Accelerometry-measured Physical Activity and Determinants in PE classes of Fourth-Grade Primary school students in China

doi:10.21203/rs.3.rs-4995802/v1

Purpose

Physical education (PE) classes provide opportunities for students to meet recommended daily moderate-to-vigorous physical activity (MVPA). This study aimed to explore PA levels and determinants in PE among Chinese fourth-grade primary school students.

Methods

This cross-sectional study recruited 195 Grade 4 children (49.2% boys; aged 12 to 13 years). Accelerometers (ActiGraph GT3X) were used to measure PA in PE. Physical fitness (PF) was measured by professional PE teachers during PE lessons from October 10 to October 20, 2020, following the Chinese National Student Physical Fitness Standard (CNSPFS) guidelines, as established by the Ministry of Education. Students' body mass index (BMI) and fitness scores were calculated and evaluated from their PF test. We observed 10 PE lessons and recorded lesson contents. Independent samples t-tests and analysis of variance (ANOVA) were applied to compare the differences in PA between genders, weight statuses, and PF scores among the students. The multiple linear regression model (MLR) was developed to identify the influencing factors that influence the PA levels of boys and girls enrolled in PE classes.

Results

Within 40 minutes of each PE class, children averagely accumulated 6.69 ± 4.05 minutes MVPA, equaling 16.73% of PE time. Boys were more active than girls (%MVPA: Boys 18.95%, Girls 14.56%; %Sedentary Behaviour: Boys 42.44%, Girls 49.29%; P < 0.01). MVPA was significantly affected by teaching content (Boys β = 0.613, P < 0.001; Girls β = 0.837, P < 0.001). PF (Boys β = 0.113, P = 0.246; Girls β = 0.093, P = 0.196) and BMI (Boys β=-0.069, P = 0.474; Girls β=-0.029, P = 0.690) did not significantly affect MVPA in PE.

Conclusion

The percentage of MVPA in PE was much lower than the proposed standards (50%). Teaching content significantly affects the MVPA level of elementary school students, especially for girls. PF and BMI did not significantly affect MVPA in PE. In China, there is an urgent need to design contents for improving MVPA in PE.

Physical activity

MVPA

physical education classes

accelerometry

teaching content

Physical inactivity is an alarming global issue [1]. The World Health Organization (2020) recommends that children and adolescents should engage in a minimum of 60 minutes of Moderate to Vigorous Physical Activity (MVPA) daily to achieve essential health benefits [2]. However, currently, more than 80% of children and adolescents do not meet the recommended PA levels [3–6], contributing to the decline in children and adolescents' physical and mental health as well as the development of many severe chronic diseases like obesity and metabolic syndrome [7–9].

School physical education (PE) has great potential to increase physical activity (PA) levels and help meet the PA guidelines among children [10]. Structured PE classes are the most promising opportunity to promote MVPA in school children [11]. According to the WHO's 2013–2020 Global Action Plan, PE presents a significant opportunity to promote MVPA in children [12]. The U.S. Department of Health and Human Services (USDHHS, 2010) [13] and the U.K. Association of Physical Education (AFPE, 2017) [14] suggested that children and adolescents should engage in MVPA for 50% of their PE class time. However, many studies found that elementary school students do not meet the recommended MVPA time in many countries [15, 16]. Wood and Hall (2015) even found that elementary school students aged 8–9 years in the U.K. only spent 9.5% of class time in MVPA [17]. In China, where a large number of school-aged children receive compulsory education [18], PE is mandatory. It typically occurs four times a week, lasting for 40–45 minutes each session, and is usually taught by certified physical education specialists in most elementary schools. Therefore, PA in PE classes plays a crucial role in meeting the daily recommendation of ≥ 60 minutes of MVPA, especially for students in China.

Given the potential significance of PE in promoting PA, numerous scholars have investigated PA levels and influencing factors within PE settings. Reasons for PA levels in PE classes are complex, including gender [15, 19], grade levels [20, 21], BMI [22, 23], teacher influence [23, 24], and teaching contents [20, 25, 26], and so on. However, there is a lack of recent research on the effect of teaching contents on PA levels in PE classes, and it is not clear whether content makes the same difference in PA levels in PE classes for boys and girls. Consequently, this study aims to: 1) objectively measure PA levels in Chinese fourth-grade elementary school PE using accelerometers, and 2) identify whether teaching content has the same effect on PA levels in boys' and girls' physical education classes.

