***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: BACKGROUND A large proportion of children do not reach the recommended levels of physical activity for health . A quasiexperimental study with nonr and om assignment was performed to evaluate the effectiveness and feasibility of a school-based physical education intervention aim ed at increasing the levels of moderate-to-vigorous physical activity ( MVPA ) . METHODS Ten classes from 4 primary schools , including 241 children aged 8 to 10 years , were recruited . The experimental group ( n = 97 ) received 4 additional sessions/week of 60 minutes of MVPA for 8 months . The control group ( n = 135 ) continued their st and ard program ( 2 sessions of 50 minutes/week ) . Motor abilities ( st and ing long jump , h and grip strength , Harre circuit , sit and reach ) , physical fitness ( Yo-Yo Intermittent Recovery Level-1 ) , anthropometric measures ( body mass index , waist to height ratio ) , and self-efficacy ( Perceived Physical Ability Scale for Children ) were evaluated at baseline and after the intervention . RESULTS The experimental group significantly improved in the Harre circuit both in males ( P < .001 ) and females ( P < .01 ) , whereas physical fitness test improved only in males ( P < .001 ) . Males in the experimental group improved the perception of self-efficacy in coordinative abilities ( P = .017 ) . CONCLUSIONS The proposed school-based MVPA program showed effectiveness and feasibility . The differences observed by gender highlight the need to use different strategies to increase the involvement of all the participants ABSTRACT Purpose : This study investigated the academic achievement and physical activity differences between types of activity breaks implemented in elementary school classrooms . This study evaluated whether there was a difference between the impact of purely aerobic-based movement breaks and the impact of academic-based breaks on children ’s academic achievement outcomes .  Method : Participants included 460 children in 3rd grade through 5th grade at 4 elementary schools . There were 176 children in the schools that engaged in academic-based breaks and 284 in the schools that engaged in aerobic-only breaks .  Schools were r and omly assigned at the school level to implement either aerobic movement breaks with academic content infused within the breaks ( “ academic-based breaks ” ) or aerobic-only movement breaks without the addition of academic material ( “ aerobic-only breaks ” ) for approximately 10 min of activity per day . Math and reading achievement as well as children ’s step counts were measured before and after the intervention . A mixed-effects ( multilevel-growth ) model , in which the repeated measures of individuals nested within a classroom are analyzed , was used to answer all posited research questions . Results : Small to moderate effect sizes ( ES ) indicating gains in reading achievement ( ES = .13 ) and steps ( ES = .33 ) were found for classrooms that used aerobic-only movement breaks compared with those that used academic-based breaks . Conclusions : The type of movement breaks that are implemented in classrooms may have differential outcomes for  children ’s achievement and activity levels . Results from the present study indicate that children who were given aerobic-only movement breaks had slightly larger gains in reading achievement and physical activity levels than children who were given academic-based breaks The school has been identified as a key setting to promote physical activity . The purpose of this study was to evaluate the effect of a classroom-based activity break on in-school step counts of primary school children . Data for 90 children ( 49 boys , 41 girls , 9.3 ± 1.4 years ) from three Irish primary schools is presented . In each school one class was r and omly assigned as the intervention group and another as controls . Children 's step counts were measured for five consecutive days during school hours at baseline and follow-up . Teachers of the intervention classes led a 10 min activity break in the classroom each day ( Bizzy Break ! ) . Mean daily in-school steps for the intervention at baseline and follow-up were 5351 and 5054 . Corresponding values for the control group were 5469 and 4246 . There was a significant difference in the change in daily steps from baseline to follow-up between groups ( p < .05 ) . There was no evidence that girls and boys responded differently to the intervention ( p > .05 ) . Children participating in a daily 10 min classroom-based activity break undertake more physical activity during school hours than controls Classroom-based physical activity breaks are postulated to positively impact children 's attention during their school day . However , empirical evidence for this cl aim is scarce and the role of cognitive engagement in enhancing children 's attentional performance is unexplored in studies on physical activity breaks . The aim of the present study was therefore to disentangle the separate and /or combined effects of physical exertion and cognitive