Physical activity and objectively assessed sleep in 6‐month‐old infants in Taiwan Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study A cluster-randomized controlled trial to reduce sedentary behavior and promote physical activity and health of 8-9 year olds: The Transform-Us! Study THE IMPACT OF PHYSICAL‐PHYSIOLOGICAL ACTIVITY ON INFANTS' GROWTH AND DEVELOPMENT Activity Begins in Childhood (ABC) – inspiring healthy active behaviour in preschoolers: study protocol for a cluster randomized controlled trial Promoting Physical Activity With the Out of School Nutrition and Physical Activity (OSNAP) Initiative: A Cluster-Randomized Controlled Trial. A Novel Approach to Characterize Physical Activity Patterns in Preschool-Aged Children “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 Cross-sectional and prospective associations between sleep, screen time, active school travel, sports/exercise participation and physical activity in children and adolescents Morning versus afternoon gymnastic time and diurnal and seasonal changes in psychophysiological variables of school children. Supporting Physical Activity in the Childcare Environment (SPACE): rationale and study protocol for a cluster randomized controlled trial Determinants of sufficient daily activity in Australian primary school children. Promoting fundamental movement skill development and physical activity in early childhood settings: a cluster randomized controlled trial. Multicenter randomized controlled trial of pediatric constraint-induced movement therapy: 6-month follow-up. Calibration and validation of the ActiGraph GT3X+ in 2-3 year olds. An Intervention to Increase Physical Activity in Children: A Randomized Controlled Trial With 4-Year-Olds in Preschools. Clustered randomised controlled trial of two education interventions designed to increase physical activity and well-being of secondary school students: the MOVE Project
Adequate physical activity is associated with improved sleep in adults . Such associations , however , vary greatly across studies in pediatric population s , with no studies involving infants found in the literature . This prospect i ve observational study was design ed , therefore , to examine the association between physical activity and  sleep patterns in infants . A total of 183 healthy infants aged 6 months wore an actigraph for 7 days to measure physical activity and sleep .  Parents and caregivers completed a  sleep-activity diary  over the same period documenting the different types of infant activities . Daily mean time spent in  screen-time-or-limited physical activity , including screen-based ( e.g. , watching television or other electronic devices ) and non-screen based activity ( e.g. , quiet play or restricted infant movement when carried by caregivers or seated in high chairs , swings , or bouncer seats ) , was 6.68 hr ( SD = 1.99 ) , which represented 47.50 % of daytime waking hours ( SD = 13.73 ) . We found that 65 ( 35.5 % ) infants engaged in some screen time during the study , with 10 ( 5.5 % ) infants having an average daily screen time > 30 min . In our multivariate linear regression model , more hours of screen-time-or-limited physical activity per day were significantly associated with a decrease in total daily 24 hr sleep duration ( p < 0.01 ) . Findings from our study suggest that reducing screen-time-or-limited physical activity might be an approach for promoting adequate sleep and lengthening infant daily sleep duration Background Most preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day . Within this time frame , children accumulate most of their activity within the first 10 min . This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers ( STEP ) study . The STEP study is a cluster r and omized controlled study design ed to examine the effects of short bouts of structured physical activity ( SBS-PA ) implemented within the classroom setting as part of design ated gross-motor playtime on during-school physical activity ( PA ) in preschoolers . Methods / Design Ten preschool centers serving low-income families were r and omized into  SBS-PA versus unstructured PA ( UPA ) . SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting , twice daily , followed by 20 min of usual unstructured playtime . UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily . Interventions were implemented during the morning and afternoon design ated gross-motor playtime for 30 min/session , five days/week for six months . Outcome measures were between group difference in during-preschool PA ( accelerometers and direct observation ) over six-months . Ten preschool