Results From South Africa's 2022 Healthy Active Kids' Report Card on Physical Activity, Body Composition Proxies, and Nutritional Status in Children and Adolescents.

BACKGROUND: Physical activity (PA) and nutrition in children have an impact on overall physical and mental well-being, cognitive, and social development. This study aims to report on the best current available evidence on PA, body composition proxies, and nutritional status of South African children and adolescents, based on the published findings between 2018 and 2022, which comprise the 2022 Healthy Active Kids South Africa Report Card. METHODS: A comprehensive literature search of online databases, along with hand searching and a gray literature search, was conducted based on PA, body composition proxies, and nutrition indicators defined, in part, by the Active Healthy Kids Global Alliance. RESULTS: Compared with the 2018 report card, there was an improvement in the majority of PA indicators which include overall PA (B-), active transportation (B-), physical fitness (B-), and government policy and programs (C). Body composition proxies and most of the nutrition indicators remained unchanged. The indicators that regressed from 2018 to 2022 included community and environmental influences (D), as well as participation in organized sport (D-). CONCLUSIONS: Despite the apparent improvement in overall PA levels in children and adolescents, there is a lack of tangible evidence of actual implementation of policies and programs. There was also a lack of nationally representative data for most indicators. Overall, there is a need to identify intersectoral, equitable approaches for promoting PA and healthy eating in South African children and adolescents and ongoing monitoring and surveillance.

Which outcomes are key to the pre-intervention assessment profile of a child with developmental coordination disorder? A systematic review and meta-analysis.

BACKGROUND: Purpose of this study was to determine what key aspects of function should be incorporated to make up a pre-intervention assessment profile of a child with Developmental Coordination Disorder (DCD); more specifically, what aspects of functioning are implicated in DCD and what is their relative impact? METHODS: A systematic review and meta-analysis were conducted, for which Pubmed, Web of Science, Scopus and Proquest were searched (last update: April 2023, PROSPERO: CRD42023461619). Case-control studies were included to determine point estimates for performances on field-based tests in different domains of functioning. Risk of bias was assessed, and level of evidence estimated. Random-effect meta-analyses were performed to calculate the pooled standardized mean differences for domains of functioning and subgrouping was done for clinically relevant subdomains. Heterogeneity was determined with I2. RESULTS: 121 papers were included for analyses. Data of 5 923 children with DCD were included (59.8% boys) and 23 619 Typically Developing (TD) children (45.8% boys). The mean (SD) age of the DCD group was 10.3y (1.2) and 9.3y (1.3) for the TD children. Moderate evidence was found for motor performance, executive functions, sensory processing and perceptions, cognitive functions and sports and leisure activities to be affected in children with DCD. CONCLUSION: Differences between the two groups varied per domain of functioning. This emphasizes the diversity present within children with DCD and provides a rationale for explaining the heterogeneity in this patient group. Yet, results highlight the potential involvement of all these domains and call for clinicians to be alert not only to examine motor skill difficulties but also other aspects of function. Results indicate the need to develop an individualized pre-intervention multi-dimensional assessment profile for each child with DCD. It also supports the important role that clinicians play in an interdisciplinary team to tackle the difficulties encountered by children with DCD.

Do Girls Have an Advantage Compared to Boys When Their Motor Skills Are Tested Using the Movement Assessment Battery for Children, 2nd Edition?

This study aims to investigate sex-related differences in raw item scores on the Movement Assessment Battery for Children, 2nd Edition (MABC-2) in a large data set collected in different regions across the world, seeking to unravel whether there is an interaction effect between sex and the origin of the sample (European versus African). In this retrospective study, a secondary analysis was performed on anonymized data of 7654 children with a mean age of 8.6 (range 3 to 16; SD: 3.4), 50.0% of whom were boys. Since country-specific norms were not available for all samples, the raw scores per age band (AB) were used for analysis. Our results clearly show that in all age bands sex-related differences are present. In AB1 and AB2, girls score better on most manual dexterity and balance items, but not aiming and catching items, whereas in AB3 the differences seem to diminish. Especially in the European sample, girls outperform boys in manual dexterity and balance items, whereas in the African sample these differences are less marked. In conclusion, separate norms for boys and girls are needed in addition to separate norms for geographical regions.

Effect of a Three-Month HOPSports Brain Breaks® Intervention Program on the Physical Fitness Levels of Grade 6-Learners in South Africa.

