Boost your brain, while having a break! The effects of long-term cognitively engaging physical activity breaks on children's executive functions and academic achievement

The effects of short exercise bouts on error-related negativity (ERN) and academic achievement in children

While short bouts of exercise are known to improve cognitive and academic performance in children, the underlying neural mechanisms driving these changes remain unclear. This study evaluates the effects of short (9-min) acute bouts of exercise (high intensity interval exercise, HIIE; moderate-intensity cycling) on error-related negativity (ERN), and academic achievement. School-aged children (n = 25; ages 9-12) participated in a within-subjects, crossover design, completing one of three conditions (HIIE, moderate-intensity cycling, and seated rest) on three separate days. ERN was measured using electroencephalography (EEG) during a flanker task. Academic achievement tests were completed following only HIIE and seated rest. HIIE significantly reduced ERN amplitude compared to both cycling and seated rest conditions, suggesting improved neural efficiency in error processing. Children also exhibited improved word recognition fluency following HIIE, with a positive trend observed for decoding fluency. These findings suggest that HIIE sessions can enhance neural markers of error processing and academic performance in children. Further research is necessary to explore the long-term effects and potential for broader cognitive improvements resulting from regular integration of HIIE interventions for children.

The synergy of embodied cognition and cognitive load theory for optimized learning

The integration of embodied cognition and cognitive load theory offers a promising framework for advancing educational practices. Cognitive load theory emphasizes the constraints of working memory and the importance of managing cognitive load through effective instructional design. Embodied cognition highlights the role of physical actions, such as gestures, object manipulation and whole-body activities, in enhancing cognitive processes. This Review highlights the importance of bridging these frameworks by exploring their theoretical foundations and synthesizing empirical evidence on the benefits of physical actions in learning. Here we present the introduction of the relevance-integration taxonomy as a transformative advancement in embodied cognition research, offering new perspectives for educational interventions. Additionally, we identify current gaps in cognitive load theory applications and propose future research directions to unify these approaches, aiming to optimize learning outcomes across diverse educational settings. This work has broad implications for advancing evidence-based instructional design.

Effects of different long-term exercise interventions on working memory in children and adolescents: a network meta-analysis

Objectives

To compare the relative efficacy of different exercise modalities on working memory accuracy and reaction time in healthy children and adolescents.

Methods

A systematic review and network meta-analysis was conducted in accordance with PRISMA guidelines (CRD420251005303). PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science were searched from inception to March 1, 2025. Randomized controlled trials examining the impact of any exercise intervention (e.g., aerobic exercise, dance, high-intensity interval training, sports games, mixed exercise) versus control on working memory accuracy and/or reaction time were eligible. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated, and a random-effects model was applied to account for between-study heterogeneity. The surface under the cumulative ranking curve (SUCRA) was used to determine the relative ranking of each modality.

Results

Thirty-three studies met inclusion criteria for working memory accuracy, and eight studies contributed data on reaction time. Dance demonstrated the highest SUCRA ranking for accuracy (87.8%), and was significantly superior to control (SMD = 0.67, 95% CI 0.13 to 1.21). Aerobic exercise ranked first for reaction time (93.6%), outperforming control (SMD = -0.40, 95% CI -0.69 to -0.11 for accuracy; SMD = -0.82, 95% CI -1.26 to -0.38 for reaction time compared with mixed exercise). Mixed exercise consistently showed lower rankings for both outcomes.

Conclusion

Distinct exercise modalities differentially affect working memory components in young populations. Dance and aerobic exercise appear most beneficial-dance maximizes accuracy, while aerobic exercise optimizes reaction time. Tailoring exercise interventions to specific cognitive targets may enhance working memory development and inform practical, evidence-based strategies in educational and clinical settings.

Systematic review registration

RD420251005303.

Getting physical with medical education: Exercise based virtual anatomy review classes for medical students

The benefits of regular physical activity are well known. Yet, few studies have examined the effectiveness of integrating physical activity (PA) into curricula within a post-secondary setting. To investigate the incorporation of PA into medical curriculum, we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal (MSK) anatomy course material. These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor. The fitness instructor would lead students through both strength and yoga style exercises, while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered. After the sessions, participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge, PA levels, and mental wellbeing. Thirty participants completed surveys; a majority agreed that the classes increased understanding of MSK concepts (90.0%) and activity levels (97.7%). Many (70.0%) felt that the classes helped reduce stress. The majority of respondents (90.0%) agreed that the classes contributed to increased feelings of social connectedness. Overall, medical students saw benefit in PA based interventions to supplement MSK course concepts. Along with increasing activity levels and promoting health behaviours, integrating PA into medical curriculum may improve comprehension of learning material, alleviate stress and foster social connectivity among medical students.

The relationship between acute aerobic exercise and inhibitory control in college students: The impact of physical and cognitive engagement

OBJECTIVE

Evidence suggests that acute exercise is an effective way for improving inhibition control, however, the effect of different types of Acute Aerobic Exercise and Inhibitory Control (IC) remains unclear.

METHOD

Using a crossover design, 25 participants (M = 20.20year, SD=0.91) completed 20 min of interventions at 1) moderate intensity exercise, 2) moderate intensity exercise with high cognitive demand (high cognitive-demand exercise), 3) moderate intensity exercise with high physical demand (high physical-demand exercise), and 4) rest condition (low physical and cognitive demand) in a counterbalanced way. Flanker task was completed before and after each intervention to evaluate their inhibitory control ability.

RESULTS

The four interventions significantly reduce reaction times for both congruent and incongruent trials with Flanker task (all P < 0.05). Compared to acute moderate intensity exercise, high physical-demand exercise induced a greater reduction in reaction times for both trial types, whereas high cognitive-demand exercise led to faster reaction times in incongruent trials.

CONCLUSION

Although each intervention effectively enhanced inhibitory control, the exercise demanding high cognitive and physical effort contributed to a more pronounced improvement in inhibitory control performance. This indicates that both increased physical and cognitive engagement can significantly improve the level of inhibitory control in young adults.

Effects of different types of chronic physical activities and sports on executive functions among children and adolescents: A systematic review and meta-analysis

This meta-analysis aimed to examine the effects of various types of chronic physical activities (PA) and sports interventions on executive functions (EF) in children and adolescents, comparing the effectiveness of cognitive engagement, frequency and intensity, and combined factors. A search of PubMed, Web of Science, and PsycInfo databases identified 30 randomized clinical trials (RCTs) with 93 comparisons, exploring the impact of chronic PA on EF subdomains (working memory, inhibitory control, and cognitive flexibility). Publication bias was assessed using funnel plots and statistical indices. Results showed that cognitively enriched PA and combined interventions had statistically significant but trivial effects on EF, with considerable variability. Specific PA subtypes, such as high-frequency, high-intensity activities and coordination games, resulted in small to moderate improvements in EF. PA interventions had a small significant impact on working memory, a trivial effect on cognitive flexibility, and no effect on inhibitory control. While both qualitative and quantitative elements in PA interventions produced statistically significant effects on EF, their practical significance was limited. This limitation persisted across specific PA subtypes. The study suggests future research focus on cognitively enriched activities to explore the various qualitative elements influencing cognitive function in these subtypes.

