Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trial

Abstract Background This cluster‐randomized trial examined the effects of active breaks (AB) and physically active lessons (PAL) on cognitive function and health indicators in elementary school children. Methods Six schools were randomly assigned to three groups: AB group (n = 61), PAL group (n = 77...

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Main Authors: João Carlos N. Melo, Julian Tejada, Ellen Caroline M. Silva, José Ywgne, David N. Oliveira, Larissa Gandarela, Danilo R. Silva
Format: Article
Language:English
Published: BMC 2025-07-01
Series:International Journal of Behavioral Nutrition and Physical Activity
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Online Access:https://doi.org/10.1186/s12966-025-01789-6
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author João Carlos N. Melo
Julian Tejada
Ellen Caroline M. Silva
José Ywgne
David N. Oliveira
Larissa Gandarela
Danilo R. Silva
author_facet João Carlos N. Melo
Julian Tejada
Ellen Caroline M. Silva
José Ywgne
David N. Oliveira
Larissa Gandarela
Danilo R. Silva
author_sort João Carlos N. Melo
collection DOAJ
description Abstract Background This cluster‐randomized trial examined the effects of active breaks (AB) and physically active lessons (PAL) on cognitive function and health indicators in elementary school children. Methods Six schools were randomly assigned to three groups: AB group (n = 61), PAL group (n = 77), and a control group (CTL, n = 46). First-year elementary school students participated (6.9 ± 0.6 years; 52.7% girls), and the interventions lasted eight weeks. Cognitive function was measured via reaction time and correct responses on computerized tests (Go/NoGo, DigitSpan, Mental Rotation, Visual Search, and Cueing Posner). Secondary outcomes included physical activity, quality of life, daytime sleepiness, and school perception. Results Significant group-by-time interactions were found in four tests: Go/NoGo (reaction time: p = 0.045), DigitSpan (correct responses: p = 0.020), Mental Rotation (reaction time: p = 0.049), and Cueing Posner (reaction time: p = 0.017). Only the PAL group presented a reduction in reaction time in inhibitory control (Go/NoGo) (change from baseline [Δ] = -106.4 ms; p < 0.001; d = 0.50), with a greater reduction than the AB group (difference-in-differences [DiD] = -107.3 ms; p = 0.019; d = 0.47). Short-term memory (Digit Span) improved only in the PAL group (Δ =  + 0.6; p < 0.001; d = 0.44), with larger gains than the CTL group (DiD =  + 0.7; p = 0.024; d = 0.54) and AB group (DiD =  + 0.7; p = 0.010; d = 0.49). Spatial reasoning (Mental Rotation) improved in both the PAL (Δ = -1967.5 ms; p < 0.001; d = 0.72) and AB groups (Δ = -1477.8 ms; p < 0.001; d = 0.54), but only the PAL group showed a greater change than the CTL group (DiD = -1394.0 ms; p = 0.012; d = 0.54). Spatial orientation (Posner Cueing) improved in all groups (PAL group: Δ = -386.6 ms; p < 0.001; d = 0.68; CTL group: Δ = -183.8 ms; p = 0.024; d = 0.29; AB group: Δ = -158.4 ms; p = 0.007; d = 0.36), with the PAL group presenting greater reductions than the CTL (DiD = -202.8 ms; p = 0.045; d = 0.33) and AB groups (DiD = -228.2 ms; p = 0.007; d = 0.45). Conclusions Physically active lessons enhanced various cognitive functions, while active breaks, although less impactful, also represent a beneficial strategy. Trial registration Brazilian Clinical Trials Registry (REBEC trial: RBR-10zxwdrh, retrospectively registered on 2025-01-09, https://ensaiosclinicos.gov.br/rg/RBR-10zxwdrh ).
