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

Comparative efficacy of physical activity types on executive functions in children and adolescents: A network meta-analysis of randomized controlled trials

OBJECTIVES

This study investigates the impact of various physical activity (PA) types on executive functions (EFs) in children and adolescents.

DESIGN

A systematic review and network meta-analysis of randomized clinical trials.

METHODS

We searched databases such as PubMed, Embase, Cochrane, and Web of Science up to April 2023, including randomized controlled trials involving 6 distinct PA types for healthy children and adolescents. The Cochrane risk of bias tool was used to assess the risk of bias, and a random-effects model in STATA 17.0 was used to calculate standardized mean differences (SMDs) and 95 % confidence intervals (CI).

RESULTS

Ball Games emerged as the most effective modality for improving updating accuracy, securing a SUCRA score of 94.4 %, and for reducing inhibition reaction time, with a SUCRA score of 94.8 %. Cognitively Engaging Physical Activity led in improving inhibition accuracy with a SUCRA score of 71.7 %. Dance excelled in improving update accuracy and reducing shifting reaction time, with SUCRA scores of 86.6 % and 99.5 %, respectively.

CONCLUSIONS

PA has a significant benefit in EFs in children and adolescents, however the size of the effect varies by type of PA. Ball Games emerged as the most efficacious modality for enhancing updating accuracy and for expediting inhibition reaction time. Cognitively Engaging Physical Activity proved to be the preeminent strategy for improving inhibition accuracy. Dance was distinguished as the optimal approach for improving updating accuracy and reducing shifting reaction time.

Effects of a Complex Physical Activity Program on Children's Arithmetic Problem Solving and Arithmetic Reasoning Abilities

Research has shown that higher levels of physical activity are associated with better cognitive performance in children. However, the benefits of physical activity on academic achievement and specifically on mathematics performance need to be further explored. Therefore, this study aimed to investigate the effects of a complex physical activity (CPA) intervention program, including cognitive involvement, on children’s mathematics performance. The participants were 128 children (aged 12−13 years) attending third grade in three middle schools. They were randomly allocated into a CPA intervention (n = 64) or a waitlist control group (n = 64), the latter of which was given a regular and easy-to-perform activity program. At baseline and after the intervention, students’ physical fitness was measured using a battery of standardized motor tests (20 m shuttle run test, curl-up test, push-up test, and sit and reach test). In addition, the AC-MT 11-14 test was administered to allow a standardized and comprehensive assessment of arithmetic problem-solving and arithmetic reasoning abilities. In comparison to the control, the intervention group showed significant improvements (p < 0.001) in comprehension and production (d = 1.88), arithmetic reasoning (d = 2.50), and problem solving (d = 1.32), as well as in 20 m shuttle run test (d = 1.81), push-up test (d = 1.88), curl-up (d = 3.52), and sit and reach (d = 2.52). No significant changes were found in the control group. In conclusion, findings showed that a 12-week CPA intervention program can improve mathematical performance in children in the third grade of middle school. CPA intervention may be an effective method to improve academic performance and avoid student failure.

Stand up, stand out. Feasibility of an active break targeting prolonged sitting in university students

ObjectiveTo assess the acceptability, appropriateness, and feasibility of an active break designed to disrupt prolonged sitting in university students. Participants: Students attending lectures in Trinity College Dublin, Ireland. Methods: Participants took part in an active break, which consisted of following a short exercise video lasting ∼4 min. They then completed a validated questionnaire consisting of 12 statements with two open-ended questions capturing likes/dislikes. Results: Overall 106 (response rate 96%) predominately female (83%, n = 87), health sciences students (91%, n = 96) participated. Percentage agreement ranged from 93.4% (n = 99) to 96.2% (n = 102) for acceptability, 84.9% (n = 90) to 93.4% (n = 99) for appropriateness, and 80.2% (n = 85) to 96.2% (n = 102) for feasibility. Space constraints and warm temperatures impacted negatively. Conclusion: An active break delivered during lectures is an acceptable and feasible intervention to disrupt sitting in students. Further investigation using a broader representation of the university population is needed prior to implementation.

