A systematic review and meta-analysis on the effects of physically active classrooms on educational and enjoyment outcomes in school age children

Physically active learning for children with learning disorders attending special-needs schools: A program evaluation

BACKGROUND

Physically active learning (PAL) is a potentially valuable method to stimulate academic performance and physical activity (PA) in children with learning disorders (LD) attending special-needs schools. It is yet unknown whether PAL can be successfully implemented in special-needs schools.

AIMS

This study aimed to evaluate a PAL-program in special-needs schools by examining teacher's dose delivered, children's dose received, and associations of children's characteristics with dose received.

METHODS

Children (N = 37) from two special-needs schools participated in a six-week PAL-program. Dose delivered was evaluated based on PAL-lessons' implementation rate and duration. Dose received was assessed through time-on-task observations (n = 23) and PA (n = 37). To assess the association between dose received and children's characteristics (sex, behavioral disorders, motor skills, and physical fitness), Mann-Whitney U tests and Spearman's rho correlations were used.

RESULTS

For teacher's dose delivered, the implementation rate exceeded 95%, and the PAL-lessons lasted the intended 12 minutes. For dose received, children's on-task behavior was above 79%, and children spent 43% of the time in moderate-to-vigorous PA during PAL. Motor skills were positively related to on-task behavior related to the movements, and physical fitness was positively related to moderate-to-vigorous PA.

CONCLUSIONS

PAL was successfully implemented in terms of dose delivered and dose received for children with LD attending special-needs schools.

An active break program (ACTIVA-MENTE) at elementary schools in Chile: study protocol for a pilot cluster randomized controlled trial

Background

Physical inactivity is prevalent in childhood. Schools can be an ideal context to promote the regular practice of physical activity since children spend there a large part of the day. In this sense, an emerging and current trend is active breaks at school. This article presents a study protocol that seeks to assess the feasibility and effectiveness of an intervention with active breaks (ACTIVA-MENTE program) in a school context on physical activity, on-task classroom behavior, and the physical activity enjoyment in schoolchildren.

Methods

The protocol includes children aged 10 to 11 years. Two groups will be randomized (intervention and control groups). The intervention group will use the active break program, ACTIVA-MENTE, which consists of the application of a 4-min, 30-s video with moderate to vigorous-intensity physical activity. These breaks will be taken 6 times a day in the classes for 6 weeks. The total physical activity will be measured with accelerometers (Actigraph wGT3X-BT), the on-task behavior through the Direct Behavior Rating Scale and the level of enjoyment through the Physical Activity Enjoyment Scale.

Discussion

Previous research reported that active breaks have positive results in physical activity levels. This study will be one of the few to design active breaks through videos without depending on the presence of a physical education teacher and it can also provide new findings on the effectiveness of an active break's structure (e.g., types of exercises and intensity) on the indicated outcomes.

Expected results

It is expected that the ACTIVA-MENTE program can be a suitable program for school settings, potentially increasing physical activity levels, and the commitment to the task, as well as be a pleasant moment for the students.

Clinical trial registration

Clinicaltrials.gov, identifier NCT05403996.

The Effects of Using a Cycling Desk at School on Executive Function, Physical Fitness, and Body Composition in Primary School Children: Impact of Socioeconomic Status

CONTEXT

Physical inactivity and sedentary behaviors are associated with adverse health outcomes in both adults and children. The purpose of this study was to investigate the effects of a 9-week program using a Cycle Desk during school time in French primary school children from high or low socioeconomic status (SES) on body composition, physical fitness (PF), and executive function.

METHODS

Seventy-five (n = 75) children completed a test battery before and after 9 weeks of use of Cycle Desk to evaluate anthropometric characteristics, body composition, PF, and executive function.

RESULTS

Body mass index increased significantly (P = .0095), while body fat decreased after the use of Cycle Desks (P < .0001). Specifically, lean mass increased in the high-SES group while it decreased in the low-SES group (P < .0001). After 9 weeks, there was an improvement in motor skills (P < .0001), upper and lower limbs' strength (P < .0001), and executive function performance (P < .0001). More specifically, the low-SES group had a greater improvement in motor skills and maximal aerobic speed between T0 and T1, compared to the high-SES group (P = .001, P = .023, respectively). In contrast, the high-SES group had a greater improvement in executive function at 9 weeks of use of Cycle Desk compared with the low-SES group (P = .0084).

CONCLUSIONS

The promotion of low-intensity physical activity with the use of a Cycle Desk at school may help offset some adverse effects of excess sedentary behavior among children. Moreover, this strategy appears to be particularly effective in children from low-SES backgrounds. What's New: The use of a Cycle Desk during school time has no deleterious effects on PF as well as cognitive executive functions in primary children. Modifications are more beneficial in children from low SES.

Promoting physical activity and academic achievement through physically active learning: Qualitative perspectives of co-design and implementation processes

This article discussed the issue of low PA levels among school-aged children and highlights the promising approach of school-based interventions, including physically active learning (PAL), to increase PA levels. The study aimed to co-design and to assess the implementation of a PAL program for 8 weeks in 4 elementary classrooms (82 students and 7 teachers), emphasizing the potential of integrating PA with academic learning and the importance of co-designing programs with teachers to maximize their effectiveness. Technology was found to support PAL practices in promoting PA and academic achievement. The study underscores the need for further research to explore the societal implications of PAL programs, including their potential to improve the health and well-being of children while promoting positive academic outcomes.

