Classroom-based high-intensity interval activity improves off-task behaviour in primary school students

Was it a HIIT? A process evaluation of a school-based high-intensity interval training intervention

BACKGROUND

Despite a growing body of research investigating high-intensity interval training (HIIT) in schools, there are limited process evaluations investigating their implementation. This is concerning because process evaluations are important for appropriately interpreting outcome findings and augmenting intervention design. This manuscript presents a process evaluation of Making a HIIT, a school-based HIIT intervention.

METHODS

The Making a HIIT intervention spanned 8 weeks and was completed at three schools in Greater Brisbane, Australia. Ten classes (intervention group) completed 10-min teacher-led HIIT workouts at the beginning of health and physical education (HPE) lessons, and five classes (control group) continued with regular HPE lessons. The mixed methods evaluation was guided by the Framework for Effective Implementation by Durlak and DuPre.

RESULTS

Program reach: Ten schools were contacted to successfully recruit three schools, from which 79% of eligible students (n = 308, x ¯ age: 13.0 ± 0.6 years, 148 girls) provided consent. Dosage: The average number of HIIT workouts provided was 10 ± 3 and the average number attended by students was 6 ± 2. Fidelity: During HIIT workouts, the percentage of time students spent at ≥ 80% of maximum heart rate (HRmax) was 55% (interquartile range (IQR): 29%-76%). Monitoring of the control group: During lessons, the intervention and control groups spent 32% (IQR: 12%-54%) and 28% (IQR: 13%-46%) of their HPE lesson at ≥ 80% of HRmax, respectively. Responsiveness: On average, students rated their enjoyment of HIIT workouts as 3.3 ± 1.1 (neutral) on a 5-point scale. Quality: Teachers found the HIIT workouts simple to implement but provided insights into the time implications of integrating them into their lessons; elements that helped facilitate their implementation; and their use within the classroom. Differentiation: Making a HIIT involved students and teachers in the co-design of HIIT workouts. Adaption: Workouts were modified due to location and weather, the complexity of exercises, and time constraints.

CONCLUSION

The comprehensive evaluation of Making a HIIT provides important insights into the implementation of school-based HIIT, including encouragings findings for student enjoyment and fidelity and recommendations for improving dosage that should be considered when developing future interventions.

TRIAL REGISTRATION

ACTRN, ACTRN12622000534785 , Registered 5 April 2022 - Retrospectively registered.

The effects of active classroom breaks on moderate to vigorous physical activity, behaviour and performance in a Northern NSW primary school: A quasi-experimental study

ISSUE ADDRESSED

Approximately 77% of NSW children aged 5 to 15 years do not meet physical activity guidelines and many spend a considerable amount of time sitting. Active breaks at primary school are feasible, may increase daily moderate to vigorous physical activity (MVPA) and decrease off-task behaviour without adversely affecting cognitive function and learning.

METHODS

In this quasi-experimental study, 101 primary school children in six intervention classrooms participated in three 10-minute active breaks per day for six-weeks during class time, while five control classrooms were run as usual (n = 89). Physical activity levels were measured using wrist-worn Actigraph wGT3X-BT accelerometers and analysed using a random forest model. Students' off-task behaviour, wellbeing, cognitive function and maths performance were also measured. School staff completed a brief feedback survey.

RESULTS

Children in the intervention group engaged in 15.4 and 10.9 minutes more MVPA per day at 3 and 6 weeks respectively (P < .001). Participation significantly increased the proportion of children who met the Australian 24-Hour Movement Guidelines (P < .001). At pre, middle and end of intervention, 44.4%, 60.8% and 55.1% of intervention children and 46.5%, 45.9% and 45.8% of controls met the guidelines. Significantly fewer students engaged in off-task behaviour in the intervention classes at mid and final weeks of intervention (-1.4 students, P = .003). No significant intervention effects were found for wellbeing, cognitive and maths performance.

CONCLUSIONS

Active classroom breaks are an effective way to increase physical activity among primary school children while reducing off-task classroom behaviour. SO WHAT?: Primary school students' health would benefit from active breaks with no detrimental effects on wellbeing, maths and cognitive performance.

Physical activity predicts task-related behaviour, affect and tiredness in the primary school classroom: A within-person experiment

AIM

We investigated the dose-response relationship between acute physical activity (PA) intensity during physical education (PE) lessons (dose), and task behaviour and learning experiences in the classroom after PE (response), and mediation effects of acute PA on-task behaviour via learning experiences.

METHOD

A total of 78 children (Mage  = 9.30 years; 43 females) took part. Participants reported learning experiences (tiredness, positive and negative affect) during one afternoon per week for 6 weeks. Their task behaviour was observed (on-task, active off-task and passive off-task) during two classroom lessons. Between the classroom lessons, they took part in a PE lesson, with experimentally induced PA intensity (low, medium and high). Accelerometers were worn for 24 h leading up to and during every intervention afternoon. Participants completed self-reports three times per classroom lesson, both before and after PE. Intra- and interindividual differences in PA, task behaviour and learning experiences were analysed with multilevel structural equation models.

RESULTS

Moderate PA directly increased on-task behaviour and reduced passive off-task behaviour, whereas light PA increased active off-task behaviour and reduced on-task behaviour. We found no direct effects of vigorous PA or mediated effects of any PA intensity on-task-related behaviour. However, a greater positive affect during PE indirectly led to more on-task and less passive off-task behaviour. Regularly active children reported less tiredness in the classroom.

CONCLUSION

PE lessons can increase on-task behaviour and reduce both passive and active off-task behaviours. Positive affect and tiredness are indirectly involved in the impact of PA on task-related behaviour. The greatest benefits were found for moderate PA and for PE lessons, which left children feeling positive. Moreover, regular participation in moderate-to-vigorous PA leads children to feel less tired during school lessons.

Pre-Service Teachers' Perceptions of and Experiences with Classroom Physical Activity

Physical inactivity is one of the most modifiable factors linked to childhood obesity. Several Canadian provinces adopted daily physical activity (DPA) policies to promote physical activity during the school day. In Ontario, only 23% of in-service teachers meet DPA mandates. Promoting DPA implementation must occur at the pre-service level to foster self-efficacy and create long-term teaching habits. This study surveyed 155 pre-service teachers from an Ontario university to determine key perceptions and practices that should be targeted during their educational training to improve DPA fidelity. Findings revealed that over 96% of pre-service teachers viewed physical activity as beneficial for their own and their students mental and physical health, and as much as 33% received no education or training related to DPA. Pre-service teachers valued DPA more if they had opportunities to learn about and observe DPA during school placements. Pre-service teachers were more confident implementing DPA if they were more physically active, viewed themselves as more athletic, and had more positive physical education experiences. This work brings to the forefront important factors that could contribute to DPA implementation among in-service teachers and highlights target areas at the pre-service level for improved fidelity.

