Elsevier

Preventive Medicine

Volume 72, March 2015, Pages 116-125
Preventive Medicine

Review
Physically active lessons as physical activity and educational interventions: A systematic review of methods and results

https://doi.org/10.1016/j.ypmed.2014.12.027Get rights and content

Highlights

  • 11 papers measured effects of physically active lessons on activity and education.

  • 6 out of 7 studies found lessons to improve physical activity levels.

  • 3 out of 6 studies found lessons to improve educational outcomes.

  • Identified studies were assessed to have a range of risk-of-biases.

  • Future high-quality studies with longer intervention periods are warranted.

Abstract

Objective

Physically active lessons aim to increase children's physical activity whilst maintaining academic time. This systematic review aimed to investigate the methods used in such interventions and their effects on physical activity and educational outcomes.

Methods

In March 2014; PubMed, Web of Science, PsycINFO and ERIC electronic databases were searched. Inclusion criteria were: 1. Classroom lessons containing both PA and educational elements; 2. intervention studies featuring a control group or within-subjects baseline measurement period; 3. any age-group; and 4. English language. Studies assessing physically active lessons within complex interventions were excluded. Data were extracted onto a standardised form. Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) tool.

Results

Eleven studies were identified: five examined physical activity outcomes only, three examined educational outcomes only and three examined both physical activity and educational outcomes. All studies found improved physical activity following physically active lessons: either in the whole intervention group or in specific demographics. Educational outcomes either significantly improved or were no different compared to inactive teaching. Studies ranged from low to high risk of bias.

Conclusions

Encouraging evidence of improved physical activity and educational outcomes following physically active lessons is provided. However, too few studies exist to draw firm conclusions. Future high-quality studies with longer intervention periods are warranted.

Introduction

Physical activity is associated with improved cardiovascular risk factors (Andersen et al., 2011, Cesa et al., 2014) and mental health in children (Biddle and Asare, 2011). However, the typical classroom is currently inherently sedentary, with obligatory seated lessons contributing greatly to the 7–8 h a day spent sedentary in children (Esliger and Hall, 2009, Mantjes et al., 2012). Despite ever-increasing demands on teaching time and school space, no such rigid demands have been made for improved child physical activity (PA) levels (Weiler et al., 2013). National frameworks to secure time for physical education are currently absent in both the UK (Weiler et al., 2013) and USA (Slater et al., 2012).

There is evident efficacy for school-based physical activity interventions (Dobbins et al., 2013). School environments provide a unique opportunity to ensure physical activity in a maximum number of children over lengthy periods of time (Donnelly and Lambourne, 2011, Rasberry et al., 2011). A recent Cochrane review analysis found school-based interventions to significantly increase pupils' VO2 max and their moderate and vigorous physical activity (MVPA) during school hours (Dobbins et al., 2013). However, authors noted that studies typically found small effects and featured moderate or high risk of bias: proposing a need for further research into school-based PA interventions (Dobbins et al., 2013). Although teachers may support physical activity interventions, insufficient time is often available to implement them with preference given to academic tasks (Erwin et al., 2012, Ward et al., 2006).

Physically active lessons are a novel teaching technique that introduces PA into the school learning environment (Centers for Disease Control and Prevention, 2010, Kibbe et al., 2011). These teacher-led sessions aim to incorporate physical activity into the teaching of academic content (Bartholomew and Jowers, 2011). Physically active lessons are hence distinct from ‘activity-’ or ‘brain breaks’ which facilitate bouts of classroom-based PA without educational features (Bartholomew and Jowers, 2011). The accumulation of short PA intervals during physically active lessons may be more feasible in helping reach recommended guidelines compared to extending recess or physical education (Barr-Anderson et al., 2011).

The combination of movement and learning via physically active lessons follows well-supported associations between physical activity and learning outcomes (Tomporowski et al., 2011). A significant positive relationship between physical activity and cognition in children has been identified in meta-analytic study, with significant effect sizes of 0.32 (Sibley and Etnier, 2003). Such findings align with the Executive Function Hypothesis: finding executive function tasks of goal-directed planning to be improved with physical activity (Best, 2010, Diamond and Lee, 2011, Tomporowski et al., 2011). Physically active lessons also follow the principals of Experiential Learning theory: learning through action and experience as opposed to via rote (Kolb, 1984, Kolb et al., 2001).