Play Smart, Be Smart? Effect of Cognitively Engaging Physical Activity Interventions on Executive Function among Children 4~12 Years Old: A Systematic Review and Meta-Analysis

This paper aims to collect a compendium of randomized controlled trials (RCTs) exploring the effects of cognitively engaging physical activity (PA) interventions (basketball and floorball) on various domain-specific executive functions (EFs) in children aged 4 to 12. Following the PRISMA principle, 11 articles (total sample size: 2053) were analyzed for effect size and moderating impact with Stata 13.0 software. Overall EFs (SMD = 0.21, 95% CI 0.10 to 0.32, p < 0.05), updating (SMD = 0.17, 95% CI 0.03 to 0.30, p < 0.05) and shifting (SMD = 0.32, 95% CI 0.02 to 0.61, p < 0.05) were enhanced by cognitively engaging PA interventions. Age and BMI were found to have no effect on overall EFs performance in Meta regression. Overall EFs performance was improved by interventions with a session length (≥35 min) (SMD = 0.30, 95 % CI 0.10 to 0.49, p = 0.033). The review suggests that despite the moderate effect sizes, cognitively engaging PA may be an effective approach to improving EFs in children aged 4 to 12, especially updating and shifting.

The feasibility and acceptability of a classroom-based physical activity program for children attending specialist schools: a mixed-methods pilot study

BACKGROUND

Children with disabilities often engage in less than the recommended amount of daily physical activity (PA). Classroom-based PA breaks are a favourable method of promoting PA for children. However, evaluations of these programs in specialist schools are scarce, with even less research into their feasibility and acceptability. This may hinder effective implementation and program scalability. This pilot study investigated the feasibility and acceptability of implementing a classroom-based PA break program in Australian specialist school classrooms, using the Australian Joy of Moving (AJoM) program.

METHODS

Forty primary/junior classes and their teachers across five specialist schools implemented the AJoM program for eight weeks as the intervention group within a pilot cluster randomised controlled trial. A mixed-methods design investigated classroom teachers' (N = 22; 6 males, 16 females) perspectives of the feasibility and acceptability of the program after implementation through semi-structured telephone interviews (n = 7 teachers), qualitative survey responses (n = 18 teachers) and quantitative survey items (n = 19 teachers). Qualitative data were analysed using predominantly deductive thematic analysis. Quantitative data were analysed using descriptive statistics.

RESULTS

Classroom-based PA breaks may be feasible for getting children with disabilities more active at school. However, considerable variation exists in teachers' perception of the AJoM experience. While several teachers indicate that the program content could be pertinent for their class, common divergences in perceptions of feasibility and acceptability appear to relate to the age and developmental level or needs of the students in the class.

CONCLUSIONS

This study provides preliminary evidence for the feasibility and acceptability of implementing classroom-based PA breaks in specialist schools. However, results demonstrate the importance of (1) allowing a high level of flexibility in the design and implementation of programs to meet the varying needs of class groups and (2) providing a large variety of resources to cater to the heterogeneity of the children.

TRIAL REGISTRATION

This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12619000193178 ) on 11 February 2019.

Investigating Relationships between Preschool Children's Perceived Competence, Motor Skills, and Physical Activity: A Cross-Lagged Panel Model

Background: Motor skill competence (MSC) and perceived competence (PC) are primary correlates that are linked with physical activity (PA) participation, yet there is limited evidence of the mutual longitudinal or temporal associations between these variables in preschoolers. Therefore, this study’s purpose was to examine the bidirectional relationships between MSC and PA, MSC and PC, and PC and PA in preschoolers over time. Methods: The final sample were 61 preschoolers (M_age = 4.45 years, ranging from 4 to 5) from two underserved schools. MSC was assessed using the Test of Gross Motor Development, Second Edition (TGMD-2). PC was assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children. PA was assessed using ActiGraph GT9X Link accelerometers during three consecutive school days. All assessments of MSC, PC, and PA were measured in identical conditions at schools at the baseline (T1) and the end of the eighth week (T2). We employed a cross-lagged model approach to understand the bidirectional relationships between MSC, PC, and PA. Results: The results showed that T1 MSC significantly predicted T2 MSC (p < 0.01) and T1 MSC significantly predicted T2 PA only in girls (p = 0.03). Additionally, a cross-lagged effect of T1 MSC and T2 PC was only observed in boys (p = 0.03). Lastly, a significant association for T1 moderate-to-vigorous physical activity (MVPA) and T2 PC was only observed in girls (p = 0.04). Conclusions: Bidirectional relationships between the variables were not observed in preschoolers. However, significant gender differences were observed in each cross-lagged model.

