Longitudinal Effects of School-Based Physical Activity on BMI, Motor Skill Development, and Sleep Quality in Elementary School Children
DOI:
https://doi.org/10.53905/inspiree.v7i01.165Keywords:
physical activity, body mass index, motor skills, sleep quality, elementary school children, longitudinal study, health promotionAbstract
The purpose of the study. Childhood obesity and physical inactivity represent significant public health challenges affecting multiple dimensions of child health and development, including body mass index (BMI), motor competence, and sleep quality. This longitudinal study examined the effects of a 12-week school-based physical activity (PA) intervention on BMI, motor skill development, and sleep quality in elementary school children, with a one-year follow-up assessment.
Materials and methods. A controlled longitudinal design was employed with 143 elementary school children (grades 4–5; M = 10.3 years; SD = 0.8; 48% female) recruited from 6 primary schools. The intervention group (n = 73) participated in an enhanced PA program (additional 120 minutes per week of structured physical activity) for 12 weeks, while the control group (n = 70) maintained regular school curriculum. BMI, motor skill performance (50-meter run, jump rope, sit-and-reach, 1-minute sit-ups), moderate-to-vigorous physical activity (MVPA), and sleep quality (Pittsburgh Sleep Quality Index for children) were assessed at baseline, 12 weeks, and 12 months post-intervention.
Results. Repeated-measures ANOVA revealed statistically significant group × time interactions for BMI (F(2, 141) = 18.44, p < 0.001, η² = 0.21), motor skill performance (F(2, 141) = 22.67, p < 0.001, η² = 0.24), and sleep quality (F(2, 141) = 15.32, p < 0.001, η² = 0.18). The intervention group demonstrated a significant BMI reduction (−0.8 kg/m²; p < 0.001), improved motor skills (+19% on composite score; p < 0.001), increased MVPA (+41 minutes/day; p < 0.001), and enhanced sleep quality (+1.8 hours; p = 0.002). Benefits persisted at 12-month follow-up with partial effect maintenance.
Conclusions. School-based physical activity interventions of 120 minutes weekly demonstrate significant and sustained positive effects on BMI, motor skill development, and sleep quality in elementary school children. These findings support the implementation of integrated PA programs as an evidence-based strategy for comprehensive child health promotion and obesity prevention.
References
Acevedo, A. R., Story, D., Werner, L., Barker, D., McGeary, J. E., Dunsiger, S., & Grigsby‐Toussaint, D. S. (2025). Associations between objectively and subjectively measured sleep outcomes among elementary school children in Rhode Island. Frontiers in Pediatrics, 13. https://doi.org/10.3389/fped.2025.1622943
Arthur, W., Day, E. A., Villado, A. J., Boatman, P. R., Kowollik, V., Bennett, W., & Bhupatkar, A. (2007). Decay, Transfer, and the Reacquisition of a Complex Skill: An Investigation of Practice Schedules, Observational Rehearsal, and Individual Differences. https://apps.dtic.mil/sti/pdfs/ADA482766.pdf
Astill, R. G., Heijden, K. B. van der, IJzendoorn, M. H. van, & Someren, E. J. W. V. (2012). Sleep, cognition, and behavioral problems in school-age children: A century of research meta-analyzed. [Review of Sleep, cognition, and behavioral problems in school-age children: A century of research meta-analyzed.]. Psychological Bulletin, 138(6), 1109. American Psychological Association. https://doi.org/10.1037/a0028204
Bardid, F., Utesch, T., Stodden, D. F., & Lenoir, M. (2021). Developmental perspectives on motor competence and physical fitness in youth. Scandinavian Journal of Medicine and Science in Sports, 31, 5. https://doi.org/10.1111/sms.13946
