# Exercise as it relates to Disease/Classroom-based Physical Activity: The impact of teacher-directed exercise in elementary school children

Effect of Low Cost Teacher Directed Classroom Intervention on elementary Students' Physical Activity

## What is the background to this research?

The school system has been identified as a logical tool for increasing children's involvement in physical activity. For this reason a study was conducted to explore the effect of a classroom-based physical activity intervention. This paper explores the impact of a low-cost, teacher-directed classroom intervention for increasing elementary student's physical activity.
Statistical evidence identifies that youths with low physical activity levels are at a higher risk of negative health effects. A wide range of research has demonstrated a significant and positive outcome for physical activity interventions in schools. However, these interventions resulted from highly funded grants requiring significant resources to implement and maintain. This paper identified the need for research surrounding a classroom intervention that was low in cost, easy to implement and effective in its results.
This study is important as it fills the gap in existing research by exploring a classroom physical activity intervention that is low in cost, resources and effective in increasing children's activity during the school day. It has been noted that there is a reduction in physical education programs resultant from low funding in schools, pressures on teachers to focus on academic standards and economical fluctuations. For these reasons a simple, low-cost method that requires minimal training to implement is a valuable tool to enhance physical activity levels.

## Where is the research from?

Published in 2011, this research study was conducted in America with the intervention being implemented in two elementary schools residing in the Southern East of the United States. This is significant as the study is based off previous research and statistical data conducted in America. Since publication, the study has been cited fifty-three times, remaining relevant throughout decades.
The research article was published by the American School Health Association (ASHA). ASHA was founded in 1927, with memberships available to professionals promoting school health. The authors have each been involved in a number of research articles, with each one involved in at least one research paper similar in nature to this one, ensuring a high level of expertise. All authors have obtained a Doctor of Philosophy (PHD).
Participants were required to wear a pedometer from Walk4Life. It was reported that this brand was selected as it is accurate and appropriate for research with children.

## What kind of research was this?

The study was a Randomised Control Trial (RCT), a gold standard method for studying exposures such as physical activity. An RCT is most likely to demonstrate a link between the intervention and respective health outcome due to the randomised nature of the study.
Advantages of RCTs include:
* Eliminates biases.
* Safe for testing.
* Minimal expense to conduct.
* High success rate.
* Control groups.
In comparison to other types of research, an RCT is best for obtaining accurate data as a clear relationship between the intervention and participants can be established. A meta-analysis could be beneficial, as the conclusion is supported by a wide range of literature, determining a highly accurate outcome. However, if the results from the studies differed, drawing an accurate conclusion may be difficult. An observational study would not be viable for an exercise intervention due to the lack of interaction from the researchers.

## What did the research involve?

Participants
106 students ranging from grade three to five.
Method
The procedure of this study consisted of activity break cards provided to the teachers to conduct with their students. The activity breaks were roughly five to ten minutes in length and consisted of movement activities that were suited to a small space. Students were fitted with pedometers and given training on how to use them.
Limitations
Limitations included lack of specification surrounding the length of each classroom physical activity break. It was noted that this would be beneficial in determining optimal length and regularity of movement breaks.
Due to the nature of the research study, the authors were limited in accruing participants for optimal data collection; a number of students dropped out of the study, transferred schools or had malfunctioning pedometers. It was noted that the pedometers may not have been accurate due to user faults. Furthermore, pedometers are not capable of determining exercise intensity. In order to be more accurate, future research should explore the impact of intensity, length of time and type of movement.

## What were the basic results?

Main Findings
Teachers who complied with the intervention improved student's average steps during the school day by 33%. These students had more steps in comparison to children in the control and non-compliance groups. The intervention was most effective in classrooms where the teacher implemented at least one activity break per day.
Average School Classroom Steps per Day :
| | Baseline | Follow Up | Post Follow Up |
| Control | ≥2400 | ≥2100 | ≥2700 |
| Intervention (non-compliance) | ≥2000 | ≥1800 | ≥3200 |
| Intervention (compliance) | ≥2500 | ≥3300 | ≥4250 |
Analysis of Results
Students in the compliance intervention demonstrated a significantly increased number of steps. There were no significant differences between gender, however it was noted this data is not valid as there was a significantly higher number of girls than boys. Baseline measures ensured accurate analysis of follow up and post follow up data. The results demonstrated a large effect size and good validity due to minimisation of biases and the large number of participants.
A simple dose-response relationship has been supported through statistical significance and the conclusion does not stray from or exemplify this data.

