Purpose: The aim of this systematic review and meta-analysis was to evaluate the effects of movement-based interventions during academic time, based on the level of integration with and relevance to the learning content, on children’s and adolescents’ cognitive processing (e.g., executive function, selective attention), memory (e.g., free recall), behavioral control, and academic achievement.

Methods: Intervention studies during academic time by the classroom teacher were grouped into: a) high integration–high relevance (e.g., movements occurring simultaneously and are meaningfully related with the learning task, while academic concepts are explained through movements), b) high integration–low relevance (e.g., movements occurring simultaneously with the learning task but are not meaningfully related with the learning task – usually known as integrated activities), c) low integration–high relevance (e.g., subtle movements occurring before or after the learning task but are meaningfully related with the learning task – usually known as gestures), and d) low integration–low relevance (e.g., movements occurring before the learning task and are not meaningfully related with the learning task – usually known as activity breaks). Risk of bias was assessed using the Cochrane Tool for Quality Assessment for randomized controlled trials. Meta-analyses were conducted per outcome for acute and chronic studies. A total of 79 studies involving 26,186 participants (2-18 years) were included.

Results: There was a large effect (ES = 0.94) of chronic interventions with high integration-high relevance (10 studies; 850 participants), and a medium effect (ES = 0.61) with high integration-low relevance (8 studies; 933 participants) on memory performance. Chronic interventions (15 studies; 2,956 participants) with high integration-low relevance had a small effect (ES = 0.30) on academic achievement. Both chronic (ES = 1.14) and acute interventions (ES = 1.15) with low integration-low relevance had large effects on behavioral control measures. No effects were found for cognitive processing (neither for chronic nor for acute studies).

Conclusion: The theory-driven mapping of studies showed a nuanced pattern of effects of acute and chronic classroom-based movement strategies on memory, behavioral control and academic achievement. Consistencies were identified and explained referring to arousal, attention, cognitive load, and embodiment theories.

Purpose: Research in controlled laboratory settings shows that physical activity programs enriched with cognitive challenges enhance the benefits of physical activity on cognitive functioning in older adults. The current research aimed to translate these lab-based findings and to develop a real-life cognitively enriched walking program. This was done by investigating (a) which cognitive tasks are most suited for cognitive enrichment of a walking program for older adults, and (b) how to embed these cognitive tasks in a walking program to make it feasible, attractive and scalable for the older population (65+).

Methods: A co-design process was used with consecutive input from 34 academic experts and 535 end users. First, the expert panel discussed the fundamentals of a real-life cognitively enriched walking program in an online three-round Delphi procedure. Next, end users provided feedback and suggestions on what the experts concluded, and gave more insight into their preferences and concerns in an online/telephone-administered survey. Closed-ended questions were analyzed with descriptive statistics and open-ended questions were coded and analyzed using content analyses.

Results: Combined input of the experts and end users revealed that it would be most beneficial to provide a range of cognitive tasks to choose from. Each of these cognitive tasks should provide as much variation and differentiation as possible, should be implemented with increasing levels of difficulty and should be integrated in the walk. In addition, it was recommended to divide the walk into three parts: (a) 5-10 minutes brisk walking, (b) cognitive tasks for most of the walk, approximately 15-20 minutes per 30 minutes of walking, and (c) 5-10 minutes spontaneous small task or rest and relaxation. Other recommendations were to strive to a minimal session frequency of twice a week, to include competition occasionally and carefully, to ensure safety and to keep the walks fun. 

Conclusions: This study developed a real-life, cognitively enriched walking program for older adults, based on a co-design process. Further research will explore the effectiveness and feasibility of the program before it will be implemented on a large scale to enhance the benefits of physical activity on cognitive functioning in older adults.

Purpose. Combining physical and cognitive activity is shown to have a synergistic impact on brain plasticity in older adults. However, to date this has mainly been studied in controlled laboratory conditions. Using a co-design process we developed a real-life cognitively enriched walking program for older adults by means of three Delphi rounds with 34 academic experts and a survey with 535 end users. The current study aimed to examine older adults’ perceptions of this cognitively enriched walking program including 32 cognitive tasks.

Methods. Unfortunately, due to COVID-19 and restrictive measures, planned group walk-along sessions with 40 older adults (in groups of 10) had to be cancelled. Alternatively, 80 university students of physical education and movement sciences at Ghent University were asked to each conduct walking-sessions with two older adults (> 65 years) (together or separately). The students were instructed to walk at least 1 km, try out three randomly assigned cognitive tasks, and devote at least 15-20 minutes to the tasks during the walk with older adults. For each walk-along session students filled out an observational report (e.g. weather conditions, adverse events), a survey with seven closed-ended questions to evaluate older adults’ perceptions, and two open-ended questions to explore potential suggestions for improvement.

Results. In total 160 older adults performed a walk along, supervised by a total of 80 students. Each cognitive task was trialed by at least 14 different older adults. Results are currently being analysed and will be presented at the conference. Differences in perceptions of attractiveness, task challenge, self-efficacy, suitability, safety, age-appropriateness, and positive influence on the brain for each of the 32 tasks will be examined. Additionally, age and gender differences will be explored. Finally, a synthesis of recurring suggestions on how to improve the program will be made based on students’ observations and older adults’ answers to open-ended questions.

Conclusions. This study is the first to pilot test a real-life, cognitively enriched walking program for older adults which was created following a co-design process. Findings will inform the final cognitively enriched walking program which will be evaluated in an RCT by the end of 2021.

