Background: About 70% of children and adolescents worldwide do not meet the recommended level of physical activity (PA), which is closely associated with physical, psychological, and cognitive well-being. Nowadays, the use of technologies to change PA is of interest due to the need for novel, more effective intervention approaches. The previous meta-analyses have examined smartphone-based interventions and their impact on PA in adults, but evidence in children and adolescents still needs further research. Objective: This systematic review and meta-analysis aimed to determine the effectiveness of smartphone-based interventions for improving PA in children and adolescents. Methods: Five electronic databases (PubMed, Web of Science, OVID, Scopus, and the China National Knowledge Infrastructure) were searched up to June 29, 2020. Randomized controlled trials with a control group that examine the effect of smartphone interventions on PA among children and adolescents were included. Bias risks were assessed using the Cochrane collaboration tool. Meta-analysis was performed to assess the pooled effect on PA using a random effects model. Subgroup analyses were conducted to examine the potential modifying effects of different factors (eg, types of intervention, intervention duration, age, measurement, study quality). Results: A total of 9 studies were included in this review, including 4 mobile app interventions, 3 SMS text messaging interventions, and 2 app + SMS text messaging interventions. In general, the risk of bias of included studies was low. Compared with the control group, the use of smartphone intervention significantly improved PA (standardized mean difference [SMD] 0.44, 95% CI 0.11-0.77, P=.009), especially for total PA (TPA; weighted mean difference [WMD] 32.35, 95% CI 10.36-54.33, P=.004) and daily steps (WMD 1185, 95% CI 303-2068, P=.008), but not for moderate-to-vigorous PA (WMD 3.91, 95% CI –1.99 to 9.81, P=.19). High statistical heterogeneity was detected (I2=73.9%, P<.001) for PA. Meta-regression showed that duration (β=–.08, 95% CI –0.15 to –0.01, n=16) was a potential factor for high heterogeneity. The results of subgroup analyses indicated that app intervention (SMD 0.76, 95% CI 0.23-1.30, P=.005), children (SMD 0.64, 95% CI 0.10-1.18, P=.02), “≤8 weeks” (SMD 0.76, 95% CI 0.23-1.30, P=.005), objective measurement (SMD 0.50, 95% CI 0.09-0.91, P=.02), and low risk of bias (SMD 0.96, 95% CI 0.38-1.54, P=.001) can significantly improve PA. Conclusions: The evidence of meta-analysis shows that smartphone-based intervention may be a promising strategy to increase TPA and steps in children and adolescents. Currently, app intervention may be a more effective strategy among smartphone intervention technologies. To extend the promise of smartphone intervention, the future needs to design comparative trials among different smartphone technologies. Trial Registration: PROSPERO CRD42019148261; https://tinyurl.com/y5modsrd

Purpose. To evaluate the relationships between objectively measured physical activity and physical fitness among preschool children. Methods. A total of 346 participants (201 boys and 145 girls) aged 3.5–5.5 years (M=4.5 yr, SD = 0.47) from Shanghai, China, completed physical fitness assessments, including triceps skinfold thickness (TSFT), grip strength, tennis throwing, sit and reach test, standing long jump, balance beam, 10mSRT, and 20mSRT. Physical activity was objectively measured by ActiGraphGT3X+ accelerometer. Multiple linear regression models were used to explore the cross-sectional associations between PA and physical fitness after adjusting for age, gender, BMI, and valid wearing time. Results. Positive associations were observed between stand long jump (p<.01), tennis throwing (p<.01), laps in 20mSRT (p<.01), and MVPA. However, TSFT (p<.05), time in 10mSRT (p<.01), and balance beam (p<.05) were negatively associated with MVPA. Furthermore, positive associations were found between stand long jump (p<.01), tennis throwing (p<.01), and MVPA only in boys. Negative associations were found between time on balance beam (p<.01) and MVPA only in girls. Conclusions. MVPA appears to be an effective and reliable predictor of preschoolers’ physical fitness. Boys’ body composition, muscular strength, explosive strength, agility, aerobic fitness, girls’ agility, aerobic fitness, and balance could improve as MVPA increases.

