Abel Ruiz-Hermosa

Introduction: Classroom-based active breaks (ABs) have been shown to reduce sedentary time and increase physical activity in primary school children; however, evidence regarding their effects on body composition, physical fitness, cognition and other health-related outcomes remains limited in preschool children. This article describes the rationale and prespecified methods of the MOVI-HIIT study, a cluster-randomised controlled trial (RCT) evaluating a classroom-based, HIIT-inspired ABs intervention delivered through a gamified digital platform to improve body composition, physical fitness, and cognition in children aged 4–6 years. In addition, we outline a nested qualitative study designed to explore teachers’ perceptions of barriers and facilitators to programme implementation and monitoring. Methods: A RCT was conducted in nine schools in the province of Ciudad Real, Spain. Schools were randomly assigned to the MOVI-HIIT intervention group ( n = 5) or the control group ( n = 4). A total of 522 children aged 4–6 years were assessed at baseline (September 2022) and post-intervention (June 2023). The programme included two daily 6-minute HIIT-based ABs (20″/10″ work-to-rest ratio) guided by interactive avatars via a gamified digital platform. The primary outcomes were body composition, physical fitness, and executive function. Secondary outcomes included physical activity, sleep quality, blood pressure, and health-related quality of life. In parallel, a qualitative study using semi-structured interviews and focus groups examined teachers’ perceptions of barriers and facilitators related to the implementation and monitoring of the programme. Discussion: MOVI-HIIT represents the first intervention in early childhood education to integrate HIIT-based ABs with a gamified digital platform. Its structured, high-intensity exercise, combined with a mixed-methods process evaluation, may provide an innovative and potential reproducible model that can strengthen the evidence on classroom-based physical activity and contribute to creating active and healthy educational environments from early childhood onwards. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT04863040 , identifier NCT04863040.

Introduction: Gross motor competence is positively associated with academic achievement in schoolchildren, potentially mediated by fitness and cognition. However, the extent to which these mediators contribute—and whether effects differ by sex—remains unclear. This study explored the mediating roles of specific fitness components and executive function in the relationship between gross motor competence and academic achievement, considering sex differences. Methods: This cross-sectional study included 562 Spanish schoolchildren aged 9–11 years (293 girls). Gross motor competence was evaluated using the Movement Assessment Battery for Children-Second Edition; fitness components (cardiorespiratory fitness, speed/agility, upper and lower body strength) through the ALPHA-Fitness test battery; executive function using the NIH Toolbox Battery; and academic achievement from school grades in language and mathematics. Serial multiple mediation models were applied using the PROCESS macro in SPSS, adjusted for age, BMI, and maternal education level. Analyses were conducted for the total sample and by sex. Results: Both fitness and executive function partially mediated the relationship between gross motor competence and academic achievement. In the total sample, direct effects explained most of the association (51–73%), followed by the cognitive pathway (20–31%), fitness pathway (11–19%), and multiple pathway—gross motor competence, fitness, executive function, and academic achievement—(4–9%). Sex-specific analyses showed that cognitive mediation was predominant in boys, accounting for over half of the total effect (56–69%), with no direct effect observed. In contrast, fitness mediation was more relevant in girls, especially through cardiorespiratory fitness and speed/agility, each contributing up to 20% of the effect. The multiple pathway was also significant in girls. Conclusions: Enhancing motor competence may improve academic outcomes, partly through gains in fitness and executive function. These findings support implementing integrated school programs, tailored to sex-specific needs—emphasizing cognitively engaging activities for boys and fitness-focused strategies for girls. The cross-sectional design implies association, not causality.

High‐intensity interval training (HIIT) has emerged as a time‐efficient approach to improve aerobic capacity, cardiovascular health, and cognitive functioning in children and adolescents. However, evidence regarding the impact of school‐based HIIT programs on motor competence and health‐related quality of life in children is limited. This study evaluated the effectiveness of a HIIT intervention, based on playground games on gross motor competence and health‐related quality of life in schoolchildren aged 9–11 years. A cluster‐randomized controlled trial was conducted with 562 participants. The intervention involved four weekly 60 min sessions of extracurricular physical activity using traditional games adapted to a HIIT protocol. Gross motor competence and health‐related quality of life were assessed using the Movement Assessment Battery for Children‐Second Edition (MABC‐2) and the KIDSCREEN‐27 questionnaire, respectively. Analyzes were conducted on an intention‐to‐treat basis using mixed linear regression models to compare changes from baseline to postintervention between the intervention and control groups. No significant improvements in gross motor competence or health‐related quality of life were observed after adjusting for baseline variables, age, sex, and school. The results suggest that this HIIT‐based program was not effective in enhancing gross motor competence or in improving health‐related quality of life. Future programs could improve effectiveness by optimizing the balance between movement intensity and quality, aligning activities with gross motor competence assessment tools, emphasizing health‐related quality of life components, training educators to enhance quality of life, extending intervention duration to impact self‐esteem and psychological well‐being, and improving adherence rates.

