Background, rationale, and methodological overview of the REACT project-return-to-action on growth, motor development, and health after the COVID-19 pandemic in primary school children

Is there an association between proficiency in fundamental movement skills and mderate-to-vigorous physical activity in childhood on weekdays and weekends? The REACT project

OBJECTIVE

The present study probes into the association between children's fundamental movement skills (FMS) and moderate-to-vigorous physical activity (MVPA) during weekdays and weekends.

METHODS

This cross-sectional sample included 1014 children aged 6-10 years from the REACT project. Physical activity was assessed with accelerometry, and five FMS (stationary dribble, kick, catch, overhand throw, and underhand roll) were assessed with the digital platform Meu Educativo®. Three groups were formed based on the frequency of FMS that each child mastered: group 1 (wizard level in four or five FMS); group 2 (wizard level in two or three FMS); and group 3 (wizard level in at most one skill). Multilevel models were used to analyze the data treating children (level-1) nested within schools (level-2).

RESULTS

Compared to group 1, groups 2 (-12.9 ± 2.3 min day-1) and 3 (-23.9 ± 2.4 min day-1) were less physically active during weekdays and weekends (group 2: -14.7 ± 2.7 min day-1 and group 3: -22.4 ± 2.9 min day-1), independent of age and sex. There was a decline in MVPA during the weekend. Further, on average, boys were more active than girls, and with increasing age, children were less active.

CONCLUSION

On average, children with higher FMS levels are generally more physically active than their peers with lower FMS levels. Even though MVPA tends to decline on weekends, FMS proficiency is a significant factor in maintaining 60 min of MVPA on weekends.

Individual and school correlates of body mass index and cardiorespiratory fitness in primary school children from the REACT project: A multivariate multilevel analysis

OBJECTIVE

This paper examines the relationship between body mass index (BMI) and cardiorespiratory fitness (CRF) using a multivariate multilevel approach and investigates the links between individual and school-related correlates with children's BMI and CRF.

METHODS

This cross-sectional sample included 1014 children (6-10 years) from 25 Portuguese primary schools. BMI was calculated, and CRF was assessed with the PACER test. Fundamental movement skills (FMS) included five object control tasks. Moderate-to-vigorous physical activity (MVPA), sleep, and sedentary time were assessed with the ActiGraph wGT3X-BT accelerometer. Socioeconomic status (SES) and school variables were also obtained. A multivariate multilevel model was used, and alpha was set at 5%.

RESULTS

BMI and CRF systematically increased with age. Most of the joint variance (94.4%) was explained at the child level, and BMI and CRF were correlated at this level (ρ = -.37). More active children demonstrated higher CRF levels and had lower BMI levels; sedentary and sleep time were not significantly associated with BMI or CRF. FMS were positively associated with CRF but were not significantly associated with BMI. Children at higher SES were more fit and had lower BMI than their peers of lower SES. Finally, school-level variables were not significantly related to BMI and CRF.

CONCLUSION

BMI and CRF had a low but statistically significant negative correlation in this sample of children. Most of the variation in BMI and CRF was explained by child-level characteristics.

Validity and reliability of Meu Educativo®: A new tool to assess fundamental movement skills in school-aged children

OBJECTIVES

There is evidence showing that children's proficiency in fundamental movement skills (FMS) is positively related to weight status, physical activity, fitness levels, cognitive development, as well as academic performance. Yet, the feasibility of FMS assessment is challenging, especially with relatively large samples of children. This article presents a new tool named Meu Educativo® to assess children's FMS levels, including its validity and reliability.

METHODS

We relied on the validity evidence approach based on test content to develop the FMS assessment checklist and the rating system with a team of experts. In this article, we used five FMS (stationary dribbling, kick, overhand throw, catch the ball, and underhand roll). Further, we conducted a series of reliability studies and used percent agreement and Cohen's kappa (κ) as statistics.

RESULTS

Experts agreed highly on the checklist's components in the five FMS. Inter-rater reliability ranged from 0.63 for stationary dribbling to 0.93 for overhand throw, and the intra-rater reliability ranged from 0.46 to 0.94.

CONCLUSION

Based on the first results, Meu Educativo® was not only easy to use, but was also a reliable tool for FMS assessments. Notwithstanding the need for future studies, Meu Educativo® is a new tool that can be used by teachers, coaches, and motor development specialists dealing with school-aged children and researchers working with large samples.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Sleep and fundamental movement skills in primary schoolchildren: The REACT project

OBJECTIVE

Whether sleep is related to fundamental movement skills (FMS) in the pediatric population is largely unknown. The objective of this study was to examine the association between sleep characteristics (duration, efficiency, regularity) and FMS proficiency levels in school-aged children.

