# Exercise as it relates to Disease/Promoting children's physical activity in primary school - SWEATING THE SMALL STUFF

This is an analysis of the journal article " 'Promoting children's physical activity in primary school: An intervention study using playground markings' " by Stratton (2000)

## What is the background to this research?

The physical inactivity of children has been viewed as a modifiable risk factor, potentially leading to diseases later in life. It has been recommended that moderate to vigorous physical activity (MVPA) for 60 minutes per day is the ideal for children from the ages 5 to 18 years old. Physical education lessons and playtime during a regular school day, represent the two main circumstances in which children have the opportunity to part take in physical activity. .
Other studies have shown that playgrounds that stimulate physical activity and also has the potential to promote children's overall health due to the amount of time spent on the playground during the school day.

## Where is the research from?

The study was conducted by Professor Gareth Stratton, the Head of the Research Centre in Applied Sports, Technology, Exercise and Medicine, at two schools situated in an urban industrialised area in north-west England. Sixty children helped with the investigation. It is a topic that has increased in interest within the last decade. Not only do we need to encourage physical activity, but also make children from a young age aware of the advantages of staying healthy and physically active.

## What kind of research was this?

The research was a quantitative study utilising self applied accelerometers within both a control and intervention group. School 1 (The experimental group) consisted of 18 boys and 18 girls aged 5 to 7 years, randomly selected from the first and second grade. School 2 (the control group) consisted of 12 boys and 12 girls of similar age, stature and body mass of those in the experimental group. The experimental group involved an area on the school playground where the children designed a series of 10 markings that were painted in bright fluorescent colours linked to their school curriculum. These included letter squares, snakes and ladders, clock face and a flower maze. No equipment was used, other than a single football. The control group had no markings on their school playground, but was allowed a limited amount of equipment on to the playground. The children played for approximately 60 min, divided in to 3 time slots (5 days per week).

## What did the research involve?

In this study, a lightweight chest strap as the transmitter and a wristband as the receiver was used and placed on each child. Heart rates (HR) were monitored and recorded once every 5 seconds (s) during a morning, lunch and afternoon playtime, before and after the playground was marked. The use of Rowland's 1996 Max HR, individual HR reserves (HRR) were used at thresholds 50, 60 and 75% for each participant. These thresholds respectively represent:
* Moderate Physical Activity (MPA)
* Moderate to Vigorous Physical Activity (MVPA)
* Vigorous Physical Activity (VPA)
For 4 weeks before playground marking and 4 weeks with playground painting (using safe and dry playgrounds) the study was conducted on the same day for both schools . HR was recorded during the respective times. The sum of HRR50, HRR60 and HRR75 showed the total time in MVPA that were calculated for each participant. This investigation is a great opportunity to showcase the importance of children stimulation through a fun, school-based play time. Although the study was on a smaller scale, it can lead to further studies for less developed communities and disadvantaged schools without the benefit of resources.
Limitations
Limitations included that of the limited sample size of only 47 children from two schools. This shows that further investigations and monitoring of a larger sample size and schools of different backgrounds and socioeconomic class of the suburb or school can and should be investigated to see how a stimulated play area, allows children to increase their activity levels during the school day. Considerations of individual child sports outside of school and sports offered at the school.
Another aspect that the authors address, is that of the Hawthorne Effect, also referred to as the observer effect. It is a type of reactivity in which individuals modify an aspect their behaviour in response to their awareness to being observed. This may have slightly altered the results but not significant enough to be the deciding factor.

## What were the basic results?

Stratton found that before the intervention, children in the experimental school spent approximately 5% less time in MVPA that children in the control school. He found that vigorous physical activity almost doubled in the experimental group, compared to the control group. The mean HR of the experimental group increased by 7 bpm during the investigation compared to the little change within the control group, as shown in the table below.
| | Experimental group (n=27) | Experimental group (n=27) | Control Group (n=20) | Control Group (n=20) |
| | Before Intervention | After Intervention | Before Intervention | After Intervention |
| Mean HR (bpm) | 126.1 | 132.8 | 128.9 | 129.4 |
| MVPA (HRR50) % playtime | 35.1 | 46.2 | 40.5 | 39.1 |
| VPA (HRR75) % playtime | 5.3 | 10.0 | 7.0 | 6.8 |
| Playtime Duration (min) | 25.3 | 32.0 | 23.4 | 29.8 |

## How did the researchers interpret the results?

Stratton shows significant interaction of all three variables and suggests that in schools where physical activity levels may be low, playground markings can have a positive influence. The author concludes that there were no main differences between groups and suggests that factors other than the playground markings stimulated physical activity in the control school. Furthermore, with the small sample size, further studies are suggested to be conducted to further the conclusion that playground markings play asignificant difference in children physical activity within the school day.