Acute effects of mindful interval exercise on cognitive performance in a higher education setting

Interval exercise (IE) has been shown to have acute facilitating effects on cognition; however, the existing literature has been limited to laboratory settings and has focused on manipulating the parameters of exercise bouts during IE. This study included two classroom-based experiments to (1) investigate the effect of an acute bout of IE delivering mindfulness activity during its recovery intervals (mindful IE) on cognitive performance, and (2) compare cognitive performance following acute bouts of mindful IE with non-mindful IE. Experiment 1: Using a class-based within-subject crossover design, 59 participants completed the Stroop, d2, and trail-making tests to measure inhibitory control, attention, and cognitive flexibility, after a 30-min non-exercise or mindful IE session on separate counterbalanced days. Experiment 2: Using a similar design, 70 participants were assigned to two groups to receive a non-exercise and an IE session with (mindful) or without (non-mindful) mindfulness-based recovery intervals on separate counterbalanced days. Results from Experiment 1 showed superior d2 performance following the mindful IE than the non-exercise session. Although Experiment 2 found exercise-related decreases in commission error rate during the d2 test in both groups, the non-mindful group showed additional decreases in omission and total error rates. Further, higher scores on the nonreactivity facet of dispositional mindfulness were correlated with larger decreases in omission and total error rates during the d2 test for the mindful IE group. No exercise-related effect was found for outcomes of the Stroop and trail-making tests in both experiments. These findings in the selective improvements in d2 test performance are the first to suggest the feasibility of integrating mindfulness activity into the recovery intervals of IE for enhanced cognitive performance that may depend on individual differences in dispositional mindfulness.

Listening to Music and Playing Activities during Recreation between Lessons Regenerate Children's Cognitive Performance at Different Times of Day

The interruption of learning processes by breaks filled with diverse activities is common in everyday life. The purpose of this study was to investigate the effects of the time of day (TOD) of playing with or without music during recess on cognitive performance regeneration among students aged between 11 and 12. Twenty-seven volunteer children (aged 12 ± 0.6 years) completed four trials at 09h45, 10h15, 14h45, and 15h15. Each test session was separated by recreation between classroom lessons with different conditions: music only (MSC), playing only (PAY), music and playing (MSC-PAY), and without music and playing (NON). During each session, oral temperature, reaction time (RT), and constant attention (CA) were measured. For all parameters, the ANOVA revealed a significant effect of the type of activity. However, no significant effect of the TOD and no significant interaction of type of activity × TOD were reported. The Bonferroni post hoc test revealed that Δ-core temperature was significantly higher during PAY and MSC-PAY compared to NON (p < 0.05). Δ-attention was higher during MSC, PAY, and MSC-PAY compared to NON (p < 0.001). Δ-attention was lower during MSC (p < 0.05), PAY (p < 0.05), and MSC-PAY (p < 0.01) compared to NON. Therefore, playing, listening to music, and playing while listening to music at recess improve the child’s ability to regenerate cognitive performance regardless of the TOD.

Effect of game-based high-intensity interval training program on the executive function of children with ADHD: Protocol of a randomized controlled trial

Background

Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder in childhood, with a 5%-6% worldwide prevalence. Children with ADHD often demonstrate impaired executive function, which is closely related to the development of the commonly observed behavioral problems such as inattention, impaired inhibition, and hyperactivity. The purpose of this study is to examine whether a game-based high-intensity interval training (HIIT) program can improve the executive function of children with ADHD, compared with a traditional structured aerobic exercise program and a non-treatment control group.

Methods/Design

A total of 42 children with ADHD will be recruited to participate in this three-arm school-based randomized controlled trial. An 8-week specially designed game-based HIIT (GameHIIT) program and a traditional game-based structured aerobic exercise (GameSAE) program will be delivered to those children randomly assigned to these two intervention groups, while the children in the control group will maintain their regular physical activity over the same period. A number of outcome measures including executive function, cerebral hemodynamic response, physical activity, physical fitness, and enjoyment and adherence to the intervention will be assessed for both groups at baseline (T0), immediately after the intervention period (T1), and after the follow-up period (T2).

Discussion

HIIT has recently emerged as a feasible and efficacious strategy for increasing physical health outcomes and cognitive function, including executive function, in healthy young people. However, research has yet to investigate whether the executive function of children with ADHD can be effectively enhanced through HIIT. If, as hypothesized, GameHIIT program improves outcomes for children with ADHD, the present research will inform the development of targeted exercise programs that can be more broadly used with this particular population.

School-based high-intensity interval training programs in children and adolescents: A systematic review and meta-analysis

PURPOSE

1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions.

METHODS

We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5-17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups.

RESULTS

Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment-insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups.

CONCLUSION

School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings.

TRIAL REGISTRATION NUMBER

PROSPERO CRD42018117567.

Consensus statement on Singapore integrated 24-hour activity guide for children and adolescents

INTRODUCTION

Lifestyle activities, such as regular physical activity, are important for good metabolic health and the prevention of non-communicable diseases. Epidemiological studies highlight an increase in the proportion of overweight children in Singapore. A workgroup was formed to develop recommendations to encourage children and adolescents (aged 7-17 years) to adopt a holistic approach towards integrating beneficial activities within a daily 24-hour period for good metabolic and general health.

METHODS

The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision framework was employed to formulate the public health question, assess the evidence and draw conclusions for the guide. The evidence for international 24-hour movement guidelines, and guidelines for physical activity, sedentary behaviour, and sleep and eating habits were reviewed. An update of the literature review from August 2018 to end of September 2020 was conducted through an electronic search of Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases.

RESULTS

Ten consensus statements were developed. The statements focused on the overall aim of achieving good metabolic health through integration of these activities and initiatives: light and moderate- to vigorous-intensity physical activity on a regular basis; muscle- and bone-strengthening activities; limiting sedentary behaviour; regular and adequate sleep; good eating habits and choosing nutritionally balanced foods and drinks; practise safety in exercise; and aiming to achieve more or all aforementioned recommendations for the best results.

CONCLUSION

This set of recommendations provides guidance to encourage Singapore children and adolescents to adopt health-beneficial activities within a 24-hour period.

