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Objective: To conduct a meta-analysis of randomised controlled trials aimed at testing whether school-based physical activity programmes improve cardiorespiratory fitness (CRF) in children.Design: Systematic review with meta-analysis.Data Sources: Using keywords, we performed a computerised search in five databases: MEDLINE, EMBASE, CINAHL, Web of Science and SportDiscus.Eligibility Criteria For Selecting Studies: Studies that assessed the effectiveness of school-based physical activity programmes on improving CRF in children (3-12 years old). We selected interventions that included an additional physical activity programme and not only a physical activity educational component. The reference lists of selected full-text articles and systematic reviews were also searched for relevant studies. Pooled effect size (Hedges' g) was calculated assuming a random-effects model.Results: Twenty trials with 7287 healthy children aged 3-12 years were included in the meta-analysis. School-based physical activity interventions with aerobic games and activities were associated with a significant small increase in CRF (Hedges' g=0.22; 95% CI 0.14 to 0.30; p<0.001). Based on subgroup analysis, the increase in CRF was significant in girls (Hedges' g=0.25; 95% CI 0.13 to 0.37; p<0.001), but not in boys (Hedges' g=0.02; 95% CI -0.10 to 0.14; p=0.731).Summary: Moderate quality evidence supports the effectiveness of school-based physical activity interventions on improving CRF in children.Trial Registration Number: Protocol PROSPERO registration number CRD42016050173. [ABSTRACT FROM AUTHOR]

Background and Aim: There is a widely held and influential view that physical activity begins to decline at adolescence. This study aimed to identify the timing of changes in physical activity during childhood and adolescence.Methods: Longitudinal cohort study (Gateshead Millennium Study) with 8 years of follow-up, from North-East England. Cohort members comprise a socioeconomically representative sample studied at ages 7, 9, 12 and 15 years; 545 individuals provided physical activity data at two or more time points. Habitual total volume of physical activity and moderate-to-vigorous intensity physical activity (MVPA) were quantified objectively using the Actigraph accelerometer over 5-7 days at the four time points. Linear mixed models identified the timing of changes in physical activity across the 8-year period, and trajectory analysis was used to identify subgroups with distinct patterns of age-related changes.Results: Four trajectories of change in total volume of physical activity were identified representing 100% of all participants: all trajectories declined from age 7 years. There was no evidence that physical activity decline began at adolescence, or that adolescent declines in physical activity were substantially greater than the declines during childhood, or greater in girls than boys. One group (19% of boys) had relatively high MVPA which remained stable between ages 7 and15 years.Conclusions: Future policy and research efforts to promote physical activity should begin well before adolescence, and should include both boys and girls. [ABSTRACT FROM AUTHOR]

Objective: To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE).Methods: A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for [Formula: see text].Results: Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative [Formula: see text]). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age.Conclusions: This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance. [ABSTRACT FROM AUTHOR]

Objectives To describe Action Schools! BC (AS! BC) from efficacy to scale-up. Participants/setting Education and health system stakeholders and children in grades 4-6 from elementary schools in British Columbia, Canada. Intervention At the provincial level, the AS! BC model reflected socioecological theory and a partnership approach to social change. Knowledge translation and exchange were embedded as a foundational element. At the school level, AS! BC is a comprehensive school health-based model providing teachers and schools with training and resources to integrate physical activity (PA) and healthy eating (HE) into the school environment. Our research team partnered with key community and government stakeholders to deliver and evaluate AS! BC over efficacy, effectiveness and implementation trials. Results On the basis of significant increases in PA, cardiovascular fitness, bone and HE in AS! BC schools during efficacy trials, the BC government supported a provincial scale-up. Since its inception, the AS! BC Support Team and >225 trained regional trainers have delivered 4677 teacher-focused workshops (training approximately 81 000 teachers), reaching approximately 500 000 students. After scale-up, PA delivery was replicated but the magnitude of change appeared less. One (HE) and 4 (PA) years after scale-up, trained AS! BC teachers provided more PA and HE opportunities for students even in the context of supportive provincial policies. Conclusions Whole school models like AS! BC can enhance children's PA and health when implemented in partnership with key stakeholders. At the school level, adequately trained and resourced teachers and supportive school policies promoted successful scale-up and sustained implementation. At the provincial level, multisectoral partnerships and embedded knowledge exchange mechanisms influenced the context for action at the provincial and school level, and were core elements of successful implementation. Trial registration number Clinical Trials Registry NCT01412203. [ABSTRACT FROM AUTHOR]

