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Physical Education in Schools

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Physical health benefits, mental health benefits, educational benefits.

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Educating the Student Body: Taking Physical Activity and Physical Education to School (2013)

Chapter: 5 approaches to physical education in schools.

Approaches to Physical Education in Schools

Key Messages

• Because it is guaranteed to reach virtually all children, physical education is the only sure opportunity for nearly all school-age children to access health-enhancing physical activities.

• High-quality physical education programs are characterized by (1) instruction by certified physical education teachers, (2) a minimum of 150 minutes per week (30 minutes per day) for children in elementary schools and 225 minutes per week (45 minutes per day) for students in middle and high schools, and (3) tangible standards for student achievement and for high school graduation.

• Students are more physically active on days on which they have physical education.

• Quality physical education has strong support from both parents and child health professional organizations.

• Several models and examples demonstrate that physical education scheduled during the school day is feasible on a daily basis.

• Substantial discrepancies exist in state mandates regarding the time allocated for physical education.

• Nearly half of school administrators (44 percent) reported cutting significant time from physical education and recess to increase time spent in reading and mathematics since passage of the No Child Left Behind Act.

• Standardized national-level data on the provision of and participation, performance, and extent of engagement in vigorous- or moderate-intensity physical activity are insufficient to allow assessment of the current status and trends in physical education in the United States.

• Systematic research is needed on personal, curricular, and policy barriers to successful physical education.

• The long-term impact of physical education has been understudied and should be a research priority to support the development of evidence-based policies.

P hysical education is a formal content area of study in schools that is standards based and encompasses assessment based on standards and benchmarks. It is defined in Chapter 1 as “a planned sequential K-12 standards-based program of curricula and instruction designed to develop motor skills, knowledge, and behaviors of healthy active living, physical fitness, sportsmanship, self-efficacy, and emotional intelligence.” As a school subject, physical education is focused on teaching school-aged children the science and methods of physically active, healthful living (NASPE, 2012). It is an avenue for engaging in developmentally appropriate physical activities designed for children to develop their fitness, gross motor skills, and health (Sallis et al., 2003; Robinson and Goodway, 2009; Robinson, 2011). This chapter (1) provides a perspective on physical education in the context of schooling; (2) elaborates on the importance of physical education to child development; (3) describes the consensus on the characteristics of quality physical education programs; (4) reviews current national, state, and local education policies that affect the quality of physical education; and (5) examines barriers to quality physical education and solutions for overcoming them.

PHYSICAL EDUCATION IN THE CONTEXT OF SCHOOLING

Physical education became a subject matter in schools (in the form of German and Swedish gymnastics) at the beginning of the 19th century (Hackensmith, 1966). Its role in human health was quickly recognized. By the turn of the 20th century, personal hygiene and exercise for bodily health were incorporated in the physical education curriculum as the major learning outcomes for students (Weston, 1962). The exclusive focus on health, however, was criticized by educator Thomas Wood (1913; Wood and Cassidy, 1930) as too narrow and detrimental to the development of the whole child. The education community subsequently adopted Wood’s inclusive approach to physical education whereby fundamental movements and physical skills for games and sports were incorporated as the major instructional content. During the past 15 years, physical education has once again evolved to connect body movement to its consequences (e.g., physical activity and health), teaching children the science of healthful living and skills needed for an active lifestyle (NASPE, 2004).

Sallis and McKenzie (1991) published a landmark paper stating that physical education is education content using a “comprehensive but physically active approach that involves teaching social, cognitive, and physical skills, and achieving other goals through movement” (p. 126). This perspective is also emphasized by Siedentop (2009), who states that physical education is education through the physical. Sallis and McKenzie (1991) stress two main goals of physical education: (1) prepare children and youth for a lifetime of physical activity and (2) engage them in physical activity during physical education. These goals represent the lifelong benefits of health-enhancing physical education that enable children and adolescents to become active adults throughout their lives.

Physical Education as Part of Education

In institutionalized education, the main goal has been developing children’s cognitive capacity in the sense of learning knowledge in academic disciplines. This goal dictates a learning environment in which seated learning behavior is considered appropriate and effective and is rewarded. Physical education as part of education provides the only opportunity for all children to learn about physical movement and engage in physical activity. As noted, its goal and place in institutionalized education have changed from the original focus on teaching hygiene and health to educating children about the many forms and benefits of physical movement, including sports and exercise. With a dramatic expansion of content beyond the original Swedish and German gymnastics programs of the 19th century, physical education has evolved to become a content

area with diverse learning goals that facilitate the holistic development of children (NASPE, 2004).

To understand physical education as a component of the education system, it is important to know that the education system in the United States does not operate with a centralized curriculum. Learning standards are developed by national professional organizations such as the National Association for Sport and Physical Education (NASPE) and/or state education agencies rather than by the federal Department of Education; all curricular decisions are made locally by school districts or individual schools in compliance with state standards. Physical education is influenced by this system, which leads to great diversity in policies and curricula. According to NASPE and the American Heart Association (2010), although most states have begun to mandate physical education for both elementary and secondary schools, the number of states that allow waivers/exemptions from or substitutions for physical education increased from 27 and 18 in 2006 to 32 and 30 in 2010, respectively. These expanded waiver and substitution policies (discussed in greater detail later in the chapter) increase the possibility that students will opt out of physical education for nonmedical reasons.

Curriculum Models

Given that curricula are determined at the local level in the United States, encompassing national standards, state standards, and state-adopted textbooks that meet and are aligned with the standards, physical education is taught in many different forms and structures. Various curriculum models are used in instruction, including movement education, sport education, and fitness education. In terms of engagement in physical activity, two perspectives are apparent. First, programs in which fitness education curricula are adopted are effective at increasing in-class physical activity (Lonsdale et al., 2013). Second, in other curriculum models, physical activity is considered a basis for students’ learning skill or knowledge that the lesson is planned for them to learn. A paucity of nationally representative data is available with which to demonstrate the relationship between the actual level of physical activity in which students are engaged and the curriculum models adopted by their schools.

Movement Education

Movement has been a cornerstone of physical education since the 1800s. Early pioneers (Francois Delsarte, Liselott Diem, Rudolf von Laban) focused on a child’s ability to use his or her body for self-expression (Abels and Bridges, 2010). Exemplary works and curriculum descriptions include those by Laban himself (Laban, 1980) and others (e.g., Logsdon et al.,

1984). Over time, however, the approach shifted from concern with the inner attitude of the mover to a focus on the function and application of each movement (Abels and Bridges, 2010). In the 1960s, the intent of movement education was to apply four movement concepts to the three domains of learning (i.e., cognitive, psychomotor, and affective). The four concepts were body (representing the instrument of the action); space (where the body is moving); effort (the quality with which the movement is executed); and relationships (the connections that occur as the body moves—with objects, people, and the environment; Stevens-Smith, 2004). The importance of movement in physical education is evidenced by its inclusion in the first two NASPE standards for K-12 physical education (NASPE, 2004; see Box 5-7 later in this chapter).

These standards emphasize the need for children to know basic movement concepts and be able to perform basic movement patterns. It is imperative for physical educators to foster motor success and to provide children with a basic skill set that builds their movement repertoire, thus allowing them to engage in various forms of games, sports, and other physical activities (see also Chapter 3 ).

Sport Education

One prevalent physical education model is the sport education curriculum designed by Daryl Siedentop (Siedentop, 1994; Siedentop et al., 2011). The goal of the model is to “educate students to be players in the fullest sense and to help them develop as competent, literate, and enthusiastic sportspersons” (2011, p. 4, emphasis in original). The model entails a unique instructional structure featuring sport seasons that are used as the basis for planning and teaching instructional units. Students are organized into sport organizations (teams) and play multiple roles as team managers, coaches, captains, players, referees, statisticians, public relations staff, and others to mimic a professional sports organization. A unit is planned in terms of a sports season, including preseason activity/practice, regular-season competition, playoffs and/or tournaments, championship competition, and a culminating event (e.g., an awards ceremony or sport festivity). Depending on the developmental level of students, the games are simplified or modified to encourage maximum participation. In competition, students play the roles noted above in addition to the role of players. A sport education unit thus is much longer than a conventional physical education unit. Siedentop and colleagues (2011) recommend 20 lessons per unit, so that all important curricular components of the model can be implemented.

Findings from research on the sport education model have been reviewed twice. Wallhead and O’Sullivan (2005) report that evidence is insufficient to support the conclusion that use of the model results in

students’ developing motor skills and fitness and learning relevant knowledge; some evidence suggests that the model leads to stronger team cohesion, more active engagement in lessons, and increased competence in game play. In a more recent review, Hastie and colleagues (2011) report on emerging evidence suggesting that the model leads to improvement in cardiorespiratory fitness (only one study) and mixed evidence regarding motor skills development, increased feeling of enjoyment in participation in physical education, increased sense of affiliation with the team and physical education, and positive development of fair-play values. The only study on in-class physical activity using the model showed that it contributed to only 36.6 percent activity at the vigorous- or moderate-intensity levels (Parker and Curtner-Smith, 2005). Hastie and colleagues caution, however, that because only 6 of 38 studies reviewed used an experimental or quasi-experimental design, the findings must be interpreted with extreme caution. The model’s merits in developing motor skills, fitness, and desired physical activity behavior have yet to be determined in studies with more rigorous research designs.

Fitness Education

Instead of focusing exclusively on having children move constantly to log activity time, a new curricular approach emphasizes teaching them the science behind why they need to be physically active in their lives. The curriculum is designed so that the children are engaged in physical activities that demonstrate relevant scientific knowledge. The goal is the development and maintenance of individual student fitness. In contrast with the movement education and sport education models, the underlying premise is that physical activity is essential to a healthy lifestyle and that students’ understanding of fitness and behavior change result from engagement in a fitness education program. The conceptual framework for the model is designed around the health-related components of cardiorespiratory fitness, muscular strength and endurance, and flexibility. A recent meta-analysis (Lonsdale et al., 2013) suggests that physical education curricula that include fitness activities can significantly increase the amount of time spent in vigorous- or moderate-intensity physical activity.

Several concept-based fitness education curriculum models exist for both the middle school and senior high school levels. They include Fitness for Life: Middle School (Corbin et al., 2007); Personal Fitness for You (Stokes and Schultz, 2002); Get Active! Get Fit! (Stokes and Schultz, 2009); Personal Fitness: Looking Good, Feeling Good (Williams, 2005); and Foundations of Fitness (Rainey and Murray, 2005). Activities in the curriculum are designed for health benefits, and the ultimate goal for the student is to develop a commitment to regular exercise and physical

activity. It is assumed that all children can achieve a health-enhancing level of fitness through regular engagement in vigorous- or moderate-intensity physical activity.

Randomized controlled studies on the impact of a science-based fitness curriculum in 15 elementary schools showed that, although the curriculum allocated substantial lesson time to learning cognitive knowledge, the students were more motivated to engage in physical activities than students in the 15 control schools experiencing traditional physical education (Chen et al., 2008), and they expended the same amount of calories as their counterparts in the control schools (Chen et al., 2007). Longitudinal data from the study reveal continued knowledge growth in the children that strengthened their understanding of the science behind exercise and active living (Sun et al., 2012). What is unclear, however, is whether the enthusiasm and knowledge gained through the curriculum will translate into the children’s lives outside of physical education to help them become physically active at home.

To incorporate standards and benchmarks into a fitness education model, a committee under the auspices of NASPE (2012) developed the Instructional Framework for Fitness Education in Physical Education. It is suggested that through this proposed comprehensive framework, fitness education be incorporated into the existing physical education curriculum and embedded in the content taught in all instructional units. The entire framework, highlighted in Box 5-1 , can be viewed at http://www.aahperd.org/naspe/publications/upload/Instructional-Framework-for-Fitness-Education-in-PE-2012-2.pdf (accessed February 1, 2013).

Emergence of Active Gaming in Fitness Education

Today, active gaming and cell phone/computer applications are a part of physical activity for both youth and adults. Accordingly, fitness education in school physical education programs is being enhanced through the incorporation of active video games, also known as exergaming. Examples of active gaming programs with accompanying equipment include Konami Dance Dance Revolution (DDR), Nintendo Wii, Gamebikes, Kinect XBOX, Xavix, and Hopsports. These active games have been incorporated into school wellness centers as high-tech methods of increasing student fitness levels to supplement the traditional modes for attaining vigorous- or moderate-intensity physical activity (Greenberg and Stokes, 2007).

Bailey and McInnis (2011) compared selected active games with treadmill walking and found that each game—DDR, LightSpace (Bug Invasion), Nintendo Wii (Boxing), Cyber Trazer (Goalie Wars), Sportwall, and Xavix (J-Mat)—raised energy expenditure above that measured at rest. Mean metabolic equivalent (MET) values for each game were comparable to or

Instructional Framework for Fitness Education in Physical Education

Technique: Demonstrate competency in techniques needed to perform a variety of moderate to vigorous physical activities.

• Technique in developing cardiovascular fitness.

• Technique when developing muscle strength and endurance activities.

• Technique in developing flexibility.

• Safety techniques.

Knowledge: Demonstrate understanding of fitness concepts, principles, strategies, and individual differences needed to participate and maintain a health-enhancing level of fitness.

• Benefits of physical activity/dangers of physical inactivity.

• Basic anatomy and physiology.

• Physiologic responses to physical activity.

• Components of health-related fitness.

• Training principles (overload, specificity, progression) and workout elements.

• Application of the Frequency Intensity Time Type principle. Factors that influence physical activity choices.

Physical activity: Participate regularly in fitness-enhancing physical activity.

• Physical activity participation (e.g., aerobic, muscle strength and endurance, bone strength, flexibility, enjoyment/social/personal meaning).

• Create an individualized physical activity plan.

• Self-monitor physical activity and adhere to a physical activity plan.

Health-related fitness: Achieve and maintain a health-enhancing level of health-related fitness.

• Physical fitness assessment (including self-assessment) and analysis.

• Setting goals and create a fitness improvement plan.

• Work to improve fitness components.

• Self-monitor and adjust plan.

• Achieve goals.

Responsible personal and social behaviors: Exhibit responsible personal and social behaviors in physical activity settings.

• Social interaction/respecting differences.

• Self-management.

• Personal strategies to manage body weight.

• Stress management.

Values and advocates: Value fitness-enhancing physical activity for disease prevention, enjoyment, challenge, self-expression, self-efficacy, and/or social interaction and allocate energies toward the production of healthy environments.

• Value physical activity.

• Advocacy.

• Fitness careers.

• Occupational fitness needs.

Nutrition: Strive to maintain healthy diet through knowledge, planning, and regular monitoring.

• Basic nutrition and benefits of a healthy diet.

• Healthy diet recommendations.

• Diet assessment.

• Plan and maintain a healthy diet.

Consumerism: Access and evaluate fitness information, facilities, products, and services.

• Differentiate between fact and fiction regarding fitness products.

• Make good decisions about consumer products.

SOURCE: NASPE, 2012. Reprinted with permission.

higher than those measured for walking on a treadmill at 3 miles per hour. Graf and colleagues (2009), studying boys and girls aged 10-13, found that both Wii boxing and DDR (level 2) elicited energy expenditure, heart rate, perceived exertion, and ventilatory responses that were comparable to or greater than those elicited by moderate-intensity walking on a treadmill. Similar results were found by Lanningham-Foster and colleagues (2009) among 22 children aged 10-14 and adults in that energy expenditure for both groups increased significantly when playing Wii over that expended during all sedentary activities. Staiano and colleagues (2012) explored factors that motivated overweight and obese African American high school students to play Wii during school-based physical activity opportunities. They found greater and more sustained energy expenditure over time and noted that players’ various intrinsic motivations to play also influenced their level of energy expenditure. Mellecker and McManus (2008) determined that energy expenditure and heart rate were greater during times of active play than in seated play. Fawkner and colleagues (2010) studied 20 high school–age girls and found that dance simulation games provided an opportunity for most subjects to achieve a moderate-intensity level of physical activity. The authors conclude that regular use of the games aids in promoting health through physical activity. Haddock and colleagues (2009) conducted ergometer tests with children aged 7-14 and found increased oxygen consumption and energy expenditure above baseline determinations. Maddison and colleagues (2007), studying children aged 10-14, found that active video game playing led to significant increases in energy expenditure, heart rate, and activity counts in comparison with baseline values. They conclude that playing these games for short time periods is comparable to light- to moderate-intensity conventional modes of exercise, including walking, skipping, and jogging. Mhurchu and colleagues (2008) also conclude that a short-term intervention involving active video games is likely to be an effective means of increasing children’s overall level of physical activity. Additionally, Sit and colleagues (2010), studying the effects of active gaming among 10-year-old children in Hong Kong, found the children to be significantly more physically active while playing interactive games compared with screen-based games.

Exergaming appears to increase acute physical activity among users and is being used in school settings because it is appealing to students. Despite active research in the area of exergaming and physical activity, however, exergaming’s utility for increasing acute and habitual physical activity specifically in the physical education setting has yet to be confirmed. Further, results of studies conducted in nonlaboratory and nonschool settings have been mixed (Baranowski et al., 2008). Moreover, any physical activity changes that do occur may not be sufficient to stimulate physiologic changes. For example, White and colleagues (2009) examined the effects

of Nintendo Wii on physiologic changes. Although energy expenditure was raised above resting values during active gaming, the rise was not significant enough to qualify as part of the daily 60 minutes or more of vigorous-or moderate-intensity exercise recommended for children.

While collecting data on the effects of Nintendo Wii on 11-year-olds in New Zealand, White and colleagues (2009) found that active video games generated higher energy expenditure than both resting and inactive screen watching. They determined, however, that active gaming is a “low-intensity” physical activity. Therefore, it may be helpful in reducing the amount of sedentary behavior, but it should not be used as a replacement for more conventional modes of physical activity. Sun (2012) found that active gaming can increase student motivation to engage in physical activity, but the motivation may decrease as a result of prolonged exposure to the same games. This study also found that exergaming lessons provided less physical activity for children than regular conventional physical education. For inactive children, however, the exergaming environment is conducive to more active participation in the game-based physical activities than in conventional physical education (Fogel et al., 2010). Finally, Sheehan and Katz (2012) found that among school-age children the use of active gaming added to postural stability, an important component of motor skills development.

