Effects of physically active maths lessons on children's maths performance and maths-related affective factors: Multi-arm cluster randomized controlled trial.

BACKGROUND: Physical activity (PA) may benefit academic performance, but it is unclear what kind of classroom-based PA is optimal for learning. AIM: We studied the effects of physically active maths lessons on children's maths performance and maths-related effects, and whether gender and previous mathematical or motor skills modify these effects. SAMPLE: A total of 22 volunteered teachers and their pupils with signed consent (N = 397, mean age: 9.3 years, 51% females) participated in a 5-month, teacher-led, multi-arm, cluster-randomized controlled trial. METHODS: The intervention included a PAL group (20 min of physically active learning in each 45-min lesson), a breaks group (two 5-min PA breaks in each 45-min lesson) and a control group (traditional teaching). Maths performance was assessed with a tailored curriculum-based test. Maths-related enjoyment, self-perceptions and anxiety were measured with a self-reported questionnaire. The individual-level intervention effects were tested via covariate-adjusted linear mixed-effect models with school classes serving as random effects. RESULTS: Changes in maths performance or self-perceptions did not differ between the intervention groups. Maths anxiety in learning situations increased in the PAL group (effect .28, 95% CI = .01-.56); there was no change in the other groups. Subgroup analyses suggested that maths anxiety increased in the PAL group among children in the two lowest tertiles of motor skills. It decreased in the highest tertile. Enjoyment decreased in the breaks group among pupils in the lowest motor skill tertile. CONCLUSIONS: Physically active maths lessons did not affect maths performance or self-perceptions but had divergent effects on maths anxiety and enjoyment, depending on motor skills.

Physical activity, physical fitness and self-rated health: cross-sectional and longitudinal associations in adolescents.

Objectives: To evaluate the independent associations of physical activity and physical fitness with self-rated health in adolescents. Methods: Data from a 2-year observational study (2013-2015) were used (n=256, 58% girls, 13.7±0.3 years at baseline). Self-rated health was assessed with a questionnaire, physical activity by an accelerometer and a questionnaire, and physical fitness via the measurements included in the Finnish national Move! monitoring system for physical functional capacity and their z-score average (fitness index). Results: Self-reported physical activity had cross-sectional associations with self-rated health (girls ß 0.213, p=0.006, ß 0.221 boys p=0.021) while accelerometer-based moderate-to-vigorous physical activity did not. Higher self-reported physical activity at baseline was associated with higher self-rated health at follow-up in boys (ß 0.289, p<0.001), but not in girls (ß -0.056, p=0.430). Accelerometer-based moderate-to-vigorous physical activity had positive longitudinal associations with future self-rated health in boys, but some of these similar associations were negative in girls. Fitness index had a positive cross-sectional association with self-rated health in boys (ß 0.282 or ß 0.283, p=0.002), but not in girls (ß 0.162 or ß 0.161, p=0.051). Physical fitness was not longitudinally associated with self-rated health. Conclusions: Self-reported physical activity showed potential to explain current and future self-rated health better than accelerometer-based physical activity or physical fitness. We recommended to consider self-reported physical activity as an adequate metric of adolescent health in the population-level surveillance systems.

How physical activity, fitness, and motor skills contribute to math performance: Working memory as a mediating factor.

PURPOSE: The purpose of this study was to examine whether physical activity, fitness, and motor skills have an indirect association with math performance via cognitive outcomes and if so, through which aspects of cognition? METHODS: This study comprised 311 6th-9th grade adolescents (12-17 years [M age = 14.0 years], 59% girls) from seven schools throughout Finland in 2015. Math performance was measured via a teacher-rated math achievement and the Basic Arithmetic test. Cognitive functions were measured by broad cognitive test battery. Physical activity was assessed with a self-reported questionnaire and a hip-worn accelerometer. Aerobic fitness was estimated using a maximal 20-m shuttle run test, muscular fitness with curl-up and push-up tests, and motor skills with a 5-leaps test and a throwing-catching combination test. Structural equation modeling was applied to examine the associations. RESULTS: In both boys and girls, motor skills had a positive indirect association with math outcomes through visuospatial working memory. Among girls, muscular fitness had a positive indirect association with math outcomes through visuospatial working memory. Aerobic fitness was positively associated with math achievement, but the indirect path via cognition was not observed. Self-reported physical activity had a borderline indirect positive association with math outcomes through visuospatial working memory. Accelerometer-based physical activity did not correlate with math performance. CONCLUSION: Motor skills and muscular fitness had indirect positive associations with math performance, mediated by visuospatial working memory. The results give support to the viewpoints that the connections between motor skills, fitness, and physical activity to academic skills are mediated via specific cognitive skills.

