***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: AIM The purpose of this study was to examine the effects of a 10-week aerobic games programme on physical fitness . METHODS One hundred eleven children , aged 3 to 6 years , participated in this study ; 60 children were male ( age : 4.28 ± 0.61 years old ) , and 51 were female ( age 4.59 ± 0.49 years old ) . Participants were r and omly assigned to an experimental group ( EG ; n = 56 ) and a control group ( CG ; n = 55 ) . A fitness test battery previously vali date d for preschoolers was used . The children in the EG performed 3 weekly training sessions of physical activity in a classroom during a 10-week period . Every EG session lasted about 30 min . RESULTS There were no significant differences in any variable in the pretest between groups . In the posttest , the EG achieved better results in horizontal jump and sprint . In relation to posttest-pretest differences , the EG showed a greater increase in horizontal jump , sprint , and endurance . CONCLUSION An aerobic games programme in the school setting improved physical fitness in preschool children OBJECTIVES The aims were to examine the relationship between children 's motor skill levels and types of physical activities performed during preschool attendance , and to examine the relationship between motor skill performance and parent perception of athletic competence . DESIGN Cross-sectional . METHODS Participants were 264 , 3- , 4- , and 5-year-old children from 22 preschools .  Locomotor and object control skills were assessed with a st and ardized motor skill protocol . Direct observation ( OSRAC-P ) was used to record activity types : walk , run , jump/skip , dance , and throw .  Parents rated their child 's athletic competence . Children were categorized into tertiles for locomotor and object control scores . Mixed models were used to test for differences across motor skill tertiles for each aim . Models controlled for sex , age , race/ethnicity , body mass index , and parent education , with preschool as a r and om variable . RESULTS Children in the highest locomotor tertile engaged in more dancing than children in the lowest tertile ( p = 0.04 ) . Children in the highest object control tertile engaged in throwing more frequently than children in lower tertiles ( p < 0.05 ) . Parents of children in the highest locomotor tertile perceived their children 's competence as higher than parents of children in lower tertiles ( p < 0.05 ) . Parents of children in the lowest object control tertile perceived their children 's competence as significantly lower than parents of children in higher tertiles ( p < 0.05 ) . CONCLUSIONS These findings point to the need for policy and practice research to help parents and child care professionals provide opportunities for young children to learn and practice motor skills OBJECTIVE To prospect ively examine the effects of a r and omized school-based intervention on nutrition and physical activity knowledge and preferences , anthropometric measures , and fitness in low socioeconomic kindergarten children . STUDY DESIGN A total of 376 children completed a school-year combined dietary-behavioral-physical activity intervention  and were compared with 349 control subjects ( age 3.8 to 6.8 years ) . RESULTS The prevalence of overweight and obesity among the kindergarten children was 27.7 % . Even though the intervention was not associated with between group differences in body mass index changes , it was associated with significantly ( P < .05 ) greater increase in nutrition knowledge and preferences , physical activity knowledge and preferences , and improvement in fitness . There was a greater ( P < .05 ) decrease in the number of overweight children in the intervention group ( -31.9 % ) compared with the controls ( -17.5 % ) . CONCLUSIONS A kindergarten dietary-physical activity intervention applied by the kindergarten teachers , had no effect on body mass index changes between the groups , but improved nutrition and physical activity knowledge and preferences , improved fitness , and decreased the percent of overweight children . This intervention may play an important role in health promotion , prevention and treatment of childhood obesity Background Obesity is the most common chronic pediatric disease in westernized , especially low socioeconomic societies . We previously demonstrated the beneficial effects of a r and omized prospect i ve school-based health education program for low socioeconomic status Arab-Israeli kindergarten children . Methods To examine whether the effects of our program on nutrition and physical activity knowledge and preferences , anthropometric measures , and fitness persisted one year after the end of