From the research cited above, as well as ongoing research being conducted by the Health Games Research Project funded by the Robert Wood Johnson Foundation, active gaming is promising as a means of providing young children an opportunity to become more physically active and helping them meet the recommended 60 or more minutes of vigorous- or moderate-intensity physical activity per day. Different types of games may influence energy expenditure differentially, and some may serve solely as motivation. Selected games also appear to hold greater promise for increasing energy expenditure, while others invite youth to be physically active through motivational engagement. The dynamic and evolving field of active gaming is a promising area for future research as more opportunities arise to become physically active throughout the school environment.

Other Innovative Programs

While several evidence-based physical education programs—such as the Coordinated Approach to Child Health (CATCH) and Sports, Play, and Active Recreation for Kids (SPARK)—are being implemented in schools, many innovative programs also have been implemented nationwide that are motivating and contribute to skills attainment while engaging youth in activities that are fun and fitness oriented. These programs include water sports, involving sailing, kayaking, swimming, canoeing, and paddle boarding; adventure activities such as Project Adventure; winter sports, such as

snow skiing and snowshoeing; and extreme sports, such as in-line skating, skateboarding, and cycling.

Differences Among Elementary, Middle, and High Schools

Instructional opportunities vary within and among school levels as a result of discrepancies in state policy mandates. Although the time to be devoted to physical education (e.g., 150 minutes per week for elementary schools and 225 minutes per week for secondary schools) is commonly included in most state mandates, actual time allocation in school schedules is uncertain and often left to the discretion of local education officials.

With respect to content, in both elementary and secondary schools, physical activity is an assumed rather than an intended outcome except in the fitness education model. The goals of skill development and knowledge growth in physical education presumably are accomplished through participation in vigorous- or moderate-intensity physical activity. Data are lacking, however, to support the claim that physical activity offered to further the attainment of skills and knowledge is of vigorous or moderate intensity and is of sufficient duration for children to reap health benefits.

Children in Nontraditional Schools

Research on physical education, physical activity, and sports opportunities in nontraditional school settings (charter schools, home schools, and correctional facilities) is extremely limited. Two intervention studies focused on charter schools addressed issues with Mexican American children. In the first (Johnston et al., 2010), 10- to 14-year-old children were randomly assigned to either an instructor-led intervention or a self-help intervention for 2 years. The instructor-led intervention was a structured daily opportunity for the students to learn about nutrition and to engage in structured physical activities. The results indicate that the children in the instructor-led intervention lost more weight at the end of the intervention than those in the self-help condition. In the second study (Romero, 2012), 11- to 16-year-old Mexican American children from low-income families participated in a 5-week, 10-lesson, hip-hop dance physical activity intervention. In comparison with data collected prior to the intervention, the children reported greater frequency of vigorous- or moderate-intensity physical activity, lower perceived community barriers to physical activity, and stronger self-efficacy for physical activity. Collectively, the results of these two studies suggest that a structured physical activity intervention can be effective in enhancing and enriching physical activity opportunities for Mexican American adolescents in charter schools.

Research on physical activity among home-schooled children is also limited. The only study found was published in 2004 (Welk et al., 2004). It describes differences in physical fitness, psychosocial correlates of physical activity, and physical activity between home-schooled children and their public school counterparts aged 9-16. No significant differences were found between the two groups of children on the measures used, but the researchers did note that the home-schooled children tended to be less physically active.

Research on physical education and physical activity in juvenile correction institutions is equally scarce. Munson and colleagues (1985, 1988) conducted studies on the use of physical activity programs as a behavior mediation intervention strategy and compared its impact on juvenile delinquents’ behavior change with that of other intervention strategies. They found that physical activity did not have a stronger impact than other programs on change in delinquent behavior.

Fitness Assessment

All states except Iowa have adopted state standards for physical education. However, the extent to which students achieve the standards is limited since no accountability is required.

An analysis of motor skills competency, strategic knowledge, physical activity, and physical fitness among 180 4th- and 5th-grade children demonstrated that the physical education standards in force were difficult to attain (Erwin and Castelli, 2008). Among the study participants, fewer than a half (47 percent) were deemed motor competent, 77 percent demonstrated adequate progress in knowledge, only 40 percent were in the Healthy Fitness Zone on all five components of the Fitnessgram fitness assessment, and merely 15 percent engaged in 60 or more minutes of physical activity each day. Clearly most of the children failed to meet benchmark measures of performance for this developmental stage. This evidence highlights the need for additional physical activity opportunities within and beyond physical education to enhance opportunities for students to achieve the standards.

Relationships among these student-learning outcomes were further decomposed in a study of 230 children (Castelli and Valley, 2007). The authors determined that aerobic fitness and the number of fitness test scores in the Healthy Fitness Zone were the best predictors of daily engagement in physical activity relative to factors of gender, age, body mass index (BMI), motor skills competency, and knowledge. However, in-class engagement in physical activity was best predicted by aerobic fitness and motor skills competence, suggesting that knowledge and skills should not be overlooked in a balanced physical education curriculum intended to promote lifelong physical activity.

As an untested area, student assessment in physical education has been conducted on many indicators other than learning outcomes. As reported in a seminal study (Hensley and East, 1989), physical education teachers base learning assessment on participation (96 percent), effort (88 percent), attitude (76 percent), sportsmanship (75 percent), dressing out (72 percent), improvement (68 percent), attendance (58 percent), observation of skills (58 percent), knowledge tests (46 percent), skills tests (45 percent), potential (25 percent), and homework (11 percent). These data, while several years old, show that most learning assessments in physical education fail to target relevant learning objectives such as knowledge, skills, and physical activity behavior. The development of teacher-friendly learning assessments consistent with national and/or state standards is sorely needed.

Fitness assessment in the school environment can serve multiple purposes. On the one hand, it can provide both teacher and student with information about the student’s current fitness level relative to a criterion-referenced standard, yield valid information that can serve as the basis for developing a personal fitness or exercise program based on current fitness levels, motivate students to do better to achieve a minimum standard of health-related fitness where deficiencies exist, and possibly assist in the identification of potential future health problems. On the other hand, an overall analysis of student fitness assessments provides valuable data that can enable teachers to assess learner outcomes in the physical education curriculum and assess the present curriculum to determine whether it includes sufficient fitness education to allow students to make fitness gains throughout the school year. Fitness assessment also provides a unique opportunity for schools to track data on students longitudinally. The ultimate goal of assessing student fitness in the school environment should be to educate students on the importance of maintaining a physically active lifestyle throughout the life span.

When administering fitness assessments in the school setting, caution is essential to ensure confidentiality of the results. The results and their interpretation should be shared with students and parents/guardians to have the greatest impact. To ensure the greatest benefits from fitness assessment, NASPE (2010) developed a position statement on “Appropriate Uses of Fitness Measurement.” Table 5-1 outlines appropriate and inappropriate practices related to fitness testing in schools and other educational settings.

When fitness assessment becomes part of a quality physical education program, teaching and learning strategies will guide all students to acquire the knowledge and skills necessary to maintain and improve their personal health-related fitness as part of their commitment to lifelong healthy lifestyles. Teachers who incorporate fitness education as a thread throughout all curricula will make the greatest impact in engaging and motivating

TABLE 5-1 Appropriate and Inappropriate Practices Related to Fitness Testing in Schools and Other Educational Settings

students to participate in vigorous- or moderate-intensity physical activity in order to maintain and/or improve their personal health-related fitness. For example, the development of the Presidential Youth Fitness Program with the use of a criterion-referenced platform provides students with the educational benefits of fitness assessment knowledge (see Box 5-2 ). The emergence of one national fitness assessment, Fitnessgram, along with professional development and recognition protocols, further supports fitness education in the school environment.

Online Physical Education

Online physical education is a growing trend. Fully 59 percent of states allow required physical education credits to be earned through online courses. Only just over half of these states require that the online courses be taught by state-certified physical education teachers. Daum and Buschner (2012) report that, in general, online physical education focuses more on cognitive knowledge than physical skill or physical activity, many online courses fail to meet national standards for learning and physical activity

Presidential Youth Fitness Program

The Presidential Youth Fitness Program, launched in September 2012, is a comprehensive program that provides training and resources to schools for assessing, tracking, and recognizing youth fitness. The program promotes fitness testing as one component of a comprehensive physical education curriculum that emphasizes regular physical activity. The program includes a health-related fitness assessment, professional development, and motivational recognition. A key to the program’s success is helping educators facilitate a quality fitness assessment experience. The Presidential Youth Fitness Program was developed in partnership with the Cooper Institute; the Centers for Disease Control and Prevention; the American Alliance for Health, Physical Education, Recreation and Dance; and the Amateur Athletic Union.

The implementation of the Presidential Youth Fitness Program aligns with the Institute of Medicine report Fitness Measures and Health Outcomes in Youth, the result of a study whose primary purpose was to evaluate the relationship between fitness components and health and develop recommendations for health-related fitness tests for a national youth survey (IOM, 2012b). The report includes guidance on fitness assessments in the school setting. It confirms that Fitnessgram, used in the Presidential Youth Fitness Program, is a valid, reliable, and feasible tool for use in schools to measure health-related fitness. Use of the Fitnessgram represents a transition from the current test, which focuses on performance rather than health and is based on normative rather than criterion-referenced data, to a criterion-referenced, health-related fitness assessment instrument. Accompanying the assessment, as part of a comprehensive program, are education and training through professional development, awards, and recognition.

SOURCE: Presidential Youth Fitness Program, 2013.

guidelines, and teachers are not concerned about students’ accountability for learning.

Although online courses differ from traditional in-school physical education courses in the delivery of instruction, the standards and benchmarks for these courses must mirror those adopted by each individual state, especially when the course is taken to meet high school graduation requirements.

NASPE (2007a, p. 2) recommends that all physical education programs include “opportunity to learn, meaningful content, appropriate instruction, and student and program assessment.” If an online physical education program meets these standards, it may be just as effective as a face-to-face program. Online physical education can be tailored to each student’s needs, and it helps students learn how to exercise independently. The full NASPE position statement on online physical education can be found at http://www.ncpublic-schools.org/docs/curriculum/healthfulliving/resources/onlinepeguidelines.pdf (accessed February 1, 2013). The physical education policy of one online school, the Florida Virtual School, is presented in Box 5-3 .

Florida Virtual School’s Physical Education Policy

Sections 1001.11(7) and 1003.453(2) of the Florida Statutes require that every school district have a current version of its Physical Education Policy on the district website. This document satisfies that requirement.

Florida law defines “physical education” to mean:

“the development or maintenance of skills related to strength, agility, flexibility, movement, and stamina, including dance; the development of knowledge and skills regarding teamwork and fair play; the development of knowledge and skills regarding nutrition and physical fitness as part of a healthy lifestyle; and the development of positive attitudes regarding sound nutrition and physical activity as a component of personal well-being.

Florida Virtual School [FLVS] courses are designed to develop overall health and well-being through structured learning experiences, appropriate instruction, and meaningful content. FLVS provides a quality Physical Education program in which students can experience success and develop positive attitudes about physical activity so that they can adopt healthy and physically active lifestyles. Programs are flexible to accommodate individual student interests and activity levels in a learning environment that is developmentally appropriate, safe, and supportive.”

SOURCE: Excerpted from FLVS, 2013.

Online physical education provides another option for helping students meet the standards for physical education if they lack room in their schedule for face-to-face classes, need to make up credit, or are just looking for an alternative to the traditional physical education class. On the other hand, online courses may not be a successful mode of instruction for students with poor time management or technology skills. According to Daum and Buschner (2012), online learning is changing the education landscape despite the limited empirical research and conflicting results on its effectiveness in producing student learning. Through a survey involving 45 online high school physical education teachers, the authors found that almost three-fourths of the courses they taught failed to meet the national guideline for secondary schools of 225 minutes of physical education per week. Most of the courses required physical activity 3 days per week, while six courses required no physical activity. The teachers expressed support, hesitation, and even opposition toward online physical education.

Scheduling Decisions

Lesson scheduling is commonly at the discretion of school principals in the United States. The amount of time dedicated to each subject is often mandated by federal or state statutes. Local education agencies or school districts have latitude to make local decisions that go beyond these federal or state mandates. Often the way courses are scheduled to fill the school day is determined by the managerial skills of the administrator making the decisions or is based on a computer program that generates individual teacher schedules.

Successful curriculum change requires supportive scheduling (see Kramer and Keller, 2008, for an example of curriculum reform in mathematics). More research is needed on the effects of scheduling of physical education. In one such attempt designed to examine the impact of content and lesson length on calorie expenditure in middle school physical education, Chen and colleagues (2012) found that a lesson lasting 45-60 minutes with sport skills or fitness exercises as the major content would enable middle school students to expend more calories than either shorter (30-40 minutes) or longer (65-90 minutes) lessons. The evidence from such research can be used to guide allocation of the recommended weekly amount of physical education (150 minutes for elementary schools, 225 minutes for secondary schools) to achieve optimal health benefits for youth. Additional discussion of scheduling is provided later in this chapter in the section on solutions for overcoming the barriers to quality physical education.

IMPORTANCE OF PHYSICAL EDUCATION TO CHILD DEVELOPMENT

As discussed in Chapter 3 , there is a direct correlation between regular participation in physical activity and health in school-age children, suggesting that physical activity provides important benefits directly to the individual child (HHS, 2008). Physical activity during a school day may also be associated with academic benefits ( Chapter 4 ) and children’s social and emotional well-being (HHS, 2008; Chapter 3 ). Physical education, along with other opportunities for physical activity in the school environment (discussed in Chapter 6 ), is important for optimal health and development in school-age children. It may also serve as a preventive measure for adult conditions such as heart disease, high blood pressure, and type 2 diabetes.

Little has been learned about the short- and long-term effectiveness of physical education in addressing public health issues (Pate et al., 2011). Because the learning objectives of physical education have not included improvement in health status as a direct measure, indirect measures and correlates have been used as surrogates. However, some promising research, such as that conducted by Morgan and colleagues (2007), has demonstrated that students are more physically active on days when they participate in physical education classes. Further, there is no evidence of a compensatory effect such that children having been active during physical education elect not to participate in additional physical activity on that day. Accordingly, quality physical education contributes to a child’s daily accumulation of physical activity and is of particular importance for children who are overweight or who lack access to these opportunities in the home environment (NASPE, 2012).

Unlike other physical activity in school (e.g., intramural or extramural sports), physical education represents the only time and place for every child to learn knowledge and skills related to physical activity and to be physically active during the school day. It also is currently the only time and place for all children to engage in vigorous- or moderate-intensity physical activity safely because of the structured and specialist-supervised instructional environment. It is expected that children will use the skills and knowledge learned in physical education in other physical activity opportunities in school, such as active recess, active transportation, and intramural sports. For these reasons, physical education programming has been identified as the foundation on which multicomponent or coordinated approaches incorporating other physical activity opportunities can be designed and promoted.

Coordinated approaches in one form or another have existed since the early 1900s, but it was not until the 21st century that physical education was acknowledged as the foundation for these approaches. The Centers for Disease Control and Prevention (CDC) (2010), the National Association

of State Boards of Education (NASBE; 2012), and NASPE (2004, 2010) all support this view because physical education provides students with the tools needed to establish and maintain a physically active lifestyle throughout their life span. As discussed in Chapter 3 , research on motor skills development has provided evidence linking physical skill proficiency levels to participation in physical activity and fitness (Stodden et al., 2008, 2009). Exercise psychology research also has identified children’s perceived skill competence as a correlate of their motivation for participation in physical activity (Sallis et al., 2000). When school-based multicomponent interventions include physical activities experienced in physical education that are enjoyable and developmentally appropriate, such coordinated efforts are plausible and likely to be effective in producing health benefits (Corbin, 2002). Accordingly, two of the Healthy People 2020 (Healthy People 2020, 2010) objectives for physical activity in youth relate to physical education: “PA-4: Increase the proportion of the Nation’s public and private schools that require daily physical education for all students ” and “PA-5: Increase the proportion of adolescents who participate in daily school physical education.” 1

The importance of physical education to the physical, cognitive, and social aspects of child development has been acknowledged by many federal, state, and local health and education agencies. Many private entities throughout the country likewise have offered their support and recommendations for strengthening physical education. For example, the Institute of Medicine (2012a), in its report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation , points to the need to strengthen physical education to ensure that all children engage in 60 minutes or more of physical activity per school day. Similarly, the National Physical Activity Plan (2010), developed by a group of national organizations at the forefront of public health and physical activity, comprises a comprehensive set of policies, programs, and initiatives aimed at increasing physical activity in all segments of schools. The plan is intended to create a national culture that supports physically active lifestyles so that its vision that “one day, all Americans will be physically active and they will live, work, and play in environments that facilitate regular physical activity” can be realized. To accomplish this ultimate goal, the plan calls for improvement in the quantity and quality of physical education for students from prekindergarten through 12th grade through significant policy initiatives at the federal and state levels that guide and fund physical education and other physical activity programs. Specifically, the plan prescribes seven specific tactics presented in Box 5-4 .

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1 Available online at http://www.healthypeople.gov/2020/topicsobjectives2020/pdfs/PhysicalActivity.pdf (accessed February 1, 2013).

Medical professional associations, such as the American Cancer Society (ACS), American Diabetes Association (ADA), and American Heart Association (AHA), have long acknowledged the importance of physical education and have endorsed policies designed to strengthen it. A position statement on physical education from the ACS Cancer Action Network, ADA, and AHA (2012) calls for support for quality physical education and endorses including physical education as an important part of a student’s comprehensive, well-rounded education program because of its positive impact on lifelong health and well-being. Further, physical education policy should make quality the priority while also aiming to increase the amount of time physical education is offered in schools.

Recently, private-sector organizations—such as the NFL through its Play60 program—have been joining efforts to ensure that youth meet the guideline of at least 60 minutes of vigorous- or moderate-intensity physical activity per day. One such initiative is Nike’s (2012) Designed to Move: A Physical Activity Action Agenda , a framework for improving access to physical activity for all American children in schools. Although the framework does not focus exclusively on physical education, it does imply the important role of physical education in the action agenda (see Box 5-5 ).