Despite the numerous health benefits of being physically active, children are not active enough. Various researchers have indicated that intervention programs improve physical fitness levels. Still, only a few have focused on improving physical fitness levels by incorporating technology. HOPSports Brain Breaks® are designed and presented as physical activity solutions with online videos requiring the participants to imitate the movements. These videos are 2-5-min classroom activity breaks. This study determined the effect of a three-month HOPSports Brain Breaks® intervention program on the physical fitness levels of Grade 6-learners. Physical fitness was measured with the EUROFIT test battery. The experimental group consisted of 79 children (26 boys and 47 girls) and the control group of 47 children (16 boys and 33 girls). The mean age for the entire group was 11.92 (±0.36) years. The results indicated that there was a statistically (p ≤ 0.05) and practically (d ≥ 0.20) significant difference between the experimental and control group for percentage body fat; stork balance; plate tapping; sit-and-reach; standing jump; sit-ups; and 10 × 5 m shuttle run and 20 m shuttle run between the pre-and post-test. Therefore, considering the results mentioned above, the HOPSports Brain Breaks® intervention program can indeed contribute to the improvement of physical fitness, and motor skills of children. Therefore, future studies should be conducted to determine the effect of HOPSports Brain Breaks® between genders as well as what impact it will have on academic performance.

Underweight children are agile but lack power.

Given the knowledge gap in literature on the impact of undernutrition on muscular power and agility in school-aged children, the aim of this study was to compare physical fitness in such underweight- and normal weight children. In this cross-sectional study, 853 children were included (459 boys; mean age: 9.2 (1.8) years). The children were grouped according to their BMI-for-age-and-sex: normal weight (- 1 ≤ z-score < 2) and underweight (z-score < - 1). Within the underweight group, three thinness subgroups were composed: grade 1 (- 2 ≤ z-score < - 1), grade 2 (- 3 ≤ z-score < - 2) and grade 3 (z-score < - 3). Their agility, muscular endurance and power were assessed with the Performance and Fitness test battery (PERF-FIT). Regardless the country they lived in, the underweight children showed better agility (p = 0.012) and muscular endurance (p = 0.004) than those with normal weight. They presented with lower muscular power than the normal weight group, shown by significantly shorter overhead throwing distances (p = 0.017) and less standing long jump peak power (p < 0.001). The standing long jump peak power decreased further with increasing thinness grade (p = 0.027).Conclusion: Underweight children are more agile, but have lower muscular power compared to their normal weight peers. Its relationship with motor competence and physical activity, necessitates attention for tackling muscular strength deficiencies in these children, enabling them to meet the basic requirements for a healthy lifestyle later in life.

An Exploratory Investigation of the Effect of a Sports Vision Program on Grade 4 and 5 Female Netball Players' Visual Skills.

Vision is one of the most complex and dominant sensory systems necessary for information feedback from the environment. Few studies have already reported a positive effect of a sport vision program on elite sport teams' visual skills; however, few studies have focused on the effect of sport vision programs on children's visual skills. Therefore, the aim of this study was to determine the effect of a sports vision program on Grade 4 and 5 female netball players' visual skills. Girls (N = 25) with a mean age of 10.08 years (SD = 0.65) formed part of this study. A pre-test-post-test design was followed with a retention test. The eight-week sports vision program was executed twice a week for 60 min on the experimental group (n = 13). The Developmental Test of Visual-Motor Integration (VMI-4), the Wayne Saccadic Fixator (WSF) and the Developmental Eye Movement (DEM) test were used to evaluate the girls' visual skills, hand-eye coordination, visual reaction time, peripheral vision and saccadic eye movements. No statistical differences were found between the two groups before starting with the sports vision program. After intervention, significant differences between the two groups were reported, with the experimental group performing better in hand-eye coordination (p = 0.001) and reaction time (p = 0.001). Results further indicated that the experimental group experienced significant improvements (p ≤ 0.05) in motor coordination, hand-eye coordination, reaction speed and visual tracking after intervention with significant lasting effects (p ≤ 0.05). The control group performed significantly worse in reaction time (p = 0.01). A sports vision program can be recommended for Grade 4 and 5 female netball players to improve certain visual skills.

Age and Sex Differences in the State and Relationships between Process and Product Assessments of Fundamental-Motor Skills in Five to Eight-Year-Olds: The ExAMIN Youth SA Study.