Effects of Cognitively Engaging Physical Activity on Preschool Children's Cognitive Outcomes

Research combining physical activity with the training of cognitive skills such as executive functions is emerging as a novel and fruitful intervention approach for children. Purpose: This study aimed to examine the impact of an intervention program including cognitively engaging physical activity on preschool children's cognitive outcomes and physical activity. Methods: Children (N = 144, 65 female; Mage = 4.41 years, SD = 0.61), randomly assigned to one of three groups: cognitively engaging physical activity (CPA; i.e., storytelling, cognitive activities, and motor tasks, n = 55), cognition (i.e., storytelling and cognitive activities without motor tasks, n = 48), or control (i.e., traditional storytelling, n = 41). Sessions lasted approximately 17 minutes, conducted twice a week, for 6 weeks. Children's executive function, self-regulation, and related outcomes (i.e., numeracy) were assessed at baseline and again-along with perceived enjoyment-at the end of the program. Accelerometers measured children's physical activity during each session. Teachers completed a logbook for each session, and two fidelity checks per preschool took place by the researcher. Main analyses used linear mixed models adjusted for covariates (age, sex) and clustering at the preschool level. Results: Results showed no significant group by time interaction for executive function, self-regulation, numeracy, enjoyment. During the sessions, children in the CPA group were more physically active than children in the cognition and control groups. Conclusion: While we did not find the expected amplified cognitive benefits, making storytelling more active has the potential to meet two needs (increase cognitive stimulation and physical activity levels) in one deed.

Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews

BACKGROUND

Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents.

METHODS

We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review's research question. Data charting form included the identification of the study, health outcomes, and PE classes' strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary.

RESULTS

An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted.

CONCLUSIONS

These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.

A cross-sectional study of Canadian children's valuation of literacies across social contexts

Background

Children, on average, do not engage in sufficient physical activity to reap the physical, mental, and social health benefits. Understanding the value that children place on movement across social contexts, and the relative ranking of this valuation, may help us to understand and intervene on activity levels.

Method

This exploratory study examined the valuation of reading/writing, math, and movement across three social contexts (school, home, with friends) among children 6–13 years of age (N = 7,845; 51.3% male). Subjective task values across contexts were assessed with the valuing literacies subscale of the PLAYself. One-way Kruskal-Wallis ANOVAs were performed to test for differences between contexts and between literacies, respectively.

Results

Sex differences and age-related variation were explored. Valuations of reading/writing (d = 1.16) and math (d = 1.33) decreased across context (school &gt; family &gt; friend), while the valuation of movement was relatively stable (d = 0.26). Valuations differed substantially with friends (p &lt; 0.001, d = 1.03). Sex dependent effect sizes were minimal (d = 0.05–0.11).

Conclusions

Movement is highly valued by children across social contexts; thus, programming across contexts should be prioritized to align with their valuation.

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.

Adolescent Mental Health Priorities During the Covid-19 Pandemic

Increasing evidence has shown that the Covid-19 outbreak has impacted adolescents' mental health. Utilising a mixed-method design, the current study examined a total of 518 adolescent perspectives (60% female), in Scotland, on what has and could help their mental health in the context of Covid-19. A reflexive thematic analysis revealed three themes in relation to what has helped adolescents' mental health since the Covid-19 outbreak. These related to findings about the value of: (1) engaging in recreational activities, (2) engaging with friends, and (3) the disruption to schooling. The remaining four themes related to what could have helped adolescents mental health and wellbeing since the Covid-19 outbreak. These focussed on (1) better support: in relation to mental health; school work; and communication, (2) contact with friends, and (3) more opportunities for recreational activities. Males were more likely to report recreational activities had helped and less likely to report better support could have helped. Adolescents who reached clinical threshold for depression and anxiety and those with elevated PTSD-like symptoms about Covid-19 were more likely to state more support could have helped, and adolescents who reached clinical threshold for depression were less likely to report that friends could have helped their mental health. The findings may inform mental health policy and interventions in the recovery from the Covid-19 pandemic.

The Effects of the ACTIVE VALUES Program on Psychosocial Aspects and Executive Functions

The main objective of this study was to implement an educational program named ACTIVE VALUES and to analyse the psychosocial and cognitive effects of its application. It is a quasi-experimental repeated measures research with a non-randomised experimental group (EG) and a control group (CG). The sample consisted of 102 students in the 6th grade of primary school, aged between 11 and 13 years (M = 11.59; SD = 0.60), and 4 teachers aged between 27 and 52 years (M = 38.5). The intervention program lasted 4 months, in which the EG implemented a teaching methodology based on the incorporation of classroom-based physical activity (CB-PA) in the structure of the Teaching for Personal and Social Responsibility (TPSR) model to develop personal and social values in students, as well as to reduce children's sedentary behaviour in the classroom in different educational areas (e.g., mathematics, Spanish language, social sciences and natural sciences), while the CG used a conventional methodology based on direct instruction. The main results found show significant improvements in intrinsic motivation variables (including intrinsic motivation for achievement, stimulating experiences and knowledge), self-determination index, autonomy, relatedness, psychological mediators index, personal and social responsibility, teacher climate, intention to be physically active and executive functions in the EG, while amotivation values increased in the CG. In conclusion, interdisciplinary educational programs based on the combination of pedagogical models and active methodologies are postulated as methodological alternatives to achieve an integral and multilateral development of children and adolescents, as well as to improve the different learning domains of physical education, such as cognitive, social and motor. It is recommended that future research should consider longitudinal designs with mixed methods and follow-up data to assess learning retention, as well as larger samples and the measurement of a greater number of executive functions (e.g., inhibitory control and attention).

