OBJECTIVES: Mastery in -fundamental motor skills (FMS) is associated with increased physical activity (PA) in school-aged children; however, there is limited research on pre-schoolers (3 to 5 years). We aimed to evaluate interventions for improving FMS as well as PA. DESIGN/METHODS: A search of electronic databases was conducted for controlled trials using PA interventions with FMS as outcomes in healthy pre-schoolers. Standardised mean difference (SMD), 95% confidence intervals and publication bias were calculated for each outcome using Revman 5.3. RESULTS: Twenty trials met inclusion criteria. In total, 4255 pre-schoolers were analysed with 854 completing a FMS intervention. Studies were categorised into three groups: (i) teacher-led (TL) (n = 13); (ii) child-centred (CC) (n = 6) and (iii) parent-led (PL) (n = 1). Mean age was 4.3 +/- 0.4 years, with equal gender distribution. Interventions ran for 21 +/- 17 weeks, 3 +/- 1 times per week for 35 +/- 17 minutes. TL interventions significantly improved overall FMS (SMD 0.14 (0.06 to 0.21); p = 0.0003), object control (SMD 0.47 (0.15 to 0.80); p = 0.004), and locomotor skills (SMD 0.44 (0.16 to 0.73); p = 0.002), whereas CC interventions were not significant. There was a small, non-significant reduction in sedentary time (SMD -0.35 (-0.80 to 0.10); p = 0.12), and a large non-significant increase in PA (SMD 0.79 (-0.83 to 2.41); p = 0.34). CONCLUSION: PA interventions improve FMS in pre-schoolers; however, due to limited research, more study is needed on CC interventions. Targeting FMS development in pre-schoolers may promote higher PA levels and reduce sedentary time, however more study is needed.

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