Aims Worldwide levels of daily physical activity (PA) in children are low. This has negative health consequences. Schools have been recognised as key settings to promote PA. This study evaluates the effectiveness of the playground programme PLAYgrounds on increasing PA. Methods PLAYgrounds was evaluated by a controlled trial, with a follow-up during one school year (10 months). Accelerometer data were collected on 1500 children in total, divided over 19 sampling moments (every 2 weeks). SOPLAY data were collected at nine sampling moments (once a month). Four intervention and four control schools were matched for playground size, number of pupils and PA levels at baseline. The intervention consisted of restructuring the playground by playground markings and by encouragement of the active use of the playground, through the provision of play equipment and educational measures such as adult encouragement and supporting physical education classes. Multilevel regression analyses were performed to analyse the effects of the intervention. Results PA levels in the intervention group (moderate PA) were significantly different (p<0.001) from the control group (light PA). During the intervention on an average 77.3% of the children engaged in moderate-to-vigorous physical activity in the intervention group and 38.7% in the control group. The effect of the intervention was significantly stronger for girls than for boys (p<0.001). Conclusions The PLAYgrounds programme was effective in increasing PA levels in children during recess over the course of one school year. Thus, the programme could be used to provide structured PA promotion. [ABSTRACT FROM AUTHOR]

The authors emphasize the need for current and future governments in Great Britain to develop a comprehensive and thorough national policy for child-centred physical education provision. Topics covered include the pervasiveness of physical inactivity among school children in Great Britain, the decline of physical education in schools and lack of play facilities, and lack of child physical activity policy in schools as a case of child neglect.

Exercise can provoke asthma symptoms, such as dyspnoea, in children with asthma. Exercise-induced bronchoconstriction (EIB) is prevalent in 40-90% of children with asthma. Conversely, exercise can improve physical fitness. The purpose of this paper is to provide a systematic review of the literature regarding the effects of exercise training in children with asthma, particularly in relation to: EIB, asthma control, pulmonary function, cardiorespiratory parameters and parameters of underlying pathophysiology. A systematic search in several databases was performed. Controlled trials that undertook a physical training programme in children with asthma (aged 6-18 years) were selected. Twenty-nine studies were included. Training had positive effects on several cardiorespiratory fitness parameters. A few studies demonstrated that training could improve EIB, especially in cases where there was sufficient room for improvement. Peak expiratory flow was the only lung function parameter that could be improved substantially by training. The effects of training on asthma control, airway inflammation and bronchial hyper-responsiveness were barely studied. Owing to the overall beneficial effects of training and the lack of negative effects, it can be concluded that physical exercise is safe and can be recommended in children with asthma. A training programme should have a minimum duration of 3 months, with at least two 60 min training sessions per week, and a training intensity set at the (personalised) ventilatory threshold. Further research is recommended regarding the effects of exercise on underlying pathophysiological mechanisms and asthma control in children with asthma. [ABSTRACT FROM AUTHOR]

Background To investigate the interpersonal and physical environment mediators of the Transform-Us! mid-intervention effects on physical activity (PA) during recess and lunchtime. Methods Transform-Us! is a clustered randomised school-based intervention with four groups: sedentary behaviour intervention (SB-I), PA intervention (PA-I), combined PA+SB-I and control group. All children in grade 3 from 20 participating primary schools in Melbourne, Australia were eligible to complete annual evaluation assessments. The outcomes were the proportion of time spent in moderate-to-vigorous PA (MVPA) and light PA (LPA) during recess and lunchtime assessed by accelerometers. Potential mediators included: perceived social support from teachers; perceived availability of line markings; perceived accessibility of sports equipment; and perceived school play environment. Generalised linear models were used and mediation effects were estimated by product-of-coefficients (a ⋅ b) approach. Results 268 children (8.2 years, 57% girls at baseline) provided complete data at both time points. A significant intervention effect on MVPA during recess in the SB-I and PA-I groups compared with the control group (proportional difference in MVPA time; 38% (95% CI 21% to 57%) and 40% (95% CI 20% to 62%), respectively) was found. The perceived school play environment was significantly positively associated with MVPA at recess among girls. An increase in perceived social support from teachers suppressed the PA+SB-I effect on light PA during recess (a ⋅ b= -0.03, 95% CI -0.06 to -0.00). No significant mediating effects on PA during recess and lunchtime were observed. Conclusions A positive perception of the school play environment was associated with higher MVPA during recess among girls. Future studies should conduct mediation analyses to explore underlying mechanisms of PA interventions. [ABSTRACT FROM AUTHOR]

