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Table 7 Summary of results for fitness indicators organized by study design

From: School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review

No. of participants (No. of studies)

Design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other

Absolute effect

Quality

4211 (6)

[37, 49,50,51, 124, 125]

Clustered RCT

No serious risk of bias

No serious risk of inconsistency

Very serious risk of indirectnessa

No serious risk of imprecision

None

Overall:

 • 3/6 studies reported null findings

 • 1/6 studies reported more sedentary behaviour unfavourable for health

 • 2/6 studies reported mixed findings

  • 1: More sedentary behaviour favourable, null, and unfavourable for health

  • 1: More sedentary behaviour null and unfavourable for health

Active breaks:

 • 1/1 studies reported mixed findingsb

  • 1: More sedentary behaviour null and unfavourable for health [124]

Additional PA:

 • 2/4 studies reported null findings [37, 50]

 • 1/4 studies reported more sedentary behaviour unfavourable for health [49]

 • 1/4 studies reported mixed findingsc

  • 1: More sedentary behaviour favourable, null, and unfavourable for health [125]

Recess/PE:

 • 1/1 studies reported null findings [51]

Low

487 (2)

[56, 126]

Non-Randomised Intervention

No serious risk of bias

No serious risk of inconsistency

Serious risk of indirectnessd

No serious risk of imprecision

None

Active breaks:

 • 2/2 studies reported more sedentary behaviour unfavourable for health [56, 126]

Very Low

526,998e (5)

[60, 62, 71, 92, 127]

Cross-sectional

Serious risk of biasf

No serious risk of inconsistency

Serious risk of indirectnesse

No serious risk of imprecision

None

Overall:

 • 4/5 studies reported null findings

 • 1/5 studies reported more sedentary behaviour unfavourable for health

Active breaks:

 • 1/1 studies reported null findings [60]

Additional PA:

 • 1/1 studies reported null findings [60]

Homework:

 • 2/2 studies reported null findings [62, 92]

Recess/PE:

 • 1/1 studies reported null findings [60]

Sedentary time:

 • 1/2 studies reported null findings [127]

 • 1/2 studies reported more sedentary behaviour unfavourable for health [71]

Very Low

  1. Mean age at baseline ranged from 8.4 to 14.9 years; when mean age was not reported age or grade range minimums were 7.0 years and grade 1 and range maximums were 13.0 years and grade 5. Study designs included clustered RCT and non-randomized intervention with up to 4 years follow-up, and cross-sectional. Fitness indicators were assessed objectively for aerobic fitness (20 m Shuttle run, Andersen test, FitnessGram Progressive Aerobic Cardiovascular Endurance Run (PACER), FitnessGram Test, and Resting HR), balance (four rotations while standing on upside down stool), composite physical fitness score (vital capacity, standing long jump, 50 m run, flexibility, sit-up [for girls] or pull-up [for boys], and 800 m [for girls] or 1000 m [for boys] run tests, were performed according to the Chinese National Student Physical Fitness Standard [CNSPFS] battery), coordination (ball bouncing, and running to cones aligned with a number the administrator yells out), locomotor gross motor skills (TGMD-3), max running duration (modified Bruce protocol for children, portable spirometry system), maximum power (modified Bruce protocol for children, portable spirometry system), motor quotient (Body Coordination Test: Balancing backwards, one-legged obstacle jumping, lateral jumping, and sideways movements), motor skill composite score (catching with one hand, throwing at a wall target, and shuttle run [10 × 5 m]), muscular endurance (sit-ups), muscular power (standing broad jump, and standing long jump), muscular strength (handgrip strength, push-up [from knees], push-up [regular]), object control gross motor skills (TGMD-3), relative power (modified Bruce protocol for children, portable spirometry system), total gross motor skills (TGMD-3), and VO2 peak (modified Bruce protocol for children, portable spirometry system)
  2. a 4/6 studies did not report a school-related sedentary exposure, 1/6 studies found no intervention effect on school-related sedentary behaviours, and 1/6 studies found an intervention effect for one of the intervention arms (educational PA decreased school-related sedentary, recreational PA increased school-related sedentary)
  3. b 1: Null and unfavourable [1: unfavourable for muscular power (standing long jump and push-ups), but null for coordination (ball bouncing, and running to cones aligned with a number the administrator yells out) and balance (four rotations while standing on upside down stool) outcomes [124]]
  4. c 1: Favourable, null, and unfavourable [Favourable for girls hand grip strength, and for both genders (pooled) when compared to the educational PA intervention, cardiorespiratory fitness for girls and pooled sample when compared to recreational PA intervention; unfavourable for boys and pooled for cardiorespiratory fitness and sit-ups when compared to the educational PA intervention, and standing broad jump for girls when compared to the educational PA intervention; Null for all other outcome (cardio, handgrip, sit-ups, broad jump), genders (boys, girls, pooled), and intervention group comparisons (educational or recreational PA interventions) [125]]
  5. d 1/2 studies found an intervention effect on school-related sedentary exposures, 1/2 studies did not report a school-related sedentary exposures
  6. e 1 study sampled 905 schools and approximated sample size based on teachers estimates (~ 524,600)
  7. f 2/5 studies appeared to use convenience sampling to recruit participants
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International Journal of Behavioral Nutrition and Physical Activity

ISSN: 1479-5868

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