16 Weeks of Physically Active Mathematics and English Language Lessons Improves Cognitive Function and Gross Motor Skills in Children Aged 8-9 Years

The aim of the present study was to examine the effects of physically active lessons, implemented through the Mathematics and English Language curriculum, on cognitive function and gross motor skill development. Following ethical approval, 192 children aged 8-9 years were randomly allocated to an intervention group (n = 98) or a control group (n = 94). The intervention consisted of 8 h.wk^-1 of physically active lessons, equally split between Mathematics and English Language, for 16 weeks. Cognitive function (digit span, coding and arithmetic reasoning) and gross motor skill development (TGMD-3) were assessed at baseline and follow-up. The improvement in every domain of cognitive function was greater in the intervention group compared to the control group (group * time, p = 0.008-0.023, d = 0.34-0.42). Furthermore, total TGMD-3 score (group * time, p < 0.001, d = 1.16) and both sub-scales (locomotor, p < 0.001, d = 0.63; object control, p < 0.001, d = 1.29) also improved by a greater extent in the intervention group than in the control group. These findings suggest that 16 weeks of physically active lessons, taught in both Mathematics and English Language curriculum, synergistically improved cognitive function and gross motor skill development in primary school children aged 8-9 years.

Freedom dreaming to STEM: A conceptual model for Black youth's racial and STEM identity development through social media

Social media use has become increasingly enmeshed in the lives of youth. Although investigations in this area have tended to focus on risk (e.g., cyberbullying) and negative outcomes (e.g., in mental health and academic functioning), a growing body of literature suggests there may be positive developmental outcomes associated with Black youths' social media use. Social media may offer Black youth a means of resisting negative experiences, expand their opportunities to create and explore, and facilitate the integration of their racial and STEM identities. Aligned with PYD perspectives and PVEST, we suggest this dynamic process occurs iteratively within youth and bidirectionally between youth and their environment (online and offline) over the course of development. In this article, we present a conceptual model to guide future investigations to address gaps in the literature and elucidate the linkages between social media use, racial identity, and STEM identity among Black youth. We begin by reviewing two frameworks that provide the theoretical foundations for our model. We then discuss our outcomes of interest: racial identity and STEM identity. Given its rapidly evolving nature, we then proceed with a discussion about how social media may be operationalized, noting limitations in the current literature and highlighting the unique ways in which social media differs from offline contexts. Subsequently, we present our conceptual model, which we situate within distal, proximal, and individual offline influences. We also propose processes that may link social media use to positive identity outcomes. We conclude this article with recommendations for future investigations.

The longitudinal association between objectively-measured school-day physical activity and academic achievement in US elementary school students

Background

It is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement.

Methods

In a diverse suburban public school district, 4936 Grade 4 students were recruited in 40 elementary schools. Students wore accelerometers to measure school-day MVPA for 15 days across three semesters. Academic performance data was collected across Grade 3 fall to Grade 5 spring, including teacher-assigned grades and standardized test scores. Multilevel modeling was conducted controlling for student demographics and school characteristics.

Results

Cross-sectional analyses found small negative associations in Grade 4. Grade 4 full-year mean daily school-day MVPA had β = −-0.066, β = −-0.063, β = −-0.066, and β = −-0.058 associations (p <  0.001) with Grade 4 math, reading, spelling, and writing grades respectively, and Grade 4 full-year mean daily school-day MVPA had β = −-0.206 and β = −-0.283 (p <  0.001) associations with Grade 4 math and English Language Arts (ELA) standardized test scores respectively out of approximately 500 points. Longitudinal analyses found no significant associations between Grade 4 full-year mean daily school-day MVPA and Grade 5 Fall course grades. Results also indicated small negative associations for students attaining 30+ minutes of daily school-day MVPA compared to those attaining less than 15 minutes, but only in Grade 4 Fall cross-sectional analyses where teacher-assigned reading, spelling, and writing grades were − 1.666, − 1.638, and − 1.993 points lower respectively (p <  0.001).

Conclusion

The cross-sectional findings, while statistically significant in a negative direction, have a negligible association when translated practically. For example, even if students attained twice the recommended amount of school-day MVPA – which would constitute an approximately 300% increase from current levels – results suggest that grades would only decrease by 2 points on a 100-point scale. Furthermore, longitudinal analyses suggest school-day MVPA does not have a predictive association with course grades or standardized test scores. Findings suggest school-based MVPA implemented in accordance with recommendations does not meaningfully detract from academic progress.

Trial registration

ClinicalTrials.gov, NCT03765047. Registered 05 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03765047

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01328-7.

A mixed method investigation of teacher-identified barriers, facilitators and recommendations to implementing daily physical activity in Ontario elementary schools

Background

Fewer than 17% of children worldwide are meeting the international recommendations for daily physical activity. Since most children are in school for the bulk of their day, the classroom has been identified as an ideal space to incorporate physical activity opportunities. In Ontario (Canada), the Daily Physical Activity (DPA) policy aims to ensure all elementary school children receive a minimum of 20 min of moderate to vigorous physical activity each school day during instructional time. However, a 2015 evaluation found that only half of Ontario teachers were meeting this expectation; this work advocated for additional research to monitor implementation and its predictors and to further identify fidelity recommendations. Thus, the current study investigated contemporary factors influencing DPA fidelity in Ontario elementary schools and provides teacher-identified recommendations to support DPA implementation.

