Comparative effectiveness of school-based exercise interventions on physical fitness in children and adolescents: a systematic review and network meta-analysis

Abstract

BackgroundSchools provide a favorable setting for health education, however, the most effective school-based exercise mode for improving physical fitness remains unclear. This network meta-analysis was designed to assess and rank the comparative efficacy of six exercise modalities on physical fitness indicators in a school-based setting.MethodsAn online search of the Web of Science, PubMed, SPORTDiscus, and Scopus databases was conducted. Randomized and quasi-randomized controlled trials were considered. Outcomes included measures of anthropometry and body composition, muscular fitness, and cardiorespiratory fitness. Data were pooled with a random effects model using the frequentist framework.ResultsA total of 66 studies with 8,578 participants (48% girls) were included. High-intensity interval training was the most effective intervention reducing body mass index (mean difference (MD) = −0.60 kg·m−2, 95% confidence interval (95%CI) = −1.04 to −0.15, p = 0.009), elevating VO2max (MD = 3.59 mL·kg−1·min−1, 95% CI = 2.45 to 4.74, p < 0.001), and 20-meter sprint performance (MD = −0.35 s, 95% CI = −0.55 to −0.14, p = 0.001). Aerobic training had the highest probability of reducing waist circumference (standardized mean difference (SMD) = −0.60, 95% CI = −0.88 to −0.32, p < 0.001). Active video games emerged as a promising modality for improving countermovement jump (MD = 2.43 cm, 95% CI = 0.06 to 4.80, p = 0.041) and shuttle running performance (SMD = 0.86, 95% CI = 0.29 to 1.43, p = 0.003). Strength training was the best exercise mode for improving standing long jump performance (SMD = 1.03, 95% CI = 0.07 to 1.98, p = 0.035) while combined training was rated the first for decreasing body fat percent (MD = −2.56%, 95% CI = −4.73 to −0.40, p = 0.022) and increasing push-up repetitions (SMD = 3.59, 95% CI = 0.81 to 6.37, p = 0.012).ConclusionSchool-based exercise interventions have multiple effects on physical fitness. The findings of this study will help to inform physical education teachers and coaches how best to deliver exercise programs in a school setting. Since the study was limited by the original research, the conclusions will require further verification using high-quality randomized controlled trials.Systematic Review RegistrationPROSPERO, Identifier: CRD42023401963.

Effects of a physical education intervention on children’s physical activity and fitness: the PROFIT pilot study

“…The benefits of physical education intervention programs on children’s physical fitness are well documented [ 24 ]. Regarding possible confounding variables, such as age, sexual maturation, and weight status, evidence suggest that different youth populations does not benefit themselves equally from school-based intervention.…”

“…A common benefit from physical education intervention programs for children is the improvement of cardiorespiratory fitness [ 24 ]. Also, intervention programs seem to consistently increase children’s MVPA during physical education lessons in addition to their physical fitness [ 11 , 25 ].…”

Efectos de 52 semanas de un programa de ejercicio físico sobre la velocidad y fuerza muscular de jugadores rusos de baloncesto de entre 12 a 13 años. Ensayo Controlado Aleatorizado (Effects of 52 weeks of a physical exercise program on the speed and muscle strength of Russian basketball players aged 12 to 13 years. Randomized Controlled Trial)

“…En cuanto a la velocidad aláctica, se ha observado que las intervenciones escolares fundamentales pueden mejorar significativamente la capacidad de sprint (Wu et al, 2023). Esta observación podría explicar, al menos en parte, por qué en el estudio presente solo el CC mostró una mejora significativa en la prueba de sprint de 20 metros, siendo los menores resultados del GE posiblemente atribuida a la variabilidad de la base, lo que podría haber limitado el margen de mejora debido al principio de especificidad en la carga de trabajo (Kasper, 2019).…”

Handgrip strength thresholds associated with metabolic syndrome risk in children and adolescents: a systematic review and meta-analysis

“…Some research has indicated that physical activity not only mitigates health issues related to MetS, including adiposity and inflammation, but also strengthens physical fitness, bone health, and cognitive performance [33,34]. School-based intervention studies have reported that physical activity is associated with improvements in physical fitness, muscle strength, and cardiorespiratory fitness [35]. The World Health Organization has published guidelines on physical activity for children and adolescents [36].…”