Physical Activity, Fitness, and Executive Functions in Youth: Effects, Moderators, and Mechanisms

Short, frequent physical activity breaks improve working memory while preserving cerebral blood flow in adolescents during prolonged sitting - AbbaH teen, a randomized crossover trial

PURPOSE

Physical activity (PA) breaks during school lessons have been suggested as a promising strategy to improve working memory performance in children and adolescents. There is a lack of studies investigating the underlying physiological mechanisms of PA on cognition, especially among adolescents. This study aimed to investigate the effects of different types of short frequent PA on adolescents' cognitive task-related changes in cerebral blood flow in the prefrontal cortex (PFC) and working memory performance compared to prolonged sitting.

METHODS

In this randomized crossover study, adolescents visited the laboratory on three different occasions for 80-minute sessions of prolonged sitting interrupted by four breaks for three minutes of simple resistance training (SRA), step-up at a pre-determined pace (STEP), or remaining seated (SOCIAL). Before and after each session, cognitive task-related changes in cerebral blood flow (oxygenated-hemoglobin, Oxy-Hb) during working memory tasks (1-, 2-, 3-back tests) were measured using functional near-infrared spectroscopy in the PFC. Accuracy and reaction time were derived from the working memory tasks. Linear mixed-effect models were used to analyze the data.

RESULTS

A total of 17 students participated (mean age 13.6 years, 11 girls). Significant time x condition interactions were noted for Oxy-Hb in the most demanding working memory task (3-back), with a decrease following prolonged sitting in the SOCIAL condition compared to both the SRA (β 0.18, 95% CI 0.12, 0.24) and the STEP (β 0.11, 95% CI 0.05, 0.17). This was observed in parallel with improvements in reaction time following SRA (β -30.11, 95% CI -59.08, -1.13) and STEP (β -34.29, 95% CI -69.22, 0.63) although this was only significant for the SRA and no improvements in the SOCIAL condition.

CONCLUSION

We found that short frequent PA breaks during prolonged sitting among adolescents can prevent the decrease in cognitive task-related changes in cerebral blood flow that occur following prolonged sitting. This was observed simultaneously with improvements in working memory, indicating that changes in cerebral blood flow could be one factor explaining the effects on working memory. Future studies should investigate the efficacy of implementing these PA breaks in schools.

TRIAL REGISTRATION

Retrospectively registered on 21/09/2020, ClinicalTrial (NCT04552626).

Physical activity intervention improves executive function and language development during early childhood: The active early learning cluster randomized controlled trial

This study aimed to determine the effects of the Active Early Learning (AEL) childcare center-based physical activity intervention on early childhood executive function and expressive vocabulary via a randomized controlled trial. Three-hundred-and-fourteen preschool children (134 girls) aged 3-5 years from 15 childcare centers were randomly assigned to the intervention (8 centers; n = 170 children) or control group (7 centers, n = 144 children) in May 2019. Participants were mostly Australian (85%) and from slightly higher areas of socio-economic status than the Australian average. There was an AEL intervention effect on inhibition (β = 0.5, p = .033, d = 0.29) and expressive vocabulary (β = 1.97, p = .001, d = 0.24). Integration of the AEL physical activity intervention into the daily childcare routine was effective in enhancing children's executive function and expressive language development.

Associations of physical activity dose and movement quality with executive functions in socioeconomically disadvantaged children aged 5-6 years

BACKGROUND

Growing up in areas of high deprivation can negatively impact children's movement behaviours and cognitive development. Enhancing the quantity and quality of children's movement experiences is believed to enhance cognitive development. This study investigated the association of three different modes of movement assessment, movement proficiency and divergent movement ability (collectively understood as motor competence) and PA dose with executive function in a low socio-economic demographic. Demographics, motor competence, and a combination of motor competence and physical activity were hypothesized to be significantly predictor of executive functions.

METHOD

In this cross-sectional study, 360 children aged 5-6 years from deprived areas were assessed using three movement assessments: wrist-worn accelerometery for physical activity dose, Test of Gross Motor Development-3 for movement proficiency, and divergent movement assessment. Executive function, including inhibitory control, working memory, and cognitive flexibility, was measured using the NIH Toolbox on an iPad. Multiple linear regression models were designed to evaluate the independent and combined association of demographics, movement competence and physical activity variables with executive function.

