Effects of a programme of vigorous physical activity during secondary school physical education on academic performance, fitness, cognition, mental health and the brain of adolescents (Fit to Study): study protocol for a cluster-randomised trial

School-based physical activity interventions: which intervention characteristics are associated with participation and retention? A meta-analysis

OBJECTIVE

Many school-based intervention studies are conducted to increase students' physical activity (PA). Recruitment and retention problems potentially impact the robustness of RCT findings. We conducted a meta-analysis to summarize recruitment and retention rates in long-term secondary school-based PA intervention studies and examined associated participant and intervention characteristics.

METHODS

Web of Science, Pubmed, Medline, and PsychInfo were searched until March 20th 2023. We included studies on secondary school-based PA interventions ≥12 weeks, aimed at typically developing adolescents. We abstracted number of schools and students invited, randomized, and participating at follow-up to calculate pooled recruitment and retention rates; participant and intervention characteristics were abstracted to execute subgroup or meta-regression analyses.

RESULTS

Recruitment rates were 51% for invited schools and 80% for invited students, the retention for schools was almost 100% and for students 91%. Interventions with fixed and flexible components, executed in Asia and South America, and from later publication years had higher student recruitment rates. Students' retention rates were lower for interventions which had flexible components, were theory/model-based, used an accelerometer, had a longer intervention duration, and included more females.

CONCLUSION

Recruitment and retention rates in school-based PA interventions are high. Some participant and intervention characteristics influence these rates: flexibility of the intervention, theory/model-based intervention, accelerometer use, intervention duration, continent, and number of females. Researchers should consider these characteristics in intervention development to achieve optimal balance between intervention effectiveness, recruitment, and retention.

Process evaluation of school-based high-intensity interval training interventions for children and adolescents: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Several systematic reviews have been published to investigate the effectiveness of high-intensity interval training (HIIT) in schools. However, there has been limited attention given to understanding the functioning of the intervention processes, which is of paramount importance for interpreting and translating the intervention effectiveness. The aim of this systematic review is to determine the extent to which process evaluation is measured in school-based HIIT interventions and to explore the effects of process evaluation and intervention characteristics on cardiorespiratory fitness (CRF), body composition, muscular strength, and blood pressure.

METHODS

A comprehensive search was conducted in SPORT Discus (EBSCOhost), Web of Science, Scopus, Medline (Ovid) and Cochrane Central Register of Controlled Trials. The extent to which process evaluation is measured was narratively reported, alongside with the guidance of process evaluation of complex interventions by UK Medical Research Council. Meta-analyses and meta-regressions were conducted to determine the effects of process evaluation and intervention characteristics to the intervention outcomes.

RESULTS

The literature search identified 77 studies reporting on 45 school-based HIIT interventions. In total, five interventions reported process evaluation in a section or in a separate study, and only one intervention adopted a process evaluation framework. On average, 6 out of 12 process evaluation measures were reported in all interventions. Subgroup analyses did not indicate any beneficial treatment effects for studies with process evaluation group, whereas all pooled data and studies without process evaluation group showed significant improvement for CRF and body composition.

CONCLUSION

Process evaluation is frequently omitted in the literature of school-based HIIT in children and adolescents. Although reporting of process evaluation measures may not directly associate with better intervention outcomes, it allows accurate interpretation of intervention outcomes, thereby enhancing the generalisability and dissemination of the interventions.

Functional physical training improves fitness and cognitive development in 4~5 years old children

Background

Development of physical and cognitive function is very critical in 4~5 years children. It has been addressed in this research if the 18 weeks of specific functional training with or without cognitive training can be effective on improving fitness and cognitive development in 4~5 years preschool children.

Methods

A total of 126 preschool children in the 4~5 age range were selected as participants and randomly assigned to one of four groups: the control group (C), the functional physical training group (P), the cognitive training group (CT), and the functional physical training combined with cognitive training group (PCT).

Results

The results revealed significant pre/post differences in body height and weight among all four groups of children. Furthermore, there was no significant difference in physical fitness between the C group and the CT group after the intervention. However, the children in the P group and the PCT group showed significant improvements in three indicators including standing long jump, continuous jump, and 10-meter shuttle running. Additionally, the children in P group, CT group, and the PCT group demonstrated significant improvement in simple reaction time, attention, and spatial memory. No significant cognitive improvement was found in C group.

