Association Between Sitting, Screen Time, Fitness Domains, and Fundamental Motor Skills in Children Aged 5-16 Years: Cross-Sectional Population Study

BMI, Dental Caries, and Risk Factors among Elementary School Children: A Cross-Sectional Study

Background/Objectives: Obesity and dental caries are multifactorial diseases with high prevalence amongst Saudi children. The aim of the study was to determine their association with common risk factors. Methods: This cross-sectional study examined 300 children attending elementary schools. After taking their height and weight, their body mass indices (BMIs) were calculated. Oral examination was performed to record the decayed, missed, and filled scores (dmft/DMFT). A thorough questionnaire was compiled and validated to gather information on diet and physical activity (PA). The KIDMED score was calculated from a 16-item questionnaire to assess diet. Junk food and PA scores were also calculated based on relevant questions. Nonparametric tests were used to assess the associations between the scores and health outcomes (dmft/DMFT and BMI). Results: Fifty-eight of the children had poor diets, which was associated with higher dmft/DMFT (p = 0.012). PA levels were very low, and the average PA score was 2.12 ± 0.61. No association was found between BMI percentiles and PA level, nor between BMI percentiles and diet quality. Older children had lower BMI percentiles compared with younger children (coefficient = -9.35, 95% CI: -17.05, -1.65), and a borderline significant negative association was observed between dmft/DMFT and BMI percentile. Conclusions: Poor diets and chips consumption were related to dental caries. Obesity was not related to diet quality nor PA level.

Factors Associated With Screen Time Among Preschool Children in Lima, Peru

OBJECTIVE

This study aims to identify factors associated with excessive screen time among preschoolers in Lima, Peru.

METHODS

Cross-sectional analysis from a 2019 panel study in Lima, Peru, was conducted focusing on women, aged 18 and above, who are mothers of 3- to 5-year-olds in mid-high and mid-low districts. There were two outcome variables: excessive TV and excessive electronic devices screen time, defined as ≥ 1 h of screen exposure for each one. Explored factors included the mother's age, education and wealth index and the children's age, sex, physical activity, day care attendance and ultra-processed food consumption. Crude (cPR) and adjusted prevalence ratios (aPR) were estimated for the association between associated factors and excessive screen time using the GLM Poisson of with a logarithmic link.

RESULTS

Excessive TV screen time and electronic devices prevalence was 74% and 36.9%, respectively. For TV screen time, a high wealth index (aPR 1.13; 95%CI: 1.03-1.23) and children's age (aPR 1.18; 95%CI: 1.08-1.29 for 4 years, PR = 1.17; 95%CI: 1.07-1.28 for 5 years) were significant. For electronic devices, significant associations included mothers with more than 3 children (aPR 0.77; 95%CI: 0.62-0.96), being single (aPR 1.27; 95%CI: 1.01-1.58) and a high wealth index (aPR 1.38; 95%CI: 1.13-1.68). Furthermore, significant associations were found between excessive electronic device screen time and consumption of candies and chocolates (aPR 1.38; 95%CI: 1.08-1.77).

CONCLUSIONS

Seven out of 10 preschool children exceeded the recommended television screen time. Certain characteristics of the children, their mothers and the family's socio-economic situation are related to excessive television screen time and excessive electronic device screen time.

Associations of obesity, movement behaviors, and socioeconomic status with fundamental movement skills in children: Results from the REACT project

OBJECTIVE

To investigate the relationship of biological characteristics (age, sex, and obesity), movement behaviors (physical activity and sedentary time), and family socioeconomic status with fundamental movement skills (FMS) in primary school children.

METHODS

This cross-sectional study sampled 1014 children (537 girls) aged 6 to 10 years from 25 primary schools in Matosinhos, north of Portugal. Five object control skills (dribbling, kicking, catching, throwing, and underarm rolling) were assessed with a categorical scale using the Meu Educativo® platform. Body Mass Index (BMI) was calculated and transformed into z-scores. Moderate-to-vigorous physical activity (MVPA) and sedentary time were monitored with accelerometry (ActiGraph wGT3X-BT) for seven consecutive days. Family socioeconomic status (SES) was obtained from the Portuguese social support system. Ordinal multilevel logistic regression was used to analyze the associations of weight status, MVPA, sedentary time and SES with FMS, adjusted for sex and age.