Finally, in response to First Lady Michelle Obama’s Let’s Move initiative, the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) launched the Let’s Move In School initiative, which takes a holistic approach to the promotion of physical activity in schools. The purpose of the initiative is to help elementary and secondary schools launch the Comprehensive School Physical Activity Program (CSPAP), which is focused on strengthening physical education and promoting all opportunities for physical activity in school. The CSPAP in any given school is intended to accomplish two goals: (1) “provide a variety of school-based physical activity opportunities that enable all students to participate in at least 60 minutes of moderate-to-vigorous physical activity each day” and (2) “provide coordination among the CSPAP components to maximize understanding, application, and practice of the knowledge and skills learned in physical education so that all students will be fully physically educated and well-equipped for a lifetime of physical activity” (AAHPERD, 2012). The five CSPAP components, considered vital for developing a physically educated and physically active child, are physical education, physical activity during school, physical activity before and after school, staff involvement, and family and community involvement (AAHPERD, 2012). Schools are allowed to implement all or selected components.

An AAHPERD (2011) survey indicated that 16 percent of elementary schools, 13 percent of middle schools, and 6 percent of high schools (from a self-responding nationwide sample, not drawn systematically) had implemented a CSPAP since the program was launched. Although most schools

National Physical Activity Plan: Strategy 2

The National Physical Activity Plan’s Strategy 2 is as follows:

Strategy 2: Develop and implement state and school district policies requiring school accountability for the quality and quantity of physical education and physical activity programs.

1. Advocate for binding requirements for PreK-12 standards-based physical education that address state standards, curriculum time, class size, and employment of certified, highly qualified physical education teachers in accordance with national standards and guidelines, such as those published by the National Association for Sport and Physical Education (NASPE).

2. Advocate for local, state and national standards that emphasize provision of high levels of physical activity in physical education (e.g., 50 percent of class time in vigorous- or moderate-intensity physical activity).

sampled (90 percent) provided physical education, the percentage declined through middle school and high school, such that only 44 percent of high schools provided physical education to seniors. In most schools (92 percent), classes were taught by teachers certified to teach physical education.

More than 76 percent of elementary schools provided daily recess for children, and 31 percent had instituted a policy prohibiting teachers from withholding children from participating in recess for disciplinary reasons. In 56 percent of elementary schools that had implemented a CSPAP, physical activity was encouraged between lessons/classes; in 44 percent it was integrated into academic lessons; and in 43 percent the school day started with physical activity programs.

The percentage of schools that offered intramural sports clubs to at least 25 percent of students declined from 62 percent of middle schools to

3. Enact federal legislation, such as the FIT Kids Act, to require school accountability for the quality and quantity of physical education and physical activity programs.

4. Provide local, state, and national funding to ensure that schools have the resources (e.g., facilities, equipment, appropriately trained staff) to provide high-quality physical education and activity programming. Designate the largest portion of funding for schools that are underresourced. Work with states to identify areas of greatest need.

5. Develop and implement state-level policies that require school districts to report on the quality and quantity of physical education and physical activity programs.

6. Develop and implement a measurement and reporting system to determine the progress of states toward meeting this strategy. Include in this measurement and reporting system data to monitor the benefits and adaptations made or needed for children with disabilities.

7. Require school districts to annually collect, monitor, and track students’ health-related fitness data, including body mass index.

SOURCE: National Physical Activity Plan, 2010.

50 percent of high school for males, and from 53 to 40 percent, respectively, for females. Interscholastic sports were offered in 89 percent of high schools. Among them, approximately 70 percent involved at least 25 percent of the male student population participating and 58 percent involved at least 25 percent of the female student population participating. Sixty-five percent of high schools had “cut” policies, which could limit the enrollment of students in interscholastic sports.

CHARACTERISTICS OF QUALITY PHYSICAL EDUCATION PROGRAMS

As noted, a high-quality physical education program can help youth meet the guideline of at least 60 minutes of vigorous- or moderate-intensity physical activity per day. This increase in physical activity should be bal-

Nike’s Designed to Move: A Physical Activity Action Agenda

1. Universal access: Design programs that are effective for every child, including those who face the most barriers to participating in physical activity.

2. Age appropriate: Physical activities and tasks that are systematically designed for a child’s physical, social, and emotional development, as well as his or her physical and emotional safety, are a non-negotiable component of good program design.

3. Dosage and duration: Maximum benefit for school-aged children and adolescents comes from group-based activity for at least 60 minutes per day that allows for increased mastery and skill level over time.

4. Fun: Create early positive experiences that keep students coming back for more, and let them have a say in what “fun” actually is.

5. Incentives and motivation: Focus on the “personal best” versus winning or losing.

6. Feedback to kids: Successful programs build group and individual goal setting and feedback into programs.

7. Teaching, coaching, and mentorship: Teachers of physical education, coaches, and mentors can make or break the experience for students. They should be prepared through proper training and included in stakeholder conversations. A well-trained physical activity workforce shares a common commitment and principles that promote physical activity among children. Great leaders create positive experiences and influence all learners.

SOURCE: Excerpted from Nike, 2012.

anced with appropriate attention to skill development and to national education standards for quality physical education (see Box 5-6 ). In a recent literature review, Bassett and colleagues (2013) found that physical education contributes to children achieving an average of 23 minutes of vigorous- or moderate-intensity physical activity daily. However, the time spent in vigorous- or moderate-intensity physical activity could be increased by 6 minutes if the physical education curriculum were to incorporate a standardized curriculum such as SPARK (discussed in detail below) (Bassett et al., 2013). Thus, it is possible for physical education to contribute to youth meeting at least half (30 minutes) of their daily requirement for vigorous- or moderate-intensity physical activity. To help children grow holistically, however, physical education needs to achieve other learning goals when children are active. To this end, physical education programs must possess the quality characteristics specified by NASPE (2007b, 2009b,c) (see Box 5-6 ). Designing and implementing a physical education program with these characteristics in mind should ensure that the time and curricular materials of the program enable students to achieve the goals of becoming knowledgeable exercisers and skillful movers who value and adopt a physically active, healthy lifestyle.

Findings from research on effective physical education support these characteristics as the benchmarks for quality programs. In an attempt to understand what effective physical education looks like, Castelli and Rink (2003) conducted a mixed-methods comparison of 62 physical education programs in which a high percentage of students achieved the state physical education learning standards with programs whose students did not achieve the standards. Comprehensive data derived from student performance, teacher surveys, and onsite observations demonstrated that highly effective physical education programs were housed in cohesive, long-standing departments that experienced more facilitators (e.g., positive policy, supportive administration) than inhibitors (e.g., marginalized status as a subject matter within the school). Further, effective programs made curricular changes prior to the enactment of state-level policy, while ineffective programs waited to make changes until they were told to do so. The teachers in ineffective programs had misconceptions about student performance and, in general, lower expectations of student performance and behavior.

Examples of Evidence-Based Physical Education Curricular Programs

Two large-scale intervention studies—SPARK and CATCH—are discussed in this section as examples of how programs can be structured to increase vigorous- or moderate-intensity physical activity in physical education classes.

NASPE’s Characteristics of a High-Quality Physical Education Program

Opportunity to learn

All students are required to take physical education.
Instructional periods total 150 minutes per week (elementary schools) and 225 minutes per week (middle and secondary schools).
Physical education class size is consistent with that of other subject areas.
A qualified physical education specialist provides a developmentally appropriate program.
Equipment and facilities are adequate and safe.

Meaningful content

A written, sequential curriculum for grades PreK-12 is based on state and/or national standards for physical education.
Instruction in a variety of motor skills is designed to enhance the physical, mental, and social/emotional development of every child.
Fitness education and assessment are designed to help children understand, improve, and/or maintain physical well-being.
Curriculum fosters the development of cognitive concepts about motor skill and fitness.
Opportunities are provided to improve emerging social and cooperative skills and gain a multicultural perspective.
Curriculum promotes regular amounts of appropriate physical activity now and throughout life.

The aim of SPARK, a research-based curriculum, is to improve the health, fitness, and physical activity levels of youth by creating, implementing, and evaluating programs that promote lifelong wellness. Each SPARK program “fosters environmental and behavioral change by providing a coordinated package of highly active curriculum, on-site teacher training, extensive follow-up support, and content-matched equipment focused on the development of healthy lifestyles, motor skills and movement knowledge, and social and personal skills” (SPARK, 2013).

Appropriate instruction

Full inclusion of all students.
Maximum practice opportunities for class activities.
Well-designed lessons that facilitate student learning.
Out-of-school assignments that support learning and practice.
Physical activity not assigned or withheld as punishment.
Regular assessment to monitor and reinforce student learning.

Student and program assessment

Assessment is an ongoing, vital part of the physical education program.
Formative and summative assessments of student progress are conducted.
Student assessments are aligned with state/national physical education standards and the written physical education curriculum.
Assessment of program elements that support quality physical education is conducted.
Stakeholders periodically evaluate the effectiveness of the total physical education program.

SOURCE: Adapted from NASPE, 2009c.

Research supports the use of SPARK as a platform for improving the quality of physical activity instruction in schools. The SPARK curriculum has demonstrated the ability to improve student activity levels, increase the number of minutes of vigorous- or moderate-intensity physical activity for students, and provide sustainable and positive change in a school district (Myers-Schieffer and Thomas, 2012). In one study, researchers found that “the children were positive about this specific curriculum. This is gratifying because one of the goals of the program was to engender positive feeling

in the students toward physical activity” (McKenzie et al., 1994, p. 213). In another study, a SPARK intervention is credited with exposing students to an increase in motor skills drills, which in turn led to a higher level of manipulative motor skills acquisition (McKenzie et al., 1998). As a result of improved activity levels, students who participated in the SPARK curriculum improved their times in the 1-mile run and sit-up tests (Sallis et al., 1997). Finally, System for Observing Fitness Instruction Time (SOFIT) classroom observations revealed that students in SPARK classes increased their time spent in vigorous- or moderate-intensity physical activity per class from 17.8 to up to 40.2 minutes compared with students in non-SPARK classes, who engaged in 17.8 minutes of vigorous- or moderate-intensity physical activity per class. Teachers involved in the SPARK intervention offered increased levels of fitness promotion and provided students with an increased amount of general instruction and increased minutes of attention per week (McKenzie et al., 1997; Myers-Schieffer and Thomas, 2012).

The CATCH program teaches children in grades K-8 how to be healthy throughout their lifetimes through a coordinated approach that involves engaging the community, families, and educators to work together. The goal of CATCH is to impact children’s health behaviors positively, improve the school health environment, and influence and change school health policies and practices in order to reduce and eliminate health risk factors and risk-related behaviors of students (Perry et al., 1990). CATCH significantly increases the physical activity levels of students during physical education class and provides a wide range of learning experiences for students of all abilities.

CATCH began as a clinical trial from 1991 to 1994 in four regional sites: Tulane University in New Orleans; the University of California, San Diego; the University of Minnesota in Minneapolis; and the University of Texas in Houston. The participants were elementary school children in grades 3 through 5 and included children from multiethnic backgrounds. Upon completion of the main trial, CATCH had succeeded in producing positive and lasting changes in children’s behaviors, including decreasing fat consumption and increasing physical activity (Luepker et al., 1996). The changes were maintained for 3 years postintervention (Nader et al., 1999).

National Standards

Because physical education is part of the curriculum in schools, its quality should be judged only by whether and to what extent children have learned and benefited from it. In a landmark document on learning goals, Moving into the Future: National Standards for Physical Education , NASPE (2004) proposes six student learning standards specifying both conceptual and behavioral characteristics that a physically educated person must pos-

sess and display (see Box 5-7 ). These characteristics encompass knowledge, skill, behavior, and confidence critical to the development and maintenance of health and to the enjoyment of a physically active, healthful lifestyle.

Certified Physical Education Specialists as the Main Teaching Force

If standards are the gauge for quality, teachers make the difference in a particular school in terms of the extent to which students can achieve the standards. Research has made clear that certified physical education specialists can provide more and longer opportunities for students to meet physical activity guidelines compared with classroom teachers trained to teach physical education (McKenzie et al., 2001). Moreover, when teachers are taught strategies to encourage vigorous- or moderate-intensity physical activity in physical education class, a significant increase in physical activity can be expected (Lonsdale et al., 2013). The role of certified physical

Standards for a Physically Educated Person

education specialists in health-enhancing physical education has become increasingly critical (McKenzie, 2007). The evidence is unequivocal regarding the need for a continued effort to train physical education specialists and the need for schools to continue to employ them as the main teaching force designing and implementing health-enhancing physical education programs to the fullest extent.

Aside from serving as the instructional leader for physical education, physical education specialists can serve as expert resources for classroom teachers in the implementation of classroom physical activity breaks and recess (discussed in detail in Chapter 6 ). Their expertise in age-appropriate physical activity helps ensure that students are participating in activities that are fun and engaging. Additionally, as the catalyst for a healthy school environment, the physical education specialist can assist in the design and delivery of intramural programs provided before and after school, as well as serve as a community outreach specialist for onsite activity partnerships. For physical education specialists interested in a more formal role as a physical activity leader at their school, NASPE has developed a director of physical activity certification program.

It is a commonly held notion of society that to maintain the quality of education, schools should hire teachers certified to teach in the subject matter areas in which they are licensed. Unfortunately, in the United States, not all physical education classes are taught by certified physical education specialists. Indeed, 68 percent of elementary schools allow classroom teachers (generalists) to teach physical education (NASPE, 2012). Certification or licensure of middle/junior high school and high school physical education teachers is required in only 82 percent and 90 percent of states (NASPE, 2012), respectively. Only 37 states (72 percent) have a requirement for professional development and continuing education hours/credit for physical education teachers to maintain or renew their certification, with renewal time ranging from 3 to 5 years (NASPE, 2012). Twenty-eight states (55 percent) allow temporary/emergency certificates to teach physical education that are valid for 1 to 3 years (NASPE, 2012). The basic requirements for emergency certification include a bachelor’s degree in teaching or in any area except physical education. Only 31 states (60 percent) support physical education teachers going through the national board certification process, and only New York requires each school district to have a licensed physical education specialist serving as a physical education coordinator (NASPE, 2012).

Preservice Education for Teachers

Teaching physical education to children effectively and safely requires specific knowledge about children and their physical/mental development,

body composition (anatomy) and functions (physiology and biomechanics), and motor skills development and acquisition. In addition, teaching physical education requires substantial knowledge and skill in pedagogy—the science and art of teaching. Box 5-8 lists the NASPE standards for beginning physical education teachers who have completed a bachelor’s teacher training program and those who have completed advanced (master’s-level) training.

These standards are accompanied by measurement rubrics (unacceptable, acceptable, and target, with target being exemplary) developed jointly by NASPE and the National Council for Accreditation of Teacher Education (NCATE) for evaluating physical education teacher education programs across the country (the 50 states, the District of Columbia, and Puerto Rico). NCATE identified a total of 133 physical education teacher education programs as “nationally recognized.” The committee was unable to determine how many programs nationwide have met the minimum standards (not at the nationally recognized level) or locate reliable information on the total number of physical education teacher education programs. A Web search using the term “physical education” resulted in two different but relatively reliable statistics: 720 (College Board, 2013) and 1,945 (Peterson’s, 2013). But the data sources did not distinguish between physical education teaching majors and other kinesiology concentrations (e.g., sports medicine, exercise physiology/fitness). Statistics on the number of physical education teacher education programs and their quality based on the NASPE standards are needed.

The current wave of effort to curb physical inactivity among youth has begun to influence teacher education programs. According to a national survey study (Kulinna et al., 2010), current teacher candidates believe that helping K-12 students become physically active and fit is the first priority of physical education, followed by helping them actualize their own goals, develop motor skills, and become responsible. These data appear to suggest that physical education teacher education programs are beginning to turn from a traditionally sports- and skills-centered model to a more comprehensive, physical activity– and health-centered model. This change is important in that the role of both current and future physical education teachers extends beyond merely teaching their classes to advancing public health goals (McKenzie, 2007).

In many universities, however, teacher education programs in physical education have either been reduced or eliminated because of the decline in physical education requirements, which has resulted in a decrease in the number of physical education teachers being employed. Concomitantly, physical education teacher education programs are experiencing an unprecedented crisis. A recent report indicates that, in school year 2008-2009, only 23 doctorate-granting kinesiology departments offered doctoral programs

National Association for Sport and Physical Education Standards for Beginning Physical Education Teachers

Initial Standards

1. Scientific and theoretical knowledge: Physical education teacher candidates know and apply discipline-specific scientific and theoretical concepts critical to the development of physically educated individuals.

2. Skill-based and fitness-based competence: Physical education teacher candidates are physically educated individuals with the knowledge and skills necessary to demonstrate competent movement performance and health-enhancing fitness as delineated in the NASPE K-12 standards.

3. Planning and implementation: Physical education teacher candidates plan and implement developmentally appropriate learning experiences aligned with local, state, and national standards to address the diverse needs of all students.

4. Instructional delivery and management: Physical education teacher candidates use effective communication and pedagogical skills and strategies to enhance student engagement and learning.

that were training future teacher educators (Boyce and Rikard, 2011a). A total of 140 doctoral students were receiving training offered by 114 professors (including part-time), and 11 percent of those professors were planning to retire. Boyce and Rikard (2011a) report that in the past 13 years, 479 doctoral students graduated as physical education teacher educators—36.8 each year on average—89 percent of whom were able to find positions in colleges and universities. During the same period, 61 positions were open, only 39 of which were filled (64 percent), with an applicant pool of 38 candidates with earned degrees and 13 who completed the doctoral course-work but did not complete the dissertation research (Boyce and Rikard, 2011b). Clearly there is a shortage of physical education teacher educators

5. Impact on student learning: Physical education teacher candidates use assessments and reflection to foster student learning and inform decisions about instruction.

6. Professionalism: Physical education teacher candidates demonstrate dispositions essential to becoming effective professionals.

Advanced Standards

1. Professional knowledge: Advanced physical education teacher candidates come to understand disciplinary content knowledge, the application of content knowledge to teaching physical education, and modes of inquiry that form the bases for physical education programs and instruction.

2. Professional practice: Advanced physical education teacher candidates (AC) use content knowledge and pedagogical content knowledge (PCK) to design and conduct appropriate learning experiences that facilitate and enhance the growth of learners.

3. Professional leadership: Advanced physical education teacher candidates are continuous, collaborative learners who further their own professional development and use their abilities to contribute to the profession.

SOURCE: Excerpted from NASPE, 2009a.

in higher education institutions. Because of a lack of national tracking data on physical education graduates, the extent to which the teacher educator shortage has impacted and will impact the need to supply quality physical education teachers to the nation is unclear.

