Effects of a 2‐year school‐based daily physical activity intervention on cardiorespiratory fitness: the Sogndal school‐intervention study

The aim of this study was to describe changes in children's cardiorespiratory fitness (CRF) following a school‐based physical activity (PA) intervention. In total, 259 children (age 9.3±0.3 years) were invited to participate, of whom 256 participated. The children from the intervention school (63 boys, 62 girls) carried out 60‐min PA over 2 school years. The children from the control school (62 boys, 69 girls) had the regular curriculum‐defined amount of physical education in school, i.e. 45 min twice weekly. One hundred and eighty‐eight children (73.4%) successfully completed both the baseline and the post‐intervention peak oxygen uptake (VO_2peak) test. VO_2peak was measured directly during a continuous progressive treadmill protocol where the children ran until exhaustion. The children from the intervention school increased their mean VO_2peak (95% confidence interval) 3.6 (2.5–4.6) mL/kg/min more than the children from the control school. This VO_2peak value was adjusted for both sex and baseline VO_2peak. Boys and girls demonstrated similar VO_2peak responses. The intervention, primarily carried out at a moderate intensity, had the biggest impact in children with low initial CRF levels. In conclusion, a 2‐year school‐based 60‐min daily PA intervention significantly improved CRF in children.     

Effects of extra school‐based physical education on overall physical fitness development – the CHAMPS study DK

First, this study aimed to investigate if four extra physical education (PE) lessons per week improved children's development in physical fitness. Second, to investigate if the extra PE lessons improved development in physical fitness for children with lower levels of fitness at baseline. This study was a longitudinal controlled school‐based study. The study population consisted of 10 Danish public schools with children in preschool to fourth grade (cohorts 0–4) with 2.5‐year follow‐up. Six schools had extra PE and four schools had normal PE. In total 1247 children were included (normal PE = 536, extra PE = 711). Development in fitness was analyzed using a composite z‐score from six fitness tests. Multilevel mixed‐effects linear regression was used to examine the association between school type and development in fitness. Extra PE increased the total development of composite z‐score units among children enrolled in cohort 4 and borderline in cohort 3 with 1.06 (95% confidence interval 0.48–1.65) and 0.52 z‐score units (?0.06 to 1.09), respectively. Children in the lower 50 percentiles increased their development with 0.47 (0.08–0.85) z‐score units. Extra PE in schools improved development in fitness for cohort 4 and borderline for cohort 3 among all children. Extra PE improved fitness development across all cohorts among children with low fitness levels.     

Attitudes towards exercise and physical activity behaviours in Greek schoolchildren after a year long health education intervention

Objective

To examine the short term effects of a health education programme on Greek primary schoolchildren

Methods

The school based intervention programme was applied to 29 children in the 6th grade of the 2nd Primary School of Agios Stefanos (∼12 000 inhabitants); 49 pupils from the 1st Primary School constituted the control group. To assess the effectiveness of the intervention, attitude and behavioural variables were measured before and after the intervention.

Results

After adjustment for initial differences in the assessed variables, pupils who took part in the intervention had more positive attitudes towards physical activity than the control group and scored significantly more highly on their intention to participate in physical activity. Moreover, pupils in the intervention group reported more hours/week spent in organised physical activities than pupils in the control group (mean (SD) 3.54 (0.32) v 2.54 (0.26), p<0.020). Finally, a higher proportion of pupils in the intervention classes matched the recommendations of 60 minutes of moderate to vigorous physical activity daily (77.4% v 55.1%, p<0.043).

Conclusions

Within the limitations of the study, the data show that school health education programmes have the potential to slow the age related decline in physical activity and help pupils establish lifelong, healthy physical activity patterns. Promoting healthy habits and physical activity behaviours during childhood may prevent some of the leading causes of morbidity and mortality in the Greek population, and also decrease direct healthcare costs and improve quality of life.     