RESULTS

Boys (odds ratio (OR) = 6.54; 95% CI: 5.13-8.36) and older children (OR = 2.04; 95% CI: 1.85-2.26) were more likely to achieve higher FMS scores. Children with obesity (OR = 0.60; 95% CI: 0.45-0.80), those less active (OR = 0.56; 95% CI: 0.42-0.75) and children with more sedentary time (OR = 0.86; 95%CI: 0.77-0.97) were less likely to score high on FMS. Family SES was not significantly associated with FMS scores.

CONCLUSION

Primary school children's FMS are significantly related to biological and behavioral factors but not to family SES. These findings highlight the need for suitable strategies to enhance children's FMS proficiency, considering differences in these characteristics. Fostering adequate motor skill proficiency levels will assist in establishing a robust foundation for healthy lifestyles of all children.

Children with developmental coordination disorders: a review of approaches to assessment and intervention

Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder characterized by deficits in motor skills, with gross and fine motor dysfunction being the main symptom. This condition greatly impairs children's daily life, learning, and social interaction. Symptoms typically appear during preschool or school age, and if left untreated, they can persist into adulthood. Thus, early assessment and intervention are crucial to improve the prognosis. This study aims to review the existing literature on DCD, providing a comprehensive overview of the assessment for children with DCD in terms of body functions and structures, activities and participation, and environmental factors within the framework of the International Classification of Functioning, Disability, and Health - Children and Youth (ICF-CY). Additionally, specific rehabilitation interventions will be described, offering valuable insights for the clinical assessment and intervention of children with DCD.

Screen Time and Its Health Consequences in Children and Adolescents

Nowadays, children and adolescents are exposed to digital media (DM) from an early age. Therefore, specific guidelines have been published by the World Health Organization, whose aim is to limit daily screen time (ST) viewing. However, during the COVID-19 pandemic, a rise in DM use, and consequently ST viewing, was observed. More and more aspects of modern life are thought to be affected by excessive ST viewing. Accordingly, the aim of this review is to document the health effects of excessive ST viewing on children and adolescents. A narrative review was performed in searchable databases. In total, 43 original articles were considered. Excessive ST viewing was correlated with increased risk for obesity and other cardiometabolic risk factors, mental health, unhealthy dietary habits and eating disorders, and problems in development and child-parent relationships. Sleep, physical activity, eyesight, headaches, and the musculoskeletal system were negatively affected as well. However, the effect of ST was weighted by the type of media used and the way types of media were used. Other confounding factors were reported. There is evidence to suggest a negative correlation between excessive ST and youth health exists. Nevertheless, more research is needed if this correlation is to be established.

Does Sedentary Behavior Predict Motor Competence in Young Children?

Background: Understanding how or whether sedentary behavior affects motor competence in young children is important considering that children spend a lot of time sedentary. The aim of this study was to examine whether sedentary behavior predicts motor competence in young children. Methods: A longitudinal study with a total of 372 children aged 3.5 years at baseline and 5 years at follow-up was conducted. Objectively measured activity patterns (i.e., using accelerometers) were conducted in a subsample with 188 children. Sedentary behavior was assessed both objectively and subjectively (parent-reported screen time). Locomotor and object control skill scores were determined using the Test of Gross Motor Development—Second Edition. A multivariable analysis was executed adjusting for potential confounders (such as age, sex, time spent in moderate- to vigorous-intensity physical activity, monitor wear time, body mass index z scores, and maternal education). Results: Sedentary behavior at either time point was not significantly associated with either locomotor or object control skills after adjusting for potential confounders. Discussion: Our results did not support the assumption that sedentary behavior affects motor competence in young children. Regardless, given the lack of consistency in the evidence base, we recommend to parents, educators, and health professionals that sedentary activities should be kept within government recommendations due to potential negative effects on child development.