Precision exercise medicine: predicting unfavourable status and development in the 20-m shuttle run test performance in adolescence with machine learning.

OBJECTIVES: To assess the ability to predict individual unfavourable future status and development in the 20m shuttle run test (20MSRT) during adolescence with machine learning (random forest (RF) classifier). METHODS: Data from a 2-year observational study (2013‒2015, 12.4±1.3 years, n=633, 50% girls), with 48 baseline characteristics (questionnaires (demographics, physical, psychological, social and lifestyle factors), objective measurements (anthropometrics, fitness characteristics, physical activity, body composition and academic scores)) were used to predict: (Task 1) unfavourable future 20MSRT status (identification of individuals in the lowest 20MSRT tertile after 2 years), and (Task 2) unfavourable 20MSRT development (identification of individuals with 20MSRT development in the lowest tertile among adolescents with baseline 20MSRT below median level). RESULTS: Prediction performance for future 20MSRT status (Task 1) was (area under the receiver operating characteristic curve, AUC) 83% and 76%, sensitivity 80% and 60%, and specificity 78% and 79% in girls and boys, respectively. Twenty variables showed predictive power in boys, 14 in girls, including fitness characteristics, physical activity, academic scores, adiposity, life enjoyment, parental support, social status in school and perceived fitness.Prediction performance for future development (Task 2) was lower and differed statistically from random level only in girls (AUC 68% and 40% in girls and boys). CONCLUSION: RF classifier predicted future unfavourable status in 20MSRT and identified potential individuals for interventions based on a holistic profile (14‒20 baseline characteristics). The MATLAB script and functions employing the RF classifier of this study are available for future precision exercise medicine research.

Physical activity and aerobic fitness in relation to local and interhemispheric functional connectivity in adolescents' brains.

INTRODUCTION: Adolescents have experienced decreased aerobic fitness levels and insufficient physical activity levels over the past decades. While both physical activity and aerobic fitness are related to physical and mental health, little is known concerning how they manifest in the brain during this stage of development, characterized by significant physical and psychosocial changes. The aim of the study is to examine the associations between both physical activity and aerobic fitness with brains' functional connectivity. METHODS: Here, we examined how physical activity and aerobic fitness are associated with local and interhemispheric functional connectivity of the adolescent brain (n = 59), as measured with resting-state functional magnetic resonance imaging. Physical activity was measured by hip-worn accelerometers, and aerobic fitness by a maximal 20-m shuttle run test. RESULTS: We found that higher levels of moderate-to-vigorous intensity physical activity, but not aerobic fitness, were linked to increased local functional connectivity as measured by regional homogeneity in 13-16-year-old participants. However, we did not find evidence for significant associations between adolescents' physical activity or aerobic fitness and interhemispheric connectivity, as indicated by homotopic connectivity. CONCLUSIONS: These results suggest that physical activity, but not aerobic fitness, is related to local functional connectivity in adolescents. Moreover, physical activity shows an association with a specific brain area involved in motor functions but did not display any widespread associations with other brain regions. These results can advance our understanding of the behavior-brain associations in adolescents.

Physical fitness development in relation to changes in body composition and physical activity in adolescence.

