Ekeland E, Heian F, Hagen K B, Abbott J, Nordheim L
Norwegian Directorate for Health and Social Affairs, P.O.Box 8054 Dep., Oslo, Norway, N-0031.
Cochrane Database Syst Rev. 2004(1):CD003683. doi: 10.1002/14651858.CD003683.pub2.
Psychological and behavioural problems in children and adolescents are common, and improving self-esteem may help to prevent the development of such problems. There is strong evidence for the positive physical health outcomes of exercise, but the evidence of exercise on mental health is scarce.
To determine if exercise alone or exercise as part of a comprehensive intervention can improve self-esteem among children and young people.
Computerised searches in MEDLINE, EMBASE, The Cochrane Controlled Trials Register (CENTRAL), CINAHL, PsycINFO and ERIC were undertaken and reference lists from relevant articles were scanned. Relevant studies were also traced by contacting authors. Dates of most recent searches: May 2003 in (CENTRAL), all others: January 2002.
Randomised controlled trials where the study population consisted of children and young people aged from 3 to 20 years, in which one intervention arm was gross motor activity for more than four weeks and the outcome measure was self-esteem.
Two reviewers independently selected trials for inclusion, assessed the validity of included trials and extracted data. Investigators were contacted to collect missing data or for clarification when necessary.
Twenty-three trials with a total of 1821 children and young people were included. Generally, the trials were small, and only one was assessed to have a low risk of bias. Thirteen trials compared exercise alone with no intervention. Eight were included in the meta-analysis, and overall the results were heteregeneous. One study with a low risk of bias showed a standardised mean difference (SMD) of 1.33 (95% CI 0.43 to 2.23), while the SMD's for the three studies with a moderate risk of bias and the four studies with a high risk of bias was 0.21 (95% CI -0.17 to 0.59) and 0.57 (95% CI 0.11 to 1.04), respectively. Twelve trials compared exercise as part of a comprehensive programme with no intervention. Only four provided data sufficient to calculate overall effects, and the results indicate a moderate short-term difference in self-esteem in favour of the intervention [SMD 0.51 (95% CI 0.15 to 0.88)].
REVIEWER'S CONCLUSIONS: The results indicate that exercise has positive short-term effects on self-esteem in children and young people. Since there are no known negative effects of exercise and many positive effects on physical health, exercise may be an important measure in improving children's self-esteem. These conclusions are based on several small low-quality trials.
儿童和青少年的心理及行为问题很常见，提高自尊可能有助于预防此类问题的发展。有充分证据表明运动对身体健康有积极影响，但运动对心理健康的证据却很少。
确定单独运动或作为综合干预一部分的运动是否能提高儿童和年轻人的自尊。
在MEDLINE、EMBASE、Cochrane对照试验注册库（CENTRAL）、CINAHL、PsycINFO和ERIC中进行计算机检索，并浏览相关文章的参考文献列表。还通过联系作者追踪相关研究。最近一次检索日期：CENTRAL为2003年5月，其他均为2002年1月。
随机对照试验，研究人群为3至20岁的儿童和年轻人，其中一个干预组为进行超过四周的大肌肉活动，结局指标为自尊。
两名评价员独立选择纳入试验，评估纳入试验的有效性并提取数据。必要时联系研究者收集缺失数据或进行澄清。
共纳入23项试验，涉及1821名儿童和年轻人。总体而言，试验规模较小，只有一项被评估为偏倚风险较低。13项试验将单独运动与无干预进行比较。8项纳入荟萃分析，总体结果具有异质性。一项偏倚风险较低的研究显示标准化均数差（SMD）为1.33（95%CI 0.43至2.23），而三项偏倚风险中等的研究和四项偏倚风险高的研究的SMD分别为0.21（95%CI -0.17至0.59）和0.57（95%CI 0.11至1.04）。12项试验将作为综合项目一部分的运动与无干预进行比较。只有四项提供了足以计算总体效应的数据，结果表明在自尊方面干预组有中度短期差异[SMD 0.51（95%CI 0.15至0.88）]。
结果表明运动对儿童和年轻人的自尊有短期积极影响。由于运动没有已知的负面影响且对身体健康有许多积极影响，运动可能是提高儿童自尊的一项重要措施。这些结论基于几项小规模低质量试验。
