The challenge of quality physical education
An article entitled "The challenge of low physical activity during the school day: at recess, lunch and in physical education" was recently published in the British Journal of Sport Medicine. Briefly, Nettlefold and colleagues used uniaxial accelerometers (Actigraph GT1M) to estimate the level of physical activity (PA) over the school day in Canadian children aged 8-11 years. One of their most striking findings was that only 1.8% of girls and 2.9% of boys in the compliant fraction (216 of 629 students recruited) met the U.S. guideline of performing moderate to vigorous physical activity (MVPA) during at least 50% of their physical education (PE) classes. This troubling finding has important implications regarding the quality of PE programmes.
All the PE classes in this study were taught by regular classroom teachers, as it is commonly the case for primary students in British Columbia and elsewhere.[1, 3] However, in interview data collected from two different Manitoban primary schools, DeCorby and colleagues  found normal classroom teachers were very uncomfortable in delivering PE instruction, due to a lack of specific knowledge and appropriate training. The principal of the school concerned commented: "I really feel sorry for them [the kids] because we wouldn't ask teachers to teach music, for example, with no training, but yet we do with phys. ed." In the second school that was examined, PE was taught by a specialist who developed a programme that focused on the acquisition of developmentally appropriate motor skills, a variety of physical activities performed in a non- competitive environment, and positive social development. That programme proved successful in stimulating participation and enjoyment, particularly among the girls and the boys who had difficulty in undertaking PE.
A small number of experimental, quasi-experimental and/or longitudinal studies in various jurisdictions have compared the response of primary school students to high quality, specialist taught PE programmes with the response to a "normal" curriculum. In the Trois- Rivieres study, conducted from 1971 to 1978, 546 Quebecois children were assigned (on the basis of year of entry to a school) to either an experimental programme (5 h of PE per week taught by a qualified physical educator from Grades 1 through 6) or the standard curriculum (40 min of PE once per week under the supervision of their home-room teacher). The PE classes for children in the experimental group were designed to ensure that students spent most of the class performing vigorous exercise (heart rate equal or greater than 160 beats per minute), and this was verified by telemetry. Moreover, questionnaire data demonstrated that there was not a compensatory reduction of PA level during the rest of the day.
The CATCH intervention studied American children in grades 3 to 5; the experimental group received a comprehensive intervention which included modifications to school food services, enhanced PE classes and use of health curricula in the classroom . The proportion of MVPA during PE for the experimental group gradually increased to over 50% of class time; they also accumulated more intense PA than the controls (58.6 vs. 46.5 minutes daily). Similarly, in the SPARK project, American children who received PE from a specialist accumulated more minutes of MVPA during their PE classes than those who were taught by a partially trained or an untrained (e.g. control) classroom teacher (40 vs. 33 vs. 18 minutes respectively).
More recently, a Swiss study of students in Grades 1 and 5 has examined the effects of supplementing the regular PE curriculum (3 weekly 45 minutes PE lessons taught by a classroom teacher) by twice weekly 45 minutes specialist-taught PE lessons, several 5 minutes PA breaks throughout the school day, and 10 minutes of daily PA homework in the context of a cluster randomized control trial. Accelerometry data suggested that students in the experimental group accumulated more MVPA and total PA than controls during school time, but unfortunately in this study there was a compensatory reduction of PA during leisure hours, so that the experimental group did not increase their total activity for the day relative to controls.
Some investigators have noted quite strong relationships between curricular time devoted to PE and health-related outcomes including: a higher maximal aerobic power and muscular fitness, enhanced motor skills, a reduction of adiposity, and enhanced academic achievement.[3, 7-9] German researchers compared sixth grade children who were assigned to an enhanced PE program for an entire school year (45 minutes of daily PE with a particular emphasis on endurance training) to a control group which received 45 minutes sessions of PE only twice per week. ANCOVA analyses revealed major increases in maximal aerobic power (a gain of 3.7 ml*kg-1*min-1) and circulating progenitor cells and a trend to a decrease in the prevalence of overweight and obesity (from 12.8% to 7.3%, N.S.) in the experimental group.
These several investigations highlight the importance of specialist PE training to the quality of PE programmes, and their resulting ability to maximize the fraction of class time spent in MVPA. Key elements of a quality programme include: 1) development of a full range of motor skills during early primary school; 2) improvement of both aerobic and muscular fitness through a wide variety of physical activities; 3) a reduced emphasis on competition, in order to foster participation of less skilled individuals, and 4) the development of skills that will encourage physical activity throughout the individual's lifespan.[3, 4, 8] Nevertheless, the age-related decline in PA points the need for further research on long term outcomes. Changes in the content of PE classes still seem needed to encourage long term participation in a volume of physical activity that is optimal for health.
The British Columbia PE curriculum specifies a wide range of learning outcomes, from knowledge of the topic to active living, movement skills, safety, fair play and leadership. Possibly, the demands on the PE class are too diverse, and the responsibility for teaching some of these topics should be delegated to other school disciplines. This strategy was effective in the CATCH intervention.
1. Nettlefold L, McKay HA, Warburton DER, et al. The challenge of low physical activity during the school day: at recess, lunch and physical education. Br J Sport Med. Published Online First 9 March 2010. doi: 10.1136/bjsm.2009.068072
2. United States Department of Health and Human Services. Healthy people 2010: understanding and improving health. Washington, DC: U.S. Government Printing Office 2000.
3. Trudeau F, Shephard RJ. Contribution of school programmes to physical activity levels and attitudes in children and adults. Sports Med 2005;35(2):89-105.
4. DeCorby K, Halas J, Dixon S, et al. Classroom teachers and the challenge of delivering quality physical education. J Educ Res 2005;98(4):208-220.
5. Lavallee H, Shephard RJ, Jequier J-C, et al. A compulsory physical activity program and out-of-school free activities in the Trois-Rivieres study [In French]. In: Lavallee H, Shephard RJ, eds. Child growth and development. Trois-Rivieres, Qc: editions du Bien Public 1982:61-71.
6. Luepker RV, Perry CL, McKinlay SJ, et al. Outcomes of a field trial to improve children's dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996;275(10):768-776.
7. Sallis JF, McKenzie TL, Alcaraz JE, et al. The effect of a 2-year physical education program (SPARK) on physical activity and fitness in elementary school students. Am J Public Health 1997;87(8):1328-1334.
8. Kriemler S, Zahner L, Schindler C, et al. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomized control trial. BMJ 2010;340:c785. doi:10.1136/bmj.c785
9. Shephard RJ. Long-term studies of physical activity in children - The Trois-Rivieres experience. In: Binkhorst RA, Kemper HCG, Saris WHM, eds. Children and Exercise XI. Champaign, Ill.: Human Kinetics 1985:252- 259.
10. Walther C, Gaede L, Adams V, et al. Effect of increased exercise in school children on physical fitness and endothelial progenitor cells: A prospective randomized trial. Circulation 2009;120:2251-2259.
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