Raising active children: how family and school shape health-promoting physical activity-findings from the FAMIPASS study

This study investigated the combined impact of family dynamics and school environments on physical activity levels in children aged 3-9 years across distinct segments of the school day. Conducted as part of the FAMIPASS project in the Czech Republic, the study collected data in 2022 and 2023 from 502 families affiliated with 36 preschools and primary schools. The device-based monitoring of movement behaviors in children and their parents was conducted over a one-week period using ActiGraph accelerometers, complemented by detailed family questionnaires. Regression analysis revealed that parental physical activity, BMI, and education level significantly influenced children's moderate-to-vigorous physical activity, with educated parents more likely to raise active children. Active transport to school emerged as a key factor associated with higher child activity levels specifically in the time segment before school. This research underscores the role of family and school as critical arenas for promoting health and physical activity. These insights highlight the need for integrated family-school strategies to foster healthy activity habits in children, thereby laying the groundwork for a more active generation.

Effectiveness of school-based active breaks on classroom behavior, executive functions and physical fitness in children and adolescent: a systematic review

Introduction

The classroom environment is ideal for promoting physical activity interventions since children spend most of their day there but often engage in sedentary behavior. Given this context, an emerging trend to promote physical activity is active breaks at school. This systematic review evaluated the effects of school-based physical activity interventions involving active breaks on children and adolescents' classroom behavior, executive functions, and physical fitness.

Methods

This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was conducted using PubMed, Web of Science, Scopus, and EBSCOhost. Studies published between January 2010 and August 31, 2023, including participants aged 5 to 18, were included. Interventions involving active breaks and outcomes related to classroom behavior, executive functions, and physical fitness were considered.

Results

Initially, 145 studies were identified, with 22 duplicates excluded. After screening 123 articles by title and abstract, 86 were excluded. Subsequently, 37 articles underwent full-text screening, resulting in 22 included studies. Six studies showed positive effects on classroom behavior; five studies showed improvements in executive functions, and only two studies indicated increases in physical fitness.

Discussion

This review suggests incorporating active breaks during school hours can improve classroom behavior in children and adolescents. However, the effects of active breaks on executive functions and physical fitness are unclear. More research is needed to fully understand the benefits of implementing active break programs in the classroom.

Systematic review registration

PROSPERO, CRD42023448267, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023448267.

Improving Executive Function in Children and Adolescents with Cognitive-Engaging Physical Activity: A Systematic Review and Multilevel Meta-Analysis

ABSTRACT

Executive function (EF) development is vital for children and adolescents, with physical activity (PA) playing a key role in its enhancement. Through a systematic review and multilevel meta-analysis, this study investigates the effectiveness of cognitively engaging physical activity (CEPA) over traditional PA in fostering EF in children and adolescents. The research involved 1671 participants across 15 studies to determine if CEPA is superior to PA in enhancing EF and to analyze interventions and dose-response effects. Results demonstrated that CEPA had a more pronounced impact on EF development compared with PA, with a Hedges' g of 0.50 (95% confidence interval, 0.10-0.48), although potentially overestimated due to small-study effects and publication bias. Subgroup analyses did not find notable differences in effectiveness among various intervention types. The most substantial effect was observed with 45-minute interventions, while frequencies less than twice weekly and durations beyond 12 weeks were less effective. These findings suggest that CEPA could be a more efficacious method for advancing EF in youth, indicating a need for larger-scale randomized controlled trial (RCTs) to confirm the results and more accurately estimate their magnitude.

Getting up for brain health: Association of sedentary behavior breaks with cognition and mental health in children

Children spend most of their waking hours sedentary and reducing this behavior has been challenging. Interrupting prolonged episodes of sedentary behavior with active breaks can provide mental and cognitive health benefits. Considering the multifactorial nature of these health aspects, this study aimed to verify the role of body mass index (BMI), cardiorespiratory fitness (CRF), and moderate to vigorous physical activity (MVPA) in the relationship between the break in sedentary time with cognitive and mental health in children. This is a cross-sectional study with 129 children (62 boys), aged between 6 and 11 years (mean 8.73 ± 1.53) from a public school in southern Brazil. For the assessment of fluid intelligence, psychologists applied Raven's Colored Progressive Matrices test. Mental health was measured using the Strengths and Difficulties Questionnaire. Sedentary breaks were measured using accelerometers, and CRF was determined using the 6-min walk test. Generalized linear regression analyses were used to verify associations of sedentary breaks with fluid intelligence and mental health, according to children's BMI, CRF, and MVPA. All models were adjusted for sex, age, somatic maturation, and total time of accelerometer use. Our results indicated that sedentary breaks were associated with fluid intelligence in overweight/obese (β = 0.108; p = 0.021) and physically inactive children (β = 0.083; p = 0.010). Regarding mental health, no association was identified with sedentary breaks. In conclusion, sedentary breaks should be encouraged for the benefits of fluid intelligence, especially in children who do not meet physical activity recommendations and are overweight.

Comparative effectiveness of open and closed skill exercises on cognitive function in young adults: a fNIRS study

While it is widely acknowledged that exercise has positive effects on cognitive function, the specific impacts of different types of exercises, particularly open and closed skill exercises, on cognitive impairment continue to be a debated topic. In this study, we used fNIRS and cognitive psychology tasks to investigate the effects of different types of exercises on cognitive function and brain activity in young adults. We conducted an observational study to assess the cognitive function of participants who had engaged in these exercises for a long period. Additionally, we examined the effects of open skill exercise (badminton) and closed skill exercise (calisthenics) on localized blood flow in the prefrontal lobe of the brain using an experimental research method. Specifically, during the Stroop task, the badminton group exhibited significantly higher △HbO2 in channel 18, corresponding to the dorsolateral prefrontal cortex, compared to the calisthenics group (F = 4.485, P < 0.05, η2 = 0.074). In the 2-back task, the calisthenics group showed significantly higher △HbO2 in channel 17, corresponding to the frontopolar area, dorsolateral prefrontal cortex and inferior prefrontal gyrus, than the badminton group (F = 8.842, P < 0.01, η2 = 0.136). Our findings reveal that open skill exercises are more effective in enhancing cognitive inhibition, thereby increasing attention capacity, self-regulation, and flexibility in response to environmental changes. Conversely, closed skill exercises demonstrate greater efficacy in improving working memory within cognitive functions, showcasing an enhanced capacity for information processing and storage. These data indicate that while both open and closed skill exercises are beneficial for cognitive function, they exhibit significant distinctions in some aspects.

