PURPOSE: To examine the effects of three types of school-based exercises on bone health and physical fitness function in Chinese boys and girls. METHODS: One hundred and seventy-four Chinese boys and girls were randomly assigned into four groups: (1) sham exercise (ShEx); (2) high-impact exercise (HiEx); (3) high-impact exercise with various directions (HiExVi); and (4) high-intensity interval exercise (HiInEx). Speed of sound (SOS) and physical fitness parameters were determined before and after six-month intervention. RESULTS: At the end of six-month intervention, participants in all groups show an increment of SOS compared with the baseline (p < 0.05), and the changes were higher in HiEx (mean: 38.878 m/s, 95% CI 32.885 to 44.872, p = 0.001) and HiExVi groups (49.317 m/s, 42.737 to 55.897, p < 0.001) compared with ShEx group (20.049 m/s, 13.751 to 26.346). Six-month exercise training generated a reduction of percent of body fat (PBF) and waist-hip ratio (WHR) (p < 0.05). The decrease of PBF was greater in HiExVi (-1.222%, -1.820 to -0.624, p = 0.012) and HiInEx groups (-1.395%, -1.809 to -0.982, p = 0.003), whereas the reduction of WHR was larger in HiEx (-0.026, -0.039 to -0.014, p = 0.009), HiExVi (-0.024, -0.036 to -0.012, p = 0.021), and HiInEx groups (-0.035, -0.046 to -0.024, p < 0.001) compared with ShEx group. Balance function (BLF), vital capacity (VC), standing long jump (SLJ), and sit up (SU) increased in all intervention groups (p < 0.05). The BLF increased in HiEx (6.332 s, 4.136 to 8.528, p = 0.001), HiExVi (10.489 s, 8.934 to 12.045, p < 0.001), and HiInEx groups (9.103 s, 7.430 to 10.776, p < 0.001) showed a greater change than that of ShEx group (1.727 s, 0.684 to 2.770). The increment of VC (273.049 mL, 199.510 to 346.587, p < 0.001) and SU (2.537 times/min, 0.639 to 4.435, p = 0.017) was higher in HiInEx group, whereas the accrual in SLJ was larger in HiExVi (7.488 cm, 4.936 to 10.040, p = 0.007) compared with ShEx group (58.902 mL, 7.990 to 109.814; -0.463 times/min, -2.003 to 1.077; 1.488 cm, -0.654 to 3.630). CONCLUSION: The brief school-based exercises were effective in improving schoolchildren's health, but they showed different effects, with HiEx mostly improving bone health, HiInEx largely benefiting physical fitness function, and HiExVi enhancing both bone and physical fitness.

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