Conclusion

Functional physical training with or without cognitive intervention can promote both physical fitness and cognitive development in children aged 4~5 years. Cognitive training alone can significantly improve cognitive function but not physical. Therefore, functional physical training can be used alone to improve the physical and cognitive abilities for aged 4~5 years old children.

Effects of two years of physically active lessons on cognitive indicators in children

Our purpose was to evaluate the effect of physically active lessons (PAL) on the cognitive performance of children during two years of follow-up. Four classes (second grade of elementary school) were divided into two intervention classes (n = 34) and two control classes (n = 27). Evaluations were performed before the intervention (M1), after 3 (M2) and 9 (M3) months in the 1st year, and 14 (M4) and 18 (M5) months in the 2nd year. The intervention was based on PAL integrated with the curricular components, which stimulated the children to stand or move in the classroom. Cognitive performance was evaluated using three computerized tests for response inhibition, selective attention, and cognitive flexibility. The children in the intervention classes presented improved cognitive performance in the execution of all tasks along the two years follow-up, in both correct answers and time reactions, with exception of correct answers of visual search. For the intervention classes, in most of the tasks, the mean differences confidence interval of 95% did not include the 0 on the two last moments of evaluation, and in all cases, the mean differences of them between M1 versus M5 were significantly different with high values of effect size (cohen -d > 1). PAL promotes modest improvements in diverse cognitive functions in children.

Classroom-Based Physical Activity as a Means to Improve Self-Efficacy and Academic Achievement among Normal-Weight and Overweight Youth

Although physical activity has positive physical and mental health outcomes, particularly among adolescents, a significant percentage of young people maintain a largely sedentary lifestyle. Considering that the youths spend the greater part of the day at school, this is considered an ideal setting to foster active and healthy living. Consequently, this study is intended to investigate the connection between physical activity, self-efficacy and academic achievement in normal-weight and overweight adolescents. In total, 100 students (aged 14-15) from a public high school placed in the south of Italy were enrolled. They participated either in a 12-week classroom-based physical activity break program performed during science classes (60'/2 days per week) in which a nutritional educational program was carried out or in regular science lessons (60'/2 days per week). At the beginning and end of the intervention programs, a set of standardized motor evaluation tests (standing long jump test, Harvard step test, push up, sit and reach test), the scholastic self-efficacy test and the Amos 8-15 were administered. As a result, a meaningful Time × Group interaction for the self-efficacy variable and Amos 8-15 was observed in the intervention group. Specifically, they reported significant improvement in study skills, motivational factors, concentration and self-efficacy, as well as a decrease in anxiety and BMI (p < 0.001). No significant change was observed in the control group. The conclusions of this research underpin the notion that classroom-based physical activity break is a successful approach for enhancing students' psycho-physical well-being, as well as academic achievement.

Main results and public health implications of the National School Health Survey (ENSE), Colombia 2017

Introduction

The school population represents a fundamental group for health promotion actions, given that the foundations of healthy behaviors in adult life are established in children and adolescents, who can be greatly influenced by the school.

Objective

To describe the health-related behavioral factors of schoolchildren between 13 and 17 years of age in secondary and middle school in Colombia.

Methods

A national cross-sectional study was conducted (i.e., School Health Survey -ENSE-) that recorded information on dietary practices, physical activity, alcohol and drug consumption, injuries and bullying, and oral, visual and hearing health. Sampling was probabilistic, cluster and multistage.

Results

Schoolchildren have low consumption of fruits, vegetables (13.1%) and dairy (76.5 %), high consumption of ultra-processed foods (82.4 %), sugary drinks (74.0 %) and fast foods (14.8 %), frequent addition of salt at the table (43.3 %), low compliance with physical activity recommendations (15.0 %) and high sedentary lifestyle (46.3 %), frequent consumption of alcohol (44.7 %) and psychoactive substances (14.7 %), in addition to prevalent situations of bullying (15.4 %), rejection (8.2 %) and verbal aggression (42.7 %).

Conclusions

The ENSE shows critical inequalities by gender, ethnicity and social class, throughout the country. The indicators observed in schoolchildren are precursors of various chronic and degenerative diseases and mental illness, which requires the urgent attention of the different social actors in the country.