Effects of cognitively engaging physical activity interventions on executive function in children and adolescents: a systematic review and meta-analysis

Background

This systematic review and meta-analysis aim to evaluate the effects of cognitively engaging Physical Activity (PA) interventions on Executive Function (EF) in children and adolescents. It examines how different intervention modalities, durations, frequencies, and session lengths influence these effects.

Methods

We followed the PRISMA guidelines and searched PubMed, SPORTDiscus, Embase, and Web of Science for relevant studies. Studies were included if they were Randomized Controlled Trials (RCTs) focusing on PA with cognitive elements targeting EF in healthy children and adolescents. Data were extracted and effect sizes computed using Standardized Mean Differences (SMDs).

Results

From an initial 1,635 articles, 23 studies with 2,857 participants were included. The overall effect of cognitively engaging PA on EF was significant (SMD = 0.32, 95% CI 0.14-0.51), with notable improvements in inhibitory control (SMD = 0.35) and working memory (SMD = 0.34). High heterogeneity was observed (I 2 = 91.1%). Moderator analyses revealed that interventions lasting more than 6 weeks, with sessions over 20 min and conducted more than twice a week, were particularly effective.

Conclusion

Cognitively engaging PA interventions positively impact EF in children and adolescents, particularly in inhibitory control. Effective interventions are characterized by longer duration, higher frequency, and extended session lengths. These findings underscore the importance of integrating cognitive challenges within PA programs to enhance EF, warranting future research and practical applications in educational and developmental settings.

Ten-Minute Physical Activity Breaks Improve Attention and Executive Functions in Healthcare Workers

Occupational health is a major problem in modern work environments. Physical activity breaks (PABs), short exercise periods delivered during working hours, incorporating exergames or outdoor activities, have emerged as a novel approach that could be used to improve work efficiency and workplace wellbeing. Therefore, this study aimed to investigate the impact of PABs on attention levels and executive functions in healthcare workers. A total of 27 healthcare workers (M = 14, W = 13; 49.55 ± 12.46 years), after 4 h of work, randomly performed one of three 10 min conditions weekly in a counterbalanced order: No Physical Activity Break (NPAB); Outdoor Physical Activity Break (OPAB); Physical Activity Break with Exergame (PABEx). After the conditions, executive functions and selective attention were assessed by the Stroop Color and Word Test (SCWT), and the Trail Making A,B test (TMT A,B), respectively. Significant differences between OPAB and NPAB as well as between PABEx and NPAB in the TMT-A test χ2(2) = 44.66 (p < 0.001) and TMT-B test χ2(2) = 48.67 (p < 0.001) were found, respectively. TMT-A and SCWT interference/time scores of the PABEx and OPAB conditions were significantly lower than those of NPAB (p < 0.001). In the SCWT interference/error score, no significant difference was found between the PABEx and NPAB (p > 0.05), but the score was statistically lower in the OPAB condition than PABEx (p = 0.001) and PABEx condition compared to OPAB for TMT-A (p = 0.001). Findings showed that the OPAB and PABEx conditions are effective in improving selective attention and executive functions in healthcare workers. Employers can foster a healthier and more productive workforce by promoting a culture of movement and prioritizing employee health, which in turn can enhance patient care outcomes.

In-classroom physical activity breaks program among school children in Sri Lanka: study protocol for a randomized controlled trial

Background

The problem of sedentary behavior among primary school children is alarming, with numbers gradually increasing worldwide, including Sri Lanka. Physical activity interventions within classroom settings have been acknowledged as a critical strategy to increase students' movement behaviors while enhancing their academic achievement and health. Yet, the busy curriculum and challenging educational demands encourage more sedentary classroom behavior. Hence, this study aims to develop and evaluate an in-classroom physical activity breaks (IcPAB) intervention among fifth graders in Sri Lanka.

Methods

The study will adopt a randomized controlled trial (RCT), comprising an in-classroom physical activity breaks program group and a control group to evaluate the effects of IcPAB on academic achievement, movement behaviors and health outcomes. The intervention design is based on the capability (C), opportunity (O) and motivation (M) behavior (B) (COM-B) model. A least 198 fifth graders will be recruited from two schools in Uva province, Sri Lanka. The recruitment process will start in late 2022. Class teachers of the intervention group will implement 5-min activity breaks at least three times a day after completing a training session. The primary variables include mathematics and reading achievement. The secondary variables include physical activity levels, steps count, sedentary behavior, body mass index, aerobic fitness, and perceived stress. Data collection will be implemented at pre-test and post-test, respectively. Intervention fidelity and the process will also be evaluated.

Discussion

The IcPAB is designed to prevent pure educational time loss by introducing curriculum-integrated short bouts of physical active breaks into the classroom routine. If the IcPAB is effective, it can (1) improve the mathematics and reading achievement of fifth-grade girls and boys, which is a significant factor determining the performance at the Grade Five National Scholarship Examination in Sri Lanka; (2) improve movement behaviors as well as physical and mental health outcomes among primary school students. Sequentially, the IcPAB will enrich school-based physical activity intervention approaches which can in turn bring academic and health benefits to primary school children in Sri Lanka.

Trial registration

The first version of the trial was registered with the ISRCTN registry (Ref: ISRCTN52180050) on 20/07/2022.

Sitting Less for Success: Reducing Sedentary Behaviors to Increase Kindergarten Achievement

BACKGROUND

Physical activity (PA) improves outcomes, but disadvantaged children typically experience more sedentary behavior (SB). This study explored movement, executive function (EF) health, and academic achievement (AA) for economically disadvantaged kindergarteners.

METHODS

Children in 2 classrooms (n = 16; n = 7) wore wrist-based accelerometers to assess PA/SB during the school day. Independent t-tests and analysis of variance analyzed mean group differences in PA/SB and EF/AA, and correlations explored AA and EF associations.

RESULTS

The movement-based class spent significantly less time in SB compared to the contemporary class (t = 2.552, g = 1.115), made greater reading (t = -2.611) and math (t = .967) gains, and had better EF (t = .012). There were significant negative correlations between SB and math (r = -.534) and reading (r = -.592), but no significant relationships with EF.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Schools should consider methods to decrease time spent in SB at lower-SES schools, which is financially feasible and less time-consuming than programs to increase PA.

CONCLUSION

Decreased SB time was associated with better AA. More research is needed to determine whether interventions to decrease time spent in SB at school improve academic outcomes in disadvantaged children.