## What conclusions should be taken away from this research?

Results show that children in both the experimental and control groups increased the amount of time spent in MVPA by a mean of 6 minutes and 2 minutes respectively. Influenced by investigators such as Hovell et al (1978) and Kraft (1989), Stratton takes these findings into consideration and suggests that further studies need to be taken to help improve physical activity within schools and promote health within children. We cannot conclude that playground markings are the most appropriate and best solution to increasing physical activity, but with these findings, we can see that more studies should be done using playground markings as children are drawn to this idea.

## What are the implications of this research?

The research suggests that any stimulated activity will increase children's HR, promoting increased fitness and overall health. With further implementation of this in schools, creating lessons that incorporate a fun environment that increases physical activity, it will help increase a child's physical activity. With the changing world, increase in obesity and the rise of technology, it is essential for us to teach the growing minds of children about the importance of health and fitness.

## Further reading

For further information on the rise of obesity, causes and interventions read below:
* Prevalence of overweight and obesity among children: http://jamanetwork.com/journals/jama/fullarticle/198912
* Childhood obesity associated with healthcare expenditure: http://onlinelibrary.wiley.com/doi/10.1002/oby.21544/full
* Early intervention to decrease childhood obesity: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2836-0
* Contribution of organised sport to physical activity for young children: http://www.sciencedirect.com/science/article/pii/S1440244015000936

## References

* ↑ Stratton, G. (2000). Promoting children's physical activity in primary school: an intervention study using playground markings. Ergonomics, 43(10), 1538-1546.
* ↑ Bailey, D. A. (1995). The role of mechanical loading in the regulation of skeletal development during growth. New horizons in pediatric exercise science, 97-108.
* ↑ Biddle, S. J., Sallis, J. F., & Cavill, N. (1998). Young and active? Young people and health-enhancing physical activity-evidence and implications. Health Education Authority.
* ↑ Dishman, R. K., Motl, R. W., Saunders, R., Felton, G., Ward, D. S., Dowda, M., & Pate, R. R. (2005). Enjoyment mediates effects of a school-based physical-activity intervention. Medicine and science in sports and exercise, 37(3), 478-487.
* ↑ Trudeau, F., & Shephard, R. J. (2008). Physical education, school physical activity, school sports and academic performance. International Journal of Behavioral Nutrition and Physical Activity, 5(1), 10.
* ↑ Simons-Morton, B. G., Parcel, G. S., Baranowski, T., Forthofer, R., & O'Hara, N. M. (1991). Promoting physical activity and a healthful diet among children: results of a school-based intervention study. American journal of public health, 81(8), 986-991.
* ↑ Fairclough, S. J., Dumuid, D., Taylor, S., Curry, W., McGrane, B., Stratton, G., ... & Olds, T. (2017). Fitness, fatness and the reallocation of time between children’s daily movement behaviours: an analysis of compositional data. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 64.
* ↑ James, M., Christian, D., Scott, S., Todd, C., Stratton, G., McCoubrey, S., ... & Brophy, S. (2017). Active children through individual vouchers–evaluation (ACTIVE): protocol for a mixed method randomised control trial to increase physical activity levels in teenagers. BMC public health, 18(1), 7.
* ↑ Ridgers, N. D., Fairclough, S. J., & Stratton, G. (2010). Twelve-month effects of a playground intervention on children’s morning and lunchtime recess physical activity levels. Journal of Physical Activity and Health, 7(2), 167-175.
* ↑ Sedgwick, P. (2012). The Hawthorne effect. BMJ: British Medical Journal (Online), 344.
* ↑ Hovell, M. F., Bursick, J. H., Sharkey, R., & McClure, J. (1978). An evaluation of elementary students' voluntary physical activity during recess. Research Quarterly. American Alliance for Health, Physical Education and Recreation, 49(4), 460-474.
* ↑ Kraft, R. E. (1989). Children at play: Behavior of children at recess. Journal of Physical Education, Recreation & Dance, 60(4), 21-24.
* ↑ Hayes, A., Chevalier, A., D'Souza, M., Baur, L., Wen, L. M., & Simpson, J. (2016). Early childhood obesity: Association with healthcare expenditure in Australia. Obesity, 24(8), 1752-1758.