PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
Sports Med. 2019 Sep;49(9):1383-1410. doi: 10.1007/s40279-019-01099-5.
Evidence suggests that participation in physical activity may support young people's current and future mental health. Although previous reviews have examined the relationship between physical activity and a range of mental health outcomes in children and adolescents, due to the large increase in published studies there is a need for an update and quantitative synthesis of effects.
The objectives of this study were to determine the effect of physical activity interventions on mental health outcomes by conducting a systematic review and meta-analysis, and to systematically synthesize the observational evidence (both longitudinal and cross-sectional studies) regarding the associations between physical activity and sedentary behavior and mental health in preschoolers (2-5 years of age), children (6-11 years of age) and adolescents (12-18 years of age).
A systematic search of the PubMed and Web of Science electronic databases was performed from January 2013 to April 2018, by two independent researchers. Meta-analyses were performed to examine the effect of physical activity on mental health outcomes in randomized controlled trials (RCTs) and non-RCTs (i.e. quasi-experimental studies). A narrative synthesis of observational studies was conducted. Studies were included if they included physical activity or sedentary behavior data and at least one psychological ill-being (i.e. depression, anxiety, stress or negative affect) or psychological well-being (i.e. self-esteem, self-concept, self-efficacy, self-image, positive affect, optimism, happiness and satisfaction with life) outcome in preschoolers, children or adolescents.
A total of 114 original articles met all the eligibility criteria and were included in the review (4 RCTs, 14 non-RCTs, 28 prospective longitudinal studies and 68 cross-sectional studies). Of the 18 intervention studies, 12 (3 RCTs and 9 non-RCTs) were included in the meta-analysis. There was a small but significant overall effect of physical activity on mental health in children and adolescents aged 6-18 years (effect size 0.173, 95% confidence interval 0.106-0.239, p < 0.001, percentage of total variability attributed to between-study heterogeneity [I] = 11.3%). When the analyses were performed separately for children and adolescents, the results were significant for adolescents but not for children. Longitudinal and cross-sectional studies demonstrated significant associations between physical activity and lower levels of psychological ill-being (i.e. depression, stress, negative affect, and total psychological distress) and greater psychological well-being (i.e. self-image, satisfaction with life and happiness, and psychological well-being). Furthermore, significant associations were found between greater amounts of sedentary behavior and both increased psychological ill-being (i.e. depression) and lower psychological well-being (i.e. satisfaction with life and happiness) in children and adolescents. Evidence on preschoolers was nearly non-existent.
Findings from the meta-analysis suggest that physical activity interventions can improve adolescents' mental health, but additional studies are needed to confirm the effects of physical activity on children's mental health. Findings from observational studies suggest that promoting physical activity and decreasing sedentary behavior might protect mental health in children and adolescents. PROSPERO Registration Number: CRD42017060373.
有证据表明，参加体育活动可能有助于年轻人当前和未来的心理健康。尽管之前的综述已经研究了体育活动与儿童和青少年一系列心理健康结果之间的关系，但由于发表研究的大量增加，需要对其进行更新和定量综合评估。
本研究的目的是通过系统评价和荟萃分析来确定体育活动干预对心理健康结果的影响，并系统地综合观察证据（包括纵向和横断面研究），以了解学龄前儿童（2-5 岁）、儿童（6-11 岁）和青少年（12-18 岁）中体育活动与久坐行为和心理健康之间的关系。
两位独立研究人员于 2013 年 1 月至 2018 年 4 月对 PubMed 和 Web of Science 电子数据库进行了系统检索。对随机对照试验（RCT）和非随机对照试验（即准实验研究）进行荟萃分析，以检验体育活动对心理健康结果的影响。对观察性研究进行了叙述性综合分析。如果研究包括体育活动或久坐行为数据以及至少一个心理不适（即抑郁、焦虑、压力或负性情绪）或心理幸福感（即自尊、自我概念、自我效能感、自我形象、正性情绪、乐观、幸福感和生活满意度）结果，则纳入研究。
共有 114 篇原始文章符合所有纳入标准，并纳入本综述（4 项 RCT、14 项非 RCT、28 项前瞻性纵向研究和 68 项横断面研究）。在 18 项干预研究中，有 12 项（3 项 RCT 和 9 项非 RCT）纳入荟萃分析。6-18 岁儿童和青少年的体育活动对心理健康有小但显著的总体影响（效应大小 0.173，95%置信区间 0.106-0.239，p<0.001，研究间异质性归因于总变异的百分比 [I] = 11.3%）。当分别对儿童和青少年进行分析时，结果对青少年显著，但对儿童不显著。纵向和横断面研究表明，体育活动与较低水平的心理不适（即抑郁、压力、负性情绪和总心理困扰）和更高的心理幸福感（即自我形象、生活满意度和幸福感以及心理幸福感）之间存在显著关联。此外，在儿童和青少年中，久坐行为与心理不适（即抑郁）和心理幸福感降低（即生活满意度和幸福感降低）之间存在显著关联。关于学龄前儿童的证据几乎不存在。
荟萃分析的结果表明，体育活动干预可以改善青少年的心理健康，但需要更多的研究来证实体育活动对儿童心理健康的影响。观察性研究的结果表明，促进体育活动和减少久坐行为可能有助于保护儿童和青少年的心理健康。PROSPERO 注册号：CRD42017060373。