Professional Development

In all educational settings, professional development for teachers and administrators is a continuous process of acquiring new knowledge and skills that relate to an educator’s profession or academic subject area, job responsibilities, or work environment. Professional development is essential for improving classroom instruction and student achievement (Ball and

Cohen, 1999; Cohen and Hill, 2000). Through a variety of delivery methods, professional development activities may include credit or noncredit courses, classroom or online venues, workshops, seminars, teleconferences, and webinars, with the ultimate goal of improving the delivery of instruction to enhance student achievement.

Yoon and colleagues (2007) assert that a strong link exists among professional development, teacher learning and practice, and student achievement. Figure 5-1 , which aligns with the research on effective professional development (Kennedy, 1998; Loucks-Horsley and Matsumoto, 1999; Cohen and Hill, 2000; Garet et al., 2001; Fishman et al., 2003; Guskey and Sparks, 2004), illustrates how (1) professional development enhances teacher knowledge and skills, (2) better knowledge and skills improve classroom teaching, and (3) improved teaching raises student achievement.

The most impactful statement of government policy on the preparation and professional development of teachers was the 2002 reauthorization of the Elementary and Secondary Education Act (Whitehurst, 2002), known as the No Child Left Behind Act. While Title I of the act places highly qualified teachers in the classroom, Title II addresses the same goal by funding professional development for teachers. The importance of quality professional development is well documented in the act.

Professional development, according to the No Child Left Behind Act, should be offered to improve teachers’ knowledge of the subject matter they teach, strengthen their classroom management skills, advance their understanding and implementation of effective teaching strategies, and build their capabilities to address disparities in education. The act states that high-quality professional development programs should have the characteristics listed in Box 5-9 .

Although there is a substantial literature on professional development, only a few high-quality studies relate teachers’ professional development experiences to student outcomes. Recommendations for high-quality professional development tend to emphasize the importance of

FIGURE 5-1 Logic model of the impact of professional development on student achievement.

Characteristics of a High-Quality Professional Development Program

1. It is sustained, intensive, and content-focused to have a positive and lasting impact on classroom instruction and teacher performance.

2. It is aligned with and directly related to state academic content standards, student achievement standards, and assessments.

3. It improves and increases teachers’ knowledge of the subjects they teach.

4. It advances teachers’ understanding of effective instructional strategies founded on scientifically based research.

5. It is regularly evaluated for effects on teacher effectiveness and student achievement. Intensive and focused in-service training.

SOURCE: No Child Left Behind Act of 2001, Public Law 107-110, 115 stat. 1425 (2002).

intense, content-focused experiences, as well as opportunities for peer collaboration and structured induction experiences for new teachers. Wiley and Yoon (1995) and Kennedy (1998) suggest that teaching practice and student achievement are likely to improve when professional development is focused on academic content and curriculum that are aligned with standards-based reform.

Kulinna (2012) used Guskey and Sparks’ (2004) Model of Teacher Change to determine whether students’ physical activity and BMI changed after their teacher underwent a 1-year professional development program. Significant increases in students’ physical activity levels were found, but no significant changes in BMI. Looking at the effect of professional development on changes in behavior among physical education teachers, Martin and colleagues (2008) found that, following a variety of professional development experiences and follow-up sessions, teachers showed increases in their efficacy in attaining motor skills objectives, physical activity and fitness knowledge objectives, and personal and social objectives. These

results lend support to the value of professional development in enhancing teachers’ perceptions of self-efficacy for teaching the curriculum. McCaughtry and colleagues (2006) explored the factors that make teacher professional development successful and what success might mean in terms of teachers’ instructional practices and feelings about change. Results indicated that after teachers completed professional development the resources they gained enabled them to improve their instruction by teaching more content, maximizing student learning opportunities, teaching diverse learners, teaching to development, and increasing classroom safety.

Learning Forward (formerly known as the National Staff Development Council) provides research-based guidelines to assist districts in aligning local professional development programs with qualitative standards. Its Standards for Professional Learning were revised in 2011 and are guided by the relationship between professional learning and student results (see Box 5-10 ). According to Learning Forward (2012):

• When professional learning is standards based, it has greater potential to change what educators know, are able to do, and believe.

• When educators’ knowledge, skills, and dispositions change, they have a broader repertoire of effective strategies to use in adapting their practices to meet performance expectations and students’ learning needs.

• When educator practices improve, students have a greater likelihood of achieving results.

• When student results improve, the cycle repeats for continuous improvement.

• Professional learning standards provide a foundation on which to design professional learning experiences at the district or school level that will assist educators in acquiring the necessary knowledge, skills, and tools.

As a recognized means of providing physical education teachers with the tools necessary to enhance student achievement, quality professional development should be provided on a regular basis with follow-up support, along with a method for determining its effectiveness in meeting both curricular and pedagogical standards. Furthermore, to enhance the fitness achievement of students, school-based professional development should provide instruction on the integration of fitness testing into a curriculum and should include training in protocols, the interpretation and communication of results, and the setting and achievement of fitness goals and recommendations for developing healthy living habits for both students and their parents (IOM, 2012a).

Standards for Professional Learning

Learning communities: Professional learning that increases educator effectiveness and results for all students occurs within learning communities committed to continuous improvement, collective responsibility, and goal alignment.

Leadership: Professional learning that increases educator effectiveness and results for all students requires skillful leaders who develop capacity, advocate, and create support systems for professional learning.

Resources: Professional learning that increases educator effectiveness and results for all students requires prioritizing, monitoring, and coordinating resources for educator learning.

Data: Professional learning that increases educator effectiveness and results for all students uses a variety of sources and types of student, educator, and system data to plan, assess, and evaluate professional learning.

Learning designs: Professional learning that increases educator effectiveness and results for all students integrates theories, research, and models of human learning to achieve its intended outcomes.

Implementation: Professional learning that increases educator effectiveness and results for all students applies research on change and sustains support for implementation of professional learning for long-term change.

Outcomes: Professional learning that increases educator effectiveness and results for all students aligns its outcomes with educator performance and student curriculum standards.

SOURCE: Learning Forward, 2012.

POLICIES THAT AFFECT THE QUALITY OF PHYSICAL EDUCATION

Instructional opportunities for physical activity and physical education are mandated by most states. In comparison with data prior to 2006, more states have developed mandates for physical education at both the elementary and secondary school levels. However, most mandates lack a specified time allocation that ensures meeting the NASPE recommendation of 150 and 225 minutes per week for elementary and secondary schools, respectively (McCullick et al., 2012), despite the fact that physical education has been considered a cornerstone for developing schoolwide multicomponent interventions to address the issue of physical inactivity in schools. Some obstacles to the implementation of quality physical activity are listed in Box 5-11 .

According to Title IX of the No Child Left Behind Act (Part A Sec 9101-11), core academic subjects include “English, reading or language arts, mathematics, science, foreign languages, civics and government, eco-

Obstacles to Implementation of Quality Physical Education

1. Class periods dedicated to physical education are declining at all school levels.

2. Existing discrepancies between policy and implementation with respect to specific time allocation contribute to a reduction in actual instructional time for physical education.

3. There is a potential shortage of physical education specialists to influence the design and maintenance of quality physical education programs.

4. Reductions in active learning time and opportunities in physical education contribute to potential student underachievement on national standards.

5. Disparities may exist in instructional opportunities for children in nontraditional learning settings.

nomics, arts, history, and geography.” If physical education were designated as a core academic subject, it would receive much-needed policy attention that would enhance its overall quality with respect to content offerings, instruction, and accountability. In support of the inclusion of physical education as a core subject, Senator Tom Udall (D-NM) reintroduced the Promoting Health for Youth Skills in Classrooms and Life (PHYSICAL) Act on February 27, 2013, to support and encourage the health and well-being of elementary and secondary school students.

With physical education not being considered a core subject, and amid growing concern regarding the increase in childhood obesity and physical inactivity, several national studies and reports have emphasized the importance of implementing state statutes, laws, and regulations both mandating time requirements for physical education and monitoring compliance. Yet although several national governmental, nongovernmental, private industry, and public health organizations have recommended specific day and time/minute requirements for physical education, no standardized state policy has emerged.

Analysis of State Statutes and Administrative Codes

In the United States, school policies on curriculum and school-based activities are determined by local education agencies according to state laws governing educational activities. Decisions about what to teach, who will teach it, and what level of resources will be provided are made by the state, county or district, and school administration. To better understand the status of state statutes, administrative codes, and policies impacting physical education in schools, the committee analyzed NASBE’s State School Health Policy Database (NASBE, 2012; www.nasbe.org/healthy_schools [accessed February 1, 2013]). Of importance to this analysis is the distinction made between state statutes and administrative codes, which accords with the definition proffered by Perna and colleagues (2012): “At the state level, the 2 primary official public policy levers referred to as ‘codified law’ used for developing school-based physical education policy are 1) statutory laws (laws enacted by the given State legislature); and 2) administrative laws (rule and regulations by state executive branch agencies, such as the Department of Education)” (p. 1594). A second point to note is that in descriptions of physical education graduation requirements, it is impossible to differentiate among “credit,” “Carnegie unit,” and “course” so as to determine the exact time requirements for graduation.

Using the NASBE database, the committee performed an overall analysis of policies on physical education and physical activity of the 50 states and the District of Columbia. The analysis revealed that 45 states (88 percent) mandate physical education; 22 states (23 percent) require it

with mandatory minutes, while 25 states (49 percent) have no mandatory minutes and 4 (0.07 percent) leave the required number of minutes up to local decision makers. A majority of states allow for waivers or substitutions for physical education (see the discussion below). Fitness assessment is required in 15 states (29 percent), and other curricular assessments are required in 4 states (0.07 percent). Twenty-six states (53 percent) require physical education grades to be included in a student’s grade point average. Forty-three states (84 percent) require some degree of physical education for high school graduation, with a range of 0.5 to 3.75 credits. One state (0.02 percent) requires K-12 physical education but does not require 4 years of physical education for high school graduation.

Although no federal policies requiring physical education presently exist, the above evidence shows that the majority of states require physical education. However, the number of days and time required vary greatly by state and local school district, as does the amount of physical education required for high school graduation. Given the reduced time for physical activity in school through recess, and absent the implementation of stronger policies, schools have not only the opportunity but also the responsibility to nurture in youth the skills, knowledge, and confidence to develop and maintain a healthy lifestyle. The consensus among states indicated by the mandates for physical education summarized above, together with the discrepancies in specific policies, may suggest the need for general guidelines or a federal-level mandate that can serve to guide a collective effort to address the prevalence of childhood inactivity and obesity.

Policies That Support Physical Education

In addition to policies that directly require offering physical education in schools, other policies support physical education opportunities in schools. In 2004 the U.S. government issued a mandate, under the Child Nutrition and WIC Reauthorization Act of 2004, requiring school districts that receive funds under this act to establish local school wellness policies. These policies were to include provisions for physical activity and healthy eating, thus expanding schools’ responsibility for providing physical activity to school-age children. The enactment of this mandates made schools “the central element in a community system that ensures that students participate in enough physical activity to develop healthy lifestyles” (Pate et al., 2006, p. 1215). Several government agencies and organizations have recommended embedding a specific number of days and minutes of physical education into each school’s or district’s wellness policy. Although school districts are required to include goals for physical activity in their local school wellness policies, they are not required to address physical education specifically.

Policies That Hinder Physical Education

Some policies have contributed to the substantial reduction in the opportunities for school-age children to be physically active, such as by shortening or eliminating physical education classes. These reductions can be attributed to budget cuts and increased pressure for schools to meet academic standards imposed by the federal government.

No Child Left Behind Act

The No Child Left Behind Act of 2001 requires that states develop assessment and accountability measures to verify performance improvements in the subject areas of reading and mathematics (P.L. No. 107-110, Section 115). Specifically, federal funding is now dependent on schools making adequate progress in reading and mathematics. No Child Left Behind requires all public schools receiving federal funding to administer statewide standardized annual tests for all students. Schools that receive Title I funding through the Elementary and Secondary Education Act of 1965 must make adequate yearly progress in test scores (e.g., each year 5th graders must do better on standardized tests than the previous year’s 5th graders). If required improvements are not made, schools are penalized through decreased funding. If a school produces poor results for 2 consecutive years, improvement plans must be developed for the school. If a school does not make adequate progress for 5 consecutive years, a full restructuring of the school is mandated.

Under the act, physical education, music, and art are considered “nonessential” subjects and are not a main focus of the school learning environment. In response to the act, schools have devoted more time in the school day to instruction in reading and mathematics. Since the act was passed, 62 percent of elementary schools and 20 percent of middle schools have increased instructional time in reading/language arts and mathematics (Center on Education Policy, 2008). Unfortunately, 44 percent of school administrators reported that these increases in instructional time for reading and mathematics were achieved at the expense of time devoted to physical education, recess, art, music, and other subjects (Center on Education Policy, 2007, 2008) (see Table 5-2 ).

The emphasis on high-stakes testing and pressure for academic achievement in the core subjects has had unintended consequences for other subjects throughout the school day. In developing master schedules, school site administrators have been forced to make difficult decisions regarding the allotment of time for “nonessential” subjects. The average reduction in instructional time in these “nonessential” subjects has been 145 minutes per week. As discussed earlier, however, no evidence suggests that physical education and physical activity have a negative effect on student achievement

TABLE 5-2 Changes in Time Allocation in Elementary Schools Since 2001-2002

SOURCE: Center on Education Policy, 2007, District Survey, item 19 (revised Tables IT-2A, IT-16, and IT-17).

or academic outcomes (CDC, 2010). On the contrary, positive academic-related outcomes (e.g., improved on-task classroom behavior, cognitive development, academic performance) have been associated with physical education and physical activity (see Chapter 4 ).

The Center on Education Policy (2007) conducted an analysis of 2006-2007 survey data from 349 school districts on the amount of time devoted to specific subjects to determine the impact of the No Child Left Behind Act. Shifts in instructional time toward English language arts and mathematics and away from other subjects were relatively large in a majority of school districts that made these types of changes. Sixty-two percent of districts reported increasing time in elementary schools in English language arts and/or mathematics since 2001-2002. A higher proportion of urban districts (76 percent) than rural districts (54 percent) reported such increases.

Districts that increased instructional time for English language arts and/or mathematics did so by 43 percent on average. Districts that also reduced instructional time in other subjects reported total reductions of 32 percent, on average. Eight of 10 districts that reported increasing time for English language arts did so by at least 75 minutes per week, and more than half (54 percent) did so by 150 minutes or more per week. Among districts that reported adding time for mathematics, 63 percent added at least 75 minutes per week, and 19 percent added 150 minutes or more per week.

Most districts that increased time for English language arts or mathematics also reported substantial cuts in time for other subjects or periods, including social studies, science, art and music, physical education, recess,

and lunch. Among the districts that reported both increasing time for English language arts or mathematics and reducing time in other subjects, 72 percent indicated that they reduced the time for one or more of these other subjects by a total of at least 75 minutes per week. For example, more than half (53 percent) of these districts cut instructional time by at least 75 minutes per week in social studies, and the same percentage (53 percent) cut time by at least 75 minutes per week in science (Center on Education Policy, 2007).

Districts that reported an increase in instructional time for elementary school English language arts spent an average of 378 minutes per week on this subject before No Child Left Behind was enacted. After the act became law, they spent 520 minutes per week. The average increase for English language arts was 141 minutes per week, or a 47 percent increase over the level prior to the act (Center on Education Policy, 2007; see district survey items 18 and 19 in Table IT-18A). Table 5-3 shows the specific amounts of time cut from various subjects in districts that reported decreases.

Districts with at least one school identified as “in need of improvement” under the act were far more likely than districts not in need of improvement to decrease time in certain subjects so as to devote more time to English language arts and mathematics (78 versus 57 percent). For example, 51 percent of districts with a school in need of improvement reported decreased time in social studies, compared with 31 percent of districts with no school in need of improvement (Center on Education Policy, 2007).

TABLE 5-3 Time Cut from Subjects or Periods in Districts Reporting Decreases in Instructional Time

NOTE: * = sample size too small to allow reporting of data on minutes per week; NCLB = No Child Left Behind. SOURCE: Center on Education Policy, 2007, District Survey items 18 and 19 (Table IT-18B).

Exemptions from Physical Education Requirements

The 2012 Shape of the Nation Report includes documentation of the multiple reasons students may be exempt from physical education classes. Thirty-three states permit school districts or schools to allow students to substitute other activities for physical education. The most common substitutions are Junior Reserve Officer Training Corps (JROTC), inter-scholastic sports, marching band, cheerleading, and community sports. Twenty-eight states allow schools and school districts to grant exemptions/waivers from physical education time or credit requirements. Reasons for exemptions/waivers include health, physical disability, religious belief, and early graduation; six states leave the reasons to the local schools or school districts. Although it would seem reasonable that some substitution programs such as JROTC or cheerleading might accrue physical activity comparable to that from physical education, these programs do not necessarily offer students opportunities to learn the knowledge and skills needed for lifelong participation in health-enhancing physical activities. Research on the impact of exemptions/waivers from physical education is lacking. No evidence currently exists showing that students receive any portion of the recommended 60 minutes or more of vigorous- or moderate-intensity physical activity through substituted activities sanctioned by their schools.

BARRIERS TO QUALITY PHYSICAL EDUCATION AND SOLUTIONS

Barriers other than the policies detailed above hinder efforts to improve and maintain high-quality physical education. This section reviews these barriers, along with some solutions for overcoming them.

Morgan and Hanson (2008) classify barriers that hinder schools from implementing quality physical education programs as either institutional (outside the teacher’s control) or teacher related (arising from teacher behavior). Table 5-4 lists institutional and teacher-related as well as student-related barriers identified by various authors.

Dwyer and colleagues (2003) examined Toronto teachers’ perspectives on why children were not engaged in daily physical education. They identified three categories of barriers: lower priority for physical education relative to other subjects, lack of performance measures for physical activity, and lack of sufficient infrastructure. Jenkinson and Benson (2010) surveyed 270 secondary school physical education teachers in Victoria, Australia, and asked them to rank order the barriers they perceived to providing quality physical education. The results are shown in Table 5-5 . The institutional

TABLE 5-4 Barriers to the Delivery of Physical Education and Physical Activity Programs to Primary and Secondary School Students

NOTES: PA = physical activity; PE = physical education; sport = sport education. SOURCES: a Barroso et al., 2005; b Boyle et al., 2008; c Dagkas and Stathi, 2007; d DeCorby et al., 2005; e Dwyer et al., 2003; f Dwyer et al., 2006; g Morgan and Bourke, 2005; h Morgan and Hansen, 2008; i Mowling et al., 2004; j Salvy et al., 2009; k Sherar et al., 2009; l Xiang et al., 2002.

