of 19 studies were included, with a total of 6788 participants, a mean age of 9.3 years (50.2% boys, and 49.8% girls). Overall, 63.2% were nondisabled, while 36.8% were diagnosed with a disability. Two authors met, reviewed papers with regard to the inclusion criteria, and agreed on outputs to be included. Evidence suggests that associations between PA and academic performance were primarily positive or nonsignificant. PA levels of 90 min plus per week were associated with improved academic performance, as was PA performed at moderate to vigorous intensity. The optimal duration of PA was 30-60 min per session, whilst various sports induced positive academic effects. Importantly, findings support that PA does not have a deleterious effect on academic performance but can enhance it.
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Affiliation(s)
- Joseph James
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Andy Pringle
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Stuart Mourton
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Clare M P Roscoe
- Department of Sport and Exercise Science, Clinical Exercise and Rehabilitation Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK
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Jiménez-Parra JF, Belando-Pedreño N, Valero-Valenzuela A. The Effects of the ACTIVE VALUES Program on Psychosocial Aspects and Executive Functions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010595. [PMID: 36612915 PMCID: PMC9819049 DOI: 10.3390/ijerph20010595] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 05/27/2023]
Abstract
The main objective of this study was to implement an educational program named ACTIVE VALUES and to analyse the psychosocial and cognitive effects of its application. It is a quasi-experimental repeated measures research with a non-randomised experimental group (EG) and a control group (CG). The sample consisted of 102 students in the 6th grade of primary school, aged between 11 and 13 years (M = 11.59; SD = 0.60), and 4 teachers aged between 27 and 52 years (M = 38.5). The intervention program lasted 4 months, in which the EG implemented a teaching methodology based on the incorporation of classroom-based physical activity (CB-PA) in the structure of the Teaching for Personal and Social Responsibility (TPSR) model to develop personal and social values in students, as well as to reduce children's sedentary behaviour in the classroom in different educational areas (e.g., mathematics, Spanish language, social sciences and natural sciences), while the CG used a conventional methodology based on direct instruction. The main results found show significant improvements in intrinsic motivation variables (including intrinsic motivation for achievement, stimulating experiences and knowledge), self-determination index, autonomy, relatedness, psychological mediators index, personal and social responsibility, teacher climate, intention to be physically active and executive functions in the EG, while amotivation values increased in the CG. In conclusion, interdisciplinary educational programs based on the combination of pedagogical models and active methodologies are postulated as methodological alternatives to achieve an integral and multilateral development of children and adolescents, as well as to improve the different learning domains of physical education, such as cognitive, social and motor. It is recommended that future research should consider longitudinal designs with mixed methods and follow-up data to assess learning retention, as well as larger samples and the measurement of a greater number of executive functions (e.g., inhibitory control and attention).
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Affiliation(s)
| | - Noelia Belando-Pedreño
- Faculty of Sports Sciences, Department of Physical Activity and Sport, European University of Madrid, 28670 Madrid, Spain
| | - Alfonso Valero-Valenzuela
- Faculty of Sport Sciences, Department of Physical Activity and Sport, University of Murcia, 30720 Murcia, Spain
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Drozdowska A, Jendrusch G, Platen P, Lücke T, Kersting M, Sinningen K. Dose-Related Effects of Endurance, Strength and Coordination Training on Executive Functions in School-Aged Children: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111651. [PMID: 36360379 PMCID: PMC9688908 DOI: 10.3390/children9111651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 01/25/2023]
Abstract
This systematic review aims to evaluate previous findings on the dose-related effects of short- and long-term physical activities (PA) on executive functions (EF) using a new approach by considering the success of experimental manipulation. Eight electronic databases were searched between May 2021 and September 2021. Randomized control trials among healthy children (6-12 years) were screened. Data extraction included the measurement of experimental manipulations and pre-post measurements of physical fitness. After identifying 1774 records, 17 studies were included (nine short-term PA and eight long-term PA). The overall results suggest that a single 20-min PA may be overwhelming for short-term EF in children up to 9 years of age but may be beneficial for children 9 years and older. A dose-related relationship between PA and EF could not be verified in long-term studies, which is possibly due to insufficient fitness gains and participation in the intervention. Short- and long-term endurance and coordination training could improve children's executive functions, but so far, there is no specific evidence on the duration, frequency, and intensity of PA. Not quantity but quality of intervention seems to be important in this context. Further intervention studies are needed that control for the characteristics of the experimental manipulation.
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Affiliation(s)
- Alina Drozdowska
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr University Bochum, 44791 Bochum, Germany
- Correspondence: ; Tel.: +49-234-509-2615
| | - Gernot Jendrusch
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, 44801 Bochum, Germany
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, 44801 Bochum, Germany
| | - Thomas Lücke
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr University Bochum, 44791 Bochum, Germany
| | - Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr University Bochum, 44791 Bochum, Germany
| | - Kathrin Sinningen
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr University Bochum, 44791 Bochum, Germany
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Ludyga S, Gerber M, Kamijo K. Exercise types and working memory components during development. Trends Cogn Sci 2022; 26:191-203. [PMID: 35031211 DOI: 10.1016/j.tics.2021.12.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 12/08/2021] [Accepted: 12/18/2021] [Indexed: 12/11/2022]
Abstract
Working memory is crucial to learning and academic success. Exercise has been found to benefit working memory in late life, but its effects during cognitive development are less clear. Building on findings that working memory is supported by the motor system, we highlight the sensitivity of different working memory components to acute and long-term exercise in children and adolescents. We also consider how the specific skill demands of endurance and coordinative exercise influence this sensitivity. Distinct effects of these exercise types are further linked with neurocognitive and neuroendocrine pathways. Our review suggests long-term rather than acute benefits of exercise for children and adolescents' working memory, which are more pronounced and specific for exercise with high coordinative demands.
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Affiliation(s)
- Sebastian Ludyga
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Keita Kamijo
- Faculty of Liberal Arts and Sciences, Chukyo University, Nagoya, Japan
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
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.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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10
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Effect of classroom-based physical activity interventions on attention and on-task behavior in schoolchildren: A systematic review. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 3:125-133. [PMID: 35784522 PMCID: PMC9219312 DOI: 10.1016/j.smhs.2021.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 11/22/2022] Open
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Mazzoli E, Salmon J, Teo WP, Pesce C, He J, Ben-Soussan TD, Barnett LM. Breaking up classroom sitting time with cognitively engaging physical activity: Behavioural and brain responses. PLoS One 2021; 16:e0253733. [PMID: 34260606 PMCID: PMC8279315 DOI: 10.1371/journal.pone.0253733] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/08/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Classroom-based active breaks are a feasible and effective way to reduce and break up sitting time, and to potentially benefit physical health in school children. However, the effect of active breaks on children's cognitive functions and brain activity remains unclear. OBJECTIVE We investigated the impact of an active break intervention on typically developing children's cognitive functions and brain activity, sitting/standing/stepping, on-task behaviour, and enjoyment. METHODS Up to 141 children, aged between 6 and 8 years (46% girls), were included, although about half of them completed two of the assessments (n = 77, working memory; n = 67, dorsolateral prefrontal cortex haemodynamic response). Classrooms from two consenting schools were randomly allocated to a six-week simple or cognitively engaging active break intervention. Classrooms from another school acted as a control group. The main analyses used linear mixed models, clustered at the class level and adjusted for sex and age, to investigate the effects of the interventions on response inhibition, lapses of attention, working memory, event-related brain haemodynamic response (dorsolateral prefrontal cortex). The mediating effects of sitting/standing/stepping on cognition/brain activity were also explored. To test intervention fidelity, we investigated differences by group on the change values in children's sitting, standing, and moving patterns during class/school time using linear mixed models. Generalized linear mixed models clustered at the individual level were used to examine on-task behaviour data. For the intervention groups only, we also assessed children's perceived enjoyment, physical exertion and mental exertion related to the active breaks and compared the results using independent t-tests. RESULTS There was a significantly greater positive change in the proportion of deoxygenated haemoglobin in the left dorsolateral prefrontal cortex of children assigned to cognitively engaging active breaks compared to the control group (B = 1.53 × 10-07, 95% CI [0.17 × 10-07, 2.90 × 10-07]), which under the same cognitive performance is suggestive of improved neural efficiency. Mixed models showed no significant effects on response inhibition, lapses of attention, working memory. The mediation analysis revealed that the active breaks positively affected response inhibition via a change in sitting and standing time. The sitting, standing, and moving patterns and on-task behaviour were positively affected by the active breaks at end of trial, but not at mid-trial. Children in both intervention groups showed similarly high levels of enjoyment of active breaks. CONCLUSION Cognitively engaging active breaks may improve brain efficiency in the dorsolateral prefrontal cortex, the neural substrate of executive functions, as well as response inhibition, via effects partially mediated by the change in sitting/stepping time. Active breaks can effectively reduce sitting and increase standing/stepping and improve on-task behaviour, but the regular implementation of these activities might require time for teachers to become familiar with. Further research is needed to confirm what type of active break best facilitates cognition.
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Affiliation(s)
- Emiliano Mazzoli
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Wei-Peng Teo
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC, Australia
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education (NIE), Nanyang Technological University, Singapore, Singapore
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, Università degli Studi di Roma ’Foro Italico’, Rome, Italy
| | - Jason He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Tal Dotan Ben-Soussan
- Research Institute for Neuroscience, Education and Didactics, Cognitive Neurophysiology Laboratory, Patrizio Paoletti Foundation, Assisi, Italy
| | - Lisa Michele Barnett
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Bacon P, Lord RN. The impact of physically active learning during the school day on children's physical activity levels, time on task and learning behaviours and academic outcomes. HEALTH EDUCATION RESEARCH 2021; 36:362-373. [PMID: 33982097 PMCID: PMC8375005 DOI: 10.1093/her/cyab020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/15/2021] [Indexed: 06/12/2023]
Abstract
UNLABELLED The benefits of physical activity in school settings and its impact on health and academic outcomes are of interest from public health and educational contexts. This study investigates how physically active learning (PAL): (i) contributes to children's physical activity levels, (ii) impacts on academic outcomes and (iii) influences children's focus and concentration, defined as time on task (ToT). METHODS Over a 2-week period, participants were exposed to PAL and non-active learning (NAL) lessons in a counterbalanced design. Physiological responses and ToT behaviour were recorded throughout PAL and NAL lessons. Academic outcomes were assessed the week before, during and the week after each mode of delivery. RESULTS Children were more active during PAL (196�542 steps per week) compared to NAL (152�395 steps per week, P = 0.003). The physiological demands of PAL (73% HRmax), were significantly greater (P < 0.001) than NAL (51% HRmax). Children's ToT was significantly higher (P < 0.001) with PAL (97%) than NAL (87%). There were no differences in academic outcomes when PAL and NAL were compared. CONCLUSIONS Modest levels of PAL increased activity levels. No evidence was found to suggest PAL had a negative effect on children's academic outcomes, and PAL could positively impact on children's concentration.