intervention . We were able to perform the one year follow-up in 203 kindergarten children ( 59 % of our 342 original cohort ; 85 control , 118 intervention ) . Results At one year following the intervention BMI and BMI percentiles approached baseline level in both the intervention ( 16.4±0.2 kg/m2 and 61.5±2.4 % , respectively ) and control group participants ( 16.5±0.2 kg/m2 and 58.5±3.3 % , respectively ) . Yet , a year after the end of the intervention , the decrease in BMI % ile from baseline was significantly greater in the intervention group ( -7.8±1.5 vs. -1.9±1.9 , p<0.012 ) . Nutritional and physical activity knowledge and preferences , and physical fitness remained significantly elevated in the intervention compared to the control group participants . Conclusions The beneficial effects of a kindergarten dietary-physical activity intervention applied by the kindergarten teachers , on nutrition and physical activity knowledge and preferences , fitness , and BMI percentile were evident one year after the end of intervention . This promising program may play a role in health promotion , prevention and treatment of childhood obesity Background Physical activity interventions targeting children and adolescents ( ≤18 years ) often focus on complex intra- and inter-personal behavioral constructs , social-ecological frameworks , or some combination of both . Recently published meta-analytical review s and large-scale r and omized controlled trials have demonstrated that these intervention approaches have largely produced minimal or no improvements in young people ’s physical activity levels . Discussion In this paper , we propose that the main reason for previous studies ’ limited effects is that fundamental mechanisms that lead to change in youth physical activity have often been overlooked or misunderstood . Evidence from observational and experimental studies is presented to support the development of a new theory positing that the primary mechanisms of change in many youth physical activity interventions are approaches that fall into one of the following three categories : ( a ) the expansion of opportunities for  youth  to be active by the inclusion of a new occasion to be active , ( b ) the extension of an existing physical activity opportunity by increasing the amount of time allocated for that opportunity , and /or ( c ) the enhancement of existing physical activity opportunities through strategies design ed to increase physical activity above routine practice . Their application and considerations for intervention design and interpretation are presented . Summary The utility of these mechanisms , referred to as the Theory of Exp and ed , Extended , and Enhanced Opportunities ( TEO ) , is demonstrated in their parsimony , logical appeal , support with empirical evidence , and the direct and immediate application to numerous setting s and context s. The TEO offers a new way to underst and youth physical activity behaviors and provides a common taxonomy by which interventionists can identify appropriate targets for interventions across different setting s and context s. We believe the formalization of the TEO concepts will propel them to the forefront in the design of future intervention studies and through their use , lead to a greater impact on youth activity behaviors than what has been demonstrated in previous studies Objective To test the effect of a multidimensional lifestyle intervention on aerobic fitness and adiposity in predominantly migrant preschool children . Design Cluster r and omised controlled single blinded trial ( Ballabeina study ) over one school year ; r and omisation was performed after stratification for linguistic region . Setting 40 preschool classes in areas with a high migrant population in the German and French speaking regions of Switzerl and . Participants 652 of the 727 preschool children had informed consent and were present for baseline measures ( mean age 5.1 years ( SD 0.7 ) , 72 % migrants of multicultural origins ) . No children withdrew , but 26 moved away . Intervention The multidimensional culturally tailored lifestyle intervention included a physical activity programme , lessons on nutrition , media use ( use of television and computers ) , and sleep and adaptation of the built environment of the preschool class . It lasted from August 2008 to June 2009 . Main outcome measures Primary outcomes were aerobic fitness ( 20 m shuttle run test ) and body mass index ( BMI ) . Secondary outcomes included motor agility , balance , percentage body fat , waist circumference , physical activity , eating habits , media use , sleep , psychological health , and cognitive abilities . Results Compared with controls , children in the intervention group had