Study Design and participants

This cross-sectional study employed convenience sampling to recruit fourth-grade students from a single public school in Xi'an, China, spanning from the Autumn semester of 2020 to the Summer semester of 2021. The primary school featured coeducational settings with 2,100 students across 42 classes. Each student in fourth grade in this school was invited to participate, while those with conditions potentially affecting the measurement of physical activity and fitness were excluded. A total of 195 fourth-grade students participated in our study. Before data collection, parental written consent and child verbal assent were secured from 195 children. Approval for all procedures was granted by the Institutional Review Board at Xi'an University of Architecture and Technology.

Anthropometrics Measures

Children’s standing height and weight were measured by the trained researcher. Children’s height was measured to the nearest 0.1 cm using a portable stadiometer (Shorr Productions, Olney, MD). Weight was measured to the nearest 0.1 kg using an electronic scale (Model 770; Seca GmbH & Co. KG, Hamburg, Germany). All anthropometric data were recorded as the average of two measurements for both height and weight. BMI (kg/m²) was calculated from the average measures of height and weight. Children's Weight Status (WS) was classified on BMI according to the Chinese National Student Physical Fitness Standard (CNSPFS, Revised 2014) [27]. For boys, classifications included normal weight (14.2–20.1), low weight (≤ 14.1), overweight (20.2–22.6), and obese (≥ 22.7). Similarly, girls were categorized into normal weight (13.7–19.4), low weight (≤ 13.6), overweight (19.5–22.0), and obese (≥ 22.1).

Assessment of Physical Fitness

Physical fitness was measured and assessed by PE teachers during PE lessons from October 10 to October 20, 2020, following the guidelines outlined in CNSPFS, as established by the Ministry of Education. The measurement consisted of six fitness indicators: vital capacity, 50m running, sit and reach, 1-minute rope skipping, 1-minute sit-ups, and 50m×8 round-trip running. Each indicator was scored 100 points. The total physical fitness score was calculated from the above fitness test indicators, considering the weighting of each indicator. The physical fitness level was then classified as follows: excellent (≥ 90 points), good (80-89.9 points), qualified (60-79.9 points), and failed (< 60 points).

Assessment of PA and SB

PA was assessed using accelerometers (ActiGraph GT3X + Activity monitors, Pensacola, Florida, USA) from the Autumn semester of 2020 to the Summer semester of 2021 (September 2020 to June 2021). PA intensity was categorized into sedentary behavior (SB), low-intensity physical activity (LPA), moderate physical activity (MPA), vigorous physical activity (VPA), and moderate-to-vigorous physical activity (MVPA). The day before the test, the accelerometer was configured with a sampling frequency of 30 Hz and an epoch of 1 second. The objective was to monitor all brief MVPAs performed by elementary school students. Evenson's thresholds were used to classify physical activity intensity, with ≥ 2296 counts per minute (CPM) for MVPA, and ≤ 100 CPM for SB [28]. Each student was provided with an accelerometer to collect PA data. The accelerometers were assigned codes corresponding to the roll book order, and it was ensured that they were worn correctly throughout the assessment period. The accelerometers were affixed to elastic belts and positioned on the right side of the waist and abdomen of the children upon arrival at the PE class, and removed just before they concluded the lesson. A researcher and a professional PE teacher were present during every PE session. The researcher observed and documented the class context, as well as verified the appropriate placement of the accelerometers on the right hip throughout the PE lesson.

Assessment of Teaching Contents

During each physical education class, a trained researcher, in a position that does not disturb the students and the teacher in class, carefully observes the content of the lesson and takes notes. We observed and documented the teaching contents of all physical education classes. A topic was documented as the lesson content if it occupied more than half of the physical education lesson. After observing all PE classes, the content was categorized into four distinct groups: indoor dance, balls, fitness training, and games to process the data.