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Affiliation(s)
- Paul Bacon
- Cardiff School of Sport and Health Sciences, Cardiff
Metropolitan University, Cardiff, UK
| | - Rachel N Lord
- Cardiff School of Sport and Health Sciences, Cardiff
Metropolitan University, Cardiff, UK
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13
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Hecht MF, Garber CE. Effectiveness of the POWER Program in Improving Physical Activity and Executive Function in Fifth Grade Students. THE JOURNAL OF SCHOOL HEALTH 2021; 91:574-583. [PMID: 34005838 DOI: 10.1111/josh.13035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/27/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND High volumes of school-based sedentary time may impact academic achievement and executive function negatively. This study evaluated a multimodal classroom program's (POWER) effect on fifth graders' physical activity (PA) and executive function. METHODS Six 5th grade classes (3 = intervention [POW]; 3 = waitlist control [CONT]) in 2 diverse New Jersey schools participated. Data were collected before, during, and post-intervention. PA was assessed via accelerometer, executive function by NIH Toolbox, and academic achievement via standardized math tests. The POW principal, teachers, and select students participated in follow-up interviews. Group comparisons were made by multivariate repeated-measures ANOVA and linear regression. RESULTS PA decreased in both groups over time, but POW's post-intervention class-time PA was significantly higher than CONT's. POW's NIH Toolbox score increased 3 percentiles more than CONT's. Intervention fidelity was associated with significantly higher scores for one NIH Toolbox test. Student math test scores increased significantly for both schools, but there was no significant main effect for group. POW's feedback was positive, with the principal reporting fewer disciplinary referrals and teachers and students conveying positive growth. CONCLUSIONS Overall, POW's positive changes and the favorable reception of POWER support POWER'S ability to improve children's socioemotional and physical health.
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Affiliation(s)
- Mindy Feldman Hecht
- Teachers College, Columbia University, 525 W. 120th Street, Box 93, New York, NY, 10027
| | - Carol Ewing Garber
- Applied Physiology Teachers College, Columbia University, 525 W. 120th Street, Box 93, New York, NY, 10027
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14
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Amatriain-Fernández S, Ezquerro García-Noblejas M, Budde H. Effects of chronic exercise on the inhibitory control of children and adolescents: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1196-1208. [PMID: 33559271 DOI: 10.1111/sms.13934] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/25/2022]
Abstract
Inhibitory control is a main component of executive functions that relate to the ability to control prepotent responses and to resist interferences. Deficits in inhibitory control have been associated with numerous disorders, but exercise has become a promising approach to benefit this domain. This systematic review and meta-analysis aims to provide synthesized information and effect size calculations of the benefits of chronic exercise interventions on the inhibitory control of healthy children and adolescents. A systematic search of PubMed, PsycINFO, MEDLINE, ERIC, SPORTDiscus, and PsycArticles identified 4166 articles to be screened for eligibility. A total of 10 studies (3138 participants) met the inclusion criteria. A random-effects analysis model was performed in three variables: accuracy, reaction time and combined scores. The results showed a very small but statistically significant effect in accuracy (d = 0.14, 95% CI 0.01 to 0.27, P =.04), and two almost null effects (statistically non-significant), in the reaction time (d = 0.03, 95% CI -0.10 to 0.16, P =.62) and the combined scores (d = 0.06, 95% CI -0.03 to 0.15, P =.17). Despite the high number of studies that reported positive outcomes, this meta-analysis found only modest benefits in the inhibitory control of healthy children and adolescents after they participated in different chronic exercise interventions. The strict inclusion criteria of this study and the high variability in the designs of the exercise interventions included, among other reasons, might explain the obtained results.
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Affiliation(s)
- Sandra Amatriain-Fernández
- Department of Pedagogy, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany.,Department of Physical and Sports Education, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Milagros Ezquerro García-Noblejas
- Department of Physical and Sports Education, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Henning Budde
- Department of Pedagogy, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
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Pedro Ángel LR, Beatriz BA, Jerónimo AV, Antonio PV. Effects of a 10-week active recess program in school setting on physical fitness, school aptitudes, creativity and cognitive flexibility in elementary school children. A randomised-controlled trial. J Sports Sci 2021; 39:1277-1286. [PMID: 33407022 DOI: 10.1080/02640414.2020.1864985] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this study was to assess the effects of a 10-week active recess programme in school setting on physical fitness, school aptitudes, creativity and cognitive flexibility in children. A total of 114 children (age range = 8-12 years old, 47.3% girls) participated in this study. The students were randomly assigned to two groups, experimental group (EG) and control group (CG). The EG performed a programme of physical exercise at moderate to vigorous intensity with cognitive engagement for 10 weeks, three times a week. Physical fitness, school aptitudes, creativity, and cognitive flexibility were tested. Non-significant differences were found in physical fitness (both pre-test and post-test) between groups. The EG experienced significant improvements in all school aptitudes, creativity and cognitive flexibility (TMT test). In addition, the EG showed greater increase (p<0.05) than the CG in all variables of school aptitudes (p<0.01), creativity (p<0.001) and cognitive flexibility (p<0.05). Significant correlation between ∆ TMT-B and ∆ V.O2max (r=-0.289, p=0.031) was found. In conclusion, active recess based on high intensity training can be a proper tool to improve some cognitive skills, such as school aptitudes, creativity, and cognitive flexibility.
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Affiliation(s)
| | - Berrios-Aguayo Beatriz
- Department of Didactics of Music, Plastic and Corporal Expression, University of Jaén, Jaén, Spain
| | - Aragón-Vela Jerónimo
- Department of Nutrition, Exercise and Sports(NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Pantoja-Vallejo Antonio
- Department of Didactics of Music, Plastic and Corporal Expression, University of Jaén, Jaén, Spain
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Liu S, Yu Q, Li Z, Cunha PM, Zhang Y, Kong Z, Lin W, Chen S, Cai Y. Effects of Acute and Chronic Exercises on Executive Function in Children and Adolescents: A Systemic Review and Meta-Analysis. Front Psychol 2020; 11:554915. [PMID: 33391074 PMCID: PMC7773601 DOI: 10.3389/fpsyg.2020.554915] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/17/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Physical exercises can affect executive function both acutely and chronically, with different mechanisms for each moment. Currently, only a few reviews have elaborated on the premise that different types of exercises have different mechanisms for improving executive function. Therefore, the primary purpose of our systematic review was to analyze the effects of acute and chronic exercises on executive function in children and adolescents. Objective: We identified acute and chronic exercise studies and randomized controlled trials (RCTs) of executive function in children and adolescents that reported overall effect, heterogeneity, and publication bias of acute and chronic exercises on executive function. Methods: We searched for RCTs of exercise interventions in children and adolescents from databases including PubMed, Web of Science, Scopus, The Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang, from January 1 2009 to December 31 2019. We performed methodological quality evaluations on the included literature using the Physiotherapy Evidence Database Scale (PEDro) and graded evidence with a meta-analysis using Stata 12.0 software. Results: In total, 36 RCTs were included (14 acute exercises, 22 chronic exercises); the overall results of the meta-analysis (4,577 students) indicated that acute exercises significantly improved working memory (standardized mean difference (SMD) = -0.72; 95% confidence interval (CI) -0.89 to -0.56; p < 0.001), inhibitory control (SMD = -0.25; 95% CI -0.40 to -0.09; p = 0.002), and cognitive flexibility (SMD = -0.34; 95% CI -0.55 to -0.14; p < 0.005), whereas chronic exercises significantly improved working memory (SMD = -0.54; 95% CI -0.74 to -0.33; p < 0.001), inhibitory control (SMD = -0.30; 95% CI -0.38 to -0.22; p < 0.001), and cognitive flexibility (SMD = -0.34, 95 % CI -0.48 to -0.20, p < 0.001). Conclusion: Acute and chronic exercises can effectively improve the executive function of children and adolescents. The effects on inhibitory control and cognitive flexibility are considered as small effect sizes, while the effects on working memory are considered as moderate effect size. Limited by the quantity and quality of the included studies, the above conclusions need to be verified with more high-quality studies.
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Affiliation(s)
- Shijie Liu
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Qian Yu
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, China
| | - Zaimin Li
- School of Wushu, Chengdu Sport University, Chengdu, China
| | - Paolo Marcello Cunha
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil
| | - Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, seoul National University, Seoul, South Korea
| | - Zhaowei Kong
- Faculty of Education, University of Macao, Macao, China
| | - Wang Lin
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
| | - Sitong Chen
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Yujun Cai
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
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Schmidt M, Mavilidi MF, Singh A, Englert C. Combining physical and cognitive training to improve kindergarten children’s executive functions: A cluster randomized controlled trial. CONTEMPORARY EDUCATIONAL PSYCHOLOGY 2020. [DOI: 10.1016/j.cedpsych.2020.101908] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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18
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Gendron É, Caru M, Léveillé P, Sultan S, Robaey P, Lemay V, Drouin S, Bertout L, Andelfinger G, Krajinovic M, Laverdière C, Sinnett D, Lippé S, Curnier D. The effect of cardiorespiratory fitness and physical activity levels on cognitive functions in survivors of childhood acute lymphoblastic leukemia. Pediatr Hematol Oncol 2020; 37:582-598. [PMID: 32510265 DOI: 10.1080/08880018.2020.1767737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction. Most childhood acute lymphoblastic leukemia (ALL) survivors develop chronic treatment-related adverse effects several years after the end of the treatment. Regular physical activity and a good cardiorespiratory fitness can decrease the risks of neurological disturbances and increase cognitive function scores. The aim of this study was to examine the effect of good cardiorespiratory fitness and physical activity levels on cognitive functions.Methods. We enrolled 219 survivors of childhood ALL. The participants underwent a cardiopulmonary exercise test, neuropsychological tests of executive functions (i.e. verbal fluency, cognitive flexibility, working memory, processing speed) and completed a physical activity questionnaire. We calculated the odds ratio to obtain the preventive fraction of physical activity and cardiorespiratory fitness levels on cognitive functions.Results. The cohort is 52% male and 48% female. A total of 182 survivors (83%) have a cardiorespiratory fitness below their predicted (<100%). Our analyses show that there is an association between good cardiorespiratory fitness and processing speed (preventive fraction of 70% for dominant hand (p < 0.01) and 65% for non-dominant hand (p < 0.01)) and with cognitive flexibility identified as the category switching measure of the D-KEFS verbal fluency (preventive fraction of 61%; p < 0.05).Conclusion. Good cardiorespiratory fitness and good levels of physical activity were associated to a preventive fraction for most cognitive function parameters measured. Good cardiorespiratory fitness levels were significantly associated with a lower prevalence of deficits in processing speed (i.e., dominant hand and non-dominant hand) and in cognitive flexibility (i.e., category switching) in childhood acute lymphoblastic leukemia survivors.
