Effect of an Educational Program on Schoolchildren's Energy Expenditure during Physical Education Classes

Cunha, Cristianne Troleis da; Poblacion, Ana Paula; Colugnati, Fernando Antonio Basile; Taddei, José Augusto de Aguiar Carrazedo; Bracco, Mario Maia

doi:10.5935/MedicalExpress.2016.01.04

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Original Research • MedicalExpress (São Paulo, online) 03 (01) • Feb 2016 • https://doi.org/10.5935/MedicalExpress.2016.01.04 copy

Effect of an Educational Program on Schoolchildren's Energy Expenditure during Physical Education Classes

EFEITO DE UM PROGRAMA DE EDUCAÇÃO NO GASTO ENERGÉTICO DE ESCOLARES DURANTE AS AULAS DE EDUCAÇÃO FÍSICA

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

Physical activity is a means of prevention of noncommunicable diseases. The level of physical activity of children is decreasing in Brazil, and this can increase the risks of diseases associated with sedentary lifestyles and obesity.

METHOD:

This is a school-based randomized controlled trial which evaluated the impact of an educational intervention on children's physical activity level, energy expenditure, and teacher's behavior during physical education classes at public schools in São Paulo. The studied population comprised children attending the 1st and the 2nd grades of eight schools (three exposed and five unexposed to teacher training on a course in nutrition and physical activity). Outcomes were measured by direct observation, recorded by a VHS camera during physical education classes; data from 78 physical education classes were analyzed by the System for Observing Fitness Instruction Time - SOFIT.

RESULTS:

After intervention, results showed highly significant increases in children's physical activity level (walking, p < 0.001; vigorous activities (p < 0.001), and a decrease in the standing category (p < 0.001). It also showed a nonsignificant increase in mean energy expenditure of children (70.6% = 27.6Kcal), but the interaction's effect of group and time (intervention) was highly significant (32.4Kcal; 95%CI 24.7 - 40.1, p < 0.001) indicating the intervention effectiveness in increasing the energy expenditure of children during Physical Education classes. It also showed an increase in length of physical education classes (26.2 to 32.1 minutes (p = 0.01).

CONCLUSION:

There was a change in teachers' behavior with a positive impact on children's physical activity level and energy expenditure after the educational intervention.

KEYWORDS:
Energy Expenditure; Physical Education; Child; Randomized Controlled Trial

		Exposed			Unexposed
Variables		Enrolled (%)	Lost (%)	P^b b probability	Enrolled (%)	Lost (%)	P^b b probability
Sample		43	22		136	98
Nutritional Status	Overweight + Obesity	72.1	77.3	0.65	71.3	73.5	0.93
Nutritional Status	Underweight + Normal	27.9	22.7		28.7	26.5	0.93
Sex	Male	53.5	59.0	0.66	49.3	46.9	0.72
Sex	Female	46.5	41.0		50.7	53.1	0.72
Age^a a categorized according to the median age of the initial sample;	< 7,3 years	53.5	54.5	0.93	49.3	48.0	0.84
	> 7,3 year	46.5	45.5		50.7	52.0	0.84

	Schools
		Exposed			Unexposed
	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P^b b probability	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P^b b probability
Children’s physical activity total duration	26.2 (7,39)	32.1(6.08)	0.01	27.5 (10.32)	24.1 (9.00)	0.13

Teacher’s involvement	Teachers
	Exposed N = 18			Unexposed N = 35
	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P ^b b probability	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P^b b probability
1. Promotes fitness	7.3 (11.0)	2.9 (3.4)	0.12	2.1 (5.3)	2.1 (4.2)	1.00
2. Demonstrates fitness	11.4 (13.7)	4.0 (4.0)	0.04	7.9 (13.0)	1.9 (5.4)	0.02
3. Instructs	17.1 (11.2)	17.9 (6.2)	0.79	16.6 (14.2)	13.2 (7.9)	0.22
4. Manages	39.3 (19.2)	40.2 (10.0)	0.86	34.5 (21.2)	26.4 (10.6)	0.04
5. Observes	24.6 (20.9)	33.7 (11.5)	0.11	33.9 (23.7)	48.5 (16.2)	0.004
6. Other-task	0.2 (0.9)	1.1 (4.3)	<0.001	5.0 (11.0)	7.8 (15.5)	0.38

Knowledge content	Class Duration
		Exposed			Unexposed
	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P ^b b probability	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P ^b b probability
1.General content	36.6 (14.28)	30.63 (16.20)	0.25	27.93 (17.03)	18.94 (16.6)	0.03
2.General knowledge	0	0	-	0	0	-
3. Fitness knowledge	0	0	-	0	0	-
4. Fitness practice	13.7 (20.8)	5.54 (5.16)	0.12	10.0 (18.34)	1.31 (3.32)	0.01
5.Skill practice	0	6.61 (11.66)	0.03	0	0	-
6.Game play	49.66 (21.27)	57.22 (21.61)	0.29	62.05 (25.25)	79.74 (17.05)`	0.001

Student’s physical activity engagement	Students
		Exposed			Unexposed
	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P^b b probability	Pre Mean (SD) ^a a standard deviation;	Post Mean (SD) ^a a standard deviation;	P^b b probability
Lying down	0.4 (1.4)	0.2 (1.0)	0.44	1.0 (3.5)	0.9 (1.0)	0.74
Sitting	21.9 (21.5)	15.5 (14.8)	0.11	20.7 (23.3)	16.5 (23.7)	0.14
Standing	65.5 (22.4)	42.7 (13.7)	<0.001	48.3 (22.7)	51.5 (22.5)	0.24
Walking	5.6 (4.8)	25.5 (11.4)	<0.001	12.8 (15.5)	13.8 (10.6)	<0.001
Vigorous	6.5 (4.4)	16.1 (9.6)	<0.001	15.5 (15.6)	10.6 (9.7)	0.002

	Coef. ^a a coefficient;	CI ^b b confidence interval; (95%CI)	P>z^c c probability
Pre/Post Momentum	-4.8	(-8.6; -1.0)	<0.0001
Exposed/Unexposed Groups	-15.6	(-39.4; 8.1)	0.2
Interaction	32.4	(24.7; 40.1)	<0.0001
(Momentum*Groups)
Constant	54.7	(40.4; 69.0)	<0.0001

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