centers , representing 34 classrooms and 315 children , enrolled in the study . The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile , respectively . Participants spent 74 % and 6 % of their preschool day engaged in sedentary and MVPA , respectively . Discussion Results from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers ’ PA levels . Trial registration Clinical trials.gov , Background Physical activity ( PA ) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior ( SB ) may be detrimental to children 's health independent of PA . The primary aim of the Transform-Us ! study is to determine whether an 18-month , behavioral and environmental intervention in the school and family setting s results in higher levels of PA and lower rates of SB among 8 - 9 year old children compared with usual practice ( post-intervention and 12-months follow-up ) . The secondary aims are to determine the independent and combined effects of PA and SB on  children 's cardio-metabolic health risk factors ; identify the factors that mediate the success of the intervention ; and determine whether the intervention is cost-effective . Methods / design A four-arm cluster-r and omized controlled trial ( RCT ) with a 2 × 2 factorial design , with schools as the unit of r and omization . Twenty schools will be allocated to one of four intervention groups , sedentary behavior ( SB-I ) , physical activity ( PA-I ) , combined SB and PA ( SB+PA-I ) or current practice control ( C ) , which will be evaluated among approximately 600 children aged 8 - 9 years in school year 3 living in Melbourne , Australia . All children in year 3 at intervention schools in 2010 ( 8 - 9 years ) will receive the intervention over an 18-month period with a maintenance ' booster ' delivered in 2012 and children at all schools will be invited to participate in the evaluation assessment s. To maximize the sample and to capture new students arriving at intervention and control schools , recruitment will be on-going up to the post-intervention time point . Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey . Discussion To our knowledge , Transform-Us ! is the first RCT to examine the effectiveness of intervention strategies for reducing children 's overall sedentary time , promoting PA and optimizing health outcomes . The integration of consistent strategies and messages to children from teachers and parents in both school and family setting s is a critical component of this study , and if shown to be effective , may have a significant impact on educational policies as well as on pedagogical and parenting practice s . Trial registration ACTRN12609000715279 ; Current Controlled Trials IS RCT Forty‐seven infants four to 40 weeks of age in Dumaguete City , the Philippines , were given a cycling motion exercise of the upper and lower limbs for Jour five‐minute periods a day , six days a week , for two months . They were measured , against a control group of 17 infants of the same age and sex . Pretest , mid test , and pastiest measurements were taken for weight gain , length gain , and development of motor , language , adaptive , and personal‐social behaviors . Significant differences were found between the two groups of infants to substantiate the hypothesis that increases in growth and development of infants who receive physical care and emotional support plus planned physical‐physiological activity in the form of passive cycling exercises would be greater than those of infants who receive only physical care and , emotional support Background Today ’s children are more overweight than previous generations and physical inactivity is a contributing factor . Modelling and promoting positive behaviour in the early years is imperative for the development of lifelong health habits . The social and physical environments where children spend their time have a powerful influence on behaviour . Since the majority of preschool children spend time in care outside of the home , this provides an ideal setting to examine the ability of an intervention to enhance movement skills and modify physical activity behaviour . This study aims to evaluate the efficacy of the Activity Begins in Childhood ( ABC ) intervention delivered in licensed daycare setting s alone or in combination with a parent-driven home physical activity-promotion component to increase preschoolers ’  overall physical activity levels and , specifically , the time spent in moderate to vigorous physical activity . Methods / design This study is a single site , three-arm , cluster-r and omized controlled trial design with a daycare centre as the unit of measurement ( clusters ) . All daycare centres in the National Capital region that serve children between the ages of 3 and 5 , expressing an interest in receiving the ABC intervention will be invited to participate . Those who agree will be r and omly assigned to one of three groups : i ) ABC program delivered at a daycare centre only , ii ) ABC program delivered at daycare with a home/parental education component , or iii ) regular daycare curriculum . This study will recruit 18 daycare centres , 6 in each of the three groups . The intervention will last approximately 6 months , with baseline assessment prior to ABC implementation and follow-up assessment s at 3 and 6 months . Discussion Physical activity is an acknowledged component of a healthy lifestyle and childhood experiences as it has an important impact on lifelong behaviour and health . Opportunities for physical activity and motor development in early childhood may , over the lifespan , influence the maintenance of a healthy body weight and reduce cardiovascular disease risk . If successful , the ABC program may be implemented in daycare centres as an effective way of increasing healthy activity behaviours of preschoolers . Trial registration Current Controlled Trials : IS RCT N94022291 . Registered in December 2012 , first cluster r and omized in April 2013 IMPORTANCE Millions of children attend after-school programs in the United States . Increasing physical activity levels of program participants could have a broad effect on children 's health . OBJECTIVE To test the effectiveness of the Out of School Nutrition and Physical Activity ( OSNAP ) Initiative in increasing children 's physical activity levels in existing after-school programs . DESIGN , SETTING , AND PARTICIPANTS Cluster-r and omized controlled trial with matched program pairs . Baseline data were collected September 27 through November 12 , 2010 , with follow-up data collected April 25 through May 27 , 2011 . The date s of our analysis were March 11 , 2014 , through August 18 , 2015 . The setting was 20 after-school programs in Boston , Massachusetts . All children 5 to 12 years old in participating programs were eligible for study inclusion . INTERVENTIONS Ten programs participated in a series of three 3-hour learning collaborative workshops , with additional optional opportunities for training and technical assistance . MAIN OUTCOMES AND MEASURES Change in number of minutes and bouts of moderate to vigorous physical activity , vigorous physical activity , and sedentary activity and change in total accelerometer counts between baseline and follow-up . RESULTS Participants with complete data were 402 racially/ethnically diverse children , with a mean age of 7.7 years .  Change in the duration of physical activity opportunities offered to children during program time did not differ between conditions ( -1.2 minutes ; 95 % CI , -14.2 to 12.4 minutes ; P = .87 ) . Change in moderate to vigorous physical activity minutes accumulated by children during program time did not differ significantly by intervention status ( -1.0 ; 95 % CI , -3.3 to 1.3 ; P = .40 ) . Total minutes per day of vigorous physical activity ( 3.2 ; 95 % CI , 1.8 - 4.7 ; P < .001 ) , vigorous physical activity minutes in bouts ( 4.1 ; 95 % CI , 2.7 - 5.6 ; P < .001 ) , and total accelerometer counts per day ( 16,894 ; 95 % CI , 5101 - 28,686 ; P = .01 ) increased significantly during program time among intervention participants compared with control participants . CONCLUSIONS AND RELEVANCE Although programs participating in the OSNAP Initiative did not allot significantly more time for physical activity , they successfully made existing time more vigorously active for children receiving the intervention . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01396473 Objective Routine moderate-to-vigorous physical activity ( MVPA ) is associated with better health outcomes ; the purpose of this work was to evaluate healthy preschooler physical activity patterns with objective measurement . Methods and Procedures An objective prospect i ve study of fifty normally-developing children 3–5 years old who were ≥50th and < 95th BMI percentile and enrolled in a family-based healthy lifestyle study in 2011–2012 . Participants wore a tri-axial accelerometer for 7 continuous days . Outcome measures consisted of wear time examining four common MVPA patterns : isolated spurt ( IS ) , isolated sustained activity ( ISA ) , clustered spurt ( CS ) , and clustered sustained activity ( CSA ) . Results Participants were 4.3 years , 56 % female , 52 % African-American , and 26 % overweight . Forty-five children met wear