Statistical analysis

All statistical analyses were conducted using SPSS software, version 26.0 (SPSS Inc., Chicago, Illinois, USA). Descriptive statistics, including frequencies and percentages, summarized categorical data, while means and standard deviations (SD) were utilized for continuous data presentation. The percentage of PE lessons spent in moderate-to-vigorous physical activity (%MVPA), sedentary behavior (%SB), low-intensity physical activity (%LPA), and vigorous physical activity (%VPA) was estimated based on the cut-point established by Evenson et al. [28]. Independent two-sample t-tests were employed to explore gender differences (Boys vs. Girls) in SB, LPA, and MVPA. Analysis of variance (ANOVA) was utilized to assess differences in SB, LPA, and MVPA among children with varying weight statuses and fitness levels. Additionally, a multiple linear regression model (MLR) was constructed to identify determining factors such as gender, teacher, weight status, and physical fitness level influencing children's accumulated MVPA during PE lessons. The significance level was set at 0.05 (α = 0.05).

Descriptive Characteristics

The descriptive characteristics of the study sample are detailed in Table 1. A total of 195 children, comprising 96 boys and 99 girls, with valid accelerometer data were included in the analysis. The mean height of the participants was 140.3 ± 6.73 cm, while the mean weight was 34.9 ± 7.69 kg. The majority (77.44%) of the children were in the normal weight range, with over one-fifth (20.51%) classified as overweight or obese based on BMI. Surprisingly, most (65.13%) of the children attained only a qualified level of Physical Fitness score. There were no significant differences in participant characteristics concerning height and fitness score, however, boys exhibited significantly higher weight and BMI levels compared to girls (Table 1).

Physical activity levels during physical education

Table 2 displays the average time and proportion spent in each category of PA during PE classes. Each PE lesson had a duration of 40 minutes. On average, children accumulated only 6.69 ± 4.05 minutes MVPA of each class, accounting for merely 16.73% of a single PE lesson time. Boys (18.95%) significantly accumulated more MVPA in PE than girls (14.56%). Conversely, girls (49.29%) significantly accumulated more sedentary behavior (SB) in PE than boys (42.44%). In comparison with students at failed, qualified, and good fitness levels, those at excellent fitness level exhibited significantly more MVPA and less SB in PE classes; however, the difference was not statistically significant (P ≥ 0.05). Furthermore, there was no significant difference in MVPA during PE lessons either between normal weight and low weight or overweight and obese students (data not shown). Among the four teaching contents, students at indoor dance classes exhibited significantly more sedentary behavior and less MVPA than those in balls, fitness, and games classes.

Regression Analysis for Prediction of MVPA in Physical Education

The results of the regression analyses are shown in Table 3. In terms of the boys' MVPA levels, in model 1, including teacher, fitness score, and BMI, accounted for 6.4% of the variance in physical activity. Teaching content was a significant predictor of MVPA. For girls' MVPA, teachers and teaching content were significant influencing factors. The addition of the teaching content in model 2 dramatically improved the prediction of MVPA, accounting for an additional 42.7% of the variance (Table 3).

Table 1 Characteristics of the Study Population

	Total(n=195)	Boys(n=96)	Girls(n=99)
Height(cm)	140.3(6.73)	140.6 (6.94)	140.0 ( 6.55)
Weight(Kg)	34.9 (7.69)	36.0 (8.50)^*	33.8 (6.66)
BMI(kg/m²)	17.6(2.84)	18.1(3.14)^*	17.1(2.44)
Normal	151(77.44)	74(77.08)	77(77.78)
low weight	4(2.05)	2(2.08)	2(2.02)
Overweight	30(15.38)	14(14.58)	16(16.16)
Obese	10(5.13)	6(6.25)	4(4.04)
Physical Fitness Level	76.34(7.22)	76.27(7.92)	76.41(6.51)
Excellent	4(2.05)	3(3.13)	1(1.01)
Good	60(30.77)	29(30.21)	31(3.44)
Qualified	127(65.13)	61(63.54)	66(66.67)
Failed	4(2.05)	3(3.13)	1(1.01)

Abbreviations: BMI, body mass index. Significant difference^* (p < 0.05)