Adequate development of Fundamental Motor Skills (FMS) at a young age benefit holistic development and positive health outcomes. This study determined age and sex developmental differences in the state and the relationships between process and product assessments of four fundamental-motor skills (FMS) in five to eight-year-olds. An availability sample of 636 children; 291 boys, 345 girls, mean age of 6.8 ± 0.97 years in the North West Province of South Africa participated in the study. Spearman rank order correlations analyzed relationships between assessments, while sex and age differences were examined using independent t-testing and one-way ANOVA. Age showed significant developmental trajectories in all FMS. Older children were found to be more at risk for not learning FMS to mastery, while unique developmental patterns were also established compared to international trends. Strong to moderate significant practical associations (p < 0.05) emerged between process and product assessments in catching (r = 0.79), jumping (r = 0.40) running (r = −0.33) and kicking (r = 0.20), while also confirming that the strength of the associations varies depending upon the skill type. Associations strengthened with increasing age, were higher in girls in all FMS, while associations between behavioral criteria in all FMS also differed between FMS and sexes. These strong associations, need to be taken into consideration during the development of FMS towards obtaining full mastery.

Exploring Cultural Bias in Two Different Motor Competence Test Batteries When Used in African Children.

Both the Movement Assessment Battery for Children second edition (M-ABC-2) and Bruininks-Oseretsky Test of Motor Proficiency second edition short form (BOT-2-SF) are frequently used in research and in the clinical practice to evaluate motor competence in children. Despite its widespread use in research, no studies have reported the results of case identification in African children. Comparing these two motor assessment tools for a different target group is important in order to select the most appropriate clinical and research tool. Methods. A total of 444 children performed MABC-2, 165 children also performed the BOT-2-SF and subsamples were tested on specific subtests of the BOT-2 (Running and Agility, Balance, and Strength). Tests were administered to randomly selected children between 6 and 10 years of age. Results: 36% for the children scored at or below the 16th percentile of the MABC-2, while this was 43%, 27%, and 23% for the component score in Manual Dexterity, Aiming and Catching, and Balance, respectively. Of the children 16% scored at or below the 17th percentile of the BOT-2-SF total score, while this was 3%, 9% and 22% for the subtest scores Running and agility, Balance, and Strength, respectively. A moderate correlation (r = 0.44) was found between total scores of the two tests. No significant correlations were found between the dynamic MABC-2 item (Jumping/Hopping) standard scores and any of the 9 balance items of the BOT-2. Conclusion: Far more children scored in the clinical "at risk" range (<16th percentile) when tested with the MABC-2 than with the BOT-2-SF. Overall, these children seemed not to be limited in motor performance measured by the BOT-2-SF, Running and Agility, and Balance. South African children did show lower levels of strength and explosive power. Children from different cultures will need tests for the specific motor skills that are representative for optimal functioning in their own setting. Thus, adapting reference norms and cut-off values may not be the optimal solution.

Do We Drop the Ball When We Measure Ball Skills Using Standardized Motor Performance Tests?

BACKGROUND: Ball skill performance changes over time during childhood and depends on the child's physical and psychological characteristics, environmental opportunities, and task constraints. The aim of this study was to examine whether different standardized ball skill-items measure similar constructs and whether results differentiate among age groups. Methods: A total of 250 children (6-10 years) were administered the Movement Assessment Battery for children second edition (MABC-2), the subtest upper-limb coordination of the Bruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2), the tennis ball throw of the Fitness Test Battery (FTB), and the ball skills and overhead throw of the Performance and Fitness test (PERF-FIT). Results: Correlations among scores of BOT-2, FTB, and PERF-FIT ranged from fair to moderate, but correlations were low with the MABC-2. Principal component analysis retrieved three components: the first component contained catch, dribble, bounce, and throw items (MABC-2, BOT-2-SF, and PERF-FIT, respectively); the second contained throwing for distance (PERF-FIT and FTB); the third contained aiming (MABC-2). Most ball skill scores differed significantly between 6-7 and 7-8 years, but less between 8-9 years; the PERF-FIT discriminated best between age groups. Conclusion: Most ball skill items in motor tests belong to a comparable construct containing throw, dribble, bounce, and catch skills. However, aiming tasks belong to a separate category. Additionally, throwing for distance is a task that requires predominantly explosive power.

Children with Poor Motor Skills Have Lower Health-Related Fitness Compared to Typically Developing Children.