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Affiliation(s)
- Élisabelle Gendron
- Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.,Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - Maxime Caru
- Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.,Research Center, Sainte-Justine University Health Center, Montreal, Canada.,Laboratoire EA 4430 - Clinique Psychanalyse Developpement (CliPsyD), Department of psychology, University of Paris Nanterre, Nanterre, France
| | - Pauline Léveillé
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - Serge Sultan
- Research Center, Sainte-Justine University Health Center, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
| | - Philippe Robaey
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - Valérie Lemay
- Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.,Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - Simon Drouin
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - Laurence Bertout
- Research Center, Sainte-Justine University Health Center, Montreal, Canada
| | - Gregor Andelfinger
- Research Center, Sainte-Justine University Health Center, Montreal, Canada.,Department of Pediatrics, University of Montreal, Montreal, Canada
| | - Maja Krajinovic
- Research Center, Sainte-Justine University Health Center, Montreal, Canada.,Department of Pediatrics, University of Montreal, Montreal, Canada
| | - Caroline Laverdière
- Research Center, Sainte-Justine University Health Center, Montreal, Canada.,Department of Pediatrics, University of Montreal, Montreal, Canada
| | - Daniel Sinnett
- Research Center, Sainte-Justine University Health Center, Montreal, Canada.,Department of Pediatrics, University of Montreal, Montreal, Canada
| | - Sarah Lippé
- Research Center, Sainte-Justine University Health Center, Montreal, Canada.,Department of Psychology, Université de Montréal, Montreal, Canada
| | - Daniel Curnier
- Laboratory of Pathophysiology of EXercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.,Research Center, Sainte-Justine University Health Center, Montreal, Canada
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19
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Berg V, Rogers SL, McMahon M, Garrett M, Manley D. A Novel Approach to Measure Executive Functions in Students: An Evaluation of Two Child-Friendly Apps. Front Psychol 2020; 11:1702. [PMID: 32765379 PMCID: PMC7378958 DOI: 10.3389/fpsyg.2020.01702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/22/2020] [Indexed: 11/13/2022] Open
Abstract
Interest in measurement of children's executive functions has shown a major increase over the past two decades. The present study evaluates two new apps (EYT and eFun) for measuring executive functions in children. The results of this study show that children (aged 5-8) enjoy executive function assessment in the form of games on an iPad. However, only one executive function, EYT working memory, showed significant positive correlations with several types of grades (e.g., English and maths) in primary school students. New, self-assessed, child-friendly executive function measurement tools have the potential to provide future possibilities for teachers to integrate information on cognitive ability into student learning plans.
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Affiliation(s)
- Valeska Berg
- School of Arts and Humanities, Edith Cowan University, Perth, WA, Australia
| | - Shane L. Rogers
- School of Arts and Humanities, Edith Cowan University, Perth, WA, Australia
| | - Mark McMahon
- School of Arts and Humanities, Edith Cowan University, Perth, WA, Australia
| | - Michael Garrett
- School of Arts and Humanities, Edith Cowan University, Perth, WA, Australia
- Cinglevue International, Perth, WA, Australia
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Sember V, Jurak G, Kovač M, Morrison SA, Starc G. Children's Physical Activity, Academic Performance, and Cognitive Functioning: A Systematic Review and Meta-Analysis. Front Public Health 2020; 8:307. [PMID: 32760689 PMCID: PMC7372103 DOI: 10.3389/fpubh.2020.00307] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/05/2020] [Indexed: 01/08/2023] Open
Abstract
Researching the relationship between physical activity and academic performance is becoming an important research topic due to increasing evidence about the positive effect of physical activity on cognitive functioning. The present systematic review and meta-analysis (PROSPERO registration number: CDR132118) is a unique contribution to the recently published reviews since it only includes interventions longer than 6 weeks and acknowledges the influence of the qualifications of practitioners who deliver interventions. After identifying 14,245 records in five databases and selecting 247 full-text articles assessed for eligibility, 44 interventions passed all eligibility criteria. This meta-analysis uses validity generalization in a random effects model, which shows that academic performance itself is not solely caused by increased physical activity. The weighted mean population effect of all included interventions was rw = 0.181. Most of the studies had serious limitations since they did not report physical activity intensity, which is an essential component to achieving positive exercise effects on cognition. In addition, the qualifications of the staff who administer the interventions were largely ignored in existing literature. It was found that 13 out of 20 physical activity interventions with significant positive effects on academic performance were performed by practitioners who held higher qualifications in the field of physical education and exercise science, who could mediate higher physical activity intensities of the given interventions. The population effect in studies where interventions were administered by practitioners with lower qualifications in the field (rw = 0.14) was lower compared to interventions performed by staff with higher qualifications (rw = 0.22). There was also a significant difference in academic performance with regard to staff qualification level (χ = 4.464; p = 0.035). In addition to activity duration, future physical activity intervention studies including those investigating academic performance should focus on the importance of physical activity intensity and include measures of physical fitness as objective indicators to enable more reliable analyses to establish physical activity influence on academic performance.
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Affiliation(s)
- Vedrana Sember
- Laboratory for the Diagnostics of Somatic and Motor Development, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Jurak
- Laboratory for the Diagnostics of Somatic and Motor Development, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Marjeta Kovač
- Laboratory for the Diagnostics of Somatic and Motor Development, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Shawnda A Morrison
- Laboratory for the Diagnostics of Somatic and Motor Development, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Gregor Starc
- Laboratory for the Diagnostics of Somatic and Motor Development, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Takken T, de Jong N, Duijf M, van den Berg S, Wendel-Vos W. Results from the Netherlands' 2018 Report Card and Report Card + on physical activity for children and youth with and without chronic medical condition. Public Health 2020; 185:161-166. [PMID: 32634607 DOI: 10.1016/j.puhe.2020.04.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/06/2020] [Accepted: 04/30/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this study was to summarize the results of the 2018 the Netherlands' Physical Activity Report Card (PARC) for children and youth as well as for children and youth with a chronic medical condition (CMC; PARC+). STUDY DESIGN This study is a survey. METHODS A total of 12 indicators were graded using the Active Healthy Kids Global Alliance PARC development process, which includes a synthesis of the best available research, surveillance, policy and practice findings and expert consensus. Grades were based on the best available evidence and ranged from grade A (>80% of the children succeed) to grade F (less than 20% succeed) or incomplete (INC). Sources included national surveys, peer-reviewed literature and grey literature such as government and non-government reports and online content. RESULTS Grades assigned for PARC/PARC+ were as follows: Overall Physical Activity: C-/D+; Organized Sports Participation: B/B-; Active Play: D/D; Active Transportation: A-/B+; Sedentary Behaviour: D/D; Physical Fitness: INC /INC; Family and Peers: C/INC; School: C+/A-; Community and Environment: INC /INC; Government: INC /INC; Sleep: A-/B+ and Weight Status: A-/A-, respectively. CONCLUSIONS The report shows that the Netherlands' youth scores well on (organized) participation in sports and active transport to and from school. However, they do not participate enough in overall physical activity. Despite the fact that outdoor play is the most important exercise activity for children, outdoor play scores an insufficient score for both healthy children and children with a CMC. Sports participation also contributed significantly to daily physical activity. However, sports participation alone is not enough to comply with the national activity guidelines.
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Affiliation(s)
- T Takken
- Child Development & Exercise Center, Wilhelmina's Children's Hospital, UMC Utrecht, the Netherlands.
| | - N de Jong
- Child Development & Exercise Center, Wilhelmina's Children's Hospital, UMC Utrecht, the Netherlands
| | - M Duijf
- Knowledge Centre for Sport Netherlands, Ede, the Netherlands
| | - S van den Berg
- Dutch National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - W Wendel-Vos
- Dutch National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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“Walkabouts” Integrated Physical Activities from Preschool to Second Grade: Feasibility and Effect on Classroom Engagement. CHILD & YOUTH CARE FORUM 2020. [DOI: 10.1007/s10566-020-09563-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ruotsalainen I, Gorbach T, Perkola J, Renvall V, Syväoja HJ, Tammelin TH, Karvanen J, Parviainen T. Physical activity, aerobic fitness, and brain white matter: Their role for executive functions in adolescence. Dev Cogn Neurosci 2020; 42:100765. [PMID: 32072938 PMCID: PMC7013351 DOI: 10.1016/j.dcn.2020.100765] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 11/26/2022] Open
Abstract
Physical activity and exercise beneficially link to brain properties and cognitive functions in older adults, but the findings concerning adolescents remain tentative. During adolescence, the brain undergoes significant changes, which are especially pronounced in white matter. Studies provide contradictory evidence regarding the influence of physical activity or aerobic-exercise on executive functions in youth. Little is also known about the link between both fitness and physical activity with the brain's white matter during puberty. We investigated the connection between aerobic fitness and physical activity with the white matter in 59 adolescents. We further determined whether white matter interacts with the connection of fitness or physical activity with core executive functions. Our results show that only the level of aerobic fitness, but not of physical activity relates to white matter. Furthermore, the white matter of the corpus callosum and the right superior corona radiata moderates the links of aerobic fitness and physical activity with working memory. Our results suggest that aerobic fitness and physical activity have an unequal contribution to the white matter properties in adolescents. We propose that the differences in white matter properties could underlie the variations in the relationship between either physical activity or aerobic fitness with working memory.
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Affiliation(s)
- Ilona Ruotsalainen
- Department of Psychology, Centre for Interdisciplinary Brain Research, University of Jyväskylä, Jyväskylä, Finland.
| | - Tetiana Gorbach
- Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden; Department of Mathematics and Statistics, University of Jyväskylä, Jyväskylä, Finland
| | - Jaana Perkola
- Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Ville Renvall
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland; AMI Centre, Aalto NeuroImaging, School of Science, Aalto University, Espoo, Finland
| | - Heidi J Syväoja
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Juha Karvanen
- Department of Mathematics and Statistics, University of Jyväskylä, Jyväskylä, Finland
| | - Tiina Parviainen
- Department of Psychology, Centre for Interdisciplinary Brain Research, University of Jyväskylä, Jyväskylä, Finland
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Naveed S, Lakka T, Haapala EA. An Overview on the Associations between Health Behaviors and Brain Health in Children and Adolescents with Special Reference to Diet Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E953. [PMID: 32033054 PMCID: PMC7037721 DOI: 10.3390/ijerph17030953] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 01/14/2023]
Abstract
Unhealthy diet has been associated with overweight, obesity, increased cardiometabolic risk, and recently, to impaired cognition and academic performance. The aim of this review is to provide an overview of the associations between health behaviors and cognition and academic achievement in children and adolescents under 18 years of age with a special reference to diet quality. Dietary patterns with a low consumption of fish, fruits, and vegetables, and high in fast food, sausages, and soft drinks have been linked to poor cognition and academic achievement. The studies on the associations between the high intake of saturated fat and red meat and low intake of fiber and high-fiber grain products with cognition are limited. The available evidence and physiological mechanisms suggest that diet may have direct, indirect, and synergistic effects on brain and cognition with physical activity, sedentary behaviors, cardiometabolic health, and sleep, but the associations have been modest. Therefore, integrating a healthy diet, physically active lifestyle, and adequate sleep may provide optimal circumstances for brain development and learning. We conclude that most of the existing literature is contained in cross-sectional studies, which therefore highlights the need for longitudinal and intervention studies on the effects of diet, physical activity, sedentary behavior, and sleep on cognition and academic performance.
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Affiliation(s)
- Sehrish Naveed
- Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland; (T.L.); (E.A.H.)
| | - Timo Lakka
- Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland; (T.L.); (E.A.H.)
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, 70211 Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, 70100 Kuopio, Finland
| | - Eero A. Haapala
- Physiology, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland; (T.L.); (E.A.H.)
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
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Schmidt SK, Reinboth MS, Resaland GK, Bratland-Sanda S. Changes in Physical Activity, Physical Fitness and Well-Being Following a School-Based Health Promotion Program in a Norwegian Region with a Poor Public Health Profile: A Non-Randomized Controlled Study in Early Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E896. [PMID: 32023995 PMCID: PMC7037455 DOI: 10.3390/ijerph17030896] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/26/2020] [Accepted: 01/30/2020] [Indexed: 01/22/2023]
Abstract
The purpose of this study was to examine the changes in physical activity (PA), physical fitness and psychosocial well-being in early adolescents following implementation of a school-based health promotion program in secondary schools. METHODS Six municipalities in Telemark County, Norway, were recruited into intervention (6 schools) or control groups (9 schools). A total of 644 pupils participated in the study (response rate: 79%). The schools in the intervention group implemented the Active and Healthy Kids program, where the PA component consisted of (1) 120 min/week of physically active learning (PAL) and (2) 25 min/week of physical active breaks. Furthermore, both the intervention and control schools carried out 135 min/week of physical education. The primary outcome was PA. Secondary outcomes were sedentary time, physical fitness, subjective vitality and health-related quality of life (HRQoL) in five domains: physical health, psychological well-being, parent, peers and school. RESULTS There was a group x time effect on school-based PA (p < 0.05), but not total PA, as well as on physical fitness (p < 0.05) and vitality (p < 0.01). In girls, there also was a group x time effect on three out of the five domains on HRQoL (p < 0.05). CONCLUSIONS A multi-component, school-based health-promotion program with emphasis on the use of PAL led to positive changes in school-based PA levels. Furthermore, positive changes were seen in physical fitness, vitality and HRQoL among early adolescents in a county with a poor public health profile. This might have implications for the development and promotion in schools of general health and well-being throughout adolescence.
