Given accumulating evidence indicating that acute and chronic physical activity and cardiorespiratory fitness are related to modulation of the P3b‐ERP component, this systematic review provides an overview of the field across the last 30+ years and discusses future directions as the field continues to develop. A systematic review was conducted on studies of physical activity and cardiorespiratory fitness on P3b. PubMed, Web of Science, and Scopus were searched from database inception to March 28, 2018. Search results were limited to peer‐reviewed and English‐written studies investigating typically developed individuals. Seventy‐two studies were selected, with 39 studies examining cross‐sectional relationships between chronic physical activity (n = 19) and cardiorespiratory fitness (n = 20) with P3b, with 16 and 17 studies reporting associations of P3b with physical activity and cardiorespiratory fitness, respectively. Eight studies investigated the effects of chronic physical activity interventions, and all found effects on P3b. Eight studies investigating P3b during acute bouts of physical activity showed inconsistent results. Nineteen of 23 studies demonstrated acute modulation of P3b following exercise cessation. Conclusions drawn from this systematic review suggest that physical activity and cardiorespiratory fitness are associated with P3b modulation during cognitive control and attention tasks. Acute and chronic physical activity interventions modulate the P3b component, suggesting short‐ and long‐term functional adaptations occurring in the brain to support cognitive processes. These summary findings suggest physical activity and cardiorespiratory fitness are beneficial to brain function and that P3b may serve as a biomarker of covert attentional processes to better understand the relationship of physical activity and cognition.

BackgroundCardiorespiratory fitness (CRF) is an important marker of current and future health status. The primary aim of our study was to evaluate the impact of a time-efficient school-based intervention on older adolescents’ CRF.MethodsTwo-arm cluster randomised controlled trial conducted in two cohorts (February 2018 to February 2019 and February 2019 to February 2020) in New South Wales, Australia. Participants (N=670, 44.6% women, 16.0±0.43 years) from 20 secondary schools: 10 schools (337 participants) were randomised to the Burn 2 Learn (B2L) intervention and 10 schools (333 participants) to the control. Teachers in schools allocated to the B2L intervention were provided with training, resources, and support to facilitate the delivery of high-intensity interval training (HIIT) activity breaks during curriculum time. Teachers and students in the control group continued their usual practice. The primary outcome was CRF (20 m multi-stage fitness test). Secondary outcomes were muscular fitness, physical activity, hair cortisol concentrations, mental health and cognitive function. Outcomes were assessed at baseline, 6 months (primary end-point) and 12 months. Effects were estimated using mixed models accounting for clustering.ResultsWe observed a group-by-time effect for CRF (difference=4.1 laps, 95% CI 1.8 to 6.4) at the primary end-point (6 months), but not at 12 months. At 6 months, group-by-time effects were found for muscular fitness, steps during school hours and cortisol.ConclusionsImplementing HIIT during curricular time improved adolescents’ CRF and several secondary outcomes. Our findings suggest B2L is unlikely to be an effective approach unless teachers embed sessions within the school day.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12618000293268).

IMPORTANCECardiorespiratory fitness is an important marker of childhood health and low fitness levels are a risk factor for disease later in life. Levels of children's fitness have declined in recent decades. Whether school-based physical activity interventions can increase fitness at the population level remains unclear.OBJECTIVE To evaluate the effect of an internet-based intervention on children's cardiorespiratory fitness across a large number of schools.DESIGN, SETTING, AND PARTICIPANTS In this cluster randomized clinical trial, 22 government-funded elementary schools (from 137 providing consent) including 1188 students stratified from grades 3 and 4 in New South Wales, Australia, were randomized. The other schools received the intervention but were not included in the analysis. Eleven schools received the internet-based intervention and 11 received the control intervention. Recruitment and baseline testing began in 2016 and ended in 2017. Research assistants, blinded to treatment allocation, completed follow-up outcome assessments at 12 and 24 months. Data were analyzed from July to August 2020. INTERVENTIONSThe internet-based intervention included standardized online learning for teachers and minimal in-person support from a project mentor (9-10 months). MAIN OUTCOMES AND MEASURESMultistage 20-m shuttle run test for cardiorespiratory fitness. RESULTSOf 1219 participants (49% girls; mean [SD] age, 8.85 [0.71] years) from 22 schools, 1188 students provided baseline primary outcome data. At 12 months, the number of 20-m shuttle runs increased by 3.32 laps (95% CI, 2.44-4.20 laps) in the intervention schools and 2.11 laps (95% CI, 1.38-2.85 laps) in the control schools (adjusted difference = 1.20 laps; 95% CI, 0.17-2.24 laps). By 24 months, the adjusted difference was 2.22 laps (95% CI, 0.89-3.55 laps). The cost per student was AUD33 (USD26). CONCLUSIONS AND RELEVANCEIn this study, a school-based intervention improved children's cardiorespiratory fitness when delivered in a large number of schools. The low cost and sustained effect over 24 months of the intervention suggests that it may have potential to be scaled at the population level.

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