Methods

The first part of the study was a quantitative approach surveying 186 elementary school teachers across Ontario. Descriptive statistics including frequencies and means were used to characterize barriers, facilitators, and recommendations to DPA implementation. Spearman’s correlations were used to assess the relation between the likelihood of DPA implementation and intrapersonal factors of gender, teaching experience, prior DPA training and personal physical activity participation. The second part of the study consisted of a qualitative approach using teacher interviews to explore in-depth teachers’ recommendations to support DPA implementation. A thematic analysis was used to analyze the transcripts and identify recommendations for DPA.

Results

Survey results showed that only 23% of teachers met the mandated 20 min of DPA per day. Barriers to implementation included space and time constraints, inadequate training, student behavioural issues and low self-efficacy. Gender, teaching experience and prior DPA training were not related to the likelihood of DPA implementation. Teachers who rated themselves as more physically fit were more likely to implement DPA. Teacher interviews elucidated key areas for improving DPA implementation including greater DPA training opportunities, resources, community partnerships, accountability and strategies that support school-wide implementation.

Conclusion

The current study demonstrated that fidelity to the DPA policy in Ontario elementary schools is on the decline. This work highlights unique factors implicated in DPA fidelity and brings to the forefront teacher recommendations to improve DPA implementation.

Understanding the Benefits of Brief Classroom-Based Physical Activity Interventions on Primary School-Aged Children's Enjoyment and Subjective Wellbeing: A Systematic Review

BACKGROUND

Engaging in classroom-based physical activity (PA) breaks may help increase children's subjective wellbeing and enjoyment of PA, important precursors for children to remain engaged in PA. We conducted a systematic review to investigate the effect of brief classroom-based PA interventions on primary school children's subjective wellbeing and enjoyment of PA.

METHODS

Databases were reviewed between the earliest date of records and April 2020. Eligibility criteria included peer-reviewed empirical quantitative or mixed methods studies reporting enjoyment of PA or wellbeing outcomes of participating in a brief classroom-based PA program. Fifteen papers were included. Interventions supported 7022 child participants enrolled at baseline and 6286 children analyzed in interventions across 148 schools.

RESULTS

Thirteen studies examined the effect of brief classroom-based PA interventions on subjective wellbeing. Four found a significant positive effect for children in the intervention group (specifically for children's self-efficacy in learning with video exercises, quality of life, and self-confidence). Eight studies examined the effect of brief classroom-based PA interventions on enjoyment of PA. Five studies reported a positive effect for children in the intervention group and only 1 study found a negative effect for 1 grade level of children in the intervention group. The remaining studies with wellbeing and/or enjoyment outcomes reported no significant effect.

CONCLUSIONS

Findings from these studies indicate that the integration of brief PA breaks may support PA enjoyment and specific self-beliefs and quality of life perceptions that contribute to children's subjective wellbeing. However, more research is needed to confirm this effect.

Online physically active academic lessons in COVID-19 times: A pilot study

Schools play an important role in promoting physical activity among students. This paper studies the perception of educators, students, and parents about the use of online physically active academic lessons during COVID-19 in the north of Chile. Starting the first week of November 2020, and for a period of five weeks, 323 students, alongside 11 educators, practiced a geometry-based dance routine online. The qualitative analysis results reveal a positive perception of the experience and an increase in physical activity without reducing the amount of time spent on academic activities. There were also improvements in learning, social relationships, and enjoyment.

Classroom Movement Breaks and Physically Active Learning Are Feasible, Reduce Sedentary Behaviour and Fatigue, and May Increase Focus in University Students: A Systematic Review and Meta-Analysis

Background: University students are mostly sedentary in tertiary education settings which may be detrimental to their health and learning. This review aimed to examine the feasibility and efficacy of classroom movement breaks (CMB) and physically active learning (PAL) on physical and cognitive outcomes in university students in the tertiary setting. Methods: Five electronic databases (MEDLINE, CINAHL, Embase, PsychINFO, and PubMed) were searched for articles published up until November 2021. Manual searching of reference lists and citation tracking were also completed. Two reviewers independently applied inclusion and exclusion criteria and completed quality assessment. Articles were included if they evaluated CMB or PAL interventions delivered to university students in a tertiary setting. Results: Of the 1691 articles identified, 14 studies with 5997 participants met the inclusion criteria. Average study quality scores were poor for both CMB and PAL studies. CMBs and PAL are feasible in the tertiary setting and increase physical activity, reduce sedentary behaviour, increase wellbeing, and reduce fatigue in university students. In addition, CMBs increased student focus and attention in class and PAL had no detrimental effect on academic performance. Conclusions: University educators should feel confident in introducing CMB and/or PAL interventions into their classes to improve student health and wellbeing.

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

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

The effect of low-intensity exercise on emotional and cognitive engagement in the classroom

This study examined whether engaging in physical exercise during a university class would have beneficial effect on students' learning motivation. One hundred and forty-nine participants took part in a psychology class over nine weeks (one lesson per week); for each lesson, participants engaged in a three-minute physical activity (low-intensity aerobic exercise) or control activity (watching a video), about 20 min after the lesson started. Participants reported higher vigour and lower fatigue during the class when they exercised than when they engaged in control activities. These findings suggest the utility of incorporating a short exercise activity in university settings to enhance students' classroom motivation.