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Affiliation(s)
- Sabrina K. Schmidt
- Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Pb 235, 3603 Kongsberg, Norway; (M.S.R.); (S.B.-S.)
| | - Michael S. Reinboth
- Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Pb 235, 3603 Kongsberg, Norway; (M.S.R.); (S.B.-S.)
| | - Geir K. Resaland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Science, Campus Sogndal, 6856 Sogndal, Norway;
| | - Solfrid Bratland-Sanda
- Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Pb 235, 3603 Kongsberg, Norway; (M.S.R.); (S.B.-S.)
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Associations between Food Group Intake, Cognition, and Academic Achievement in Elementary Schoolchildren. Nutrients 2019; 11:nu11112722. [PMID: 31717571 PMCID: PMC6893423 DOI: 10.3390/nu11112722] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/28/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022] Open
Abstract
Nutrition plays an important role in proper physical and cognitive functioning. However, there is limited evidence on the relationship between overall diet, cognition, and academic success in children, particularly among low-income and diverse groups. The objective of this study was to examine the relationships between healthful versus less healthful food group intake, cognitive performance, and academic achievement in a diverse sample of schoolchildren. 868 urban schoolchildren (age 8 to 10 years) participated in the study. Intake of healthful (fruits, vegetables, unsweetened beverages) and less healthful (sweet and salty snacks, sugar-sweetened beverages) food groups was determined via a food frequency questionnaire. Digit Span and Stroop test scores were used to assess cognitive performance. Academic achievement was assessed via standardized test scores. Multiple Poisson and multiple linear regression were used to test the associations between diet and cognitive scores. Multiple ordered logistic regression was used to assess the associations between diet and academic achievement. Potential confounders (age, sex, body mass index (BMI) z-score, race/ethnicity, English language learner status, individualized education plan enrollment, physical activity, and parent education level) were tested for inclusion in all models. The sample included 868 children (56.7% girls; 33.2% non-Hispanic white, 26.2% Hispanic, 17.1% multiracial/other, 8.3% non-Hispanic black; 40.5% overweight/obese). The most frequently consumed foods were fruits and sweet snacks (1.9 and 1.6 servings per day, respectively). There were no statistically significant associations between diet and cognitive test scores. Greater intake of less healthful food groups (sweet snacks, salty snacks, and sweetened beverages) was associated with lower math (OR = 0.91, CI [0.84, 0.98], p = 0.014) and English standardized test scores (OR = 0.87, CI [0.80, 0.94, p = 0.001). Greater intake of sweet snacks and fruits was associated with lower English scores (OR = 0.72, 95% CI [0.59, 0.88] p = 0.001; and OR = 0.75, 95% CI [0.72, 0.94] p = 0.003, respectively). Consumption of less healthful food groups was associated with poorer academic achievement. Further research may shed light on unexpected associations between fruit consumption and achievement. Policies targeting multiple dietary components may positively influence child academic achievement and development.
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Norris E, van Steen T, Direito A, Stamatakis E. Physically active lessons in schools and their impact on physical activity, educational, health and cognition outcomes: a systematic review and meta-analysis. Br J Sports Med 2019; 54:826-838. [PMID: 31619381 DOI: 10.1136/bjsports-2018-100502] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This review provides the first meta-analysis of the impact of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. DESIGN Systematic review and meta-analysis of controlled studies. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. DATA SOURCES PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. STUDIES ELIGIBILITY CRITERIA Physically active lessons compared with a control group in a randomised or non-randomised design, within single component interventions in general school populations. RESULTS 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible to be included in the systematic review and 37 of them were included across the six meta-analyses (n=12 663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95% CI 1.42 to 3.25: k=16) and small, increases on overall PA (d=0.32; 95% CI 0.18 to 0.46: k=8), large, improvement in lesson-time educational outcomes (d=0.81; 95% CI 0.47 to 1.14: k=7) and a small improvement in overall educational outcomes (d=0.36; 95% CI 0.09 to 0.63: k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least two domains. CONCLUSION In elementary and preschool settings, when physically active lessons were added into the curriculum they had positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool setting. TRIAL REGISTRATION NUMBER CRD42017076933.
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Affiliation(s)
- Emma Norris
- Centre for Behaviour Change, University College London, London, UK
| | - Tommy van Steen
- Institute of Security and Global Affairs, Leiden University, Leiden, The Netherlands
| | - Artur Direito
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emmanuel Stamatakis
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Sjöwall D, Thorell LB, Mandic M, Westerståhl M. No effects of a long-term physical activity intervention on executive functioning among adolescents. SAGE Open Med 2019; 7:2050312119880734. [PMID: 31632675 PMCID: PMC6778986 DOI: 10.1177/2050312119880734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives: We investigated whether a school-based physical activity intervention would lead to improvements in working memory, inhibition and cognitive flexibility in adolescents aged 13–15 years. Methods: The adolescents at the active school (n = 108) participated in an intervention that included increased physical activity for 20 min/day, focused on aerobic activity with low cognitive demands for an entire school year. The adolescents at the control school (n = 59) received no extra physical activity. At the beginning (baseline) and end (follow-up) of the school year, the participants performed tests of executive function (working memory, inhibition and cognitive flexibility) and performed tests of physical fitness and health. Results: There was no change in executive functioning at follow-up when comparing the schools. However, only 46% complied with the intervention. When non-compliers were excluded from the analyses, the results remained the same, except for a small but significant increase in working memory for the active school as compared to the control school. Conclusion: These results indicate that compliance with the intervention was low and that aerobic exercise with low cognitive load does not produce improvements in executive functioning.
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Affiliation(s)
- Douglas Sjöwall
- The Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Habilitation and Health, Stockholm County Council, Stockholm, Sweden
| | - Lisa B Thorell
- The Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mirko Mandic
- Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Westerståhl
- Habilitation and Health, Stockholm County Council, Stockholm, Sweden.,Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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29
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Solis-Urra P, Olivares-Arancibia J, Suarez-Cadenas E, Sanchez-Martinez J, Rodríguez-Rodríguez F, Ortega FB, Esteban-Cornejo I, Cadenas-Sanchez C, Castro-Piñero J, Veloz A, Chabert S, Saradangani KP, Zavala-Crichton JP, Migueles JH, Mora-Gonzalez J, Quiroz-Escobar M, Almonte-Espinoza D, Urzúa A, Dragicevic CD, Astudillo A, Méndez-Gassibe E, Riquelme-Uribe D, Azagra MJ, Cristi-Montero C. Study protocol and rationale of the "Cogni-action project" a cross-sectional and randomized controlled trial about physical activity, brain health, cognition, and educational achievement in schoolchildren. BMC Pediatr 2019; 19:260. [PMID: 31349791 PMCID: PMC6659252 DOI: 10.1186/s12887-019-1639-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Education and health are crucial topics for public policies as both largely determine the future wellbeing of the society. Currently, several studies recognize that physical activity (PA) benefits brain health in children. However, most of these studies have not been carried out in developing countries or lack the transference into the education field. The Cogni-Action Project is divided into two stages, a cross-sectional study and a crossover-randomized trial. The aim of the first part is to establish the associations of PA, sedentarism, and physical fitness with brain structure and function, cognitive performance and academic achievement in Chilean schoolchildren (10-13 years-old). The aim of the second part is to determinate the acute effects of three PA protocols on neuroelectric indices during a working memory and a reading task. METHODS PA and sedentarism will be self-reported and objectively-assessed with accelerometers in a representative subsample, whilst physical fitness will be evaluated through the ALPHA fitness test battery. Brain structure and function will be assessed by magnetic resonance imaging (MRI) in a randomized subsample. Cognitive performance will be assessed through the NeuroCognitive Performance Test, and academic achievement by school grades. In the second part 32 adolescents (12-13 year-old) will be cross-over randomized to these condition (i) "Moderate-Intensity Continuous Training" (MICT), (ii) "Cooperative High-Intensity Interval Training" (C-HIIT), and (iii) Sedentary condition. Neuroelectric indices will be measures by electroencephalogram (EEG) and eye-tracking, working memory by n-back task and reading comprehension by a reading task. DISCUSSION The main strength of this project is that, to our knowledge, this is the first study analysing the potential association of PA, sedentarism, and physical fitness on brain structure and function, cognitive performance, and academic achievement in a developing country, which presents an important sociocultural gap. For this purpose, this project will use advanced technologies in neuroimaging (MRI), electrophysiology (EEG), and eye-tracking, as well as objective and quality measurements of several physical and cognitive health outcomes. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03894241 Date of register: March 28, 2019. Retrospectively Registered.
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Affiliation(s)
- Patricio Solis-Urra
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaiso, Viña del Mar, Chile
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Jorge Olivares-Arancibia
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaiso, Viña del Mar, Chile
- Department of Physical Education, Faculty of Sciences of Sport and Physical Education, University of A Coruña, A Coruña, Spain
- Physical Education School, Universidad de Las Américas, Viña del Mar, Chile
| | | | - Javier Sanchez-Martinez
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaiso, Viña del Mar, Chile
| | - Fernando Rodríguez-Rodríguez
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaiso, Viña del Mar, Chile
| | - Francisco B. Ortega
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Irene Esteban-Cornejo
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Cristina Cadenas-Sanchez
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Jose Castro-Piñero
- Departament of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto real, Spain
| | - Alejandro Veloz
- Biomedical Engineering Department, Universidad de Valparaíso, Valparaíso, Chile
- CINGS, Centro de Investigación en Ingeniería para la Salud, Universidad de Valparaíso, Valparaíso, Chile
| | - Steren Chabert
- Biomedical Engineering Department, Universidad de Valparaíso, Valparaíso, Chile
- CINGS, Centro de Investigación en Ingeniería para la Salud, Universidad de Valparaíso, Valparaíso, Chile
| | - Kabir P. Saradangani
- School of Kinesiology, Faculty of Health Sciences, Universidad San Sebastián, Santiago, Chile
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile
| | - Juan Pablo Zavala-Crichton
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Facultad de Educación y Ciencias Sociales, Universidad Andrés Bello, Viña del Mar, Chile
| | - Jairo H. Migueles
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Jose Mora-Gonzalez
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | | | - Alfonso Urzúa
- School of Psychology, Universidad Católica del Norte, Antofagasta, Chile
| | - Constantino D. Dragicevic
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaiso, Viña del Mar, Chile
- Auditory and Cognition Center, Universidad de Chile, Santiago, Chile
| | - Aland Astudillo
- CINGS, Centro de Investigación en Ingeniería para la Salud, Universidad de Valparaíso, Valparaíso, Chile
| | | | - Daniel Riquelme-Uribe
- Universidad Adventista de Chile, Chillan, Chile
- Center for Research, Development and Innovation APLICAE, Santiago, Chile
| | - Marcela Jarpa Azagra
- School of Pedagogy, Pontificia Universidad Católica de Valparaiso, Valparaíso, Chile
| | - Carlos Cristi-Montero
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaiso, Viña del Mar, Chile
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Bedard C, St John L, Bremer E, Graham JD, Cairney J. A systematic review and meta-analysis on the effects of physically active classrooms on educational and enjoyment outcomes in school age children. PLoS One 2019; 14:e0218633. [PMID: 31237913 PMCID: PMC6592532 DOI: 10.1371/journal.pone.0218633] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/04/2019] [Indexed: 01/22/2023] Open
Abstract
Objectives Despite the relationship between physical activity (PA) and learning outcomes, the school system has not been able to support the inclusion of PA throughout the day. A solution to this problem integrates PA into the academic classroom. The objective of this review is to determine the impact of active classrooms compared to traditional sedentary classrooms on educational outcomes of school-aged children. Design We searched ERIC, PubMed, PsychINFO, and Web of Science, reference lists of included studies for randomised controlled studies. Independent reviewers screened the texts of potentially eligible studies and assessed the risk of bias. Data were pooled using random-effects models on standardized mean differences. Results This review identified 25 studies examining educational outcomes, including approximately 6,181 students. Risk of bias was assessed as either some or high risk of bias for most of the studies and outcomes. Pooled data from 20 studies and 842 participants measuring academic performance shows a small positive effect of active classrooms compared with traditional, sedentary classrooms (SMD = 0.28, 95% CI: 0.09 to 0.47). Conclusions Physically active classrooms may slightly improve academic achievement compared to the traditional sedentary lessons. Future research is needed to ensure that studies are adequately powered, employ appropriate methods of randomization, and measure a wide range of important student outcomes across the full spectrum of the school-age.
