An active play intervention to improve physical activity and fundamental movement skills in children of low socio-economic status: feasibility cluster randomised controlled trial

Introduction: Active play is a novel approach to addressing low physical activity levels and fundamental movement skills (FMS) in childhood and new interventions must be developed and evaluated.

Aim: This study aimed to determine the feasibility of a 10-week school-based 'active play' intervention, and present preliminary findings on four outcomes: physical activity levels, FMS, inhibition, and maths fluency.

Methods: This was a feasibility cluster RCT in which eight schools (one primary three class per school) were paired and randomly allocated to either the 10-week intervention (n = 4) or waiting-list control (n = 4). The active play intervention consisted of a 1-h outdoor physical activity session per week, incorporating 30 min of facilitated games and 30 min of free play. Feasibility measures were gathered using appropriate methods and physical activity was measured using an ActiGraph GT3X accelerometer, FMS were assessed using the Test of Gross Motor Development-2 (TGMD-2), inhibition was measured using a Flanker Test and maths fluency was assessed using the One Minute Basic Number Facts Test.

Results: Sixty-six percent of eligible children (n = 137) agreed to participate in the research. No schools withdrew from the study and three participants were lost to follow-up. Compliance to the intervention was high-none of the participants missed more than two of the ten scheduled active play sessions. Data lost to follow-up were minimal; most were lost (14%) for school day physical activity. Active play sessions were shorter than planned on average by 10 min, and participants spent a mean of 39.4% (14.2) of the session time in moderate-to-vigorous intensity physical activity (MVPA). There was preliminary evidence of a small intervention effect on MVPA (d = 0.3), FMS score (d = 0.4), inhibition (fish trial: d = 0.1, arrow trial d = 0.1) and maths fluency (addition: d = 0.3, subtraction: d = 0.1).

Conclusion: The active play intervention was feasible and benefitted from a relatively high MVPA content; however, preliminary findings suggest the intervention had a small effect on the outcomes. Having more active play sessions per week and/or extending the duration of the intervention may increase the effects and these should be tested before a future definitive cluster RCT is undertaken.

Trial registration: This trial was registered on the International Standardised Randomised Controlled Trials Number register (ISRCTN) in August 2017 (ISRCTN11607781).