The systematic review revealed overall positive effects of outdoor time  on physical activity , sedentary behaviour , and cardiorespiratory fitness , although causality could not be assumed due to a lack of RCTs .
Motor skill development was unrelated to outdoor time ; however , this relationship was only examined in a single study of preschool children .
No studies were found that examined associations between outdoor time and musculoskeletal fitness
The objective of this systematic review was to examine the relationship between outdoor time and : ( 1 ) physical activity , ( 2 ) cardiorespiratory fitness , ( 3 ) musculoskeletal fitness , ( 4 ) sedentary behaviour ; or ( 5 ) motor skill development in children aged 3 - 12 years .
“Pre-schoolers in the playground” an outdoor physical activity intervention for children aged 18 months to 4 years old: study protocol for a pilot cluster randomised controlled trial
Background The pre-school years are considered critical for establishing healthy lifestyle behaviours such as physical activity . Levels of physical activity track through childhood into adulthood , thus establishing habitual physical activity early in life is vital . Time spent outdoors is associated with greater physical activity and playground interventions have been shown to increase physical activity in school aged children . There are few pre-school , playground-based interventions , and evaluations of these have found mixed results . A recent report published by the UK Chief Medical Officer ( CMO ) highlighted that new interventions to promote movement in the early years ( 0–5 years old ) are needed . The aim of this study is to undertake a pilot cluster r and omised controlled trial ( RCT ) of an outdoor playground-based physical activity intervention for parents and their children aged 18 months to 4 years old ( “ Pre-schoolers in the Playground ” ; PiP ) and to assess the feasibility of conducting a full scale cluster RCT . The PiP intervention is grounded in behavioural theory ( Social Cognitive Theory ) , and is in accordance with the CMO guidance for physical activity in the early years . It is informed by existing literature and data collected from focus groups with parents . Methods / Design One hundred and fifty pre-school children affiliated to 10 primary schools will be recruited . Schools will be r and omised to either the PiP intervention arm or the control arm ( usual practice ) . Children in the intervention arm will be invited to attend three 30 minute outdoor play sessions per week for 30 weeks ( 3 school terms ) at the school . Feasibility will be assessed by examining recruitment rates , attendance , attrition , acceptability of the trial and of the PiP intervention to parents , fidelity of intervention implementation , capability and capacity for schools to deliver the intervention . Health outcomes and the feasibility of outcome measurement tools will be assessed . These include physical activity via triaxial , accelerometry ( Actigraph GT3X+ ) , anthropometry ( height , body mass , BMI , waist and upper arm circumference ) , health related quality of life for child ( PedsQL ) and parent ( EQ5D ) , parent wellbeing ( ComQol-A5 ) , injuries and health service use . A health economic evaluation will also be undertaken . Discussion It is anticipated that results of this pilot trial will be published in spring 2015.Trial registration Current controlled trials : IS RCT
The systematic review revealed overall positive effects of outdoor time  on physical activity , sedentary behaviour , and cardiorespiratory fitness , although causality could not be assumed due to a lack of RCTs .
Motor skill development was unrelated to outdoor time ; however , this relationship was only examined in a single study of preschool children .
No studies were found that examined associations between outdoor time and musculoskeletal fitness
The objective of this systematic review was to examine the relationship between outdoor time and : ( 1 ) physical activity , ( 2 ) cardiorespiratory fitness , ( 3 ) musculoskeletal fitness , ( 4 ) sedentary behaviour ; or ( 5 ) motor skill development in children aged 3 - 12 years .