Study protocol for the ACTIVE SCHOOL study investigating two different strategies of physical activity to improve academic performance in Schoolchildren.

BACKGROUND: Previous research has suggested that school-based physical activity (PA) interventions may have a positive impact on academic performance. However, existing literature on school-based interventions encompasses various forms of PA, spanning from vigorous intensity PA outside the academic classes to light intensity PA and movement integrated into academic learning tasks, and results on academic performance are inconclusive. ACTIVE SCHOOL will implement two different PA interventions for one school year and assess the effects on the pupils' academic performance, with math performance as the primary outcome. METHODS/DESIGN: The ACTIVE SCHOOL project consists of two phases: 1) Development phase and 2) Randomized Controlled Trial (RCT). In phase one, two interventions were developed in collaboration with school staff. The two interventions were tested in an 8-weeks feasibility study. In phase two, a RCT-study with three arms will be conducted in 9-10-year-old children for one school year. The RCT-study will be carried out in two intervention rounds during the school years 2023/2024 and 2024/2025. Schools will be randomized to one of two interventions or control;1) Run, Jump & Fun intervention (4 × 30 min/week of moderate-to-vigorous physical activity; 2) Move & Learn intervention (4 × 30 min/week focusing on embodied learning in math and Danish lessons); or 3) a control condition, consisting of normal teaching practices. Outcome measures include academic performance, PA level, cognitive functions, cardiorespiratory fitness, anthropometry, well-being and school motivation (collected before, during and after the intervention period). A process evaluation will be conducted to assess implementation. DISCUSSION: The ACTIVE SCHOOL study will expand knowledge regarding the impact of PA on academic performance. The study will have the potential to significantly contribute to future research, as well as the scientific and educational debate on the best way to implement PA to support education and learning. TRIAL REGISTRATION: The study was registered on the 25th of October 2022 in ClinicalTrials.gov, NCT05602948.

Effects of 8 Weeks with Embodied Learning on 5-6-Year-Old Danish Children's Pre-reading Skills and Word Reading Skills: the PLAYMORE Project, DK.

The aim of this study was to investigate the effects of embodied learning on children's pre-reading and word reading skills. We conducted a three-armed randomized controlled trial including two intervention groups and one control group. One hundred forty-nine children from grade 0 (5-6 years old) who had just started school were recruited from 10 different classes from four elementary schools. Within each class, children were randomly assigned to receive teaching of letter-sound couplings and word decoding either with whole-body movements (WM), hand movements (HM), or no movements (CON) over an 8-week period. Children were evaluated on pre-reading, word reading, and motor skills before (T1), immediately after (T2), and after 17-22 weeks of retention period (T3) following the intervention. Between-group analysis showed a significant improvement in children's ability to name letter-sounds correctly from T1 to T2 (p < 0.001) and from T1 to T3 (p < 0.05) for WM compared to CON. HM and WM improved significantly in naming conditional letter-sounds from T1 to T2 (p < 0.01, p < 0.01) compared to CON and from T1 to T3 for the HM group compared to CON (p < 0.05). We did not find an effect on word reading or a correlation between motor skill performance and reading. Results from the present study suggest that there are beneficial effects of using whole-body movements for children. Hand motor movements indeed also had a performance effect on letter-sound knowledge; however, the whole-body movements had longer-lasting effects. We do not see an effect on whole word reading.

Six Weeks of Basketball Combined With Mathematics in Physical Education Classes Can Improve Children's Motivation for Mathematics.

This study investigated whether 6 weeks of basketball combined with mathematics once a week in physical education lessons could improve children's motivation for mathematics. Seven hundred fifty-seven children (mean age = 10.4 years, age range: 7-12 years) were randomly selected to have either basketball combined with mathematics once a week (BM) or to have basketball sessions without mathematics (CON). Children in BM and CON motivation for classroom-based mathematics were measured using the Academic Self-Regulation Questionnaire (SRQ-A) before (T0) and after the intervention (T1). Among the BM, levels of intrinsic motivation, feelings of competence, and autonomy were measured using the Post-Experimental Intrinsic Motivation Inventory (IMI) questionnaire acutely after a basketball session combined with mathematics and immediately after a session of classroom-based mathematics. BM had significantly higher acute levels of perceived autonomy (+14.24%, p < 0.0001), competencies (+6.33%, p < 0.0001), and intrinsic motivation (+16.09%, p < 0.0001) during basketball sessions combined with mathematics compared to when having classroom-based mathematics. A significant decrease in the mean for intrinsic motivation was observed from T0 to T1 for CON (-9.38%, p < 0.001), but not for BM (-0.39%, p = 0.98). BM had a more positive development in intrinsic motivation compared to CON from T0 to T1 (p = 0.006), meaning that BM had a positive influence on children's intrinsic motivation for classroom-based mathematics. This study indicates that basketball combined with mathematics is an intrinsically motivating way to practice mathematics, which also has a positive influence on children's general intrinsic motivation for mathematics in the classroom.

Motor-enriched learning for improving pre-reading and word recognition skills in preschool children aged 5-6 years - study protocol for the PLAYMORE randomized controlled trial.

