Rhythmic Physical Activity Intervention: Exploring Feasibility and Effectiveness in Improving Motor and Executive Function Skills in Children

Associations Between Motor Competence and Executive Functions in Children and Adolescents: A Systematic Review and Meta-analysis

BACKGROUND

Motor competence and executive functions co-develop throughout childhood and adolescence, and there is emerging evidence that improvements in motor competence may have cognitive benefits in these populations. There is a need to provide a quantitative synthesis of the cross-sectional, longitudinal and experimental studies that have examined the association between motor competence and executive functions in school-aged youth.

OBJECTIVES

The primary aim of our systematic review was to synthesise evidence of the association between motor competence and executive functions in school-aged children and adolescents (5-18 years). Our secondary aim was to examine key moderators of this association.

METHODS

We searched the PubMed, PsycINFO, Scopus, Ovid MEDLINE, SPORTDiscus and EMBASE databases from inception up to 27 June 2023. We included cross-sectional, longitudinal and experimental studies that assessed the association between motor competence (e.g., general motor competence, locomotor skills, object control skills and stability skills) and executive functions (e.g., general executive functions, inhibition, working memory and cognitive flexibility) in children and adolescents aged 5-18 years.

RESULTS

In total, 12,117 records were screened for eligibility, and 44 studies were included. From the 44 included studies, we meta-analysed 37 studies with 251 effect sizes using a structural equation modelling approach in the statistical program R. We found a small positive association (r = 0.18, [95% confidence interval (CI) 0.13-0.22]) between motor competence and executive functions. The positive associations were observed in cross-sectional (r = 0.17, [95% CI 0.13-0.22]), longitudinal (r = 0.15, [95% CI 0.03-0.28]) and experimental studies (r = 0.25, [95% CI 0.01-0.45]). We also found that general motor competence (r = 0.25, [95% CI 0.18-0.33]), locomotor (r = 0.15, [95% CI 0.09-0.21]), object control (r = 0.14, [95% CI 0.08-0.20]) and stability (r = 0.14, [95% CI 0.08-0.20]) skills were associated with executive functions. We did not find any moderating effects for participants' age on the associations between motor competence and executive functions.

CONCLUSIONS

Our findings suggest a small-to-moderate positive association between motor competence and executive functions in children and adolescents. The small number of experimental studies included in this review support the assertion that interventions targeting children's motor competence may be a promising strategy to improve their executive functions; however, more research is needed to confirm these findings. Future studies should explore the underlying mechanisms linking motor competence and executive functions as their comprehension may be used to optimise future intervention design and delivery.

PROSPERO REGISTRATION

CRD42021285134.

The "thinking system" in a new school concept: A rhythmic teaching approach in physical education to develop creativity

System Thinking is an actual construct supported by several scientific evidence that offer a perspective on how phenomena relate. Rhythm methodology, teaching-learning, and enjoyment in physical education are the main system elements we hypothesize interacting closely to determine direct or mediated effects on motor creativity and rhythmic perceptive capacity. Seventy-six elementary and middle school students (8.9 ± 2.1 years) were randomly assigned to two groups: a) an intervention group that received a physical education lesson based on rhythmic methodology and b) a control group that received conventional lessons without specific rhythmic interventions. Participants were engaged in eight physical education lessons lasting one hour each for eight weeks. Tests and questionnaires were administered before and after the intervention to evaluate motor creativity, rhythmic perception capacity, self-perception and enjoyment. Two lessons were randomly analyzed to identify the teaching style and motor content (moderate and vigorous activity). The main results revealed direct effects on the intervention group's motor creativity (p = 0.001) and its rhythmic perception capacity (p = 0.02). Furthermore, enjoyment mediated the effects of the intervention on motor creativity (p = 0.01). Finally, the results have shown that self-perception does not mediate the effect of rhythmic intervention group on motor creativity and rhythmic perceptive capacity (p > 0.05). A rhythmic methodology proposed by specific multi-teaching styles can involve children and young people in an enjoyable activity with more moderate to vigorous physical activity.

Influence of rhythmic-movement activity intervention on hot executive function of 5- to 6-year-old children

Hot Executive Function (hot EF) refers to cognitive process involved in high emotion or motivation, and the operation of this function is related to the activities of the ventromedial prefrontal lobe and orbitofrontal lobe. Meanwhile, rhythmic-movement activity is a musical activity in which one expresses and feels music with one's own body movements which involves cognitive abilities such as adjusting and understanding emotions among children. To explore how rhythmic-movement activity with rewards influences the development of hot EF in children of 5-6 years old, the organization principles of rhythmic-movement activity with rewards intervention on hot EF were designed, and 62 children of 5-6 years old in a kindergarten in Yantai of China were selected as research participants (M = 5.80 years old, SD = 0.37 years old) for pre-test and post-test experimental design. The experimental group received rhythmic-movement activity with rewards three times a week for 6 weeks, while the control group did not. The gift delay task and the children's gambling task were used to measure two sub-components of hot EF before and after the intervention, and the results show that rhythmic-movement activity with rewards has a significant effect on gratification delay and affective decision-making ability of children. Finally, the effects and enlightenment of rhythmic-movement activity with rewards on hot EF are discussed.