Purpose: Children with obesity are prone to suffer from sleep-related breathing disorders (SRBD) and to have impaired brain health. To date, no studies have focused on the association between SRBD and brain health in this population. This study aimed to examine the association of SRBD risk with brain health, including academic performance and brain structure (i.e., total gray and white matter volumes, total brain volume, and gray matter volume in the right and left hippocampus) in children with overweight/obesity.

Methods: One-hundred and nine children (10.0±1.1 years old, 45 girls) with overweight/obesity were included. SRBD risk was evaluated via the Spanish version of the Pediatric Sleep Questionnaire. Academic performance was assessed by the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. Hierarchical linear regression analyses were performed. We additionally explored mean differences in academic and brain outcomes between children with high vs low risk of SRBD using ANCOVA analyses.

Results/findings: Risk of SRBD was not associated with academic performance measured by standardized tests (all β<-0.160 and P’s>0.076). For school grades, the risk of SRBD was significantly associated with overall academic performance, i.e., grade point average, and particularly with natural and social science grades (β=-0.226, P=0.007, β=-0.269 and P=0.024, respectively). Furthermore, those children with high risk of SRBD (SRBD score>0.33) showed lower performance on grade point average, and specifically with writing, Spanish language and natural and social science compared to peers grouped at low risk of SRBD. No associations were found between the risk of SRBD and the remaining school grades variables (all β<-0.188 and P’s>0.065). Risk of SRBD were not associated with total brain volume or hippocampal gray matter volume (all P’s>0.05).

Conclusions: Our study shows that risk of SRBD was associated with lower academic performance at school whilst no associations were found with the brain structure in children with overweight/obesity. This study is relevant from a public health perspective to enhance brain health by targeting SRBD. Further randomized controlled trials should contrast these findings.

Physically active learning (PAL) has been actively implemented as a new teaching method, as physical activity has shown to benefit children’s cognitive and academic performance, especially maths performance. However, it is not known, what type, time and frequency of PAL is the most suitable or optimal for children from the learning perspective.

The purpose of this study was to examine the effects of the physically active maths lessons on children’s maths performance and maths-related affect.

Methods:  398 Finnish children (mean age 9.3 y., 49% boys) from 13 school in Central Finland participated in a six-month (October 2019 - March 2020), school-based cluster-randomized controlled trial. The intervention included three intervention groups following different teaching methods: Group 1 (20 minutes of physical activity integrated into maths curriculum goals in each 45 min lesson), Group 2 (two five-minute physically active breaks in each 45 min lesson) and Group 3 (traditional teaching). Before and after the intervention, curriculum-based maths performance was assessed with a custom-made test battery, while affective traits (enjoyment, self-efficacy, and anxiety) of maths were measured with a self-report questionnaire. The intervention effects were tested by covariate-adjusted linear mixed effect models with school classes as random effects.

Results: The change in maths performance, maths enjoyment or maths self-efficacy did not differ between the intervention groups. Maths anxiety in learning situations increased in Group 1 (p=0.045), while not in other groups. Subgroup analyses revealed that while maths anxiety increased in children in the lowest and intermediate tertiles of motor skills, the maths anxiety decreased in children in the highest motor skills tertile (p=0.041).

Conclusion: Physically active maths lessons did not affect maths performance, enjoyment, or self-efficacy. However, the PAL in which maths tasks include both mathematical and motor challenges may reduce the maths anxiety among children with high motor skills, while increase it in motorically less skilled children. When implementing PAL, the children’s motor skills should be taken into account, and the physically active maths tasks are recommended to be differentiated according to both mathematical and motor skill levels.

Purpose: To investigate whether a 4.5-month exercise program induces changes in brain current source density underlying working memory processes in children with overweight/obesity.

Methods: Sixty-seven children (10.0 ± 1.1 years) participated in the present randomized controlled trial and were randomly allocated to an exercise group (EG; N = 35) or a wait-list control group (CG; N = 32). The EG participants were instructed to participate in the exercise program at least 3 times/week (90 min/session). Electroencephalography was performed during a low and high cognitive-demanding Delayed Non-Match-to-Sample (DNMS) task that assessed working memory in three phases: encoding, maintenance and retrieval. Current source density (µA/mm²) estimations at pre- and post-intervention were obtained using sLORETA. The effects of exercise program on current source density were tested with an independent groups analysis. 

Results: Both groups significantly presented shorter reaction times at post-intervention in both DNMS conditions. The EG showed a higher increment of the current source density from pre- to post-intervention with respect to the CG in temporal and frontal areas during retention of 2^nd stimuli (peak t = from 3.4-3.8, cluster size [k] = from 11- 39); in frontal areas during retention of the 3^rd stimuli (peak t = from 3.7-3.9, k = from 15-26); and in temporal and occipital areas during retention of the 4^th stimuli (peak t = from 2.7-4.3, k = from 13-101) of the high working memory condition. There was not a significant differential change between groups during the maintenance and retrieval phases and neither in the low working memory condition.

Conclusions: A 4.5-month exercise program induces brain activation changes as measured by current source density during working memory processes in children with overweight/obesity. Children from the EG, to a higher extent than those from the CG, significantly increased the current source density of a broad network of brain areas primarily of the temporal and frontal lobes during a working memory task. These effects were observed during the encoding phase of the high load condition, suggesting that a long-term practice of physical activity might enhance the capacity to process and store information during working memory processes.