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.

Promoting Physical Activity Habits after Completing Secondary School: Does the Age Matter?

Physical inactivity is one of the most important problems in our society, especially during adolescence. During this stage of schooling, students practice physical activity in physical education classes, but after they finish school, many of them stop practicing it. This research aims to determine which variables predict the intention to practice physical activity after finishing secondary school and to discover the effect that age during adolescence has on these predictive variables. A questionnaire was administered to a sample of secondary school students. The results show that physical exercise identity influences the three antecedents of this theory, while the attitude towards the behaviour (β = 0.13; p < 0.05), perceived behavioural control (β = 0.46; p < 0.05), and physical self-concept (β = 0.41; p < 0.05), have a statistically significant influence on the intention to be physically active. Moreover, when the age is lower, is more important to develop a positive perceived behavioural control and physical exercise identity. Moreover, for younger male adolescents instead of the physical exercise itself, identity seems more important in developing a positive attitude towards behaviour. Likewise, in young female adolescents a low level of support from their close environment (subjective norm) leads to dropping out. The research concludes with the importance of including these variables in physical education classes to promote physical activity practice after completion of secondary school. Some practical implications are presented.

Influencing Factors and Improvement Path of Academic Engagement among College Students in the Context of Epidemic Prevention and Control

OBJECTIVE

The implementation of online teaching in the context of epidemic prevention and control has had an impact on the learning engagement of college students to some extent. This study aims to investigate the mechanisms that influence perceived social support and health behaviors on learning engagement, so as to make college students more focused on their studies by improving their physical and mental health as well as their ability to perceive social support.

METHODS

A total of 538 college students from Henan Province, China, were studied using the Perceived Social Support Scale, Health Behavior Scale and Learning Engagement Scale, and the data were analyzed by IBM SPSS Amos 26.0 software (IBM SPSS Inc., Chicago, IL, USA).

RESULTS

(1) The level of health behavior among college students was positively correlated with perceived social support ability (β = 0.289, p < 0.001); both perceived social support and health behaviors predicted college students' learning engagement significantly (β = 0.200, p < 0.01; β = 0.406, p < 0.001). (2) College students' perceived social support partially mediated the relationship between health behaviors and learning engagement.

CONCLUSION

One of the main ways to improve college students' learning engagement is to improve their health behavior and perceived social support. This study contributes to a better understanding of the relationships between health behaviors and learning engagement, as well as to the development of interventions to improve learning engagement among college students.

Persistence of Anxiety/Depression Symptoms in Early Adolescence: A Prospective Study of Daily Life Stress, Rumination, and Daytime Sleepiness in a Genetically Informative Cohort

In this prospective study of mental health, we examine the influence of three interrelated traits - perceived stress, rumination, and daytime sleepiness - and their association with symptoms of anxiety and depression in early adolescence. Given the known associations between these traits, an important objective is to determine the extent to which they may independently predict anxiety/depression symptoms. Twin pairs from the Queensland Twin Adolescent Brain (QTAB) project were assessed on two occasions (N = 211 pairs aged 9-14 years at baseline and 152 pairs aged 10-16 years at follow-up). Linear regression models and quantitative genetic modeling were used to analyze the data. Prospectively, perceived stress, rumination, and daytime sleepiness accounted for 8-11% of the variation in later anxiety/depression; familial influences contributed strongly to these associations. However, only perceived stress significantly predicted change in anxiety/depression, accounting for 3% of variance at follow-up after adjusting for anxiety/depression at baseline, although it did not do so independently of rumination and daytime sleepiness. Bidirectional effects were found between all traits over time. These findings suggest an underlying architecture that is shared, to some degree, by all traits, while the literature points to hypothalamic-pituitary-adrenal (HPA) axis and/or circadian systems as potential sources of overlapping influence and possible avenues for intervention.

The importance of prototype similarity for physical activity: Cross-sectional and longitudinal associations in a large sample of young adolescents

Objectives

Physical activity declines during adolescence. The Theory of Planned Behaviour (TPB) is a useful framework for investigating activity but leaves variance unexplained. We explored the utility of a dual‐process approach using the TPB and the Prototype Willingness Model (PWM) to investigate correlates of physical activity, and 1‐year change in physical activity, among a large sample of adolescents.