Association between physical activity and self-regulation in early childhood: A systematic review

Physical activity and self-regulation are important predictors of pediatric overweight and obesity. Young children (0-5 years) with lower physical activity levels and poorer self-regulation skills are at greater risk for overweight. Despite growing evidence that the two constructs are interrelated, their association remains unclear in young children. This review systematically summarized associations between physical activity and self-regulation in early childhood and explored the directionality of associations. Searches were run in six electronic databases. Forty-seven papers met inclusion criteria. Only three studies investigated all three domains of self-regulation (behavioral, cognitive, and emotional). Overall, findings were inconclusive; studies reported weak to moderate positive associations (n = 17), inverse associations (n = 5), mixed associations (n = 15), null association (n = 2), and negative (n = 1) between physical activity and self-regulation. Compared with the emotional and cognitive domains, physical activity was most consistently positively associated with behavioral self-regulation. Only one study assessed bidirectional associations, reporting a positive association. The three studies that included global self-regulation showed contradicting findings. There is some evidence that physical activity dose and sex potentially confound these associations; however, further research is needed given the paucity of studies. This review highlights the need for more in-depth investigation of the complex association between physical activity and global self-regulation.

The Influence of Motor Competence on Broader Aspects of Health: A Systematic Review of the Longitudinal Associations Between Motor Competence and Cognitive and Social-Emotional Outcomes

BACKGROUND

Motor competence has important developmental associations with aspects of physical health, but there has been no synthesis of longitudinal associations with cognitive and social-emotional health.

OBJECTIVES

The first aim was to present a conceptual model that positions motor competence as a mediator between physical activity and cognitive and social-emotional outcomes. The second aim was to synthesize the association of motor competence and cognitive and social-emotional development using longitudinal observational and experimental evidence, in particular to (i) identify the role of task, individual, and environmental characteristics in moderating the association between motor and cognitive and social-emotional outcomes and (ii) synthesize the strength of evidence pertaining to domain-specific relationships.

METHODS

This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses. Five electronic databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were systematically searched. Following study screening and risk-of-bias assessment by two authors, 49 eligible studies were identified for inclusion and grouped by study design. Evidence for domain-specific paths between motor competence and cognitive and social-emotional outcomes was synthesized by calculating the significant analyses in the hypothesized direction, divided by the total number of analyses for that path. These percentages were then collated for each domain outcome. This collated influence was classified as either no association (0-33%), written as '0', or indeterminate/inconsistent (34-59%), written as '?' If there were fewer than three studies in the domain, the strength of evidence was classified as insufficient (I).

RESULTS

Of the 49 studies, 35% were able to satisfy six or more of the seven risk-of-bias criteria. Longitudinal observational evidence about domain-specific and global associations of motor competence and cognitive and social-emotional development is indeterminate. The included studies also did not provide evidence for a consistent moderating role of age and sex. Some preliminary experimental evidence does support the role of motor competence in moderating the influence of cognitively enriched physical activity on cognitive outcomes, especially working memory and social-emotional skills. However, too few studies were appropriately designed to acknowledge the moderating role of contextual mechanisms.

CONCLUSIONS

Between-study heterogeneity means it was not possible to identify definitive domain- and construct-specific relationships between motor competence and cognitive and social-emotional outcomes. To further develop our understanding, it is important that researchers acknowledge the complexity of these relationships within rigorous study designs.

Multimodal personalised executive function intervention (E-Fit) for school-aged children with complex congenital heart disease: protocol for a randomised controlled feasibility study

INTRODUCTION

Children with congenital heart disease (CHD) are at risk for executive functions (EF) impairments. To date, interventions have limited effects on EF in children and adolescents with complex CHD. Therefore, we developed a new multimodal and personalised EF intervention (E-Fit). This study aims to test the feasibility of this intervention called 'E-Fit' for children with complex CHD and EF impairments.

METHODS AND ANALYSIS

This is a single-centre, single-blinded, randomised controlled feasibility study exploring the E-Fit intervention. We aim to enrol 40 children with CHD aged 10-12 years who underwent infant cardiopulmonary bypass surgery and show clinically relevant EF impairments (T-score ≥60 on any Behaviour Rating Inventory for Executive Function questionnaire summary scale). The multimodal intervention was developed with focus groups and the Delphi method involving children and adolescents with CHD, their parents and teachers, and health professionals. The intervention is composed of three elements: computer-based EF training using CogniFit Inc 2022, performed three times a week at home; weekly EF remote strategy coaching and analogue games. The content of the computer and strategy training is personalised to the child's EF difficulties. The control group follows their daily routines as before and completes a diary about their everyday activities four times a week. Participants will be randomised in a 1:1 ratio. Feasibility is measured by the participants' and providers' ratings of the participants' adherence and exposure to the intervention, recruitment rates and the evaluation of the intended effects of the programme.

