Physical Activity for Health Group, University of Strathclyde, Glasgow, Scotland.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland.
BMC Public Health. 2018 Jun 26;18(1):789. doi: 10.1186/s12889-018-5687-z.
Children's physical activity levels are low and efforts to improve their physical activity levels have proven difficult. Freely chosen and unstructured physical activity (active play) has the potential to be promoted in a variety of settings and potentially every day of the year in contrast to other physical activity domains, but active play interventions are an under-researched area. Therefore, the primary aim of this systematic review was to determine the effect of active play interventions on children's physical activity levels, particularly moderate-to-vigorous intensity physical activity (MVPA), and fundamental movement skills (FMS).
Studies were included if they were solely or predominantly active play randomised, or cluster randomised controlled trials that targeted children aged 3-12 years. They had to report on at least one of the following outcomes: objectively measured physical activity, FMS, cognition and weight status. During December 2016, four databases (PE Index, SPORTDiscus, Medline and ERIC) were searched for relevant titles. Duplicates and irrelevant titles and abstracts were removed. The included studies had their quality assessed using the Effective Public Health Practice Project (EPHPP) tool. Suitable studies were combined in a meta-analysis using a random-effect model. A narrative synthesis was conducted for all outcomes.
Of the 4033 records, 91 studies were eligible for full text screening, of which 87 were removed, leaving four studies (representing five papers). The meta-analysis of two studies highlighted there was no significant effect of active play interventions on MVPA. However, the narrative synthesis suggested that active play interventions may increase total volume of physical activity. Only two studies examined the effect of active play interventions on children's FMS, one study examined effects on weight status and none examined effects on cognition.
Due to the small number of eligible studies and their heterogeneity, the review could not draw firm conclusions on the effect of active play interventions on children's physical activity levels. High-quality active play interventions, targeting different times of the day (school and after school) in different populations and settings, and with a wider range of outcomes, are required to determine the potential of active play.
儿童的身体活动水平较低，改善其身体活动水平的努力已被证明颇具难度。与其他身体活动领域相比，自由选择和无组织的身体活动（积极玩耍）具有在各种环境中促进的潜力，并且有可能在一年中的每一天进行，但积极玩耍干预是一个研究不足的领域。因此，本系统评价的主要目的是确定积极玩耍干预对儿童身体活动水平的影响，特别是中等到剧烈强度的身体活动（MVPA）和基本运动技能（FMS）。
如果研究是单纯或主要是积极玩耍的随机或整群随机对照试验，且目标人群为 3-12 岁儿童，则将其纳入研究。这些研究必须报告以下至少一项结果：客观测量的身体活动、FMS、认知和体重状况。在 2016 年 12 月，四个数据库（PE Index、SPORTDiscus、Medline 和 ERIC）中搜索了相关标题。删除了重复和不相关的标题和摘要。使用有效公共卫生实践项目（EPHPP）工具评估纳入研究的质量。使用随机效应模型对合适的研究进行了荟萃分析。对所有结果进行了叙述性综合。
在 4033 条记录中，有 91 项研究符合全文筛选标准，其中 87 项被排除，留下 4 项研究（代表 5 篇论文）。两项研究的荟萃分析表明，积极玩耍干预对 MVPA 没有显著影响。然而，叙述性综合表明，积极玩耍干预可能会增加身体活动的总量。只有两项研究考察了积极玩耍干预对儿童 FMS 的影响，一项研究考察了对体重状况的影响，没有研究考察对认知的影响。
由于合格研究的数量较少且存在异质性，因此本评价无法就积极玩耍干预对儿童身体活动水平的影响得出明确结论。需要高质量的积极玩耍干预，针对不同人群和环境中一天中的不同时间（学校和放学后），以及更广泛的结果，以确定积极玩耍的潜力。