Design

A cross‐sectional and longitudinal analysis of baseline and follow‐up data from the Fit to Study cluster‐randomized trial.

Methods

A total of 9,699 secondary school pupils at baseline and 4,632 at follow‐up (mean age = 12.5 years) completed measures of past week physical activity and constructs from both behaviour‐change models, at time‐points 1 year apart. Cross‐sectional analyses used multilevel, stepwise regression models to measure the strength of associations between model constructs and physical activity, and variance in behaviour explained by PWM over and above TPB. In longitudinal analyses, change scores were calculated by subtracting follow‐up from baseline scores. Models controlling for trial treatment status measured the strength of associations between change scores, and variance explained.

Results

At baseline, after controlling for past behaviour, physically active prototype similarity had the strongest relationship with activity after the intention to be active. Change in prototype similarity had the strongest relationship with change in activity after the change in intention and attitudes. Prototype perceptions and willingness explained additional variance in behaviour.

Conclusion

A dual‐process model incorporating prototype perceptions could more usefully predict physical activity than models based on rational expectations alone. Behaviour‐change interventions promoting an active self‐image could be tested for effects on physical activity.

Physical Activity Knowledge, Attitude, and Behaviours Among Adolescents in the Kingdom of Saudi Arabia Prior to and during COVID-19 Restrictions

BACKGROUND

The prevalence of childhood and adolescent obesity has increased dramatically and poses a major public health threat globally. In the Kingdom of Saudi Arabia (KSA), the main cause of adolescent obesity is an increase in physical inactivity and unhealthy eating habits due to lifestyle changes. This study reports on factors associated with physical activity (PA) prior to and during the coronavirus disease of 2019 (COVID-19) among middle school students in Jeddah, KSA.

METHOD

A cross-sectional online survey was conducted in Jeddah, KSA among 1500 middle school students aged 11 to 15 years. Sociodemographic characteristics; PA knowledge, attitude, and behaviours; and information about the impact of COVID-19 on PA were collected. Knowledge, attitude, and behaviours of PA before and during COVID-19 restrictions and between gender were compared. Regression analyses were conducted to assess the determinants of PA.

RESULTS

Female students were significantly more likely to report better knowledge of PA compared to males (p < 0.001). However, males were significantly more likely to participate in PA compared to females (p < 0.001). Approximately 60% of students reported their PA decreased during COVID-19 isolations. Most students did not participate in the recommended levels of daily PA during COVID-19 lockdowns and school closures. After adjusting for demographics, knowledge, and attitude, students who did not usually participate in school sports (p=0.017) and as members of clubs (p=0.002) were less likely to be active during COVID-19 lockdown.

CONCLUSIONS

Efforts to enhance PA should be implemented through coordinated school and community-based programs to achieve the recommended PA among adolescents at home and in schools. Policy to ensure students receive PA opportunities at school is recommended.

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.

Collecting big data with small screens: Group tests of children's cognition with touchscreen tablets are reliable and valid

Collecting experimental cognitive data with young children usually requires undertaking one-on-one assessments, which can be both expensive and time-consuming. In addition, there is increasing acknowledgement of the importance of collecting larger samples for improving statistical power Button et al. (Nature Reviews Neuroscience 14(5), 365-376, 2013), and reproducing exploratory findings Open Science Collaboration (Science, 349(6251), aac4716-aac4716 2015). One way both of these goals can be achieved more easily, even with a small team of researchers, is to utilize group testing. In this paper, we evaluate the results from a novel tablet application developed for the Resilience in Education and Development (RED) Study. The RED-app includes 12 cognitive tasks designed for groups of children aged 7 to 13 to independently complete during a 1-h school lesson. The quality of the data collected was high despite the lack of one-on-one engagement with participants. Most outcomes from the tablet showed moderate or high reliability, estimated using internal consistency metrics. Tablet-measured cognitive abilities also explained more than 50% of variance in teacher-rated academic achievement. Overall, the results suggest that tablet-based, group cognitive assessments of children are an efficient, reliable, and valid method of collecting the large datasets that modern psychology requires. We have open-sourced the scripts and materials used to make the application, so that they can be adapted and used by others.