Table 2 Physical activity levels during physical education

		No.	SB		LPA		MVPA
		No.	M（SD）	%PE	M（SD）	%PE	M（SD）	%PE
Total		195	18.37(5.74)	45.93	14.94(3.10)	37.35	6.69(4.05)	16.73
Genders	Boys	96	16.98(5.98)^**	42.44	15.44(2.90)^*	38.61	7.58(4.56)^**	18.95
	Girls	99	19.72(5.18)	49.29	14.46(3.22)	36.15	5.82(3.28)	14.56
Weight status	Low weight	5	24.23(3.70)	60.58	12.53(3.28)	31.33	3.23(1.58)	8.08
	Normal weight	147	18.05(5.75)	45.13	15.18(3.02)	37.95	6.77(4.15)	16.92
	Overweight	30	18.59(5.44)	46.49	14.41(3.16)	36.03	6.99(3.80)	17.49
	Obese	13	19.14(6.18)	47.85	14.45(3.52)	36.12	6.41(3.72)	16.03
Fitness level	Excellent	2	14.92(9.07)	37.29	14.67(0.00)	36.67	10.42(9.07)	26.04
	Good	60	18.86(5.77)	47.16	14.96(2.98)	37.40	6.18(4.21)	15.44
	Qualified	117	18.20(5.62)	45.49	14.91(3.19)	37.27	6.90(3.86)	17.25
	Failed	4	19.38(7.77)	48.44	14.25(5.16)	35.63	6.37(2.94)	15.94
Teaching content	Indoor Dance	80	23.17(3.42)^***	57.93	13.78(2.97)^***	34.45	3.05(1.18)^***	7.62
	Balls	40	13.38(4.60)	33.45	17.15(2.94)	42.88	9.47(4.54)	23.68
	Fitness Training	15	12.13(3.59)	30.33	16.59(2.14)	41.47	11.28(2.70)	28.19
	Games	60	16.85(3.90)	42.12	14.61(2.64)	36.53	8.54(2.13)	21.35

Abbreviations: SB, Sedentary behavior; LPA, light physical activity; MVPA, moderate-to-vigorous physical activity. Note: ^*P<0.05, ^**P<0.01, ^*** P<0.001.

Table 3 Results of Regression Analysis for Prediction of MVPA in Physical Education Among Fourth-Grades by Gender

Independent Variables	Girls				Boys
Independent Variables	β	T-value	P-value	Adjusted r²	β	T-value	P-value	Adjusted r²
Model 1
Intercept		-1.628	0.107	0.123				0.064
Teacher	0.374	3.810	<0.001		0.296	2.923	0.004
Fitness score	-0.028	-0.287	0.775		0.074	0.694	0.489
BMI	0.028	0.278	0.781		-0.045	-0.424	0.673
Model 2				0.550				0.229
Intercept		0.627	0.532
Teacher	-0.107	-1.235	0.220		-0.155	-1.147	0.254
Fitness sore	0.093	1.302	0.196		0.113	1.168	0.246
BMI	-0.029	-0.400	0.690		-0.069	-0.718	0.474
Teaching content	0.837	9.536	<0.001		0.613	4.546	<0.001

Abbreviations: BMI, body mass index; Fitness score, total physical fitness score. Significant difference* (p < 0.05)

Physical Education (PE) in schools presents a significant opportunity for promoting MVPA among children [10, 29, 30]. Globally, guidelines recommend that at least 50% of PE class time be dedicated to MVPA. However, the MVPA percentage in this study was a mere 16.73% (18.95% for boys, and 14.56% for girls), which is significantly below the recommended standard and previous research findings utilizing accelerometers [15, 31-35]. Notably, our findings indicate that MVPA accounted for only 6–7 minutes of a PE class session among Chinese fourth-grade students, which is even lower than one-sixth of the daily PA guidelines (60 minutes) and recommended MVPA levels. In a populous country like China, promoting MVPA in PE classes could help achieve PA guidelines. Exploring interventions to increase MVPA levels in Chinese PE classes could serve as a reasonable reference for other similar countries, potentially reducing the global prevalence of physical inactivity.