Two-Year Effectiveness of a Controlled Trial With Physically Active Lessons on Behavioral Indicators of School Children

Purpose: In this study, we evaluated the effectiveness of two years of an intervention with physically active lessons on indicators of sedentary behavior and physical activity measured objectively in elementary school children. Methods: A controlled clinical trial with cluster sampling was carried out in 2018 and 2019, with four classes of children in the 2nd year of elementary school. The intervention group classes received dynamic activities linked to the pedagogical content (n = 34) for 2 years. The indicators of sedentary behavior and physical activities were evaluated using ActivPal and ActiGraph GT3X accelerometers during the school shift. Crude and adjusted models of Generalized Estimation Equations with Bonferroni's post hoc were used to identify the differences between the groups (three evaluations in 2018 and two evaluations in 2019). Results: There was a reduction in stationary behavior (p = .01) and an increase in light physical activity (p = .044) during the two years. In the first year there were reductions in standing time (p = .044) and number of transitions (p ≤ .001), and an increase in walking time (p = .017). However, in the second year, the mean differences in percentage points were smaller than in the first year. No differences were found for sitting time as well as for moderate and vigorous physical activity. We observed a large effect size for all variables. Conclusions: The introduction of physically active lessons in the classroom reduced time in stationary behavior and increased time in light physical activity. However, the effects on behavior observed in the first year were not maintained in the second year of intervention.

Examining the Link Between Physical Activity and Cognitive Function: A Parallel Mediation Model of Health and Wellbeing Among Adolescents

Background

Adolescents’ engagement in daily physical activity brings multiple benefits, including reduction in obesity, improvement of mental health, and enhancement of cognitive function (CF). While prior studies have examined the link between physical activity and cognitive function, little is known regarding the extent to which this relationship is shaped by health and wellbeing factors. This study examines how subjective wellbeing (SWB) and general health (GH) mediate the relationship between adolescents’ physical activity and cognitive function.

Methods

This study estimates a parallel structural equation model using the Program for International Student Assessment 2018 dataset. Specifically, a total of 63,228 15-year-old subjects in nine countries/economies satisfied the study inclusion criteria, including in Bulgaria, Georgia, Hong Kong, Ireland, Mexico, Panama, Serbia, Spain, and United Arab Emirates. Frequency of moderate physical activity (MPA, ≥3.0 Metabolic Equivalent Task) was reported weekly; SWB and GH were assessed using an internationally validated multi-item standardized questionnaire. SWB was measured by students’ self-evaluated satisfaction with their health, life, and schooling. GH was measured by students’ physical health and mental health status. Cognitive function (CF) was modeled as a latent function consisting of plausible values derived using item response theory on reading, mathematics, and science achievement tests.

Results

Findings indicated that increase in weekly MPA was positively associated with higher levels of SWB (p < .001), GH (p < .001), and CF (p < .001) among the study subjects. Parallel mediation analyses revealed that more frequent weekly MPA had relatively large direct effects (p < .001) on CF, and indirect effects channeling through improvements in SWB and GH were non-trivial (p < .001). Heterogeneity results showed that boosts to CF, associated with MPA, were larger for mathematics and science than for reading (p < .001).

Conclusion

This study used a large-scale international dataset to show that the positive relationship observed between MPA and CF among adolescents was robust, and that SWB and GH were two critical mediators through which physical activity positively bolster CF.

Do the implementation processes of a school-based daily physical activity (DPA) program vary according to the socioeconomic context of the schools? a realist evaluation of the Active at school program

Background

Less than half of Canadian children meet the Canadian Physical Activity (PA) Guidelines, and the proportion is even lower among children living in underprivileged neighbourhoods. Regular PA supports physical, cognitive, and psychological/social health among school-aged children. Successful implementation of school-based daily physical activity (DPA) programs is therefore important for all children and crucial for children who attend schools in lower socioeconomic settings. The purpose of this study is to uncover what worked, for whom, how, and why during the three-year implementation period of a new “flexible” DPA program, while paying particular attention to the socioeconomic setting of the participating schools.

Methods

This study is a realist evaluation using mixed methods for data generation. Longitudinal data were collected in 415 schools once a year during the three-year implementation period of the program using questionnaires. Data analysis was completed in three steps and included qualitative thematic analysis using a mixed inductive and deductive method and chi-square tests to test and refine context-mechanism-outcome (CMO) configurations.

Results

Giving the school teams autonomy in the choice of strategies appropriate to their context have allowed schools to take ownership of program implementation by activating a community empowerment process, which resulted in a cultural shift towards a sustainable DPA provision in most settings. In rural underprivileged settings, the mobilization of local resources seems to have successfully created the conditions necessary for implementing and maintaining changes in practice. In disadvantaged urban settings, implementing local leadership structures (leader, committee, and meetings) provided pivotal assistance to members of the school teams in providing new DPA opportunities. However, without continued external funding, those schools seem unable to support local leadership structures on their own, jeopardizing the sustainability of the program for children living in disadvantaged urban areas.

Conclusion

By exploring CMO configurations, we have been able to better understand what worked, for whom, how and why during the three-year implementation period of the Active at School! program. When implementing DPA policies, decision makers should consider adjusting resource allocations to meet the actual needs of schools from different backgrounds to promote equal PA opportunities for all children.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12797-7.