Bloch, M., Cordovil, R., Rodrigues, L. P., Martins, C., Braga, M. M., Vale, S., Proença, R., Brito, J., Guilherme, J., Neto, C., Seabra, A., & Costa, J. A. (2025). The impact of a school-based physical activity program on children’s movement behaviors, aerobic fitness and motor competence: a follow up study. Frontiers in Sports and Active Living, 7, 1541862. https://doi.org/10.3389/fspor.2025.1541862
Buman, M. P., & King, Abby C. (2010). Exercise as a Treatment to Enhance Sleep. American Journal of Lifestyle Medicine, 4(6), 500. https://doi.org/10.1177/1559827610375532
Button, A. M., Webster, E. K., Kracht, C. L., Hendrick, C., Okely, A. D., Chong, K. H., Cross, P., & Staiano, A. E. (2023). Validation of remote assessment of preschool children’s anthropometrics and motor skills. Frontiers in Digital Health, 5. https://doi.org/10.3389/fdgth.2023.1168618
Chaput, J., Willumsen, J., Bull, F., Chou, R., Ekelund, U., Firth, J., Jago, R., Ortega, F. B., & Katzmarzyk, P. T. (2020). 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: summary of the evidence [Review of 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: summary of the evidence]. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 141. BioMed Central. https://doi.org/10.1186/s12966-020-01037-z
Christiansen, L., Larsen, M. N., Madsen, M. A. J., Grey, M. J., Nielsen, J. B., & Lundbye‐Jensen, J. (2020). Long-term motor skill training with individually adjusted progressive difficulty enhances learning and promotes corticospinal plasticity. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-72139-8
Combs, K. M., Drewelow, K. M., Lain, M. A., Habesland, M. S., Ippolito, A., & Finigan‐Carr, N. (2022). Sustainment of an Evidence-Based, Behavioral Health Curriculum in Schools. Prevention Science, 24(3), 541. https://doi.org/10.1007/s11121-022-01454-5
Cools, W., Martelaer, K. D., Samaey, C., & Andries, C. (2009). Movement skill assessment of typically developing preschool children: a review of seven movement skill assessment tools. [Review of Movement skill assessment of typically developing preschool children: a review of seven movement skill assessment tools.]. PubMed, 8(2), 154. National Institutes of Health. https://pubmed.ncbi.nlm.nih.gov/24149522
Coppens, E., Rommers, N., Bardid, F., Deconinck, F., Martelaer, K. D., D’Hondt, E., & Lenoir, M. (2020). Long‐term effectiveness of a fundamental motor skill intervention in Belgian children: A 6‐year follow‐up. Scandinavian Journal of Medicine and Science in Sports, 31, 23. https://doi.org/10.1111/sms.13898
Demetriou, Y., Gillison, F., & McKenzie, T. L. (2017). After-School Physical Activity Interventions on Child and Adolescent Physical Activity and Health: A Review of Reviews [Review of After-School Physical Activity Interventions on Child and Adolescent Physical Activity and Health: A Review of Reviews]. Advances in Physical Education, 7(2), 191. Scientific Research Publishing. https://doi.org/10.4236/ape.2017.72017
Dhuli, K., Naureen, Z., Medori, M. C., Fioretti, F., Caruso, P., Perrone, M. A., Nodari, S., Manganotti, P., Xhufi, S., Bushati, M., Bozo, D., Connelly, S. T., Herbst, K. L., & Bertelli, M. (2022). Physical activity for health. https://doi.org/10.15167/2421-4248/jpmh2022.63.2S3.2756
Dobbins, M., Husson, H., DeCorby, K., & LaRocca, R. L. (2013). School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18 [Review of School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18]. Cochrane Library. Elsevier BV. https://doi.org/10.1002/14651858.cd007651.pub2
Dumpa, V., & Bhandari, V. (2021). Non-Invasive Ventilatory Strategies to Decrease Bronchopulmonary Dysplasia—Where Are We in 2021? Children, 8(2), 132. https://doi.org/10.3390/children8020132
Ekstedt, M., Nyberg, G., Ingre, M., Ekblom, Ö., & Marcus, C. (2013). Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 10(1), 82. https://doi.org/10.1186/1479-5868-10-82