Background: Physical literacy (PL) can positively affect the health of children, adolescents, and adults, and is closely related to cardiorespiratory fitness (CRF). Objective: To perform a systematic review and meta-analysis to examine the relationship between overall physical literacy (PL) and CRF in children and adolescents. Methods: Cross-sectional, cohort and experimental studies on the relationship between PL and CRF in children and adolescents were collected by searching the Web of Science Core Collection, PubMed, EBSCOhost, ScienceDirect, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases. Based on the characteristics of the included literature, PL was divided into physical competence (PC), daily behavior (DB), knowledge and understanding (K&U), and motivation and confidence (M&C). R 4.3.6 was used to analyze the combined effect size of PL and the relationships of the four dimensions with CRF among children and adolescents. Results: A total of 21 articles were included, 42.9% of which were published after 2020, involving a total of 43,352 children and adolescents from 23 countries or regions. The characteristics of the included studies showed that, except for the K&U of children and adolescents aged 13–18 years, the K&U of other age groups and the PL, PC, DB, M&C of all age groups were significantly positively correlated with CRF. Furthermore, the results of male and female samples in all included studies were the same. The results of the meta-analysis indicated that PL (COR = 0.64, 95% CI 0.58, 0.70), PC (COR = 0.74, 95% CI 0.69, 0.79), DB (COR = 0.49, 95% CI 0.40, 0.57), K&U (COR = 0.41, 95% CI 0.23, 0.56), and M&C (COR = 0.45, 95% CI 0.41, 0.49) were significantly positively correlated with CRF. Regarding DB, total physical activity (TPA) was positively correlated with CRF (COR = 0.49, 95% CI = 0.40, 0.57). Moderate to vigorous physical activity (MVPA), vigorous physical activity (VPA) and high physical activity (HPA) were positively correlated with CRF (COR = 0.16, 95% CI 0.09, 0.22; COR = 0.33, 95% CI 0.22, 0.43; COR = 0.38, 95% CI 0.13, 0.58), but light physical activity (LPA) was negatively correlated with CRF (COR = − 0.20, 95% CI − 0.32, 0.06). Conclusion: PL and CRF are positively correlated among children and adolescents, suggesting that the development of physical literacy has a wide range of effects on children and adolescents’ cardiopulmonary health and that these effects are not limited by PL and its various dimensions or sex. In addition, to exert the positive effect of daily activities on cardiopulmonary health, the intensity of physical activity should reach a moderate level or above.

Background: It has been suggested that higher levels of fundamental motor skills (FMS) promote the physical health of preschool-aged children. The impacts of structured and unstructured interventions on FMS in children aged 10–16 years have been widely acknowledged in previous studies. However, there is a lack of relevant studies in preschool-aged children.Objective: This meta-analysis aimed to compare the effects of structured and unstructured interventions on FMS in preschool-aged children.Methods: The PubMed, Web of Science, and Google Scholar databases were searched from inception to 1 November 2023 to identify experiments describing structured and unstructured interventions for FMS in preschool-aged children. The Downs and Black Checklist was used to assess the risk of bias. A random effects model was used for the meta-analysis to evaluate the pooled effects of interventions on FMS. Subgroup analyses based on the duration and characteristics of the intervention were conducted to identify sources of heterogeneity.Results: A total of 23 studies with 4,068 participants were included. There were 12 studies examining structured interventions, 9 studies examining unstructured interventions, and 6 studies comparing structured vs. unstructured interventions. The risk of bias in the included studies was generally low. All interventions significantly improved FMS in preschool-aged children compared to control treatments (p < 0.05). Structured interventions had more significant effects on locomotor skills (LMSs) in preschool-aged children than unstructured interventions (Hedges’ g = 0.44, p = 0.04). The effects of structured interventions were strongly influenced by the total intervention duration, such that long-term interventions were more effective (Hedge’s g = 1.29, p < 0.001).Conclusion: Structured interventions play a crucial role in enhancing FMS among young children, especially when considering LMSs. These interventions require consistent and repeated practice over time to reach proficiency.Systematic review registration: PROSPERO, identifier number CRD42023475088, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023475088.

