How to design and establish a national school-based physical fitness monitoring and surveillance system for children and adolescents: A 10-step approach recommended by the FitBack network.

BACKGROUND: Providing individual- and population-level data on children's physical fitness (PF) is a crucial public health and education priority. However, few national fitness monitoring or surveillance systems are currently in practice internationally. We aim to summarize the current European PF monitoring and surveillance systems for school-aged children and to provide experience-based guidelines on how to design such systems. METHODS: The FitBack network consists of experts from diverse backgrounds with the common interest to improve the accessibility of PF monitoring for young people globally. Through FitBack network, we identified and compared the national or regional PF monitoring and surveillance systems currently in operation across Europe. We formulated a 10-step approach for designing and establishing one's own system, based on analysis of experienced strengths, weaknesses, opportunities, and threats to monitoring childhood fitness. RESULTS: We identified a total of eight PF monitoring systems in Finland, France, Galicia of Spain, Hungary, Lithuania, Portugal, Serbia, and Slovenia. The FitBack network recommends the following steps for designing and establishing one's own system: (1) set up mission statements and aims, (2) involve stakeholders, (3) utilize scientific background, (4) governance structure, (5) ensure sufficient funding, (6) data management planning, (7) provide meaningful feedback, (8) conduct pilot testing, (9) plan implementation process, and (10) invest in communication with stakeholders. CONCLUSIONS: This study provides an updated overview of the best practices for school-aged children's fitness monitoring and surveillance in Europe. Additionally, it offers a 10-step approach to assist in the creation of similar systems in Europe or globally.

Children With Cardiac Disease and Heat Exposure: Catastrophic Converging Consequences?

The detrimental impact of extreme heat exposure on the health and well-being of children is widely acknowledged. The direct and indirect effects of climate change have led to an increased risk of certain cardiovascular events which may be particularly harmful to children who are born with, or develop, heart disease. PURPOSE: To highlight the worrying paucity of investigative research aimed at differentiating how higher ambient temperatures further tax an already compromised cardiovascular system in children. METHODS: This commentary describes basic thermoregulatory concepts relevant to the healthy pediatric population and summarizes common heart diseases observed in this population. RESULTS: We describe how heat stress and exercise are important factors clinicians should more readily consider when treating children with heart disease. Countermeasures to physical inactivity are suggested for children, parents, clinicians, and policymakers to consider. CONCLUSIONS: As sudden, excessive heat exposures continue to impact our rapidly warming world, vulnerable populations like children with underlying heart conditions are at greater heat health risk, especially when coupled with the negative physical activity and fitness trends observed worldwide.

Challenges of social change: The 2021 Republic of Slovenia report card on physical activity of children and adolescents.

Background: Slovenian children are facing considerable health challenges from the rapid social changes that influence their opportunity to engage in daily physical activity. Objective: To overlay the social changes to the established Report Card model as a means of contextualising the extreme changes in physical activity and fitness observed over several years. Methods: Benchmarks were graded for 10 core indicators, plus two (Sleep, Seasonal Variations). Active Healthy Kids Slovenia members met (predominantly via zoom) liaising with team leader(s) on a flexible, individual basis, based on coronavirus disease 2019 (COVID-19) regulations, over the ∼2-year assessment period of the project. Data were separated to the years prior to, 'pre' 2018-2020, and 'during' the global pandemic (2020-2021). Where sufficient data existed for both timeframes, grades were averaged to produce an overall grade. Results: Grade results are expressed as pre/during/final grade, where the final grade (bolded) is a straight average of the two preceding time epochs: Overall Physical Activity (A-/A-/A-), Organized Sport and Physical Activity (C+/C/C), Active Play (D/C+/C), Active Transport (C/INC/C), Sedentary Behaviour (B/C/C+), Physical Fitness (A+/A-/A), Family and Peers (B+/INC/B+), Schools (A/A/A), Community and Environment (A+/A+/A+), Government (A/F/D), Sleep (D-/INC/D-), Seasonal Variations (D/C-/D+). Conclusion: Although Slovenia has some of the most consistently physically-active children in the world, the effects of the COVID-19 pandemic exerted significant reductions in physical activity opportunities, and especially when coupled with funding re-distributions, resulted in the steepest decline of child physical fitness observed within the >35-year history of Slovenia's well-established national fitness surveillance system.