TABLE 5-5 Physical Education Teachers’ Ranking of Barriers to Providing Quality Physical Education (PE) in Victorian State Secondary Schools

NOTE: I = institutional barrier; SD = standard deviation. SOURCE: Jenkinson and Benson, 2010.

barriers listed in this table are similar to those identified for U.S. schools in Table 5-4 .

Jenkinson and Benson (2010) also presented teachers with a list of barriers to student participation in physical education and physical activity in three categories: institutional, teacher-related, and student-related. The teachers were asked to rank the top five barriers they perceived. Results are presented in Table 5-6 .

Finally, Gallo and colleagues (2006) found that the greatest process barriers to assessing students in physical education were grading students on skill levels and abilities; time constraints; class size; and record keeping, especially when assessing students on skills, cognitive knowledge, and fitness.

Two key barriers to physical education identified in the studies summarized above are staffing and funding. These barriers reflect a lack of support structure in schools for quality physical education.

TABLE 5-6 Perceived Barriers to Student Participation in Physical Education and Physical Activity in Victorian State Secondary Schools: Physical Education Teachers’ Ranking (from most [“5”] to least [“1”] influential)

NOTE: a Ranking = based on most frequently ranked as number 1 barrier; b I = institutional barrier, T = teacher-related barrier, S = student-related barrier; c PE = physical education; d PA = physical activity; e Sport = sport education. SOURCE: Jenkinson and Benson, 2010.

As noted earlier in this chapter, physical education is short staffed. State mandates have placed pressure on schools to preserve instructional resources for the high-stakes tested core subject areas at the expense of non-core subjects. For example, when a state mandates a maximum class size of 20 students per teacher in all core subjects, with noncompliance resulting in some form of penalty, an elementary school with an average of 25 students per teacher is forced to hire additional teachers in these subjects to meet the state mandate. Consequently, the school must shrink its teaching force in noncore subjects, such as physical education, to balance its budget. If noncore classes are to be preserved, their class sizes must increase, with fewer teachers serving more students. As a result, it becomes difficult to implement a quality program, and physical education teachers perceive their programs as being undervalued.

According to the Government Accountability Office report K-12 Education: School-Based Physical Education and Sports Programs (GAO, 2012), school officials cite budget cuts and inadequate facilities as major challenges to providing physical education opportunities for students. Budget cuts have affected schools’ ability to hire physical education teachers, maintain appropriate class sizes, and purchase sufficient equipment. As noted earlier, lack of equipment and limited access to facilities are cited as top barriers in the study by Jenkinson and Benson (2010) (see Tables 5-5 and 5-6 ). Limited budgets have a negative impact on a school’s ability to purchase enough physical education equipment to engage all students in increasingly large class sizes and cause physical education teachers to abandon quality evidence-based physical education programs and resort to large-group games and “throw out the ball” activities. Students disengaged as a result of such practices may prefer sedentary activities to more active lifestyles. A NASPE (2009a) survey found that the median physical education budget for physical education programs nationally was $764 per school ($460 per elementary school, $900 per middle school, and $1,370 per high school).

Solutions for Overcoming the Barriers

For many adolescents who have few opportunities to be active outside of the school day, quality physical education becomes the only option for physical activity. For students in large urban communities, physical education classes serve as a safe environment in which to be physically active under adult supervision in a structured environment. For students with dis-

abilities in particular, physical education classes are one of the only outlets for physical activity. For these reasons, it is crucial to overcome the above barriers to quality physical education. Some school districts have found ways to do so and provide robust physical education programs.

The barrier of limited time during the school day can be overcome through creative scheduling that makes use of every minute of the day in a constructive manner. For example, Miami-Dade County Public Schools is the fourth largest school district in the United States, in a large urban minority-majority community with large budgetary shortfalls and attention in schools being diverted to academic requirements. Yet the district has always had daily physical education in its elementary schools taught by a certified physical education teacher. This is accomplished by scheduling physical education during the classroom teacher’s planning time. In addition, students receive school board–mandated recess for either 20 minutes two times per week or 15 minutes three times per week. Figures 5-2 and 5-3 show examples of elementary school teacher schedules that demonstrate how 150 minutes of time for physical education can be incorporated successfully into any master schedule.

Other positive examples, identified in the report Physical Education Matters (San Diego State University, 2007), include successful case studies from low-resource California schools. The report acknowledges, however, that advancing such opportunities will require policy changes at the state, district, and local levels. These changes include securing grant funds with which to implement high-tech physical education wellness centers, staff commitment to professional development, administrative support, physical education being made a priority, community support, use of certified physical education teachers, and district support. Identifying the need to reform physical education guided by evidence-based findings, the report concludes that (1) curriculum matters, (2) class size matters, (3) qualified teachers matter, (4) professional development matters, and (5) physical environment matters. If programs are to excel and students are to achieve, delivery of the curriculum must be activity based; class sizes must be commensurate with those for other subject areas; highly qualified physical education specialists, as opposed to classroom teachers, must be hired to deliver instruction; professional development in activity-focused physical education must be delivered; and school physical education facilities, such as playing fields and indoor gym space and equipment, must be available.

A separate report, Physical Education Matters: Success Stories from California Low Resource Schools That Have Achieved Excellent Physical Education Programs (San Diego State University, 2007), notes that when funding from a variety of grant resources, including federal funding, became available, schools were able to transition to high-quality programs using innovative instructional strategies. Those strategies included well-

FIGURE 5-2 Example of a schedule demonstrating time for 150 minutes per week of physical education. NOTE: Sample is taken from a teacher schedule in a traditional elementary school. SOURCE: Large Urban Public School District, Miami-Dade County Public Schools.

ness centers and active gaming, which engaged students in becoming more physically active. Administrative support was found to be a key factor in turning programs around, along with staff commitment and professional development. Having certified physical education teachers and making physical education a priority in the schools were other key factors. External factors further strengthened programs, including having school district support, having a physical education coordinator, and using state standards to provide accountability. Additional ways to overcome the barriers to quality physical education include scheduling time for physical education, ensuring reasonable class size, providing nontraditional physical education activities, making classes more active and fun for all students, and acknowledging the importance of role modeling and personal investment and involvement in participation in physical activity among staff.

Still another way to overcome the barriers to quality physical education is to assist administrative decision makers and policy makers in understand-

FIGURE 5-3 Example of a schedule demonstrating time for 150 minutes per week of physical education. NOTES: Sample is taken from a teacher schedule in a combination special education and disabilities (SPED)/Spanish-language elementary class. PE = physical education; S.S. = social studies. SOURCE: Large Urban Public School District, Miami-Dade County Public Schools.

ing the correlation between physical education and academic achievement (see Chapter 4 ). The report Active Education: Physical Education, Physical Activity and Academic Performance by Active Living Research (Trost, 2009) cites evidence that “children who are physically active and fit tend to perform better in the classroom and that daily physical education does not adversely affect academic performance. Schools can provide outstanding learning environments while improving children’s health through physical education.” The findings reported include the following (p. 6):

“In some cases, more time in physical education leads to improved grades and standardized test scores.”
“Physically active and fit children tend to have better academic achievement.”
“Evidence links higher levels of physical fitness with better school attendance and fewer disciplinary problems.”
“There are several possible mechanisms by which physical education and regular physical activity may improve academic achievement, including enhanced concentration skills and classroom behavior.”
“Additional research is needed to determine the impact of physical activity on academic performance among those children who are at highest risk for obesity in the United States, including black, Latino, American Indian and Alaska Native, and Asian-American and Pacific Islander children, as well as children living in lower-income communities.”

Physical education is a formal content area of study in schools, it is standards based, and it encompasses assessment according to standards and benchmarks. Select curriculum-based physical education programs have been described in this chapter to show the potential of high-quality physical education in developing children into active adults. Such models provide the only opportunity for all school-age children to access health-enhancing physical activities. Curriculum models for physical education programs include movement education, which emphasizes the importance of fundamental motor skills competence as a prerequisite for engagement in physical activity throughout the life span; sport education, which emphasizes helping students become skillful players in lifetime sports of their choosing; and fitness education, which imparts physical fitness concepts to students, including the benefits and scientific principles of exercise, with the goal of developing and maintaining individual fitness and positive lifestyle change. The emergence of a technology-focused fitness education curriculum and the new Presidential Youth Fitness Program offer further motivational opportunities for students to engage in lifelong physical activities.

Because quality physical education programs are standards based and assessed, they are characterized by (1) instruction by certified physical education teachers, (2) a minimum of 150 minutes per week for elementary schools and 225 minutes per week for middle and high schools, and (3) tangible standards for student achievement and for high school graduation. Quality professional development programs are an essential component for both novice and veteran teachers to ensure the continued delivery of quality physical education.

An analysis of datasets from NASPE, NASBE, and Bridging the Gap reveals that the implementation of supportive physical education policies varies from state to state and from school to school. Since passage of the No Child Left Behind Act in 2001, several studies and reports have identi-

fied a decline in physical education resulting from the shifting of time to academic subjects. Because physical education is not a high-stakes tested content area, the implementation of supportive policies often is hindered by other education priorities. Although the above analysis indicates that 30 states (74.5 percent) mandate physical education, most policies do not require specific amounts of instructional time, and more than half allow for waivers or exemptions. In addition, an unintended consequence of the No Child Left Behind Act has been disparities in access to physical education and physical activity opportunities during the school day for Hispanic students and those of lower socioeconomic status. In high school, relying on students to elect physical education after meeting the minimum required credit hours (one credit in all states but one) appears to be unfruitful.

Strengthening of school physical education has received support from the public, health agencies, and parents. Parents recently surveyed expressed favorable views of physical education. Specifically:

A majority of parents (54-84 percent) believe that physical education is at least as important as other academic subjects (CDC, 2010).
Ninety-one percent believe that there should be more physical education in schools (Harvard School of Public Health, 2003).
Seventy-six percent think that more school physical education could help control or prevent childhood obesity (NASPE, 2009a).
Ninety-five percent believe that regular daily physical activity helps children do better academically and should be a part of the school curriculum for all students in grades K-12 (NASPE, 2003).

Additionally, many public and private organizations have proposed initiatives aimed at developing a comprehensive school-based strategy centered on curriculum physical education. As the largest institution where children spend more than half of their waking hours on school days, schools can play a pivotal role in increasing students’ physical activity levels by providing access for all to quality physical education, along with physical activities throughout the school environment, the subject of Chapter 7 .

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Physical inactivity is a key determinant of health across the lifespan. A lack of activity increases the risk of heart disease, colon and breast cancer, diabetes mellitus, hypertension, osteoporosis, anxiety and depression and others diseases. Emerging literature has suggested that in terms of mortality, the global population health burden of physical inactivity approaches that of cigarette smoking. The prevalence and substantial disease risk associated with physical inactivity has been described as a pandemic.

The prevalence, health impact, and evidence of changeability all have resulted in calls for action to increase physical activity across the lifespan. In response to the need to find ways to make physical activity a health priority for youth, the Institute of Medicine's Committee on Physical Activity and Physical Education in the School Environment was formed. Its purpose was to review the current status of physical activity and physical education in the school environment, including before, during, and after school, and examine the influences of physical activity and physical education on the short and long term physical, cognitive and brain, and psychosocial health and development of children and adolescents.

Educating the Student Body makes recommendations about approaches for strengthening and improving programs and policies for physical activity and physical education in the school environment. This report lays out a set of guiding principles to guide its work on these tasks. These included: recognizing the benefits of instilling life-long physical activity habits in children; the value of using systems thinking in improving physical activity and physical education in the school environment; the recognition of current disparities in opportunities and the need to achieve equity in physical activity and physical education; the importance of considering all types of school environments; the need to take into consideration the diversity of students as recommendations are developed.

This report will be of interest to local and national policymakers, school officials, teachers, and the education community, researchers, professional organizations, and parents interested in physical activity, physical education, and health for school-aged children and adolescents.

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Physical Education is just as important as any other school subject

physical education as a discipline essay

Lecturer in Physical Education, University of Central Lancashire

Senior Lecturer in PE and Sports Studies, University of Central Lancashire

Disclosure statement

Andrew Sprake is affiliated with the North Western Counties Physical Education Association and FIEP in a voluntary capacity.

Clive Palmer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Physical Education (PE) is often viewed as a marginal subject within the curriculum. And many secondary schools actively reduce PE time to make way for what are deemed more “serious” or “important” subjects.

Research from the Youth Sport Trust shows that 38% of English secondary schools have cut timetabled PE for 14- to 16-year-olds. One of the main reasons for this is the increased pressure to produce exam results . Much of the time pupils would usually spend in PE lessons is now spent receiving extra tutoring on topics other than PE.

Despite these cuts, however, PE is still championed for its potential to promote health and encourage lifelong physical activity. This is an important issue given that over 30% of year six pupils are classed as “overweight” or “obese” according to the latest government figures .

PE is also praised for its contribution to improved psychological health , for helping to nurture social and moral development – as well as supporting cognitive and academic performance .

The Association for Physical Education maintains that high quality PE fosters the physical, moral, social, emotional, cultural and intellectual development of pupils. But the many aims for PE – such as health promotion, skills development as well as a focus on social and moral issues – has resulted in confusion about the subject and has done little to further the educational experiences in practice. In fact, it has been argued that PE offers more entertainment than education .

Not intellectual enough

A waste of time and a bit of entertainment, or vitally important to the education and development of a child – which is it?

Part of the problem seems to be that PE is often viewed as an opportunity for pupils to be active and to enjoy themselves. Or in some cases, as a form of stress relief and to serve as a break from traditional learning.

Clearly, these areas are valuable for pupils’ general well-being and there is a growing evidence base to suggest that physical activity has the potential to support learning more broadly . But the role of PE is not merely to prop up and support pupils’ learning in other subjects. Instead, it should provide meaningful learning experiences within the subject itself.

What PE seemingly lacks in comparison to all other subjects is a platform on which pupils’ learning can be communicated and evidenced with clarity and rigour. And while PE is often marginalised to make way for more valuable or academic subjects, it seems the intellectual and academic value of PE itself is largely overlooked.

The potential of PE

PE, sport and physical culture each offer a unique platform on which to explore a multitude of holistic learning opportunities. For instance, the ethical or moral controversies in sport can give teachers a range of educational stimuli for debate, reasoning and critical thinking.

The Sports Monograph is a recent project we worked on, which invited learners to collaborate and share their opinions and experiences about sport and what it means to them. The project included primary and secondary school pupils, as well as undergraduate and postgraduate students, who were all supported by their teachers and lecturers.

As part of the project, not only were the pupils recognised for their written contributions at school awards evenings, but unlike in traditional PE, their work left a trail of learning evidence and intellectual engagement – which the schools recognised and celebrated. PE was effectively standing shoulder to shoulder with other subjects in the curriculum as a valuable educational endeavour, with written evidence to support the claim. These pupils now have publications that are being used to teach undergraduate students at the University of Central Lancashire.

Future health

The spiralling downtrend of PE time in secondary schools is a major cause for concern and it would seem that PE is in urgent need of an overhaul. But while the future of PE may be uncertain, there are certainly many opportunities for cross-curricular links and integrative learning in PE.

A recent project, for instance, explored the link between cycling and wider conceptual learning. Similarly, another recent study explored the physical aspects of learning across all curriculum areas, simply through setting up a tent .

The role that PE can play as part of the wider academic curriculum seems to be, at best understated, and at worst, completely overlooked. Activities like the ones raised here could help to broaden the educational potential of PE, encourage more pupils to engage with the subject and strengthen the place of PE as a unique and valuable educational pursuit. The opportunities are there, but PE must be ready to grasp them and let the pupils write about their sporting passions to reflect what they are said to be learning.

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Essay on Physical Education in School for Students 1000+ Words

Essay on Physical Education in School for Students in 1000+ Words

In this article, we have published an essay on physical education in school. It includes its meaning, importance, and benefits. Also, how is physical education good for our health?

Table of Contents

Essay on Physical Education in School (1000 Words)

Physical education is essential because it improves the fitness of youngsters, makes them disciplined and active. It helps them to find out teamwork, test their decision-making capabilities too.

Education should be mandatory in every school, from preschools, primary, elementary to secondary school and also in colleges, hostels. But we should always not force them to try to do it, and they ought to be made conscious of its benefits.

The goal of education is to assist students in developing healthy habits that can serve them within the long term. In today’s world, things have become easy due to technology, and we are enjoying the facilities like no other generation.

Adults spend their whole day in air-cooled offices; they eat food, don’t find time to exercise. It’s getting to be very tough for our generation.

If we get good healthy habits now, once we are within the school, it’ll help us now and within the future. It’s a dire need of your time.

The education system should be proactive and make it mandatory in schools. So allow us to see why do children need physical education?

Healthy Habits

With education, children can improve their fitness, body posture, and ultimately it’ll boost their confidence.

It helps students to make good habits from an early age. Running, jogging, weight training, eating, and sleeping on time are a few habits that can help them in the future.

One of the essential aspects of education is discipline . It’ll help them to plan their studies, finances, and life generally.

They’re going to be ready to allot time to studies and for fun too. Alongside academics, children should get time to be children; it’s the most uncomplicated phase of human life.

Interpersonal Skills & Team Work

Physical education and sports improve the interpersonal skills of youngsters. These skills are very crucial at work and within the relationship.

Physical education teaches the way to communicate messages effectively and the way to figure them together.

Stress Buster

Education comes with exams, assignments, projects, and homework, which can stress students.

Alongside this, they even have parents’ expectations burden, Financial worries. In today’s time, the overuse of social media makes them suffer from social anxiety, envy, and FOMO.

In this case, education becomes an excellent outlet. It cuts them from these worries and situations. Due to it, they’re going to be ready to focus more on studies and life generally.

Makes you Confident

With improved interpersonal skills, relaxed and calm composure, and healthy habits, one becomes more confident. Physical education plays a notable role during this too.

Alternate Career Opportunity

Everyone is different; not all students will be great at academics, and there is no such rule. Children find themselves in trouble with selecting a career . Education can help them during this also. One might find the internet in sports and games.