ETHICS AND DISSEMINATION

Local ethics committee approval was obtained for the study (BASEC-Nr: 2021-02413). Parents provide written informed consent. Key outputs from the trial will be disseminated through presentations at conferences, peer-reviewed publications and directly to participating families. Furthermore, these results will inform the decision whether to proceed to a randomised controlled trial to investigate effectiveness.

TRIAL REGISTRATION NUMBER

NCT05198583.

Joint association of sleep duration and physical activity with cognitive performance among Chinese adults: an analysis of nationally representative survey data

Background

Although previous studies have identified that both physical activity and sleep problems are independently associated with decreased risk of cognitive function. However, the joint association of physical activity and sleep duration with cognitive function was rarely studied.

Methods

A total of 21,128 participants who had records from the China Family Panel Studies (CFPS) in 2018 were included in this study. Linear regression was used to examine the associations of joint between physical activity and sleep duration with cognitive function in the nationally representative survey data.

Results

Compared with individuals reporting 150 min/week or more of activity, those reporting no physical activity had a 116% higher risk of getting lower vocabulary scores (coefficient: -1.16, 95% CI: -1.55 ~ -0.78) and a 61% higher risk of getting lower mathematics scores (coefficient: -0.61, 95% CI: -0.78 ~ -0.44). Compared with those who slept for 7-10 h/day, those who slept more than 10 h/day had the lower vocabulary scores (coefficient: -1.34, 95% CI: -1.86 ~ -0.83) and mathematics scores (coefficient: -0.68, -0.94 ~ -0.42). The results of joint analysis showed that the adjusted coefficient for vocabulary scores were - 2.58 (95% CI, -3.33 ~ -1.82) for individuals reporting no physical activity and sleeping for 10 h/day, and - 1.00 (95% CI, -1.88 ~ -0.12) for individuals reporting more than 150 min/week and sleeping for 10 h/day, compared with those who reported a sleep duration for 7-10 h/day and more than 150 min/week physical activity, Any level of physical activity combined with longer sleep duration (≥10 h/day) was associated with a higher risk of getting low mathematics scores.

Conclusion

Appropriate sleep and sufficient physical activity together may have amplified association on cognitive performance, highlighting the importance of a comprehensive healthy lifestyle.

Rhythmic Physical Activity and Global Cognition in Older Adults with and without Mild Cognitive Impairment: A Systematic Review

Growing evidence suggests that rhythmic physical activity (PA) improves cognitive function in both persons with normal brain aging and with cognitive impairment. This study aims to conduct a systematic review of randomized controlled trials assessing the effects of rhythmic PA over global cognition in older adults with and without mild cognitive impairment. Different keywords related to the topic and Boolean operators were used in the Web of Science, PubMed, and Scopus databases. A total of 11 articles that met the inclusion criteria were analyzed; all of them assessed global cognition using either the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA) or the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Five studies showed beneficial effects over global cognition. All studies had at least one experimental group with rhythmic training, and the interventions evidenced a great diversity of rhythmic stimuli, as well as a varied frequency, duration and type of activities. The heterogeneity of the protocols could be the reason for the mixed findings. Future studies with more precise exercise prescriptions are needed to establish whether rhythmic PA has beneficial effects on global cognition.

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.

Can Earth's Mightiest Heroes Help Children Be Physically Active? Exploring the Immersive Qualities of Les Mills' and Marvel's "Move Like the Avengers" Video

There have been calls for more enjoyable Physical Activity (PA) interventions which focus on ensuring a positive affective response. This study explored how using a narrative, characters, and music in a video-led PA session might influence the sense of immersion and impact the affective response. One hundred and thirty-six participants (boys n = 65, girls n = 71) were recruited, 85% aged between 7 and 11 years old. Participants completed the "Move Like the Avengers" PA video created by Les Mills and Marvel, then complete a survey answering questions on their post activity affective responses, and the use of immersive elements. Positive average affective responses were found (valence mean score: 3.6 ± 2.2, arousal mean score: 5.1 ± 1.0). Analysis revealed the narrative with characters indirectly mediate the valence response through creating a sense of immersion (β_std = 0.122 [95%CI 0.013 to 0.231]; p = 0.012). Musical elements had both a direct (β_std = 0.449 [95%CI 0.264 to 0.634]; p < 0.001), and an indirect (β_std = 0.122 [95%CI 0.014 to 0.229]; p = 0.011) effect upon valence and a direct effect upon arousal (β_std = 0.244 [95%CI 0.006 to 0.482]; p = 0.021). These promising results provide justification for future research into children's immersive PA.