The effect of a one-year vigorous physical activity intervention on fitness, cognitive performance and mental health in young adolescents: the Fit to Study cluster randomised controlled trial

Abstract

Background Physical activity (PA) may positively stimulate the brain, cognition and mental health during adolescence, a period of dynamic neurobiological development. High-intensity interval training (HIIT) or vigorous PA interventions are time-efficient, scalable and can be easily implemented in existing school curricula, yet their effects on cognitive, academic and mental health outcomes are unclear. The primary aim of the Fit to Study trial was to investigate whether a pragmatic and scalable HIIT-style VPA intervention delivered during school physical education (PE) could improve attainment in maths. The primary outcome has previously been reported and was null. Here, we report the effect of the intervention on prespecified secondary outcomes, including cardiorespiratory fitness, cognitive performance, and mental health in young adolescents. Methods The Fit to Study cluster randomised controlled trial included Year 8 pupils (n = 18,261, aged 12–13) from 104 secondary state schools in South/Mid-England. Schools were randomised into an intervention condition (n = 52), in which PE teachers delivered an additional 10 min of VPA per PE lesson for one academic year (2017–2018), or into a “PE as usual” control condition. Secondary outcomes included assessments of cardiorespiratory fitness (20-m shuttle run), cognitive performance (executive functions, relational memory and processing speed) and mental health (Strength and Difficulties Questionnaire and self-esteem measures). The primary intention-to-treat (ITT) analysis used linear models and structural equation models with cluster-robust standard errors to test for intervention effects. A complier-average causal effect (CACE) was estimated using a two-stage least squares procedure. Results The HIIT-style VPA intervention did not significantly improve cardiorespiratory fitness, cognitive performance (executive functions, relational memory or processed speed), or mental health (all p > 0.05). Subgroup analyses showed no significant moderation of intervention effects by sex, socioeconomic status or baseline fitness levels. Changes in cardiorespiratory fitness were not significantly related to changes in cognitive or mental health outcomes. The trial was marked by high drop-out and low intervention compliance. Findings from the CACE analysis were in line with those from the ITT analysis. Conclusion The one-academic year HIIT-style VPA intervention delivered during regular school PE did not significantly improve fitness, cognitive performance or mental health, but these findings should be interpreted with caution given low implementation fidelity and high drop-out. Well-controlled, large-scale, school-based trials that examine the effectiveness of HIIT-style interventions to enhance cognitive and mental health outcomes are warranted. Trial registration ISRCTN registry, 15,730,512. Trial protocol and analysis plan for primary outcome prospectively registered on 30th March 2017. ClinicalTrials.gov, NCT03286725. Secondary measures (focus of current manuscript) retrospectively registered on 18 September 2017.

Associations between the School Environment and Physical Activity Pattern during School Time in Swedish Adolescents

“…Also, the comparability is limited because the purpose and structure of PE differs between countries. Another challenge is that many studies have problems with implementation fidelity of interventions in schools which makes it difficult to evaluate the effects of specific strategies [ 15 , 23 ]. One of the reasons for the lack of implementation is that many teachers experience a high workload where time constraints appear to be a major barrier for the implementation of programmes [ 24 ].…”

The effectiveness of a high‐intensity interval games intervention in schoolchildren: A cluster‐randomized trial

“…Our study has some strengths and innovations that may be highlighted. First, similar to previous interventions from our group and other groups, 23,44,45 this intervention is characterized by its noncompetitive nature and appropriateness for all children with the exception of those with serious disabilities. Moreover, in this case, our data also suggest that HIIT interventions are appropriate for inclusion as a part of playground games and that, as expected, those children with low CRF levels benefited the most from this type of intervention.…”

“…Although it is true that the scalability of MOVI‐daFit! is a debatable issue, especially when compared with other recently reported HIIT alternatives in the classroom 44 or in the physical education lessons, 45 the lack of effectiveness on improving health and fitness parameter of these interventions, as well as their very high dropout rate 45 suggest that MOVI‐daFit! may represent a good strategy for incorporating HIIT into playground games, although its implementation may need to be improved to extend the benefits to both girls and boys.…”

Using physical education lessons to develop the autonomy of primary school children

“…The results of previous studies indicate negative trends in the physical fitness of schoolchildren (Núñez-Quiroga et al, 2018;Fu et al, 2019;Masanovic et al, 2020;Fühner et al, 2021;Oñate Navarrete et al, 2021;Jiang et al, 2021); unwillingness of the majority of schoolchildren to engage in physical culture and sports on a systematic basis (Rodriguez-Ayllon et al, 2019;Goh et al, 2019;Andermo et al, 2020). For example, Guthold et al, 2020 Great attention in the context of our research was paid to works where the role of general developing exercises in primary school is investigated (Taylor et al, 2018;Watson et al, 2019;Cañas Encinas et al, 2021); theoretical views on the use of means for physical education in educationaleducative activities (Chanal et al, 2019;Ledezma, 2019;Quennerstedt, 2019;Masini et al, 2020;Gómez-Álvarez et al, 2021;Thorjussen, 2021;Wassenaar et al, 2021).…”