Physical education may be an excellent opportunity to scout for potential athletic talent also. They were within the suitable career matters tons.

If one gets to try to do a thing they like to do, their lives will be happier. Physical education can help them to seek out that or a minimum of narrow down the alternatives.

Health is Wealth

Our current generation is affected by obesity from an early age. They also get spectacles at an old age. Obesity comes with related illnesses too.

An obese child is susceptible to diseases like diabetes, cardiovascular diseases, stress, vital sign, etc. Habits formed with education will make them fit from infancy. It’ll encourage them to enhance and maintain their health in the future.

Children inculcate with the importance of physical education for maintaining a healthy body and teach them the importance of regular fitness activity in daily routine, which successively keeps them happy and energized.

It helps the youngsters to take care of their fitness, develop their muscular strength, and increase their stamina.

Research has proven that children who regularly play different types of sports lead to high self-confidence, which is essential for building a person’s character.

Education instills the will to participate, enjoy the victory, and take defeat positively, developing the character’s general personality.

By making children participate in sports, especially team sports, education also imbibes in them a way of solidarity. Children find out how to figure as a team member, organize themselves, and perform together towards attaining a goal.

It successively improves a child’s overall communication skills and, therefore, urges alongside different people.

Physical education helps one gain knowledge about the general aspects of physical health. Teenagers face many health-related problems like obesity, anemia, bulimia, and even diabetes, which are rampant amongst teenagers.

Through education, teachers can promote the advantages of healthy and nutritious food and discourage them from having food by highlighting their ill effects. They will easily promote sound eating practices and guidelines for nutrition.

Physical education also teaches about the importance of private hygiene and the importance of cleanliness . They guide the scholars by informing them about the essential hygiene practices for maintaining health and well-being throughout life.

Additionally, to the present, the education classes also cover a crucial aspect that the youngsters need to affect at puberty.

Apart from the health and knowledge benefits that students get from education, they also learn how to unwind and relieve themselves of stress and anxiety. Sports and other fitness activities offered within the education classes are a welcome break for the scholars.

It won’t be wrong to mention that children, who learn the importance of health and hygiene at an early age, tend to get older to be responsible and healthy adults who are conscious of the advantages of a healthy lifestyle.

Children who provided good education are more likely to become responsible adults who know the importance of a healthy lifestyle.

Anti-Depressant

It is proven that physical activities help us to alleviate stress. Though we all know its importance, we make all possible excuses to avoid it.

Physical education helps us to take care of a timely schedule of physical activities. Students become calmer composed; then, they will focus more on their goals.

The Bottom Line

Physical education leads to a more focused, active, composed, and happy in life . It makes us disciplined and arranged.

Habits formed with the assistance of education tend to remain with us for an extended time. We should bring skilled coaches and needed equipment to colleges.

Students should know its benefits. There are real advantages of education and in the present situation, children, also as adults, need it the foremost.

The opportunity to participate in physical activity daily in schools may increase the probability of adopting a physically active lifestyle.

Choosing to measure a physically active lifestyle is vital to health and wellness. A school’s education department is responsible for assisting students in being involved in and adopting a private lifestyle of regular physical activity.

I hope you liked this essay on physical education in school for students and children.

Educating the Student Body: Taking Physical Activity and Physical Education to School.

Hardcopy Version at National Academies Press

3 Physical Activity and Physical Education: Relationship to Growth, Development, and Health

Key messages.

Regular physical activity promotes growth and development and has multiple benefits for physical, mental, and psychosocial health that undoubtedly contribute to learning.
Specifically, physical activity reduces the risk for heart disease, diabetes mellitus, osteoporosis, high blood pressure, obesity, and metabolic syndrome; improves various other aspects of health and fitness, including aerobic capacity, muscle and bone strength, flexibility, insulin sensitivity, and lipid profiles; and reduces stress, anxiety, and depression.
Physical activity can improve mental health by decreasing and preventing conditions such as anxiety and depression, as well as improving mood and other aspects of well-being.
Physical activity programming specifically designed to do so can improve psychosocial outcomes such as self-concept, social behaviors, goal orientation, and most notably self-efficacy. These attributes in turn are important determinants of current and future participation in physical activity.
Sedentary behaviors such as sitting and television viewing contribute to health risks both because of and independently of their impact on physical activity.
Health-related behaviors and disease risk factors track from childhood to adulthood, indicating that early and ongoing opportunities for physical activity are needed for maximum health benefit.
To be effective, physical activity programming must align with the predictable developmental changes in children's exercise capacity and motor skills, which affect the activities in which they can successfully engage.
Frequent bouts of physical activity throughout the day yield short-term benefits for mental and cognitive health while also providing opportunities to practice skills and building confidence that promotes ongoing engagement in physical activity.
Distinct types of physical activity address unique health concerns and contribute in distinct ways to children's health, suggesting that a varied regimen including aerobic and resistance exercise, structured and unstructured opportunities, and both longer sessions and shorter bouts will likely confer the greatest benefit.

The behaviors and traits of today's children, along with their genetics, are determinants of their growth and development; their physical, mental, and psychosocial health; and their physical, cognitive, and academic performance. Technological advances of modern society have contributed to a sedentary lifestyle that has changed the phenotype of children from that of 20 years ago. Children today weigh more and have a higher body mass index (BMI) than their peers of just a generation earlier ( Ogden et al., 2012 ). Behaviorally, most children fail to engage in vigorous- or moderate-intensity physical activity for the recommended 60 minutes or more each day, with as many as one-third reporting no physical activity in the preceding 5 days ( CDC, 2012 ). This lack of participation in physical activity has contributed to a greater prevalence of pediatric obesity, a decrease in fitness (e.g., flexibility, muscular strength, cardiorespiratory capacity), and a greater risk for disease ( Boreham and Riddoch, 2001 ; Eisenmann, 2003 ; Malina, 2007 ; Steele et al., 2008 ). (See Box 3-1 for an overview of the relationship between physical activity and physical fitness.)

Physical Activity and Physical Fitness. As noted in Chapter 1 (see the box titled “Key Terms Used in This Report” on p. 17), physical activity, a behavior, is defined as bodily movement that increases energy expenditure, whereas fitness (more...)

While more can always be learned, the evidence for the health benefits of physical activity is irrefutable ( HHS, 1996 , 2008 ). Adults engaged in regular physical activity have lower rates of chronic disease (e.g., coronary heart disease, cardiovascular disease, type 2 diabetes, hypertension, osteoporosis, and some cancers) and are less likely to die prematurely ( HHS, 1996 , 2008 ; Bauman, 2004 ). And while the ill effects of chronic disease are manifested mainly in adults, it is increasingly better understood that the development of these conditions starts in childhood and adolescence ( Hallal et al., 2006 ; Cook et al., 2009 ; Halfon et al., 2012 ). It appears evident, then, that promotion of health-enhancing behaviors must also start early in life. Indeed, growing evidence points to long-term effects of child and adolescent physical activity on adult morbidity and mortality in addition to its more immediate effects ( Hallal et al., 2006 ) (see Figure 3-1 ).

Conceptual model of how physical activity in childhood and adolescence is beneficial to health. Physical activity has both immediate and long-term health benefits: (a) Physical activity tends to track; early physical activity is associated with physical (more...)

Evidence for both direct and indirect health effects of physical activity has been reported ( Hallal et al., 2006 ), and the need for ongoing participation in physical activity to stimulate and maintain the chronic adaptations that underlie those benefits is well documented. To understand the relationship of physical activity and aerobic fitness to health during childhood, it is important first to recognize the developmental changes that occur throughout maturation. During the early stages of adolescence, for example, participation in physical activity and corresponding physical fitness begin to decline ( Duncan et al., 2007 ). Such differences across stages of development highlight the importance of examining the effects of growth and maturation on physical and cognitive health. Accordingly, this chapter reviews how physical activity may influence developmental processes and other aspects of somatic growth and maturation. A complete review of the effects of physical activity on all tissues and systems is beyond the scope of this report. Rather, the focus is on components of body composition and systems that underlie engagement in physical activity, physical fitness, and chronic disease risk and that in turn influence other aspects of health and academic performance (discussed in Chapter 4 ). Addressed in turn is the relationship between physical activity and physical, psychosocial, and mental health. Structural and functional brain maturation and how physical activity may influence those developmental processes and cognitive health are also reviewed in Chapter 4 .

PHYSICAL HEALTH

This section reviews what is known about the relationship between physical activity and (1) somatic growth, development, and function and (2) health- and performance-related fitness.

Somatic Growth, Development, and Function

Growth occurs through a complex, organized process characterized by predictable developmental stages and events. Although all individuals follow the same general course, growth and maturation rates vary widely among individuals. Just as it is unrealistic to expect all children at the same age to achieve the same academic level, it is unrealistic to expect children at the same age to have the same physical development, motor skills, and physical capacity. Regular physical activity does not alter the process of growth and development. Rather, developmental stage is a significant determinant of motor skills, physical capacity, and the adaptation to activity that is reasonable to expect (see Box 3-2 ).

Growth, Development, and Maturation. Growth is the normal process of increase in size as a result of accretion of tissues characteristic of the organism; growth is the dominant biological activity for most of the first two decades of life. Changes in (more...)

Developmental Stages

Postnatal growth is commonly divided into three or four age periods. Infancy spans the first year of life. Childhood extends from the end of infancy to the start of adolescence and is often divided into early childhood, which includes the preschool years, and middle childhood, which includes the elementary school years, into the 5th or 6th grade. Adolescence is more difficult to define because of variation in its onset and termination, although it is commonly defined as between 10 and 18 years of age ( WHO, 1986 ). The rapid growth and development of infancy continue during early childhood, although at a decelerating rate, whereas middle childhood is a period of slower, steady growth and maturation. Differences between boys and girls are relatively small until adolescence, which is marked by accelerated growth and attainment of sexual maturity ( Tanner, 1962 ).

Across developmental stages, neurological development and control of movement advance in cephalocaudal and proximodistal directions; that is, they advance “head to toe” (cephalocaudal) and “midline to periphery” (proximodistal), while predictable changes in body proportions also occur. For example, the head accounts for 25 percent of recumbent length in an infant and only 15 percent of adult height, while the legs account for 38 percent of recumbent length at birth and 50 percent of adult height. These changes in body proportions occur because body parts grow at different rates. From birth to adulthood, as the head doubles in size, the trunk triples in length, and arm and leg lengths quadruple.

Coincident with these changes in body proportions, and in part because of them, the capacity to perform various motor tasks develops in a predictable fashion. For example, running speed increases are consistent with the increase in leg length. Neurological development also determines skill progression. Young children, for example, when thrown a ball, catch it within the midline of the body and do not attempt to catch it outside the midline or to either side of the body. As proximodistal development proceeds, children are better able to perform tasks outside their midline, and by adolescence they are able to maneuver their bodies in a coordinated way to catch objects outside the midline with little effort.

Physically active and inactive children progress through identical stages. Providing opportunities for young children to be physically active is important not to affect the stages but to ensure adequate opportunity for skill development. Sound physical education curricula are based on an understanding of growth patterns and developmental stages and are critical to provide appropriate movement experiences that promote motor skill development ( Clark, 2005 ). The mastery of fundamental motor skills is strongly related to physical activity in children and adolescents ( Lubans et al., 2010 ) and in turn may contribute to physical, social, and cognitive development. Mastering fundamental motor skills also is critical to fostering physical activity because these skills serve as the foundation for more advanced and sport-specific movement ( Clark and Metcalfe, 2002 ; Hands et al., 2009 ; Robinson and Goodway, 2009 ; Lubans et al., 2010 ). Physical activity programs, such as physical education, should be based on developmentally appropriate motor activities to foster self-efficacy and enjoyment and encourage ongoing participation in physical activity.

Biological Maturation

Maturation is the process of attaining the fully adult state. In growth studies, maturity is typically assessed as skeletal, somatic, or sexual. The same hormones regulate skeletal, somatic, and sexual maturation during adolescence, so it is reasonable to expect the effect of physical activity on these indicators of maturity to be similar. Skeletal maturity is typically assessed from radiographs of the bones in the hand and wrist; it is not influenced by habitual physical activity. Similarly, age at peak height velocity (the most rapid change in height), an indicator of somatic maturity, is not affected by physical activity, nor is the magnitude of peak height velocity, which is well within the usual range in both active and inactive youth. Discussions of the effects of physical activity on sexual maturation more often focus on females than males and, in particular, on age at menarche (first menses). While some data suggest an association between later menarche and habitual physical activity ( Merzenich et al., 1993 ), most of these data come from retrospective studies of athletes ( Clapp and Little, 1995 ). Whether regular sports training at young ages before menarche “delays” menarche (later average age of menarche) remains unclear. While menarche occurs later in females who participate in some sports, the available data do not support a causal relationship between habitual physical activity and later menarche.

Puberty is the developmental period that represents the beginning of sexual maturation. It is marked by the appearance of secondary sex characteristics and their underlying hormonal changes, with accompanying sex differences in linear growth and body mass and composition. The timing of puberty varies, beginning as early as age 8 in girls and age 9 in boys in the United States and as late as ages 13-15 ( NRC/IOM, 1999 ). Recent research suggests that the onset of puberty is occurring earlier in girls today compared with the previous generation, and there is speculation that increased adiposity may be a cause ( Bau et al., 2009 ; Rosenfield et al., 2009 ). Conversely, some data suggest that excess adiposity in boys contributes to delayed sexual maturation ( Lee et al., 2010 ). Pubescence, the earliest period of adolescence, generally occurs about 2 years in advance of sexual maturity. Typically, individuals are in the secondary school years during this period, which is a time of decline in habitual physical activity, especially in girls. Physical activity trends are influenced by the development of secondary sex characteristics and other physical changes that occur during the adolescent growth spurt, as well as by societal and cultural factors. Research suggests that physical inactivity during adolescence carries over into adulthood ( Malina, 2001a , b ; CDC, 2006 ).

It is critical that adolescents be offered appropriate physical activity programs that take into account the physical and sociocultural changes they are experiencing so they will be inspired to engage in physical activity for a lifetime. As discussed below, adequate physical activity during puberty may be especially important for optimal bone development and prevention of excess adiposity, as puberty is a critical developmental period for both the skeleton and the adipose organ.

Adolescence is the transitional period between childhood and adulthood. The adolescent growth spurt, roughly 3 years of rapid growth, occurs early in this period. An accelerated increase in stature is a hallmark, with about 20 percent of adult stature being attained during this period. Along with the rapid increase in height, other changes in body proportions occur that have important implications for sports and other types of activities offered in physical education and physical activity programs. As boys and girls advance through puberty, for example, biacromial breadth (shoulder width) increases more in boys than in girls, while increases in bicristal breadth (hip width) are quite similar. Consequently, hip-shoulder width ratio, which is similar in boys and girls during childhood, decreases in adolescent boys while remaining relatively constant in girls ( Malina et al., 2004 ). Ratios among leg length, trunk length, and stature also change during this period. Prior to adolescence, boys have longer trunks and shorter legs than girls ( Haubenstricker and Sapp, 1980 ). In contrast, adolescent and adult females have shorter legs for the same height than males of equal stature. Body proportions, particularly skeletal dimensions, are unlikely to be influenced by physical activity; rather, body proportions influence performance success, fitness evaluation, and the types of activities in which a person may wish to engage. For example, there is evidence that leg length influences upright balance and speed ( Haubenstricker and Sapp, 1980 ). Individuals who have shorter legs and broader pelvises are better at balancing tasks than those with longer legs and narrower pelvises, and longer legs are associated with faster running times ( Dintiman et al., 1997 ). Also, longer arms and wider shoulders are advantageous in throwing tasks ( Haubenstricker and Sapp, 1980 ), as well as in other activities in which the arms are used as levers. According to Haubenstricker and Sapp (1980) , approximately 25 percent of engagement in movement-related activities can be attributed to body size and structure.

Motor Development

Motor development depends on the interaction of experience (e.g., practice, instruction, appropriate equipment) with an individual's physical, cognitive, and psychosocial status and proceeds in a predictable fashion across developmental periods. Clark and Metcalfe (2002) provide an eloquent metaphor—“the mountain of motor development”—to aid in understanding the global changes seen in movement across the life span. Early movements, critical for an infant's survival, are reflexive and dominated by biology, although environment contributes and helps shape reflexes. This initial reflexive period is followed quickly by the preadapted period , which begins when an infant's movement behaviors are no longer reflexive and ends when the infant begins to apply basic movement skills (e.g., crawling, rolling, standing, and walking) that generally are accomplished before 12 months of age. The period of fundamental motor patterns occurs approximately between the ages of 1 and 7 years, when children begin to acquire basic fundamental movement skills (e.g., running, hopping, skipping, jumping, leaping, sliding, galloping, throwing, catching, kicking, dribbling, and striking). Practice and instruction are key to learning these skills, and a great deal of time in elementary school physical education is devoted to exploration of movement. Around age 7, during the so-called context-specific period of motor development, children begin to refine basic motor skills and combine them into more specific movement patterns, ultimately reaching what has been called skillfulness . Compensation , the final period of motor development, occurs at varying points across the life span when, as a result of aging, disease, injury, or other changes, it becomes necessary to modify movement.

While all children need not be “expert” in all movement skills, those who do not acquire the fundamental motor skills will likely experience difficulty in transitioning their movement repertoire into specific contexts and engagement in physical activity ( Fisher et al., 2005 ; Barnett et al., 2009 ; Cliff et al., 2009 ; Robinson et al., 2012 ). A full movement repertoire is needed to engage in physical activities within and outside of the school setting. Thus, beyond contributing to levels of physical activity, physical education programs should aim to teach basic fundamental motor skills and their application to games, sports, and other physical activities, especially during the elementary years (i.e., the fundamental motor patterns and context-specific periods). At the same time, it is important to be mindful of the wide interindividual variation in the rate at which children develop motor skills, which is determined by their biological makeup, their rate of physical maturation, the extent and quality of their movement experiences, and their family and community environment.