METHODS

This cross-sectional study included 996 children (mean age: 8.3 ± 1.2 years) from 25 of the 32 primary schools in Matosinhos, northern Portugal. Data collection occurred between January and June 2022. Sleep was assessed using an ActiGraph wGT3X-BT accelerometer worn on the wrist for 7 consecutive days. FMS proficiency levels were assessed in the schools with a new digital platform (Meu Educativo®) that evaluated five object control skills (dribble, kick, catch, throw, and underhand roll), with a total score ranging between 5 and 15. Multilevel ordinal logistic regression was used to test the associations between sleep characteristics and FMS proficiency levels. Covariates included age, sex, body mass index z-score, socioeconomic status, and moderate-to-vigorous physical activity.

RESULTS

The results showed that sleep characteristics (duration, efficiency, and regularity) were not related to FMS proficiency. Being a boy, older age, and higher moderate-to-vigorous physical activity levels were all significantly associated with better FMS proficiency levels. There were no significant sex-by-age interactions.

CONCLUSION

Sleep was not found to be related to FMS performance in children. This finding suggests that sleep is not a good correlate of FMS proficiency levels in school-aged children, and attention should be dedicated to other more important factors such as skill-learning-specific physical activity.

A multivariate multilevel approach to unravel the associations between individual and school factors on children's motor performance in the REACT project

OBJECTIVE

The aim was to (1) estimate the relationship between physical fitness (PF) and object control fundamental movement skills (FMS), (2) identify child characteristics that relate with PF and FMS, and (3) examine associations between the school environment, PF, and FMS.

METHODS

The sample included 1014 Portuguese children aged 6-10 years from the REACT project. PF was assessed via running speed, shuttle run, standing long jump, handgrip, and the PACER test. Object control FMS were assessed with stationary dribble, kick, catch, overhand throw, and underhand roll. Test performances were transformed into z-scores, and their sum was expressed as overall PF and FMS. Child-level variables included body mass index (BMI) z-scores, accelerometer-measured sedentary time and moderate-to-vigorous physical activity, and socioeconomic status (SES). School size, physical education classes, practice areas, and equipment were also assessed.

RESULTS

Approximately, 90% of the variance in object control PF and FMS was at the child level, and 10% at the school level. The correlation between PF and object control FMS was .62, which declined to .43 with the inclusion of covariates. Older, more active, and higher SES children had higher object control PF and FMS, and boys outperformed girls. BMI was negatively associated with PF but not with object control FMS. Sedentary time and number of physical education classes were not significant predictors. Most school predictors did not jointly associate with PF and object control FMS.

CONCLUSION

PF and object control FMS z-scores were moderately related. Not all child characteristics were associated with both PF and object control FMS, and their effect sizes were different. School characteristics only explained 10% of the total variation in PF and object control FMS.

Statistical analysis of the longitudinal fundamental movement skills data in the REACT project using the multilevel ordinal logistic model

OBJECTIVES

The REACT project was designed around two main aims: (1) to assess children's growth and motor development after the COVID-19 pandemic and (2) to follow their fundamental movement skills' developmental trajectories over 18 months using a novel technological device (Meu Educativo®) in their physical education classes. In this article, our goal is to describe statistical analysis of the longitudinal ordinal motor development data that was obtained from these children using the multilevel ordinal logistic model.

METHODS

Longitudinal ordinal data are often collected in studies on motor development. For example, children or adolescents might be rated as having poor, good, or excellent performance levels in fundamental movement skills, and such ratings may be obtained yearly over time to assess changes in fundamental movement skills levels of performance. However, such longitudinal ordinal data are often analyzed using either methods for continuous outcomes, or by dichotomizing the ordinal outcome and using methods for binary data. These approaches are not optimal, and so we describe in detail the use of the multilevel ordinal logistic model for analysis of such data from the REACT project. Our intent is to provide an accessible description and application of this model for analysis of ordinal motor development data.

DISCUSSION

Our analyses show both the between-subjects and within-subjects effects of age on motor development outcomes across three timepoints. The between-subjects effect of age indicate that children that are older have higher motor development ratings, relative to thoese that are younger, whereas the within-subject effect of age indicates higher motor development ratings as a child ages. It is the latter effect that is particularly of interest in longitudinal studies of motor development, and an important advantage of using the multilevel ordinal logistic model relative to more traditional methods.