Classroom-Based Strategies to Reduce Disparities in Physical Activity Among Children with Asthma

Children with asthma often experience physical activity (PA) induced symptoms 5-15 min following the start of exercise. Classroom PA breaks provide short intermittent bouts of PA and may represent a novel strategy to safely promote PA participation in this clinical population. The purpose of this study was to determine the feasibility of a classroom-based PA intervention, Interrupting Prolonged Sitting with Activity (InPACT), where teachers implement 5 × 4-min moderate-to-vigorous physical activity (MVPA) breaks throughout the school day. Nine classrooms at one elementary-middle school in Detroit, MI (student demographics: 79% Hispanic; 80% on free/reduced lunch; 31% prevalence of asthma and asthma-like symptoms) participated in this 20-week intervention. Asthma status was self-reported via the International Study of Asthma and Allergies in Childhood (ISAAC) Video Questionnaire in conjunction with nurse documentation. PA participation, exercise intensity, and asthmatic symptom occurrence were assessed via direct observation. Students accumulated approximately 17 min of activity per day during PA breaks. Compared to students without asthma, a higher percentage of students with asthma participated in MVPA (asthma: 52.9% ± 1.2%; non-asthma: 46.2% ± 0.8%; p = 0.01), a lower percentage participated in light PA (asthma: 25.9% ± 1.0%; non-asthma: 30.1% ± 0.7%; p = 0.01), and sedentary time during activity breaks (asthma: 21.2% ± 0.9%; non-asthma: 23.8% ± 0.7%; p = 0.02). Out of 294 observations, six instances of asthmatic symptoms (coughing) were observed in students with asthma 5-15 min following the PA break. Symptoms self-resolved within 15-min of the PA break and did not result in sustained exercise-induced bronchoconstriction. Classroom-based interventions that incorporate short intermittent bouts of PA represent safe exercises for children with asthma and may help to reduce PA disparities in this clinical population.

Classroom Activity Breaks Improve On-Task Behavior and Physical Activity Levels Regardless of Time of Day

Classroom physical activity breaks (CAB) are beneficial for increasing children's physical activity (PA) levels as well as the amount of time spent being on-task within the classroom. Purpose: To examine the effect of CAB at different times within the school day on on-task behavior and PA levels in primary school (grade 1-3) children. Methods: Thirty-five children (6 ± 1 y, 22 = male, 13 = female) participated in four conditions in a randomized order: morning (AM), afternoon (PM), morning and afternoon (BOTH), and no CAB (CTRL). CAB followed a traditional Tabata format of 20 s work and 10 s rest repeated 8 times for a total of 4 min. PA levels were monitored (accelerometry). On-task behavior and three types of off-task (motor, verbal, passive) were recorded following each CAB (mobile application). Results: When compared to control, AM, PM, and BOTH increased on-task behavior AM: Δ10.4%, PM: Δ10.5%, BOTH: Δ14%; p < .001). AM was most beneficial for reducing off-task motor (Δ-6.5%) and off-task verbal (Δ-3%) behavior, while PM was most beneficial for reducing off-task passive (Δ-9%) behavior. These effects were greatest in those students demonstrating higher amounts off-task behavior during CTRL (r > 0.67, p < .001). Students achieved an additional 8.4 (p = .070; d = 0.93), 12.2 (p < .001, d = 0.49), and 6.3 min (p = .09, d = 0.47) of moderate-vigorous physical activity (MVPA) over 24 h following a CAB vs CTRL in AM, PM, and BOTH, respectively. Additionally, performing any of the CAB conditions increased the number of steps taken during the school day by an average of 2007 steps (p < .009). Conclusion: Overall, these results demonstrate that CAB improve both on-task behavior and PA levels, regardless of time of day. However, performing two CAB (BOTH) is recommended to derive the greatest improvements in on-task behavior across the school day.

Asia-Pacific Consensus Statement on integrated 24-hour activity guidelines for children and adolescents

Non-communicable diseases (NCDs) constitute a significant public health challenge and pose a great burden on health and social systems throughout the world. The Asia-Pacific region is in a vulnerable position as the prevalence of NCDs will inevitably increase with rapid socioeconomic transitions; yet it is ill prepared for this public health challenge as Asian children are among the most physically inactive in the world. Aligned with the WHO's global strategy to control NCDs via preventive measures and health promotion policies, representatives from the Asia-Pacific region came together to develop consensus statement on integrated 24-hour activity guidelines for children and adolescents. These guidelines apply to children and adolescents, aged 5-18 years, in the Asia-Pacific region, regardless of gender, cultural background or socioeconomic status. These guidelines aim to provide the latest evidence-based recommendations, taking a holistic approach to lifestyle activities and adopting a practical perspective by framing these activities within a 24-hour period. Eating and dietary elements were incorporated as they closely influence the energy balance of the movement behaviours and vice versa. By investing in the younger generations through advocacy for healthier lifestyles, we aim to reduce the burden of NCDs in the Asia-Pacific region.

Feasibility and Provisional Efficacy of Embedding High-Intensity Interval Training Into Physical Education Lessons: A Pilot Cluster-Randomized Controlled Trial

PURPOSE

The aim of this study was to determine the feasibility of generalist school teachers delivering curriculum connected high-intensity interval training in a school's physical education class time.

METHOD

Two schools volunteered to participate. A total of 84 students (11.9 [0.5] y, M = 64 and F = 19) volunteered to participate. Four classes from 2 schools were randomized to either intervention (n = 53) or control (n = 31) for one school term (8 wk). Intervention class teachers participated in a 1-day workshop instructing them how to deliver twice weekly, high-intensity interval training sessions. The control classes continued with their usual physical education curriculum. Recruitment, intervention fidelity, and program satisfaction were assessed. Preliminary efficacy (primary outcome cardiorespiratory fitness) was quantified using generalized linear mixed models, expressed as effect size. A range of secondary outcomes was also assessed.

RESULTS

The recruitment rate was 88%. About 84% of the sessions were delivered. The heart rate peak over all sessions was 89.6% (13%) of the predicted maximum. The intervention teachers reported high levels of satisfaction. Almost all student participants were positive about participating. No adverse events occurred. The adjusted between-group difference for cardiorespiratory fitness was trivial (effect size 0.02).

CONCLUSIONS

This teacher-delivered high-intensity interval training program was feasible and acceptable to both teachers and student participants. It is therefore potentially scalable.

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

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.