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

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

Physical Activity in High School Classrooms: A Promising Avenue for Future Research

Adolescence represents a sensitive period whereby lifestyle factors such as physical activity can have profound, long-lasting effects on development and later life habits. However, adolescence constitutes a period of frequent sedentary behaviour. Among children, integrating physical activity into elementary school classrooms has been shown to reduce sedentary behaviour and improve academic achievement and overall physical and mental health. However, this promising area of research has not extended to adolescents and high school classrooms. In this paper, we describe the benefits of conducting research on the impact of physically active high school classrooms, and highlight the challenges and potential misconceptions associated with research in this field. Specifically, we review research on the role of physical activity in adolescent development, the benefits of classroom-based physical activity for children, and discuss the factors that may have led researchers to focus on classroom-based physical activity primarily for children, despite the potentially similar benefits for adolescents.

Cognitively Engaging Physical Activity for Targeting Motor, Cognitive, Social, and Emotional Skills in the Preschool Classroom: The Move for Thought preK-K Program

Despite the growing body of research indicating that integrated physical activity with learning benefits children both physically and cognitively, preschool curricula with integrated physical activities are scarce. The "Move for Thought (M4T) preK-K" program provides activities on fundamental motor skills that are integrated with academic concepts, executive function, and social-emotional skills in the preschool environment. The aim of this study was to evaluate the feasibility, usability, and effectiveness of the M4T preK-K program over an eight-week period in 16 preschool centers (N=273; M _age=4.22 SD=0.61) that were randomly assigned to the intervention (8 M4T; n=138; M _age=4.31 SD=0.61) and the control (8 traditional; n=135; M _age=4.13 SD=0.60) group. In both groups, teacher ratings of children's attention, behavioral control, and social skills (i.e., cooperation, assertion, and self-control) in the classroom, as well as children's perceived motor skill competence and executive functions, were collected before and after the intervention. A daily teacher log measured intervention fidelity and perceived experiences with the program. Results showed a significant improvement on attention scores for children in the M4T preK-K group, compared to the control group. No significant differences emerged for behavioral control, social skills, executive functions, and perceived motor competence among groups. A significant time effect was evident for executive functions, with both groups improving over time. Further, the program was well-received, easy to implement in the preschool classroom and with high rates of satisfaction for both children and teachers. The M4T preK-K program is promising in helping teachers prepare preschool children for future educational success.

Parents' and Early Childhood Educators' Perceptions on Movement and Learning Program Implementation

There is currently limited evidence on parents' and early childhood educators' perspectives on implementing programs that combine cognitive and motor tasks in early childhood. An online survey was distributed across Australia through social network platforms and emails at preschool centres, asking 65 parents of preschool children and early childhood educators about their preferences on program delivery, duration, and mode. Responses from the survey were evaluated in order to develop and pilot a 4 week home-based (n = 5 parents) and a 6 week school-based program (n = 5 educators) including cognitively engaging physical activity, requesting parents' and educators' perspectives, respectively, about the program components. Results from the online survey showed a preference for programs with online (e.g., video-based) compared to traditional delivery (e.g., books), emphasising the potential benefits on children's physical activity levels, sleep, and cognitive function. However, after piloting the program, educators preferred to use the book version instead of the video. This program has the potential to become part of daily regular practice. Barriers reported include logistics issues (i.e., book size), connectivity issues with internet, and the need for varying activities.

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

BACKGROUND

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

OBJECTIVES

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

SEARCH METHODS

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

SELECTION CRITERIA

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

MAIN RESULTS

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

AUTHORS' CONCLUSIONS

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

Breaking up classroom sitting time with cognitively engaging physical activity: Behavioural and brain responses

INTRODUCTION

Classroom-based active breaks are a feasible and effective way to reduce and break up sitting time, and to potentially benefit physical health in school children. However, the effect of active breaks on children's cognitive functions and brain activity remains unclear.

OBJECTIVE

We investigated the impact of an active break intervention on typically developing children's cognitive functions and brain activity, sitting/standing/stepping, on-task behaviour, and enjoyment.

METHODS

Up to 141 children, aged between 6 and 8 years (46% girls), were included, although about half of them completed two of the assessments (n = 77, working memory; n = 67, dorsolateral prefrontal cortex haemodynamic response). Classrooms from two consenting schools were randomly allocated to a six-week simple or cognitively engaging active break intervention. Classrooms from another school acted as a control group. The main analyses used linear mixed models, clustered at the class level and adjusted for sex and age, to investigate the effects of the interventions on response inhibition, lapses of attention, working memory, event-related brain haemodynamic response (dorsolateral prefrontal cortex). The mediating effects of sitting/standing/stepping on cognition/brain activity were also explored. To test intervention fidelity, we investigated differences by group on the change values in children's sitting, standing, and moving patterns during class/school time using linear mixed models. Generalized linear mixed models clustered at the individual level were used to examine on-task behaviour data. For the intervention groups only, we also assessed children's perceived enjoyment, physical exertion and mental exertion related to the active breaks and compared the results using independent t-tests.