The key finding of this study was that teaching content accounted for a much larger fraction of the variance in MVPA for girls than for boys. After teaching content is added to the regression model, boys' %MVPA ranged from 6.4% to 22.9%, and girls' %MVPA from 12.3% to 55.0% (Table 3). This demonstrates that %MVPA in PE for girls is much more significantly influenced by the teaching content. Scholars have consistently found that girls are less likely than boys to be active in school [22, 36, 37]. However, our findings show that by carefully crafting the content of physical education classes to encourage MVPA in girls, it is possible to reduce the imbalance in PA between girls and boys. Therefore, PE classes in schools could potentially serve as a crucial "window of opportunity" for girls to be more active. It is particularly important to develop teaching content that fit the interests of girls in order to improve the MVPA level of girls in PE.

In our study, we investigate four teaching contents that include indoor dance, balls, fitness training, and games. The mean minutes of MVPA in different teaching contents varied from 3.05 to 11.28 (Table 2). Fitness training classes had the highest MVPA, which was consistent with a previous study [25]. Children at indoor dance classes had the least MVPA, probably because in these kinds of lessons, they had to learn some skills or orders in quiet, resulting in fewer MVPA. Tanaka et al. [38] also found that children in gymnastic lessons accumulated the highest time in SB. However, it has been demonstrated that improving children's skills while increasing physical activity can be accomplished simultaneously [39]. So what really matters is that teachers should carefully construct the content structure of each PE lesson to promote more PA, rather than only focusing on some kinds of teaching content.

The relationships between BMI, fitness levels and PA have been widely explored in settings besides PE classes, and researchers agree that overweight or obese children are not as active as normal-weight children [40-42], and similarly, children with poorer fitness levels have less PA than children with better fitness levels [43-45]. However, the data from this study showed that there was no statistically significant difference between the MVPA levels of overweight and obese children or those with lower fitness scores and those with normal weight or higher fitness scores. This may be attributed to elementary school PE classes providing equal opportunities for all students among different weight statuses and fitness levels. Consequently, children with lower BMI levels or fitness levels exert similar efforts to participate in MVPA to achieve teachers' requirements during PE classes as students with higher BMI levels or fitness levels. Therefore, we firmly believe that high-quality PE has the essential potential to promote MVPA equally among students regardless of their weight statuses or physical fitness levels. Encouragingly, there is a growing advocacy for schools to provide realistic and equal opportunities for children to promote participation in MVPA, thereby for educational equity.

Strengths and limitations

The exploration of teaching content as a determinant of physical activity levels in physical education primarily took place in the early 20th century, predominantly relying on observational data collection methods. Consequently, the primary strength of our present study lies in its utilization of accelerometers to quantify physical activity (PA) levels and assess the impact of various teaching contents on boys' and girls' MVPA in PE classes. By using ActiGraph GT3X accelerometers, we enabled an objective evaluation of PA and SB in children, capturing activity intensity at a 1-second interval. Moreover, the obligation of PE in China, scheduled four times weekly, presents a significant opportunity for promoting MVPA levels. However, there is a dearth of research data of PA levels and the determinants of PE classes in China. Consequently, our study holds the potential to shed light on the level and influencing factors of MVPA in PE classes within this context, thereby furnishing policymakers and researchers with comparative data to inform the design and refinement of PA interventions.

Several limitations should be acknowledged when interpreting the findings of this study. Firstly, the investigation was conducted solely within one elementary school, thus caution is warranted when generalizing the findings to other schools across China. Future research endeavors should aim to include a larger and more diverse sample comprising multiple schools to enhance the generalizability of the results. Secondly, the analysis focused exclusively on MVPA within the fourth-grade level. Expanding the scope to include a broader age range in future studies would bolster the universality of the findings. Thirdly, this study solely examined the effects of four types of teaching contents on MVPA in PE classes. Subsequent research efforts should encompass a more comprehensive array of teaching content to discern which strategies most effectively promote physical activity engagement within PE.

On average, only less than one-sixth (6.69 ± 4.05 minutes, 16.73%) of each PE lesson time was spent in MVPA. The percentage of MVPA was very low in Chinese PE classes. There were significant gender differences in %MVPA. Teaching content significantly affects the MVPA in PE classes, especially for girls. PF and BMI did not significantly affect MVPA in PE. The potential for PE to contribute to public health goals is extremely important because students of any weight status and fitness level can realize an increase in MVPA through PE classes.