time criteria . On average , children spent 14.5 % of wake-wear time in MVPA , requiring 11.3 hours to complete 90 % of their daily MVPA . Children spent the majority of MVPA in CS ( 62.1 % , followed by CSA ( 20.1 % ) . Remaining MVPA was spent in IS ( 15.5 % ) and ISA ( 2.3 % ) . Conclusion It takes most of the waking day for preschoolers to attain their PA . They engage in short spurts of small duration , in four common MVPA patterns . Utilizing this method could better characterize preschooler physical activity needs in practice and policy guidelines 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 Background The aim of this study was to investigate how sleep , screen time , active school travel and sport and /or exercise participation associates with moderate-to-vigorous physical activity ( MVPA ) in nationally representative sample s of Norwegian 9- and 15-y-olds , and whether these four behaviors at age nine predict change in MVPA from age nine to 15 years . Method We pooled cross-sectional accelerometer and question naire data  from 9- ( n = 2366 ) and 15-y-olds ( n = 1554 ) that participated in the first ( 2005/06 ) and second ( 2011/12 ) wave of the Physical Activity among Norwegian Children Study to investigate cross-sectional associations . To investigate prospect i ve associations , we used data from a sub- sample that participated in both waves ( at age nine and 15 years , n = 517 ) . Results Cross-sectional analyses indicated a modest , inverse association between screen time and MVPA among 9- ( − 2.2 min/d ( 95 % CI : -3.1 , − 1.3 ) ) and 15-y-olds ( − 1.7 min/d ( 95 % CI : -2.7 , − 0.8 ) ) . Compared to their peers with 0–5 min/d of active travel to school , 9- and 15-y-olds with ≥16 min/d accumulated 7.2 ( 95 % CI : 4.0 , 10.4 ) and 9.0 ( 95 % CI : 3.8 , 14.1 ) more min/d of MVPA , respectively . Nine-y-old boys and 15-y-olds reporting ≥8 h/week of sports and /or exercise participation accumulated 14.7 ( 95 % CI : 8.2 , 21.3 ) and 17.9 ( 95 % CI : 14.0 , 21.8 ) more min/d of MVPA , respectively , than those reporting ≤2 h/week . We found no cross-sectional association between sleep duration and MVPA in either age group . None of the four behaviors predicted change in MVPA from age nine to 15 years ( p ≥ 0.102 ) . Conclusion Active travel to school and sport/exercise participation may be important targets for future interventions aim ed at increasing MVPA in children and adolescents . However , future studies are needed to determine causality The aims of this study were to document time-related ( morning versus afternoon ) effects of physical activities ( gymnastics ) on a set of physiological and psychological variables in school children , including diurnal changes . For the study , 61 boys and 69 girls , 6 to 11 years of age , volunteered . They were considered healthy according to routine clinical criteria . They were synchronized with diurnal activity from around 07:00 to 21:00 and nocturnal rest , time of year being taken into account . Tests were performed at school during 4 weeks of 4.5 days of school at fixed clock hours : 09:00 , 11:00 , 14:00 , and 16:00 . Gym time was r and omized with regard to week order and season . Four different classes ( 39 boys and 38 girls ) were involved in psychophysiological tests , and two different classes ( 22 boys and 31 girls ) collected saliva sample s for morning free cortisol determination . Both t-test and three-factor analysis of variance ( ANOVA ) were used for statistical analyses . Better performances were obtained in June than in mid-winter with reference to letter cancellation and r and om number addition tests . As a group phenomenon , morning ( 09:00 to 10:00 ) versus afternoon ( 14:00 to 15:00 ) gym was not an influential condition with regard to sleep duration , oral temperature , self-rated fatigue and drowsiness , letter cancellation , addition tests , or salivary cortisol . However , gym-time-related differences were observed in classes of younger subjects ( e.g. , 6 - 7 years ) with regard to self-rated fatigue and the letter cancellation test . Such variability among subgroups suggests that interindividual differences are likely to exist in younger children with regard to manipulation of environmental factors . In addition , gym itself ( without gym time consideration ) may be an influential factor with regard to diurnal patterns of some variables ( e.g. , the letter cancellation test ) Background Young children are prone to low levels of physical activity in childcare . Research ers have identified that preschoolers tend to be more active outdoors than indoors , with higher activity levels