An increasing amount of evidence suggests that people who feel competent in performing physical skills remain more active throughout their lives ( Lubans et al., 2010 ). Conversely, those who are less skilled may be hesitant to display what they perceive as a shortcoming and so may opt out of activities requiring higher levels of motor competence ( Stodden et al., 2008 ). Children who are less physically skillful tend to be less active than their skillful counterparts ( Wrotniak et al., 2006 ; Williams et al., 2008 ; Robinson et al., 2012 ) and thus have a greater risk of overweight and obesity ( Graf et al., 2004 ). Fundamental skills are the building blocks of more complex actions that are completed in sports, physical activities, and exercise settings. For example, throwing is a fundamental skill that is incorporated into the context-specific throw used in activities such as handball, softball, and water polo. Fundamental skills are of primary interest to both physical education teachers and coaches, and physical education classes should be designed to challenge learners to develop their motor skills.

In 1998 the Centers for Disease Control and Prevention's (CDC's) Division of Nutrition and Physical Activity organized a workshop to determine future directions for research on physical activity. The workshop convened 21 experts from a wide range of academic disciplines. One recommendation resulting from the proceedings was for future research to describe the temporal relationship between motor development and physical activity ( Fulton et al., 2001 ), signifying the importance of better understanding of the nature of the relationship between motor competence and physical activity. The assumption of this relationship is implied in multiple models of motor development ( Seefeldt, 1980 ; Clark and Metcalfe, 2002 ; Stodden et al., 2008 ), which emphasize the importance of motor competence as a prerequisite for engagement in physical activity throughout the life span.

Two models that are commonly used to examine this relationship are Seefeldt's (1980) hierarchical order of motor skills development and the dynamic association model of Stodden and colleagues (2008) . Seefeldt proposed a hierarchical order of motor skills development that includes four levels: reflexes, fundamental motor skills, transitional motor skills (i.e., fundamental motor skills that are performed in various combinations and with variations and that are required to participate in entry-level organized sports, such as throwing for distance, throwing for accuracy, and/or catching a ball while in motion), and specific sports skills and dances. With improved transitional motor skills, children are able to master complex motor skills (e.g., those required for playing more complex sports such as football or basketball). At the end of this developmental period, children's vision is fully mature. The progression through each level occurs through developmental stages as a combined result of growth, maturation, and experience. Seefeldt hypothesized the existence of a “proficiency barrier” between the fundamental and transitional levels of motor skills development. If children are able to achieve a level of competence above the proficiency barrier, they are more likely to continue to engage in physical activity throughout the life span that requires the use of fundamental motor skills. Conversely, less skilled children who do not exceed the proficiency barrier will be less likely to continue to engage in physical activity. Thus, it is assumed that “a confident and competent mover will be an active mover” ( Clark, 2005 , p. 44). For example, to engage successfully in a game of handball, baseball, cricket, or basketball at any age, it is important to reach a minimum level of competence in running, throwing, catching, and striking. The assumption of the existence of a relationship between motor competence and physical activity is at the “heart of our physical education programs” ( Clark, 2005 , p. 44). A thorough understanding of how this relationship changes across developmental stages is crucial for curriculum development and delivery and teaching practices.

Lubans and colleagues (2010) recently examined the relationship between motor competence and health outcomes. They reviewed 21 studies identifying relationships between fundamental motor skills and self-worth, perceived physical competence, muscular and cardiorespiratory fitness, weight status, flexibility, physical activity, and sedentary behavior. Overall, the studies found a positive association between fundamental motor skills and physical activity in children and adolescents, as well as a positive relationship between fundamental motor skills and cardiorespiratory fitness. Other research findings support the hypothesis that the most physically active preschool-age ( Fisher et al., 2005 ; Williams et al., 2008 ; Robinson et al., 2012 ), elementary school–age ( Bouffard et al., 1996 ; Graf et al., 2004 ; Wrotniak et al., 2006 ; Hume et al., 2008 ; Lopes et al., 2011 ), and adolescent ( Okely et al., 2001 ) youth are also the most skilled.

An advantage of the “proficiency barrier” hypothesis proposed by Seefeldt (1980) is its recognition that the relationship between motor competence and physical activity may not be linear. Rather, the hypothesis suggests that physical activity is influenced when a certain level of motor competence is not achieved and acknowledges that below the proficiency barrier, there is bound to be substantial variation in children's motor competence and participation in physical activity. The proficiency barrier is located between the fundamental and transitional motor skills periods. The transition between these two levels of motor competence is expected to occur between the early and middle childhood years. Stodden and colleagues (2008) suggest that the relationship between motor competence and physical activity is dynamic and changes across time. In their model the “development of motor skill competence is a primary underlying mechanism that promotes engagement in physical activity” (p. 290).

The relationship between skills and physical activity is considered reciprocal. It is expected that as motor skills competence increases, physical activity participation also increases and that the increased participation feeds back into motor skills competence. The reciprocal relationship between motor skills competence and physical activity is weak during the early childhood years (ages 2-8) because of a variety of factors, including environmental conditions, parental influences, and previous experience in physical education programs ( Stodden et al., 2008 ). Also, children at this age are less able to distinguish accurately between perceived physical competence and actual motor skills competence ( Harter and Pike, 1984 ; Goodway and Rudisill, 1997 ; Robinson and Goodway, 2009 ; Robinson, 2011 ), and thus motor skills are not expected to strongly influence physical activity. The literature supports this hypothesis, as indicated by low to moderate correlations between motor skills competence and physical activity in preschool ( Sääkslahti et al., 1999 ; Williams et al., 2008 ; Cliff et al., 2009 ; Robinson and Goodway, 2009 ; Robinson, 2011 ) and early elementary school–age ( Raudsepp and Päll, 2006 ; Hume et al., 2008 ; Morgan et al., 2008 ; Houwen et al., 2009 ; Ziviani et al., 2009 ; Lopes et al., 2011 ) children.

In older children, perceived competence is more closely related to actual motor skills competence. Older, low-skilled children are aware of their skills level and are more likely to perceive physical activity as difficult and challenging. Older children who are not equipped with the necessary skills to engage in physical activity that requires high levels of motor skills competence may not want to display their low competence publicly. As children transition into adolescence and early adulthood, the relationship between motor skills competence and physical activity may strengthen ( Stodden et al., 2008 ). Investigators report moderate correlations between motor skills competence and physical activity in middle school–age children ( Reed et al., 2004 ; Jaakkola et al., 2009 ). Okely and colleagues (2001) found that motor skills competence was significantly associated with participation in organized physical activity (i.e., regular and structured experiences related to physical activity) as measured by self-reports. A strength of the model of Stodden and colleagues (2008) is the inclusion of factors related to psychosocial health and development that may influence the relationship between motor skills competence and physical activity, contributing to the development and maintenance of obesity. Other studies have found that perceived competence plays a role in engagement in physical activity ( Ferrer-Caja and Weiss, 2000 ; Sollerhed et al., 2008 ).

Motor skills competence is an important factor; however, it is only one of many factors that contribute to physical activity. For instance, three studies have reported negative correlations between girls' motor competence and physical activity ( Reed et al., 2004 ; Cliff et al., 2009 ; Ziviani et al., 2009 ), suggesting that sex may be another determining factor. A possible explanation for these findings is that since girls tend to be less active than boys, it may be more difficult to detect differences in physical activity levels between high- and low-skilled girls. It is also possible that out-of-school opportunities for physical activity are more likely to meet the interests of boys, which may at least partially explain sex differences in physical activity levels ( Le Masurier et al., 2005 ). Previous research suggests that in general boys are more motor competent than girls ( Graf et al., 2004 ; Barnett et al., 2009 ; Lopes et al., 2011 ) and that this trend, which is less apparent in early childhood, increases through adolescence ( Thomas and French, 1985 ; Thomas and Thomas, 1988 ; Thomas, 1994 ), although one study reports that girls are more motor competent than boys ( Cliff et al., 2009 ).

One component of motor competence is the performance of gross motor skills, which are typically classified into object control and locomotor skills. Consistent evidence suggests that boys are more competent in object control skills, while girls are more competent in locomotor skills ( McKenzie et al., 2004 ; Morgan et al., 2008 ; Barnett et al., 2009 ). In light of these sex differences, it is important to examine the relationships of object control and locomotor skills with physical activity separately for boys and girls. For boys, object control skills are more related to physical activity than are locomotor skills ( Hume et al., 2008 ; Morgan et al., 2008 ; Williams et al., 2008 ; Cliff et al., 2009 ), whereas evidence suggests that the reverse is true for girls ( McKenzie et al., 2002 ; Hume et al., 2008 ; Cliff et al., 2009 ; Jaakkola et al., 2009 ). Three studies report a significant relationship between balance and physical activity for girls but not boys ( Reed et al., 2004 ; Ziviani et al., 2009 ). Cliff and colleagues (2009) suggest that object control and locomotor skills may be more related to boys' and girls' physical activity, respectively, because of the activity type in which each sex typically engages.

The relationship between motor competence and physical activity clearly is complex. It is quite likely that the relationship is dynamic and that motor competence increases the likelihood of participating in physical activity while at the same time engaging in physical activity provides opportunities to develop motor competence ( Stodden et al., 2008 ). Despite some uncertainty, the literature does reinforce the important role of physical education in providing developmentally appropriate movement opportunities in the school environment. These opportunities are the only means of engaging a large population of children and youth and providing them with the tools and opportunities that foster health, development, and future physical activity.

Regular physical activity has no established effect on linear growth rate or ultimate height ( Malina, 1994 ). Although some studies suggest small differences, factors other than physical activity, especially maturity, often are not well controlled. It is important to note that regular physical activity does not have a negative effect on stature, as has sometimes been suggested. Differences in height among children and adolescents participating in various sports are more likely due to the requirements of the sport, selection criteria, and interindividual variation in biological maturity than the effects of participation per se ( Malina et al., 2004 ).

Body Weight

Although physical activity is inversely related to weight, correlations are generally low (~r–0.15), and differences in body weight between active and inactive boys and girls tend to be small ( Mirwald and Bailey, 1986 ; Saris et al., 1986 ; Beunen et al., 1992 ; Lohman et al., 2006 ;), except in very obese children and adolescents. Similarly, physique, as represented in somatotypes, does not appear to be significantly affected by physical activity during growth ( Malina et al., 2004 ). In contrast, components of weight can be influenced by regular physical activity, especially when the mode and intensity of the activity are tailored to the desired outcome. Much of the available data in children and adolescents is based on BMI, a surrogate for composition, and indirect methods based on the two-compartment model of body composition in which body weight is divided into its fat-free and fat components ( Going et al., 2012 ). While studies generally support that physical activity is associated with greater fat-free mass and lower body fat, distinguishing the effects of physical activity on fat-free mass from expected changes associated with growth and maturation is difficult, especially during adolescence, when both sexes have significant growth in fat-free mass. The application of methods based on the two-compartment model is fraught with errors, especially when the goal is to detect changes in fat-free mass, and no information is available from these methods regarding changes in the major tissue components of fat-free mass—muscle and skeletal tissue.

Skeletal muscle is the largest tissue mass in the body. It is the main energy-consuming tissue and provides the propulsive force for movement. Muscle represents about 23-25 percent of body weight at birth and about 40 percent in adults, although there is a wide range of “normal” ( Malina, 1986 , 1996 ). Postnatal muscle growth is explained largely by increases in cell size (hypertrophy) driving an increase in overall muscle mass. The increase in muscle mass with age is fairly linear from young childhood until puberty, with boys having a small but consistent advantage ( Malina, 1969 , 1986 ). The sex difference becomes magnified during and after puberty, driven primarily by gender-related differences in sex steroids. Muscle, as a percentage of body mass, increases from about 42 percent to 54 percent in boys between ages 5 and 11, whereas in girls it increases from about 40 percent to 45 percent between ages 5 and 13 and thereafter declines ( Malina et al., 2004 ). It should be noted that absolute mass does not decline; rather, the relative decline reflects the increase in the percentage of weight that is fat in girls. At least part of the sex difference is due to differences in muscle development for different body regions ( Tanner et al., 1981 ). The growth rate of arm muscle tissue during adolescence in males is approximately twice that in females, whereas the sex difference in the growth of muscle tissue in the leg is much smaller. The sex difference that develops during puberty persists into adulthood and is more apparent for the musculature of the upper extremities.

Sex-related differences in muscular development contribute to differences in physical performance. Muscle strength develops in proportion to the cross-sectional area of muscle, and growth curves for strength are essentially the same as those for muscle ( Malina and Roche, 1983 ). Thus the sex difference in muscle strength is explained largely by differences in skeletal muscle mass rather than muscle quality or composition. Aerobic (endurance) exercise has little effect on enhancing muscle mass but does result in significant improvement in oxygen extraction and aerobic metabolism ( Fournier et al., 1982 ). In contrast, numerous studies have shown that high-intensity resistance exercise induces muscle hypertrophy, with associated increases in muscle strength. In children and adolescents, strength training can increase muscle strength, power, and endurance. Multiple types of resistance training modalities have proven effective and safe ( Bernhardt et al., 2001 ), and resistance exercise is now recommended for enhancing physical health and function ( Behringer et al., 2010 ). These adaptations are due to muscle fiber hypertrophy and neural adaptations, with muscle hypertrophy playing a more important role in adolescents, especially in males. Prior to puberty, before the increase in anabolic sex steroid concentrations, neural adaptations explain much of the improvement in muscle function with exercise in both boys and girls.

The skeleton is the permanent supportive framework of the body. It provides protection for vital organs and is the main mineral reservoir. Bone tissue constitutes most of the skeleton, accounting for 14-17 percent of body weight across the life span ( Trotter and Peterson, 1970 ; Trotter and Hixon, 1974 ). Skeletal strength, which dictates fracture risk, is determined by both the material and structural properties of bone, both of which are dependent on mineral accrual. The relative mineral content of bone does not differ much among infants, children, adolescents, and adults, making up 63-65 percent of the dry, fat-free weight of the skeleton ( Malina, 1996 ). As a fraction of weight, bone mineral (the ash weight of bone) represents about 2 percent of body weight in infants and about 4-5 percent of body weight in adults ( Malina, 1996 ). Bone mineral content increases fairly linearly with age, with no sex difference during childhood. Girls have, on average, a slightly greater bone mineral content than boys in early adolescence, reflecting their earlier adolescent growth spurt. Boys have their growth spurt later than girls, and their bone mineral content continues to increase through late adolescence, ending with greater skeletal dimensions and bone mineral content ( Mølgaard et al., 1997 ). The increase in total body bone mineral is explained by both increases in skeletal length and width and a small increase in bone mineral density ( Malina et al., 2004 ).

Many studies have shown a positive effect of physical activity on intermediate markers of bone health, such as bone mineral content and density. Active children and adolescents have greater bone mineral content and density than their less active peers, even after controlling for differences in height and muscle mass ( Wang et al., 2004 ; Hind and Burrows, 2007 ; Tobias et al., 2007 ). Exercise interventions support the findings from observational studies showing beneficial effects on bone mineral content and density in exercise participants versus controls ( Petit et al., 2002 ; Specker and Binkley, 2003 ), although the benefit is less than is suggested by cross-sectional studies comparing active versus inactive individuals ( Bloomfield et al., 2004 ). The relationship between greater bone mineral density and bone strength is unclear, as bone strength cannot be measured directly in humans. Thus, whether the effects of physical activity on bone mineral density translate into similar benefits for fracture risk is uncertain ( Karlsson, 2007 ). Animal studies have shown that loading causes small changes in bone mineral content and bone mineral density that result in large increases in bone strength, supporting the notion that physical activity probably affects the skeleton in a way that results in important gains in bone strength ( Umemura et al., 1997 ). The relatively recent application of peripheral quantitative computed tomography for estimating bone strength in youth has also provided some results suggesting an increase in bone strength with greater than usual physical activity ( Sardinha et al., 2008 ; Farr et al., 2011 ).

The intensity of exercise appears to be a key determinant of the osteogenic response ( Turner and Robling, 2003 ). Bone tissue, like other tissues, accommodates to usual daily activities. Thus, activities such as walking have a modest effect at best, since even relatively inactive individuals take many steps (>1,000) per day. Activities generating greater muscle force on bone, such as resistance exercise, and “impact” activities with greater than ordinary ground reaction forces (e.g., hopping, skipping, jumping, gymnastics) promote increased mineralization and modeling ( Bloomfield et al., 2004 ; Farr et al., 2011 ). Far fewer randomized controlled trials (RCTs) examining this relationship have been conducted in children than in adults, and there is little evidence on dose response to show how the type of exercise interacts with frequency, intensity, and duration. Taken together, however, the available evidence supports beneficial effects of physical activity in promoting bone development ( Bailey et al., 1996 ; Modlesky and Lewis, 2002 ).

Physical activity may reduce osteoporosis-related fracture risk by increasing bone mineral accrual during development; by enhancing bone strength; and by reducing the risk of falls by improving muscle strength, flexibility, coordination, and balance ( Bloomfield et al., 2004 ). Early puberty is a key developmental period. Approximately 26 percent of the mineral content in the adult skeleton is accrued during the 2 years around the time of peak height velocity ( Bailey et al., 2000 ). This amount of mineral accrual represents approximately the same amount of bone mineral that most people will lose in their entire adult lives ( Arlot et al., 1997 ). The increase in mineral contributes to increased bone strength. Mineral is accrued on the periosteal surface of bone, such that the bone grows wider. Increased bone width, independent of the increased mineral mass, also contributes to greater bone strength. Indeed, an increase of as little as 1 mm in the outer surface of bone increases strength substantially. Adding bone to the endosteal surface also increases strength ( Parfitt, 1994 ; Wang et al., 2009 ). Increases in testosterone may be a greater stimulus of periosteal expansion than estrogen since testosterone contributes to wider and stronger bones in males compared with females. Retrospective studies in tennis players and gymnasts suggest structural adaptations may persist many years later in adulthood and are greatest when “impact” activity is initiated in childhood ( Kannus et al., 1995 ; Bass et al., 1998 ). RCTs on this issue are few, although the available data are promising ( McKay et al., 2000 ; Fuchs et al., 2001 ; MacKelvie et al., 2001 , 2003 ; Lindén et al., 2006 ). Thus, impact exercise begun in childhood may result in lasting structural changes that may contribute to increased bone strength and decreased fracture risk later in life ( Turner and Robling, 2003 ; Ferrari et al., 2006 ).