Most of the current empirical evidence regarding the relationship between health-related fitness and level of motor performance is based on children from high-income countries. Yet, children from low-resource areas may have fewer opportunities to develop their fitness skills. The aim of the study was to determine if South African children from both low- and middle-income areas scoring below the 16th percentile on the Movement Assessment Battery for Children-2 (probable-Developmental Coordination Disorder (p-DCD)) have lower health-related fitness levels than typically developing (TD) children. We hypothesized that children with p-DCD would have lower overall health-related fitness than TD children. A sample of 146 participants aged 10 to 11 (10.05 years (SD = 0.41)) was collected from schools in the North West Province of South Africa, on the basis of their poverty classification. Children were tested for anaerobic capacity and strength using the Bruininks-Oseretsky test of motor proficiency second edition (BOT-2) and aerobic capacity using the Progressive Aerobic Cardiovascular Endurance Run (PACER). Body composition was evaluated using body mass index corrected for age and sex (BMI-z), body fat (BF), and waist circumference. The data was analyzed using Spearman correlations and chi-squared tests. Statistically significant differences (p < 0.05) were found between groups for running and agility, strength, and aerobic capacity. No significant differences were found between p-DCD and TD groups in terms of body mass (36.1 kg vs. 33.3 kg), waist circumference (62.2 cm vs. 59.8 cm), BMI-z (19.7 vs. 17.6), and fat percentage (20.2 vs. 18.1%). Overweight and obesity prevalence was 15% in those with low socio-economic status (SES) and 27% in high SES. In conclusion, children with p-DCD had lower muscular strength, aerobic capacity, and endurance than TD children. Although it has been reported that children with p-DCD have a higher risk for overweight/obesity than TD children, this is not (yet) the case in 10-11-year-old children living in rural areas in South Africa (North West Province).

Longitudinal Effects of Excessive Weight and Obesity on Academic Performance of Primary School Boys in Different Socio-Economic Statuses: The NW-CHILD Study.

Obesity affects millions of children worldwide and can often impact their academic performance. This longitudinal study, conducted over seven years, determines the effects of excessive weight and obesity on the academic performance of primary school boys, taking into account their socio-economic status (SES). The study forms part of a seven-year (2010-2016) longitudinal study, the North-West Child-Health-Integrated-Learning and Development (NW-CHILD) study, which includes a baseline measurement and two follow-up measurements of the 181 participants from varying areas in the North West Province. Two-way frequency tables, repeated measure ANOVA's and Spearman rank order correlations were used to analyze the data. The Body Mass Index (BMI) of the participants reported an increase from 2010-2016. Nearly all of the school subjects reported small to large correlations between BMI and academic performance (r ≥ 0.1 and r ≥ 0.3), except for Afrikaans in 2013 (r = -0.06). Only two subjects (English and Language as tested with the ANA test) reported medium effects (r ≥ 0.3), whereas the other subjects only reported small effects (r ≥ 0.1). No statistically significant relationships (p ≥ 0.05) were observed between the BMI values and academic subjects, however SES and school subject scores reported several statistically significant relationships, especially regarding Language (English and First Additional Language) and Mathematics (p = 0.02). Overweight and obese primary school boys in the North West Province of South Africa reported a higher academic performance in comparison to boys of a normal weight, even when SES was taken into consideration. Further studies are recommended to verify current findings regarding weight, obesity and academic performance.

High BMI and Low Muscular Fitness Predict Low Motor Competence in School-Aged Children Living in Low-Resourced Areas.

Childhood obesity is a relatively new problem for Sub-Saharan developing countries. Especially in children with a low socioeconomic background, the link between motor competence, muscular fitness, and body mass index (BMI) remains poorly investigated. Due to the interrelatedness of BMI and physical fitness, the aim of this study is to determine the predictive value of these factors in relation to low motor competence in school-aged children living in low-resourced areas. Motor competence and physical fitness were assessed in 1037 school-aged Ghanaian and South African children using the Performance and Fitness test battery (PERF-FIT). "Low motor competence" was predicted using odds ratios calculated from backward logistic regression analyses. Low motor competence was less prevalent in Ghanaian children (3.7-11.1%) compared to the South African children (21.9-24.2%). Increased BMI and decreased muscular fitness predicted low motor competence in both Ghanaian and South African children. For example, the chance for a Ghanaian child to have low static balance increased by 22.8% (OR = 1.228, p < 0.001) with a 1-point increase in BMI, whereas this decreased by 30.0% (OR = 0.970, p < 0.001) with a 10-cm increase on the standing long jump. In the case of the South African children, if their BMI increased by 1 point, the chance for those children of having low static balance increased by 7.9%, and if their SLJ performance decreased by 10 cm, their chance of low performance increased by 13%. Clearly, motor competence is associated with both BMI and muscular fitness. Policy makers can use this information to counteract the establishment of childhood obesity by promoting weight control through physical activity and stimulating motor competence at school.