RESULTS

There was a significantly greater positive change in the proportion of deoxygenated haemoglobin in the left dorsolateral prefrontal cortex of children assigned to cognitively engaging active breaks compared to the control group (B = 1.53 × 10-07, 95% CI [0.17 × 10-07, 2.90 × 10-07]), which under the same cognitive performance is suggestive of improved neural efficiency. Mixed models showed no significant effects on response inhibition, lapses of attention, working memory. The mediation analysis revealed that the active breaks positively affected response inhibition via a change in sitting and standing time. The sitting, standing, and moving patterns and on-task behaviour were positively affected by the active breaks at end of trial, but not at mid-trial. Children in both intervention groups showed similarly high levels of enjoyment of active breaks.

CONCLUSION

Cognitively engaging active breaks may improve brain efficiency in the dorsolateral prefrontal cortex, the neural substrate of executive functions, as well as response inhibition, via effects partially mediated by the change in sitting/stepping time. Active breaks can effectively reduce sitting and increase standing/stepping and improve on-task behaviour, but the regular implementation of these activities might require time for teachers to become familiar with. Further research is needed to confirm what type of active break best facilitates cognition.

The Effects of Bike Desks in Formal Education Classroom-Based Physical Activity: A Systematic Review

A systematic review of the research conducted on classroom-based physical activity using bike desks, a school health prevention strategy. To our knowledge, this is the first systematic review of bike desks effects on formal education students. Articles from two databases, Web of Science and PubMed, were analyzed according to PRISMA. The quality of each study was analyzed. After the exclusion criteria, eight articles were fully assessed based on six criteria: (1) author and year, (2) setting and sample, (3) duration, (4) outcomes measurements, (5) instruments and (6) main results. The results show how the interventions are mainly in secondary education and university, and most of them are quantitative studies of short-term interventions. Physical activity is the most frequently variable assessed, using logs, questionnaires and objective methods such as accelerometry and heart rate monitoring. Based on all the studies, it is feasible to implement bike desks in the classroom during theoretical lessons. The weaknesses are related to small samples and the use of different instruments to measure. In conclusion, this systematic review compiles the current information about bike desks in order to inform teachers and administrators for the implementation of bike desk in their schools. They should consider bike desks’ strengths and weaknesses.

Effects of Physically Active Lessons on Movement Behaviors, Cognitive, and Academic Performance in Elementary Schoolchildren: ERGUER/Aracaju Project

BACKGROUND

To evaluate the effects of the introduction of physically active lessons on movement behaviors, cognitive, and academic performance in schoolchildren.

METHODS

This was a cluster-controlled trial. A total of 61 students from the second year of elementary school in a public school in Brazil made up 2 intervention classes (n = 34) with the introduction of physically active lessons and 2 control classes (n = 27). Sedentary behavior, physical activity, cognitive, and academic performance were evaluated in 3 moments, which were compared using models of generalized estimating equations.

RESULTS

The intervention was effective for reducing the standing time between the baseline and 3 months while increasing the walking time between baseline and 3 months and baseline and 9 months. There was a reduction in time in stationary activities and increased time in light physical activities between all moments. The intervention group increased their performance in the go/no go test, showing a smaller number of errors between the baseline and 3 months and baseline and 9 months, and a reduction in the test time between baseline and 3 months. No impact on students' academic performance was observed.

CONCLUSION

Physically active lessons improve movement behaviors and cognitive functions among elementary schoolchildren.

Can school-based physical activity foster social mobility?

Social mobility refers to the intergenerational transmission of socio-economic status, and therefore of health status. Hence, it is important to consider social mobility to tackle the social gradient in health in the long term. Fostering social mobility requires developing public policies that ensure equal opportunities for all children. The intent of this commentary is to illustrate how a proportionate universalism approach to school-based physical activity could be a way to promote equal opportunity for children within the school environment. Alberta's Daily Physical Activity policy and the APPLE Schools program are used to illustrate this approach: these two programs not only create enabling environments that can support children in adopting healthy lifestyles but also contribute to the reduction of social inequalities in physical activity by fostering capacity building.

Physically active learning in preschoolers: Improved self-regulation, comparable quantity estimation

BACKGROUND

Providing physical activity during the school day may mitigate increasingly sedentary lifestyles among children. Young children may be susceptible to interference during learning and consolidation when performing physical activity concurrently with academic instruction.

METHODS

Preschoolers (N = 72, mean age 5.1 ± 0.8 years, 50% female) completed a quantity estimation task before, following, and one week after engaging in either a 20-min physically active or sedentary lesson. Physical activity intensity and volume were measured using heart rate and pedometer step counts, respectively. Off-task behavior was recorded prior to and following the lesson.

RESULTS

Children exhibited similar learning and retention, but an added benefit of physically active lessons was a 1900% step increase and a 58% reduction in off-task behavior.

CONCLUSION

Providing physically active lessons instead of sitting for extended periods of time in early childhood classrooms reduces sedentary behavior and improves self-regulation while not interfering with educational outcomes.

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.

Examining Associations Between Physical Activity and Academic Performance in a Large Sample of Ontario Students: The Role of Inattention and Hyperactivity

BACKGROUND

Participation in physical activity (PA) is a modifiable factor that contributes to academic success, yet the optimal dose (ie, frequency) and mechanisms underlying the effect require further exploration.

METHODS

Using data from 19,886 elementary and 11,238 secondary school students across Ontario, Canada, this study examined associations between PA participation frequency, academic achievement, and inattention and hyperactivity.