The decline in adolescents' physical fitness (PF) in recent decades has raised concerns about current population's possible future challenges with health and physical functional capacity. This study explored the associations between body composition, physical activity, maturation, and PF development in adolescents. Furthermore, PF development of adolescents with low initial PF was assessed. A 2-year observational study was conducted between spring 2013 and 2015. Nine comprehensive schools and their 10- to 13-year-old students were invited to participate in the study (1778), and a total of 971 students (54.6%) agreed. Cardiorespiratory fitness (20-meter shuttle run), muscular fitness (push-ups), fundamental movement skills (5-leaps test), body composition (bioelectrical impedance analysis), moderate-to-vigorous physical activity (accelerometer), and pubertal status (self-assessment questionnaire) were measured at 1-year intervals. Latent growth curve modeling (LGM) was used to study PF development over time. Change in fat mass had the strongest and most coherent associations with PF development during adolescence. Fat-free mass, moderate-to-vigorous physical activity, and pubertal status were associated with PF development, although not systematically. Subgroup analyses showed that PF development in the low fitness group followed a similar pattern as the whole population. However, their PF remained significantly lower throughout the 2-year period. The findings suggest that fat accumulation is an essential detrimental factor for PF development during adolescence. Actions to prevent excessive fat accumulation might help to prevent future declines in functional capacity. Indications that low fitness levels sustain during adolescence highlight the relevance of detecting these individuals and providing interventions already before adolescence.

Physical activity, aerobic fitness, and brain white matter: Their role for executive functions in adolescence.

Physical activity and exercise beneficially link to brain properties and cognitive functions in older adults, but the findings concerning adolescents remain tentative. During adolescence, the brain undergoes significant changes, which are especially pronounced in white matter. Studies provide contradictory evidence regarding the influence of physical activity or aerobic-exercise on executive functions in youth. Little is also known about the link between both fitness and physical activity with the brain's white matter during puberty. We investigated the connection between aerobic fitness and physical activity with the white matter in 59 adolescents. We further determined whether white matter interacts with the connection of fitness or physical activity with core executive functions. Our results show that only the level of aerobic fitness, but not of physical activity relates to white matter. Furthermore, the white matter of the corpus callosum and the right superior corona radiata moderates the links of aerobic fitness and physical activity with working memory. Our results suggest that aerobic fitness and physical activity have an unequal contribution to the white matter properties in adolescents. We propose that the differences in white matter properties could underlie the variations in the relationship between either physical activity or aerobic fitness with working memory.

The Longitudinal Associations of Fitness and Motor Skills with Academic Achievement.

PURPOSE: This study aimed to examine both independent and dependent longitudinal associations of physical fitness (PF) components with academic achievement. METHODS: A total of 954 fourth to seventh graders (9-15 yr [Mage = 12.5 yr], 52% girls) from nine schools throughout Finland participated in a 2-yr follow-up study. Register-based academic achievement scores (grade point average [GPA]) and PF were assessed in the spring of 2013-2015. Aerobic fitness was measured with a maximal 20-m shuttle run test, muscular fitness with curl-up and push-up tests, and motor skills with a 5-leaps test and a throwing-catching combination test. Structural equation modeling was applied to examine the longitudinal associations adjusting for age, gender, pubertal stage, body fat percentage, learning difficulties, and mother's education. RESULTS: The changes in aerobic and muscular fitness were positively associated with the changes in GPA (B = 0.27, 99% confidence interval [CI] = 0.06-0.48; B = 0.36, 99% CI = 0.11-0.63, respectively), whereas the changes in motor skills were not associated with the changes in GPA. Better motor skills in year 2 predicted better GPA a year later (B = 0.06, 99% CI = 0.00-0.11; B = 0.06, 99% CI = 0.01-0.11), whereas aerobic and muscular fitness did not predict GPA. GPA in year 1 predicted both aerobic (B = 0.08, 99% CI = 0.01-0.15) and muscular (B = 0.08, 99% CI = 0.02-0.15) fitness, and motor skills (B = 0.08, 99% CI = 0.02-0.15) a year later. CONCLUSION: The changes in both aerobic and muscular fitness were positively associated with the changes in academic achievement during adolescence, whereas the changes in motor skills had only borderline significant association. However, better motor skills, although not systematically, independently predicted better academic achievement 1 yr later, whereas aerobic or muscular fitness did not. Better academic achievement predicted better motor skills, aerobic fitness, and muscular fitness. Developmental changes in adolescence may induce parallel and simultaneous changes in academic achievement and PF.