Introducción: La alta prevalencia del sedentarismo y la insuficiente actividad física en la infancia es un problema persistente con graves repercusiones para la salud y el rendimiento escolar. Las escuelas, respaldadas por las leyes educativas que subrayan su importancia, deben fomentar hábitos y estilos de vida saludables y activos. Estrategias como los Escape Rooms, que motivan y fomentan la colaboración y la reflexión, podrían ser efectivas para enseñar al alumnado los beneficios de la actividad física y la reducción del sedentarismo para la salud física y mental. Objetivo: El objetivo de este trabajo es presentar una experiencia didáctica mediante el Escape Room “¡Sé inteligente, Muévete!” para que el alumnado de Educación Primaria conozca los efectos de los hábitos saludables y la actividad física en la salud mental y cerebral. Además, se evaluó la percepción de aprendizaje y disfrute de los y las participantes. Resultados: Los resultados mostraron una alta percepción de aprendizaje y disfrute. Las chicas puntuaron más alto en disfrute que los chicos, aunque sin diferencias estadísticamente significativas. No se encontraron diferencias estadísticamente significativas en la percepción de aprendizaje por curso, aunque los estudiantes de 3º curso puntuaron más alto que el resto de los grupos. En cuanto al disfrute, el alumnado de 6º curso percibió un menor disfrute que el resto de los cursos. Conclusiones: El Escape Room "¡Sé inteligente, Muévete!" mostró ser divertido y efectivo para adquirir conocimientos y reflexionar sobre los efectos de los hábitos saludables y la actividad física en la salud mental y cerebral.

Introduction: Good motor competence is linked to better academic achievement in schoolchildren, potentially mediated by fitness and cognition. However, the relative impact of these factors and whether they differ by sex remains unclear. The aim of the present study was to assess the mediating role of fitness components and executive function on this relationship, with a particular focus on sex differences. Methods: This cross-sectional study included 562 schoolchildren (9-11 years, 293 girls) from Cuenca, Spain. We assessed gross motor competence (MABC-2 battery), fitness components (ALPHA battery), executive function (Toolbox battery), academic achievement (mean of language and mathematics grades), weight, height, and sociodemographic variables. Serial multiple mediation models between gross motor competence to AA through fitness and cognition were conducted using the Hayes’ PROCESS SPSS macro, both for the total sample and by sex. Results: Both fitness and executive function partially mediated the relationship between gross motor competence and AA. In the total sample, the direct effect explained most of the total effect (51.22% to 72.68%), followed by the cognitive path (19.51% to 30.73%), fitness path (10.84% to 19.02%), and multiple path (4.43% to 9.27%). In boys, only the cognitive path mediated the relationship (56.35% to 68.91%), while in girls, the fitness path (for cardiorespiratory fitness and speed/agility, 19.08% and 20.27%), the cognitive path (limited to upper body strength, 14.92%), and the multiple path (for cardiorespiratory fitness, speed/agility, and lower body strength, 4.93%, 8.31% and 9.43%) were partial mediators. Conclusions: Our results suggest that part of the effect found between gross motor competence and academic achievement in children occurs from improvements in fitness and executive function. These findings emphasize the need for motor competence programs that target both fitness (especially cardiorespiratory fitness and speed/agility) and executive function to boost academic achievement in children aged 9-11. Additionally, interventions should consider sex-specific differences.