The effect of a one-year vigorous physical activity intervention on fitness, cognitive performance and mental health in young adolescents: the Fit to Study cluster randomised controlled trial

Background

Physical activity (PA) may positively stimulate the brain, cognition and mental health during adolescence, a period of dynamic neurobiological development. High-intensity interval training (HIIT) or vigorous PA interventions are time-efficient, scalable and can be easily implemented in existing school curricula, yet their effects on cognitive, academic and mental health outcomes are unclear. The primary aim of the Fit to Study trial was to investigate whether a pragmatic and scalable HIIT-style VPA intervention delivered during school physical education (PE) could improve attainment in maths. The primary outcome has previously been reported and was null. Here, we report the effect of the intervention on prespecified secondary outcomes, including cardiorespiratory fitness, cognitive performance, and mental health in young adolescents.

Methods

The Fit to Study cluster randomised controlled trial included Year 8 pupils (n = 18,261, aged 12–13) from 104 secondary state schools in South/Mid-England. Schools were randomised into an intervention condition (n = 52), in which PE teachers delivered an additional 10 min of VPA per PE lesson for one academic year (2017–2018), or into a “PE as usual” control condition. Secondary outcomes included assessments of cardiorespiratory fitness (20-m shuttle run), cognitive performance (executive functions, relational memory and processing speed) and mental health (Strength and Difficulties Questionnaire and self-esteem measures). The primary intention-to-treat (ITT) analysis used linear models and structural equation models with cluster-robust standard errors to test for intervention effects. A complier-average causal effect (CACE) was estimated using a two-stage least squares procedure.

Results

The HIIT-style VPA intervention did not significantly improve cardiorespiratory fitness, cognitive performance (executive functions, relational memory or processed speed), or mental health (all p > 0.05). Subgroup analyses showed no significant moderation of intervention effects by sex, socioeconomic status or baseline fitness levels. Changes in cardiorespiratory fitness were not significantly related to changes in cognitive or mental health outcomes. The trial was marked by high drop-out and low intervention compliance. Findings from the CACE analysis were in line with those from the ITT analysis.

Conclusion

The one-academic year HIIT-style VPA intervention delivered during regular school PE did not significantly improve fitness, cognitive performance or mental health, but these findings should be interpreted with caution given low implementation fidelity and high drop-out. Well-controlled, large-scale, school-based trials that examine the effectiveness of HIIT-style interventions to enhance cognitive and mental health outcomes are warranted.

Trial registration

ISRCTN registry, 15,730,512. Trial protocol and analysis plan for primary outcome prospectively registered on 30th March 2017.

ClinicalTrials.gov, NCT03286725. Secondary measures (focus of current manuscript) retrospectively registered on 18 September 2017.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01113-y.

Exploring activity levels in physical education lessons in the UK: a cross-sectional examination of activity types and fitness levels

OBJECTIVES

To establish pupil fitness levels, and the relationship to global norms and physical education (PE) enjoyment. To measure and describe physical activity (PA) levels during secondary school PE lessons, in the context of recommended levels, and how levels vary with activity and lesson type.

METHODS

A cross-sectional design; 10 697 pupils aged 12.5 (SD 0.30) years; pupils who completed a multistage fitness test and wore accelerometers to measure PA during PE lessons. Multilevel models estimated fitness and PE activity levels, accounting for school and class-level clustering.

RESULTS

Cardiorespiratory fitness was higher in boys than girls (ß=-0.48; 95% CI -0.56 to -0.39, p<0.001), within absolute terms 51% of boys and 54% of girls above the 50th percentile of global norms. On average, pupils spent 23.8% of PE lessons in moderate-to-vigorous PA (MVPA), and 7.1% in vigorous PA (VPA). Fitness-focused lessons recorded most VPA in co-educational (ß=1.09; 95% CI 0.43 to 1.74) and boys-only lessons (ß=0.32; 95% CI -0.21 to 0.85). In girls-only lessons, track athletics recorded most VPA (ß=0.13; 95% CI -0.50 to 0.75) and net/wall/racket games (ß=0.97; 95% CI 0.12 to 1.82) the most MVPA. For all lesson types, field athletics was least active (ß=-0.85; 95% CI -1.33 to -0.36). There was a relationship of enjoyment of PE to fitness (ß=1.03; 95% CI 0.83 to 1.23), and this relationship did not vary with sex (ß=-0.14 to 0.23; 95% CI -0.16 to 0.60).

