***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : An emerging field of research indicates that physical activity can benefit cognitive functions and academic achievements in children . However , less is known about how academic achievements can benefit from specific types of motor activities ( e.g. , fine and gross ) integrated into learning activities . Thus , the aim of this study was to investigate whether fine or gross motor activity integrated into math lessons ( i.e. , motor-enrichment ) could improve  children 's mathematical performance . Methods : A 6-week within school cluster-r and omized intervention study investigated the effects of motor-enriched mathematical teaching in Danish preadolescent children ( n = 165 , age = 7.5 ± 0.02 years ) . Three groups were included : a control group ( CON ) , which received non-motor enriched conventional mathematical teaching , a fine motor math group ( FMM ) and a gross motor math group ( GMM ) , which received mathematical teaching enriched with fine and gross motor activity , respectively . The children were tested before ( T0 ) , immediately after ( T1 ) and 8 weeks after the intervention ( T2 ) . A st and ardized mathematical test ( 50 tasks ) was used to evaluate mathematical performance . Furthermore , it was investigated whether motor-enriched math was accompanied by different effects in low and normal math performers . Additionally , the study investigated the potential contribution of cognitive functions and motor skills on mathematical performance . Results : All groups improved their mathematical performance from T0 to T1 . However , from T0 to T1 , the improvement was significantly greater in GMM compared to FMM ( 1.87 ± 0.71 correct answers ) ( p = 0.02 ) . At T2 no significant differences in mathematical performance were observed . A subgroup analysis revealed that normal math-performers benefitted from GMM compared to both CON 1.78 ± 0.73 correct answers ( p = 0.04 ) and FMM 2.14 ± 0.72 correct answers ( p = 0.008 ) . These effects were not observed in low math-performers . The effects were partly accounted for by visuo-spatial short-term memory and gross motor skills . Conclusion : The study demonstrates that motor enriched learning activities can improve mathematical performance . In normal math performers GMM led to larger improvements than FMM and CON . This was not the case for the low math performers . Future studies should further eluci date the neurophysiological mechanisms underlying the observed behavioral effects We compared changes in academic achievement across 3years between children in elementary schools receiving the Academic Achievement and Physical Activity Across the Curriculum intervention ( A+PAAC )  , in which classroom teachers were trained to deliver academic lessons using moderate-to-vigorous physical activity ( MVPA ) compared to a non-intervention control .  Elementary schools in eastern Kansas ( n=17 ) were cluster r and omized to A+PAAC ( N=9 , target ≥100min/week ) or control ( N=8 ) . Academic achievement ( math , reading , spelling ) was assessed using the Wechsler Individual Achievement Test-Third Edition ( WIAT-III ) in a sample of children ( A+PAAC=316 , Control=268 ) in grade s 2 and 3 at baseline ( Fall 2011 ) and repeated each spring across 3years . On average 55min/week of A+PACC lessons were delivered each week across the intervention . Baseline WIAT-III scores ( math , reading , spelling ) were significantly higher in students in A+PAAC compared with control schools and improved in both groups across 3years . However , linear mixed modeling , accounting for baseline between group differences in WIAT-III scores , ethnicity , family income , and cardiovascular fitness , found no significant impact of A+PAAC on any of the academic achievement outcomes as determined by non-significant group by time interactions . A+PAAC neither diminished or improved academic achievement across 3-years in elementary school children compared with controls . Our target of 100min/week of active lessons was not achieved ; however , students attending A+PAAC schools received an additional 55min/week of MVPA which may be associated with both physical and mental health benefits , without a reduction in time devoted to academic instruction BACKGROUND Physically active learning that combines physical activity with core curriculum areas is emerging in school-based health interventions . This study investigates the effectiveness of learning an important numeracy skill of times tables ( TT ) while concurrently engaging in aerobic activity compared with a seated classroom approach . METHODS Grade -4 primary school students were r and omly allocated to physical activity ( P ) or