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Affiliation(s)
- Chloe Bedard
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- INfant and Child Health (INCH) Lab, Department of Family Medicine, Master University, Hamilton, Ontario, Canada
- * E-mail:
| | - Laura St John
- INfant and Child Health (INCH) Lab, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Emily Bremer
- INfant and Child Health (INCH) Lab, Department of Family Medicine, Master University, Hamilton, Ontario, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey D. Graham
- INfant and Child Health (INCH) Lab, Department of Family Medicine, Master University, Hamilton, Ontario, Canada
| | - John Cairney
- INfant and Child Health (INCH) Lab, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Egger F, Benzing V, Conzelmann A, Schmidt M. Boost your brain, while having a break! The effects of long-term cognitively engaging physical activity breaks on children's executive functions and academic achievement. PLoS One 2019; 14:e0212482. [PMID: 30840640 PMCID: PMC6402646 DOI: 10.1371/journal.pone.0212482] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 02/03/2019] [Indexed: 01/11/2023] Open
Abstract
Classroom-based physical activity (PA) is gaining attention in terms of its potential to enhance children's cognitive functions, but it remains unclear as to which specific modality of PA affects cognitive functions most. The aim of the study was to examine the effects of qualitatively different PA breaks on children's cognitive outcomes. Children (N = 142) aged between 7 and 9 years were allocated to a 20-week classroom-based PA program, with either high physical exertion and high cognitive engagement (combo group), high physical exertion and low cognitive engagement (aerobic group), or low physical exertion and high cognitive engagement (cognition group). Executive functions (updating, inhibition, shifting) and academic achievement (mathematics, spelling, reading) were measured pre- and post-intervention. Results showed that the combo group profited the most displaying enhanced shifting and mathematic performance. The cognition group profited only in terms of enhanced mathematic performance, whereas the aerobic group remained unaffected. These results suggest that the inclusion of cognitively engaging PA breaks seem to be a promising way to enhance school children's cognitive functions.
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Affiliation(s)
- Fabienne Egger
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Valentin Benzing
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Achim Conzelmann
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, Bern, Switzerland
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32
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Xue Y, Yang Y, Huang T. Effects of chronic exercise interventions on executive function among children and adolescents: a systematic review with meta-analysis. Br J Sports Med 2019; 53:1397-1404. [PMID: 30737201 DOI: 10.1136/bjsports-2018-099825] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To synthesise randomised controlled trials (RCTs) regarding the effects of chronic exercise interventions on different domain-specific executive functions (EFs) among children and adolescents. DESIGN Systematic review with meta-analysis. DATA SOURCES PsycINFO, PubMed, SPORTDiscus, Academic Search Premier, Embase and Web of Science were searched. ELIGIBILITY CRITERIA FOR SELECTING STUDIES RCTs or cluster RCT design, which employ chronic exercise interventions and target healthy children (age 6-12 years) and adolescents (age 13-17 years). We defined chronic exercise as physical activity (PA) which consists of multiple exercise sessions per week and lasts for an extended period of time (typically over 6 weeks). RESULTS We included 19 studies, with a total of 5038 participants. The results showed that chronic exercise interventions improved overall EFs (standardised mean difference (SMD)=0.20, 95% CI 0.09 to 0.30, p<0.05) and inhibitory control (SMD=0.26, 95% CI 0.08 to 0.45, P<0.05). In meta regression, higher body mass index was associated with greater improvements in overall EFs performance (β=0.03, 95% CI 0.0002 to 0.06, p<0.05), whereas age and exercise duration were not. In subgroup analysis by intervention modality, sports and PA programme (SMD=0.21, 95% CI 0.12 to 0.31, p<0.05) and curricular PA (SMD=0.39, 95% CI 0.08 to 0.69, p<0.05) improved overall EFs performance, but integrated PA did not (SMD=0.02, 95% CI -0.05 to 0.09, p>0.05). Interventions with a session length < 90 minutes improved overall EFs performance (SMD=0.24, 95%CI 0.10 to 0.39, p=0.02), but session length ≥ 90 minutes did not (SMD=0.05, 95%CI -0.03 to 0.14). No other moderator was found to have an effect. CONCLUSIONS Despite small effect sizes, chronic exercise interventions, implemented in curricular or sports and PA programme settings, might be a promising way to promote multiple aspects of executive functions, especially inhibitory control.
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Affiliation(s)
- Yue Xue
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yanxiang Yang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Huang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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Kvalø SE, Dyrstad SM, Bru E, Brønnick K. Relationship between aerobic fitness and academic performance: the mediational role of executive function. J Sports Med Phys Fitness 2019; 59:1397-1404. [PMID: 30722648 DOI: 10.23736/s0022-4707.18.08971-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This cross-sectional study investigated whether the relationship between aerobic fitness and academic performance was mediated by executive functioning. METHODS A total of 378 children (9-10 years old) from nine primary schools in Stavanger, Norway were included. The children's aerobic fitness was measured by a 10-minute interval-running test; executive function was tested by four cognitive tests (Stroop, Trail Making, Verbal Fluency and Backwards Digit Span). A composite score for executive functions was computed and used in analyses. Academic achievement in reading, mathematics and English was determined using Norwegian national standardized tests. RESULTS Bivariate correlation analysis showed the following significant associations: mathematic achievement with executive functions (r=0.48, P=0.001), aerobic fitness with mathematics (r=0.13, P=0.012) and executive functions (r=0.17, P=0.001). A regression-based mediation analysis (PROCESS) with executive function as a mediator variable was conducted. Mediation analysis showed that the relationship between aerobic fitness and mathematic achievement was mediated by executive functions (P<0.001). CONCLUSIONS Findings revealed an indirect effect of executive function on the positive relationship between aerobic fitness and mathematic achievement.
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Affiliation(s)
- Silje E Kvalø
- Department of Education and Sport Science, University of Stavanger, Stavanger, Norway -
| | - Sindre M Dyrstad
- Department of Education and Sport Science, University of Stavanger, Stavanger, Norway.,Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Edvin Bru
- Center of Learning Environment, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Brønnick
- Department of Public Health, University of Stavanger, Stavanger, Norway.,Center for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
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Ludyga S, Koutsandréou F, Reuter EM, Voelcker-Rehage C, Budde H. A Randomized Controlled Trial on the Effects of Aerobic and Coordinative Training on Neural Correlates of Inhibitory Control in Children. J Clin Med 2019; 8:E184. [PMID: 30720733 PMCID: PMC6406880 DOI: 10.3390/jcm8020184] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/22/2019] [Accepted: 01/26/2019] [Indexed: 12/19/2022] Open
Abstract
Whereas aerobic training has found to be beneficial for inhibitory control, less is known on the efficiency of other exercise types in children. The present study compared the effects of aerobic and coordinative training on behavioral and neurophysiological measures of inhibitory control. Forty-five children were randomly assigned (1:1:1 ratio) to groups performing aerobic training, coordinative training or assisted homework sessions over 10 weeks. Before and after intervention, all participants completed a Flanker task. The P300 component of event-related potentials elicited from the task was recorded via electroencephalography. Additionally, aerobic fitness and gross-motor skills were assessed using 20 m Shuttle Run and Heidelberg Gross-Motor Test, respectively. Statistical analyses revealed no time by group interactions for the P300 component (amplitude, latency), p = 0.976, η² = 0.007, and behavioral performance (reaction time, accuracy), p = 0.570, η² = 0.045. In contrast, there was a significant group-difference in pre- to post-test changes in aerobic fitness, p = 0.008, η² = 0.246, with greater improvements following aerobic and coordinative training compared to assisted homework sessions. In conclusion, no differences regarding the efficiency of aerobic and coordinative training for the enhancement of inhibitory control were found as both exercise programs failed to elicit changes in speed and accuracy of stimulus evaluation and the allocation of attentional resources.
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Affiliation(s)
- Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Flora Koutsandréou
- Faculty of Human Sciences, Medical School Hamburg, 20457 Hamburg, Germany.
| | - Eva-Maria Reuter
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09111 Chemnitz, Germany.
| | - Henning Budde
- Faculty of Human Sciences, Medical School Hamburg, 20457 Hamburg, Germany.
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania.
- Physical Activity, Physical Education, Health and Sport Research Centre (PAPESH), Sports Science Department, School of Science and Engineering, Reykjavik University, IS-101 Reykjavik, Iceland.
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Mezcua-Hidalgo A, Ruiz-Ariza A, Suárez-Manzano S, Martínez-López EJ. 48-Hour Effects of Monitored Cooperative High-Intensity Interval Training on Adolescent Cognitive Functioning. Percept Mot Skills 2019; 126:202-222. [PMID: 30665339 DOI: 10.1177/0031512518825197] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Physical activity has been positively related to better cognitive performance though the effects of varied exercise type and intensity and the duration of cognitive benefits are unclear. This study analyzed the effect of 16 minutes of monitored cooperative high-intensity interval training (monitored C-HIIT) at the start of the school day, on various cognitive variables over the next 24-48 hours. We randomly assigned 158 participants either to a control group ( n = 81) that engaged only in static stretching or to an experimental group ( n = 77) that performed monitored C-HIIT. We assessed cognitive functioning before the exercise, immediately afterward, and for five follow-up time points over the next two days (i.e., at 2, 3, 4, 24, and 48 hours). We analyzed age, sex, body mass index, and moderate-to-vigorous physical activity as potential confounder variables. Adolescents in the monitored C-HIIT group increased selective attention by 17.39% during the next hour ( p = .015) and increased concentration by 20.31% and 15.26% during the first ( p = .022) and second ( p = .059) subsequent hours, respectively. This positive short-term benefit of monitored C-HIIT during immediate subsequent hours is an important finding with implications for the school curricula and schedule.