Objective To compare the longitudinal trajectories of cardiorespiratory fitness (CRF) in children with probable developmental coordination disorder (DCD) with those of typically developing children. Setting School-based study, conducted in a large region of Ontario, Canada. 75 out of a possible 92 schools (83%) consented to participate. Participants A cohort of children, enrolled in grade 4 (mean 9 years 11 months; SD 0.05) at baseline (n=2278) were followed twice-yearly over a 2-year period. Measures The short form of the Bruininks-Oseretsky test of motor proficiency was used to identify children with probable DCD and the Leger shuttle run to measure maximal oxygen uptake (VO2max). Results Mixed-effects modelling was used to estimate the change over time in predicted VO2max for both children with probable DCD and typically developing children. For all children, VO2max declined over time. Children (boys and girls) with probable DCD not only had lower VO2max at baseline compared with typically developing children, VO2max declined among these children at a much steeper rate. Conclusion Although previous research has found children with DCD to have poor CRF compared with typically developing children, most of this work has relied on cross-sectional designs to examine group differences. The results of this study confirm that differences in CRF between children with and without probable DCD persist over time, highlighting the concern that DCD is a risk factor for poor cardiovascular health in children. [ABSTRACT FROM AUTHOR]

The article investigates reviews of literature and systemic update on the impact of school-based interventions on physical activity (PA) and fitness among children and adolescents. It describes potentially relevant factors for a positive school-based intervention outcome for PA and fitness. It concludes that multi-component intervention strategies of schools are considered the most consistent and promising strategy while controversy is present on the effectiveness of family involvement.

The article offers information on the increased training and participation of children and adolescents in organized athletic activities. It explores the epidemiology of acute and chronic sports-related injuries caused by increased exposure and decreased preparedness of children for sports participation. It also discusses the need for an accurate injury surveillance data to understand the magnitude of sports-related injuries.

The article discusses evidence that justify new physical activity (PA) recommendation released by the World Health Organization (WHO) involving health risk factors among children. It explores the findings of an analysis which determined the association between cardiovascular disease (CVD) risk factors and PA. It cites the possible beneficial effects of PA on the risk factors of CVD in children.

The article offers a review of the association between obesity and physical activity (PA) in children. It provides an overview of the increasing prevalence of obesity among children in developed countries. It offers a look at the number of potential health and psychosocial problems associated with excess body fat. It explains the prevention and management of obesity among children through physical activity and diet.

Background: Difficulty falling asleep (prolonged sleep latency) is a frequently reported problem in school-aged children. Aims: This study aimed to describe the distribution of sleep latency and factors that influence its duration. Methods: 871 children of European mothers were recruited at birth. 591 (67.9%) children took part in the follow-up at 7 years of age. Sleep and daytime activity were measured objectively by an actigraph worn for 24 h. Results: Complete sleep data were available for 519 children (87.8%) with a mean age of 7.3 years (SD 0.2). Median sleep latency was 26 minutes (interquartile range 13-42). Higher mean daytime activity counts were associated with a decrease in sleep latency (-1.2 minutes per 102 movement count per minute, p = 0.05). Time spent in sedentary activity was associated with an increase in sleep latency (3.1 minutes per hour of sedentary activity, p = 0.01). Conclusions: These findings emphasise the importance of physical activity for children, not only for fitness, cardiovascular health and weight control, but also for promoting good sleep. [ABSTRACT FROM AUTHOR]