Moving in a hotter world: Maintaining adequate childhood fitness as a climate change countermeasure.

Children cope with high temperatures differently than adults do, largely because of slight alterations in their body proportions and heat loss mechanisms compared to fully mature humans. Paradoxically, all current tools of assessing thermal strain have been developed on adults. As the Earth's warming continues to accelerate, children are set to bear the health risk brunt of rising global temperatures. Physical fitness has a direct impact on heat tolerance, yet children are less fit and more obese than ever before. Longitudinal research reveals that children have 30% lower aerobic fitness than their parents did at the same age; this deficit is greater than can be recovered by training alone. So, as the planet's climate and weather patterns become more extreme, children may become less capable of tolerating it. This comprehensive review provides an outline of child thermoregulation and assessment of thermal strain, before moving to summarize how aerobic fitness can modulate hyperthermia, heat tolerance, and behavioral thermoregulation in this under-researched population. The nature of child physical activity, physical fitness, and one's physical literacy journey as an interconnected paradigm for promoting climate change resilience is explored. Finally, future research foci are suggested to encourage continued exploration of this dynamic field, notable since more extreme, multifactorial environmental stressors are expected to continue challenging the physiological strain of the human population for the foreseeable future.

24-h movement behaviour, thermal perception, thirst, and heat management strategies of children and adults during heat alerts: a pilot study.

Background: Heat waves caused by climate change are increasingly challenging the wellbeing of individuals across the lifespan. Current efforts to understand the thermal perceptions and behaviours of people throughout the lifespan during heat waves are limited. Methods: Since June 2021, the Active Heatwave project has been recruiting households to better understand how individuals perceive, cope, and behave during heat waves. Using our novel web platform, participants were prompted to answer our Heat Alert Survey on days when a participants geolocation corresponded to a broadcasted local heat alert. Participants provided 24-h movement behaviour, thirst, thermal perception, and cooling strategies via validated questionnaires. Results: A total of 285 participants (118 children) from 60 distinct weather station locations globally participated between June and September 2021 and 2022. At least 1 heat alert (834 total) were identified from 95% (57/60) of the weather stations. Children reported spending more time performing vigorous intensity exercise compared to adults (p < 0.05), but no differences in thermal sensation, thermal comfort, or thirst sensation (all p > 0.31) were observed. For thirst management, 88% of respondents used water to relieve thirst, although notably, 15% of adults reported using alcohol. Regardless of age, staying indoors was the most common heat management strategy, whereas visiting cooling centres was the least. Conclusion: The present study presents a proof-of-concept combining local heat alert notifications with e-questionnaires for collecting near-real-time perceptual and behavioural data for both children and adults during heat waves. The observed patterns of behaviour suggest that present public heat-health guidelines are often ignored, children engage in fewer heat management strategies compared to adults, and these disparities highlight the need to improve public health communication and knowledge dissemination around promoting effective and accessible cooling solutions for children and adults.

Effectiveness of a population-scaled, school-based physical activity intervention for the prevention of childhood obesity.

OBJECTIVE: The aim of this study was to examine the effectiveness of a real-world, population-scaled, school-based physical activity (PA) intervention that provided two to three additional physical education lessons per week to children aged 6 to 14 years in Slovenia. METHODS: More than 34,000 participants from over 200 schools were compared with a similar number of nonparticipants from the same schools. Generalized estimating equations were used to estimate the effects of differing levels of exposure to the intervention (i.e., from 1-5 years) on BMI in children with normal weight, overweight, or obesity at baseline. RESULTS: BMI was lower in the intervention group, irrespective of participation duration or baseline weight status. The difference in BMI increased with the program duration, with maximal effects being seen after 3 to 4 years of participation, and was consistently larger for children with obesity (peaking at 1.4 kg/m2 [95% CI: 1.0-1.9] for girls with obesity and peaking at 0.9 kg/m2 [95% CI: 0.6-1.3] for boys with obesity). The program started to become effective at reversing obesity after 3 years, whereas the lowest numbers needed to treat (NNTs) were observed after 5 years (NNTs = 17 for girls and 12 for boys). CONCLUSIONS: The population-scaled, school-based PA intervention was effective in preventing and treating obesity. The effects were the greatest in children initially presenting with obesity, such that the program was able to benefit children needing support the most.

Economic Freedom, Climate Culpability, and Physical Activity Indicators Among Children and Adolescents: Report Card Grades From the Global Matrix 4.0.