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Affiliation(s)
| | - Alberto Ruiz-Ariza
- 1 Faculty of Humanities and Educational Sciences, University of Jaén, Spain
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Burns RD, Brusseau TA, Fu Y. Moderators of School-Based Physical Activity Interventions on Cardiorespiratory Endurance in Primary School-Aged Children: A Meta-Regression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081764. [PMID: 30115882 PMCID: PMC6121563 DOI: 10.3390/ijerph15081764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/01/2018] [Accepted: 08/14/2018] [Indexed: 01/09/2023]
Abstract
The purpose of this study was to examine potential moderators of school-based physical activity interventions on cardiorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past 30 years. Studies were included if there was a control or comparison group, if the study sample included primary school-aged children, if the targeted outcome of cardiorespiratory endurance was objectively assessed, if the intervention was at least partially school-based, and if the effect estimate's variability was reported. An inverse-variance random effects meta-regression was employed using the primary predictors of component number (single component or multi-component) and intervention length using 20 extracted studies with 23 total effects. The overall pooled effect on cardiorespiratory endurance was statistically significant (Hedges' g = 0.30, 95% C.I.: 0.19⁻0.40; p < 0.001). Using random effects meta-regression, neither component number (b = ⁻0.09, 95% C.I.: ⁻0.40⁻0.23; p = 0.560) or intervention length (b = 0.001, 95% C.I.: ⁻0.002⁻0.004; p = 0.427) yielded a significant modifying effect on cardiorespiratory endurance. School-based physical activity interventions have a significant pooled effect on cardiorespiratory endurance in primary school-aged children. Component number and intervention length does not modify this effect, suggesting other sources for between-study heterogeneity.
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Affiliation(s)
- Ryan D Burns
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Timothy A Brusseau
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - You Fu
- School of Community Health Sciences, University of Nevada Reno, Reno, NV 89557, USA.
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Singh AS, Saliasi E, van den Berg V, Uijtdewilligen L, de Groot RHM, Jolles J, Andersen LB, Bailey R, Chang YK, Diamond A, Ericsson I, Etnier JL, Fedewa AL, Hillman CH, McMorris T, Pesce C, Pühse U, Tomporowski PD, Chinapaw MJM. 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. Br J Sports Med 2018; 53:640-647. [PMID: 30061304 DOI: 10.1136/bjsports-2017-098136] [Citation(s) in RCA: 219] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 04/15/2018] [Accepted: 06/20/2018] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Amika S Singh
- Department of Public and Occupational Health and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Emi Saliasi
- Department of Public and Occupational Health and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Vera van den Berg
- Department of Public and Occupational Health and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Renate H M de Groot
- Welten Institute - Research Centre for Learning, Teaching and Technology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Jelle Jolles
- Centre for Brain & Learning, Faculty of Psychology and Education, LEARN! Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lars B Andersen
- Department of Teacher Education and Sport, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Richard Bailey
- International Council of Sport Science and Physical Education, Berlin, Germany
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan, Republic of China
| | - Adele Diamond
- Program in Developmental Cognitive Neuroscience, Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Ingegerd Ericsson
- Department of Sport Sciences, Faculty of Learning and Society, Malmö University, Malmö, Sweden
| | - Jennifer L Etnier
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Alicia L Fedewa
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Charles H Hillman
- Department of Psychology, Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Terry McMorris
- Department of Sport and Exercise Science, Institute for Sport, University of Chichester, Chichester, UK
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, Italian University Sport and Movement "Foro Italico", Rome, Italy
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Mai J M Chinapaw
- Department of Public and Occupational Health and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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Norris E, Dunsmuir S, Duke-Williams O, Stamatakis E, Shelton N. Physically Active Lessons Improve Lesson Activity and On-Task Behavior: A Cluster-Randomized Controlled Trial of the "Virtual Traveller" Intervention. HEALTH EDUCATION & BEHAVIOR 2018; 45:945-956. [PMID: 29562763 DOI: 10.1177/1090198118762106] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physically active lessons have not often been assessed with randomized controlled trials. AIMS Evaluate the effects of the "Virtual Traveller" (VT) intervention delivered using classroom interactive whiteboards on physical activity, on-task behavior, and student engagement. METHODS Participants were 219 children aged 8 to 9 years from 10 schools in Greater London, assessed in a cluster-randomized controlled trial between March 2015 and May 2016. For 6 weeks, intervention children received 10-minute VT sessions three times a week during math and English lessons (VT group: n = 113). Children in control schools received regular teaching (COM group: n = 106). Outcomes were school-day, weekend-day, and lesson-time sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA), and on-task behavior and student engagement, assessed at baseline (T0), 2 weeks (T1), and 4 weeks (T2) during the VT intervention and 1 week (T3) and 3 months (T4) postintervention using multilevel modeling. RESULTS VT pupils engaged in significantly more school-day MVPA at T1 only, with no other significant differences between groups in overall school-day or weekend-day activity. VT pupils engaged in significantly less SB and more MVPA during lesson time than COM pupils. More on-task behavior was shown in VT pupils than COM pupils but there was no difference in student engagement. DISCUSSION VT reduced sedentary behavior and increased physical activity during lesson time but not across overall school or weekend days. VT improved on-task behavior but had no effect on student engagement. CONCLUSION Physical activity can be integrated into teaching using interactive whiteboards with no detriment to educational outcomes.
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Martin A, Booth JN, Laird Y, Sproule J, Reilly JJ, Saunders DH. Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database Syst Rev 2018; 3:CD009728. [PMID: 29499084 PMCID: PMC5865125 DOI: 10.1002/14651858.cd009728.pub4] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The global prevalence of childhood and adolescent obesity is high. Lifestyle changes towards a healthy diet, increased physical activity and reduced sedentary activities are recommended to prevent and treat obesity. Evidence suggests that changing these health behaviours can benefit cognitive function and school achievement in children and adolescents in general. There are various theoretical mechanisms that suggest that children and adolescents with excessive body fat may benefit particularly from these interventions. OBJECTIVES To assess whether lifestyle interventions (in the areas of diet, physical activity, sedentary behaviour and behavioural therapy) improve school achievement, cognitive function (e.g. executive functions) and/or future success in children and adolescents with obesity or overweight, compared with standard care, waiting-list control, no treatment, or an attention placebo control group. SEARCH METHODS In February 2017, we searched CENTRAL, MEDLINE and 15 other databases. We also searched two trials registries, reference lists, and handsearched one journal from inception. We also contacted researchers in the field to obtain unpublished data. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials (RCTs) of behavioural interventions for weight management in children and adolescents with obesity or overweight. We excluded studies in children and adolescents with medical conditions known to affect weight status, school achievement and cognitive function. We also excluded self- and parent-reported outcomes. DATA COLLECTION AND ANALYSIS Four review authors independently selected studies for inclusion. Two review authors extracted data, assessed quality and risks of bias, and evaluated the quality of the evidence using the GRADE approach. We contacted study authors to obtain additional information. We used standard methodological procedures expected by Cochrane. Where the same outcome was assessed across different intervention types, we reported standardised effect sizes for findings from single-study and multiple-study analyses to allow comparison of intervention effects across intervention types. To ease interpretation of the effect size, we also reported the mean difference of effect sizes for single-study outcomes. MAIN RESULTS We included 18 studies (59 records) of 2384 children and adolescents with obesity or overweight. Eight studies delivered physical activity interventions, seven studies combined physical activity programmes with healthy lifestyle education, and three studies delivered dietary interventions. We included five RCTs and 13 cluster-RCTs. The studies took place in 10 different countries. Two were carried out in children attending preschool, 11 were conducted in primary/elementary school-aged children, four studies were aimed at adolescents attending secondary/high school and one study included primary/elementary and secondary/high school-aged children. The number of studies included for each outcome was low, with up to only three studies per outcome. The quality of evidence ranged from high to very low and 17 studies had a high risk of bias for at least one item. None of the studies reported data on additional educational support needs and adverse events.Compared to standard practice, analyses of physical activity-only interventions suggested high-quality evidence for improved mean cognitive executive function scores. The mean difference (MD) was 5.00 scale points higher in an after-school exercise group compared to standard practice (95% confidence interval (CI) 0.68 to 9.32; scale mean 100, standard deviation 15; 116 children, 1 study). There was no statistically significant beneficial effect in favour of the intervention for mathematics, reading, or inhibition control. The standardised mean difference (SMD) for mathematics was 0.49 (95% CI -0.04 to 1.01; 2 studies, 255 children, moderate-quality evidence) and for reading was 0.10 (95% CI -0.30 to 0.49; 2 studies, 308 children, moderate-quality evidence). The MD for inhibition control was -1.55 scale points (95% CI -5.85 to 2.75; scale range 0 to 100; SMD -0.15, 95% CI -0.58 to 0.28; 1 study, 84 children, very low-quality evidence). No data were available for average achievement across subjects taught at school.There was no evidence of a beneficial effect of physical activity interventions combined with healthy lifestyle education on average achievement across subjects taught at school, mathematics achievement, reading achievement or inhibition control. The MD for average achievement across subjects taught at school was 6.37 points lower in the intervention group compared to standard practice (95% CI -36.83 to 24.09; scale mean 500, scale SD 70; SMD -0.18, 95% CI -0.93 to 0.58; 1 study, 31 children, low-quality evidence). The effect estimate for mathematics achievement was SMD 0.02 (95% CI -0.19 to 0.22; 3 studies, 384 children, very low-quality evidence), for reading achievement SMD 0.00 (95% CI -0.24 to 0.24; 2 studies, 284 children, low-quality evidence), and for inhibition control SMD -0.67 (95% CI -1.50 to 0.16; 2 studies, 110 children, very low-quality evidence). No data were available for the effect of combined physical activity and healthy lifestyle education on cognitive executive functions.There was a moderate difference in the average achievement across subjects taught at school favouring interventions targeting the improvement of the school food environment compared to standard practice in adolescents with obesity (SMD 0.46, 95% CI 0.25 to 0.66; 2 studies, 382 adolescents, low-quality evidence), but not with overweight. Replacing packed school lunch with a nutrient-rich diet in addition to nutrition education did not improve mathematics (MD -2.18, 95% CI -5.83 to 1.47; scale range 0 to 69; SMD -0.26, 95% CI -0.72 to 0.20; 1 study, 76 children, low-quality evidence) and reading achievement (MD 1.17, 95% CI -4.40 to 6.73; scale range 0 to 108; SMD 0.13, 95% CI -0.35 to 0.61; 1 study, 67 children, low-quality evidence). AUTHORS' CONCLUSIONS Despite the large number of childhood and adolescent obesity treatment trials, we were only able to partially assess the impact of obesity treatment interventions on school achievement and cognitive abilities. School and community-based physical activity interventions as part of an obesity prevention or treatment programme can benefit executive functions of children with obesity or overweight specifically. Similarly, school-based dietary interventions may benefit general school achievement in children with obesity. These findings might assist health and education practitioners to make decisions related to promoting physical activity and healthy eating in schools. Future obesity treatment and prevention studies in clinical, school and community settings should consider assessing academic and cognitive as well as physical outcomes.
