# Exercise as it relates to Disease/The tools for fun in school

u3068778 Tim Johnston
This is a critique an article from the European Journal of Public Health titled "Increasing Children’s Physical Activity Levels During Recess Periods in Elementary Schools: The Effects of Providing Game Equipment".

## What is the background to this research?

This experiment was conducted to gain perspective as to whether kids are getting necessary daily exercise. Previous studies found that with physical education classes alone children weren’t receiving the proper amounts of exercise.
The author has stated that previous experiments have focused on utilising time during physical education classes in order to increase physical activity, however this article aims at looking at recess and lunch times. This could potentially be more effective as there is more time during these periods and children have more freedom to do as they please.
The results of this article become paramount as previous articles have stated the importance of early childhood exercise. Proper education in physical activity from an early age teaches children to be physically active. As discussed by Coe and colleagues (2006) as children progress through school there is less pressure to remain physically active, therefore adolescents are not meeting their physical activity requirements and unknowingly putting their health at risk. Self-efficacy and social influences are positively correlated with high intensity activities, meaning the more involved in activities a child is, the results will be a healthier social life and a better perception of themselves (Strauss et al., 2001).
The author has previous experience in physical education interventions. She has completed various other studies, looking to alter the physical activity levels of people. Demonstrating her ability to confidently manage the current study.

## Where is the research from?

The study was based in Belgium, the experiment involved seven elementary schools involving 235 students. 122 children (four schools, 75 boys and 47 girls, mean age of 10.8) were in the intervention group, and 113 children (three schools, 46 boys and 67 girls) were used in the control group. It is unclear why there was a significant gender difference between the control group and the intervention group, this difference in the group could have skewed the data, as they state that girls were less likely to participate in moderate to vigorous activity. Speculatively, this could have been a conscious decision to exacerbate the results of the study, or this could simply be a coincidence of the school student ratio.
On a general basis the results of the project may be relevant to Australian schools, however, in depth analysis is required to determine if the climate of school children exercise levels and the results of the study are similar.

## What kind of research was this?

This research was a pretest post-test design, meaning prior to the commencement of the experiment the participants were tested to determine their usual MET readings. After the three month experiment the participants were tested again. The results were compared using ANOVA.

## What did the research involve?

The research involved looking at the levels of physical activity for children during recess and lunch. This involved gathering data from MTI Actigraph accelerometers that were used by the school children, and using SPSS for Windows (12.0) for statistical analysis. Several studies have validated the use of accelerometers when measuring exercise amounts in children (Trost et al., 2002, Wickel et al., 2007).

## What were the basic results?

The results show that the intervention group had increased levels of physical activity throughout the cohort, on all measures of physical activity (low, moderate, vigorous and moderate to vigorous) during both recess and lunch. The results in recess were a little more varied, however that could due to the time limit and the inability to organise a game in the amount of time available.
The article has stated that these measures were slightly higher than previous studies. Comprehensive previous studies and results have been provided, describing how they differ to the current experiment, demonstrating proper analysis of previous projects, and also demonstrating how the current results varied from others.
The statistical measures used for the experiment were sound, as they used ANOVA (both between and within subjects testing) to determine the variance between the intervention and control group.
The accelerometers used have been proven previous to be effective instruments for measuring physical activity (Wetten et al., 2014, Caprio et al., 2010,). Conversely other articles (Saint-Maurice et al., 2016 & Wickel et al., 2007) have discussed the use of adult MET readings on children (as this experiment has done) and the resulting difficulties in attaining accurate readings. This point may have disrupted the validity of the research results.

## What conclusions can we take from this research?

The conclusions we can take from this is that children are more likely to play active games during lunch and recess when there is additional play equipment to use. Which leads to children achieving their daily moderate/vigorous activity, improving their overall health.
The experiment comprehensively covered all aspects of the research and came to a sound conclusion. They have mentioned further research areas and limitations in their study.
As mentioned in the discussion a significant limitation for the project is the lack of consideration for the input from teachers during recess and lunch. Previous studies have placed significant importance on the influence of adults on children’s physical activity levels. This could have affected the experiment as the play equipment may not have been the only factor in increasing physical activity, therefore possibly skewing the results.

## Practical advice

As previously mentioned, the need to ensure good physical activity habits is paramount in children. A useful and easy method of engaging children in physical activity is to provide play equipment they can use. Simply implements like a soccer ball, or jump ropes have been proven to be effective toys to get children moving.

## Further information/resources

https://www.healthdirect.gov.au/benefits-of-physical-activity-for-children
https://www.dsr.wa.gov.au/support-and-advice/participation/youth/active-parent-education-kit/benefits-of-physical-activity-for-your-children
https://kidshealth.org/en/parents/exercise.html

## References

* Capio, C. M., Sit, C. H., & Abernethy, B. (2010). Physical activity measurement using MTI (actigraph) among children with cerebral palsy. Archives of physical medicine and rehabilitation, 91(8), 1283-1290.
* Coe, D. P., Pivarnik, J. M., Womack, C. J., Reeves, M. J., & Malina, R. M. (2006). Effect of physical education and activity levels on academic achievement in children. Medicine and science in sports and exercise, 38(8), 1515.
* Saint-Maurice, P. F., Kim, Y., Welk, G. J., & Gaesser, G. A. (2016). Kids are not little adults: what MET threshold captures sedentary behavior in children?. European journal of applied physiology, 116(1), 29-38.
* Strauss, R. S., Rodzilsky, D., Burack, G., & Colin, M. (2001). Psychosocial correlates of physical activity in healthy children. Archives of pediatrics & adolescent medicine, 155(8), 897-902.
* Trost, S. G., Pate, R. R., Sallis, J. F., Freedson, P. S., Taylor, W. C., Dowda, M., & Sirard, J. (2002). Age and gender differences in objectively measured physical activity in youth. Medicine and science in sports and exercise, 34(2), 350-355.
* Wetten, A. A., Batterham, M., Tan, S. Y., & Tapsell, L. (2014). Relative validity of 3 accelerometer models for estimating energy expenditure during light activity. Journal of Physical Activity and Health, 11(3), 638-647.
* Wickel, E. E., Eisenmann, J. C., & Welk, G. J. (2007). Predictive validity of an age-specific MET equation among youth of varying body size. European journal of applied physiology, 101(5), 555.