Examining the Acute Effects of Classroom-Based Physical Activity Breaks on Executive Functioning in 11- to 14-Year-Old Children: Single and Additive Moderation Effects of Physical Fitness

Objective: Research supports the efficacy of acute, classroom-based, physical activity breaks on executive functioning in children. However, research pertaining to the effect of physical fitness on the acute physical activity-executive functioning relationship remains limited. The primary purpose of this study was to investigate the acute effects of classroom-based, teacher-delivered, physical activity breaks on executive functioning in 11-14-year-old children. We also investigated the potential moderating effects of both aerobic and musculoskeletal fitness on the acute physical activity-executive functioning relationship. Method: Participants (N = 116) completed pre- and post-test assessments of executive functioning (i.e., inhibition, switching, and updating) separated by a classroom-based physical activity break or sedentary classroom work. We manipulated the dose (i.e., length) and type of physical activity breaks. With regards to dose, participants in the experimental conditions engaged in 5-, 10-, or 20-min of physical activity whereas controls completed sedentary classroom math work at their desk. With regards to type, one experimental condition completed traditional physical activity breaks whereas the other experimental condition completed academic physical activity breaks (i.e., performed mental math and physical activity). Participants' mood, motivation, and self-efficacy were also assessed following the experimental manipulations. Results: Overall, executive function scores improved across each assessment following the physical activity breaks when compared to sedentary classroom work regardless of dose and type. Participants also reported more positive mood states, higher motivation to complete the executive function tests, and higher self-efficacy to perform the executive functions tests following the physical activity breaks. Single moderation analyses showed that low-moderate levels of aerobic fitness moderated the acute physical activity-executive functioning relationship. Additive moderation analysis showed, collectively, that both aerobic and musculoskeletal fitness moderated the acute physical activity-executive functioning relationship. Conclusion: Findings from the present study provide evidence for the acute effects of short (i.e., 5-20 min) classroom-based physical activity breaks on executive functioning and psychological states in children. Results also suggest levels of both aerobic and musculoskeletal fitness moderate these effects, however future research is needed to further elucidate this complex relationship.

Implementation of physically active lessons: A 2-year follow-up

Combining physical activity and academic content is a promising way to improve health and academic learning in schoolchildren. This paper examined the continuation of physically active lessons (PAL) in five Norwegian elementary schools, two years after a 10-month intervention period, which consisted of weekly minimum 2 x 45 min of PAL. Data were collected through semi-structured interviews with nine teachers and five school leaders. The Level of Use instrument was used to assess how the teachers integrated PAL into the school day. Two years after the intervention period, seven of nine teachers conducted PAL regularly, on average one lesson per week. Teachers' implementation progress varied from struggling with logistics, to stable routine and creative adaption. Perceived benefits for the children, active leadership, and ongoing implementation support seem important for continuation. Introduction of PAL as a school development project, systematic planning from the onset and a gradual introduction of PAL, can be an effective strategy for continuation and long-term sustainability. In addition, the Level of Use instrument was useful to better understand which support mechanisms are needed at different stages in the implementation of PAL.

Active Breaks: A Pilot and Feasibility Study to Evaluate the Effectiveness of Physical Activity Levels in a School Based Intervention in an Italian Primary School

Background: The school gives access to children, regardless of age, ethnicity, gender and socio-economic class and can be identified as the key environment in which to promote children’s physical activity (PA). The guidelines of the European Union recommend accumulating at least 10-min bouts of PA to reach the daily 60 min. Active breaks (ABs) led by teachers inside the classroom represent a good strategy to promote PA. The aim of this pilot and feasibility study was to evaluate the feasibility and effectiveness in terms of PA level of an AB programme in children aged 8–9 years attending primary school. Methods: A pre-post quasi-experimental pilot and feasibility study was performed in two primary school classes, one of which was assigned to a 14-week AB intervention (AB group) and the other to the control group (CG). At baseline and at follow-up, children were monitored for sedentary and motor activity during an entire week using ActiGraph Accelerometer (ActiLife6 wGT3X-BT). The satisfaction of children and teachers was assessed by self-administered questionnaires. Results: In the pre-post comparison, AB group (n = 16) showed a reduction in the minutes spent in weekly sedentary activity (−168.7 min, p > 0.05), an increase in the number of step counts (+14,026.9, p < 0.05) and in time spent in moderate to vigorous PA (MVPA): weekly MVPA: +64.4 min, daily MVPA: +8.05 min, percentage of MVPA: +0.70%. On the contrary, CG showed a worsening in all variables. ANCOVA analysis, after adjusting for baseline values, showed significant differences between the AB group and CG for time spent in MVPA, percentage of MVPA and step counts. The satisfaction of children and teachers was good. Teachers were able to adapt the AB protocol to the needs of the school curriculum, thus confirming the feasibility of the AB programme. Conclusions: This pilot and feasibility study showed the feasibility and effectiveness of the AB protocol and represented the basis for a future controlled trial.

Classroom active breaks: a feasibility study in Southern Italy

Though classroom time has been identified as a contributing factor to sedentary behavior, school has been recognized as the main educational setting providing physical activity (PA) opportunities. The purpose of this study was to develop and evaluate the feasibility of a classroom-based intervention which integrates PA during the school time, and assess its potential effect on reducing inactivity in primary school children. The intervention was performed in a sample of 47 children attending a primary school in the south of Italy and it was structured in two sessions of classroom active breaks (CABs) in three school days a week, shared with and supervised by the teachers. CABs showed an overall potential positive effect on the reduction of inactivity of ∼12 min and an equivalent increase in PA levels, of which 5 min were of moderate/vigorous intensity. Girls showed lower time spent in light and moderate PA and higher amount of inactivity than boys and responded better to the intervention. The satisfaction of children and teachers was high. CABs program is a safe tool to reduce inactivity and increase moderate/vigorous PA. Designing structured exercise breaks adapted in a flexible way to meet the needs of the school curriculum program may increase the feasibility of such PA program in the schools.

A Systematic Review and Qualitative Synthesis Resulting in a Typology of Elementary Classroom Movement Integration Interventions

Background/Objective

Movement integration (MI) involves infusing physical activity into normal classroom time. A wide range of MI interventions have succeeded in increasing children’s participation in physical activity. However, no previous research has attempted to unpack the various MI intervention approaches. Therefore, this study aimed to systematically review, qualitatively analyze, and develop a typology of MI interventions conducted in primary/elementary school settings.