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Affiliation(s)
- Anne Martin
- University of EdinburghCentre for Population Health SciencesMedical School, Teviot PlaceEdinburghUKEH8 9AG
- University of GlasgowMRC/CSO Social and Public Health Sciences Unit200 Renfield StreetGlasgowUKG2 3QB
| | - Josephine N Booth
- The University of EdinburghInstitute for Education, Community and SocietyMoray House School of EducationRoom 2.17, St John's LandEdinburghUKEH8 8AQ
| | - Yvonne Laird
- University of EdinburghScottish Collaboration for Public Health Research and Policy (SCPHRP)20 West Richmond StreetEdinburghUKEH8 9DX
| | - John Sproule
- Institute for Sport, Physical Education and Health Sciences (SPEHS), University of EdinburghMoray House School of EducationHolyrood RoadEdinburghEH8 8AQUK
| | - John J Reilly
- University of StrathclydePhysical Activity for Health Group, School of Psychological Sciences and Health50 George StreetGlasgowUKG1 1QE
| | - David H Saunders
- University of EdinburghPhysical Activity for Health Research Centre (PAHRC)St Leonards LandHolyrood RoadEdinburghMidlothianUKEH8 8AQ
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de Bruijn A, Hartman E, Kostons D, Visscher C, Bosker R. Exploring the relations among physical fitness, executive functioning, and low academic achievement. J Exp Child Psychol 2018; 167:204-221. [DOI: 10.1016/j.jecp.2017.10.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 01/11/2023]
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Aadland KN, Aadland E, Andersen JR, Lervåg A, Moe VF, Resaland GK, Ommundsen Y. Executive Function, Behavioral Self-Regulation, and School Related Well-Being Did Not Mediate the Effect of School-Based Physical Activity on Academic Performance in Numeracy in 10-Year-Old Children. The Active Smarter Kids (ASK) Study. Front Psychol 2018; 9:245. [PMID: 29541050 PMCID: PMC5835798 DOI: 10.3389/fpsyg.2018.00245] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 02/14/2018] [Indexed: 01/24/2023] Open
Abstract
Inconsistent findings exist for the effect of school-based physical activity interventions on academic performance. The Active Smarter Kids (ASK) study revealed a favorable intervention effect of school-based physical activity on academic performance in numeracy in a subsample of 10-year-old elementary schoolchildren performing poorer at baseline in numeracy. Aiming to explain this finding, we investigated the mediating effects of executive function, behavioral self-regulation, and school related well-being in the relation between the physical activity intervention and child's performance in numeracy. An ANCOVA model with latent variable structural equation modeling was estimated using data from 360 children (the lower third in academic performance in numeracy at baseline). The model consisted of the three latent factors as mediators; executive function, behavioral self-regulation, and school related well-being. We found no mediating effects of executive function, behavioral self-regulation or school related well-being in the relationship between the ASK intervention and academic performance in numeracy (p ≥ 0.256). Our results suggest that the effect of the intervention on performance in numeracy in the present sample is not explained by change in executive function, behavioral self-regulation, or school related well-being. We suggest this finding mainly could be explained by the lack of effect of the intervention on the mediators, which might be due to an insufficient dose of physical activity. Trial registration: Clinicaltrials.gov registry, trial registration number: NCT02132494.
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Affiliation(s)
- Katrine N. Aadland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Eivind Aadland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - John R. Andersen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Arne Lervåg
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Education, Faculty of Educational Sciences, University of Oslo, Oslo, Norway
| | - Vegard F. Moe
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Geir K. Resaland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
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Martin A, Booth JN, Laird Y, Sproule J, Reilly JJ, Saunders DH. Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database Syst Rev 2018; 1:CD009728. [PMID: 29376563 PMCID: PMC6491168 DOI: 10.1002/14651858.cd009728.pub3] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The global prevalence of childhood and adolescent obesity is high. Lifestyle changes towards a healthy diet, increased physical activity and reduced sedentary activities are recommended to prevent and treat obesity. Evidence suggests that changing these health behaviours can benefit cognitive function and school achievement in children and adolescents in general. There are various theoretical mechanisms that suggest that children and adolescents with excessive body fat may benefit particularly from these interventions. OBJECTIVES To assess whether lifestyle interventions (in the areas of diet, physical activity, sedentary behaviour and behavioural therapy) improve school achievement, cognitive function (e.g. executive functions) and/or future success in children and adolescents with obesity or overweight, compared with standard care, waiting-list control, no treatment, or an attention placebo control group. SEARCH METHODS In February 2017, we searched CENTRAL, MEDLINE and 15 other databases. We also searched two trials registries, reference lists, and handsearched one journal from inception. We also contacted researchers in the field to obtain unpublished data. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials (RCTs) of behavioural interventions for weight management in children and adolescents with obesity or overweight. We excluded studies in children and adolescents with medical conditions known to affect weight status, school achievement and cognitive function. We also excluded self- and parent-reported outcomes. DATA COLLECTION AND ANALYSIS Four review authors independently selected studies for inclusion. Two review authors extracted data, assessed quality and risks of bias, and evaluated the quality of the evidence using the GRADE approach. We contacted study authors to obtain additional information. We used standard methodological procedures expected by Cochrane. Where the same outcome was assessed across different intervention types, we reported standardised effect sizes for findings from single-study and multiple-study analyses to allow comparison of intervention effects across intervention types. To ease interpretation of the effect size, we also reported the mean difference of effect sizes for single-study outcomes. MAIN RESULTS We included 18 studies (59 records) of 2384 children and adolescents with obesity or overweight. Eight studies delivered physical activity interventions, seven studies combined physical activity programmes with healthy lifestyle education, and three studies delivered dietary interventions. We included five RCTs and 13 cluster-RCTs. The studies took place in 10 different countries. Two were carried out in children attending preschool, 11 were conducted in primary/elementary school-aged children, four studies were aimed at adolescents attending secondary/high school and one study included primary/elementary and secondary/high school-aged children. The number of studies included for each outcome was low, with up to only three studies per outcome. The quality of evidence ranged from high to very low and 17 studies had a high risk of bias for at least one item. None of the studies reported data on additional educational support needs and adverse events.Compared to standard practice, analyses of physical activity-only interventions suggested high-quality evidence for improved mean cognitive executive function scores. The mean difference (MD) was 5.00 scale points higher in an after-school exercise group compared to standard practice (95% confidence interval (CI) 0.68 to 9.32; scale mean 100, standard deviation 15; 116 children, 1 study). There was no statistically significant beneficial effect in favour of the intervention for mathematics, reading, or inhibition control. The standardised mean difference (SMD) for mathematics was 0.49 (95% CI -0.04 to 1.01; 2 studies, 255 children, moderate-quality evidence) and for reading was 0.10 (95% CI -0.30 to 0.49; 2 studies, 308 children, moderate-quality evidence). The MD for inhibition control was -1.55 scale points (95% CI -5.85 to 2.75; scale range 0 to 100; SMD -0.15, 95% CI -0.58 to 0.28; 1 study, 84 children, very low-quality evidence). No data were available for average achievement across subjects taught at school.There was no evidence of a beneficial effect of physical activity interventions combined with healthy lifestyle education on average achievement across subjects taught at school, mathematics achievement, reading achievement or inhibition control. The MD for average achievement across subjects taught at school was 6.37 points lower in the intervention group compared to standard practice (95% CI -36.83 to 24.09; scale mean 500, scale SD 70; SMD -0.18, 95% CI -0.93 to 0.58; 1 study, 31 children, low-quality evidence). The effect estimate for mathematics achievement was SMD 0.02 (95% CI -0.19 to 0.22; 3 studies, 384 children, very low-quality evidence), for reading achievement SMD 0.00 (95% CI -0.24 to 0.24; 2 studies, 284 children, low-quality evidence), and for inhibition control SMD -0.67 (95% CI -1.50 to 0.16; 2 studies, 110 children, very low-quality evidence). No data were available for the effect of combined physical activity and healthy lifestyle education on cognitive executive functions.There was a moderate difference in the average achievement across subjects taught at school favouring interventions targeting the improvement of the school food environment compared to standard practice in adolescents with obesity (SMD 0.46, 95% CI 0.25 to 0.66; 2 studies, 382 adolescents, low-quality evidence), but not with overweight. Replacing packed school lunch with a nutrient-rich diet in addition to nutrition education did not improve mathematics (MD -2.18, 95% CI -5.83 to 1.47; scale range 0 to 69; SMD -0.26, 95% CI -0.72 to 0.20; 1 study, 76 children, low-quality evidence) and reading achievement (MD 1.17, 95% CI -4.40 to 6.73; scale range 0 to 108; SMD 0.13, 95% CI -0.35 to 0.61; 1 study, 67 children, low-quality evidence). AUTHORS' CONCLUSIONS Despite the large number of childhood and adolescent obesity treatment trials, we were only able to partially assess the impact of obesity treatment interventions on school achievement and cognitive abilities. School and community-based physical activity interventions as part of an obesity prevention or treatment programme can benefit executive functions of children with obesity or overweight specifically. Similarly, school-based dietary interventions may benefit general school achievement in children with obesity. These findings might assist health and education practitioners to make decisions related to promoting physical activity and healthy eating in schools. Future obesity treatment and prevention studies in clinical, school and community settings should consider assessing academic and cognitive as well as physical outcomes.