Aerobic fitness, but not physical activity, is associated with grey matter volume in adolescents.

Higher levels of aerobic fitness and physical activity are linked to beneficial effects on brain health, especially in older adults. The generalizability of these earlier results to young individuals is not straightforward, because physiological responses (such as cardiovascular responses) to exercise may depend on age. Earlier studies have mostly focused on the effects of either physical activity or aerobic fitness on the brain. Yet, while physical activity indicates the amount of activity, aerobic fitness is an adaptive state or attribute that an individual has or achieves. Here, by measuring both physical activity and aerobic fitness in the same study, we aimed to differentiate the association between these two measures and grey matter volume specifically. Magnetic resonance imaging scans were used to study volumes of 30 regions of interest located in the frontal, motor and subcortical areas of 60 adolescents (12.7-16.2 years old). Moderate-to-vigorous intensity physical activity (MVPA) was measured with hip-worn accelerometers and aerobic fitness was assessed with a 20-m shuttle run. Multiple regression analyses revealed a negative association between aerobic fitness and left superior frontal cortex volume and a positive association between aerobic fitness and the left pallidum volume. No associations were found between MVPA and any brain region of interest. These results demonstrate unequal contribution of physical activity and aerobic fitness on grey matter volumes, with inherent or achieved capacity (aerobic fitness) showing clearer associations than physical activity.

The Relation of Physical Activity, Sedentary Behaviors, and Academic Achievement Is Mediated by Fitness and Bedtime.

BACKGROUND: This study investigated the associations of subjectively and objectively measured physical activity (PA) and sedentary behavior with academic achievement. We further examined whether aerobic fitness, obesity, and bedtime mediate these associations. METHODS: This study included 970 children aged 9-15 years (52.3% girls) from 9 schools throughout Finland. Register-based academic achievement [grade point average (GPA)] as well as self-reported and accelerometer-measured PA/sedentary behavior were assessed during spring 2013. Aerobic fitness (assessed via a maximal shuttle run test), body composition (assessed via bioimpedance analysis), and self-reported bedtime were collected. Structural equation modeling was applied to examine the associations. Standardized regression coefficients are presented. RESULTS: Self-reported PA had a direct positive [ß = 0.084; 95% confidence interval (CI), 0.023 to 0.145] and an indirect positive association with GPA through higher aerobic fitness (ß = 0.061; 95% CI, 0.033 to -0.087). Accelerometer-based PA was not associated with GPA. Self-reported screen time had an indirect negative association with GPA through later bedtime (ß = -0.071; 95% CI, -0.096 to -0.035) and lower aerobic fitness (ß = -0.039; 95% CI, -0.059 to 0.019). Nonscreen sedentary time had a direct positive (ß = 0.193; 95% CI, 0.101 to -0.289) and an indirect negative association with GPA through lower aerobic fitness (ß = -0.040; 95% CI, -0.063 to -0.016). CONCLUSIONS: Participating in PA, avoiding excessive screen time, and going to bed earlier may benefit academic achievement.

Internal consistency and stability of the CANTAB neuropsychological test battery in children.

