Effect of Extracurricular After-School Physical Activities on Academic Performance of Schoolchildren

Abstract

ImportanceThe beneficial effects of increasing outdoor physical activity time on children’s myopia onset and physical well-being are widely acknowledged. However, in countries with competitive educational systems, such as China, parents and school administrators may be relatively reluctant to increase the extracurricular physical activity time for children due to concerns that this action will compromise children’s academic performance.ObjectiveTo investigate whether additional extracurricular physical activity time after school compromises the academic performance of schoolchildren.Design, Setting, and ParticipantsThis cluster randomized clinical trial was conducted from October 2020 to June 2021 in Yudu, Jiangxi, China. Eligible children in grades 3 and 4 from 24 elementary schools were randomized to the intervention or control group. Primary analysis was conducted in the full sample using the intention-to-treat principle.InterventionsThe intervention group received 2 hours of after-school physical activity time outdoors on school days. The control group was free to arrange their after-school activity.Main Outcomes and MeasuresThe primary outcome was the between-group mean difference in mathematics test scores at the end of 1 academic year, with a noninferiority margin of −3.3 points. Standardized mathematics tests, physical fitness assessments (in reference to the 2018 National Physical Fitness Survey Monitoring Programme in China), and cycloplegic autorefraction were performed at baseline and the end of 1 academic year. Myopia was defined as a cycloplegic spherical equivalent refraction of −0.5 diopters or less in either eye.ResultsA total of 2032 children (mean [SD] age, 9.22 [0.62] years; 1040 girls [51.2%]) from 24 schools were randomized to the intervention group (12 schools; 1012 children) or control group (12 schools; 1020 children). The mean (SD) mathematics score at the end of 1 academic year was 78.01 (17.56) points in the intervention group and 77.70 (17.29) points in the control group. The adjusted between-group mean difference was 0.65 points (95% CI, −2.85 to 4.15). The adjusted between-group mean difference in physical fitness score was 4.95 points (95% CI, 3.56-6.34; P < .001) and −1.90% (95% CI, −18.72% to 14.91%; P > .99) in myopia incidence.Conclusions and RelevanceResults of this trial indicate that, compared with the control practice of free play after school, adding 2 hours of extracurricular physical activity outdoors after school was noninferior in academic performance and had superior efficacy in improving physical fitness.Trial RegistrationClinicalTrials.gov Identifier: NCT04587765

Myopia Control: Are We Ready for an Evidence Based Approach?

“…Also, the effect on myopia progression reached a pooled mean difference of 0.15 (95% CI 0.06–0.23) D benefit on refractive error [ 68 ]. In the present literature search five articles [ 34 , 80 , 83 – 85 ] reporting results from RCTs involving increased outdoor time or activity as an intervention were identified (Supplementary Table 2 ). One of these studies indicates that it is more the aspect of being outdoors, rather than the activity level that contributes to the protective effect of outdoor times [ 84 ].…”

“…Increased outdoor time is accessible to all individuals but may be constrained by social factors such as academic expectations, weather conditions, and seasonal variations [ 87 ]. A shift towards more outdoor activity could even increase student productivity and performance: a recent Chinese study showed that school children, aged 8 to 10 years, who spent an additional 2 h outdoors, reached statistically higher academic performance compared to those who followed the regular curriculum without extracurricular physical activity outdoors [ 85 ]. However, successful implementation of such a public health intervention still requires more public and governmental awareness, as well as strategies to overcome existing hurdles to achieve more time outdoors each day [ 6 ].…”

The Optimal Cut-Off Point of Physical Activity for the Prevention of Childhood Overweight and Obesity

“…The major concerns about physical activity are a fear of injuries and less study time leading to poor academic performance. However, randomized clinical trials have confirmed that more physical activity does not compromise children's academic performance [40]. Injuries can be reduced by adequate safety awareness, sufficient warm-up, and suitable exercise environments [41].…”