RESULTS

The regression analysis, with demographic factors only, explained 12% of EF variance (r2 = 0.12 95%CI 0.06-0.18). In addition to this demographics the model with divergent movement explained 19% of EF variance (r2 = 0.19 95% CI = 0.12-0.28), the model with movement proficiency explained 16% of EF variance (r2 = 0.16 95% CI = 0.08-0.26) and the model with PA dose explained 13% of EF variance (r2 = 0.13 95% CI = 0.07-0.20). In these models both divergent movement and proficiency were significant predictors, whilst physical activity variables were not. The final models, combining motor competence and physical activity variables, explained 24% and 23% of EF variance (r2 = 0.24 CI = 0.14-0.33 and r2 = 0.23 CI = 0.14-0.32). In these models, motor competence variables were significant predictors, and only vigorous physical activity and Euclidean Norm Minus One emerged as significant PA dose predictors.

DISCUSSION

These findings emphasise that motor competence and physical activity variables better predict executive functions when they are combined. When considered individually both motor competence variables were significant predictors of executive function whilst physical activity variables were not. Importantly, among the two movement competence facets, divergent movement assessment exhibited the strongest association with executive function. Future interventions should consider how to facilitate both movement and cognitive development in children. Future interventions should consider both the interplay of movement quality and quantity and the importance of environments that invite children's exploratory movement behavior.

Acute exercise and children's cognitive functioning: What is the optimal dose of cognitive challenge?

Acute bouts of exercise have the potential to benefit children's cognition. Inconsistent evidence on the role of qualitative exercise task characteristics calls for further investigation of the cognitive challenge level in exercise. Thus, the study aim was to investigate which "dose" of cognitive challenge in acute exercise benefits children's cognition, also exploring the moderating role of individual characteristics. In a within-subject experimental design, 103 children (Mage = 11.1, SD = 0.9, 48% female) participated weekly in one of three 15-min exergames followed by an Attention Network task. Exergame sessions were designed to keep physical intensity constant (65% HRmax) and to have different cognitive challenge levels (low, mid, high; adapted to the ongoing individual performance). ANOVAs performed on variables that reflect the individual functioning of attention networks revealed a significant effect of cognitive challenge on executive control efficiency (reaction time performances; p = .014, ƞ2p = .08), with better performances after the high-challenge condition compared to lower ones (ps < .015), whereas alerting and orienting were unaffected by cognitive challenge (ps > .05). ANOVAs performed on variables that reflect the interactive functioning of attention networks revealed that biological sex moderated cognitive challenge effects. For males only, the cognitive challenge level influenced the interactive functioning of executive control and orienting networks (p = .004; ƞ2p = .07). Results suggest that an individualized and adaptive cognitively high-challenging bout of exercise is more beneficial to children's executive control than less challenging ones. For males, the cognitive challenge in an acute bout seems beneficial to maintain executive control efficiency also when spatial attention resources cannot be validly allocated in advance. Results are interpreted referring to the cognitive stimulation hypothesis and arousal theory.

The Effects of Cognitively Challenging Physical Activity Games versus Health-Related Fitness Activities on Students' Executive Functions and Situational Interest in Physical Education: A Group-Randomized Controlled Trial

This study compared cognitively challenging physical activity games and health-related fitness activities in terms of their effects on students' executive functions and situational interest in physical education. A total of 102 fourth- and fifth-grade students (56 boys, 46 girls) participated in this study. A group-randomized controlled trial design involving an acute experiment was used. Two intact classes of students (one fourth-grade and one fifth-grade) were randomly assigned to each one of the three groups. Students in Group 1 participated in cognitively challenging physical activity games, students in Group 2 participated in activities for developing their health-related fitness, and Group 3 students were the control group without physical education. Executive functions were measured pre- and post-intervention with the design fluency test, whereas situational interest was only measured post-intervention with the situational interest scale. Group 1 students who played cognitively challenging physical activity games had increased their executive functions' scores more than the Group 2 students involved in health-related fitness activities. Students of both these groups outperformed control group students. Moreover, Group 1 students reported higher levels of instant enjoyment and total interest than Group 2 students. The results of this study suggest that cognitively challenging physical activity games can be an effective means for enhancing executive functions, and motivate students to be involved in interesting and enjoyable forms of physical activity.