classroom ( C ) groups and received the alternate condition in the following term . P group received moderate to vigorous exercise ( 20 min , 3 times per week , 6 wk ) while simultaneously learning selected TT . C group received similar learning , but seated . Changes in TT accuracy , general numeracy , aerobic fitness , and body mass index were assessed . Data were expressed as mean ( SEM ) and between-condition effect size ( ES ; 95 % confidence interval ) . RESULTS Participants [ N = 85 ; 55 % male , 9.8 ( 0.3 ) y , 36.4 % overweight/obese ] improved similarly on TT in both conditions [ C group : 2.2 % ( 1.1 % ) ; P group : 2.5 % ( 1.3 % ) ; ES = 0.03 ; -0.30 to 0.36 ; P = .86 ] . Improvement in general numeracy was significantly greater for P group than C group [ C group : 0.7 % ( 1.2 % ) ; P group : 5.3 % ( 1.4 % ) ; ES = 0.42 ; 0.08 to 0.75 ; P < .03 ] . An improvement in aerobic fitness for P group ( P < .01 ) was not significantly greater than C group [ C group : 0.8 ( 0.6 ) ; P group : 2.2 ( 0.5 ) mL·kg·min-1 ; ES = 0.32 ; -0.01 to 0.66 ; P = .06 ] . Body mass index was unchanged . CONCLUSION Combined movement with learning TT was effective . Physically active learning paradigms may contribute to meeting daily physical activity guidelines while supporting or even boosting learning OBJECTIVE To investigate the effect of a seven-month , school-based cluster-r and omized controlled trial on academic performance in 10-year-old children . METHODS In total , 1129 fifth- grade children from 57 elementary schools in Sogn og Fjordane County , Norway , were cluster-r and omized by school either to the intervention group or to the control group . The children in the 28 intervention schools participated in a physical activity intervention between November 2014 and June 2015 consisting of three components : 1 ) 90min/week of physically active educational lessons mainly carried out in the school playground ; 2 ) 5min/day of physical activity breaks during classroom lessons ; 3 ) 10min/day physical activity homework . Academic performance in numeracy , reading and English was measured using st and ardized Norwegian national tests . Physical activity was measured objective ly by accelerometry . RESULTS We found no effect of the intervention on academic performance in primary analyses ( st and ardized difference 0.01 - 0.06 , p>0.358 ) . Subgroup analyses , however , revealed a favorable intervention effect for those who performed the poorest at baseline ( lowest tertile ) for numeracy ( p=0.005 for the subgroup∗group interaction ) , compared to controls ( st and ardized difference 0.62 , 95 % CI 0.19 - 1.07 ) . CONCLUSIONS This large , rigorously conducted cluster RCT in 10-year-old children supports the notion that there is still inadequate evidence to conclude that  increased physical activity in school enhances academic achievement in all children . Still , combining physical activity and learning seems a viable model to stimulate learning in those academically weakest schoolchildren A cluster-r and omized controlled trial was conducted to examine the effects of a 4-week program that integrated movements into cognitive tasks related to numerical skills . Participants ( N = 120 , Mage = 4.70 years , SD = 0.49 ; 57 girls ) were assigned to one of the following four conditions : performing integrated physical activity ( task relevant ) , performing nonintegrated physical activity ( task nonrelevant ) , observing integrated physical activity , or conventional sedentary teaching ( without performing or observing physical activity ) . Results showed that children who performed task-relevant integrated physical activity performed better than children in all other conditions . In addition , children who performed physical activity , either integrated or nonintegrated , reported higher scores for enjoyment of the instructional method than the two sedentary learning conditions . Implication s for educational theory and practice are discussed Background Physical activity is associated not only with health-related parameters , but also with cognitive and academic performance . However , no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents . The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12–14 years old adolescents . Methods A 20 week cluster r and omized controlled trial was conducted including seven intervention and seven control schools . A total of 632 students ( mean ( SD ) age : 12.9 ( 0.6 ) years ) completed the trial with baseline and follow-up data on primary or secondary outcomes ( 74 % of r and omized subjects ) . The intervention targeted physical activity during academic subjects , recess , school transportation and leisure-time . Cognitive performance  