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spelling doaj-art-db50a31d7c6a4dbca540a265a99b9d122025-08-20T03:06:05ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682025-07-0122111810.1186/s12966-025-01789-6Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trialJoão Carlos N. Melo0Julian Tejada1Ellen Caroline M. Silva2José Ywgne3David N. Oliveira4Larissa Gandarela5Danilo R. Silva6Graduate Program in Health Sciences, Universidade Estadual de Londrina (UEL)Department of Phychology, Universidade Federal de Sergipe (UFS)Graduate Program in Health Sciences, Universidade Estadual de Londrina (UEL)Graduate Program in Health Sciences, Universidade Federal de Sergipe (UFS)Graduate Program in Movement Sciences, Universidade Federal de Sergipe (UFS)Graduate Program in Health Sciences, Universidade Federal de Sergipe (UFS)Department of Physical Education, Universidade Federal de Sergipe (UFS)Abstract Background This cluster‐randomized trial examined the effects of active breaks (AB) and physically active lessons (PAL) on cognitive function and health indicators in elementary school children. Methods Six schools were randomly assigned to three groups: AB group (n = 61), PAL group (n = 77), and a control group (CTL, n = 46). First-year elementary school students participated (6.9 ± 0.6 years; 52.7% girls), and the interventions lasted eight weeks. Cognitive function was measured via reaction time and correct responses on computerized tests (Go/NoGo, DigitSpan, Mental Rotation, Visual Search, and Cueing Posner). Secondary outcomes included physical activity, quality of life, daytime sleepiness, and school perception. Results Significant group-by-time interactions were found in four tests: Go/NoGo (reaction time: p = 0.045), DigitSpan (correct responses: p = 0.020), Mental Rotation (reaction time: p = 0.049), and Cueing Posner (reaction time: p = 0.017). Only the PAL group presented a reduction in reaction time in inhibitory control (Go/NoGo) (change from baseline [Δ] = -106.4 ms; p < 0.001; d = 0.50), with a greater reduction than the AB group (difference-in-differences [DiD] = -107.3 ms; p = 0.019; d = 0.47). Short-term memory (Digit Span) improved only in the PAL group (Δ =  + 0.6; p < 0.001; d = 0.44), with larger gains than the CTL group (DiD =  + 0.7; p = 0.024; d = 0.54) and AB group (DiD =  + 0.7; p = 0.010; d = 0.49). Spatial reasoning (Mental Rotation) improved in both the PAL (Δ = -1967.5 ms; p < 0.001; d = 0.72) and AB groups (Δ = -1477.8 ms; p < 0.001; d = 0.54), but only the PAL group showed a greater change than the CTL group (DiD = -1394.0 ms; p = 0.012; d = 0.54). Spatial orientation (Posner Cueing) improved in all groups (PAL group: Δ = -386.6 ms; p < 0.001; d = 0.68; CTL group: Δ = -183.8 ms; p = 0.024; d = 0.29; AB group: Δ = -158.4 ms; p = 0.007; d = 0.36), with the PAL group presenting greater reductions than the CTL (DiD = -202.8 ms; p = 0.045; d = 0.33) and AB groups (DiD = -228.2 ms; p = 0.007; d = 0.45). Conclusions Physically active lessons enhanced various cognitive functions, while active breaks, although less impactful, also represent a beneficial strategy. Trial registration Brazilian Clinical Trials Registry (REBEC trial: RBR-10zxwdrh, retrospectively registered on 2025-01-09, https://ensaiosclinicos.gov.br/rg/RBR-10zxwdrh ).https://doi.org/10.1186/s12966-025-01789-6Physically Active LearningExecutive FunctionHealth IndicatorClassroom Physical Activity
spellingShingle João Carlos N. Melo
Julian Tejada
Ellen Caroline M. Silva
José Ywgne
David N. Oliveira
Larissa Gandarela
Danilo R. Silva
Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trial
International Journal of Behavioral Nutrition and Physical Activity
Physically Active Learning
Executive Function
Health Indicator
Classroom Physical Activity
title Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trial
title_full Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trial
title_fullStr Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trial
title_full_unstemmed Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trial
title_short Effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children: a cluster randomized trial
title_sort effects of physically active lessons and active breaks on cognitive performance and health indicators in elementary school children a cluster randomized trial
topic Physically Active Learning
Executive Function
Health Indicator
Classroom Physical Activity
url https://doi.org/10.1186/s12966-025-01789-6
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