Effect of Excessive Screen Time on Cardiorespiratory Fitness in Children: A Longitudinal Study

Background: This study investigated the effect of different components of screen time (mobile phone use, TV/video viewing, and video gaming) on cardiorespiratory fitness (CRF) development in children aged 9–12 years. Methods: This was a two-year longitudinal study conducted with 175 children (49.7% girls, mean age = 9.5) in Japan. CRF was assessed using a 20 m shuttle run test conducted at baseline and again at follow-up. Children were categorized as “Good” or “Poor” based on the change in CRF scores for each gender. Screen time was assessed using a self-reported questionnaire at baseline and termed as “high” if children reported ≥ 2 h/day. Univariate and multivariate logistic regression analyses were performed after adjusting for gender, physical activity, and time of data collection. Results: Children scoring “high” on mobile phone use had lower odds of being categorized as “Good” in CRF change (crude odds ratio (OR): 0.34; 95% confidence interval (CI): 0.15–0.90 (adjusted OR: 0.33; 95% CI: 0.12–0.91)). There were no significant effects of TV/video viewing (crude OR: 1.54; 95% CI: 0.84–2.81) and video gaming (crude OR: 0.98; 95% CI: 0.48–1.97) on changes in CRF. Conclusions: Limiting excessive mobile phone usage might be important for ensuring healthy development of CRF in children.

Impact of Virtual vs. In-Person School on Children Meeting the 24-h Movement Guidelines during the COVID-19 Pandemic

The pandemic mitigation strategy of closing schools, while necessary, may have unintentionally impacted children's moderate-to-vigorous physical activity (MVPA), sleep, and time spent watching screens. In some locations, schools used hybrid attendance models, with some days during the week requiring in-person and others virtual attendance. This scenario offers an opportunity to evaluate the impact of attending in-person school on meeting the 24-h movement guidelines. Children (N = 690, 50% girls, K-5th) wore wrist-placed accelerometers for 14 days during October/November 2020. Parents completed daily reports on child time spent on screens and time spent on screens for school. The schools' schedule was learning for 2 days/week in-person and 3 days/week virtually. Using only weekdays (M-F), the 24-h movement behaviors were classified, and the probability of meeting all three was compared between in-person vs. virtual learning and across grades. Data for 4956 weekdays (avg. 7 d/child) were collected. In-person school was associated with a greater proportion (OR = 1.70, 95% CI: 1.33-2.18) of days that children were meeting the 24-h movement guidelines compared to virtual school across all grades. Students were more likely to meet the screen time (OR = 9.14, 95% CI: 7.05-11.83) and MVPA (OR = 1.50, 95% CI: 1.25-1.80) guidelines and less likely to meet the sleep (OR = 0.73, 95% CI: 0.62-0.86) guidelines on the in-person compared to the virtual school days. Structured environments, such as school, have a protective effect on children's movement behaviors, especially physical activity and screen time.

Is Motor Milestone Assessment in Infancy Valid and Scaled Equally Across Sex, Birth Weight, and Gestational Age? Findings From the Millennium Cohort Study

Is the assessment of motor milestones valid and scaled equivalently for all infants? It is not only important to understand if the way we use gross and fine motor scores are appropriate for monitoring motor milestones but also to determine if these scores are confounded by specific infant characteristics. Therefore, the aim of the study is to investigate the latent structure underlying motor milestone assessment in infancy and measurement invariance across sex, birth weight, and gestational age. For this study, the birth cohort data from the United Kingdom Millennium Cohort Study (MCS) was used, which includes the assessment of eight motor milestone tasks from the Denver Developmental Screening Test in 9-month-old infants (N = 18,531), depicting early motor development of the first children of generation Z. Confirmatory factor analyses showed a better model fit for a two-factor structure (i.e., gross and fine motor development) compared to a one-factor structure (i.e., general motor development), and multiple indicators multiple causes modeling revealed no differential item functioning related to sex, birth weight, and gestational age. The study provides support for the use of gross and fine motor scores when assessing motor milestones in infants—both boys and girls with different birth weights and of varying gestational ages. Further investigation into widely adopted assessment tools is recommended to support the use of valid composite scores in early childhood research and practice.

[Not Available]

PURPOSE OF RESEARCH

To investigate upon the relationship between screen exposure time and graphic/fine motor skills of children aged 5 to 6 in Auvergne.

