Effectiveness of school-based physical activity programmes on cardiorespiratory fitness in children: a meta-analysis of randomised controlled trials
Source: British Journal of Sports Medicine Online First
Authors: Diana P Pozuelo-Carrascosa, Antonio García-Hermoso, Celia Álvarez-Bueno, Mairena Sánchez-López, Vicente Martinez-Vizcaino
Commentary by Trevor Shilton, Co-Director GlobalPANet/AusPAnet, National Heart Foundation of Australia
School-based physical activity interventions are recognised and promoted as good practice by international authorities such as the WHO Commission on Ending Childhood Obesity (WHO, 2016), the WHO NCD Action Plan and its appendix three on ‘best buys’ which calls for ‘implementation of whole-of-school programmes that include quality physical education, availability of adequate facilities and programs to support physical activity for all children’ (WHO, 2012) and finally; the school setting received strong focus in the forthcoming WHO Global Action Plan of Physical Activity (GAPPA).
This systematic review and meta-analysis of randomised controlled trials provides a useful contribution to our understanding of the contribution of school-based programs to the specific outcome of cardiorespiratory fitness (CRF) of children; noting that impact of CRF may be one objective of school-based programmes.
The authors accessed five data sources; MEDLINE, EMBASE, CINAHL, Web of Science and SportDiscus. The review was focused on interventions that measured impact on CRF in children aged 3-12 years. The authors also selected interventions that included an additional physical activity programme, not just the usual physical activity educational component. Twenty trials with 7,287 healthy children were included in the meta-analysis.
The findings indicate moderate quality evidence for the effectiveness of school-based interventions in increasing CRF. Interventions with components including aerobic games and activities were associated with a small but significant increase in CRF. Based on sub-group analysis the increase was significant in girls but not in boys.
The positive finding in girls is encouraging given the concerns about low prevalence of physical activity in girls, and the decline in physical activity among girls during early adolescence. This study had its focus on the outcome measure of CRF. Of course, school based physical activity interventions may also aim to achieve other outcomes including fundamental movements skills, games skills and increase in physical activity levels. These outcomes were beyond the scope of this review.
Schools offer a convenient setting for effective and cost-effective interventions targeting children and young people. This review provides insights into effectiveness of interventions on CRF. Further and ongoing research is required across a broader range of impacts across educational, fitness and health outcomes to inform evidence-based investments in interventions in the important setting of schools.
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