Ethics approval and consent to participate

The Ethical Committee of Xi'an University of Architecture and Technology approved the study protocol. Written informed consent was obtained from all participants and their parents to participate in this study.

Consent for publication

All authors provided their consent for publication.

Availability of data and materials

The dataset supporting the conclusions of this article are currently not available in the public domain but may be shared upon request. For further information on the data and materials used in this study, please contact the corresponding author.

Competing interests

All authors have no competing interests as defined by BMC, or other interests that might be perceived to influence the results and/or discussion reported in this paper.

Funding

This work was supported by the National Social Science Foundation of China (NSFC) (grant number 20BTY072). The funder had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Authors'

MeiBing Li, Zhangzhi Qian, Chong Tian, XiaoYan Han, Haonan Guo, HaiXia Guo, HongJuan Li

Contributions

MeiBing L: data processing, drafting the initial manuscript, revision the manuscript, and final approval; ZhangZhi Q: data collecting, data cleaning, and discussed the manuscript; Chong T, XiaoYan H, and HaoNan G: discussed the manuscript with suggestions for revisions; HaiXia G: study design, supervision, revision critically, and final approval; HongJuan L: revision critically, and final approval. All authors reviewed and approved the final manuscript.

Acknowledgments

The Study team thanks all the study participants for their time and cooperation. This manuscript was supported by the National office for Philosophy and Social Science, and Xi'an University of Architecture and Technology, Xi'an, China.

Authors' information (optional)

MeiBing Li^{1 2}, Zhangzhi Qian², Chong Tian², XiaoYan Han², Haonan Guo², HaiXia Guo²(corresponding author), HongJuan Li¹(corresponding author)