METHODS

A cross-sectional epidemiological study was carried out in 2019-2020 in 3 kindergarten classes in Clermont-Ferrand and 4 in Cantal, chosen according to different socio-demographic criteria. The main criteria for evaluating fine motor skills were 3 calibrated graphic/fine motor activities, carried out during an individual assessment at school. The weekly screen exposure time of the child was assessed during a parental interview.

RESULTS

127 children took part in the survey. The main results point out that children who spend more than 10 hours per school week (more than 20 hours a holiday school week) on screen have significantly lower graphic/fine motor skills. Regardless of screen exposure time, a child living with a single parent, and/or of low level of educational, and/or intermediate occupation/socio-professional category, has lower graphic/fine motor skills scores. The rural setting of the school seems to play a positive role in the level of graphic/fine motor skills, while the socio-demographic profile of the school and the attendance of the children do not seem to influence these skills.

CONCLUSIONS

Our survey shows a significant association between increased weekly screen time exposure and decreased graphic/fine motor skills in children aged 5-6 years. Further work will be required to explore this association. Health education programs implemented in school and health communities with parental involvement would be useful to improve screen usage and prevent learning disabilities.

Assessment of the influence of physical activity and screen time on somatic features and physical fitness in 6 to 7-year-old girls

Aim of the study is to assess the relationship between screen time, physical activity and physical fitness among girls 6–7 years-old.

21,528 girls aged 6 and 7 from Poland were assessed in terms of physical fitness. Arm strength, abdominal strength and explosive strength of the lower limbs were measured using the EUROFIT test. Basic somatic features were measured and BMI and WHtR indices were calculated. Spontaneous and organized physical activities as well screen time were assessed by the parents utilizing a questionnaire. The multiple logistic regression method was used to evaluate the influence of screen time and spontaneous physical activity on various components of physical fitness.

Physically active (PA) girls (≥1h/day) and those who participated in additional physical activities (APA) during the week had significantly higher height, weight, and BMI (p<0.001), but not WHtR. They had a higher level of flexibility, explosive strength of the lower limbs and arm strength (p<0.001). With an increase in screen time, the BMI, WHtR increased significantly and explosive strength of the lower limbs, abdominal strength and arm strength were lower. Regression analysis showed that more frequent participation in extracurricular activities increased the values of BMI and WHtR in quartile 4 (Q4), and strength components: Q2–Q4 (p<0.05). Spontaneous physical activity was positively related to the values of BMI, WHtR (both: Q4; p<0.05), explosive force of lower limbs (Q3–Q4; p=0.001), and negatively related to arm strength (Q2; p=0.001). Screen time (≥2hrs/day) increased odds for higher BMI values (p<0.05). Each screen time category decreased the odds of achieving abdominal muscle strength related to the quartiles: Q2–Q4 (p<0.05), arm strength (Q4: p<0.05). ST (1 <2hrs/day) decreased arm strength (Q3; p= 0.045). Our research has shown that screen time-related sedentary behavior and physical activity affect overweight and obesity indices (especially BMI) and strength abilities. The observed associations more often affected girls with a higher level of fitness The results observed in girls aged 6-7 indicate a need for early intervention aimed at limiting time spent watching TV and computer use, as well as to encourage both spontaneous and organized physical activities.

Sedentary behavior and motor competence in children and adolescents: a review

OBJECTIVE

To synthesize evidence from studies that analyzed the associations between sedentary behavior and motor competence in children and adolescents.

METHODS

Systematic review of original articles that analyzed possible associations between sedentary behavior and motor competence in children and adolescents (3-18 years of age), without restrictions on study design, instruments and analysis protocols. The articles were identified through searches in the PubMed, Web of Science, Academic Search Premier, Cinahl, Medline and SPORTDiscus databases, as well as in reference lists. The level of evidence was evaluated according to the amount of studies that reported statistical significance in the associations between the variables and the quality of the articles (risk of bias).

RESULTS

Of 2,462 initial studies, 22 composed the synthesis (two interventions, nine longitudinal and eleven cross-sectional studies). Of these, in 13, we observed negative associations between the variables, more often in the age group of seven to fourteen years. In the analysis of risk of bias, the main limitations of the studies were "convenience sampling" and "no description of sample sizing".