BACKGROUND: Results from previous studies suggest that bodily movements, spanning from gestures to whole-body movements, integrated into academic lessons may benefit academic learning. However, only few studies have investigated the effects of movement integrated into reading practice. The PLAYMORE study aims to investigate the effects of two interventions focusing on a close and meaningful coupling between bodily movement and academic content on early pre-reading and word recognition skills in children. Further, the study aims to compare two interventions involving either hand movements (i.e. using arms and hands) or whole-body movements (i.e. using the whole body). Potential mediating factors underlying the link between bodily movement on early pre-reading and word recognition skills will be explored. METHODS/DESIGN: The PLAYMORE study will be conducted as a three-armed randomized controlled trial including children aged five to six years recruited from four schools in the Copenhagen area, Denmark. Stratified by class, children will be randomly allocated to one of three 8-week intervention/control periods: 1) teaching involving whole-body movements, 2) teaching involving hand movements (i.e. arms and hands) or 3) teaching involving minimal motor movements (i.e. seated on a chair using paper and pencil). Outcome measurements, including pre-reading and word recognition skills, will be collected before and after the intervention period to assess the intervention effects. This study protocol follows the SPIRIT guidelines. DISCUSSION: The PLAYMORE study will add to the current knowledge concerning the link between bodily movement and academic performance with important details about pre-reading and word recognition skills in preschool children. If effective, evaluation of the implementation of the PLAYMORE program should be conducted in order to investigate whether the effects can be transferred into standard school settings. The PLAYMORE study will lay the foundation for future research that have the potential to inform the political and scientific debate and importantly, to provide teachers with detailed information of how to implement movements effectively during teaching in order to support and motivate children in the process of learning to read. TRIAL REGISTRATION: The study was retrospectively registered in ClinicalTrials.gov ( NCT04618822 ) the 5th of November 2020.

Motor-Enriched Encoding Can Improve Children's Early Letter Recognition.

It is not known how effective specific types of motor-enriched activities are at improving academic learning and early reading skills in children. The aim of this study was to investigate whether fine or gross motor enrichment during a single session of recognizing letters "b"/"d" can improve within-session performance or delayed retention the following day in comparison to letter recognition practice without movement. Furthermore, the aim was to investigate children's motivation to perform the specific tasks. We used a randomized controlled intervention study-design to investigate the effect of 10-min motor-enriched "b"/"d" letter training on children's ability to recognize the letters "b" and "d" (n = 127, mean age = 7.61 ± SD = 0.44 years) acutely, and in a delayed retention test. Three groups were included: a fine motor-enriched group (FME), a gross motor-enriched group (GME), that received 10 min of "b" and "d" training with enriched gestures (fine or gross motor movements, respectively), and a control group (CON), which received non motor-enriched "b"/"d" training. The children's ability to recognize "b" and "d" were tested before (T0), immediately after (T1), and one day after the intervention (T2) using a "b"/"d" Recognition Test. Based on a generalized linear mixed model a significant group-time interaction was found for accuracy in the "b"/"d" Recognition Test. Specifically, FME improved their ability to recognize "b"/"d" at post intervention (T0→T1, p = 0.008) and one-day retention test (T0→T2, p < 0.001) more than CON. There was no significant difference in change between GME and CON. For reaction time there were no significant global interaction effects observed. However, planned post hoc comparisons revealed a significant difference between GME and CON immediately after the intervention (T0→T1, p = 0.03). The children's motivation-score was higher for FME and GME compared to CON (FME-CON: p = 0.01; GME-CON: p = 0.01). The study demonstrated that fine motor-enriched training improved children's letter recognition more than non motor activities. Both types of motor training were accompanied by higher intrinsic motivation for the children compared to the non motor training group. The study suggests a new method for motor-enriched letter learning and future research should investigate the underlying mechanisms.

Plasma creatinine as predictor of delayed elimination of high-dose methotrexate in childhood acute lymphoblastic leukemia: A Danish population-based study.

BACKGROUND: Severely delayed elimination of methotrexate (MTX) is difficult to predict in patients treated with high-dose MTX (HD-MTX), but it may cause life-threatening toxicity. It has not been defined how an increase in plasma creatinine can be best used as a predictor for severely delayed MTX elimination, thus providing a guide for therapeutic interventions to minimize renal toxicity. METHODS: Pharmacokinetic data were retrospectively collected on 218 Danish children with acute lymphoblastic leukemia treated with HD-MTX 5 or 8 g/m2 on the NOPHO2000 protocol. Moderately delayed MTX elimination was defined as 42-hour plasma MTX ≥ 4.0-9.9 µM, and severely delayed elimination was defined as 42-hour plasma MTX ≥ 10 µM. RESULTS: Median 42-hour plasma MTX was 0.61 µM (interquartile range, 0.4-1.06 µM). Of 1295 MTX infusions with 5 g/m2 (n = 140 patients) or 8 g/m2 (n = 78 patients), 5.1% were severely (1.5%) or moderately (3.6%) delayed. The risk of having delayed elimination was highest in the first of eight infusions with MTX 5 g/m² (7.4% vs 0.0 to 4.1% for subsequent MTX infusions) (P < 0.02). A 25 µM increase or a 1.5-fold increase in plasma creatinine within 36 hours from start of the MTX infusion had a sensitivity of 92% (95% CI, 82%-97%) and a specificity of 85% (95% CI, 83%-87%) for predicting 42-hour MTX ≥4.0 µM. CONCLUSIONS: A 25 µM increase or a 1.5-fold in plasma creatinine within 36 hours after start of an HD-MTX infusion can predict delayed MTX elimination, thus allowing intensification of hydration and alkalization to avoid further renal toxicity and promote the elimination of MTX.