***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: Abstract Objective . To investigate the feasibility and impact on BMI and physical fitness of an intervention for obese and inactive children , based on physical activity and carried out in primary health care . Design . A prospect i ve , longitudinal one-year follow-up study . Setting . The community of Kristians and , Norway ( 80 000 inhabitants ) . Intervention . A 40-week structured intervention based on physical training with some lifestyle advice for the obese child and one parent . Subjects . A total of 62 physically inactive children aged 6–14 years with iso- BMI ≥ 30 kg/m2 . Main outcome measures . Body mass index ( BMI ) , maximum oxygen uptake , and physical fitness in tests of running , jumping , throwing , and climbing assessed at baseline and after six and 12 months as well as number of dropouts and predicting factors . Results . A total of 49 out of 62 children completed the first six months and 37 children completed 12 months . Dropout rate was higher when parents reported being physically inactive at baseline or avoided physical participation in the intervention . The children 's maximum oxygen uptake increased significantly after 12 months from 27.0 to 32.0 ml/kg/min ( means ) , as did physical fitness ( endurance , speed , agility , coordination , balance , strength ) and BMI was significantly reduced . Conclusion / implication s. This one-year activity-based intervention for obese and inactive children performed in primary health care succeeded by increasing cardiovascular capacity and physical fitness combined with reduced BMI in those who completed . Dropout was substantial and depended on the attendance and compliance with physical activity by the parents PURPOSE The purpose of this study was to evaluate the Hunter Illawarra Kids Challenge Using Parent Support physical activity program in overweight children . METHODS A multisite r and omized controlled trial was conducted with three intervention arms : 1 ) child-centered physical activity skill development program ( Activity ) , 2 ) parent-centered dietary modification program ( DIET ) , or 3 ) both programs combined ( PA+DIET ) .  Movement skill proficiency , perceived athletic competence , accelerometer-assessed physical activity , and parent-reported time spent in screen behaviors were assessed at baseline , 6 months , and 12 months in 165 prepubertal children aged 5.5 - 9 yr ( 59 % girls , 78 % obese ) . Differences in changes in outcomes between groups were assessed using linear mixed models . RESULTS Compared with the diet group , the activity group ( mean ( 95 % confidence interval ) : + 7.7 units ( 3.8 - 11.6 units ) ) and the activity + diet group ( + 6.7 units ( 2.9 - 10.5 units ) ) displayed 11%-13 % greater improvement in overall movement skill proficiency ( gross motor quotient ) at 6 months . Perceived athletic competence increased across groups at follow-up ( across groups : 6 months = + 0.21 units ( 0.11 - 0.31 units ) , 12 months = + 0.21 units ( 0.07 - 0.35 units ) ) . Groups did not differ statistically for change in physical activity outcomes . Total screen time ( min·wk(-1 ) ) decreased in all groups at 6 months ( across groups : -385.4 ( -501.0 to -269.8 ) ) and in the activity group ( -261.8 ( -470.5 to -53.1 ) ) and activity + diet group ( -340.5 ( -534.6 to -146.4 ) ) at 12 months . The diet group reported greater reductions in TV or DVD viewing time at 6 months compared with the activity group ( 248.6 ( 24.0 - 473.3 ) ) . CONCLUSIONS The activity and the activity + diet programs were efficacious in improving overweight children 's movement skill proficiency . All programs were efficacious in reducing time spent in screen behaviors . Other correlates may need to be targeted in addition to movement skills to increase physical activity among overweight children OBJECTIVE Overweight ( OW ) and low fit children represent cardiovascular high-risk groups . A multidimensional school-based lifestyle intervention performed in 652 preschoolers reduced skinfold thickness and waist circumference , and improved fitness , but did not affect BMI . The objective of this study is to examine whether the intervention was equally effective in OW ( ≥90th national percentile ) and /or low fit ( lowest sex- and age-adjusted quartile of aerobic fitness ) children compared to their normal weight and normal fit counterparts . DESIGN AND METHODS Cluster r and omized controlled single blinded trial , conducted in 2008/09 in 40 r and omly selected preschool classes in Switzerl and . The intervention included a playful physical activity program and lessons on nutrition , media use and sleeps . Primary outcomes were BMI and aerobic fitness ; secondary outcomes included sum of four skinfolds , waist circumference and motor agility . Modification of intervention effects by BMI -group and fitness-group was tested by interaction terms . RESULTS Compared to their counterparts , OW children ( n = 130 ) had more beneficial effects on waist circumference ( p for interaction = 0.001 ) and low fit children ( n = 154 ) more beneficial effects on all adiposity outcomes ( p for interaction ≤0.03 ) . The intervention effects on both fitness outcomes were not modified by BMI - or fitness-group ( all p for interaction ≥0.2 ) . Average intervention effect sizes for BMI were -0.12 , -0.05 , -0.26 and -0.02 kg/m(2 ) and for aerobic fitness were 0.40 , 0.30 , 0.12 and 0.36 stages for OW , normal weight , low fit and normal fit children , respectively . CONCLUSIONS This multidimensional intervention was equally and for some adiposity measures even more effective in high-risk preschoolers and represents a promising option for these children Part I of this study examined the effect of two 9-week instructional climates ( low autonomy [ LA ] and mastery motivational climate [ MMC ] ) on object-control ( OC ) skill development  in preschoolers ( N = 117 ) . Participants were r and omly assigned to an LA , MMC , or comparison group  . OC skills were assessed at pretest , posttest , and retention test with the Test of Gross Motor Development–2nd Edition . A significant Treatment × Time interaction ( p < .001 ) was present , supporting the effectiveness of both OC instructional climates in improving OC skills over time , while the comparison group result ed in no changes . The authors conclude that developmentally and instructionally appropriate climates are beneficial to OC skill learning , along with the need for “ planned ” movement experiences in motor learning environments BACKGROUND Physical education ( PE ) lessons are an ideal setting to improve child fundamental movement skills ( FMSs ) and increase physical activity ( PA ) for optimal health . Despite this , few studies have assessed the potential to do both simultaneously . The " Move It Groove It " primary school intervention in New South Wales , Australia , had this opportunity . METHODS A whole school approach to implementation included establishment of school project teams , a teacher " buddy " system , project Web site , teacher training workshops , and small grants for equipment . The quasi-experimental evaluation involved 1,045 year 3 and 4 children ( aged 7 to 10 years ) in nine intervention and nine control rural primary schools ( 53 % boys/47 % girls ) . It utilised pre- and postobservational surveys of ( 1 ) mastery or near mastery levels for each of eight FMSs , ( 2 ) proportion of PE lesson time spent in moderate to vigorous PA ( MVPA ) and vigorous PA ( VPA ) , and ( 3 ) teacher- and lesson-related context ual covariates . Data were analysed by hierarchical logistic multiple regression . RESULTS For FMSs , overall mastery or near mastery level at baseline was 47 % ranging from 22.7 % for the overarm throw among girls to 75.4 % for the static balance among boys . The intervention delivered substantial improvements in every FMS for both genders ranging from 7.2 % to 25.7 % ( 13 of 16 comparisons were significant ) . For PA level , mean MVPA at baseline was 34.7 % . Baseline MVPA for boys was 38.7 % and for girls was 33.2 % . The intervention was associated with a nonsignificant 4.5 % increase in MVPA and a significant 3.0 % increase in VPA . This translates to a gain of < 1 minute of MVPA per average 21-minute lesson . CONCLUSIONS This is the first study to show that by modifying existing PE lessons , significant improvements in FMS mastery can be gained without adversely affecting children 's MVPA and VPA . To increase PA levels , we recommend increasing the number of PE lessons per week This study aim ed to assess the feasibility of a community-based physical activity motor development program , called SHARK , among overweight and obese children . Thirteen overweight or obese children aged 8 - 12 years were recruited to the 10-week program from the Illawarra region of NSW , Australia . Measures at baseline , post-treatment and 9-month follow-up included BMI , motor development , perceived competence , objective ly measured physical activity and performance of an activity of daily living . At post-treatment and follow-up motor development , perceived athletic competence and perceived global self-worth had significantly increased . Although recorded minutes in moderate-to-vigorous activity significantly declined at post-treatment and follow-up , activity daily counts did not . The results indicate that community-based activity programs design ed to improve the motor development and perceived competence of overweight and obese children are feasible and may have important and sustainable benefits . However , a larger sample size and a comparison group are required to determine whether this approach can impact on activity levels and weight status This study was design ed to explore the effects of a health-related physical fitness physical education model on students ' physical activity , perceived competence , and enjoyment .  61 students ( 25 boys , 36 girls ; M age = 12.6 yr . , SD = 0.6 ) were assigned to two groups ( health-related physical fitness physical education group , and traditional physical education group ) , and participated in one 50-min . weekly basketball class for 6 wk . Students ' in-class physical activity was assessed using NL-1000 pedometers . The physical subscale of the Perceived Competence Scale for Children was employed to assess perceived competence , and children 's enjoyment was measured using the Sport Enjoyment Scale . The findings suggest that students in the intervention group increased their perceived competence , enjoyment , and physical activity over a 6-wk . intervention , while the comparison group simply increased physical activity over time . Children in the intervention group had significantly greater enjoyment Abstract Actual and perceived physical abilities are important correlates of  physical activity ( PA ) and fitness , but little research has explored these relationships over time in obese children . This study was design ed : ( a ) to assess the feasibility of a multi-modal training programme promoting changes in PA , fundamental motor skills and real and perceived physical abilities of obese children ; and ( b ) to explore cross-sectional and longitudinal relationships between real and perceived physical competence in boys and girls . Forty-one participants ( 9.2 ± 1.2 years ) were assessed before and after an 8-month intervention with respect to body composition , physical fitness , self-reported PA and perceived physical ability . After treatment , obese children reported improvements in the body mass index , PA levels , gross motor performance and actual and perceived physical abilities . Real and perceived physical competence was correlated in boys , but not in girls . Results indicate that a multi-modal programme focused on actual and perceived physical competence as associated with the gradual increase in the volume of activity might be an effective strategy to improve adherence of the participants and to increase the lifelong exercise skills of obese children Two studies investigated the impact of affective and cognitive messages compared to a no-message control on self-reported exercise . Students ( Study 1 , N = 383 and Study 2 , N = 197 ) were r and omly allocated to one of the three conditions ( control – no message , affective message or cognitive message ) . Participants completed question naire measures tapping components of the theory of planned behaviour in relation to exercise and reported their level of exercise ( 3 weeks later ) . In Study 2 , measures of need for affect ( NFA ) and need for cognition ( NFC ) were also completed . Results showed that affective messages consistently produced greater increases in self-reported level of exercise than the other conditions . In both studies , this effect was partly mediated by affective attitude change . Study 2 indicated these effects to be significantly stronger among those high in NFA or low in NFC . These findings indicate the value of affective messages that target affective attitudes in changing exercise behaviour 
    Output:
    
The evidence strongly suggests that exercise/physical activity interventions were effective in improving locomotor skill , object-control skill and complex tasks in overweight/obese peers .
However , the results for balance were equivocal .
Results from existing studies suggest overweight/obese peers have lower levels of fundamental movement skill than their healthy weight peers .
However , exercise/physical activity interventions are effective in improving their skills .
These progressions in interventions may help break the vicious cycle of childhood obesity