RESULTS

Among elementary students, there was a positive association between PA frequency and academic achievement. Participating in 1 to 2 days per week of PA related to higher academic achievement compared with no days, whereas 7 days per week had the largest associations. For secondary students, a minimum of 3 to 4 days per week was associated with higher academic achievement with no significant benefit of additional days. Indirect effects of inattention and hyperactivity were found for both groups, suggesting that the benefits of PA on academic achievement may be partly explained by reductions in inattention and hyperactivity, especially for secondary school students.

CONCLUSION

Students may experience academic benefits from PA even if they are not meeting the guidelines of exercising daily. These benefits may occur, in part, through reductions in inattention and hyperactivity. Further work is needed to determine the temporality and mechanism of these associations.

Acute Effects of an Afterschool Running and Reading Program on Executive Functioning in Children: An Exploratory Study

Objective: Emerging research within school settings suggests acute forms of physical activity and exercise lead to improvements in executive functioning among children. However, research pertaining to these effects within the afterschool setting remains limited. The primary purpose of this study was to investigate the acute effects of a community-based afterschool running and reading program on executive functioning in 8 to 12-year-old children. Method: Fifty participants were initially recruited to participate in this study. However, due to the COVID-19 pandemic, data collection was terminated prematurely which resulted in a sample size of 15 participants. Participants (N = 10) from School 1 completed two batteries of executive function assessments (i.e., inhibition, switching, and updating) separated by 15-min of running or 15-min of sedentary reading. Whereas, only 5 participants from School 2 completed assessments of executive functioning prior to and following the running portion of the program (due to the early termination of data collection). Results: Overall, executive function scores improved across each assessment following the running condition when compared to the reading condition (School 1). Inhibition scores significantly improved, and these effects were very large (School 1). Across both schools, improvements in executive functioning following the running portion of the program ranged from small-large in effect size. Conclusion: Findings from the present study provide initial evidence for the acute effects of a community-based afterschool running and reading program on executive functioning in children. Future research with larger samples in afterschool settings is recommended to replicate this preliminary work.

Physical Activity and Academic Achievement: An Umbrella Review

Background: This umbrella review aimed to summarise the evidence presented in systematic reviews and meta-analyses regarding the effect of physical activity on academic achievement of school-age children and adolescents. Methods: A comprehensive electronic search for relevant systematic reviews and meta-analyses were performed in Pubmed, Cochrane Library, Web of Science, Scopus, and Latin American and Caribbean of Health Sciences Information System, and reference lists of the included studies, from inception to May 2020. Studies were included if they were systematic reviews or meta-analyses, included school-age children or adolescents, the intervention included physical activity, and the outcome was the academic achievement. Two independent authors screened the text of potentially eligible studies and assessed the methodological quality of the studies using the AMSTAR 2 tool. Results: Forty-one systematic reviews and meta-analyses that examined the effects of physical activity on children and adolescents’ academic achievement were identified. Overall, the systematic reviews reported small positive or mixed associations between physical activity and academic achievement. From meta-analyses, it was observed that physical activity had null or small-to-medium positive effects on academic achievement. Chronic physical activity showed a medium positive effect on academic achievement, and acute physical activity did not demonstrate benefits. Conclusions: Physical activity seems not to be detrimental to school-age children and adolescents’ academic achievement, and may, in fact, be beneficial.

A critical evaluation of systematic reviews assessing the effect of chronic physical activity on academic achievement, cognition and the brain in children and adolescents: a systematic review

BACKGROUND

International and national committees have started to evaluate the evidence for the effects of physical activity on neurocognitive health in childhood and adolescence to inform policy. Despite an increasing body of evidence, such reports have shown mixed conclusions. We aimed to critically evaluate and synthesise the evidence for the effects of chronic physical activity on academic achievement, cognitive performance and the brain in children and adolescents in order to guide future research and inform policy.

METHODS

MedLine, Embase, PsycINFO, Cochrane Library, Web of Science, and ERIC electronic databases were searched from inception to February 6th, 2019. Articles were considered eligible for inclusion if they were systematic reviews with or without meta-analysis, published in peer-reviewed (English) journals. Reviews had to be on school-aged children and/or adolescents that reported on the effects of chronic physical activity or exercise interventions, with cognitive markers, academic achievement or brain markers as outcomes. Reviews were selected independently by two authors and data were extracted using a pre-designed data extraction template. The quality of reviews was assessed using AMSTAR-2 criteria.

RESULTS

Of 908 retrieved, non-duplicated articles, 19 systematic reviews met inclusion criteria. One high-quality review reported inconsistent evidence for physical activity-related effects on cognitive- and academic performance in obese or overweight children and adolescents. Eighteen (critically) low-quality reviews presented mixed favourable and null effects, with meta-analyses showing small effect sizes (0.1-0.3) and high heterogeneity. Low-quality reviews suggested physical activity-related brain changes, but lacked an interpretation of these findings. Systematic reviews varied widely in their evidence synthesis, rarely took intervention characteristics (e.g. dose), intervention fidelity or study quality into account and suspected publication bias. Reviews consistently reported that there is a lack of high-quality studies, of studies that include brain imaging outcomes, and of studies that include adolescents or are conducted in South American and African countries.

CONCLUSIONS

Inconsistent evidence exists for chronic physical activity-related effects on cognitive-, academic-, and brain outcomes. The field needs to refocus its efforts towards improving study quality, transparency of reporting and dissemination, and is urged to differentiate between intervention characteristics for its findings to have a meaningful impact on policy.