BACKGROUND: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. METHODS: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). RESULTS: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. CONCLUSIONS: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.

Association Between Physical Activity Indicators and Human Development Index at a National Level: Information From Global Matrix 4.0 Physical Activity Report Cards for Children and Adolescents.

BACKGROUND: The aim of this study was to explore the associations between the 10 key indicators of the Global Matrix 4.0 project and human development index (HDI) at a national level according to sex, age, area of residence, and ability levels. METHODS: Information from the 57 countries/localities included in the Global Matrix 4.0 project was compiled and presented according to the HDI of each country/locality for each of the 10 key indicators. Grades were assigned based on the benchmarks of the Global Matrix 4.0 project ranged between "A+" (best performance) and "F" (worst performance). RESULTS: The population subgroups of females, children, rural residents, with/without disabilities from countries/localities with higher HDI performed better in the organized sport and physical activity indicator than their peers from countries/localities with lower HDI. Children and adolescents living in rural areas of countries/localities with higher HDI showed better performance for active play, and children and adolescents living in urban areas of countries/localities with lower HDI showed better performance for the active transportation. Countries/localities with higher HDI showed better grades for sources of influence than the countries/localities with lower HDI. CONCLUSIONS: Physical activity patterns in some population subgroups of children and adolescents differed according to the development level of countries/localities.

SLOfit Lifelong: A model for leveraging citizen science to promote and maintain physical fitness and physical literacy across the lifespan.

SLOfit Lifelong is a public health initiative which was created to upgrade a well-established, national physical fitness surveillance system for Slovenian schoolchildren that has been collecting annual fitness and health data for over three decades. The ultimate objective of creating SLOfit Lifelong was to build a modern societal infrastructure with the capacity and ability to detect future causal associations between childhood physical fitness trends and future health outcomes based on the lifelong surveillance of one's own fitness status. By instilling citizens with an ambition to test, understand, and follow-up their own physical fitness and health status (including related health risk factors), this initiative provides the technical support and expert feedback needed to engender greater individual control over understanding (and thus modulating), one's own physical fitness status as they progress into older adulthood. This perspective paper details the extensive approach taken to devise appropriate fitness test batteries for adults and older adults which can also relate to the student version of the original SLOfit test database, including establishing criterion health risk zones and a public approach to establish this national, citizen-driven health feedback framework. Through its sophisticated online web applications, social media, print media, and outreach workshops, SLOfit Lifelong provides the expert support for public health engagement by fostering positive lifelong physical literacy experiences an individual can enjoy across their aging journey.

Can Primary School Mathematics Performance Be Predicted by Longitudinal Changes in Physical Fitness and Activity Indicators?

OBJECTIVE: To determine to what extent physical fitness indicators and/or moderate to vigorous physical activity (MVPA) may account for final mathematics academic performance (APmath) awarded at the end of primary school. METHODS: School-aged youth were sampled in a repeated-measures, longitudinal design in Grade 6 (∼11 years), and again in Grade 9 (∼14 years). The youth (N = 231, 111 girls) completed a fitness test battery consisting of: flamingo balance test, standing long jump, backward obstacle course, plate tapping, sit ups, sit and reach, handgrip, and 20-m shuttle run. APmath scores were obtained for all children at the end of Grade 5, end of Grade 8, and end of Grade 9 (their final year of primary school). In a sub-sample of Grade 6 youth (N = 50, 29 girls), MVPA was measured objectively via SenseWear Pro Armbands (MVPAOB) for seven consecutive days, with measurements repeated in Grade 9. RESULTS: Math scores decreased from Grade 6 to 9 for both boys and girls (95%CI: -0.89 to -0.53, p < 0.001). MVPAOB was reduced by ∼45.7 min (-33%) from Grade 6 to 9 (p < 0.01). Significant main and interaction effects are noted for each fitness indicator (p < 0.05). A backward stepwise multiple regression analysis determined significant shared variance in final APmath grade to the change scores from Grade 6 to Grade 9 in: ΔAPmath, Δbackward obstacle course, Δsit and reach, and Δsit-ups [R 2 = 0.494, F(4,180) = 43.67, p < 0.0001]. A second regression was performed only for the youth who completed MVPAOB measurements. In this sub-sample, MVPAOB did not significantly contribute to the model. CONCLUSION: Longitudinal changes in youth fitness and their delta change in APmath score accounted for 49.4% of the variance in the final math grade awarded at the end of Grade 9. Aerobic power, upper body strength, and muscular endurance share more common variance to final math grade in boys, whereas whole-body coordination was the more relevant index in girls; this finding suggests that future research exploring the relationship of AP and PF should not be limited to cardiorespiratory fitness, instead encompassing muscular and neuro-muscular components of PF.

