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Effects of a physical activity intervention in preschool children
Roth K, Kriemler S, Lehmacher W, Ruf KC, Graf C, Hebestreit H
Medicine and Science in Sports and Exercise 2015 Dec;47(12):2542-2551
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: To evaluate a multi-component, child-appropriate preschool intervention program led by preschool teachers to enhance physical activity (PA) and motor skill performance (MS) in 4- and 5-year old children. METHODS: Evaluation involved 709 children (mean age 4.7 +/- 0.6 years; 49.5% girls) of 41 preschools (intervention group n = 21; control group n = 20) in the rural and urban surroundings of two German cities. Children in the intervention group received a daily PA intervention lasting 30 minutes, and PA homework over one academic year designed by professionals, but led by preschool teachers. The intervention included educational components for parents and teachers. Primary outcomes were MS (composite motor skill score) and objectively measured moderate-to-vigorous physical activity (MVPA) by accelerometry. Measurements were performed at baseline, mid- and post-intervention, and 2 to 4 months after end of intervention. Intervention effects were analyzed by repeated measurement analysis adjusted for "group", sex, age, baseline outcomes, urban/rural location of the preschool, and cluster (preschool). RESULTS: Compared to controls, children in the intervention group showed positive effects in MS at post-intervention (estimate effect 0.625 z-score points, 95% confidence interval (CI) 0.276 to 0.975, p = 0.001) and at follow-up (estimate effect 0.590 z-score points, 95% CI 0.109 to 1.011, p = 0.007), and an increase in MVPA from baseline to post-intervention by 0.5% of total wearing time (95% CI 0.002% to 1.01%; p-value: 0.049) at borderline significance. There was no benefit on MVPA for the intervention group between baseline and follow-up. CONCLUSIONS: A child-appropriate, multidimensional PA intervention could sustainable improve MS, not PA. Findings suggest that a change of health related behaviors is difficult. Future research should implement participatory intervention components in preschool setting and better integrate the families of the children.

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