an increase in aerobic fitness at the end of the intervention ( adjusted mean difference : 0.32 stages ( 95 % confidence interval 0.07 to 0.57 ; P=0.01 ) but no difference in BMI ( −0.07 kg/m2 , −0.19 to 0.06 ; P=0.31 ) . Relative to controls , children in the intervention group had beneficial effects in motor agility ( −0.54 s , −0.90 to −0.17 ; P=0.004 ) , percentage body fat ( −1.1 % , −2.0 to −0.2 ; P=0.02 ) , and waist circumference ( −1.0 cm , −1.6 to −0.4 ; P=0.001 ) . There were also significant benefits in the intervention group in reported physical activity , media use , and eating habits , but not in the remaining secondary outcomes . Conclusions A multidimensional intervention increased aerobic fitness and reduced body fat but not BMI in predominantly migrant preschool children . Trial registration Clinical Trials NCT00674544 Objective To assess the effectiveness of a school based physical activity programme during one school year on physical and psychological health in young schoolchildren . Design Cluster r and omised controlled trial . Setting 28 classes from 15 elementary schools in Switzerl and r and omly selected and assigned in a 4:3 ratio to an intervention ( n=16 ) or control arm ( n=12 ) after stratification for grade ( first and fifth grade ) , from August 2005 to June 2006 . Participants 540 children , of whom 502 consented and presented at baseline . Intervention Children in the intervention arm ( n=297 ) received a multi-component physical activity programme that included structuring the three existing physical education lessons each week and adding two additional lessons a week , daily short activity breaks , and physical activity homework . Children ( n=205 ) and parents in the control group were not informed of an intervention group . For most outcome measures , the assessors were blinded . Main outcome measures Primary outcome measures included body fat ( sum of four skinfolds ) , aerobic fitness ( shuttle run test ) , physical activity ( accelerometry ) , and quality of life ( question naires ) . Secondary outcome measures included body mass index and cardiovascular risk score ( average z score of waist circumference , mean blood pressure , blood glucose , inverted high density lipoprotein cholesterol , and triglycerides ) . Results 498 children completed the baseline and follow-up assessment s ( mean age 6.9 ( SD 0.3 ) years for first grade , 11.1 ( 0.5 ) years for fifth grade ) . After adjustment for grade , sex , baseline values , and clustering within classes , children in the intervention arm compared with controls showed more negative changes in the z score of the sum of four skinfolds ( −0.12 , 95 % confidence interval −0.21 to −0.03 ; P=0.009 ) . Likewise , their z scores for aerobic fitness increased more favourably ( 0.17 , 0.01 to 0.32 ; P=0.04 ) , as did those for moderate-vigorous physical activity in school ( 1.19 , 0.78 to 1.60 ; P<0.001 ) , all day moderate-vigorous physical activity ( 0.44 , 0.05 to 0.82 ; P=0.03 ) , and total physical activity in school ( 0.92 , 0.35 to 1.50 ; P=0.003 ) . Z scores for overall daily physical activity ( 0.21 , −0.21 to 0.63 ) and physical quality of life ( 0.42 , −1.23 to 2.06 ) as well as psychological quality of life ( 0.59 , −0.85 to 2.03 ) did not change significantly . Conclusions A school based multi-component physical activity intervention including compulsory elements improved physical activity and fitness and reduced adiposity in children . Trial registration Current Controlled Trials IS RCT N15360785 Background The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade . This study tested the effectiveness of a multifaceted intervention that integrated childcare center , families , and community to promote healthy growth and physical fitness in preschool Chinese children . Methods This 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group . The participants were 357 children ( mean age = 4.5 year ) enrolled in three grade levels in two childcare centers in Beijing , China . The intervention included : 1 ) childcare center intervention ( physical activity policy changes , teacher training , physical education curriculum and food services training ) , 2 ) family intervention ( parent education , internet website for support , and family events ) , and 3 ) community intervention ( playground renovation and community health promotion events ) . The study outcome measures included body composition ( percent body fat , fat mass , and muscle mass ) , Body Mass Index ( BMI ) and BMI z-score and physical fitness scores in 20- 
    Output:
    
Preliminary evidence suggests that ECEC-based interventions to increase CVF are highly effective at improving  preschool children 's exercise test scores .