## What conclusions can we take from this research?

Conclusively, the implementation of a low-cost, teacher directed, classroom based physical activity intervention was effective in increasing student's accumulation of steps during the school day. As reported by more recent journals, the results of this article have been accurately reported and a concise conclusion has been devised.
Comparatively, the conclusions from other researchers and insight for future research appear similar. A number of studies have demonstrated that classroom based physical activity is an effective method in ensuring daily activity levels are increased. The majority of research is based around pedometers and step counting as it is cost effective and easy to use. More recent studies utilised measurements of height, weight, body mass index and adiposity to enhance data collection. However, it is apparent that in order for research to be more concise, accelerometers and analysis of exercise time, type and intensity would be beneficial.

## Practical advice

This study suggests that activity breaks, consisting of fitness and locomotion tasks, increases the number of steps accumulated per day. However, it is important to recognise that these activity breaks should compliment two daily recess breaks, two weekly 30 minute physical education classes and, ideally, after school activity. While interspersing short activity breaks between education classes has increased accumulated number of steps, it is not enough to meet daily physical activity guidelines. As recommended by the authors, children should be encouraged to participate in before/after school programs, engage in physical activity at home and participate in physical education classes.
Monitoring Progress
Pedometers have been shown to be effective and low cost tools for monitoring exercise in this age demographic. However, it would be beneficial to utilise heart rate monitors and accelerometers in order to monitor progression of the activity intensity and length of time. Progression of activity is important as it ensures the students are motivated and engaged.
Conclusively
Classroom-based and school-based activity programs should be implemented in all schools as it ensures all students have equal opportunities during school hours to be physically active and develop healthy habits. However, children should be encouraged to engage in extracurricular activities to meet physical activity guidelines.

## Further information/resources

How YOU can get active:
* Just Play
Australian School Based Exercise Initiatives:
* Healthy Kids
* Healthy Harold
* Active Kids
Other interesting research articles:
* Children’s Physical Activity Levels Following Participation in a Classroom-Based Physical Activity Curriculum
* The Patterns of Moderate to Vigorous Physical Activity and Physical Education Enjoyment Through a 2‐Year School‐Based Program
* Effects of different types of classroom physical activity breaks on children’s on‐task behaviour, academic achievement and cognition

## References

* 1 2 3 4 5 6 7 8 Erwin HE, Beighle A, Morgan CF, Noland M. Effect of a low-cost, teacher-directed classroom intervention on elementary students’ physical activity. J Sch Health. 2011; 81: 455-461.
* 1 2 3 Donnelly J, Lambourne K. Classroom-based physical activity, cognition, and academic achievement. Preventive Medicine. 2011;52:S36-S42.
* 1 2 3 4 Liu A, Hu X, Ma G, Cui Z, Pan Y, Chang S et al. Evaluation of a classroom-based physical activity promoting programme. Obesity Reviews. 2008;9(s1):130-134.
* 1 2 3 Mahar M, Murphy S, Rowe D, Golden J, Shields T, Raedeke T. Effects of a Classroom-Based Physical Activity Program on Physical Activity and on On-Task Behavior in Elementary School Children. Medicine & Science in Sports & Exercise. 2006;38(Supplement):S80.
* 1 2 3 4 Juni P, Altman D, Egger M. Assessing the quality of controlled clinical trials. National Library of Medicine National Institutes of Health. 2001;323(7303):42-46.
* ↑ Calvert H, Barcelona J, Melville D, Turner L. Effects of acute physical activity on NIH toolbox-measured cognitive functions among children in authentic education settings. Mental Health and Physical Activity. 2019;17:100293.
* ↑ Sánchez-López M, Ruiz-Hermosa A, Redondo-Tébar A, Visier-Alfonso M, Jimenez-López E, Martínez-Andres M et al. Rationale and methods of the MOVI-da10! Study –a cluster-randomized controlled trial of the impact of classroom-based physical activity programs on children’s adiposity, cognition and motor competence. BMC Public Health. 2019;19(1).
* ↑ Goh T, Leong C, Brusseau T, Hannon J. Children’s Physical Activity Levels Following Participation in a Classroom-Based Physical Activity Curriculum. Children. 2019;6(6):76.