The relation between student motivation and student grades in physical education: A 3‐year investigation

Enhancing students' academic engagement is the key element of the educational process; hence, research in this area has focused on understanding the mechanisms that can lead to increased academic engagement. The present study investigated the relation between motivation and grades in physical education (PE) employing a 3‐year longitudinal design. Three hundred fifty‐four Greek high school students participated in the study. Students completed measures of motivation to participate in PE on six occasions; namely, at the start and the end of the school year in the first, second, and third year of junior high school. Students' PE grades were also recorded at these time points. The results of the multilevel growth models indicated that students' PE grades increased over the 3 years and students had better PE grades at the end of each year than at the beginning of the subsequent year. In general, students and classes with higher levels of controlling motivation achieved lower PE grades, whereas higher levels of autonomous motivation were associated with higher PE grades. These findings provide new insight on the associations between class‐ and individual‐level motivation with objectively assessed achievement in PE.     

Effectiveness of a physical activity intervention in preschoolers: A cluster‐randomized controlled trial

Several activity interventions in preschool settings exist, but little attention has been paid to effects on hemodynamic factors. The study aimed to assess the effectiveness of an exercise program on health‐related outcomes including blood pressure (BP) and markers of vascular function in preschoolers, with focus on socioeconomic background. This study is a cluster‐randomized controlled trial, with preschool as unit of randomization and children as unit of analysis. Preschools with 3‐ to 6‐year‐old children, stratified by social area, were randomly allocated to: intervention (three clusters, n = 92) including 2 d·wk^?1/45 min (6 months) exercise lessons or control (two clusters, n = 43). In total, 135 children (4.8 ± 0.8 y) had minimum one outcome measurement at baseline and follow‐up. Primary outcome: peripheral BP. Secondary outcomes: central BP, pulse wave velocity (PWV), BMI, waist circumference, physical activity measures, motor skills. Maternal education was used as an indicator of socioeconomic status. Mixed models were applied to evaluate differences in mean change. Group allocation had no effect on primary or secondary outcomes. However, the intervention was effective in reducing increases in peripheral systolic BP (?3.4 mm Hg; 95% CI: ?6.6; ?0.2; P = 0.037), central systolic BP (?3.8 mm Hg; ?6.4; ?1.1; P = 0.006), and PWV (?0.1 m/s; ?0.2; ?0.0; P = 0.045) among children whose mothers had the lowest educational level. We found no evidence for effectiveness of a 6‐months preschool‐based exercise program on hemodynamics, anthropometrics, activity, or motor skills, but lack of process evaluations and poor fidelity preclude interpretation of the causal relation. However, the results indicate that children from lower social backgrounds could benefit from early exercise‐promoting interventions.     

Relationship between habitual physical activity and gross motor skills is multifaceted in 5‐ to 8‐year‐old children

Adequate motor skills are essential for children participating in age‐related physical activities, and gross motor skills may play an important role for maintaining sufficient level of physical activity (PA) during life course. The purpose of this study was to examine the relationship between gross motor skills and PA in children when PA was analyzed by both metabolic‐ and neuromuscular‐based methods. Gross motor skills (KTK – Körperkoordinationstest für Kinder and APM inventory – manipulative skill test) of 84 children aged 5–8 years (53 preschoolers, 28 girls; 31 primary schoolers, 18 girls) were measured, and accelerometer‐derived PA was analyzed using in parallel metabolic counts and neuromuscular impact methods. The gross motor skills were associated with moderate‐to‐high neuromuscular impacts, PA of vigorous metabolic intensity, and mean level of PA in primary school girls (0.5 < r < 0.7, P < 0.05), and with high impacts in preschool girls (0.3 < r < 0.5, P < 0.05). In preschool boys, moderate impacts, light‐to‐vigorous PA, and mean level of PA were associated with gross motor skills (0.4 < r < 0.7, P < 0.05). In conclusion, the result emphasizes an important relationship between gross motor skills and PA stressing both metabolic and neuromuscular systems in children. Furthermore, PA highly stressing neuromuscular system interacts with gross motor proficiency in girls especially.     