The aim of this study was to describe the goals, activities, and methods of EUMOVE project in developing a set of resources targeting both primary and secondary schools that allow the entire educational community to promote healthy lifestyles (HL). The EUMOVE project is an Erasmus+ program based in the Creating Active Schools (CAS) framework. The project lasted 3 years and was developed by 14 academic and non-governmental institutions from Spain, Portugal, France, Italy, and the UK. EUMOVE was divided into three phases. In the first phase, several work packages were carried out aimed to ensure the coordination/management of the project activities. In the second phase, seven educational resources strengthened by rigorous scientific research were developed to promote HL from schools. During the last phase, all the resources were disseminated through scientific seminars, workshops with families and teachers, and the online promotion by the non-governmental institutions of each country. The EUMOVE project developed and promoted a smartphone APP, video/activity repository of physically active lessons, active break virtual platform, learning units, and parent/teachers/school-leaders’ guidelines to promote physical activity, active commuting, active school playgrounds, healthy diet, and sleep habits. To our knowledge, EUMOVE is the first European project to provide a set of practical tools based on scientific evidence to help schools or future school-wide interventions implement a paradigm shift based on the CAS framework for the promotion of HL. Future research will need to investigate the implementation, effectiveness, and scalability of this proposal.

Objective: To describe the protocol of the MOVI-ageing randomized controlled trial, a home-based eHealth intervention of cognitive-demanding exercise for older adults, in improving global cognitive function and basic cognitive functions, cardiorespiratory fitness, and muscle fitness.Methods: This randomized controlled trial will include participants identified in the social centers of Cuenca and Talavera de la Reina who agree to participate and provide informed consent. Adults aged 60–80 years of both genders retired regardless of the reason for retirement, who do not meet frailty criteria according to Fried criteria, and without cognitive impairment will be invited to participate. This study will be developed in two phases: (i) a 12-week randomized efficacy/feasibility trial and (ii) a large-scale implementation randomized trial phase with a 12-week follow-up following similar procedures. In addition, a qualitative study on barriers to and facilitators of the implementation of the physical exercise intervention using eHealth for older people will be conducted. Participants will have access to a platform including videos of cognitively demanding physical exercise. The participants will be remotely and off-line guided through the physical exercise intervention, and the research team will be able to check the degree of compliance with the program and its correct execution. The participants will receive feedback on their compliance with the routines and reinforcement messages.Implications: The implementations of the findings and their inclusion in guidelines may directly impact in older people’s life, and relatives, through the prevention of morbidity and the reduction of years lost to disability. These benefits may be reflected in the reduction of economic expenditure by reducing the demand for social and health care services.Ethics: The Clinical Research Ethics Committee of the ‘Virgen de la Luz’ Hospital in Cuenca approved the study protocol (registration number: 2022/PI3222). In addition, this protocol was previously registered in Clinicaltrials.gov (Number: NCT05928078).

Background: The use of physical activity (PA) electronic devices offers a unique opportunity to engage children and adolescents in PA. For this age group (2-17 years), parents play a key role in promoting healthy lifestyles and regulating the use of electronic devices. Therefore, parents’ perceptions of the use of electronic devices for PA in children and adolescents are critical for efficient intervention. Objective: The aim of this qualitative systematic review was to improve the understanding of parents’ perceptions of the use of electronic devices for PA in children and adolescents. Methods: A systematic search of electronic databases (Medline/PubMed, SPORTDiscus, Web of Science, Scopus, OpenGrey, and Deep Blue) was conducted. Studies from inception (2010) to May 2022 were identified. Qualitative studies on the perceptions of healthy children’s and adolescents’ (aged 2-17 years) parents regarding PA interventions performed on electronic devices were included according to the Cochrane Qualitative and Implementation Methods Group Guidance Series and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used for methodological validity. Results: In total, 18 studies with 410 parents, mostly mothers, were included. Parents’ perceptions were grouped into 4 categories: usefulness, advantages, general perceptions (electronic devices for health promotion, preferences for real-life PA, and concerns), and acceptability (barriers and facilitators) of electronic devices for PA. Parents perceived electronic devices as useful for increasing PA, learning new skills, and increasing motivation for PA and valued those devices that promoted socialization and family and peer bonding. In terms of general perceptions, parents had positive attitudes toward PA electronic devices; however, they preferred outdoor and real-life PA, especially for preschoolers and children. Concerns, such as physical and psychological harm, addiction, conflicts, and compliance difficulties, were found. Facilitators were identified as ease of use, appropriate feedback, promotion of socialization, and motivational strategies, such as rewards, challenges, and attractiveness. Barriers, such as discomfort, price, and difficulties in using or understanding electronic devices, were also identified. For older children and adolescents, parents were more concerned about high levels of screen time and setting limits on electronic devices and therefore preferred PA electronic devices rather than traditional ones. Conclusions: Overall, the participants had positive attitudes toward electronic devices for PA and perceived them as an effective way to promote PA in children and adolescents. They also perceived several benefits of using electronic devices, such as health promotion, increased awareness and motivation, and socialization, as well as barriers, facilitators, and age differences. The results of this study could provide researchers with insights into designing more effective, age-appropriate PA electronic devices for children and adolescents and improving adherence to their use. Trial Registration: PROSPERO CRD42021292340; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=292340