CONCLUSIONS

PE lessons were inactive compared with current guidelines. We propose that if we are to continue to develop a range of sporting skills in schools at the same time as increasing levels of fitness and PA, there is a need to introduce additional sessions of PE activity focused on increasing physical activity.

TRIAL REGISTRATION NUMBER

NCT03286725.

Multimodal Imaging Brain Markers in Early Adolescence Are Linked with a Physically Active Lifestyle

The World Health Organization promotes physical exercise and a healthy lifestyle as means to improve youth development. However, relationships between physical lifestyle and human brain development are not fully understood. Here, we asked whether a human brain-physical latent mode of covariation underpins the relationship between physical activity, fitness, and physical health measures with multimodal neuroimaging markers. In 50 12-year old school pupils (26 females), we acquired multimodal whole-brain MRI, characterizing brain structure, microstructure, function, myelin content, and blood perfusion. We also acquired physical variables measuring objective fitness levels, 7 d physical activity, body mass index, heart rate, and blood pressure. Using canonical correlation analysis, we unravel a latent mode of brain-physical covariation, independent of demographics, school, or socioeconomic status. We show that MRI metrics with greater involvement in this mode also showed spatially extended patterns across the brain. Specifically, global patterns of greater gray matter perfusion, volume, cortical surface area, greater white matter extra-neurite density, and resting state networks activity covaried positively with measures reflecting a physically active phenotype (high fit, low sedentary individuals). Showing that a physically active lifestyle is linked with systems-level brain MRI metrics, these results suggest widespread associations relating to several biological processes. These results support the notion of close brain-body relationships and underline the importance of investigating modifiable lifestyle factors not only for physical health but also for brain health early in adolescence.SIGNIFICANCE STATEMENT An active lifestyle is key for healthy development. In this work, we answer the following question: How do brain neuroimaging markers relate with young adolescents' level of physical activity, fitness, and physical health? Combining advanced whole-brain multimodal MRI metrics with computational approaches, we show a robust relationship between physically active lifestyles and spatially extended, multimodal brain imaging-derived phenotypes. Suggesting a wider effect on brain neuroimaging metrics than previously thought, this work underlies the importance of studying physical lifestyle, as well as other brain-body relationships in an effort to foster brain health at this crucial stage in development.

Implementation of Brain Breaks® in the Classroom and Its Effects on Attitudes towards Physical Activity in a Chinese School Setting

This study aimed to examine the effects of three-months of classroom-based Brain Breaks Physical Activity Solution (Brain Breaks®) on attitudes toward physical activity levels of primary school children in Henan Province, China. The participants were 704 children enrolled in grades 3-5 who were randomly assigned to either an experimental or a control group. The experimental group participated in Brain Breaks® video intervention for 3-5 min daily, at low-to-moderate intensity for three consecutive months. The control group resumed their normal routine. The children's attitudes in both groups towards physical activity (PA) were evaluated using the self-reported Attitudes toward Physical Activity Scale (APAS), before and after the intervention. The effects of the intervention on APAS scores were analyzed using mixed model analysis of variance with Time as within-subject, and Group as between-subject factors. The analysis revealed evidence in support of the positive effect of classroom video interventions such as Brain Break on children's attitudes toward importance, fun, and trying to do their personal best in physical activity. Also revealed was the important role the teacher plays in this process.

Neurobiological evidence of longer-term physical activity interventions on mental health outcomes and cognition in young people: A systematic review of randomised controlled trials

OBJECTIVE

To investigate putative neurobiological mechanisms that link longer-term physical activity interventions to mental health and cognitive outcomes using randomised controlled trials in children, adolescents and young adults.

DATA SOURCES

A range of medical and psychological science electronic databases were searched (MEDLINE, EMBASE, Scopus, Web of Science, PsychINFO).

REVIEW METHODS

Original research studies were selected, data were extracted and quality was appraised.

RESULTS

Sixteen primary papers were included, ranging from healthy and community samples to subclinical and clinical populations across a variety of age ranges and using different neurobiological measures (e.g. magnetic resonance imaging, electroencephalography, cortisol, brain-derived neurotropic factor).