Behaviours that prompt primary school teachers to adopt and implement physically active learning: a meta synthesis of qualitative evidence

BACKGROUND

Physically active learning (PAL) - integration of movement within delivery of academic content - is a core component of many whole-of-school physical activity approaches. Yet, PAL intervention methods and strategies vary and frequently are not sustained beyond formal programmes. To improve PAL training, a more comprehensive understanding of the behavioural and psychological processes that influence teachers' adoption and implementation of PAL is required. To address this, we conducted a meta-synthesis to synthesise key stakeholders' knowledge of facilitators and barriers to teachers' implementing PAL in schools to improve teacher-focussed PAL interventions in primary (elementary) schools.

METHODOLOGY

We conducted a meta-synthesis using a five-stage thematic synthesis approach to; develop a research purpose and aim, identify relevant articles, appraise studies for quality, develop descriptive themes and interpret and synthesise the literature. In the final stage, 14 domains from the Theoretical Domain Framework (TDF) were then aligned to the final analytical themes and subthemes.

RESULTS

We identified seven themes and 31 sub-themes from 25 eligible papers. Four themes summarised teacher-level factors: PAL benefits, teachers' beliefs about own capabilities, PAL teacher training, PAL delivery. One theme encompassed teacher and school-level factors: resources. Two themes reflected school and external factors that influence teachers' PAL behaviour: whole-school approach, external factors. Ten (of 14) TDF domains aligned with main themes and sub-themes: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, Beliefs about Consequences, Reinforcement, Goals, Environmental Context and Resources, Social influences and Emotion.

CONCLUSIONS

Our synthesis illustrates the inherent complexity required to change and sustain teachers' PAL behaviours. Initially, teachers must receive the training, resources and support to develop the capability to implement and adapt PAL. The PAL training programme should progress as teachers' build their experience and capability; content should be 'refreshed' and become more challenging over time. Subsequently, it is imperative to engage all levels of the school community for PAL to be fully integrated into a broader school system. Adequate resources, strong leadership and governance, an engaged activated community and political will are necessary to achieve this, and may not currently exist in most schools.

Pedagogical Proposal of Tele-Exercise Based on "Square Stepping Exercise" in Preschoolers: Study Protocol

Early childhood education aims to achieve the motor, cognitive, emotional, and social development of preschoolers by providing them with a variety of learning opportunities. The square-stepping exercise (SSE) is a balance and lower limb strength training programme used to prevent falls and stimulate cognitive function in older adults. This project aims to propose an SSE tele-exercise (Tele-SSE) protocol to evaluate its effects on the motor and cognitive development of children aged between 3 and 6 years. A randomized controlled trial with experimental (Tele-SSE) and control (general education) groups will be carried out. The application of Tele-SSE will be performed for 9 months (three times per week) and one additional follow-up after the intervention at the beginning of the next academic year. One-hundred and two preschoolers will be recruited and randomly distributed into the two groups: experimental (n = 51) and control (n = 51). Although the main outcome will be balance due to the nature of the SSE, outcomes will include physical and motor (body mass index, waist circumference, handgrip and lower-limb strength, speed-agility, and cardiorespiratory fitness) and cognitive (executive functions and attention, episodic memory, and language assessment, using the Fitness Assessment in the Preschool Battery (PREFIT) and The National Institutes of Health Toolbox—Early Childhood Cognition Battery. This project aims to improve cognitive and motor skills in preschoolers aged between 3 and 6 years old, based on a 9-month Tele-SSE intervention. If this intervention proves to be effective, it could be implemented in those centres, entities and associations specializing in early childhood education.

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.