Grydeland, M., Bjelland, M., Anderssen, S. A., Klepp, K., Bergh, I. H., Andersen, L. F., Ommundsen, Y., & Lien, N. (2013). Effects of a 20-month cluster randomised controlled school-based intervention trial on BMI of school-aged boys and girls: the HEIA study. British Journal of Sports Medicine, 48(9), 768. https://doi.org/10.1136/bjsports-2013-092284
Huang, G., Yao, J., Deng, L., Huang, P., Hong, P., & Li, X. (2025). Effects of a structured after-school physical activity program on physical fitness, body composition, and sleep in primary school students: a pilot quasi-experimental study. BMC Public Health, 26(1), 123. https://doi.org/10.1186/s12889-025-25843-x
Ibri, L., & Çupi, B. (2025). Investigating Parental Attitudes and Perspectives on the Importance of Physical Activity in Early Childhood Education. Journal Human Research in Rehabilitation, 15(2), 287. https://doi.org/10.21554/hrr.092504
Kao, H.-F., Lin, C.-F., Lin, I.-T., Hung, Y.-C., Chang, T., & Ho, C.-C. (2025). Improved Sleep Quality and Sleep Duration After an 8-Week Exergaming Intervention for Exercise Training Among Elementary Schoolchildren in Taiwan. Children, 12(2), 180. https://doi.org/10.3390/children12020180
Kelly, A. S., Fox, C. K., Rudser, K. D., Gross, A. C., & Ryder, J. R. (2016). Pediatric obesity pharmacotherapy: current state of the field, review of the literature and clinical trial considerations. International Journal of Obesity, 40(7), 1043. https://doi.org/10.1038/ijo.2016.69
Kerr, J. A., Patton, G., Cini, K., Abate, Y. H., Abbas, N., Magied, A. H. A. A. A., ElHafeez, S. A., Abd‐Elsalam, S., Abdollahi, A., Abdoun, M., Abdulah, D. M., Abdulkader, R. S., Abdullahi, A., Abeywickrama, H. M., Abie, A., Abiodun, O., Abohashem, S., Abtahi, D., Abualruz, H., … Alvis‐Guzmán, N. (2025). Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021. The Lancet, 405(10481), 785. https://doi.org/10.1016/s0140-6736(25)00397-6
Key Global Organizations. (2020). In Palgrave Macmillan UK eBooks (p. 3). Palgrave Macmillan. https://doi.org/10.1057/978-1-349-95940-2_1
Korkutata, A., Korkutata, M., & Lazarus, M. (2025). The impact of exercise on sleep and sleep disorders. Deleted Journal, 2(1). https://doi.org/10.1038/s44323-024-00018-w
Kouros, C. D., & El‐Sheikh, M. (2016). Within‐Family Relations in Objective Sleep Duration, Quality, and Schedule. Child Development, 88(6), 1983. https://doi.org/10.1111/cdev.12667
Levesque, R. J. R. (2017). Obesity and Overweight (p. 1). https://doi.org/10.1007/978-3-319-32132-5_447-2
Lorås, H. (2020). The Effects of Physical Education on Motor Competence in Children and Adolescents: A Systematic Review and Meta-Analysis [Review of The Effects of Physical Education on Motor Competence in Children and Adolescents: A Systematic Review and Meta-Analysis]. Sports, 8(6), 88. Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/sports8060088
Mariano, M. A., Tang, K., Kurtz, M. M., & Kates, W. R. (2016). Examining the durability of a hybrid, remote and computer‐based cognitive remediation intervention for adolescents with 22q11.2 deletion syndrome. Early Intervention in Psychiatry, 12(4), 686. https://doi.org/10.1111/eip.12367
Maślak, A., Kusz, M., Pawluczuk, P., Alzubedi, A., & Polski, P. (2020). Causes of overweight and obesity in children and adolescents. Journal of Education Health and Sport, 10(5), 11. https://doi.org/10.12775/jehs.2020.10.05.001
Meester, A. D., Stodden, D. F., Brian, A., True, L., Cardon, G., Tallir, I., & Haerens, L. (2016). Associations among Elementary School Children’s Actual Motor Competence, Perceived Motor Competence, Physical Activity and BMI: A Cross-Sectional Study. PLoS ONE, 11(10). https://doi.org/10.1371/journal.pone.0164600
Min, H. J., Park, S. H., Lee, S., Lee, B.-H., Kang, M.-K., Kwon, M. J., Chang, M. J., Negi, L. T., Samphel, T., & Won, S. (2024). Building Resilience and Social–Emotional Competencies in Elementary School Students through a Short-Term Intervention Program Based on the SEE Learning Curriculum. Behavioral Sciences, 14(6), 458. https://doi.org/10.3390/bs14060458