Marine Survival in the Mediterranean: A Pilot Study on the Cognitive and Cardiorespiratory Response to Sudden Cool Water Immersion.

BACKGROUND AND AIM: The Mediterranean is one of the major gateways of human migratory fluxes from Northern Africa, the Middle East, and Central Asia to Europe. Sea accidents have become an urgent humanitarian crisis due to the high number of migrants on the move, but data on the physiological effects to sudden cool water immersion are not as extensive as cold-water studies. We wanted to evaluate to what extent cool water immersion (~18 °C) may detrimentally affect cognitive ability and cardiorespiratory strain compared to the more prevalent cold-water (<10-15 °C) studies. METHODS: In this case, 10 active, healthy men participated in this study which consisted of completing one familiarization trial, and then a control (CON) or experimental (EXP) trial in a randomized, repeated-measures, cross-over fashion, separated by at least 7-days. Cognitive function was assessed via the Symbol Digit Modalities Test (SDMT), a code substitution test, performed at baseline, then repeated in either a thermoneutral (~25 °C room air) dry environment, or when immersed to the neck in 18 °C water. Testing consisted of six "Step" time-blocks 45-s each, with a 5-s pause between each Step. Cardiorespiratory measures, continuously recorded, included heart rate (beats per minute), minute ventilation (V˙E, L∙min-1), oxygen consumption (V˙O2, L∙min-1), and respiratory frequency (fR, count∙min-1). RESULTS: Initial responses to cool water (<2 min) found that participants performed ~11% worse on the code substitution test (p = 0.025), consumed 149% greater amounts of oxygen (CI: 5.1 to 9.1 L∙min-1, p < 0.0001) and experienced higher cardiovascular strain (HR CI: 13 to 38 beats per minute, p = 0.001) than during the control trial. Physiological strain was in-line to those observed in much colder water temperature. CONCLUSION: Sudden, cool water immersion also negatively affects cognitive function and cardiorespiratory strain, especially during the first two minutes of exposure. The magnitude increase in heart rate is strongly associated with poorer cognitive function, even in (relatively) warmer water consistent with temperatures found in the Mediterranean Sea environment.

The Effect of Pandemic Movement Restriction Policies on Children's Physical Fitness, Activity, Screen Time, and Sleep.

Background: The negative impact of isolation, confinement, and physical (in)activity due to pandemic movement restriction has been well-documented over the past year, but less is known on the impact of these policies on children's physical fitness. This study was designed to determine the effects of pandemic movement restriction policies on the 24-hour movement behavior (24-HMB) of children, and whether any alterations are reflected in worsening physical fitness outcomes determined via direct testing. Methods: A two-phase, repeated-measures study with matched controls was conducted. Phase One: N = 62 schoolchildren (N = 31 female) completed self-assessment questionnaires on 24-HMB in October 2018 (pre-pandemic) and again in April 2020, at the height of movement restrictions enacted in response to the COVID-19 pandemic first wave. Phase Two: physical fitness of the original N = 62 children were determined directly pre- and post-isolation using an eight-component standardized fitness test battery and compared to N = 62 control children who were matched for age, sex, school region, and fitness centile scores. Results: During lockdown (total duration: 63 days), moderate-to-vigorous physical activity (MVPA) decreased by ~46 min per day, screen time demonstrated a significant interaction effect, such that kids reported spending less recreational screen time on weekends during lockdown compared to no restriction, and sleep duration was consistently lower (95% CI: -104.1 to -45.5 min, p < 0.001). No interaction effect was present for direct fitness indicators, including: hand tapping (reaction time), standing broad jump, polygon backward obstacle course (coordination), sit-ups, stand-and-reach, bent-arm hang, 60-m, and 600-m run (p ≥ 0.05) although significant main effects are noted for both sexes. Conclusion: Initial changes in 24-HMB did not translate to reductions in physical fitness per se, likely due to the high initial fitness levels of the children. Further work is needed to confirm whether longer or repeated movement restrictions exacerbate initial negative 24-HMB trends, especially for children who are less fit when restrictions are initiated, prolonged, or repeated.