Effects of classroom-based active breaks on cognition, sitting and on-task behaviour in children with intellectual disability: a pilot study

BACKGROUND

Classroom-based active breaks can help typically developing children reduce sitting, increase physical activity and improve cognitive functions and on-task behaviour. Yet, this strategy has not been tested in children with intellectual disability (ID) - a population who are insufficiently active. This study aimed to investigate the effects of a 5-week active breaks intervention on cognitive functions and on-task behaviour in schoolchildren with ID.

METHODS

Twenty-four children, aged between 8 and 12 years (37.5% girls), were recruited. Children's cognitive functions (response inhibition, lapses of attention, interference and working memory) were measured at baseline and end of trial using computer-based tests. Sitting, standing and movement patterns were assessed with inclinometers, and on-task behaviour was directly observed in the classroom before and after active breaks, at baseline, mid-trial and end of trial. Linear mixed models were used to investigate the intervention effects on cognitive functions and sedentary patterns; generalised linear mixed models were used to analyse on-task behaviour data.

RESULTS

A significant time × group interaction was found for working memory favouring the intervention (B = 11.56, 95% confidence interval [1.92, 21.21]). No significant effects were found in relation to the other measures of children's cognition or on-task behaviour. Stepping time and bouts of sitting were positively affected.

CONCLUSIONS

Classroom-based active breaks can increase physical activity and reduce sedentary behaviour in children with ID and might also benefit their working memory. Further research is required to clarify the effects on cognition and to investigate whether this strategy has other benefits in this population.

Effects of Physical Activity on Children's Motor Skill Development: A Systematic Review of Randomized Controlled Trials

Objective

This systematic review synthesized current randomized controlled trials (RCTs) examining casual evidence regarding the effects of traditional and exergaming-based physical activity (PA) interventions on motor skill development in typically developed children (i.e., those aged 6-12 years).

Methods

We adhered to the PRISMA-P statement and searched electronic databases (Medline, PsycInfo, Web of Science, PubMed, ERIC, Scopus, and SportDiscus) from inception through July 2020. We screened for peer reviewed RCTs published in English between 2000 and 2020 examining the effect of PA on motor skill development in healthy children.

Results

A total of 25 RCTs were included, 20 (80%) of which reported significant improvements in children's motor skill performance. Specifically, 18 studies examined traditional PA interventions and 7 studies examined exergaming-based PA interventions, 83% and 71% of which observed statistically significant improvements in children's motor skill development, respectively.

Conclusions

Findings support the causal evidence regarding the effects of PA on motor skill development in children. Notable limitations of this review included heterogeneity of measurement protocols and assessment tools used to test children's motor skills across studies, a wide range of PA intervention dose across studies, and the lack of power analyses and long-term follow-up assessments in individual studies to discern appropriate sample sizes and long-term effectiveness, respectively. To further strengthen the evidence in this emerging field, we advocate for future RCTs to employ a priori power analyses, long-term follow-up measurements, and more exergaming-based interventions to allow for comparisons with traditional PA interventions, to explore the dose response and moderating relationships between PA and motor skill development in childhood, and to utilize homogenous assessment instruments to allow for more rigorous, quantitative syntheses.

A Follow-Up Study of Motor Skill Development and Its Determinants in Preschool Children from Middle-Income Family

We tracked the motor skill development of young children aged 3–6 years and investigated the influence of middle-income home environment on the development of motor skill. 268 children were selected from kindergartens in Beijing. The Test of Gross Motor Development (TGMD) tool was used to test the development of locomotor and object-control skills (LS and OS), and a survey of children's behaviour and home environment was conducted. During the follow-up, the LS and OS of children aged 3–6 years continued to grow, with an annual growth rate of 20% and 30%. Five LS indicators and two OS indicators were significantly higher in the 3–4-year group than in the 4–5 and 5–6-year groups (p < 0.01). The age-sex trend model showed that girls' locomotor skill developed at a significantly higher rate than that of boys (β = 6.3004 and 4.6782, p < 0.001). Three-year-old boys performed significantly better than girls on object-control motor skill (p < 0.05). Factors affecting the rate of children's motor skill development in middle-income families included the frequency of playing with friends (β = 0.133, p = 0.032) and the frequency of bicycling, skateboarding, dancing, running, and jumping (β = 0.041, p = 0.042). Family income, parents' education level, and family activity area did not significantly affect the growth rate of motor skills. For middle-income families, the improvement of material environment at home like more playing spaces and toys did not speed up the motor development, while more opportunities to play with friends and engage in a variety of sports activities could promote children's motor skill development.