Subjects/Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to identify published MI interventions. Irrelevant records were removed first by title, then by abstract, and finally by full texts of articles, resulting in 72 studies being retained for qualitative analysis. A deductive approach, using previous MI research as an a priori analytic framework, alongside inductive techniques were used to analyze the data.

Results

Four types of MI interventions were identified and labeled based on their design: student-driven, teacher-driven, researcher-teacher collaboration, and researcher-driven. Each type was further refined based on the MI strategies (movement breaks, active lessons, other: opening activity, transitions, reward, awareness), the level of intrapersonal and institutional support (training, resources), and the delivery (dose, intensity, type, fidelity). Nearly half of the interventions were researcher-driven, which may undermine the sustainability of MI as a routine practice by teachers in schools. An imbalance is evident on the MI strategies, with transitions, opening and awareness activities, and rewards being limitedly studied. Delivery should be further examined with a strong focus on reporting fidelity.

Conclusions

There are distinct approaches that are most often employed to promote the use of MI and these approaches may often lack a minimum standard for reporting MI intervention details. This typology may be useful to effectively translate the evidence into practice in real-life settings to better understand and study MI interventions.

Effects of different types of classroom physical activity breaks on children's on-task behaviour, academic achievement and cognition

AIM

This study examined the effects of different types of classroom physical activity breaks on children's on-task behaviour, academic achievement and cognition.

METHODS

Participants were 87 Australian primary school students (mean age 9.11 ± 0.62 years), recruited from one school. Three classes were randomly assigned either to activity breaks only (n = 29), activity breaks and mathematics combined (n = 29), or control conditions involving only mathematical content (n = 29). Students were engaged in five minutes of classroom physical activity breaks, three times per week, for four weeks (divided into two minutes at the beginning of the usual mathematics curriculum lesson and three minutes in the middle of the lesson). Assessments were conducted at baseline and post-test.

RESULTS

Significant group-by-time effects were found for on-task behaviour (active engagement: activity breaks and mathematics combined versus control, p ≤ 0.001; activity breaks versus control, p ≤ 0.001; activity breaks and mathematics combined versus activity breaks, p = 0.037; passive engagement: activity breaks and mathematics combined versus control, p ≤ 0.001) and mathematics scores (activity breaks versus control, p = 0.045).

CONCLUSION

Physical activity breaks with and without integrated mathematics content were effective in improving children's on-task behaviour and learning scores.

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

OBJECTIVES

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

DESIGN

Systematic review and meta-analysis.

METHODS

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

RESULTS

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

CONCLUSIONS

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

Enhancing Children's Motor Memory Retention Through Acute Intense Exercise: Effects of Different Exercise Durations

Physical exercise has been proposed as a viable means to stimulate motor learning. Exercise characteristics, including intensity and duration, may play a role in modulating the exercise effect on motor learning. While some evidence exists regarding the benefits of intense and relatively long exercise, little is known about the effect of short exercise bouts on motor learning, especially in children. This study aimed to assess the effect of long versus short intense exercise bouts on the adaptation and consolidation of a rotational visuomotor adaptation task. The participants were 71 healthy children from two sites divided into three groups: long exercise bout (LONG), short exercise bout (SHORT), and no exercise (CON). Children performed a rotated (clockwise 60° rotation) motor task on four different occasions: an adaptation set and 1 h, 24 h, and 7 days delayed retention sets. Exercise bouts were performed prior to the adaptation set. Results showed a group effect during motor adaptation [F(2,68) = 3.160; p = 0.049; η p 2 = 0.087], but no statistical differences were found between groups. Regarding retention tests, both exercise groups (LONG and SHORT) showed superior retention compared to CON group [F(2,68) = 7.102; p = 0.002; η p 2 = 0.175]. No differences were found between exercise groups, indicating similar benefits for the two exercise interventions. Overall, whether the exercise duration was long or short, exercise improved motor memory retention as an estimate of memory consolidation process. The use of short exercise bouts may be suitable to improve children's motor memory consolidation in environments where time constraints exist.

An Evaluation of an Unstructured and Structured Approach to Increasing Recess Physical Activity

BACKGROUND

The purpose of this study was to evaluate an unstructured and a structured program designed to increase physical activity (PA). The unstructured program increased the amount of equipment during recess, whereas the structured program introduced activities to students.

METHODS

PA was observed using the System for Observing Play and Leisure Activity in Youth (SOPLAY) in two school districts in Colorado. Researchers recorded baseline and follow-up observations for sedentary activity, moderate PA, and vigorous PA, as well as for available equipment for the unstructured program. Observations from schools were aggregated for data analyses at the district level.

RESULTS

For the program increasing equipment, moderate PA and vigorous PA increased, while sedentary behavior decreased. For the structured program, moderate PA and vigorous PA did not increase, whereas sedentary behaviors increased following the program.

CONCLUSIONS

Other variables are likely influencing student PA during recess, such as teachers' interaction with students or the fidelity of the program. Results indicate that funding and implementing a program aimed at increasing PA will not necessarily accomplish that goal, and additional research should be performed to determine the best practice for increasing PA.

Increasing Physical Activity in Schools: Strategies for School Health Practitioners

Background. Colorado passed House Bill 11-1069 in 2011 requiring all public elementary schools to provide students with a minimum of 30 minutes of physical activity (PA) per school day (Physical Activity Expectation in Schools, 2011). The purpose of this article is to describe the results of a 3-year initiative to increase opportunities for PA and to provide recommendations for school health practitioners implementing similar programming. Intervention. In 2014, 13 school districts were funded to increase student PA during school hours and before and after school hours. Intervention activities spanned all components of the Comprehensive School Physical Activity Program framework. An evaluation was conducted to estimate the number of schools providing at least 30 minutes of PA a day. A mixed methods evaluation design was implemented that included tracking the number of minutes of PA provided before, during, and after school and semistructured interviews with school health coordinators. Results. In Year 1, an average of 48 minutes of PA were provided per day. By the end of year 3, the average minutes of PA doubled to 90 minutes per day. Teachers and staff identified professional development and administrator support as key components to incorporating more PA throughout the school day. Conclusions. Health promotion interventions in schools can increase access to PA opportunities for students. Sustainability of PA efforts in schools is dependent on funding to support professional development for teachers and staff and building administrative support for school-based PA.

Process evaluation of a classroom active break (ACTI-BREAK) program for improving academic-related and physical activity outcomes for students in years 3 and 4

Background

Active breaks in the classroom have been shown to be effective for increasing children’s physical activity, while simultaneously improving classroom behaviour outcomes. However, there is limited evidence on the feasibility and fidelity of these programs outside of the research context. The purpose of this study was to conduct a process evaluation to explore factors associated with feasibility and fidelity of a classroom active break (ACTI-BREAK) program designed to improve classroom behaviour and physical activity outcomes for children in primary (elementary) school Years 3 and 4.