Early childhood is a critical period for development of cognitive function, but research on the association between physical activity and cognitive function in preschool children is limited and inconclusive. This study aimed to examine the association between technology-assessed physical activity and cognitive function in preschool children. A cross-sectional analysis of baseline data from the Physical Activity and Cognitive Development Study was conducted in Shanghai, China. Physical activity was measured with accelerometers for 7 consecutive days, and cognitive functions were assessed using the Chinese version of Wechsler Young Children Scale of Intelligence (C-WYCSI). Linear regression analyses were used to assess the association between physical activity and cognitive function. A total of 260 preschool children (boys, 144; girls, 116; mean age: 57.2 ± 5.4 months) were included in analyses for this study. After adjusting for confounding factors, we found that Verbal Intelligence Quotient, Performance Intelligence Quotient, and Full Intelligence Quotient were significantly correlated with light physical activity, not moderate to vigorous physical activity, in boys. Standardized coefficients were 0.211, 0.218, and 0.242 (all p < 0.05) in three different models, respectively. However, the correlation between physical activity and cognitive functions were not significant in girls (p > 0.05). These findings suggest that cognitive function is apparently associated with light physical activity in boys. Further studies are required to clarify the sex-specific effect on physical activity and cognitive functions.

Objective: To evaluate the best option among traditional Chinese exercises for reducing oxidative stress in middle-aged and older adults, using a network meta-analysis. Methods: PubMed, Web of Science, and CNKI databases were used. We searched randomized controlled trials (RCTs) on middle-aged and older adults to influence oxidative stress by any traditional Chinese exercises from the beginning to 20 January 2022. A network meta-analysis of randomized control trials was performed comparing the changes in the concentration of glutathione peroxidase (GPX), malondialdehyde (MDA), and superoxide dismutase (SOD) as primary outcomes, following different therapeutic interventions with traditional Chinese exercises in middle-aged and older adults over 30 years old. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to assess the correlation between each group of interventions, and surface under the cumulative ranking (SUCRA) was used to rank the best interventions. Results: The meta-analysis comprised 15 trials with a total of 927 participants and six interventions: (Wuqinxi (WQX), Baduanjin (BDJ), Tai Ji Quan (TJQ), Yijinjing (YJJ), Mawangdui Daoyin (MWD), and no exercise intervention (NEI)). Regarding GPX: WQX [SMD = 2.79 (1.75, 3.83)], TJQ [SMD = 0.47 (0.23, 0.70)], YJJ [SMD = 1.78 (1.18, 2.37)], MWD [SMD = 1.89 (1.36, 2.43)] were superior in increasing GPX relative to NEI. Regarding MDA: WQX [SMD = 1.68 (0.94, 2.42)], YJJ [SMD = 0.99 (0.28, 1.69)] were superior in reducing MDA relative to NEI. Regarding SOD: WQX [SMD = 1.05 (0.10, 2.01)] were superior in increasing SOD relative to NEI. WQX topped the SUCRA with GPX: 0.97, MDA: 0.91, and SOD: 0.94. Furthermore, WQX was more effective than TJQ in interfering with GPX [SMD = 2.32 (1.26, 3.39)] and MDA [SMD = 1.47 (0.26, 2.67)], and a significantly better intervention effect on SOD than YJJ [SMD = 1.52 (0.80, 2.24)] and MWD [SMD = 0.89 (0.03, 1.75)]. Conclusion: Traditional Chinese exercise can help middle-aged and older adults reduce oxidative stress. WQX may be the best traditional Chinese exercise of the exercises evaluated for reducing oxidative stress in middle-aged and older adults.