Effect of Active Video Games on Healthy Children's Fundamental Motor Skills and Physical Fitness: A Systematic Review

Objective: The present study aimed to synthesize the most updated literature regarding the casual evidence of the effects of active video games (AVGs) on fundamental motor skills (FMS; locomotor skills and object control skills) and physical fitness among healthy children. Methods: Electronic databases were searched through October 2020. Peer-reviewed randomized control trials (RCTs) and quasi-experimental designs examining the effectiveness of AVGs on FMS and physical fitness development among healthy children (3-12 years) were screened. Results: A total of nine RCTs and one quasi-experimental study were included. Of the five studies examining the effect of AVGs on FMS, two reported significant improvements, while three reported no significant improvements in motor skills development as compared to control. Of the five studies assessing the effects of AVGs on physical fitness, four reported significant improvements in physical fitness such as balance, agility, and speed, whereas one reported significant improvements in skill-related executive function, but not in physical competence. Conclusions: Overall, the current available evidence supports AVGs as an effective means to improve physical fitness, such as balance, postural stability, and agility, among healthy children. However, the findings of AVGs on healthy children's object control and locomotor skills remain inconclusive.

Publications on the Association Between Cognitive Function and Pain from 2000 to 2018: A Bibliometric Analysis Using CiteSpace

BACKGROUND This study aimed to use CiteSpace software to conduct a bibliometric analysis of published studies on the association between pain and cognitive function from 2000 to 2018. The study also aimed to determine publication patterns and authorship and to identify recent trends for research in this field. MATERIAL AND METHODS Publications on the association between cognitive function and pain between 2000 and 2018 were identified from the Web of Science database. Bibliographic information, including authorship, country, citation frequency, changes in citation, and interactive visualization were generated using CiteSpace software. Co-citation, or frequency of two publications cited together by another publication, was also studied. RESULTS On 8th January 2019, 4,889 publications were identified. The United States (1132 publications) and the University of Washington (87 publications) were the most productive country and institution, respectively. The journal, Pain (182 publications) had the largest number of publications and was the most frequently cited journal (citation counts, 1569) with the highest centrality (0.62). Author A had the largest number of publications (21). Author B had the greatest co-citation count (223). Author C tied with Author D as the first co-cited author in terms of centrality (0.18). Author E in 2011 (co-citation count, 96) and Author F in 2008 (centrality: 0.11) had the highest co-citation counts and centrality, respectively. The keyword 'empathy' ranked first for research developments with the highest citation burst (10.045). CONCLUSIONS Bibliometric analysis of the association between pain and cognitive function might identify new directions for future research.

Associations of Class-Time Sitting, Stepping and Sit-to-Stand Transitions with Cognitive Functions and Brain Activity in Children

Previous research showed that children’s physical activity is positively related to executive functions, whilst screen time shows negative associations. However, it is unclear how school-based sitting time and transitions from sitting to standing relate to cognition. We investigated the relationship between class time sitting/stepping/sit-to-stand transitions and cognitive functions in Grade 1–2 children. Overall, 149 children (7.7 ± 0.6 years old, 54% boys) participated. Measures included class time sitting/stepping/sit-to-stand transitions and: (i) response inhibition (i.e., response time and accuracy); (ii) lapses of attention; (iii) working memory; and (iv) brain activity (cortical haemodynamic response). Linear mixed-models, adjusting for age, sex, and clustering at the classroom level, found that more sitting time was associated with higher lapses of attention (β = 0.12, p < 0.05). Children who stepped more had quicker inhibition response time (β = −0.95, p < 0.01); however, they were less accurate in their responses (β = −0.30, p < 0.05) and this was also observed with sit-to-stand transitions (β = −0.26, p < 0.05). No associations were found with brain activity. In conclusion, reducing and breaking up sitting may help keep children focused, but the evidence regarding response inhibition is unclear.