occurring during the first 10 minutes of outdoor playtime . Additionally , interventions incorporating either staff training or the inclusion of play equipment have been effective at increasing children ’s activity in this setting . As such , the overarching objective of the Supporting Physical Activity in the Childcare Environment ( SPACE ) intervention is to improve the physical activity levels of preschoolers during childcare hours , utilizing a combination of the above components . The purpose of this manuscript is to provide a detailed account of the protocol , innovative methods , and evaluation plans used in the implementation of the SPACE study ; in an effort to support the development of further research in this field . Methods / Design The SPACE study , a cluster r and omized controlled trial , involves 22 childcare centres r and omly allocated to either the experimental ( n = 11 ) or the control ( n = 11 ) group . Childcare centres receiving the intervention will adopt an 8-week physical activity intervention with the following components : 1 . shorter , more frequent bouts of outdoor playtime ( 4 × 30 min periods rather than 2 × 60 min periods ) ; 2 . new portable play equipment ( e.g. , obstacle course , balls ) ; and , 3 . staff training ( 1 × 4 hr workshop ) . Actical accelerometers will be used to assess total physical activity with measurements taken at baseline ( i.e. , week 0 ) , immediately post-intervention ( i.e. , week 8) , and at 6- and 12-month follow-up . As secondary objectives , we aim to evaluate the effectiveness of the intervention on  preschoolers ’ : a ) sedentary time ; b ) st and ardized body mass index scores ( percentiles ) ; c ) health-related quality of life ; and childcare providers ’ physical activity-related knowledge and self-efficacy to implement physical activity . Discussion The SPACE study aims to increase the low levels of physical activity observed within childcare centres . The findings of this work may be useful to policy makers and childcare providers to consider modifications to the current childcare curriculum and associated outdoor play time . Trial registration IS RCT N70604107 ( October 8 , 2014 AIMS Australian guidelines recommend that children participate in at least one hour of physical activity every day . We aim ed to measure physical activity  participation in a r and om sample of Australian primary school children and to determine the biological , behavioural , environmental and social influences associated with insufficient daily activity . METHOD We analysed the following cross-section data from a r and omly selected sample of children ( N=518 ) aged 5 to 12 years : age , gender , socioeconmic status ( SES ) indicators , family size , home play equipment availability , transport method to school , and estimated time per week in physical and sedentary activity . Logistic regression analysis was performed to determine variables that were associated with insufficient ( < 60 minutes ) daily activity . RESULTS Seventy-six children ( 15 % of the cohort ) failed to meet the minimum activity recommendations of 60 minutes of daily activity . These children were significantly less likely to walk or cycle to school ( adjusted odds ratio ( OR ) 0.43 ; 95 % CI=0.24 - 0.77 ) or participate in organised sports or activity ( OR 0.42 ; 95 % CI=0.28 - 0.64 ) and were more likely to spend in excess of 2 hours a day watching television of using a computer for entertainment ( OR 2.10 ( 1.16 - 3.78 ) . Age , gender , SES and family size were not significantly associated with insufficient activity . CONCLUSION There exists a significant proportion of the paediatric population who are insufficiently active . Interventions to encourage increased activity  in this sub-group may be successful if they seek to alter sedentary behaviour ( namely television use ) and method of transportation to and from school The aim of this study was to assess the feasibility , acceptability and potential efficacy of a physical activity program for preschool children . A 20-week , 2-arm parallel cluster r and omized controlled pilot trial was conducted . The intervention comprised structured activities for children and professional development for staff . The control group participated in usual care activities , which included design ated inside and outside playtime . Primary outcomes were movement skill development and objective ly measured physical activity . At follow-up , compared with children in the control group , children in the intervention group showed greater improvements in movement skill proficiency , with this improvement statically