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Affiliation(s)
| | - Josephine N Booth
- The University of EdinburghInstitute for Education, Community and SocietyMoray House School of EducationRoom 2.17, St John's LandEdinburghUKEH8 8AQ
| | - Yvonne Laird
- University of EdinburghScottish Collaboration for Public Health Research and Policy (SCPHRP)20 West Richmond StreetEdinburghUKEH8 9DX
| | - John Sproule
- Institute for Sport, Physical Education and Health Sciences (SPEHS), University of EdinburghMoray House School of EducationHolyrood RoadEdinburghUK
| | - John J Reilly
- University of StrathclydePhysical Activity for Health Group, School of Psychological Sciences and Health50 George StreetGlasgowUKG1 1QE
| | - David H Saunders
- University of EdinburghPhysical Activity for Health Research Centre (PAHRC)St Leonards LandHolyrood RoadEDINBURGHUKEH8 8AQ
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Wolfenden L, Nathan NK, Sutherland R, Yoong SL, Hodder RK, Wyse RJ, Delaney T, Grady A, Fielding A, Tzelepis F, Clinton‐McHarg T, Parmenter B, Butler P, Wiggers J, Bauman A, Milat A, Booth D, Williams CM. Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease. Cochrane Database Syst Rev 2017; 11:CD011677. [PMID: 29185627 PMCID: PMC6486103 DOI: 10.1002/14651858.cd011677.pub2] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND A number of school-based policies or practices have been found to be effective in improving child diet and physical activity, and preventing excessive weight gain, tobacco or harmful alcohol use. Schools, however, frequently fail to implement such evidence-based interventions. OBJECTIVES The primary aims of the review are to examine the effectiveness of strategies aiming to improve the implementation of school-based policies, programs or practices to address child diet, physical activity, obesity, tobacco or alcohol use.Secondary objectives of the review are to: Examine the effectiveness of implementation strategies on health behaviour (e.g. fruit and vegetable consumption) and anthropometric outcomes (e.g. BMI, weight); describe the impact of such strategies on the knowledge, skills or attitudes of school staff involved in implementing health-promoting policies, programs or practices; describe the cost or cost-effectiveness of such strategies; and describe any unintended adverse effects of strategies on schools, school staff or children. SEARCH METHODS All electronic databases were searched on 16 July 2017 for studies published up to 31 August 2016. We searched the following electronic databases: Cochrane Library including the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; Embase Classic and Embase; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); Dissertations and Theses; and SCOPUS. We screened reference lists of all included trials for citations of other potentially relevant trials. We handsearched all publications between 2011 and 2016 in two specialty journals (Implementation Science and Journal of Translational Behavioral Medicine) and conducted searches of the WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/) as well as the US National Institutes of Health registry (https://clinicaltrials.gov). We consulted with experts in the field to identify other relevant research. SELECTION CRITERIA 'Implementation' was defined as the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns within specific settings. We included any trial (randomised or non-randomised) conducted at any scale, with a parallel control group that compared a strategy to implement policies or practices to address diet, physical activity, overweight or obesity, tobacco or alcohol use by school staff to 'no intervention', 'usual' practice or a different implementation strategy. DATA COLLECTION AND ANALYSIS Citation screening, data extraction and assessment of risk of bias was performed by review authors in pairs. Disagreements between review authors were resolved via consensus, or if required, by a third author. Considerable trial heterogeneity precluded meta-analysis. We narratively synthesised trial findings by describing the effect size of the primary outcome measure for policy or practice implementation (or the median of such measures where a single primary outcome was not stated). MAIN RESULTS We included 27 trials, 18 of which were conducted in the USA. Nineteen studies employed randomised controlled trial (RCT) designs. Fifteen trials tested strategies to implement healthy eating policies, practice or programs; six trials tested strategies targeting physical activity policies or practices; and three trials targeted tobacco policies or practices. Three trials targeted a combination of risk factors. None of the included trials sought to increase the implementation of interventions to delay initiation or reduce the consumption of alcohol. All trials examined multi-strategic implementation strategies and no two trials examined the same combinations of implementation strategies. The most common implementation strategies included educational materials, educational outreach and educational meetings. For all outcomes, the overall quality of evidence was very low and the risk of bias was high for the majority of trials for detection and performance bias.Among 13 trials reporting dichotomous implementation outcomes-the proportion of schools or school staff (e.g. classes) implementing a targeted policy or practice-the median unadjusted (improvement) effect sizes ranged from 8.5% to 66.6%. Of seven trials reporting the percentage of a practice, program or policy that had been implemented, the median unadjusted effect (improvement), relative to the control ranged from -8% to 43%. The effect, relative to control, reported in two trials assessing the impact of implementation strategies on the time per week teachers spent delivering targeted policies or practices ranged from 26.6 to 54.9 minutes per week. Among trials reporting other continuous implementation outcomes, findings were mixed. Four trials were conducted of strategies that sought to achieve implementation 'at scale', that is, across samples of at least 50 schools, of which improvements in implementation were reported in three trials.The impact of interventions on student health behaviour or weight status were mixed. Three of the eight trials with physical activity outcomes reported no significant improvements. Two trials reported reductions in tobacco use among intervention relative to control. Seven of nine trials reported no between-group differences on student overweight, obesity or adiposity. Positive improvements in child dietary intake were generally reported among trials reporting these outcomes. Three trials assessed the impact of implementation strategies on the attitudes of school staff and found mixed effects. Two trials specified in the study methods an assessment of potential unintended adverse effects, of which, they reported none. One trial reported implementation support did not significantly increase school revenue or expenses and another, conducted a formal economic evaluation, reporting the intervention to be cost-effective. Trial heterogeneity, and the lack of consistent terminology describing implementation strategies, were important limitations of the review. AUTHORS' CONCLUSIONS Given the very low quality of the available evidence, it is uncertain whether the strategies tested improve implementation of the targeted school-based policies or practices, student health behaviours, or the knowledge or attitudes of school staff. It is also uncertain if strategies to improve implementation are cost-effective or if they result in unintended adverse consequences. Further research is required to guide efforts to facilitate the translation of evidence into practice in this setting.
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Cochrane T, Davey RC. Mixed-Methods Evaluation of a Healthy Exercise, Eating, and Lifestyle Program for Primary Schools. THE JOURNAL OF SCHOOL HEALTH 2017; 87:823-831. [PMID: 29023834 DOI: 10.1111/josh.12555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 02/23/2017] [Accepted: 05/24/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Reversing decline in physical fitness and increase in excess body weight in school children are considered major public health challenges. We evaluated a proposed model to integrate a screening and healthy exercise, eating, and lifestyle program (HEELP) into primary schools in Canberra, Australia. Objectives were: (1) to establish body status and physical competencies of 5- to 10-year-old children; (2) to evaluate the service's impact on body status and physical fitness; and (3) to gauge parent/guardian and school perspectives on the service. METHODS A mixed-methods approach was used over 4 school years, 2010-2013. Primary evaluation used direct quantitative measurement. Confirmatory qualitative methods were implemented in the last 2 years. RESULTS The service was delivered on 71 occasions involving 25 schools; 7750 children were screened and 709 completed all aspects of the HEELP evaluation. Over 60% of children screened had 2 or more measures that would benefit from remedial intervention. CONCLUSIONS All body status and physical fitness measures showed small beneficial changes on a population basis immediately after the HEELP. Further benefit did not accrue at 6 months after the program. Semistructured interviews with schools and parent/guardian surveys confirmed some beneficial effects observed by direct quantitative measurement.
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Affiliation(s)
- Thomas Cochrane
- Centre for Research and Action in Public Health, University Drive South, University of Canberra, Canberra, Australia
| | - Rachel C Davey
- Centre for Research and Action in Public Health, University Drive South, University of Canberra, Canberra, Australia
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Pozuelo-Carrascosa DP, García-Hermoso A, Álvarez-Bueno C, Sánchez-López M, Martinez-Vizcaino V. Effectiveness of school-based physical activity programmes on cardiorespiratory fitness in children: a meta-analysis of randomised controlled trials. Br J Sports Med 2017; 52:1234-1240. [DOI: 10.1136/bjsports-2017-097600] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 11/03/2022]
Abstract
ObjectiveTo conduct a meta-analysis of randomised controlled trials aimed at testing whether school-based physical activity programmes improve cardiorespiratory fitness (CRF) in children.DesignSystematic review with meta-analysis.Data sourcesUsing keywords, we performed a computerised search in five databases: MEDLINE, EMBASE, CINAHL, Web of Science and SportDiscus.Eligibility criteria for selecting studiesStudies that assessed the effectiveness of school-based physical activity programmes on improving CRF in children (3–12 years old). We selected interventions that included an additional physical activity programme and not only a physical activity educational component. The reference lists of selected full-text articles and systematic reviews were also searched for relevant studies. Pooled effect size (Hedges′ g) was calculated assuming a random-effects model.ResultsTwenty trials with 7287 healthy children aged 3–12 years were included in the meta-analysis. School-based physical activity interventions with aerobic games and activities were associated with a significant small increase in CRF (Hedges′ g=0.22; 95% CI 0.14 to 0.30; p<0.001). Based on subgroup analysis, the increase in CRF was significant in girls (Hedges′ g=0.25; 95% CI 0.13 to 0.37; p<0.001), but not in boys (Hedges′ g=0.02; 95% CI −0.10 to 0.14; p=0.731).SummaryModerate quality evidence supports the effectiveness of school-based physical activity interventions on improving CRF in children.Trial registration numberProtocol PROSPERO registration number CRD42016050173.
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Álvarez-Bueno C, Pesce C, Cavero-Redondo I, Sánchez-López M, Martínez-Hortelano JA, Martínez-Vizcaíno V. The Effect of Physical Activity Interventions on Children's Cognition and Metacognition: A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry 2017; 56:729-738. [PMID: 28838577 DOI: 10.1016/j.jaac.2017.06.012] [Citation(s) in RCA: 199] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/19/2017] [Accepted: 06/29/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective was twofold: to assess the effect of physical activity (PA) interventions on children's and adolescents' cognition and metacognition; and to determine the characteristics of individuals and PA programs that enhance the development of cognitive and metacognitive functions. METHOD We systematically searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, and PsycINFO databases from their inception to October 16, 2016. Intervention studies aimed at examining the exercise-cognition interaction at a developmental age were included in this systematic review and meta-analysis. Random-effects models were used to calculate pooled effect size (ES) values and their corresponding 95% CIs. Subgroup analyses were conducted to examine the effect of participants' and PA programs' characteristics. RESULTS A total of 36 studies were included in this systematic review and meta-analysis. Pooled ES estimations were as follows: nonexecutive cognitive functions 0.23 (95% CI = 0.09-0.37); core executive functions 0.20 (95% CI = 0.10-0.30), including working memory (0.14 [95% CI = 0.00-0.27]), selective attention-inhibition (0.26 [95% CI = 0.10-0.41]), and cognitive flexibility (0.11 [95% CI = -0.10 to 0.32]); and metacognition 0.23 (95% CI = 0.13-0.32), including higher-level executive functions (0.19 [95% CI = 0.06-0.31]) and cognitive life skills (0.30 [95% CI = 0.15-0.45]). CONCLUSION PA benefits several domains of cognition and metacognition in youth. Curricular physical education interventions and programs aimed at increasing daily PA seem to be the most effective.
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Affiliation(s)
- Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Caterina Pesce
- Human and Health Sciences, Italian University Sport and Movement "Foro Italico," Rome, Italy
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Mairena Sánchez-López
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Universidad de Castilla-La Mancha, School of Education, Ciudad Real, Spain.
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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Watson A, Timperio A, Brown H, Best K, Hesketh KD. Effect of classroom-based physical activity interventions on academic and physical activity outcomes: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017; 14:114. [PMID: 28841890 PMCID: PMC5574081 DOI: 10.1186/s12966-017-0569-9] [Citation(s) in RCA: 274] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 08/14/2017] [Indexed: 01/31/2023] Open
Abstract
Background Physical activity is associated with many physical and mental health benefits, however many children do not meet the national physical activity guidelines. While schools provide an ideal setting to promote children’s physical activity, adding physical activity to the school day can be difficult given time constraints often imposed by competing key learning areas. Classroom-based physical activity may provide an opportunity to increase school-based physical activity while concurrently improving academic-related outcomes. The primary aim of this systematic review and meta-analysis was to evaluate the impact of classroom-based physical activity interventions on academic-related outcomes. A secondary aim was to evaluate the impact of these lessons on physical activity levels over the study duration. Methods A systematic search of electronic databases (PubMed, ERIC, SPORTDiscus, PsycINFO) was performed in January 2016 and updated in January 2017. Studies that investigated the association between classroom-based physical activity interventions and academic-related outcomes in primary (elementary) school-aged children were included. Meta-analyses were conducted in Review Manager, with effect sizes calculated separately for each outcome assessed. Results Thirty-nine articles met the inclusion criteria for the review, and 16 provided sufficient data and appropriate design for inclusion in the meta-analyses. Studies investigated a range of academic-related outcomes including classroom behaviour (e.g. on-task behaviour), cognitive functions (e.g. executive function), and academic achievement (e.g. standardised test scores). Results of the meta-analyses showed classroom-based physical activity had a positive effect on improving on-task and reducing off-task classroom behaviour (standardised mean difference = 0.60 (95% CI: 0.20,1.00)), and led to improvements in academic achievement when a progress monitoring tool was used (standardised mean difference = 1.03 (95% CI: 0.22,1.84)). However, no effect was found for cognitive functions (standardised mean difference = 0.33 (95% CI: -0.11,0.77)) or physical activity (standardised mean difference = 0.40 (95% CI: -1.15,0.95)). Conclusions Results suggest classroom-based physical activity may have a positive impact on academic-related outcomes. However, it is not possible to draw definitive conclusions due to the level of heterogeneity in intervention components and academic-related outcomes assessed. Future studies should consider the intervention period when selecting academic-related outcome measures, and use an objective measure of physical activity to determine intervention fidelity and effects on overall physical activity levels.
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Affiliation(s)
- Amanda Watson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Helen Brown
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Keren Best
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, Geelong, Australia.
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