DISCUSSION

The majority of studies report improvement in mental health and cognition outcomes following longer-term physical activity interventions which coincide with neurobiological alterations, especially neuroimaging alterations in activation and electrophysiological parameters in frontal areas. Future research should include measures of pre-existing fitness and target those who would benefit the most from this type of intervention (e.g. those with a lower level of fitness and at risk for or with mental health problems).

Associations between fitness, physical activity and mental health in a community sample of young British adolescents: baseline data from the Fit to Study trial

OBJECTIVES

To examine relationships between fitness, physical activity and psychosocial problems among English secondary school pupils and to explore how components of physically active lifestyles are associated with mental health and well-being.

METHODS

A total of 7385 participants aged 11-13 took a fitness test and completed self-reported measures of physical activity, attitudes to activity, psychosocial problems and self-esteem during the Fit to Study trial. Multilevel regression, which modelled school-level cluster effects, estimated relationships between activity, fitness and psychosocial problems; canonical correlation analysis (CCA) explored modes of covariation between active lifestyle and mental health variables. Models were adjusted for covariates of sex, free school meal status, age, and time and location of assessments.

RESULTS

Higher fitness was linked with fewer internalising problems (β=-0.23; 95% CI -0.26 to -0.21; p<0.001). More activity was also related to fewer internalising symptoms (β=-0.24; 95% CI -0.27 to -0.20; p<0.001); the relationship between activity and internalising problems was significantly stronger for boys than for girls. Fitness and activity were also favourably related to externalising symptoms, with smaller effect sizes. One significant CCA mode, with a canonical correlation of 0.52 (p=0.001), was characterised high cross-loadings for positive attitudes to activity (0.46) and habitual activity (0.42) among lifestyle variables; and for physical and global self-esteem (0.47 and 0.42) among mental health variables.

CONCLUSION

Model-based and data-driven analysis methods indicate fitness as well as physical activity are linked to adolescent mental health. If effect direction is established, fitness monitoring could complement physical activity measurement when tracking public health.

Fit to Study: Reflections on designing and implementing a large-scale randomized controlled trial in secondary schools

Background

The randomised controlled trial (RCT) design is increasingly common among studies seeking good-quality evidence to advance educational neuroscience, but conducting RCTs in schools is challenging. Fit to Study, one of six such trials funded by the Education Endowment Foundation and Wellcome Trust, tested an intervention to increase vigorous physical activity during PE lessons on maths attainment among pupils aged 12–13. This review of designing and conducting an RCT in 104 schools is intended as a resource on which researchers might draw for future studies.

Method

We consider intervention design and delivery; recruitment, retention, trial management, data collection and analysis including ethical considerations and working with evaluators.

Results

Teacher training, intervention delivery and data collection during large-scale RCTs require a flexible approach appropriate to educational settings, which in turn entails planning and resources.

Conclusion

Simple interventions, with few outcome measures and minimal missing data, are preferable to more complex designs.

A critical evaluation of systematic reviews assessing the effect of chronic physical activity on academic achievement, cognition and the brain in children and adolescents: a systematic review

BACKGROUND

International and national committees have started to evaluate the evidence for the effects of physical activity on neurocognitive health in childhood and adolescence to inform policy. Despite an increasing body of evidence, such reports have shown mixed conclusions. We aimed to critically evaluate and synthesise the evidence for the effects of chronic physical activity on academic achievement, cognitive performance and the brain in children and adolescents in order to guide future research and inform policy.

METHODS

MedLine, Embase, PsycINFO, Cochrane Library, Web of Science, and ERIC electronic databases were searched from inception to February 6th, 2019. Articles were considered eligible for inclusion if they were systematic reviews with or without meta-analysis, published in peer-reviewed (English) journals. Reviews had to be on school-aged children and/or adolescents that reported on the effects of chronic physical activity or exercise interventions, with cognitive markers, academic achievement or brain markers as outcomes. Reviews were selected independently by two authors and data were extracted using a pre-designed data extraction template. The quality of reviews was assessed using AMSTAR-2 criteria.

