Physically active lessons in schools and their impact on physical activity, educational, health and cognition outcomes: a systematic review and meta-analysis
Open accessPublished version of a preprint
Abstract
Objective: This review provides the first meta-analysis of the impact of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Design: Systematic review and meta-analysis of controlled studies. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. Data sources: PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Studies eligibility criteria: Physically active lessons compared with a control group in a randomised or non-randomised design, within single component interventions in general school populations. Results: 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible to be included in the systematic review and 37 of them were included across the six meta-analyses (n=12 663). Physically active lessons were found to produce large, significant increases in lesson-time PA ( d =2.33; 95% CI 1.42 to 3.25: k =16) and small, increases on overall PA ( d =0.32; 95% CI 0.18 to 0.46: k =8), large, improvement in lesson-time educational outcomes ( d =0.81; 95% CI 0.47 to 1.14: k =7) and a small improvement in overall educational outcomes ( d =0.36; 95% CI 0.09 to 0.63: k =25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least two domains. Conclusion: In elementary and preschool settings, when physically active lessons were added into the curriculum they had positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool setting. Trial registration number: CRD42017076933.
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“The PAAL curriculum may enhance students’ concentration, working memory, and executive functioning through physically active learning experiences (Norris et al., 2020), which is a prerequisite for complex mathematical thinking.”
- Authors
- Norris, E., van Steen, T., Direito, A., & Stamatakis, E.
- Affiliations
- University College London (GB)
- National University of Singapore (SG)
- The University of Sydney (AU)
- Corresponding author
- Norris, Emma
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2019-10-16
- Volume
- 54
- Issue
- 14
- Pages
- 826-838
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2980741700
- Cited by
- 293
- References
- 84
- Citations by year
- 2026: 40 · 2025: 51 · 2024: 53 · 2023: 42 · 2022: 53 · 2021: 36 · 2020: 15 · 2019: 3
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Brunel University Research Archive (BURA) (Brunel University London) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Physical Education and Pedagogy
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- school-based physical activity, educational outcomes, cognitive outcomes, health outcomes, preschool children, elementary school students, curriculum integration, physical education
- MeSH terms
- Child, Child, Preschool, Cognition, Curriculum, Educational Status, Humans, Physical Education and Training, Schools, Health Behavior, Exercise
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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