1 School of Sport Science, Beijing Sport University, Beijing, China

2 School of Physical Education, Xi'an University of Architecture and Technology, Xi'an, China

Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT: Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet 2012, 380(9838):219-229.
Organization WH: WHO Guidelines Approved by the Guidelines Review Committee. In: WHO Guidelines on Physical Activity and Sedentary Behaviour. edn. Geneva: World Health Organization © World Health Organization 2020.; 2020.
Liu Y, Tang Y, Cao ZB, Zhuang J, Zhu Z, Wu XP, Wang LJ, Cai YJ, Zhang JL, Chen PJ: Results From China's 2018 Report Card on Physical Activity for Children and Youth. J Phys Act Health 2018, 15(S2):S333-s334.
Liu Y, Ke Y, Liang Y, Zhu Z, Cao Z, Zhuang J, Cai Y, Wang L, Chen P, Tang Y: Results from the China 2022 report card on physical activity for children and adolescents. J Exerc Sci Fit 2023, 21(1):1-5.
Paulo MS, Nauman J, Abdulle A, Aljunaibi A, Alzaabi M, Barakat-Haddad C, Sheek-Hussein M, Shah SM, Yousufzai S, Loney T: Results From the United Arab Emirates' 2018 Report Card on Physical Activity for Children and Youth. J Phys Act Health 2018, 15(S2):S419-s421.
Guthold R, Stevens GA, Riley LM, Bull FC: Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants. Lancet Child Adolesc Health 2020, 4(1):23-35.
Reis RS, Salvo D, Ogilvie D, Lambert EV, Goenka S, Brownson RC: Scaling up physical activity interventions worldwide: stepping up to larger and smarter approaches to get people moving. The Lancet 2016, 388(10051):1337-1348.
Ekelund U, Brown WJ, Steene-Johannessen J, Fagerland MW, Owen N, Powell KE, Bauman AE, Lee IM: Do the associations of sedentary behaviour with cardiovascular disease mortality and cancer mortality differ by physical activity level? A systematic review and harmonised meta-analysis of data from 850 060 participants. British Journal of Sports Medicine 2019, 53(14):886-894.
Martin AS, D. H. Shenkin, S. D. Sproule, J.: Lifestyle intervention for improving school achievement in overweight or obese children and adolescents. Cochrane Database Syst Rev 2014(3):Cd009728.
Gu X, Solmon M: Motivational processes in children's physical activity and health-related quality of life. Physical Education and Sport Pedagogy 2015, 21:1-18.
Kobel S, Kettner S, Lämmle C, Steinacker JM: Physical activity of German children during different segments of the school day. Z Gesundh Wiss 2017, 25(1):29-35.
Physical activity [ https://www.who.int/news-room/fact-sheets/detail/physical-activity]
Strategies to improve the quality of physical education
Health Position Paper [http://www.afpe.org.uk/physical-education/wp-content/uploads/ afPE_Health_Position_Paper_WebVersion.pdf]
Cheval B, Courvoisier DS, Chanal J: Developmental trajectories of physical activity during elementary school physical education. Prev Med 2016, 87:170-174.
Erwin H, Stellino M, Beets M, Beighle A, Johnson C: Physical Education Lesson Content and Teacher Style and Elementary Students' Motivation and Physical Activity Levels. Journal of Teaching in Physical Education 2013, 32:321-334.
Wood C, Hall K: Physical education or playtime: which is more effective at promoting physical activity in primary school children? BMC Research Notes 2015, 8:1-5.
Liu Y, Tang Y, Cao Z-B, Chen P-J, Zhang J-L, Zhu Z, Zhuang J, Yang Y, Hu Y-Y: Results From Shanghai’s (China) 2016 Report Card on Physical Activity for Children and Youth. Journal of Physical Activity and Health 2016, 13(s2):S124-S128.
Ajja R, Wikkeling-Scott LF, Brazendale K, Hijazi R, Abdulle A: Accelerometer measured physical activity patterns of children during segmented school day in Abu Dhabi. BMC Pediatr 2021, 21(1):182.
Fröberg A, Raustorp A, Pagels P, Larsson C, Boldemann C: Levels of physical activity during physical education lessons in Sweden. Acta Paediatr 2017, 106(1):135-141.
Waring M, Warburton P, Coy M: Observation of children's physical activity levels in primary school: Is the school an ideal setting for meeting government activity targets? Eur Phys Educ Rev 2007, 13(1).
da Costa BGG, da Silva KS, da Silva JA, Minatto G, de Lima LRA, Petroski EL: Sociodemographic, biological, and psychosocial correlates of light- and moderate-to-vigorous-intensity physical activity during school time, recesses, and physical education classes. J Sport Health Sci 2019, 8(2):177-182.
Barnett LM, van Beurden E, Zask A, Brooks LO, Dietrich UC: How active are rural children in Australian physical education? J Sci Med Sport 2002, 5(3):253-265.
Skala KA, Springer AE, Sharma SV, Hoelscher DM, Kelder SH: Environmental characteristics and student physical activity in PE class: findings from two large urban areas of Texas. J Phys Act Health 2012, 9(4):481-491.
McKenzie TL, Marshall SJ, Sallis JF, Conway TL: Student activity levels, lesson context, and teacher behavior during middle school physical education. Res Q Exerc Sport 2000, 71(3):249-259.