RESULTS

Of 908 retrieved, non-duplicated articles, 19 systematic reviews met inclusion criteria. One high-quality review reported inconsistent evidence for physical activity-related effects on cognitive- and academic performance in obese or overweight children and adolescents. Eighteen (critically) low-quality reviews presented mixed favourable and null effects, with meta-analyses showing small effect sizes (0.1-0.3) and high heterogeneity. Low-quality reviews suggested physical activity-related brain changes, but lacked an interpretation of these findings. Systematic reviews varied widely in their evidence synthesis, rarely took intervention characteristics (e.g. dose), intervention fidelity or study quality into account and suspected publication bias. Reviews consistently reported that there is a lack of high-quality studies, of studies that include brain imaging outcomes, and of studies that include adolescents or are conducted in South American and African countries.

CONCLUSIONS

Inconsistent evidence exists for chronic physical activity-related effects on cognitive-, academic-, and brain outcomes. The field needs to refocus its efforts towards improving study quality, transparency of reporting and dissemination, and is urged to differentiate between intervention characteristics for its findings to have a meaningful impact on policy.

The Mediating Role of the Self-Concept Between the Relationship of the Body Satisfaction and the Intention to Be Physically Active in Primary School Students

The aim was to analyze the extent to which anthropometric values, in line with body image and physical ability, predict physical self-concept, and the latter, in turn, predicts the practice and intention to pursue physical activity. A total of 302 participants, 150 males and 152 females were recruited from different primary schools in Extremadura (Spain). The age of the participants ranges from 10 to 13 years old (M = 11.74; SD = 0.86). The indirect effects of the model showed significant relationship between physical condition (p = 0.001) and PA levels, according to the perception of self-concept [β = 0.231, 95% BcCI = (0.055, 0.212)]. However, anthropometric variables proved not to be related to any significant extent (p < 0.05). The second level covered the indirect effects between the intention to be physically active and self-concept, which showed a significant relationship between the perception of self-concept (p = 0.000) and the intention to be physically active. Last, the third level showed significant relationships between physical condition (p = 0.001) and the intention to pursue physical activity. The present investigation concluded that physical condition, anthropometric variables, and body image predict the perception of physical self-concept in adolescents. Finally, this article highlights the importance of body image perception, anthropometric values, and physical condition in the intention of being physically active. In addition, it highlights the mediating role of physical self-concept to develop physical activity.

Efeitos da associação entre espiritualidade, religiosidade e atividade física na saúde/saúde mental: revisão sistemática

RESUMO Objetivo: Identificar na literatura evidências acerca dos efeitos da associação entre espiritualidade, religiosidade e atividade física na saúde física e mental. Método: Revisão sistemática realizada em janeiro de 2019 nas bases de dados MEDLINE/PubMed, SCOPUS, Web Of Science, CINAHL, PsycINFO, LILACS e SciELO, com os descritores “spirituality”, “religion”, “physical activity” e “physical exercise”. Incluíram-se estudos primários realizados com adultos, publicados até 2018 em português, inglês ou espanhol. Resultados: Foram selecionados nove estudos, publicados entre 2011 e 2017, todos internacionais, com desenho transversal (55%) e nível de evidência quatro (78%). Oito estudos abordaram efeitos na saúde física e um abordou efeitos na saúde mental. Conclusão: A Associação entre espiritualidade, religiosidade e atividade física promove efeitos na saúde física e mental, porém as evidências disponíveis não são suficientes para que esta associação seja aplicada na prática clínica.

Effectiveness of a Motor Intervention Program on Motivation and Learning of English Vocabulary in Preschoolers: A Pilot Study

(1) Background: Linking physical activity to the teaching of curricular contents provides numerous motivational and emotional benefits which improve academic performance and lead to the improvement and creation of healthy habits from an early age. (2) Method: The objective of the study is to analyze the effectiveness of a 5-week intervention program based on the use of a combined methodology of physical activity and gestures on motivation and vocabulary learning in English. The sample of children was aged from 4 to 7 years and was recruited from three children’s centers in Tegucigalpa, Honduras. A quasi-experimentalstudy was carried out using a pretest–posttest design in a sample (n = 88). (3) Results: Statistically significant results were obtained in the learning of words through the combined methodology of gestures and motor activity, compared to the traditional methodology used in the control group. (4) Conclusions: The main conclusions are that motor and expressive activities at an early age can be an effective motivational resource that promotes an increase in children’s physical activity time in the classroom. Further, it improves academic performance, producing a more effective learning of the vocabulary of a second language.