significant for overall movement skill development ( adjust diff . = 2.08 , 95 % CI 0.76 , 3.40 ; Cohen 's d = 0.47 ) and significantly greater increases in objective ly measured physical activity ( counts per minute ) during the preschool day ( adjust diff . = 110.5 , 95 % CI 33.6 , 187.3 ; Cohen 's d = 0.46 ) . This study demonstrates that a physical activity program implemented by staff within a preschool setting is feasible , acceptable and potentially efficacious OBJECTIVE Pediatric constraint-induced movement therapy ( CIMT ) is a promising intervention for children with unilateral cerebral palsy ( CP ) . This multisite r and omized controlled trial ( RCT ) tested the hypothesis that 6 hr versus 3 hr per day for 21 days would produce larger maintenance of gains 6 mo posttreatment . METHOD Three sites recruited 18 children ( 6 per site ) ages 3 - 6 yr with unilateral CP . Children were r and omly assigned 3 to 6 hr/day of CIMT for 21 days and wore a cast on the unaffected extremity the first 18 days . Occupational therapists applied a st and ardized pediatric CIMT protocol . Evaluators blinded to condition administered the ASsisted H and Assessment and the Quality of Upper Extremity Skills Test , and parents completed the  Pediatric Motor Activity Log  pre- and posttreatment ( 1 wk , 1 mo , and 6 mo ) . RESULTS Both CIMT dosage groups showed significant gains on all five assessment s with no significant group differences at 6 mo follow-up . Effect sizes ( n = 15 ) comparing preintervention to postintervention measures ( partial η2 ) ranged from .33 to .80 . CONCLUSION The first multisite RCT of pediatric CIMT confirmed the maintenance of positive effects at 6 mo follow-up across multiple functional performance measures . The hypothesis that maintenance of effects would differ for children who received 6 versus 3 hr/day of CIMT ( 126 vs. 63 total hr ) was not supported OBJECTIVES To calibrate and vali date the ActiGraph GT3X+ to measure sedentary behaviour and physical activity in 2 - 3 year olds , using 5-s epochs ; and to compare the predictive validity of the result ing cut-points with that of NHANES ' , Trost 's , and Pate 's 15-s cut-points . DESIGN Cross-sectional study . METHODS Eighteen children ( 2.86 ± 0.60 years ) wore an ActiGraph GT3X+ during video-recorded semi-structured calibration activity sessions . Activity was coded following Children 's Activity Rating Scale . Receiver Operating Characteristic analysis was used to derive Axis1 and vector magnitude cut-points for sedentary behaviour and moderate-to-vigorous physical activity at 5-s epochs . Agreement with Children 's Activity Rating Scale was assessed with Cohen 's kappa , Lin 's concordance , and Bl and -Altman plots . Predictive validity of all cut-points was assessed in an independent sample of 20 children ( 2.99 ± 0.48 years ) video-recorded during free-play , using the same procedures as the calibration phase . RESULTS During calibration , vector magnitude cut-points ( sedentary behaviour ≤ 96.12 counts ; moderate-to-vigorous physical activity ≥ 361.94 counts ) showed slightly better classification agreement with Children 's Activity Rating Scale than Axis1 cut-points ( sedentary behaviour ≤ 5 counts ; moderate-to-vigorous physical activity ≥ 165 counts ) , but the latter showed the lowest bias in estimated sedentary behaviour and moderate-to-vigorous physical activity time . In the validation sample , 5-s Axis1 cut-points showed the best predictive validity and lowest mean differences of all cut-points between predicted and observed sedentary behaviour ( -2.31 % ) , light physical activity ( -24.40 % ) , and total physical activity time ( -0.95 % ) . Moderate-to-vigorous physical activity time was significantly overestimated by all cut-points ( 128.33 - 184.17 % ) . CONCLUSIONS Because moderate-to-vigorous physical activity was highly overestimated , using only the 5-s Axis1 sedentary behaviour cut-point to distinguish sedentary behaviour from total physical activity is advised . The high accuracy indicates that these cut-points are useful for epidemiological studies involving the sedentary behaviour and physical activity of 2 - 3 year olds INTRODUCTION A majority of preschool-aged children spend a significant portion of every weekday in a preschool or child care setting , where they typically participate in limited physical activity . This study determined if an ecologic physical activity intervention in preschools increases children 's  moderate- to vigorous-intensity physical activity ( MVPA ) . DESIGN RCT , with preschool as the unit of r and omization and analysis . Child physical activity was