Mitchell, J. J., Bu, F., Fancourt, D., Steptoe, A., & Bone, J. K. (2022). Longitudinal associations between physical activity and other health behaviours during the COVID-19 pandemic: A fixed effects analysis. Research Square (Research Square). https://doi.org/10.21203/rs.3.rs-1807928/v1
Moon, J., Webster, C. A., Stodden, D. F., Brian, A., Mulvey, K. L., Beets, M. W., Egan, C. A., McIntosh, L. I. F., Merica, C. B., & Russ, L. (2024). Systematic review and meta-analysis of physical activity interventions to increase elementary children’s motor competence: a comprehensive school physical activity program perspective [Review of Systematic review and meta-analysis of physical activity interventions to increase elementary children’s motor competence: a comprehensive school physical activity program perspective]. BMC Public Health, 24(1). BioMed Central. https://doi.org/10.1186/s12889-024-18145-1
Nilsen, A. K. O., Anderssen, S. A., Johannessen, K., Aadland, K. N., Ylvisaaker, E., Loftesnes, J. M., & Aadland, E. (2020). Bi-directional prospective associations between objectively measured physical activity and fundamental motor skills in children: a two-year follow-up. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 1. https://doi.org/10.1186/s12966-019-0902-6
Reilly, J. J., Kelly, L. A., Montgomery, C., Williamson, A., Fisher, A., McColl, J. H., Conte, R. L., Paton, J. Y., & Grant, S. (2006). Physical activity to prevent obesity in young children: cluster randomised controlled trial. BMJ, 333(7577), 1041. https://doi.org/10.1136/bmj.38979.623773.55
Sanyaolu, A., Okorie, C., Qi, X., Locke, J. A., & Rehman, S. (2019). Childhood and Adolescent Obesity in the United States: A Public Health Concern. Global Pediatric Health, 6. https://doi.org/10.1177/2333794x19891305
Singh, A. (2012). Physical Activity and Performance at School [Review of Physical Activity and Performance at School]. Archives of Pediatrics and Adolescent Medicine, 166(1), 49. American Medical Association. https://doi.org/10.1001/archpediatrics.2011.716
Soorya, L., Siper, P. M., Beck, T., Soffes, S., Halpern, D., Gorenstein, M., Kolevzon, A. lexander, Buxbaum, J. D., & Wang, A. T. (2014). Randomized Comparative Trial of a Social Cognitive Skills Group for Children With Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), 208. https://doi.org/10.1016/j.jaac.2014.12.005
Torres‐Lopez, L. V., Migueles, J. H., Cadenas‐Sánchez, C., Bendtsen, M., Henriksson, P., Mora-González, J., Löf, M., Chaput, J., & Ortega, F. B. (2022). Effects of exercise on sleep in children with overweight/obesity: A randomized clinical trial. medRxiv (Cold Spring Harbor Laboratory). https://doi.org/10.1101/2022.09.23.22280266
Tremblay, M. S., Chaput, J., Adamo, K. B., Aubert, S., Barnes, J. D., Choquette, L., Duggan, M., Faulkner, G., Goldfield, G. S., Gray, C., Gruber, R., Janson, K., Janssen, I., Janssen, X., Garcia, A. J., Kuzik, N., LeBlanc, C., MacLean, J. E., Okely, A. D., … Carson, V. (2017). Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. BMC Public Health, 17. https://doi.org/10.1186/s12889-017-4859-6
Weiss, M. R. (2020). Motor Skill Development and Youth Physical Activity: A Social Psychological Perspective. Journal of Motor Learning and Development, 8(2), 315. https://doi.org/10.1123/jmld.2020-0009
Zapalac, K., Miller, M., Champagne, F. A., Schnyer, D. M., & Baird, B. (2024). The effects of physical activity on sleep architecture and mood in naturalistic environments. Scientific Reports, 14(1), 5637. https://doi.org/10.1038/s41598-024-56332-7
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Annemarie Christ, Krysten Rocha, Angela Saccà, Khairul Zikri
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