CONCLUSIONS

The available evidence suggests that sedentary behavior is negatively associated with motor competence in elementary school children, although the evidence is uncertain in the preschool years; the synthesis of results from longitudinal studies suggests that sedentary behavior negatively affects the development of motor competence. It is important that future studies have greater control over sociocultural determinants and deepen knowledge regarding sex and age, as well as the methods and indicators used to evaluate the two variables.

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

Background

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

Objective

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

Methods

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

Results

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

Conclusions

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

Aiming at Optimal Physical Activity for Longevity (OPAL)

Although even small volumes (15–20 min) of daily physical activity (PA) are associated with health benefits, the optimal volume for healthy aging and longevity is substantially larger, amounting to about 100 min of daily moderate PA. The accomplishment of this objective likely requires the development of an appropriate PA lifestyle at an early age. Research initiatives are necessary addressing the motivational contribution of families, school surroundings and sport clubs, perhaps combined with role model effects and instructions for the specific implementation. Such approaches would need an enlarged agreement in readdressing this new aim followed by the launch of a new research strategy in order to develop specific offers for the respective age cohorts.

Parental Self-Efficacy-A Predictor of Children's Health Behaviors? Its Impact on Children's Physical Activity and Screen Media Use and Potential Interaction Effect Within a Health Promotion Program

Insufficient physical activity (PA) and increased screen media use (SMU) can have detrimental effects on children's health. Parental self-efficacy (PSE) can act as an important predictor for a healthy upbringing. The aim of this study was to investigate the influence of PSE on children's PA and SMU. Additionally, a moderating effect of PSE on the intervention effect of the health promotion program “Join the Healthy Boat” was examined. Using a prospective randomized controlled trial, 558 kindergarten children (3.6 years [SD = 0.6]) were examined. Data was collected using parental self-report. A significant influence of PSE on children's PA (B = 0.33, p = 0.025) and children's SMU (B = 0.42, p = 0.006) was found. The moderating effect of PSE on the intervention effect was neither significantly related to children's PA (p = 0.360) nor to children's SMU (p = 0.531). This confirms the importance of PSE on children's health development. Despite the lack of a moderating effect, interventions should also promote healthy activity behaviors and self-efficacy for parents in order to engage children in a healthy lifestyle.

Cognitive and Physical Activity-Related Aspects of Children Associated to the Performance of the Crunning Movement

The aim of this investigation was to identify possible related factors associated to the performance of the crunning test in European children and adolescents. A total number of 559 children and adolescents (age range 6-14 years) of which 308 boys (55.1%) and 251 girls (44.9%), from seven European countries, were screened. A questionnaire concerning demographic and personal life-related factors and a cognitive assessment were performed. A regression analysis was conducted with the performance measures of the crunning movement. T-tests and ANCOVA were used to analyze sub-group differences. Boys have greater crunning performance values compared to girls (5.55 s vs. 7.06 s, p < 0.001) and older children perform better than younger ones (R2 -0.23; p < 0.001). Children with healthy and active habits (exercising or spending time with family members vs. reading or surfing the internet) performed better in the test. Children engaged in team sports had better crunning performances compared to those engaged in individual sports (6.01 s vs. 6.66 s, p = 0.0166). No significant association was found regarding cognitive-related aspects in either children engaged in team or individual sports and the crunning performance. Older and male children performed better in the crunning test than younger and female children. Physical activity-related aspects of children's life are associated with crunning movement performance. No association was found between higher cognitive performance and the crunning test results.

Sex-Related Differences in the Association of Fundamental Movement Skills and Health and Behavioral Outcomes in Children

This study aimed to assess whether sex moderates the association of fundamental movement skills and health and behavioral outcomes. In 170 children (10.6 ±0.3 years; 98 girls), path analysis was used to assess the associations of fundamental movement skills (Get Skilled, Get Active) with perceived sports competence (Children and Youth—Physical Self-Perception Profile), time spent in vigorous-intensity physical activity, sedentary time, and body mass index z score. For boys, object control skill competence had a direct association with perceived sports competence (β = 0.39; 95% confidence interval, CI [0.21, 0.57]) and an indirect association with sedentary time, through perceived sports competence (β = −0.19; 95% CI [−0.09, −0.32]). No significant association was observed between fundamental movement skills and perceived sports competence for girls, although locomotor skills were found to predict vigorous-intensity physical activity (β = 0.18; 95% CI [0.08, 0.27]). Perceived sports competence was associated with sedentary time, with this being stronger for boys (β = −0.48; 95% CI [−0.64, −0.31]) than girls (β = −0.29; 95% CI [−0.39, −0.19]). The study supports a holistic approach to health-related interventions and highlights a key association of perceived sports competence and the time children spend sedentary.