was assessed using an  executive functions test of inhibition ( flanker task ) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials . Secondary outcomes included mathematics performance , physical activity levels , body-mass index , waist-circumference and cardiorespiratory fitness . Results No significant difference in change , comparing the intervention group to the control group , was observed on the primary outcomes ( p’s>0.05 ) or mathematics skills ( p>0.05 ) . An intervention effect was found for cardiorespiratory fitness in girls ( 21 meters ( 95 % CI : 4.4–38.6 ) and body-mass index in boys ( -0.22 kg/m2 ( 95 % CI : -0.39–0.05 ) . Contrary to our predictions , a significantly larger change in interference control for reaction time was found in favor of the control group ( 5.0 milliseconds ( 95 % CI : 0–9 ) . Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups ( all p’s>0.05 ) . Conclusions No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared to a control group , but low implementation fidelity precludes interpretation of the causal relationship . Trial Registration www . Clinical Trials.gov OBJECTIVE This experiment tested the hypothesis that exercise would improve executive function . DESIGN Sedentary , overweight 7- to 11-year-old children ( N = 171 , 56 % girls , 61 % Black , M ± SD age = 9.3 ± 1.0 years , body mass index [ BMI ] = 26 ± 4.6 kg/m² , BMI z-score = 2.1 ± 0.4 ) were r and omized to 13 ± 1.6 weeks of an exercise program ( 20 or 40 min/day ) , or a control condition . MAIN OUTCOME MEASURES Blinded , st and ardized psychological evaluations ( Cognitive Assessment System and Woodcock-Johnson Tests of Achievement III ) assessed cognition and academic achievement .  Functional MRI  measured brain activity during executive function tasks . RESULTS Intent to treat analysis revealed dose-response benefits of exercise  on executive function and mathematics achievement . Preliminary evidence of increased bilateral prefrontal cortex activity and reduced bilateral posterior parietal cortex activity attributable to exercise was also observed . CONCLUSION Consistent with results obtained in older adults , a specific improvement on executive function and brain activation changes attributable to exercise were observed . The cognitive and achievement results add evidence of dose-response and extend experimental evidence into childhood . This study provides information on an educational outcome . Besides its importance for maintaining weight and reducing health risks during a childhood obesity epidemic , physical activity may prove to be a simple , important method of enhancing aspects of children 's mental functioning that are central to cognitive development . This information may persuade educators to implement vigorous physical activity BACKGROUND This study examined associations of fitness and fatness with cognitive processes , academic achievement , and behavior , independent of demographic factors , at the baseline of an exercise trial . METHODS Overweight , sedentary but otherwise healthy 7 - 11 year olds ( N=170 ) participated in a study of health , cognition and achievement in the Augusta , GA area from 2003 - 2006 . Children underwent evaluations of fatness and fitness , psychological assessment s of cognition and academic achievement , and behavior ratings by parents and teachers . Partial correlations examined associations of fitness and fatness with cognitive and achievement scores and behavior ratings , controlling for demographic factors . RESULTS Fitness was associated with better cognition , achievement and behavior , and fatness with worse scores . Specifically , executive function , mathematics and reading achievement , and parent ratings of child behavior were related to fitness and fatness . Teacher ratings were related to fitness . CONCLUSION These results extend prior studies by providing reliable , st and ardized measures of cognitive processes , achievement , and behavior in relation to detailed measures of fitness and fatness . However , cross-sectional associations do not necessarily indicate that improving one factor , such as fatness or fitness , will result in improvements in factors that were associated with it . Thus , r and omized clinical trials are necessary to determine the effects of interventions BACKGROUND Physical Activity Across the Curriculum ( PAAC ) was a three-year cluster r and omized controlled trial to promote physical activity and diminish increases in overweight and obesity in elementary school children . METHODS Twenty-four elementary schools 
    Output:
    
Conclusions Adding PA to the school day may enhance children ’s mathematics performance  or has no negative effects on performance .