Objective: The 6-minute walk test (6MWT) is an established measure of exercise capacity in adults and children with chronic cardiac or respiratory disease. Despite its widespread use, there are no normal values for healthy children under 12 years of age. We aimed to provide normal values for children between 4 and 11 years. Methods: Healthy children were recruited prospectively from two UK primary schools and also children visiting Great Ormond Street Hospital. 328 children (54% male) aged 4 to 11 years were included in the study. Main outcome measures were the distance walked in 6 minutes, and oxygen saturation and heart rate during the 6 minutes and during a 3-minute recovery period. Results: Mean oxygen saturation at baseline and during the 6MWT was 97-99%. Heart rate increased from 102 ± 19 bpm at baseline to a maximum of 136 ± 12 bpm. Overall, the mean distance walked in 6 minutes was 470 ± 59 m. Distance walked correlated with age (r = 0.64, p<0.0001), weight (r = 0.51, p<0.0001) and height (r = 0.65, p<0.0001) with no significant difference between boys and girls. The distance walked increased significantly year on year from 4 to 7 years (4 years 383±41 m; 5 years 420±39 m, 6 years 463 ±40 m; 7 years 488 ±35 m; p<0.05 between each); further modest increases were observed beyond 7 years of age. Conclusions: Performing a 6MWT is feasible and practical in young children. This study provides data on normal children against which the performance of sick children and the response to therapeutic intervention can be judged. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of an active school model on children's physical activity (PA). Design: 16-month cluster randomised controlled trial. Setting: 10 elementary schools in Greater Vancouver, BC. Participants: 515 children aged 9-11 years. Intervention: Action Schools! BC (AS! BC) is an active school model that provided schools with training and resources to increase children's PA. Schools implemented AS! BC with support from either external liaisons (liaison schools, LS; four schools) or internal champions (champion schools, CS; three schools). Outcomes were compared with usual practice (UP) schools (three schools). Main outcome measurements: PA was measured four times during the study using pedometers (step count, steps/day). Results: Boys in the LS group took 1175 more steps per day, on average, than boys in the UP group (95% Cl: 97 to 2253). Boys in the CS group also tended to have a higher step count than boys in the UP group (+804 steps/day; 95% Cl: -341 to 1949). There was no difference in girls' step counts across groups. Conclusions: The positive effect of the AS! BC model on boys' PA is important in light of the current global trend of decreased PA. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To review the published literature on the effectiveness of interventions to promote physical activity in children and adolescents. Design Systematic review. Data sources Literature search using PubMed, SCOPUS, Psychlit, Ovid Medline, Sportdiscus, and Embase up to December 2006. Review methods Two independent reviewers assessed studies against the following inclusion criteria: controlled trial, comparison of intervention to promote physical activity with no intervention control condition, participants younger than 18 years, and reported statistical analyses of a physical activity outcome measure. Levels of evidence, accounting for methodological quality, were assessed for three types of intervention, five settings, and three target populations. Results The literature search identified 57 studies: 33 aimed at children and 24 at adolescents. Twenty four studies were of high methodological quality, including 13 studies in children. Interventions that were found to be effective achieved increases ranging from an additional 2.6 minutes of physical education related physical activity to 283 minutes per week of overall physical activity. Among children, limited evidence for an effect was found for interventions targeting children from low socioeconomic populations, and environmental interventions. Strong evidence was found that school based interventions with involvement of the family or community and multicomponent interventions can increase physical activity in adolescents. Conclusion Some evidence was found for potentially effective strategies to increase children's levels of physical activity. For adolescents, multicomponent interventions and interventions that included both school and family or community involvement have the potential to make important differences to levels of physical activity and should be promoted. A lack of high quality evaluations hampers conclusions concerning effectiveness, especially among children. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of early social, anthropometric, and behavioural variables on physical activity in adolescence. Design: Prospective birth cohort study. Setting: Pelotas, southern Brazil. Participants: 4453 adolescents aged 10-12 years participating in the Pelotas 1993 birth cohort study (follow-up rate 87.5%). Main outcome measures: Sedentary lifestyle (< 300 minutes of physical activity per week) and median physical activity score (minutes per week). Results: The prevalence of a sedentary lifestyle at age 10-12 years was 58.2% (95% confidence interval 56.7% to 59.7%). Risk factors for a sedentary lifestyle in adolescence were female sex, high family income at birth, high maternal education at birth, and low birth order. Weight gain variables at ages 0-1, 1-4, and 4-11 years and overweight at age 1 or 4 years were not significant predictors of physical activity. Levels of physical activity at age 4 years, based on maternal report, were inversely related to a sedentary lifestyle at age 10-12 years. Conclusions: Physical activity in adolescence does not seem to be programmed by physiological factors in infancy. A positive association between birth order and activity may be due to greater intensity of play in childhood and adolescence. Tracking of physical activity from age 4 to 10-12 years, however, suggests that genetic factors or early habit formation may be important. [ABSTRACT FROM AUTHOR]