Methods

Six schools (3 intervention; 3 control) and 374 children (74% response) were included in the ACTI-BREAK pilot cluster randomised controlled trial. The intervention involved teachers implementing 3 × 5-minute moderate-intensity ACTI-BREAKS into their classroom routines, daily. This study focuses on the responses of students (n = 138) and their teachers (n = 7) who participated in the ACTI-BREAK intervention group. Intervention fidelity was assessed by number of ACTI-BREAKS completed per class per day; minutes spent in moderate-intensity physical activity (accelerometry) per ACTI-BREAK; change in physical activity from baseline to mid- and end- intervention. Intervention feasibility was explored through telephone interviews (teachers), questionnaires and focus groups (students), and teacher observations of acute effects on classroom behaviour. Qualitative data were analysed using thematic analyses; acute effects on classroom behaviour and change in physical activity were explored using paired t-tests; questionnaire data were described as frequencies.

Results

Teachers implemented two ACTI-BREAKS/day on average, mostly of light-intensity physical activity. Physical activity increased from baseline to mid-, but not baseline to end-intervention; classroom behaviour improved immediately following ACTI-BREAKS. Barriers to implementation included ability for students to return to task and scheduling. Facilitators included ease of implementation, flexible delivery options and student enjoyment. Students were largely satisfied with the program and enjoyed ACTI-BREAKS that incorporated choice, imagination and challenge but did not enjoy ACTI-BREAKS that evoked silliness or were perceived as too difficult and some did not like doing ACTI-BREAKS in the confined space of their classroom.

Conclusions

Results indicated the ACTI-BREAK program was acceptable for students and feasible for teachers, however, some minor modifications in terms of required frequency and intensity could improve fidelity.

Trial registration

Australia New Zealand Clinical Trials Registry (ACTRN12617000602325). Retrospectively registered on 27 April 2017.

Feasibility of breaking up sitting time in mainstream and special schools with a cognitively challenging motor task

BACKGROUND

Children spend ≤70% of the school day sitting in class. Classroom-based active breaks can benefit children's physical health, but if the breaks are cognitively demanding (i.e., combine physical exertion and mental engagement), they may also improve focus and cognitive functions. Teachers and students play a crucial role in the successful implementation of active breaks, and their perspectives are critical to the feasibility of these strategies. The aim of this study was to assess the feasibility of implementing a cognitively challenging motor task as an active break in mainstream and special primary schools.

METHODS

A total of 5 teachers in 2 mainstream schools and 7 teachers in 1 special school (attended by children with neurodevelopmental disorders) attended a 20-min training on how to implement a 4-min cognitively challenging active break, before conducting a feasibility trial (twice a day for 1 week). To understand individual perceptions, one-on-one semistructured interviews were conducted before and after the trial with teachers, and focus group interviews were conducted with typically developing children after the trial. Questions were based on a predefined framework for feasibility studies. All interviews were audio recorded, transcribed and analyzed in NVivo 11 using a framework approach. A total of 12 teachers (11 females; 7 between 20 and 34years old) and 34 children (16 girls; 9.3 ± 1.7years, mean ± SD) participated in the interviews.

RESULTS

In mainstream schools, teachers viewed the cognitively challenging motor task as appropriate and potentially beneficial for children's health and focus. Children reported enjoying the active breaks. Teachers in special schools viewed the task as complex and potentially frustrating for children. In both school types, children's disruptive behavior and lack of time were seen as the main potential barriers to implementation. The use of music, videos, visual cards, and support staff were noted as potential facilitators.

CONCLUSION

The cognitively challenging motor task was a feasible way to interrupt children's sitting time and promote physical activity in mainstream schools, but required changes in special schools. Further research could investigate the effectiveness of these types of task interruptions on children's physical and cognitive health.

A pilot primary school active break program (ACTI-BREAK): Effects on academic and physical activity outcomes for students in Years 3 and 4

OBJECTIVES

To assess the feasibility and efficacy of a 6-week pilot active break program (ACTI-BREAK) on academic achievement, classroom behaviour and physical activity.

DESIGN

Pilot cluster randomised controlled trial.

METHODS

374 children in Year 3 and 4 (74% response) were recruited from six schools across Melbourne, Australia. Schools were randomised to the ACTI-BREAK intervention or usual teaching practice. The intervention involved teachers incorporating 3×5min active breaks into their classroom routine daily. Academic achievement was assessed using 1-min tests in reading and mathematics; classroom behaviour at the individual and whole class level was observed by teachers; and physical activity levels were assessed using accelerometers. Multilevel mixed effects linear regression models were conducted using intention to treat (ITT) and per protocol (PP) analyses.

RESULTS

Significant intervention effects were found for classroom behaviour at the individual level (ITT B=16.17; 95% CI: 6.58, 25.76); effects were stronger for boys (B=21.42; 95% CI: 10.34, 32.49) than girls (B=12.23; 95% CI: 1.52, 22.92). No effect was found for classroom behaviour at the whole class level, reading, math or physical activity. PP findings were similar.

CONCLUSIONS

Implementing active breaks during class time may improve classroom behaviour, particularly for boys. There was no evidence to suggest that implementing active breaks had any adverse effect on academic achievement or classroom behaviour, which may encourage classroom teachers to incorporate active breaks into their routine.

Technology-Enhanced Classroom Activity Breaks Impacting Children's Physical Activity and Fitness

Background: This study examined the effects of a 4-week technology-enhanced physical activity (PA) interventions on students’ real-time daily PA and aerobic fitness levels. Methods: 116 fifth-graders were assigned to one intervention group (n = 31) participating in daily physical activity engaging the brain with Fitbit Challenge (PAEB-C), another intervention group (n = 29) wearing Fitbits only (Fitbit-O) daily, five days per week, or the comparison group (n = 56). Four-week real-time PA data were collected from the intervention students via Fitbase. Three groups were pre- and post-tested aerobic fitness. Results: The PAEB-C students showed significantly higher steps and minutes of being very active and fairly active (F = 7.999, p = 0.014, ŋ = 0.121; F = 5.667, p = 0.021, ŋ = 0.089; F = 10.572, p = 0.002, ŋ = 0.154) and lower minutes of being sedentary daily (F = 4.639, p = 0.035, ŋ = 0.074) than the Fitbit-O group. Both Fitbit groups exhibited significantly greater increases in aerobic fitness scores than the comparison group over time (F = 21.946, p = 0.001, ŋ = 0.303). Boys were more physically active and fit than girls. Conclusions: Technology-enhanced PA intervention was effective for improving real-time PA and aerobic fitness.