Intervention studies have implemented physically active lessons into various school environments. However, a review of the effects of these programmes on physical activity and educational outcomes accompanied by detailed quality assessment is yet to be performed. It is important to assess the range of strategies used and results found in this relatively novel area. This systematic review aimed to: 1) assess the current methods used to measure i) physical activity and ii) educational outcomes in physically active lesson interventions, 2) assess observed effects of physically active lessons on i) physical activity and ii) educational outcomes and 3) evaluate the risk of bias in these identified interventions.

Section snippets

Search strategy & information sources

In March to April 2014, a systematic search for original research articles was conducted using ERIC, PubMed, PsycINFO and Web of Science electronic databases. Abstracts and titles were searched with three separate strings representing: 1) physical activity, 2) class or lesson and 3) children. Fig. 1 provides a full search strategy for PubMed which was revised according to the requirements of each database. Researchers' own work and reference lists of included papers were searched. Grey

Results

In total, 8021 citations were identified from electronic database records, 16 from reference searches and 2 from grey literature (Fig. 2). Of the included studies, 9 were held in the USA, 1 in China and 1 in New Zealand. Four studies were specifically described as either feasibility (Oliver et al., 2006, Trost et al., 2008) or pilot studies (Erwin et al., 2011a, Graham et al., 2014).

Discussion

A systematic search of the literature found eleven studies assessing classroom physically active lesson interventions and either a control group or baseline comparison phase. Physically active lessons featured a variety of content, ranging from age-appropriate content based on maths, language arts and social sciences (Donnelly et al., 2009, Erwin et al., 2011a, Erwin et al., 2011b, Graham et al., 2014, Grieco et al., 2009, Helgeson, 2013, Liu et al., 2008, Mahar et al., 2006, Reed et al., 2010,

Conclusions

From eleven identified studies, a range of interventions were described to provide a number of ideas for researchers and teachers to adapt or replicate. This review has identified a need for further, larger and more rigorous research in order to firmly ascertain the effects of physically active lessons. Future interventions in this area must be developed with teachers and the school environment at their core: working to reduce school sedentary time whilst maintaining educational value.

Conflict of interest statement

The authors declare that there are no conflicts of interests.

Acknowledgments

This research was funded by UCL Crucible PhD Studentship of EN (Reference: 509180).

References (53)

  • P.D. Tomporowski et al.

    Physical activity interventions and children's mental function: an introduction and overview

    Prev. Med.

    (2011)
  • Active Living Research

    Do Short Physical Activity Breaks in Classrooms Work?

    (2013)
  • J. Alonzo et al.

    Alternate Form and Test–Retest Reliability of easyCBM Reading Measures

    (2009)
  • L.B. Andersen et al.

    Physical activity and cardiovascular risk factors in children

    Br. J. Sports Med.

    (2011)
  • S.J. Biddle et al.

    Physical activity and mental health in children and adolescents: a review of reviews

    Br. J. Sports Med.

    (2011)
  • W.H. Brown et al.

    Assessing preschool children's physical activity: the observational system for recording physical activity in children–preschool version

    Res. Q. Exerc. Sport

    (2006)
  • C.W. Buckendahl et al.

    Palmetto Achievement Challenge Tests and End-of-Course Examination Program, Buros Institute for Assessment Consultation and Outreach

    (2003)
  • R.N. Caine et al.

    Making Connections: Teaching and the Human Brain

    (1991)
  • Centers for Disease Control and Prevention

    The Association Between School-Based Physical Activity, Including Physical Education, and Academic Performance

    (2010)
  • K. Corder et al.

    Assessment of physical activity in youth

    J. Appl. Physiol.

    (2008)
  • A. Diamond et al.

    Interventions shown to aid executive function development in children 4 to 12 years old

    Science

    (2011)
  • M. Dobbins et al.

    School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18

    Cochrane Database Syst. Rev.

    (2013)
  • H.E. Erwin et al.

    Promoting children's health through physically active math classes: a pilot study

    Health Promot. Pract.

    (2011)
  • H.E. Erwin et al.

    Effect of a low-cost, teacher-directed classroom intervention on elementary students' physical activity

    J. Sch. Health

    (2011)
  • H. Erwin et al.

    A quantitative review of physical activity, health, and learning outcomes associated with classroom-based physical activity interventions

    J. Appl. Sch. Psychol.

    (2012)
  • D. Esliger et al.

    Accelerometry in Children, Health Survey for England 2008

    (2009)
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