A COVID-19 Crisis in Child Physical Fitness: Creating a Barometric Tool of Public Health Engagement for the Republic of Slovenia.

The Republic of Slovenia implements the largest longitudinal database of child physical fitness in the world-SLOfit. Slovenia has some of the most physically active children globally, and it has responded rapidly to incorporate national physical activity (PA) interventions throughout the COVID-19 pandemic. Despite aggressive campaigns to maintain PA at home, the country has seen a tremendous decrease in child physical fitness over the past several months as self-isolation measures have been mandated by national authorities. These trends prompted researchers to create a method of tracking and communicating government decisions which have a direct impact on child physical activity, fitness and overall health (i.e., the SLOfit Barometer). The research team assembled experts for consultation on creation of the SLOfit Barometer after processing preliminary data on 20,000 schoolchildren which found the greatest decline in child physical fitness since systematic testing began more than 30 years ago. Only 2 months of self-isolation erased over 10 years of hard-fought health gains acquired from national public health policies and PA interventions. This crisis in child fitness requires integrated community participation and a robust public health policy response, and with the SLOfit Barometer acting as a national bellwether system, it is envisioned that policy makers and the public will advocate for bold, progressive actions to combat this national health emergency. This surveillance tool tracks government action to combat the increasing child physical inactivity and obesity trends brought on as a direct result of COVID-19 isolation regulations.

Assessment of Secular Trends and Health Risk in Pediatric Cardiorespiratory Fitness From the Republic of Slovenia.

OBJECTIVES: Determine the temporal trends in cardiorespiratory fitness (CRF) and health risk of Slovenian schoolchildren across a 20-year span, assessed via 20-m shuttle run (20mSRT), including defining centile ranges and possible health risk(s) for each generation. METHODS: Nationally representative data from 9,426 healthy schoolchildren (6-14 years old) were used to determine changes in CRF across three generations, in 1993 (n = 3,174), 2003 (n = 3,457) and 2013 (n = 2,795) from a multistage, stratified, decennial study. RESULTS: 20mSRT performance declined ∼2.8% from 1993 to 2003, independent of age or sex of the child. This trend was reversed in 2013, increasing by ∼8.2% across all age groups, for both girls and boys, for a net increase of 5.4%. The magnitude of improvement was similar for both sexes. Moreover, girls in the 2013 generation (for ages 10-13 year) completed more stages than their 2003 male counterparts. Across all generations, children achieved CRF values corresponding to low cardiovascular risk for future health outcomes. Centile values ranged from "low" to "very high" depending on age, sex, and generation of the sample. CONCLUSION: Negative trends in CRF from Slovenian schoolchildren were reversed by 2013, indicating that Slovenia should continue implementing progressive national physical fitness strategies introduced between sampling periods (i.e., 2003-2013). Additionally, due to the universal nature of Slovenian schoolchildren achieving "healthy cut-off values" for 20mSRT (generation-inclusive), it is suggested that more specific cut-off criteria are developed, especially for younger children, and girls, so that future CRF results can be more accurately applied for both clinical and pedagogical users.

Heat risk exacerbation potential for neurology patients during the COVID-19 pandemic and related isolation.

COVID-19 may increase the risk of heat-related symptoms during hot weather since vulnerable populations, including the elderly and those with neurological disabilities, must continue to self-isolate, often indoors. Within the chronic neurological patient population, indoor conditions in summer months present a hazard because of impaired and/or altered thermoregulation, including poor hydration status due to both autonomic and behavioral dysfunction(s). To address this increased risk, telemedicine protocols should include an assessment of the patient's environmental parameters, and when combined with physiological data from wearable devices, identify those with neurological diseases who are at higher risk of heat illness. Personalized medicine during times of self-isolation must be encouraged, and using smart technology in ambient assisted living solutions, including e-health to monitor physiological parameters are highly recommended, not only during extreme weather conditions but also during times of increased isolation and vulnerability.

Effects of a cooling vest with sham condition on walking capacity in heat-sensitive people with Multiple Sclerosis.