A systematic review of screen-time literature to inform educational policy and practice during COVID-19

There is an urgent need for consensus around the matter of screen time (ST) during the COVID-19 pandemic. Some governments announced restrictions for online schooling time per day to protect students from perceived risks of prolonged screen-use, but critics and an emerging body of research question such regulations. Our review of 52 empirical studies found (a) an overwhelming majority of literature shows effect sizes too small to be of practical or clinical significance, and (b) findings more specifically on educational ST are inconclusive and critically underrepresented. These facts, along with the undeniable benefits of online learning in the absence of brick-and-mortar schooling and the ominous forecasts of learning loss caused by prolonged school closure, inform our recommendations for a more moderate policy and practical stance on restrictions - one that is focused on responsibly leveraging the educational and social benefits of ST in a world still recovering from the COVID-19 pandemic.

Movement behaviors and health-related fitness among peripubertal adolescents: 2012 NHANES national youth fitness survey data

BACKGROUND

Less than half of adolescents in the United States meet the recommended levels of moderate-to-vigorous physical activity (MVPA) and health-related fitness (HRF). Using the 2012 NHANES National Youth Fitness Survey data, this study aimed to examine the associations of movement behaviors (i.e., MVPA and screen-based sedentary behaviors) with HRF (i.e., cardiovascular and muscular fitness) among 11-16- year-old peripubertal boys and girls, respectively.

METHODS

A total of 470 adolescents (227 boys, 243 girls; age: 13.59±1.12 years old) from the 2012 NHANES dataset were included. The study variables included movement behaviors (i.e., MVPA and screen-based sedentary behavior), anthropometric indices (i.e., waist circumference, Body Mass Index [BMI]), and HRF (i.e., cardiovascular fitness and muscular fitness). Correlational and hierarchical regression analyses were conducted for boys and girls, respectively.

RESULTS

MVPA significantly predicted cardiovascular fitness for boys (β=0.16, P<0.05) and girls (β=0.15, P<0.05) regardless of weight status; screen-based sedentary behavior and waist circumference in girls significantly predicted muscular fitness (β=-0.13 and β=-0.42, P<0.05).

CONCLUSIONS

To increase overall HRF in peripubertal girls and boys, it is important to help them maintain healthy weight status and to promote MVPA and limit screen-based sedentary behavior, especially in adolescent girls.

Bipedal hopping as a new measure to detect subtle sensorimotor impairment in people with multiple sclerosis

BACKGROUND

Bipedal hopping has the potential to detect subtle multiple sclerosis (MS)-related impairments, especially among patients who "pass" typical movement tests. In this narrative review, we outline the biomechanics of bipedal hopping and propose its usefulness as a novel outcome measure for people with MS having mild disability.

METHODS

We summarize articles that (1) examined the biomechanics of jumping or hopping and (2) tested the validity and/or reliability of hopping tests. We consolidated consistencies and gaps in research and opportunities for future development of the bipedal hop test.

RESULTS

Bipedal hopping requires immense power, coordination, balance, and ability to reduce co-contraction; movement components typically affected by MS. These impairments can be measured and differentiated by examining specific variables, such as hop length (power), symmetry (coordination), center of pressure (balance), and coefficient of variability (co-contraction/spasticity). Bipedal hopping challenges these aspects of movement and exposes sensorimotor impairments that may not have been apparent during walking.