Fairclough SJ, Stratton G: A Review of Physical Activity Levels during Elementary School Physical Education. Journal of Teaching in Physical Education 2006, 25(2):240-258.
National Physical Fitness Standards for Students (2014 Revision) [http://www.moe.gov.cn/s78/A17/twys_left/moe_938/moe_792/s3273/201407/t20140708_171692.html]
Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG: Calibration of two objective measures of physical activity for children. J Sports Sci 2008, 26(14):1557-1565.
Gu X, Solmon MA: Motivational processes in children's physical activity and health-related quality of life. Physical Education and Sport Pedagogy 2016, 21(4):407-424.
Lijuan Wang YZ: A Systematic Review of Correlates of the Moderate-to-Vigorous Physical Activity of Students in Elementary School Physical Education. J Teac Phys Educ 2023, 42:44-59.
Mooses K, Pihu M, Riso EM, Hannus A, Kaasik P, Kull M: Physical Education Increases Daily Moderate to Vigorous Physical Activity and Reduces Sedentary Time. J Sch Health 2017, 87(8):602-607.
Kirkham-King M, Brusseau TA, Hannon JC, Castelli DM, Hilton K, Burns RD: Elementary physical education: A focus on fitness activities and smaller class sizes are associated with higher levels of physical activity. Prev Med Rep 2017, 8:135-139.
Volmut T, Simunic B: THE QUANTITY AND INTENSITY OF PHYSICAL ACTIVITY DURING PHYSICAL EDUCATION IN 3 RD GRADE PRIMARY SCHOOL CHILDREN. Annales Kinesiologiae 2014, 5.
N. Ruch KS, S. Kriemler, U. Mäder: <Correlates of children’s physical activity during physical education classes.pdf>. Sportmedizin und Sporttraumatologie 2012.
Gråstén A, Yli-Piipari S, Huhtiniemi M, Salin K, Seppälä S, Lahti J, Hakonen H, Jaakkola T: Predicting accelerometer-based physical activity in physical education and total physical activity: The Self-determination Theory approach. J Hum Sport Exerc 2019, 14:757-771. .
Zimmo L, Almudahka F, Ibrahim I, Al-kuwari MG, Farooq A: Moderate to Vigorous Physical Activity During Physical Education, Recess, and Class Time Among Elementary School Children in Qatar. Journal of Teaching in Physical Education 2020, 39(1):1-8.
Decelis A: Physical activity, screen time and obesity status in a nationally representative sample of Maltese youth with international comparisons. BMC Public Health 2014, 14:664.
Tanaka C, Tanaka M, Tanaka S: Objectively evaluated physical activity and sedentary time in primary school children by gender, grade and types of physical education lessons. BMC Public Health 2018, 18(1).
Paulo MS, Nauman J, Abdulle A, Aljunaibi A, Alzaabi M, Barakat-Haddad C, Sheek-Hussein M, Shah SM, Yousufzai S, Loney T: Results From the United Arab Emirates’ 2018 Report Card on Physical Activity for Children and Youth. Journal of Physical Activity and Health 2018, 15(s2):S419-S421.
Ekstedt M, Nyberg G, Ingre M, Ekblom Ö, Marcus C: Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study. Int J Behav Nutr Phys Act 2013, 10:82.
Kolunsarka I, Gråsten A, Huhtiniemi M, Jaakkola T: Development of Children's Actual and Perceived Motor Competence, Cardiorespiratory Fitness, Physical Activity, and BMI. Med Sci Sports Exerc 2021, 53(12):2653-2660.
Rodrigues LP, Stodden DF, Lopes VP: Developmental pathways of change in fitness and motor competence are related to overweight and obesity status at the end of primary school. J Sci Med Sport 2016, 19(1):87-92.
Galavíz KI, Tremblay MS, Colley R, Jáuregui E, López y Taylor J, Janssen I: Associations between physical activity, cardiorespiratory fitness, and obesity in Mexican children. Salud Publica Mex 2012, 54(5):463-469.
Ruiz JR, Rizzo NS, Hurtig-Wennlöf A, Ortega FB, Wärnberg J, Sjöström M: Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study. Am J Clin Nutr 2006, 84(2):299-303.
Kaioglou V, Dania A, Kambas A, Venetsanou F: Associations of Motor Competence, Cardiorespiratory Fitness, and Physical Activity: The Mediating Role of Cardiorespiratory Fitness. Res Q Exerc Sport 2023, 94(2):361-367.

No competing interests reported.

Accelerometry-measured Physical Activity and Determinants in PE classes of Fourth-Grade Primary school students in China

Status:

Version 1

Abstract

Purpose

Methods

Results

Conclusion

Introduction

Methods

Study Design and participants

Anthropometrics Measures

Assessment of Physical Fitness

Assessment of PA and SB

Assessment of Teaching Contents

Statistical analysis

Results

Descriptive Characteristics

Physical activity levels during physical education

Regression Analysis for Prediction of MVPA in Physical Education

Discussion

Strengths and limitations

Conclusion

Declarations

Ethics approval and consent to participate

Consent for publication

Availability of data and materials

Competing interests

Funding

Authors'

Contributions

Acknowledgments

Authors' information (optional)

References

Additional Declarations

Status:

Version 1