engagement induced by physical activity breaks on primary school children 's attention . In addition , the role of children 's affective reactions to acute interventions at school was investigated . Using a 2 × 2 between-subjects experimental design , 92 children between the ages of 11 and 12 years ( M = 11.77 , SD = 0.41 ) were r and omly assigned to one of four experimental conditions : ( 1 ) combo group ( physical activity with high cognitive dem and s ) , ( 2 ) cognition group ( sedentary with high cognitive dem and s ) , ( 3 ) physical group ( physical activity with low cognitive dem and s ) , and ( 4 ) control group ( sedentary with low cognitive dem and s )  . Attention and affect were measured before and immediately after a 10-min intervention . ANCOVAs revealed that whereas physical exertion had no effect on any measure of children 's attentional performance , cognitive engagement was the crucial factor leading to increased focused attention and enhanced processing speed . Mediational analyses showed that changes in positive affect during the interventions mediated the effect between cognitive engagement and focused attention as well as between cognitive engagement and processing speed . These surprising results are discussed in the light of theories predicting both facilitating and deteriorative effects of positive affect on attention PURPOSE This study evaluated the effects of a classroom-based physical activity program on  children 's in-school physical activity levels  and on-task behavior during academic instruction . METHODS Physical activity of 243 students was assessed during school hours . Intervention-group students ( N = 135 ) received a classroom-based program ( i.e. , Energizers ) . The control group ( N = 108 ) did not receive Energizers .  On-task behavior during academic instruction time was observed for 62 third- grade ( N = 37 ) and fourth- grade students ( N = 25 ) before and after Energizers activities . An independent groups t-test compared in-school physical activity levels between intervention and control classes . A multiple-baseline across-classrooms design was used to evaluate the effectiveness of the Energizers on on-task behavior . Additionally , a two-way ( time [ pre- vs postobservation ] x period [ baseline vs intervention ] ) repeated- measures analysis of variance compared on-task behavior between observation periods . Magnitudes of mean differences were evaluated with Cohen 's delta ( ES ) . RESULTS Students in the intervention group took significantly ( P < 0.05 ) more in-school steps ( 5587 + /- 1633 ) than control-group students ( 4805 + /- 1543 ) , and the size of this difference was moderate ( ES = 0.49 ) . The intervention was effective in improving on-task behavior ; after the Energizers were systematic ally implemented , on-task behavior systematic ally improved . The improvement in on-task behavior of 8 % between the pre-Energizers and post-Energizers observations was statistically significant ( P < 0.017 ) , and the difference was moderate ( ES = 0.60 ) . Likewise , the least on-task students improved on-task behavior by 20 % after Energizers activities . This improvement was statistically significant ( P < 0.001 ) and meaningful ( ES = 2.20 ) . CONCLUSION A classroom-based physical activity program was effective for increasing daily in-school physical activity and improving on-task behavior during academic instruction AIM Despite recognition that regular physical activity is essential for good health , many children do not accumulate sufficient daily physical activity . The aim of this study was to examine the effect of a classroom-based activity break on accelerometer-determined moderate-to-vigorous intensity physical activity ( MVPA ) and adiposity in primary school children . METHODS One hundred twenty children from seven primary schools in Northern Irel and participated in the study . In each school , one class of children was r and omly assigned to an intervention group and another class to a control group . Teachers of the intervention classes led a 5-min activity break three times per day for 12 weeks .  Accelerometer-determined MVPA , height , weight and four skinfolds  were measured at baseline and post-intervention . RESULTS Compared with the control group , the intervention group significantly increased weekday MVPA ( + 9.5 min ) from baseline to post-intervention . There were no significant changes in BMI ; however , an increase in sum-of-skinfolds of the intervention group was observed . CONCLUSIONS Classroom-based activity breaks led by the teacher are successful in increasing  children 's  physical activity levels . The programme shows a positive step in improving overall physical activity levels and contributing to the goal of 60 min daily MVPA BACKGROUND This study aim ed to assess whether a school-based physical education intervention was effective in improving physical abilities and influencing daily physical activity habits in primary school children . The possible effect on body mass index ( BMI ) was also considered . METHODS Twenty-six 