Effectiveness of a physical activity intervention in preschoolers: A cluster‐randomized controlled trial

Abstract

Several activity interventions in preschool settings exist, but little attention has been paid to effects on hemodynamic factors. The study aimed to assess the effectiveness of an exercise program on health-related outcomes including blood pressure (BP) and markers of vascular function in preschoolers, with focus on socioeconomic background. This study is a cluster-randomized controlled trial, with preschool as unit of randomization and children as unit of analysis. Preschools with 3-to 6-year-old children, stratified by social area, were randomly allocated to: intervention (three clusters, n = 92) including 2 d·wk −1 /45 min (6 months) exercise lessons or control (two clusters, n = 43). In total, 135 children (4.8 ± 0.8 y) had minimum one outcome measurement at baseline and follow-up. Primary outcome: peripheral BP. Secondary outcomes: central BP, pulse wave velocity (PWV), BMI, waist circumference, physical activity measures, motor skills. Maternal education was used as an indicator of socioeconomic status. Mixed models were applied to evaluate differences in mean change. Group allocation had no effect on primary or secondary outcomes. However, the intervention was effective in reducing increases in peripheral systolic BP (−3.4 mm Hg; 95% CI: −6.6; −0.2; P = 0.037), central systolic BP (−3.8 mm Hg; −6.4; −1.1; P = 0.006), and PWV (−0.1 m/s; −0.2; −0.0; P = 0.045) among children whose mothers had the lowest educational level. We found no evidence for effectiveness of a 6-months preschool-based exercise program on hemodynamics, anthropometrics, activity, or motor skills, but lack of process evaluations and poor fidelity preclude interpretation of the causal relation. However, the results indicate that children from lower social backgrounds could benefit from early exercise-promoting interventions. K E Y W O R D Sarterial stiffness, blood pressure, children, intervention, physical activity, preschool, social background

Effects of Exercise Intervention on Health-Related Physical Fitness and Blood Pressure in Preschool Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Although several studies show benefits of physical activity on the cardiometabolic risk profile of children [52], several recent meta-analyses have reported controversial results [49,53,54] and very little is known about preschoolers. In our systematic review, only five studies analyzed blood pressure among preschoolers [22,26,28,36,38]. In line with a Cochrane review in children and adolescents published in 2012 [54], our pooled analysis did not show significant reductions in systolic or diastolic blood pressure.…”

“…Most studies included apparently healthy preschoolers, but two studies included overweight and/or obese children [28,32]. Participants enrolled in exercise cohorts were predominantly from the Germany (n = 4) [31,32,36,38], with studies from USA (n = 3) [20,21,35], Australia (n = 2) [29,37], Israel (n = 2) [27,34], Switzerland (n = 2) [24,33], China (n = 1) [28], Scotland (n = 1) [25], Spain (n = 2) [22,30], and Thailand (n = 1) [23]. All studies included boys and girls.…”

Vascular Structure and Function in Children and Adolescents: What Impact Do Physical Activity, Health-Related Physical Fitness, and Exercise Have?

“…By contrast, Horner et al (22) found no change in aortic PWV in obese adolescents who participated in aerobic (treadmill training, 60-75% of VO 2peak ) or resistance (wholebody exercises) interventions for a period of three months. Moreover, Hacke et al (59) implemented preschool exercise lessons (45 min, two times per week for six months) but was unable to detect any improvement in aortic PWV in the intervention group compared to controls.…”

“…As such, we can conclude that exercise interventions with at least moderate levels of intensity can reduce vascular stiffness among pediatric populations at risk. Horner et al (22) and Hacke et al (59) reported no reductions in body mass index in response to these interventions; improvement in vascular function might be linked to a change in anthropometric parameters. It is also possible that the intensity of their intervention was too low to promote measurable changes in vascular function.…”

Gender differences in the rate of motor activity of senior (older) preschool children

“…lead to a decrease in motor activity. This is noted in the works of Komkov a high interest in optimizing motor activity and making programs, taking into account social factors that characterize the educational process in various countries of the world [6][7][8][9][10][11][12][13][14][15][16].…”