Associations between Gross and Fine Motor Skills, Physical Activity, Executive Function, and Academic Achievement: Longitudinal Findings from the UK Millennium Cohort Study

Accumulating evidence from behavioral studies and neuroscience suggests that motor and cognitive development are intrinsically intertwined. To explore the underlying mechanisms of this motor-cognition link, our study examined the longitudinal relationship of early motor skills and physical activity with later cognitive skills. The sample was 3188 children from the United Kingdom Millennium Cohort Study, followed at 9 months and 5, 7, and 11 years. Early motor skills were examined at 9 months. Children's daily physical activity level was measured using accelerometers at 7 years and a questionnaire was conducted at 11 years. Cognitive skills, including executive function and academic achievement, were measured at age 11. The results suggest that gross motor skills were positively associated with spatial working memory, whereas fine motor skills were predictive of good English and science outcomes. Moderate-to-vigorous activity was found to be negatively associated with English performance, although self-reported activity frequency was positively linked to math. Our results highlight the significant role of both gross and fine motor skills in cognitive development. This study also elucidates the limitations of using activity intensity to assess the impact of motor activity on children's cognitive development, suggesting that attention to the effects of specific types of physical activity would better elucidate the motor/cognition link.

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 intervention integrating physical literacy into active school recesses on physical fitness and academic achievement in Chinese children

Background/Objective

The aim of this study was to examine the effects of school-based intervention integrating physical literacy (PL) into active school recesses (ASR) on physical fitness (i.e., body composition, 20-m shuttle run, 50-m run, rope skipping, sit and reach, handgrip) and academic achievement (i.e., academic result of Chinese and Mathematics) in Chinese children.

Methods

A total of 357 children (mean age: 7.8 ± 0.7 years; boys: 50.4%) were recruited from two schools and these two schools were randomly assigned as the intervention group (IG) and the control group (CG), respectively. The IG consisted of 155 children (mean age: 7.9 ± 0.7 years, boys: 51.0%), and 202 children (mean age: 7.8 ± 0.7 years; boys: 50%) were allocated to the CG. Children in the IG received a 10-week intervention integrating PL that was conducted during ASR. In the CG, children's regular school activity was remained during the intervention period. Generalized estimating equation was performed to compare the levels of physical fitness and academic achievement between the IG and the CG after intervention.

Results

Regarding physical fitness, there was a significant group × time interaction on 20-m shuttle run (β = -3.89, 95% CI [-5.08; -2.71], p < 0.001) and handgrip (β = -0.70, 95% CI [-1.20; -0.20], p = 0.006). After intervention, children in the IG had a greater increase than the CG (p < 0.001) in terms of 20-m shuttle run and handgrip. In addition, the post-test analysis indicated that performance of children in the IG was significantly greater than those in the CG (20-m shuttle run: p < 0.001, handgrip: p = 0.002). There was a significant group × time interaction on academic result of Chinese (β = -1.21, 95% CI [-1.91; -0.56], p = 0.001) and academic result of Mathematics (β = 16.71, 95% CI [15.14; 18.143], p < 0.001). Statistically significant positive difference in post-test was observed in academic result of Mathematics between the IG and the CG (p = 0.012).

Conclusion

The results of this intervention study indicate that intervention integrating PL into ASR could bring a promising effect on physical fitness and academic achievement in children. It is recommended that future studies are necessary to assess the effects of ASR-based PL intervention on physical and cognitive outcomes using a wide range of sample.

A Literature Review on the Effects of Exergames on Executive Function in Youth

Exergames (video games that promote cognitive and physical activity simultaneously) benefit executive function in elderly populations. It has been suggested that exergames may induce larger effects than cognitive or exercise training alone, but few reviews have synthesized the causal factors of exergames on executive function from experimental research with youth. This review investigates (1) the various types of exergames and associated comparison conditions (2) the executive function outcome assessments commonly utilized in exergame research with youth (3) the efficacy of exergames by evaluating experimental studies that compared exergaming to cognitive, exercise, and passive control conditions inclusive of effect sizes and (4) the potential mechanisms underlying the changes in executive function induced from exergames. Eligible outcome data were available from 607 participants across ten studies, with the age of participants ranging from 4-21 (M age = 10.46 ). The findings indicate that exergames improve aspects of executive function from both acute and chronic studies. Despite the high variability of exergame contexts, dosage, populations, and outcome assessments, improvements in executive function comparing exergaming to passive control conditions were exhibited across all studies. While there is evidence of exergaming demonstrating advantages over passive control conditions, evidence is mixed when comparing exergaming to sedentary cognitive and exercise comparison conditions. Potential sources of these mixed results and future directions to address current gaps in the field are identified. As video game and technology use grows exponentially and concerns of childhood sedentary behavior and play deprivation increase, evidence-based practices that promote both physical and cognitive activity are needed.

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.

A Mixed-Method Evaluation of a Rural Elementary School Implementing the Coordinated Approach to Child Health (CATCH) Program

Despite children living in rural US areas having 26% greater odds of being affected by obesity compared to those living in urban areas, the implementation of evidence-based programs in rural schools is rare. We collected quantitative data (weight and height) from 272 racially and ethnically diverse students at baseline, and qualitative data from students (4 focus groups), parents, and school staff (16 semi-structured interviews and 29 surveys) to evaluate program outcomes and perceptions. At the 2-year follow-up, paired data from 157 students, represented by racial/ethnic groups of 59% non-Hispanic White, 31% non-Hispanic Black, and 10% Hispanic, showed an overall mean change (SD) in BMI z-score of -0.04 (0.59), a decrease of -0.08 (0.69) in boys, and a significant -0.18 (0.33) decrease among Hispanic students. Boys had a mean decrease in obesity prevalence of 3 percentage points (from 17% to 14%), and Hispanic students had the largest mean decrease in BMI percentile. Qualitative data showed positive perceptions of the CATCH program and its implementation. This community-engaged research, with collaboration from an academic institution, a health department, a local wellness coalition, and a rural elementary school, demonstrated successful CATCH program implementation and showed promising outcomes in mean BMI changes.

Cognitively engaging movement games improve interference control and academic performance in overweight children: A randomized control trial

The purpose of this study was to determine the (a) dose-response effects of cognitively engaging movement games (CEMGs) designed to improve aerobic capacity, interference control (IC), and academic performance, (b) relationship between intervention-induced improvements in aerobic capacity, IC, and academic performance, and (c) moderation effect of IC on the relationship between aerobic capacity and academic performance in overweight children. Seventy-five overweight children (aged 11.23 ± 0.60 years; 48% males) participated in this study conducted in Taipei during the 2018/2019 academic year and were randomly assigned to the low-dose (20-min) intervention, high-dose (40-min) intervention, and control groups and completed a Stroop test, half-mile run, and language and mathematics tests before and after a 10-week afterschool program. Both intervention groups showed similar improvements in outcomes of aerobic capacity (ds > 0.80), IC (ds > 0.76), and academic performance (ds > 0.90) from the pretest to posttest, whereas these outcomes were unchanged for the control group. Furthermore, improved IC moderated the association between improvements in aerobic capacity and academic performance. Our findings suggest that CEMG with varying doses is feasible and effective for improving aerobic capacity, IC, and academic performance in overweight children and that the association between improvements in aerobic capacity and academic performance depends on the intervention effects on IC.