Brain Breaks® Physical Activity Solutions in the Classroom and on Attitudes toward Physical Activity: A Randomized Controlled Trial among Primary Students from Eight Countries.

Classroom-based physical activity (PA) interventions have received considerable attention due to improvements seen in academic achievement, classroom behaviors, and attitude toward PA. The purpose of this study was to evaluate the effectiveness of the Brain Breaks® Physical Activity Solutions in changing children's attitudes toward PA. Students (N = 3036) aged 8-11 years from schools in Croatia, Lithuania, Macedonia, Poland, Romania, Serbia, South Africa, and Turkey were randomly assigned to either a control or an experimental group. The experimental group received Brain Breaks® videos during classroom sessions throughout the four months of intervention. Student attitudes toward PA were measured using the Attitudes toward Physical Activity Scale (APAS) before and after the intervention. Repeated measures ANOVA indicated a time interaction effect for all APAS variables except fitness. Time-by-group interaction effects with different effect sizes were found for most APAS variables, with the greatest gain effect noted in the experimental group for self-efficacy, followed by learning from the videos concerning PA benefits, exercise importance, and enjoyment from engaging in PA. This study provides evidence supporting Brain Breaks® in terms of learning experience, attitudes towards PA, and personal motivation. Using exercise videos is recommended as an interactive, technology-based PA solution that can be easily integrated into the school setting.

Influence of Different Visual Perceptual Constructs on Academic Achievement Among Learners in the NW-CHILD Study.

Visual perception plays an important and integrating role in the development of cognitive abilities and perceptual-motor skills. Visual perception comprises different independent constructs that may function in an integrative manner. This study aimed to determine whether (and the extent to which) various visual-perceptual constructs influence the academic achievement of 12-year-old school children. In a cross-sectional analysis, we extracted only 2016 data from 581 learners (mean age = 12.92 years, SD = 0.42) who were participants in the North-West Child Health, Integrated with Learning and Development longitudinal study (2010-2016). We used the Test of Visual Perceptual Skills, Third Edition, the North-West Provincial Assessment and mid-year school examination reports to determine visual perceptual abilities and academic achievement of this participant group. We calculated correlations between visual perceptual constructs and academic performance using Spearman rank order correlations and separately analyzed the influence of gender and socioeconomic status with independent T tests. Different visual perceptual constructs did have significant influences on specific areas of academic learning and on academic achievement generally ( r = .26 to r = .41). Spatial relationships showed slightly greater correlations with academic achievement ( r = .15 to r = .33) than did other basic visual perceptual constructs, possibly because spatial relationships are not completely developed at age 12. Complex and basic visual perceptual skills had medium significant retrospective correlations with grade point average ( r = .40 and r = .41) and first additional language ( r = .30 and r = .33). We concluded that basic and complex visual perceptual constructs remain important for academic achievement in this age-group, while gender and socioeconomic status influence both visual perceptual abilities and academic achievement.

The effect of visual therapy on the ocular motor control of seven- to eight-year-old children with developmental coordination disorder (DCD).

The aims of this study were to determine the extent of ocular, motor control problems and the effect of visual therapy on such problems, among seven- to eight-year-old children diagnosed with DCD. Thirty-two, children with a mean age of 95.66 months (SD ± 3.54) participated in the study. The MABC was used to classify children into DCD categories (<15th, percentile) while the Sensory Input Systems Screening Test and QNST-II, were used to evaluate ocular motor control. A two-group pre-test-post-test, cross-over design was followed with a retention test two years, thereafter to determine the lasting effect of the visual therapy, intervention. The 18-week visual therapy programme was executed once a week, for 40 min during school hours, after which the two groups were, crossed over. Percentages of ocular motor control problems ranging, between 6.25% and 93.75% were found in both the groups before participating, in the visual therapy programme, with the highest percentage problems found, in visual pursuit with the left eye. Visual therapy contributed to a, significant improvement of 75-100% in visual pursuit, fixation, ocular, alignment and convergence, with significant lasting effects (p<0.001). Visual therapy is recommended for children with DCD experiencing poor, ocular motor control.