Effects of a 2-year school-based daily physical activity intervention on cardiovascular disease risk factors: the Sogndal school-intervention study

The aim of this study was to investigate the effect of a 2-year school-based physical activity (PA) intervention in 9-year-old children on cardiovascular disease (CVD) risk factors. One intervention school (I-school) (n=125) and one control school (C-school) (n=131) were included. The children at the I-school carried out 60 min of PA daily. The PA lessons were planned, organized and led by expert physical education (PE) teachers. In the C-school, children were offered the normal 45 min of PE twice weekly. The intervention resulted in a greater beneficial development in systolic (P=0.003) and diastolic (P=0.002) blood pressure, total cholesterol-to-high-density lipoprotein cholesterol ratio (P=0.011), triglyceride (P=0.030) and peak oxygen uptake (P<0.001) in I-school children than in C-school children. No significant differences were observed in waist circumference, body mass index and the homeostasis model assessment for insulin resistance between the two groups. Furthermore, the intervention, primarily carried out at moderate intensity, had the strongest impact in children with the least favorable starting point. In conclusion, a daily school-based PA intervention can beneficially modify children's CVD risk profile if the intervention has sufficient duration and includes a substantial amount of daily PA, and if the PA is implemented by expert PE teachers.     

Retinal vascular diameters in relation to physical activity in Danish children — The CHAMPS Eye Study

Our objective was to determine associations between retinal vascular caliber and physical activity (PA ) in a school‐based child cohort. In a prospective study, we created a childhood cumulative average PA ‐index using objectively measured PA (accelerometry) assessed at four periods between 2009 and 2015. Cumulative exposure to PA intensities was estimated. Cross‐sectional examinations on biomarkers, anthropometry, and ophthalmological data including retinal fundus photographs were performed in 2015. Semi‐automated measurements of retinal vascular diameters were performed and summarized into central retinal arteriolar and venular equivalents (CRAE , CRVE ). We included 307 participants. Mean age in 2015 was 15.4 years (0.7). The mean CRAE and CRVE were 156.5 μm (2.8) and 217.6 μm (7.7), respectively. After adjusting for age, gender, and axial length, more time in PA was independently related to thinner retinal venules (β‐coefficient = −1.25 μm/%, 95% confidence interval = −2.20, −0.30, P  < .01). Sedentary time was associated with wider venules (P  < .01). Furthermore, birthweight (β‐coefficient = 0.56 μm/%, 95% confidence interval = 0.18, 0.95, P  < .01) was associated with CRVE . Blood pressure was associated with thinner retinal arterioles (β‐coefficient = −0.19 μm/mmHg, 95% confidence interval = −0.36, −0.01, P  = .04). We concluded that children with higher PA in childhood had thinner retinal venular caliber. Our results suggest that PA during childhood positively impacts the retinal microcirculation and that retinal vascular analysis may be a possible assessment to detect microvascular impairments in children with an increased risk of future cardiovascular disease.     

Fundamental movement skills and physical fitness as predictors of physical activity: A 6‐year follow‐up study

The purpose of this study was to examine the extent to which fundamental movement skills and physical fitness scores assessed in early adolescence predict self‐reported physical activity assessed 6 years later. The sample comprised 333 (200 girls, 133 boys; M age = 12.41) students. The effects of previous physical activity, sex, and body mass index (BMI) were controlled in the main analyses. Adolescents’ fundamental movement skills, physical fitness, self‐report physical activity, and BMI were collected at baseline, and their self‐report energy expenditure (metabolic equivalents: METs) and intensity of physical activity were collected using the International Physical Activity Questionnaire 6 years later. Results showed that fundamental movement skills predicted METs, light, moderate, and vigorous intensity physical activity levels, whereas fitness predicted METs, moderate, and vigorous physical activity levels. Hierarchical regression analyses also showed that after controlling for previous levels of physical activity, sex, and BMI, the size of the effect of fundamental movement skills and physical fitness on energy expenditure and physical activity intensity was moderate (R² change between 0.06 and 0.15), with the effect being stronger for high intensity physical activity.     

A Physical Education trial improves adolescents' cognitive performance and academic achievement: the EDUFIT study

To analyze the effects of an intervention focused on increasing the time and intensity of Physical Education (PE), on adolescents' cognitive performance and academic achievement. A 4‐month group‐randomized controlled trial was conducted in 67 adolescents from South‐East Spain, 2007. Three classes were randomly allocated into control group (CG), experimental group 1 (EG1) and experimental group 2 (EG2). CG received usual PE (two sessions/week), EG1 received four PE sessions/week and EG2 received four PE sessions/week of high intensity. Cognitive performance (non‐verbal and verbal ability, abstract reasoning, spatial ability, verbal reasoning and numerical ability) was assessed by the Spanish Overall and Factorial Intelligence Test, and academic achievement by school grades. All the cognitive performance variables, except verbal reasoning, increased more in EG2 than in CG (all P < 0.05). Average school grades (e.g., mathematics) increased more in EG2 than in CG. Overall, EG2 improved more than EG1, without differences between EG1 and CG. Increased PE can benefit cognitive performance and academic achievement. This study contributes to the current knowledge by suggesting that the intensity of PE sessions might play a role in the positive effect of physical activity on cognition and academic success. Future studies involving larger sample sizes should confirm or contrast these preliminary findings.     

