Movement skills and physical activity in obese children: randomized controlled trial

Purpose: The purpose of this study was to evaluate the Hunter Illawarra Kids Challenge Using Parent Support physical activity program in overweight children.

Methods: A multisite randomized controlled trial was conducted with three intervention arms: 1) child-centered physical activity skill development program (Activity), 2) parent-centered dietary modification program (DIET), or 3) both programs combined (PA+DIET). Movement skill proficiency, perceived athletic competence, accelerometer-assessed physical activity, and parent-reported time spent in screen behaviors were assessed at baseline, 6 months, and 12 months in 165 prepubertal children aged 5.5-9 yr (59% girls, 78% obese). Differences in changes in outcomes between groups were assessed using linear mixed models.

Results: Compared with the diet group, the activity group (mean (95% confidence interval): +7.7 units (3.8-11.6 units)) and the activity + diet group (+6.7 units (2.9-10.5 units)) displayed 11%-13% greater improvement in overall movement skill proficiency (gross motor quotient) at 6 months. Perceived athletic competence increased across groups at follow-up (across groups: 6 months = +0.21 units (0.11-0.31 units), 12 months = +0.21 units (0.07-0.35 units)). Groups did not differ statistically for change in physical activity outcomes. Total screen time (min·wk(-1)) decreased in all groups at 6 months (across groups: -385.4 (-501.0 to -269.8)) and in the activity group (-261.8 (-470.5 to -53.1)) and activity + diet group (-340.5 (-534.6 to -146.4)) at 12 months. The diet group reported greater reductions in TV or DVD viewing time at 6 months compared with the activity group (248.6 (24.0-473.3)).

Conclusions: The activity and the activity + diet programs were efficacious in improving overweight children's movement skill proficiency. All programs were efficacious in reducing time spent in screen behaviors. Other correlates may need to be targeted in addition to movement skills to increase physical activity among overweight children.