Associations between the built environment, policies and curriculum in schools and primary school children’s physical activity

Background: A large proportion of children in the UK do not engage in the recommended amount of physical activity. Schools are an environment where children spend a considerable portion of their time and have the potential to facilitate more physical activity. There has been little exploration of the specific school environment factors that are most pertinent to child physical activity and sedentary behaviour. This study was intended to fill this important gap. Methods: Data were collected between March 2017 and May 2018 from 50 schools and 1223 children who participated in the B-Proact1v cohort study. School level measures were the built environment (e.g. playground equipment, cycling parking, allotments), physical activity-related policies (e.g. policy to encourage active travel) and the use of physical activity in the curriculum (e.g. regular physical activity breaks throughout day). Children’s weekday moderate-to-vigorous physical activity (MVPA) was estimated via Actigraph GT3X accelerometers. Associations between school context measures and children’s weekday MVPA were analysed using linear multilevel models, with children nested within schools, adjusted for individual characteristics. Results: On average, children at schools with allotments, a larger amount of playground equipment and where cycle training was offered, engaged in higher levels of MVPA. PE being compromised due to space was associated with lower levels of MVPA. Conclusions: Whilst there is a need for further exploration, the findings suggest that school-based provision and policies for active travel, sport and active play may be important to encouraging more primary school children to be more active more regularly.

School-based physical activity interventions and language skills: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVES

School-based physical activity (PA) interventions have proven beneficial for improving cognitive performance and overall academic achievement, but their benefits on language skills remain unclear. We aimed to assess the effects of school-based PA interventions on language skills in children and adolescents.

DESIGN

Systematic review with meta-analysis.

METHODS

A systematic search was performed in PubMed, PsycINFO and Scopus until September 10th, 2022. We included randomized controlled trials (RCTs) that performed a school-based PA intervention in children/adolescents and that assessed language-related outcomes (i.e., reading, spelling, vocabulary, verbal fluency, comprehension and grammar) or language school grades. Random effect meta-analyses were conducted to pool study results.

RESULTS

Thirty-one studies (18,651 participants) were finally included. Significant benefits were observed for reading (standardized mean difference [SMD]: 0.15; 95% confidence interval [CI]: 0.08, 0.22), vocabulary (SMD: 0.71; 95%CI: 0.44, 0.97), and comprehension (SMD: 0.24; 95%CI: 0.09, 0.40), with a non-significant trend (p = 0.083) also observed for language school grades (SMD: 0.40; 95%CI: -0.05, 0.86). No significant benefits were observed for spelling or verbal fluency (both p > 0.05), and no meta-analysis could be performed for grammar skills. No consistent differences were observed between integrated (i.e., performing PA along with the academic content) and non-integrated PA interventions (e.g., extra physical education lessons).

CONCLUSIONS

School-based PA interventions appear as an effective strategy for improving different language-related skills, although further research is needed to determine how interventions' and participants' characteristics moderate these effects.

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.

The effects of physical activity timing and complexity on episodic memory: A randomized controlled trial

The role of two types of acute physical activity (PA) bouts were assessed on young adults' free-recall and recognition memory in two experiments, which differed in the temporal relation of PA and word encoding. Before or following training on the Rey Auditory Verbal Learning Task, participants performed a simple two-step dance, a complex four-step dance, or remained seated. Hypotheses proposed that PA prior to encoding and complex PA would enhance PA's mnemonic benefits. Memory assessed post-PA, 24 h, and 7 days after training indicated that timing and complexity of PA did not impact free-recall or recognition memory. Findings differ from a previous study showing complex PA benefited motor learning more than simple PA (Tomporowski & Pendleton, 2018). The inconsistency may be due to different working memory processes underlying consolidation and retrieval of procedural or episodic information. Theory-based explanations regarding memory storage and retrieval are proposed to elucidate this selective process.

Acute effects of a motor coordination intervention on executive functions in kindergartners: a proof-of-concept randomized controlled trial

BACKGROUND

Executive functions are pivotal for future academic and social functioning. Causal effects of physical activity on executive functions have been shown in adults. The primary objective of this study was to test the proof-of-concept (i.e., feasibility of implementation and acceptance) of a motor coordination intervention and a sedentary control condition in kindergartners and its preliminary effectiveness on subsequent executive function performance.

METHODS

The study used a two-group post-test only design. All children aged between 4 and 7 years old were eligible. One hundred and three children (46% girls; age: M = 5.71 years, 95% CI = 5.50 to 5.92) recruited in a middle-sized town in Germany were randomly assigned to a 20-min motor coordination intervention (n = 51) or a sedentary control condition (n = 52), both of which were conducted in a one-on-one experimenter-child setting in the university or kindergarten. A second blinded-to-condition experimenter assessed the executive function outcomes directly following the conditions. Proof-of-concept criteria were the implementation of the intervention with a moderate-to-vigorous physical activity level assessed via heart rate sensors, and with motor coordination demands, analyzed via video recordings; children's acceptance via self-reported enjoyment of the conditions; and the post-assessments of executive functions with a behavioral and computerized task.

RESULTS

The motor coordination intervention and the control condition were feasible in a one-on-one setting with kindergartners. The intervention revealed heart rate increases and challenging motor coordination tasks. Children in both conditions indicated they enjoy them. Performance in the two executive function tasks did not differ between children in the motor coordination intervention and the control condition.

CONCLUSIONS

A one-on-one experimenter-child setting was feasible to deliver in kindergartners. Future intervention studies should consider pre-testing of executive functions and take into account children's characteristics as potential moderators, such as motor coordination skills.

Effect of cognitively engaging physical activity on executive functions in children

Purpose

Physical activity (PA) has been shown to enhance executive functions (EFs) in children, and PA involving a cognitive component may confer additional benefit. The purpose of this study was to investigate whether cognitively engaging PA impacts EF, and whether affect and fitness act as either mediators or moderators of this relationship.

Methods

A randomized controlled trial was utilized to assess changes in EFs between a 20-min Dual Task (intervention condition), a PA Task (control condition), and a Cognitive Task (control condition). Children were scheduled for two visits in the INfant and Child Health (INCH) Lab at the University of Toronto. Physical fitness was assessed using the 20 m shuttle run, standing long jump, and grip strength tests. EFs were assessed using the Stroop Task, Trail Making Task (TMT), and Forward Working Memory Task (FWMT).