Acute Effects of Exergaming on Students' Executive Functions and Situational Interest in Elementary Physical Education

Two studies were conducted to examine the acute effects of exergaming on students' executive functions and to explore their situational interest regarding these games in elementary physical education. The first study involved a two-group, repeated measures, cross-over quasi-experimental design. Participants were 74 (36 boys) fourth- and fifth-grade students who were assigned to the experimental (38 students) and the waiting list control (36 students) group. The single physical education session with exergames was first implemented with the initial experimental group and after the post-test, the waiting list control group received the intervention. In the second study, a pre-test post-test, within-subjects design was involved with the experimental group students (48 fourth- and fifth-grade students, 27 boys) who participated in a booster single physical education session with exergames two months after their involvement in a four-week intervention with cognitively challenging physical activity games. Both studies involved pre- and post-intervention measures for executive functions using the design fluency test and a post-test measure for situational interest. During the acute session, students had to follow the movements of an on-screen dancing character in time to a chosen song of the Just Dance 2015 exergame. The results of the first study showed that experimental group students improved significantly from pre- to post-test their scores in design fluency and in cognitive flexibility and in the total score of the design fluency test and their improvements were higher compared to the waiting list control group. The waiting list control group students, after receiving the acute session with exergames, significantly improved their scores in design fluency, inhibition, and cognitive flexibility and in the total score of the design fluency test compared to their pre-intervention scores. Moreover, the second study showed that students' total score in the design fluency test improved significantly from pre- to post-intervention. In both studies, students reported generally high scores in all subscales of the situational interest questionnaire. These results suggested that an acute exergame-based physical education session attracted students' interest and positively triggered their executive functions.

Exercise as therapy for neurodevelopmental and cognitive dysfunction in people with a Fontan circulation: A narrative review

People with a Fontan circulation are at risk of neurodevelopmental delay and disability, and cognitive dysfunction, that has significant implications for academic and occupational attainment, psychosocial functioning, and overall quality of life. Interventions for improving these outcomes are lacking. This review article discusses current intervention practices and explores the evidence supporting exercise as a potential intervention for improving cognitive functioning in people living with a Fontan circulation. Proposed pathophysiological mechanisms underpinning these associations are discussed in the context of Fontan physiology and avenues for future research are recommended.

The Effects of a Cognitively Challenging Physical Activity Intervention on School Children's Executive Functions and Motivational Regulations

This study examined the effects of a physical education intervention consisting of cognitively challenging physical activity games on school children's executive functions and motivational regulations. Ninety-nine fourth- and fifth-grade children participated in this two-group, repeated measures, quasi-experimental study with a cross-over design. Children's executive functions (measured with the design fluency and Stroop and flanker tests) and motivational regulations were measured pre- and post-intervention and one month later. At post-test, the experimental group children outperformed the waiting-list control group children in all design fluency test conditions and accuracy in the Stroop and flanker tests. Both groups improved from pre- to post-intervention their speed (reaction time) in the Stroop and flanker tests. The waiting-list control group children, after receiving the intervention, improved their performance in the executive function tests except for Stroop test accuracy and flanker test speed. The positive effects were reduced significantly one month after the end of the intervention but remained significantly higher compared to pre-intervention. No intervention effects were found for the motivational regulations. These results showed that the intervention had positive effects on children's executive functions and supported the new shift of designing physical activity programs for developing combinedly children's physical and cognitive development.

Do Physical Fitness and Executive Function Mediate the Relationship between Physical Activity and Academic Achievement? An Examination Using Structural Equation Modelling

Background: Physical activity health benefits are widely known. However, the association between physical activity, physical fitness, executive function, and academic performance need further investigation. Additionally, one of the literature gaps reveals scarce and mixed findings on what mediators of physical activity may affect academic achievement. Purpose: This investigation aims to provide knowledge about the mediation role of physical fitness and executive function in the association of physical activity with academic achievement in a cohort of Spanish schoolchildren using a structural equation modelling approach. Methods: The data for this cross-sectional study were collected from a convenience sample of children from Spain (Balearic Islands) aged between 9 and 13 years. Physical activity levels were self-reported with the Physical Activity Questionnaire for Children; physical fitness was assessed using the International Fitness Scale; executive function was assessed with the Trail Making Test, and children’s achievements were collected from the school records. Structural equation modelling was used to explore the relationship between physical activity, physical fitness, executive function, and academic achievement. Findings: Statistically significant positive direct associations were observed between physical activity and physical fitness (β = 0.46, 95% CI [0.29, 0.64]), physical fitness and executive function (β = 0.28, 95% CI [0.04, 0.52]), and executive function and academic achievement (β = 0.46, 95% CI [0.28, 0.65]), while adjusting for the confounding effects of sex and body mass index. Furthermore, indirect associations were observed between physical activity and executive function mediated by physical fitness (β = 0.13, bias-corrected 95% CI [0.02, 0.31]) and between physical fitness and academic achievement through executive function (β = 0.13, bias-corrected 95% CI [0.03, 0.32]). Conclusions: This investigation adds to the literature with evidence supporting the idea that regular PA leads to improvements in physical fitness and may support cognitive skills and academic performance in children.