3rd- grade classes were r and omly selected stratifying by geographic location ( city , plain , hills ) and were assigned either to an  intervention ( 127 boys ; 120 girls ) or to a traditional ( 129 boys ; 121 girls ) physical education program . At baseline ( age : 8 - 9 years ) and after a 2-year follow-up ( age : 10 - 11 years ) , information was collected about sport participation and daily activity habits using a self-administered question naire . Height , weight , and BMI were measured and physical performance was assessed by means of st and ardized tests . RESULTS The enhanced program of physical education was effective in improving physical abilities of children and determining a decrease ( boys : 10 % ; girls : 12 % ) in daily sedentary activities ( preintervention versus postintervention , p < .05 ; intervention versus control group , p < .01 ) . The percentages of overweight and obese children did not vary significantly , but the experimental group showed a significantly lower rise in BMI compared to the control group ( p < .001 ) . CONCLUSION The school proved to be an ideal setting for promoting physical activity and achieving the required daily activity levels Purpose : The purpose of this study was to determine the acute dose – response relationship of classroom exercise breaks with executive function and math performance in 9- to 12-year-old children by comparing 5-min , 10-min , or 20-min classroom exercise breaks to 10 min of sedentary classroom activity . Method : This study used a within-subjects experimental design conducted in the spring of 2012 . Ninety-six 4th- and 5th- grade students in 5 classrooms in South Carolina were r and omized to receive each of 4 treatments : 5-min , 10-min , or 20-min exercise breaks or 10 min of a sedentary lesson led by research staff . Students completed the  Trail-Making Test , an Operational Digit Recall test , and a math fluency test immediately before and after each condition . Planned linear contrasts were used to compare posttest scores between conditions using a repeated- measures mixed model , adjusted for gender , classroom , and the time-varying pretest scores . Potential effect modifiers were added as interaction terms . Results : Math scores were higher after the 10-min and 20-min exercise breaks compared with the sedentary condition ( d = 0.24 , p = .04 , and d = 0.27 , p = .02 , respectively ) , and an interaction was observed with gender , IQ , aerobic fitness , and lower engagement in some of the conditions . There were no improvements in executive function tasks . Conclusions : A 10-min and 20-min classroom exercise break moderately improved math performance in students compared with a seated classroom lesson OBJECTIVES To assess the feasibility and efficacy of a 6-week pilot active break program ( ACTI-BREAK ) on academic achievement , classroom behaviour and physical activity . DESIGN Pilot cluster r and omised controlled trial . METHODS 374 children in Year 3 and 4 ( 74 % response ) were recruited from six schools across Melbourne , Australia . Schools were r and omised to the ACTI-BREAK intervention or usual teaching practice . The intervention involved teachers incorporating 3 × 5min active breaks into their classroom routine daily  . Academic achievement was assessed using 1-min tests in reading and mathematics ; classroom behaviour at the individual and whole class level was observed by teachers ; and physical activity levels  were assessed using accelerometers . Multilevel mixed effects linear regression models were conducted using intention to treat ( ITT ) and per protocol ( PP ) analyses . RESULTS Significant intervention effects were found for classroom behaviour at the individual level ( ITT B=16.17 ; 95 % CI : 6.58 , 25.76 ) ; effects were stronger for boys ( B=21.42 ; 95 % CI : 10.34 , 32.49 ) than girls ( B=12.23 ; 95 % CI : 1.52 , 22.92 ) . No effect was found for classroom behaviour at the whole class level , reading , math or physical activity . PP findings were similar . CONCLUSIONS Implementing active breaks during class time may improve classroom behaviour , particularly for boys . There was no evidence to suggest that implementing active breaks had any adverse effect on academic achievement or classroom behaviour , which may encourage classroom teachers to incorporate active breaks into their routine Exercise is assumed to have positive effects on  children ’s cognitive performance . However , given the inconclusive evidence for the long-term effects of exercise , it is difficult to 
    Output:
    
RESULTS Four AB related outcomes were analyzed : ( i ) AB interventions had a significant effect in increasing PA levels in primary school children , both in terms of increased moderate to vigorous PA and step count .
Positive effects were found for PA levels and classroom behavior , while the conflicting results for cognitive functions and academic achievements suggest that the effect could be more evident with curriculum focused active breaks and active lessons that integrate ABs with key learning aspects and cognitive engagement