CONCLUSIONS

Testing of bipedal hopping on an instrumented walkway may detect and monitor sensorimotor control in people with MS who do not currently present with clinical deficits. Early measurement is imperative for precise rehabilitation prescription to slow disability progression prior to onset of measurable gait impairment.Implications for rehabilitationJumping and hopping tests detect lower limb and balance impairments in children, athletes, and older adults.Bipedal hop test measures multiple domains: power, coordination, balance, and muscle timing.Bipedal hop test may expose subtle sensorimotor impairments in people with multiple sclerosis.Multiple variables measured can discern type of sensorimotor impairment to direct personalized rehabilitation programs.

Relationship between the 24-Hour Movement Guidelines and fundamental motor skills in preschoolers

OBJECTIVES

To examine the association among 24-Hour Movement Guidelines and fundamental motor skills (FMS) in preschoolers.

DESIGN

Prospective cohort study with one-year follow-up.

METHODS

Parents of 3-4-year-old children reported child age, sex, race, and time spent viewing screens (hours/day). Accelerometers measured preschooler physical activity (PA) and sleep. The 24-Hour Movement Guidelines were examined (≥3 h/day total PA including ≥1 h/day of moderate-to-vigorous [MVPA], 10-13 h/day of sleep, and ≤1 h/day of screen-time). Trained researchers administered the Test of Gross Motor Development-Third Edition (TGMD-3) to assess FMS. Linear regression was used to assess guidelines met and raw locomotor, ball skills, and total TGMD-3 scores with adjustment for covariates.

RESULTS

One hundred and seven preschoolers provided complete cross-sectional data, and 53 preschoolers provided complete longitudinal data. Of the 107 preschoolers, they were 3.4 ± 0.6 years of age, 44% were male, 50% were White, and the mean age-and-sex adjusted TGMD-3 total score percentile was below average (41 ± 22). Many preschoolers met the PA guideline (91%) and sleep guideline (83%), but few preschoolers met the screen-time guideline (8%) or all three guidelines (6%). MVPA was positively associated with locomotor and total TGMD-3 scores in cross-sectional analysis (p < 0.05 for all). Baseline PA, sleep, and screen-time were associated with total TGMD-3 score at follow-up (p < 0.05 for all). Meeting the screen-time guideline and all three guidelines at baseline were each positively associated with total TGMD-3 score at follow-up (p < 0.05 for all).

CONCLUSIONS

Each movement behavior contributed to later FMS. Promotion of adequate movement behaviors is warranted for child health.

Ecological study of playground space and physical activity among primary school children

OBJECTIVES

To examine the relationship between school playground size and total physical activity (PA), fitness and fundamental movement skills (FMS) of primary school students.

DESIGN

Cross-sectional ecological analysis.

SETTING

43 primary schools in New South Wales, Australia.

PARTICIPANTS

Data were from 5238 students, aged 5 to 12 years, participating in the Schools Physical Activity and Nutrition Survey.

OUTCOME MEASURES

Self (for age ≥11 years) and parent (for age <11 years) report of PA (meeting PA recommendations and number of days meeting recommendations), objectively measured FMS and cardiorespiratory and muscular fitness.

RESULTS

Associations between playground space and measures of PA and fitness were mostly non-linear and moderated by loose equipment. Students in schools with no loose equipment showed a weak association between space and meeting PA recommendations (self-report). In schools with equipment, students' predicted probability of meeting PA recommendations increased sharply between 15 m² and 25 m² per student from 0.04 (95% CI: 0.01 to 0.08) to 0.30 (95% CI: 0.14 to 0.46), but at 30 m² returned to levels comparable to students in schools with no equipment (0.18, 95% CI: 0.07 to 0.28). For cardiorespiratory fitness, in schools with no loose equipment, probabilities for being in the healthy cardiovascular fitness zone varied between 0.66 and 0.77, showing no consistent trend. Students in schools with loose equipment had a predicted probability of being in the healthy fitness zone of 0.56 (95% CI: 0.41 to 0.71) at 15 m² per student, which rose to 0.75 (95% CI: 0.63 to 0.86) at 20 m² per student. There was no relationship between space and FMS.

CONCLUSIONS

School space guidelines need to incorporate sufficient playground space for students. Our study provides evidence supporting better PA outcomes with increasing space up to 25 m² per student, and access to loose equipment, however further research is required to determine precise thresholds for minimum space. Intersectoral planning and cooperation is required to meet the needs of growing school populations.