Results

38 children (M_age = 11.95 years, SD = 0.49, 61% female) participated. Repeated measures ANOVA showed main interactions between time on inhibition scores (p < 0.05, η_p² = 0.489), and positive affect scores (p < 0.01, η_p² = 0.284). Interaction effects between condition and time were not significant (p = 0.787, η_p² = 0.014, p = .333, η_p² = 0.061, p = 0.799, η_p² = 0.013 for inhibition, switching, and passive working memory, respectively). Results showed no significant mediation effect of affect (95% CI = –0.5915, 2.147), or moderating effect between fitness and EF changes.

Conclusion

Possible explanations for these findings include inadequate cognitive engagement, lack of EF transfer, and statistical power. Results suggest any of these interventions may be beneficial for improving inhibition and positive affect in children.

Association between tennis training experience and executive function in children aged 8-12

Cognitively engaging activities have been shown to facilitate the improvement of executive functions in children. However, a limited number of studies have investigated whether the relationship between dose parameters of physical activities and executive functions, and heterogeneity exists. In the present study, we aim to explore the association between tennis training experience and executive functions in children. Sixty children between the ages of 8 and 12 were recruited in this study and were allocated to the short-term (ST) group (<12 months, n = 30) and the long-term (LT) group (more than 12 months, n = 30). The abilities of inhibitory control, cognitive flexibility, and working memory were measured by the Stop-signal task, Switching task, and N-back task, respectively. There was no significant group difference in either the accuracy or reaction time of the Stop-signal task. No significant difference between the groups' accuracy in the Switching task was observed. However, the LT group presented a shorter reaction time than the ST group (731.69 ± 149.23 ms vs. 857.15 ± 157.99 ms, P < 0.01) in the Switching task. Additionally, training experience was positively associated with the reaction time of the Switching task. As for the N-back task, in comparison with the LT group, the ST group showed a longer reaction time (711.37 ± 168.14 ms vs. 164.75 ± 635.88 ms, P < 0.05). Moreover, training experience was also positively associated with the reaction time of the N-back task. But there was no significant group difference in the accuracy of the N-back task. In conclusion, children trained for over 1 year have better performance in cognitive flexibility and working memory than those trained in <1 year; thus, tennis experience is positively associated with executive functions.

Effects of In-Classroom Physical Activity Breaks on Children's Academic Performance, Cognition, Health Behaviours and Health Outcomes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

In-Classroom physical activity breaks (IcPAB) are a promising way to promote children’s health behaviors, while contributing to the development of their academic and cognitive ability and health outcomes. Yet the effect of the activity breaks, which are exclusive to classroom settings, are still mixed and unclear. Hence, this review was conducted to identify the characteristics and the effects of IcPAB among primary school children. The review protocol was registered on PROSPERO (CRD42021234192). Following the Cochrane guidelines, PubMed, PsycINFO (ProQuest), MEDLINE (EBSCOhost), Embase/Ovid, SportDISCUS (EBSCOhost), Web of Science, Scopus and Academic Search Premier (EBSCOhost) databases were searched to collect data on randomised control trials without a time restriction. The final database search was conducted on the 8 November 2021. Random effects models were used to calculate the effect sizes. The systematic review identified ten eligible studies, nine of which were also included in the meta-analysis. Few studies used the theoretical frameworks and process evaluations. IcPAB showed mixed effectiveness on academic outcomes: i.e., IcPAB had effects on spelling performance (p < 0.05) and foreign language learning (p < 0.01) but not on mathematics and reading performance. Health behaviors such as moderate-to-vigorous physical activity levels were improved (p < 0.01), but IcPAB did not have an impact on cognition outcomes and health outcomes. Given these mixed results, further research is needed underpinned by strong methodological quality, theoretical underpinnings and reliable process evaluation methods.

Effects of aerobic versus cognitively demanding exercise interventions on brain structure and function in healthy children-Results from a cluster randomized controlled trial

The beneficial effects of physical activity on neurocognitive functioning in children are considered to be facilitated by physical activity-induced changes in brain structure and functioning. In this study, we examined the effects of two 14-week school-based exercise interventions in healthy children on white matter microstructure and brain activity in resting-state networks (RSNs) and whether changes in white matter microstructure and RSN activity mediate the effects of the exercise interventions on neurocognitive functioning. A total of 93 children were included in this study (51% girls, mean age 9.13 years). The exercise interventions consisted of four physical education lessons per week, focusing on either aerobic or cognitively demanding exercise and were compared with a control group that followed their regular physical education program of two lessons per week. White matter microstructure was assessed using diffusion tensor imaging in combination with tract-based spatial statistics. Independent component analysis was performed on resting-state data to identify RSNs. Furthermore, neurocognitive functioning (information processing and attention, working memory, motor response inhibition, interference control) was assessed by a set of computerized tasks. Results indicated no Group × Time effects on white matter microstructure or RSN activity, indicating no effects of the exercise interventions on these aspects of brain structure and function. Likewise, no Group × Time effects were found for neurocognitive performance. This study indicated that 14-week school-based interventions regarding neither aerobic exercise nor cognitive-demanding exercise interventions influence brain structure and brain function in healthy children. This study was registered in the Netherlands Trial Register (NTR5341).

Usability and Effects of a Combined Physical and Cognitive Intervention Based on Active Video Games for Preschool Children

Executive functions (EFs) are essential for early childhood development, and effective programs to improve EFs in preschool education are becoming increasingly crucial. There is rising evidence that combined physical-cognitive intervention training utilizing active video games (exergames) could be a viable strategy to improve EFs. However, there is a shortage of empirical evidence on the application of this approach in preschool education. The effectiveness of exergame intervention training in preschools must be evaluated. This study conducted a randomized controlled trial to assess the effects of exergames intervention training on preschool children's EFs. A total of 48 participants aged 4-5 years were enrolled; 24 were randomly allocated to receive exergames physical activity training, and the remaining 24 received conventional physical activity training. After a four-week intervention, the children who received the exergames intervention training exhibited considerably greater gains in all three EFs tasks than children who received the conventional physical activity program. Follow-up interviews revealed that the children accepted the exergames well. The results demonstrate the viability of incorporating exergames into preschool education to improve children's EFs, supporting prior findings and offering more empirical evidence from early childhood research.