The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a computer-assessed test battery widely use in different populations. The internal consistency and 1-year stability of CANTAB tests were examined in school-age children. Two hundred-thirty children (57% girls) from five schools in the Jyväskylä school district in Finland participated in the study in spring 2011. The children completed the following CANTAB tests: (a) visual memory (pattern recognition memory [PRM] and spatial recognition memory [SRM]), (b) executive function (spatial span [SSP], Stockings of Cambridge [SOC], and intra-extra dimensional set shift [IED]), and (c) attention (reaction time [RTI] and rapid visual information processing [RVP]). Seventy-four children participated in the follow-up measurements (64% girls) in spring 2012. Cronbach's alpha reliability coefficient was used to estimate the internal consistency of the nonhampering test, and structural equation models were applied to examine the stability of these tests. The reliability and the stability could not be determined for IED or SSP because of the nature of these tests. The internal consistency was acceptable only in the RTI task. The 1-year stability was moderate-to-good for the PRM, RTI, and RVP. The SSP and IED showed a moderate correlation between the two measurement points. The SRM and the SOC tasks were not reliable or stable measures in this study population. For research purposes, we recommend using structural equation modeling to improve reliability. The results suggest that the reliability and the stability of computer-based test batteries should be confirmed in the target population before using them for clinical or research purposes.

The associations of objectively measured physical activity and sedentary time with cognitive functions in school-aged children.

Low levels of physical activity among children have raised concerns over the effects of a physically inactive lifestyle, not only on physical health but also on cognitive prerequisites of learning. This study examined how objectively measured and self-reported physical activity and sedentary behavior are associated with cognitive functions in school-aged children. The study population consisted of 224 children from five schools in the Jyväskylä school district in Finland (mean age 12.2 years; 56% girls), who participated in the study in the spring of 2011. Physical activity and sedentary time were measured objectively for seven consecutive days using the ActiGraph GT1M/GT3X accelerometer. Self-reported moderate to vigorous physical activity (MVPA) and screen time were evaluated with the questions used in the "WHO Health Behavior in School-aged Children" study. Cognitive functions including visual memory, executive functions and attention were evaluated with a computerized Cambridge Neuropsychological Test Automated Battery by using five different tests. Structural equation modeling was applied to examine how objectively measured and self-reported MVPA and sedentary behavior were associated with cognitive functions. High levels of objectively measured MVPA were associated with good performance in the reaction time test. High levels of objectively measured sedentary time were associated with good performance in the sustained attention test. Objectively measured MVPA and sedentary time were not associated with other measures of cognitive functions. High amount of self-reported computer/video game play was associated with weaker performance in working memory test, whereas high amount of computer use was associated with weaker performance in test measuring shifting and flexibility of attention. Self-reported physical activity and total screen time were not associated with any measures of cognitive functions. The results of the present study propose that physical activity may benefit attentional processes. However, excessive video game play and computer use may have unfavorable influence on cognitive functions.

Physical activity, sedentary behavior, and academic performance in Finnish children.

PURPOSE: This study aimed to determine the relationships between objectively measured and self-reported physical activity, sedentary behavior, and academic performance in Finnish children. METHODS: Two hundred and seventy-seven children from five schools in the Jyväskylä school district in Finland (58% of the 475 eligible students, mean age = 12.2 yr, 56% girls) participated in the study in the spring of 2011. Self-reported physical activity and screen time were evaluated with questions used in the WHO Health Behavior in School-Aged Children study. Children's physical activity and sedentary time were measured objectively by using an ActiGraph GT1M/GT3X accelerometer for seven consecutive days. A cutoff value of 2296 counts per minute was used for moderate-to-vigorous physical activity (MVPA) and 100 counts per minute for sedentary time. Grade point averages were provided by the education services of the city of Jyväskylä. ANOVA and linear regression analysis were used to analyze the relationships among physical activity, sedentary behavior, and academic performance. RESULTS: Objectively measured MVPA (P = 0.955) and sedentary time (P = 0.285) were not associated with grade point average. However, self-reported MVPA had an inverse U-shaped curvilinear association with grade point average (P = 0.001), and screen time had a linear negative association with grade point average (P = 0.002), after adjusting for sex, children's learning difficulties, highest level of parental education, and amount of sleep. CONCLUSIONS: In this study, self-reported physical activity was directly, and screen time inversely, associated with academic achievement. Objectively measured physical activity and sedentary time were not associated with academic achievement. Objective and subjective measures may reflect different constructs and contexts of physical activity and sedentary behavior in association with academic outcomes.