Exercise as it relates to Disease/Strategies to increase physical activity in primary aged children during school recess breaks

This is a commentary on a study published in the European Journal of Public Health.

What is the background to this research?
Childhood inactivity is linked with obesity and other health problems and is a growing and ongoing problem in many countries around the world. With evidence detailing how childhood inactivity and obesity leads to an increased risk of adult obesity, and adult obesity and inactivity being strongly linked to a variety of health risks leading to a huge social and economic cost on society, it stands to reason that research into improving physical activity levels is extremely important ). Since all children attend school, finding ways to increase physical activity during this time may go some of the way to helping reduce the instances of childhood obesity. This study looked at the effect on, physical activity levels, of providing game equipment during primary school kid’s recess and lunch breaks.

Where is the research from?
This research was carried out by Policy Research Centre, a consortium of researchers from KULeuven, Ghent University and VUBrussel. The study was conducted across 7 schools in Belgium. The funding for the research was provided by the Flemish Government. It was published in the European Journal of Public Health by Oxford University Press on behalf of the European Public Health Association. The research was published on the 23rd of January 2006.

What kind of research was this?
This study was a randomized control study, with an intervention group (group given play equipment) and a control group (no play equipment given). The classes of children were randomly assigned to either the control or intervention group, with 6 classes in the control group or 7 classes in the intervention group.

What did the research involve?
The research involved measuring and comparing the physical activity levels of school children during recess and lunch breaks. The children in this study were 5th and 6th grade children with a mean age of 10.8 ± 0.6. The intervention group were given extra play equipment; two jump ropes, two double dutch ropes, two scoop sets, two flying discs, two catchballs, one poco bal, one plastic bal, two plastic hoops, two super grips, three juggling scarves, six juggling rings, six juggling beanballs, one diabolo, one angel-stick, four spinning plates, two sets of badminton racquets and two sets of oversized beach paddles for each class group of between 16-19 children. They were also given ‘activity cards’, which detailed games and activities for each piece of equipment. The equipment and activity cards were rotated around different kids (in the same class) over the course of the study to avoid the kids losing interest. The teachers at the participating schools were also instructed by the researches to encourage the children to play with the equipment. The control group was given no play equipment.

Activity levels in this study were measured by accelerometers that each participant wore while on their recess and lunch breaks. The children were only told of the purpose of the accelerometers after the conclusion of the study to prevent the mere fact their activity levels were being measured influence their activity levels. The data was collected and converted into activity levels per minute (measured in METs) to control for the differences in recess time across the schools participating in the study. The data was collected, and then analysed using SPSS.

What were the basic results?
The results of the study showed that the group that had been provided play equipment spent more of their recess and lunch time being moderately active, with an increase in moderate activity time from 38% to 50% in the intervention group while the control decreased from 44% to 39%. There was no significant change in time spent being vigorously active in either group.

How did the researchers interpret the results?
The researchers interpretations of their results had them state “Providing game equipment during recess periods was found to be effective in increasing children's physical activity levels. This finding suggests that promoting physical activity through game equipment provision during recess periods can contribute to reach the daily activity levels recommended for good health.” The researchers noted that the intervention had the biggest impact on moderate physical activity, and that this may have had to do with specifically what equipment and games were provided. Different equipment and activity cards that are more likely to result in vigorous activity may be more beneficial. Some limitations of the study were also noted, primarily concerning the fact that teachers in the intervention group were actively encouraging participation in physical activity and the researchers stated “further research is needed to explore the role of teacher encouragement in using the game equipment”.

What conclusions should be taken away from this research?
This study provides evidence that providing game equipment to primary aged school children can increase their physical activity levels during in school breaks. As a lot of children have lower than recommended levels of physical activity, finding ways of increasing this is important for the future health of our communities. Addressing this issue at school is a good way to influence the majority of kids to improve their levels of exercise.

What are the implications of this research?
The research implies that provision of games equipment for school children will have positive outcomes from a public health perspective, by increasing levels of physical activity of children during recess and lunch breaks. However further research into the effect of teacher encouragement on physical activity levels should be considered. Additionally research into different age groups should be conducted to see if providing game equipment is equally effective at increasing physical activity in younger children as well as teenagers should be conducted. Importantly it should be noted that while improving physical activity levels during recess breaks is a positive step in the right direction, it should be seen as one of many ways in which we encourage children to be active, including P.E. classes after school activities, out of school sport, to form lifelong physically active habits and lifestyles.