PURPOSE: Heat sensitivity is a common contraindication in people with Multiple Sclerosis (pwMS), and physical fatigue is one of the most frequently reported symptoms that can affect quality of life. Increases in body temperature may exacerbate fatigue and heat-related symptoms. Decreasing body temperature via cooling devices may mitigate disease symptoms and improve physical abilities and quality of life. This study evaluates the effects of a cooling vest with sham condition on walking capacity using a commercially-available cooling vest specifically designed for pwMS. METHODS: A counter-balanced, cross-over design was used to assess the effects of a cooling vest (CryoVest Comfort, CryoInnov, France) (COLD) from a menthol-induced sham condition (CON) on ground walking time to exhaustion (Tex, s) and distance at exhaustion (Dex, m) in ambulatory pwMS. Secondary outcomes were heart rate (HR, bpm), thermal sensation (Tsens), skin chest (Tchest) and back (Tback) temperature. RESULTS: Ten females with Multiple Sclerosis (59 ± 9 years, EDSS 3.0-5.5) participated to the study. During COLD, pwMS walked significantly longer (1896 ± 602 vs. 1399 ± 404 s, p < 0.001) and farther (1879 ± 539 vs. 1302 ± 318 m, p < 0.001) than CON. Importantly, Tsens and HR at exhaustion were not significantly different between conditions, although Tchest (- 2.7 ± 1.8 °C, p < 0.01) and Tback (- 3.9 ± 1.8 °C, p < 0.001) were lower at volitional fatigue during COLD. CONCLUSION: The lightweight cooling vest improved total walking time and distance in heat-sensitive pwMS. These physiological improvements were likely due to feeling perceptually cooler in the COLD trial, compared to the corresponding point of fatigue in the CON condition.

Up in the Air: Evidence of Dehydration Risk and Long-Haul Flight on Athletic Performance.

The microclimate of an airline cabin consists of dry, recirculated, and cool air, which is maintained at lower pressure than that found at sea level. Being exposed to this distinctive, encapsulated environment for prolonged durations, together with the short-term chair-rest immobilization that occurs during long-haul flights, can trigger distinct and detrimental reactions to the human body. There is evidence that long-haul flights promote fluid shifts to the lower extremity and induce changes in blood viscosity which may accelerate dehydration, possibly compromising an athlete's potential for success upon arrival at their destination. Surprisingly, and despite several recent systematic reviews investigating the effects of jet lag and transmeridian travel on human physiology, there has been no systematic effort to address to what extent hypohydration is a (health, performance) risk to travelers embarking on long journeys. This narrative review summarizes the rationale and evidence for why the combination of fluid balance and long-haul flight remains a critically overlooked issue for traveling persons, be it for health, leisure, business, or in a sporting context. Upon review, there are few studies which have been conducted on actual traveling athletes, and those that have provide no real evidence of how the incidence rate, magnitude, or duration of acute dehydration may affect the general health or performance of elite athletes.

Children's Physical Activity, Academic Performance, and Cognitive Functioning: A Systematic Review and Meta-Analysis.

Researching the relationship between physical activity and academic performance is becoming an important research topic due to increasing evidence about the positive effect of physical activity on cognitive functioning. The present systematic review and meta-analysis (PROSPERO registration number: CDR132118) is a unique contribution to the recently published reviews since it only includes interventions longer than 6 weeks and acknowledges the influence of the qualifications of practitioners who deliver interventions. After identifying 14,245 records in five databases and selecting 247 full-text articles assessed for eligibility, 44 interventions passed all eligibility criteria. This meta-analysis uses validity generalization in a random effects model, which shows that academic performance itself is not solely caused by increased physical activity. The weighted mean population effect of all included interventions was rw = 0.181. Most of the studies had serious limitations since they did not report physical activity intensity, which is an essential component to achieving positive exercise effects on cognition. In addition, the qualifications of the staff who administer the interventions were largely ignored in existing literature. It was found that 13 out of 20 physical activity interventions with significant positive effects on academic performance were performed by practitioners who held higher qualifications in the field of physical education and exercise science, who could mediate higher physical activity intensities of the given interventions. The population effect in studies where interventions were administered by practitioners with lower qualifications in the field (rw = 0.14) was lower compared to interventions performed by staff with higher qualifications (rw = 0.22). There was also a significant difference in academic performance with regard to staff qualification level (χ = 4.464; p = 0.035). In addition to activity duration, future physical activity intervention studies including those investigating academic performance should focus on the importance of physical activity intensity and include measures of physical fitness as objective indicators to enable more reliable analyses to establish physical activity influence on academic performance.