Tabata protocol: a review of its application, variations and outcomes

PURPOSE

The great popularity of the Tabata Protocol is accompanied by an uncomfortable lack of consistency and criteria in its use, which results in many controversies in the results obtained from its utilization. The purpose of this study was to analyse the studies that based their interventions on the Tabata Protocol and to provide a critical analysis of its use.

METHODS

A systematic literature search was conducted in PubMed and Scopus. All articles published between 1996 and October 2017 that cited at least one of the original studies of Tabata et al. were considered. Inclusion criteria were as follows: original articles, human trials and English language.

RESULTS

Thirty studies were included for analysis. Almost 37% of the studies (n = 11) used a variation of the Tabata Protocol on a cycle ergometer. Only five studies stated the use of the original Tabata Protocol. Exercise intensity was controlled by percentage of i V ˙ O₂ max (n = 8) or i V ˙ O₂ peak (n = 3), number of bouts performed (n = 3), all out (n = 10), rate of perceived exertion (n = 1), self-perception of paces (n = 1), maximal power output (n = 1), aerobic power (n = 1) and other forms (n = 2).

CONCLUSION

Based on our results, variations of the Tabata Protocol seem to be indicated to provide increases in aerobic power that are similar to traditional aerobic training while being less time consuming. These adaptations seem to be mainly due to peripheral adaptations. Moreover, the use of Tabata Protocols to promote weight loss is not substantiated by the reviewed studies.

Systematic review of acute physically active learning and classroom movement breaks on children's physical activity, cognition, academic performance and classroom behaviour: understanding critical design features

Objective

To examine the impact of acute classroom movement break (CMB) and physically active learning (PAL) interventions on physical activity (PA), cognition, academic performance and classroom behaviour.

Design

Systematic review.

Data sources

PubMed, EBSCO, Academic Search Complete, Education Resources Information Center, PsycINFO, SPORTDiscus, SCOPUS and Web of Science.

Eligibility criteria for selecting studies

Studies investigating school-based acute bouts of CMB or PAL on (PA), cognition, academic performance and classroom behaviour. The Downs and Black checklist assessed risk of bias.

Results

Ten PAL and eight CMB studies were identified from 2929 potentially relevant articles. Risk of bias scores ranged from 33% to 64.3%. Variation in study designs drove specific, but differing, outcomes. Three studies assessed PA using objective measures. Interventions replaced sedentary time with either light PA or moderate-to-vigorous PA dependent on design characteristics (mode, duration and intensity). Only one study factored individual PA outcomes into analyses. Classroom behaviour improved after longer moderate-to-vigorous (>10 min), or shorter more intense (5 min), CMB/PAL bouts (9 out of 11 interventions). There was no support for enhanced cognition or academic performance due to limited repeated studies.

Conclusion

Low-to-medium quality designs predominate in investigations of the acute impacts of CMB and PAL on PA, cognition, academic performance and classroom behaviour. Variable quality in experimental designs, outcome measures and intervention characteristics impact outcomes making conclusions problematic. CMB and PAL increased PA and enhanced time on task. To improve confidence in study outcomes, future investigations should combine examples of good practice observed in current studies.

PROSPERO registration number

CRD42017070981.

Impact of Three Years of Classroom Physical Activity Bouts on Time-on-Task Behavior

Participation in classroom physical activity (PA) may improve time-on-task (TOT); however, the influence of sustained moderate-to-vigorous PA (MVPA) on TOT is unknown.

PURPOSE

To explore the influence of classroom PA delivered with academic lessons on TOT, determine if the relationship between classroom PA and TOT differs by age, sex, race/ethnicity, weight or baseline fitness, and identify the influence of MVPA on TOT when controlling for demographic variables.

METHODS

Teachers in intervention schools were asked to deliver two 10-min PA lessons per day, 5 d·wk. PA was observed in both intervention and control schools to determine the amount and intensity of PA. Time-on-task was observed before and immediately after PA. Anthropometrics and fitness were assessed at baseline and end of the school year for 3 yr. Multilevel modeling was used to estimate overall group difference, change over the study, and group difference in change while accounting for covariates.

RESULTS

Students who participated in PA lessons engaged in significantly more MVPA than those in the control schools in all 3 yr (all P < 0.001). There was a significant linear increase in the percent of TOT before PA lessons for both control and intervention groups over the 3-yr period (P < 0.001), with no group difference. The intervention group spent significantly more TOT (P = 0.01) after PA than the control group. The percent of time spent in MVPA was significantly associated with the percent of TOT (P < 0.01).

CONCLUSIONS

Results indicate that children who received PA lessons participated in significantly more MVPA than those who did not and that PA was significantly associated with more TOT. These findings provide support for classroom PA as a means of increasing TOT in elementary age children.

A primary school active break programme (ACTI-BREAK): study protocol for a pilot cluster randomised controlled trial

Background

Levels of overall physical activity have been shown to decline across childhood. Schools are considered ideal settings to promote physical activity as children spend a large amount of their waking hours at school. Time-efficient physical activity strategies that demonstrate a positive impact on academic-related outcomes are needed to enable physical activity to be prioritised in the school day. The ACTI-BREAK programme requires classroom teachers to integrate active breaks; 5-min bursts of moderate-intensity physical activity into their classroom routine. Active breaks have been shown to be effective in improving academic-related outcomes, a potentially appealing aspect for teachers and schools. The primary aim of this study is to assess the feasibility and potential efficacy of the ACTI-BREAK programme on children’s academic achievement. Secondary aims are to explore the impact of ACTI-BREAK on children’s on-task behaviour and objectively measured physical activity levels.

Methods

ACTI-BREAK is a 6-week, classroom-based, physical activity intervention. This pilot trial of the programme will be evaluated using a cluster randomised controlled design. Government primary schools in metropolitan Melbourne, Australia will be invited to participate in the programme in 2017. Randomisation will occur at the school level, with the aim to recruit six schools (three intervention and three control). The ACTI-BREAK programme is theoretically grounded, and was developed with input and guidance from current primary school teachers. Teachers from the intervention schools will receive a 45-min training session and be asked to incorporate ACTI-BREAKS into their classroom routine three times per day for 6 weeks. Intervention support will be provided via assisted delivery. The primary outcomes will be children’s academic achievement in mathematics and reading. Children’s on-task behaviour and school-day physical activity will be assessed as secondary outcomes. Process evaluation will also be carried out.