measured by accelerometry . Mixed model analysis of covariance with preschool as a r and om variable was used to test the effects of the intervention on physical activity in the total group and in sex-specific subgroups . Data were collected in 2008 - 2010 and analyzed in 2012 - 2014 . SETTING / PARTICIPANTS Children in 4-year-olds ' classrooms in 16 preschools , pair matched and assigned to intervention or control groups . INTERVENTION The intervention focused on increasing children 's physical activity by changing instructional practice s. Research ers trained preschool teachers to engage children in physical activity during ( 1 ) structured , teacher-led physical activity opportunities in the classroom ; ( 2 ) structured and unstructured physical activity opportunities at recess ; and ( 3 ) physical activity integrated into pre-academic lessons . Research staff encouraged teachers to adapt the intervention to their classrooms . MAIN OUTCOME MEASURES Minutes/hour of MVPA during the preschool day . RESULTS In an analytic sample of 379 children ( 188 intervention , 191 control ) , those in the intervention schools engaged in significantly more MVPA than children in control schools ( 7.4 and 6.6 minutes/hour , respectively ) . This difference remained significant after adjusting for parent education and length of the school day ( half versus full day ) . In the sex-specific analyses , the difference was significant for girls ( 6.8 vs 6.1 minutes/hour of MVPA , respectively ) but not for boys ( 7.9 vs 7.2 minutes/hour , respectively ) . CONCLUSIONS A flexible ecologic physical activity intervention that trains teachers to provide children with opportunities to be active throughout the school day increased MVPA in preschool children Objective To assess the effectiveness of 2 interventions in improving the physical activity and well-being of secondary school children . Design A clustered r and omised controlled trial ; classes , 1 per school , were assigned to 1 of 3 intervention arms or a control group based on a 2 × 2 factorial design . The interventions were peer-mentoring and participative learning .  Year 7 children ( aged 11–12 ) in the peer-mentoring intervention were paired with year 9 children for 6 weekly mentoring meetings . Year 7 children in the participative learning arm took part in 6 weekly geography lessons using personalised physical activity and Global Positioning System ( GPS ) data . Year 7 children in the combined intervention received both interventions , with the year 9 children only participating in the mentoring sessions . Participants 1494 year 7 students from 60 schools in the North of Engl and took part in the trial . Of these , 43 students opted out of taking part in the evaluation measurements , 2 moved teaching group and 58 changed school . Valid accelerometry outcome data were collected for 892 students from 53 schools ;  and well-being outcome data were available for 927 students from 52 schools . Main outcome measures The primary outcomes were mean minutes of accelerometer-measured moderate-to-vigorous intensity physical activity per day , and well-being as evaluated by the KIDSCREEN-27 question naire . These data were collected 6 weeks after the intervention ; a 12-month follow-up is planned . Results No significant effects ( main or interaction ) were observed for the outcomes . However , small positive differences were found for both outcomes for the participative learning intervention . Conclusions These findings suggest that the 2 school-based interventions did not modify levels of physical activity or well-being within the period monitored . Change in physical activity may require more comprehensive individual behavioural intervention , and /or more system-based efforts to address wider environmental influences such as family , peers , physical environment , transport and educational policy . Trial registration number IS RCT N82956355
Conclusions These guidelines represent a sensible evolution of public health guidelines whereby optimal health is framed within the balance of movement behaviours across the whole day , while respecting preferences of end-users .
Background The Canadian Society for Exercise Physiology convened representatives of national organizations , research experts , method ologists , stakeholders , and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for the Early Years ( 0–4 years ) : An Integration of Physical Activity , Sedentary Behaviour , and Sleep .
These novel guidelines for children of the early years embrace the natural and intuitive integration of movement behaviours across the whole day ( 24-h period ) .