Effects of Group-Play Moderate to Vigorous Intensity Physical Activity Intervention on Executive Function and Motor Skills in 4- to 5-Year-Old Preschoolers: A Pilot Cluster Randomized Controlled Trial

The aim of the present study is to examine the effect of group-play intervention on executive function (EF) in preschoolers. This group-play intervention was integrated as moderate to vigorous physical activity and cognitively loaded exercise to promote EF in preschoolers. An 8-week group-play MVPA intervention program, consisting of a series of outdoor physical and cognitively loaded games, was designed to improve preschoolers' EF. This intervention program was implemented in group-play form, and conducted by teachers who received standardized training before the intervention. Two classes of second grade preschoolers (N = 62) were randomly allocated to experimental (n = 30, M age = 4.16, SD = 0.29) and control (n = 32, M age = 4.7, SD = 0.43) groups. The intervention group received the intervention three times a week, while the control group exercised as usual in preschool. Before, in the middle of, and after the intervention, 10-m running, standing broad jump, throwing, body flexion, balance beam, and skip jump were assessed as tests of motor skills. In addition, three components of EF were measured separately before, in the middle of, and after the intervention: inhibitory control was assessed by using the silly sound Stroop task, working memory was tested using the empty house task, and shifting was assessed using the dimensional change card sorting task. Although both groups showed an increasing trend in terms of motor skills and EF during the intervention, the increasing amounts of the intervention group were significantly higher than the control group. The findings of the present study suggested that group-play intervention has positive effects on aspects of EF in addition to motor skills in preschoolers.

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.

Effects of Varied Practice Approach in Physical Education Teaching on Inhibitory Control and Reaction Time in Preadolescents

This study aimed to investigate the effects of nonlinear and linear varied practice compared to a constant linear practice on inhibitory control and reaction time, which are capacities that involve cognition in preadolescents. Eighty-three participants in the 8th grade participated in the study. They were assigned to two experimental groups (varied practice), taught using nonlinear pedagogy (NLP) and linear pedagogy (VLP), respectively, or one control group (constant practice), taught using linear pedagogy (CLP). All participants were tested for inhibitory control (congruent and incongruent conditions) and simple reaction time. Overall, varied practice (both linear and nonlinear) induced larger improvements than constant practice under both congruent (p = 0.026) and incongruent (p = 0.013) conditions of inhibitory control. Additionally, VLP provided greater improvements in inhibitory control (for the incongruent condition) than NLP and CLP. Although NLP and VLP may be preferable to CLP approaches for enhancing executive functions in preadolescents, VLP seems to be the most effective approach aimed to improve cognition within PE classes.

Logical Intelligence and Mathematical Competence Are Determined by Physical Fitness in a Sample of School Children

Previous research has shown positive relationships between fitness level and different cognitive abilities and academic performance. The purpose of this study was to explore the relationships between logical–mathematical intelligence and mathematical competence with physical fitness in a group of pre-adolescents. Sixty-three children (50.79% girls; 49.21% boys) from Castro del Río (Córdoba, Spain), aged between 11 and 12 years (M = 11.44, SD = 0.64), participated in this research. The Superior Logical Intelligence Test (SLIT) and the EVAMAT 1.0–5 battery were used. Physical fitness was evaluated by the horizontal jump test, the 4×10 meter speed–agility test, and the Course Navette test. The analyses showed positive relationships between physical fitness with logical–mathematical intelligence and mathematical competence. Specifically, linear regression analyzes indicated that the 4×10 speed–agility test significantly predicted mathematical competence (R² = 0.16; β = −0.41) and the horizontal jump test significantly predicted logical–mathematical intelligence (R² = 0.24; β = 0.50). These results are in agreement with previous research, highlighting the importance of improving physical fitness from an early age due to its benefits for intellectual and academic development.

Effects of Classroom-Based Resistance Training With and Without Cognitive Training on Adolescents' Cognitive Function, On-task Behavior, and Muscular Fitness

Aim: Participation in classroom physical activity breaks may improve children's cognition, but few studies have involved adolescents. The primary aim of this study was to examine the effects of classroom-based resistance training with and without cognitive training on adolescents' cognitive function. Methods: Participants were 97 secondary school students (45.4% females, mean age 15.78 ± 0.44). Four-year 10 classes from one school were included in this four-arm cluster randomized controlled trial. Classes were randomly assigned to the following groups: sedentary control with no cognitive training, sedentary with cognitive training, resistance training without cognitive training, and resistance training with cognitive training. Sessions varied in levels of both cognitive demand and resistance training (i.e., high vs. low) and were administered three times per week for 4 weeks (12 sessions). Inhibition, cognitive flexibility, episodic memory, on-task behavior, and muscular fitness were assessed at baseline and post-test. Linear mixed models were used to examine changes within and between groups. Results: In comparison with the control group, episodic memory improved significantly in the resistance training without cognitive training group (-9.87 units, 95% CI: -17.71 to -2.03, p = 0.014, d = 0.72). There were no group-by-time effects for inhibition or cognitive flexibility. Classroom activity breaks both with and without cognitive demand improved participants' on-task behavior in comparison with the control and sedentary group. The resistance training programs did not lead to improvements in muscular fitness. Conclusion: Participation in body weight resistance training without cognitive training led to selective improvements in episodic memory. No training effects were found for inhibition or cognitive flexibility. A longer study period may be necessary to induce improvements in muscular fitness and associated changes in inhibition and cognitive flexibility. Clinical Trial Registration: https://www.anzctr.org.au/ACTRN12621001341819.aspx, Australian New Zealand Clinical Trials Registry-ACTRN12621001341819.

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.

Water-Based Exercise Therapy And Improvement In The Motor Skills And Cognitive Function Of Children With Autism Spectrum Disorder: A Commentary

Background — Motor and cognitive dysfunction are common impairments experienced by children with a diagnosis of autism spectrum disorder (ASD). Objective: The main aim of this study was to present suggestions for the incorporation of water-based exercises in rehabilitation for the children with ASD. Methods — Researchers collected the current available data regarding novel methods of water-based exercise therapy for the children with ASD to address motor and cognitive function. Results — Children with a diagnosis of ASD face a number of common challenges that may be addressed by the utilization of aquatic therapy in their rehabilitation plan. Challenges commonly experienced by children with ASD may be addressed by properties of water and aquatic therapies. Presently, aquatic therapy is an underutilized resource as an intervention in the population of children with ASD. Conclusions — Water-based interventions is currently underutilized as a therapeutic intervention should be considered for individuals with a diagnosis of ASD.

Does Physical Activity Improve Cognition and Academic Performance in Children? A Systematic Review of Randomized Controlled Trials

INTRODUCTION

In the last decades, different studies have investigated the effects of exercise or physical activity (PA) on cognitive functions and academic performance in children and adolescents. But given the inconsistencies regarding methodologies and the fact that many studies do not have controlled or randomized designs, a more recent review is needed in order to summarize the different outcomes and methodologies employed and correlate them from an applied perspective.

OBJECTIVES

The purpose of the present review is to systematically review and analyze the effects of acute and chronic PA interventions exclusively from randomized controlled trials (RCTs) on cognitive functions and academic performance of children and adolescents.