Discussion

The ACTI-BREAK programme has been designed to be a time-efficient, feasible and appealing approach to physical activity promotion for schools. This study will assess required teacher time commitment and the potential for the ACTI-BREAK programme to improve academic-related outcomes and school-day physical activity levels with the potential for a full-scale trial in the future.

Trial registration

Australia New Zealand Clinical Trials Registry, identifier ACTRN12617000602325. Retrospectively registered on 27 April 2017.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-2163-5) contains supplementary material, which is available to authorized users.

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

BACKGROUND

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

OBJECTIVE

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

STUDY ELIGIBILITY CRITERIA

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

DATA SOURCES

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

STUDY APPRAISAL AND SYNTHESIS METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Effect of classroom-based physical activity interventions on academic and physical activity outcomes: a systematic review and meta-analysis

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.

Intensity of commonly-reported classroom-based physical activity opportunities in public schools

The purpose of this study was to examine the intensity levels of PA opportunities offered in public school classrooms. Schools (N = 101) in school districts (N = 25) reported PA opportunities offered in classrooms using an online data collection tool over a two-year period (2014–2016). Using a randomized sampling technique, 20–30% of teachers in each school were selected each week to report PA in their classroom. These responses resulted in N = 18,210 usable responses. A researcher determined the intensity of PA opportunities using the 2011 Compendium of Physical Activities as a guideline; two additional researchers confirmed the coded categories. A descriptive analysis of PA opportunities was conducted to describe the proportion of opportunities whose intensity levels were light (LPA), moderate (MPA), vigorous (VPA), sedentary (SED), and those of unknown intensity. Chi-square analyses were utilized to examine differences between proportions of intensity levels offered by semester. Kruskal-Wallace tests were utilized to examine differences in proportion of physical activity opportunity intensity offered by grade level. Most PA opportunities were MPA (58.7%), followed by VPA (17.6%) and LPA (11.5%). Few responses were SED (0.5%), and 11.6% were of indeterminate intensity. A greater proportion of more physically intense activities reported during the fall versus spring semesters (p < 0.0001). Differences in the intensity levels of PA offered by grade also differed, with a trend of decreasing intensity as grade level increased (p < 0.0001). This study provides insight into the PA actually occurring in classrooms; a previously underexplored construct of school-based PA.

•

Most physical activity in classrooms occurs at the moderate intensity level.

•

A higher proportion of physical activity is offered in the fall compared to spring.

•

Physical activity opportunities offered decrease at higher grade levels.

Perfectionism and sport-specific engagement in elite youth soccer players

It is acknowledged that the time invested in sport-specific activities contributes to higher levels of performance. However, there is limited understanding of the potential impact of personality traits, such as perfectionism, on engagement in sport-specific activities. In the current study, we examine whether elite youth soccer players who demonstrate higher and lower levels of perfectionistic strivings tendencies can be differentiated based on their sport-specific engagement. The Sport Multidimensional Perfectionism Scale 2 and an adapted Player History Questionnaire were completed by 419 elite youth male soccer players competing at the Australian age-related national youth championships (under 13, n = 133; under 14, n = 166; under 15, n = 120). A quartile split approach was used to separate higher (n = 100) and lower (n = 107) perfectionistic strivings groups. Findings revealed the higher perfectionistic strivings group accumulated more time in sport-specific activities, including coach-led practice, individual practice, peer-led play and indirect involvement in soccer when compared to individuals with lower perfectionistic strivings tendencies. Descriptive analysis indicates this equates to approximately 159 h a year (i.e. 17 h coach-led practice, 22 h individual practice, 60 h of peer-led play and 60 h of indirect involvement) more than the lower perfectionistic strivings group. In summary, the results suggest players with varying levels of perfectionistic strivings may be differentiated based on their engagement in soccer-specific activity in a sample of elite youth players in Australia, and suggests that perfectionistic strivings may have an adaptive influence on sport-specific engagement.

Integrating movement in academic classrooms: understanding, applying and advancing the knowledge base

In the context of comprehensive and coordinated approaches to school health, academic classrooms have gained attention as a promising setting for increasing physical activity and reducing sedentary time among children. The aims of this paper are to review the rationale and knowledge base related to movement integration in academic classrooms, consider the practical applications of current knowledge to interventions and teacher education, and suggest directions for future research. Specifically, this paper (i) situates movement integration amid policy and research related to children's health and the school as a health-promoting environment; (ii) highlights the benefits of movement integration; (iii) summarizes movement integration programs and interventions; (iv) examines factors associated with classroom teachers' movement integration; (v) offers strategies for translating research to practice and (vi) forwards recommendations for future inquiry related to the effectiveness and sustainability of efforts to integrate movement into classroom routines. This paper provides a comprehensive resource for developing state-of-the-art initiatives to maximize children's movement in academic classrooms as a key strategy for important goals in both education and public health.

Four minutes of in-class high-intensity interval activity improves selective attention in 9- to 11-year olds

The amount of time allocated to physical activity in schools is declining. Time-efficient physical activity solutions that demonstrate their impact on academic achievement-related outcomes are needed to prioritize physical activity within the school curricula. "FUNtervals" are 4-min, high-intensity interval activities that use whole-body actions to complement a storyline. The purpose of this study was to (i) explore whether FUNtervals can improve selective attention, an executive function posited to be essential for learning and academic success; and (ii) examine whether this relationship is predicted by students' classroom off-task behaviour. Seven grade 3-5 classes (n = 88) were exposed to a single-group, repeated cross-over design where each student's selective attention was compared between no-activity and FUNtervals days. In week 1, students were familiarized with the d2 test of attention and FUNterval activities, and baseline off-task behaviour was observed. In both weeks 2 and 3 students completed the d2 test of attention following either a FUNterval break or a no-activity break. The order of these breaks was randomized and counterbalanced between weeks. Neither motor nor passive off-task behaviour predicted changes in selective attention following FUNtervals; however, a weak relationship was observed for verbal off-task behaviour and improvements in d2 test performance. More importantly, students made fewer errors during the d2 test following FUNtervals. In supporting the priority of physical activity inclusion within schools, FUNtervals, a time efficient and easily implemented physical activity break, can improve selective attention in 9- to 11-year olds.