1. In this cluster randomized controlled trial, children who received a daily physical activity (PA) intervention showed improvements in waist-to-height ratio, cardiorespiratory endurance, lower body muscle strength, lower body muscle endurance, and flexibility compared to the control group.
2. Furthermore, children without sports club membership showed more pronounced improvements in cardiorespiratory endurance and flexibility, indicating that this population may benefit the most from daily PA in school.
Evidence Rating Level: 1 (Excellent)
Physical activity (PA) is an important determinant of fitness and can have various long-term health benefits, especially in children and adolescents. However, due to decreases in outdoor play and the effects of the COVID-19 pandemic, there has been a substantial drop in the amount of PA that children and adolescents achieve. One strategy for improving overall population PA levels is implementing PA programs in schools. However, these require significant time, spatial, and human resources. Thus, this study aimed to evaluate a PA program that did not require additional spatial resources or curriculum changes on health-related fitness parameters in primary school children.
This cluster randomized controlled trial included 412 children (n=24 classes) attending fourth grade in Austria in September 2021. Participants were included if they were 8-12 years old and had no physical limitations preventing them from performing the fitness tests. The 24 classes were randomly assigned to either the intervention or control group. The intervention group received two standard physical education (PE) classes delivered by teachers but supported by external coaches. On the remaining three school days, students learned academic content combined with specific movement activities. Additionally, once a week, students in the intervention group received PA activities as homework. The control group received the usual school curriculum consisting of two 50-minute PE classes weekly. The study went on for the duration of one school year. Baseline measurements were conducted in September 2021, and follow-up measurements were collected in June 2022. A series of fitness tests were used to assess health-related fitness, including a 6-minute run for cardiorespiratory endurance, a standing long jump for lower body muscular strength, and more. The primary outcome was the difference in anthropometric measurements and fitness parameters between the intervention and control groups.
The results demonstrated that the intervention group exhibited a significant improvement in wait-to-height ratio, but not body mass index, compared to the control group. The intervention group also showed improvements in cardiorespiratory endurance, lower body muscle strength, lower body muscle endurance, and flexibility compared to the control group. Furthermore, for those without sports club membership, there were pronounced improvements in cardiorespiratory endurance and flexibility in the intervention group compared to the control. However, the study was limited by the lack of data on important covariates, such as nutrition, which may have influenced the results. Nonetheless, the study suggested that a daily PA program delivered in schools can significantly improve health-related fitness measures, especially in children without sports club membership.
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