Influence of a health education intervention on physical activity and screen time in primary school children: ‘Switch Off–Get Active’

Low levels of physical activity coupled with high levels of television viewing have been linked with obesity in children. The objective of this study was to assess the efficacy of 'Switch Off-Get Active', a 16-week controlled health education intervention, in increasing physical activity and reducing screen time and BMI in primary school children. A secondary objective was to compare children with high and low screen time. Participants were 312 children aged 10.2+/-0.7 years, attending nine schools in areas of social disadvantage. The 10-lesson, teacher-led intervention, conducted in spring 2003, emphasised self-monitoring, budgeting of time and selective viewing. Differences, adjusted for baseline values by ANCOVA, existed between intervention and control children at follow-up for self-reported physical activity (intervention +0.84 30 min blocks/day, 95%CI 0.11-1.57, p<0.05) and self-efficacy for physical activity (p<0.05) but not self-reported screen time (intervention--0.41 blocks/day, 95%CI--0.93-0.12, p=0.13) or BMI (p=0.63). Cross-sectional comparisons at baseline indicated lower physical activity, self-efficacy for physical activity and aerobic fitness and a higher BMI in children with high screen time. In conclusion, health education interventions can increase physical activity in primary school children but follow-ups of longer duration may be needed to demonstrate intervention effects on BMI.     

Physical benefits of expanded physical education in primary school: findings from a 3-year intervention study in Sweden

The aim of this study was to assess whether a school-based program with expanded physical education lessons was effective in increasing children's physical capacity and in preventing excessive weight gain in children. The study performed in 2000-2003 comprised 132 children, 73 boys and 59 girls at baseline 6-9 years and in follow-up 9-12 years, attending two different schools with a similar size, appearance and structure in a rural area. The norm school (N-school) followed the stipulated curricular time, one to two physical education lessons a week, while the intervention school (I-school) increased it to four lessons. More positive changes in physical index (the sum of the age-standardized results in 11 physical tests) were found among children in the I-school than in the N-school. The number of children who increased body mass index (BMI) increased in both schools, but a lower increase in BMI could be seen in the I-school. Expanded physical education lessons could increase physical status among both overweight and normal-weight children, in particular aerobic fitness. The weekly dose of physical activity must be higher than 40 min a day and must start earlier in children's life to be more effective in combating BMI increase.     

Effects of physical activity on executive functions,attention and academic performance in preadolescent children: a meta-analysis

Objectives

The aim of this meta-analysis was to provide a systematic review of intervention studies that investigated the effects of physical activity on multiple domains of executive functions, attention and academic performance in preadolescent children (6–12 years of age). In addition, a systematic quantification of the effects of physical activity on these domains is provided.

The KörperkoordinationsTest für Kinder: reference values and suitability for 6–12‐year‐old children in Flanders

An adequate coordination level in children is important for their general development, but also for health, psychosocial, academic and well‐being‐related reasons. In this study, the suitability of the KörperkoordinationsTest für Kinder (KTK) as an assessment instrument for the gross motor coordination was evaluated in 2470 children from 26 elementary schools for general education spread over the Flemish and Brussels‐capital region. All children performed four subtests: walking backwards (WB), moving sideways (MS), hopping for height (HH) and jumping sideways (JS). Age and gender‐specific values were established for the Flemish children anno 2008. Overall, the current sample scored significantly worse than their 1974 German counterparts (P<0.001). Score distribution showed 21% of the children being placed in the problematic range of gross motor coordination level. A decline in coordination was observed especially in those tasks relying primarily on coordinative capacities (WB and MS), while improvements or status quo in those tasks relying on strength and speed (JS and HH) were explained by secular trends. We suggest that the KTK is a valuable instrument for the assessment of the gross motor coordination of Flemish children and efforts should be made in order to face the decline in coordination.     