The article offers an overview and update on the advances in the field of physical activity (PA) during childhood and its impact on bone growth, with particular focus on the potential for fracture prevention. It discusses the association between bone mass and bone strength throughout the life course. It also describes the type of exercises that are considered beneficial to bone strength during growth.

In this article, the authors reflect on reducing physical fitness levels in children of Great Britain. They state that there has been a decline in the duration and intensity of physical activity required for cardiovascular fitness during a children's day curriculum. An overview of the unpublished analysis of the Health Survey for England from 1997-2007 is offered. The authors suggest the use of a number of datasets which had a resting pulse rate to measure physical fitness.

The article presents summaries of articles published in medical journals as of July 29, 2006. A study reports on the risk factors for macular degeneration among older people. The use of highly active antiretroviral therapy (HAART) is reported to improve the health outcomes of children with HIV disease. It is reported that physical activity reduces a child's risk of developing cardiovascular disease.

Mr Root is committed to children who have lost interest in physical activity or those that have not discovered a form which excites them. Mr Root engineered HOPSports to redefine student perception and participation of school-based physical education by empowering kids to choose attractive and rewarding forms of physical activity that enable them to live sustainably in healthy lifestyles throughout adulthood. Through 21st century technology mediums, HOPSports delivers entertaining and educational digital content that effectively relate to 21st century kids. Children experience a variety of sensory distractions which enable the repetition of standards-based sports and fitness skills development. Kids may simultaneously watch wellness-themed animated videos, choose modern music, or learn valuable educational and social messaging while they increase their moderate to vigorous physical activity (MVPA). Independent studies plainly show that the HOPSports Training System (HTS) achieves significant increased MVPA among its student users. Educators can no longer ignore the growing body of research which explores the connection between exercise and the brain's performance that shows even moderate exercise will, among other things, supercharge mental circuits to beat stress, sharpen thinking and enhance memory. Consequently, the HTS both fights the childhood obesity epidemic and accelerates learning by enhancing cognitive focus for substantive classroom learning. [ABSTRACT FROM PUBLISHER]

Background Given the importance of physical activity for health and age-related declines in physical activity, understanding influences on related behaviours, such as time outdoors, is crucial. This study aimed to understand individual, social and physical environmental influences on longitudinal changes in urban children's time outdoors. Methods The time children spent outdoors in 2001, 2004 and 2006 (aged 5-6 and 10-12 years at baseline) was reported by their parents (n=421). In 2001, individual, social and physical environmental factors were self-reported by parents. Generalized estimating equations examined longitudinal relationships between baseline predictors and average change in time outdoors over 5 years. Results Children's time outdoors significantly declined over time. "Indoor tendencies" inversely predicted time outdoors among younger and older boys, and younger girls. Social opportunities positively predicted time outdoors among younger boys, while "outdoor tendencies" positively predicted time outdoors among older boys. Parental encouragement for activity positively predicted time outdoors among younger and older girls, while lack of adult supervision for active play outdoors after school inversely predicted time outdoors among older girls and older boys. Conclusion Individual (indoor and outdoor tendencies) and social factors (social opportunities, parental encouragement and parental supervision) predicted children's time outdoors over 5 years. Interventions targeting reduced indoor tendencies, increased outdoor play with others, and increased parental encouragement and supervision are warranted. [ABSTRACT FROM AUTHOR]

The article discusses the British National Institute for Health and Clinical Excellence (NICE) guidelines for physical activity for youth up to 18 years old. It recommended at least 60 minutes a day of moderate exercise that can be done in intervals throughout the day. Weight bearing exercise should be done twice a week to strengthen muscles and bones. It also suggested a five year campaign promoting exercise and weight reduction for obese children. Physical inactivity has been linked to disease, work absence, and premature death.