ObjectiveTo test the effectiveness of an 8-month school-based multicomponent intervention (MOVI-KIDS) in improving health-related quality of life (HRQoL) in schoolchildren. Study DesignA randomized cluster trial was conducted including 1168 children aged 4-6 years who attended 21 schools in two Spanish provinces (Cuenca and Ciudad Real). MOVI-KIDS study is a multicomponent physical activity intervention, which consisted of (i) 3 x 60-min sessions/week, (ii) educational materials for parents and teachers, and (iii) school playground modifications. The parent's proxy report of the KINDL-R Spanish version (6 subdimensions and a total score), and the KINDL-R self-reported by children (total score) was used to measure HRQoL. Mixed linear regression models were conducted to test differences in each HRQoL dimension between intervention and control groups, controlling for baseline values, cardiorespiratory fitness, and socioeconomic status, by gender. ResultsThe boys in the intervention group presented better scores on total HRQoL than the control group in both the parent (ss = 1.46; 95% CI: 0.23-2.70) and self-reported (ss = 2.13; 95% CI: 0.53-3.74) versions, as well as on the emotional well-being dimension (ss = 2.43; 95% CI: 0.48-4.36). There was no significant effect of the intervention on physical well-being, self-esteem, family, and friends. In girls, no statistically significant differences were found between those who participated in MOVI-KIDS and those who did not. ConclusionOur data support gender differences in the effect of MOVI-KIDS, such that while in boys the intervention was successful in increasing total scores of HRQoL, as well as emotional well-being scores, the intervention was not effective in improving girls' HRQoL.

BACKGROUND The use of physical activity (PA) electronic devices offers a unique opportunity to engage children and adolescents in PA. For this age group (2-17 years), parents play a key role in promoting healthy lifestyles and regulating the use of electronic devices. Therefore, parents’ perceptions of the use of electronic devices for PA in children and adolescents are critical for efficient intervention. OBJECTIVE The aim of this qualitative systematic review was to improve the understanding of parents’ perceptions of the use of electronic devices for PA in children and adolescents. METHODS A systematic search of electronic databases (Medline/PubMed, SPORTDiscus, Web of Science, Scopus, OpenGrey, and Deep Blue) was conducted. Studies from inception (2010) to May 2022 were identified. Qualitative studies on the perceptions of healthy children’s and adolescents’ (aged 2-17 years) parents regarding PA interventions performed on electronic devices were included according to the Cochrane Qualitative and Implementation Methods Group Guidance Series and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used for methodological validity. RESULTS In total, 18 studies with 410 parents, mostly mothers, were included. Parents’ perceptions were grouped into 4 categories: usefulness, advantages, general perceptions (electronic devices for health promotion, preferences for real-life PA, and concerns), and acceptability (barriers and facilitators) of electronic devices for PA. Parents perceived electronic devices as useful for increasing PA, learning new skills, and increasing motivation for PA and valued those devices that promoted socialization and family and peer bonding. In terms of general perceptions, parents had positive attitudes toward PA electronic devices; however, they preferred outdoor and real-life PA, especially for preschoolers and children. Concerns, such as physical and psychological harm, addiction, conflicts, and compliance difficulties, were found. Facilitators were identified as ease of use, appropriate feedback, promotion of socialization, and motivational strategies, such as rewards, challenges, and attractiveness. Barriers, such as discomfort, price, and difficulties in using or understanding electronic devices, were also identified. For older children and adolescents, parents were more concerned about high levels of screen time and setting limits on electronic devices and therefore preferred PA electronic devices rather than traditional ones. CONCLUSIONS Overall, the participants had positive attitudes toward electronic devices for PA and perceived them as an effective way to promote PA in children and adolescents. They also perceived several benefits of using electronic devices, such as health promotion, increased awareness and motivation, and socialization, as well as barriers, facilitators, and age differences. The results of this study could provide researchers with insights into designing more effective, age-appropriate PA electronic devices for children and adolescents and improving adherence to their use. CLINICALTRIAL PROSPERO CRD42021292340; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=292340