The physical activity level in children with asthma based on a survey among 7–16-year-old school children

The objective was to compare the physical activity level of children with asthma with that of non-asthmatic children. A standardized written questionnaire was administered in a survey of school children in three different areas of Norway: Oslo ( n =2577), Hallingdal ( n =831) and Odda ( n = 1177). Response rates were >85% in all areas, and approximately 50% of the respondents were female. No significant differences were found between the distributions in exercise frequency either for children reported ever to have had asthma ( P =0.8) or for those with current asthma ( P =0.3) compared to non-asthmatics. Similar results were found for exercise hours a week. More than 50% of all children took part in organized sport. The data suggest that asthmatic children are as physically active as their peers.     

Social background,bullying, and physical inactivity: National study of 11‐ to 15‐year‐olds

More children from lower social backgrounds are physically inactive than those from higher ones. We studied whether bullying was a mediating factor between lower social background and physical inactivity. We also examined the combined effect of low social class and exposure to bullying on physical inactivity. The Danish sample of the Health Behaviour in School‐aged Children (HBSC) study 2006 included 6269 schoolchildren in three age groups: 11‐, 13‐, and 15‐year‐olds from a random sample of 80 schools. The students answered the internationally standardized HBSC questionnaire. The applied definition leaves 4.0% in the category physically inactive. The sex and age‐adjusted OR (95% CI) for physical inactivity was 2.10 (1.39–3.18) among students with low social class and unclassifiable 3.53 (2.26–5.53). Exposure to bullying was associated with physical inactivity, sex and age‐adjusted OR = 2.39 (1.67–3.41). Exposure to bullying did not explain the association between social class and physical inactivity. The association between social class and physical inactivity was more pronounced among participants also exposed to bullying. In conclusion, there was a significantly increased odds ratio for physical inactivity among students from lower social classes and for students exposed to bullying. There was a combined effect of low social class and bullying on physical inactivity.     

Testing the effect of text messaging cues to promote physical activity habits: a worksite‐based exploratory intervention

This study aims to test the efficacy of text messaging cues (SMS) to promote physical activity (PA) habit formation in the workplace. Employees (N = 49; 28 females and 21 males, Mage = 47.5 ± 8.29 years) were randomized into two parallel groups: a PA group enrolled in a 28‐week supervised PA program and a PA+SMS group enrolled in the same PA program with text messaging cues received before their PA sessions. The exercise habit was assessed every week from self‐reports on an online application. PA maintenance and several physical fitness measures were also assessed prior to and after the intervention to evaluate its general impact. Mixed model analysis of the 603 observations indicated a small but significant effect of the SMS cues on the speed at which participants engaged in PA behaviors, as the significant interaction effect revealed that the slope of the exercise habit over time was slightly steeper in the PA+SMS group (B = 0.0462, P = 0.0001) than in the PA group (B = 0.0216, P = 0.01). SMS delivery had a marginal effect on the maintenance of PA behaviors 1 year after the intervention. The results suggest that text messaging can help to form PA habits at the workplace and might facilitate long‐term maintenance of PA behaviors.     

Correlates of children's compliance with moderate‐to‐vigorous physical activity recommendations: a multilevel analysis

This study aimed to investigate the association between individual and school characteristics associated with the number of school days children comply with moderate‐to‐vigorous physical activity (MVPA) recommendations. Sample comprises 612 Portuguese children, aged 9–11 years, from 23 schools. Time spent in MVPA was measured by accelerometry, while individual‐level correlates were obtained by anthropometry and questionnaires. School‐level variables were collected by questionnaire, and accelerometer wear time and season were also considered. Maximum likelihood estimates of model parameters were obtained via a multilevel analysis with children as level‐1, and school as level‐2. Children who spent more time in sedentary activities and girls were less likely to comply with MVPA/daily. More mature children and those who use active transportation to school were more likely to attain the PA recommendation. Furthermore, greater accelerometer wear time and spring season increased the chance to achieve the recommended MVPA. In terms of school‐level correlates, a greater number of available facilities was negatively associated with children MVPA compliance. Given the set of variables, our results showed that individual characteristics seem to be more relevant for children's compliance rates with PA/day than school context variables, which should be taken into account in the implementation of school policies and practices.