METHODS

A literature search was conducted using MEDLINE (via PubMed), EMBASE, Web of Science, and PsycINFO databases for all RCTs published between January 2014 and July 2020. Authors searched these databases using controlled vocabularies, keywords, and Boolean logic, and data were later extracted from the studies. Effect sizes were calculated based on means and SDs at posttest using Hedge's g formula.

RESULTS

A total of 20 studies met the inclusion criteria. They were assessed for eligibility and later included in the review. Although most of the articles did not show any robust effect size and had significant methodological differences, 80% of the studies analyzed showed positive results, indicating a significant impact of exercise or PA on cognition.

DISCUSSION

Due to the heterogeneity in the design of the interventions and the variables analyzed, most of the studies showed small or medium effect sizes. Studies with big effect size in all variables had in common the fact that they involved team game variations and coordination activities. The combination of physical exertion (high intensity) and cognitive engagement with social interactions seems to have the strongest effect on executive functions. This ecological and attractive model reflects children's typical PA and might represent an ideal model for exercise in this population.

CONCLUSIONS

Although grouping different studies based on PA type, control groups, and comparison treatments is a limitation and results should be interpreted with caution, this review suggests that PA interventions, in particular, team game variations and coordination activities, have positive effects on children's cognitive functions.

Sports, Executive Functions and Academic Performance: A Comparison between Martial Arts, Team Sports, and Sedentary Children

It is well known that curricular physical activity benefits children’s executive functions and academic performance. Therefore, this study aimed to determine whether there is an influence of extracurricular sports on executive functions and academic performance. However, it is less known which specific types of the sport better enhance executive functions in children; to investigate this issue, this study compared the performance on executive functions tasks and academic performance in one hundred and two boys and girls with an average age of 11.84 years recruited from Italian schools and gyms (N = 102), who participated in martial arts or team sports or were sedentary children. Executive functions were measured with the tests: Attenzione e Concentrazione, Digit Span test, Tower of London, IOWA Gambling task BVN 5-11, and BVN 12-18. Results demonstrated that children practicing martial arts showed better executive functioning and higher school marks than those involved in team sports or not involved in any sports. Furthermore, participants aged 12 to 15 years old outperformed in cool and hot executive functions tasks and had a better academic performance. Thus, the present findings supported the view that regular practice of extracurricular sports enhances executive functions development and consequently influences academic performance.

Differential effects of long-term aerobic versus cognitively-engaging physical activity on children's visuospatial working memory related brain activation: A cluster RCT

Different types of physical activity are thought to differentially affect children's brain activation, via physiological mechanisms, or by activating similar brain areas during physical and cognitive tasks. Despite many behavioral studies relying on these mechanisms, they have been rarely studied. This study looks at both mechanisms simultaneously, by examining effects of two physical activity interventions (aerobic vs. cognitively-engaging) on children's brain activation. Functional Magnetic Resonance Imaging (fMRI) data of 62 children (48.4% boys, mean age 9.2 years) was analyzed. Children's visuospatial working memory related brain activity patterns were tested using a Spatial Span Task before and after the 14-week interventions consisting of four physical education lessons per week. The control group followed their regular program of two lessons per week. Analyses of activation patterns in SPM 12.0 revealed no activation changes between pretest and posttest (p > .05), and no differences between the three conditions in pretest-posttest changes in brain activation (p > .05). Large inter-individual differences were found, suggesting that not every child benefited from the interventions in the same way. To get more insight into the assumed mechanisms, further research is needed to understand whether, when, for whom, and how physical activity results in changed brain activation patterns.

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

Over the last decade, a growing body of research has examined the link between physical activity, fitness, and cognitive function in children and adolescents. Physical activity experimental research conducted with children and adolescents has identified selectively greater effects for tasks requiring higher order executive functions. As such, the primary aim of our chapter is to provide an overview of findings from systematic reviews and meta-analyses that have examined the effects of physical activity on measures of executive function in child and adolescent populations. We begin our chapter with definitions of key concepts associated with physical activity, fitness and cognitive function. We then provide a synthesis of systematic reviews and meta-analyses that have examined the acute and chronic effect of physical activity on EFs. Following this, we discuss the quantitative (e.g., time, intensity) and qualitative (e.g., type) characteristics of physical activity that may moderate effects. The next section focuses on the neurobiological, psychosocial and behavioral mechanisms responsible for the effect of physical activity on executive functions. We conclude by highlighting the limitations of the existing evidence base and providing recommendations for future research.

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.

Classroom-based physical activity and math performance: Integrated physical activity or not?

AIM

This 8-week intervention examined the effect of two different types of classroom-based physical activity on math performance in elementary school children.

METHODS

Students in 4th and 5th grade (N = 560; 32 classes, 9-11 years old) from six schools were assigned to integrated physical activity (Move for Thought [M4T], n = 221), activity break (AB; n = 134) and a control group (n = 205; usual instruction) for eight weeks. Students completed a standardised math test before and after the intervention. Programme fidelity was measured with a teacher daily log, recording the duration and frequency of the physical activity sessions. Linear mixed models were used for the analyses. Grade and gender were explored as moderators.

RESULTS

Move for Thought group outperformed AB (p < 0.001, d = 0.44) and control groups (p = 0.013, d = 0.38). However, subgroup analyses showed that these effects were evident only in Grade 4. No gender differences were found. Intervention fidelity showed that the classroom-based physical activities (M4T and AB) were used about every other day, with higher implementation among 4th graders.

CONCLUSION

This study indicated that integrating physical activity with mathematics has stronger effects on mathematics than activity breaks and traditional instruction.

Active School Breaks and Students' Attention: A Systematic Review with Meta-Analysis

School physical activity breaks are currently being proposed as a way to improve students’ learning. However, there is no clear evidence of the effects of active school breaks on academic-related cognitive outcomes. The present systematic review with meta-analysis scrutinized and synthesized the literature related to the effects of active breaks on students’ attention. On January 12th, 2021, PubMed, PsycINFO, Scopus, SPORTDiscus, and Web of Science were searched for published interventions with counterbalanced cross-over or parallel-groups designs with a control group, including school-based active breaks, objective attentional outcomes, and healthy students of any age. Studies’ results were qualitatively synthesized, and meta-analyses were performed if at least three study groups provided pre-post data for the same measure. Results showed some positive acute and chronic effects of active breaks on attentional outcomes (i.e., accuracy, concentration, inhibition, and sustained attention), especially on selective attention. However, most of the results were not significant. The small number of included studies and their heterogeneous design are the primary limitations of the present study. Although the results do not clearly point out the positive effects of active breaks, they do not compromise students’ attention. The key roles of intensity and the leader of the active break are discussed. INPLASY registration number: 202110054.