Adipose tissue

The adipose “organ” is composed of fat cells known as adipocytes ( Ailhaud and Hauner, 1998 ). Adipocytes are distributed throughout the body in various organs and tissues, although they are largely clustered anatomically in structures called fat depots, which include a large number of adipocytes held together by a scaffold-like structure of collagen and other structural molecules. In the traditional view of the adipocyte, the cell provides a storage structure for fatty acids in the form of triacylglycerol molecules, with fatty acids being released when metabolic fuel is needed ( Arner and Eckel, 1998 ). While adipocytes play this critical role, they are also involved in a number of endocrine, autocrine, and paracrine actions and play a key role in regulating other tissues and biological functions, for example, immunity and blood pressure, energy balance, glucose and lipid metabolism, and energy demands of exercise ( Ailhaud and Hauner, 1998 ; Frühbeck et al., 2001 ). The role of adipocytes in regulation of energy balance and in carbohydrate and lipid metabolism and the potential effects of physical activity on adipocyte function are of particular interest here, given growing concerns related to pediatric and adult obesity ( Ogden et al., 2012 ) and the associated risk of cardiometabolic disease ( Weiss et al., 2004 ; Eisenmann, 2007 a,b; Steele et al., 2008 ). Metabolic differences among various fat depots are now well known ( Frühbeck et al., 2001 ), and there is significant interest in the distribution of adipose tissue, the changes that occur during childhood and adolescence, and their clinical significance.

Adipocytes increase in size (hypertrophy) and number (hyperplasia) from birth through childhood and adolescence and into young adulthood to accommodate energy storage needs. The number of adipocytes has been estimated to increase from about 5 billion at birth to 30 billion to 50 billion in the nonobese adult, with an increase in average diameter from about 30-40 μm at birth to about 80-100 μm in the young adult ( Knittle et al., 1979 ; Bonnet and Rocour-Brumioul, 1981 ; Chumlea et al., 1982 ). In total the adipose organ contains about 0.5 kg of adipocytes at birth in both males and females, increasing to approximately 10 kg in average-weight-for-height males and 14 kg in females ( Malina et al., 2004 ). There is wide interindividual variation, however, and the difficulty of investigating changes in the number and size of adipocytes is obvious given the invasiveness of the required biopsy procedures; understandably, then, data on these topics are scarce in children and adolescents. Also, since only subcutaneous depots are accessible, results must be extrapolated from a few sites.

Based on such information, the average size of adipocytes has been reported to increase two- to threefold in the first year of life, with little increase in nonobese boys and girls until puberty ( Malina et al., 2004 ). A small increase in average adipocyte size at puberty is more obvious in girls than in boys. There is considerable variation in size across various subcutaneous sites and between subcutaneous and internal depots. The number of adipocytes is difficult to estimate. Available data suggest that the cellularity of adipose tissue does not increase significantly in early postnatal life ( Malina et al., 2004 ). Thus, gain in fat mass is the result of an increase in the size of existing adipocytes. From about 1-2 years of age and continuing through early and middle childhood, the number of adipocytes increases gradually two- to threefold. With puberty the number practically doubles, followed by a plateau in late adolescence and early adulthood. The number of adipocytes is similar in boys and girls until puberty, when girls experience a greater increase than boys.

The increases in the number of adipocytes during infancy and puberty are considered critical for enlargement of the adipose tissue organ and for the risk of obesity. Since size and number are linked, the number of adipocytes can potentially increase at any age if fat storage mechanisms are stimulated by chronic energy surfeit ( Hager, 1981 ; Chumlea et al., 1982 ). Energy expenditure through regular physical activity is a critical element in preventing energy surfeit and excess adiposity. While cellularity undoubtedly is strongly genetically determined, regular physical activity, through its contribution to energy expenditure, can contribute to less adipocyte hyperplasia by limiting hypertrophy.

Fat distribution

Fat distribution refers to the location of fat depots on the body. The metabolic activities of fat depots differ, and small variation can have a long-term impact on fat distribution. Differences in metabolic properties across depots also have clinical implications. Visceral adipose tissue in the abdominal cavity is more metabolically active (reflected by free fatty acid flux) than adipose tissue in other areas ( Arner and Eckel, 1998 ), and higher amounts of visceral adipose tissue are associated with greater risk of metabolic complications, such as type 2 diabetes and cardiovascular disease ( Daniels et al., 1999 ; He et al., 2007 ; Dencker et al., 2012 ). In contrast, subcutaneous fat, particularly in the gluteofemoral region, is generally associated with a lower risk of cardiometabolic disease. Age- and sex-associated variations in fat distribution contribute to age- and sex-associated differences in cardiometabolic disease prevalence. Girls have more subcutaneous fat than boys at all ages, although relative fat distribution is similar. After a rapid rise in subcutaneous fat in the first few months of life, both sexes experience a reduction through age 6 or 7 ( Malina and Roche, 1983 ; Malina and Bouchard, 1988 ; Malina, 1996 ). Girls then show a linear increase in subcutaneous fat, whereas boys show a small increase between ages 7 and 12 or 13 and then an overall reduction during puberty. The thickness of subcutaneous fat on the trunk is approximately one-half that of subcutaneous fat on the extremities in both boys and girls during childhood. The ratio increases with age in males during adolescence but changes only slightly in girls. In males the increasing ratio of trunk to extremity subcutaneous fat is a consequence of slowly increasing trunk subcutaneous fat and a decrease in subcutaneous fat on the extremities. In girls, trunk and extremity subcutaneous fat increase at a similar rate; thus the ratio is stable ( Malina and Bouchard, 1988 ). As a consequence, the sex difference in the distribution of body fat develops during adolescence. It is important to note that changes in subcutaneous fat pattern do not necessarily represent changes in abdominal visceral adipose tissue.

Tracking of subcutaneous fat has been investigated based on skinfold thicknesses and radiographs of fat widths in males and females across a broad age range ( Katzmarzyk et al., 1999 ; Campbell et al., 2012 ). Results indicate that subcutaneous fat is labile during early childhood. After age 7 to 8, correlations between subcutaneous fat in later childhood and adolescence and adult subcutaneous fat are significant and moderate. Longitudinal data on tracking of visceral adipose tissue are not available, but percent body fat does appear to track. Thus children and especially adolescents with higher levels of body fat have a higher risk of being overfat at subsequent examinations and in adulthood, although variation is considerable, with some individuals moving away from high fatness categories, while some lean children move into higher fatness categories.

In cross-sectional studies, active children and adolescents tend to have lower skinfold thicknesses and less overall body fat than their less active peers ( Loftin et al., 1998 ; Rowlands et al., 2000 ; Stevens et al., 2004 ; Lohman et al., 2006 ), although the correlations are modest, reflecting variation in body composition at different levels of physical activity, as well as the difficulty of measuring physical activity. Longitudinal studies indicate small differences in fatness between active and inactive boys and girls. Although some school-based studies of the effects of physical activity on body composition have reported changes in BMI or skinfolds in the desired direction ( Gortmaker et al., 1999 ; McMurray et al., 2002 ), most have not shown significant effects. High levels of physical activity are most likely needed to modify skinfold thicknesses and percent body fat. In adults, visceral adipose tissue declines with weight loss with exercise. In contrast, in a study of obese children aged 7-11, a 4-month physical activity program resulted in minimal change in abdominal visceral adipose tissue but a significant loss in abdominal subcutaneous adipose tissue ( Gutin and Owens, 1999 ). In adults, decreases in fatness with exercise are due to a reduction in fat cell size, not number ( You et al., 2006 ); whether this is true in children is not certain but appears likely. Given that adipocyte hypertrophy may trigger adipocyte hyperplasia ( Ballor et al., 1998 ), energy expenditure through regular physical activity may be important in preventing excess adipose tissue cellularity. Regular physical activity also affects adipose tissue metabolism so that trained individuals have an increased ability to mobilize and oxidize fat, which is associated with increased levels of lipolysis, an increased respiratory quotient, and a lower risk of obesity ( Depres and Lamarche, 2000 ).

Cardiorespiratory System

The ability to perform sustained activity under predominantly aerobic conditions depends on the capacity of the cardiovascular and pulmonary systems to deliver oxygenated blood to tissues and on the ability of tissues (primarily skeletal muscle) to extract oxygen and oxidize substrate. By age 2 the systems are fully functional, although young children lack the cardiorespiratory capacity of older children and adults because of their small size ( Malina et al., 2004 ). Children's aerobic capacity and consequently their ability to exercise for longer periods of time increase as they grow. Maximal aerobic power (liters per minute) increases fairly linearly in boys until about age 16, whereas it increases in girls until about age 13 and then plateaus during adolescence ( Malina et al., 2004 ; Eisenmann et al., 2011 ). Differences between boys and girls are small (~10 percent) during childhood and greater after the adolescent growth spurt, when girls have only about 70 percent of the mean value of boys. Changes with age and sex differences are explained largely by differences in the size of the relevant tissues. Dimensions of the heart and lungs enlarge with age in a manner consistent with the increase in body mass and stature ( Malina et al., 2004 ). The increase in the size of the heart is associated with increases in stroke volume (blood pumped per beat) and cardiac output (product of stroke volume and heart rate, liters per minute), despite a decline in heart rate during growth. Similarly, increase in lung size (proportional to growth in height) results in greater lung volume and ventilation despite an age-associated decline in breathing frequency. From about age 6 to adulthood, maximal voluntary ventilation approximately doubles (50–100 L/min) ( Malina et al., 2004 ). The general pattern of increase as a function of height is similar in boys and girls. In both, lung function tends to lag behind the increase in height during the adolescent growth spurt. As a result, peak gains in lung function occur about 2 years earlier in girls than in boys.

Blood volume is highly related to body mass and heart size in children and adolescents, and it is also well correlated with maximal oxygen uptake during childhood and adolescence ( Malina et al., 2004 ). Blood volume increases from birth through adolescence, following the general pattern for changes in body mass. Both red blood cells and hemoglobin have a central role in transport of oxygen to tissues. Hematocrit, the percentage of blood volume explained by blood cells, increases progressively throughout childhood and adolescence in boys, but only through childhood in girls. Hemoglobin content, which is related to maximal oxygen uptake, heart volume, and body mass, increases progressively with age into late adolescence. Males have greater hemoglobin concentrations than females, especially relative to blood volume, which has functional implications for oxygen transport during intense exercise.

Growth in maximal aerobic power is influenced by growth in body size, so controlling for changes in body size during growth is essential. Although absolute (liters per minute) aerobic power increases into adolescence relative to body weight, there is a slight decline in both boys and girls, suggesting that body weight increases at a faster rate than maximal oxygen consumption, particularly during and after the adolescent growth spurt ( Malina et al., 2004 ). Changes in maximal oxygen consumption during growth tend to be related more closely to fat-free mass than to body mass. Nevertheless, sex differences in maximal oxygen consumption per unit fat-free mass persist, and maximal oxygen consumption per unit fat-free mass declines with age.

Improvements in cardiorespiratory function—involving structural and functional adaptations in the lungs, heart, blood, and vascular system, as well as the oxidative capacity of skeletal muscle—occur with regular vigorous- and moderate-intensity physical activity ( Malina et al., 2004 ). Concern about the application of invasive techniques limits the available data on adaptations in the oxygen transport system in children. Nevertheless, it is clear that aerobic capacity in youth increases with activity of sufficient intensity and that maximal stroke volume, blood volume, and oxidative enzymes improve after exercise training ( Rowland, 1996 ). Training-induced changes in other components of the oxygen transport system remain to be determined.

Health- and Performance-Related Fitness

Physical fitness is a state of being that reflects a person's ability to perform specific exercises or functions and is related to present and future health outcomes. Historically, efforts to assess the physical fitness of youth focused on measures designed to evaluate the ability to carry out certain physical tasks or activities, often related to athletic performance. In more recent years, the focus has shifted to greater emphasis on evaluating health-related fitness ( IOM, 2012a ) and assessing concurrent or future health status. Health- and performance-related fitness, while overlapping, are different constructs. Age- and sex-related changes in the components of both are strongly linked to the developmental changes in tissues and systems that occur during childhood and adolescence. Although genetic factors ultimately limit capacity, environmental and behavioral factors, including physical activity, interact with genes to determine the degree to which an individual's full capacity is achieved.

Health-Related Fitness

Cardiorespiratory endurance, muscular strength and endurance, flexibility, and body composition are components of health-related fitness historically assessed in school-based fitness assessment programs ( IOM, 2012a ). These components of health-related fitness are considered important since they can be linked to the risk of cardiometabolic disease and musculoskeletal disability, chronic hypokinetic-related diseases.

Cardiorespiratory endurance

Cardiorespiratory (aerobic) endurance reflects the functioning of the pulmonary and cardiovascular systems to deliver oxygen and the ability of tissues (primarily skeletal muscle) to extract oxygen from the blood. Defined clinically as the maximum oxygen consumption during a maximal graded exercise test, in practice it is usually measured indirectly as performance on a field test of endurance, such as 1- or 2-mile run time ( IOM, 2012a ). During childhood, aerobic capacity approximately doubles in both boys and girls, although girls on average possess a lower capacity. Males continue to improve during adolescence, up to ages 17-18, while aerobic capacity plateaus around age 14 in females ( Malina et al., 2004 ), resulting in an approximately 20 percent difference between males and females ( Rowland, 2005 ).

Favorable associations have been found between aerobic endurance and high-density lipoproteins, systolic blood pressure, diastolic blood pressure, BMI, measures of fatness, arterial stiffness, and measures of insulin sensitivity ( Boreham et al., 2004 ; Imperatore et al., 2006 ; Hussey et al., 2007 ; Ondrak et al., 2007 ). Some evidence suggests a decline in aerobic endurance among U.S. youth in recent decades ( Eisenmann, 2003 ; Carnethon et al., 2005 ; Pate et al., 2006 ), coincident with increased sedentariness and obesity and a greater prevalence of metabolic syndrome in youth. Aerobic exercise has been shown to increase cardiorespiratory endurance by about 5-15 percent in youth ( Malina et al., 2004 ; HHS, 2008 ). The programs that produce this benefit involve continuous vigorous- or moderate-intensity aerobic activity of various types for 30-45 minutes per session at least 3 days per week over a period of at least 1-3 months ( Baquet et al., 2002 ); improvements are greater with more frequent exercise ( Baquet et al., 2003 ).

Muscle strength and endurance

Muscle strength is defined as the highest force generated during a single maximum voluntary contraction, whereas muscle endurance is the ability to perform repeated muscular contraction and force development over a period of time. Muscle strength and endurance are correlated, especially at higher levels of force production. Muscle strength is proportional to the cross-sectional area of skeletal muscle; consequently, strength growth curves parallel growth curves for body weight and skeletal muscle mass ( Malina et al., 2004 ).

Both males and females show impressive increases in muscle strength from childhood to adolescence. Strength in children increases linearly, with boys having a slight advantage over girls. However, these sex differences are magnified during the adolescent years as a result of maturation ( Malina and Roche, 1983 ). Differences in muscle strength between boys and girls become more apparent after puberty, primarily as a result of the production of sex steroid hormones. In boys the increase in strength during adolescence lags behind the growth spurt by at least a year (peak height velocity), which may explain why some boys experience a brief period of clumsiness or awkwardness during puberty, as they have not yet acquired the muscle strength necessary to handle the changes associated with their larger bodies. Muscle strength increases at its greatest rate approximately 1 year after peak height velocity in boys, whereas for girls the strength spurt generally occurs during the same year as peak height velocity ( Bar-Or, 1983 ).

A compelling body of evidence indicates that with resistance training children and adolescents can significantly increase their strength above that expected as a result of normal growth and maturation, provided that the training program is of sufficient intensity, volume, and duration ( Committee on Sports Medicine Fitness, 2001 ). Both boys and girls can benefit, and strength gains in children as young as 5-6 have been reported ( Faigenbaum et al., 2009 ), although most studies are of older children and adolescents. Gains in muscle strength of about 30 percent are typical, although considerably larger gains have been reported. Adolescents make greater gains than preadolescents in absolute strength, whereas reported relative (percent above initial strength) gains in strength during preadolescence and adolescence are similar. A variety of programs and modalities have proved efficacious ( Council on Sports Medicine Fitness, 2008 ), as long as load (~10-15 repetitions maximum) and duration (~8-20 weeks) are adequate. As in adults, training adaptations in youth are specific to the muscle action or muscle groups that are trained, and gains are transient if training is not maintained ( Faigenbaum et al., 2009 ).

Youth resistance training, as with most physical activities, does carry some degree of risk of musculoskeletal injury, yet the risk is no greater than that associated with other sports and activities in which children and adolescents participate ( Council on Sports Medicine Fitness, 2008 ; Faigenbaum et al., 2009 ) as long as age-appropriate training guidelines are followed. A traditional area of concern has been the potential for training-induced damage to growth cartilage, which could result in growth disturbances. However, a recent review found no reports of injury to growth cartilage in any prospective study of resistance training in youth and no evidence to suggest that resistance training negatively impacts growth and maturation during childhood and adolescence ( Faigenbaum et al., 2009 ). Injuries typically occur in unsupervised settings and when inappropriate loads and progressions are imposed.

In addition to the obvious goal of gaining strength, resistance training may be undertaken to improve sports performance and prevent injuries, rehabilitate injuries, and enhance health. Appropriately supervised programs emphasizing strengthening of trunk muscles in children theoretically benefit sport-specific skill acquisition and postural control, although these benefits are difficult to study and thus are supported by little empirical evidence ( Council on Sports Medicine Fitness, 2008 ). Similarly, results are inconsistent regarding the translation of increased strength to enhanced athletic performance in youth. Limited evidence suggests that strength-training programs that address common overuse injuries may help reduce injuries in adolescents, but whether the same is true in preadolescents is unclear ( Council on Sports Medicine Fitness, 2008 ). Increasing evidence suggests that strength training, like other forms of physical activity, has a beneficial effect on measurable health indices in youth, such as cardiovascular fitness, body composition, blood lipid profiles and insulin sensitivity ( Faigenbaum, 2007 ; Benson et al., 2008 ), bone mineral density and bone geometry ( Morris et al., 1997 ; MacKelvie et al., 2004 ), and mental health ( Holloway et al., 1988 ; Faigenbaum et al., 1997 ; Annesi et al., 2005 ; Faigenbaum, 2007 ). Some work has shown that muscle fitness, reflected in a composite index combining measures of muscle strength and endurance, and cardiorespiratory fitness are independently and negatively associated with clustered metabolic risk ( Steene-Johannessen et al., 2009 ). Moreover, children with low muscle strength may be at increased risk of fracture with exercise ( Clark et al., 2011 ). Finally, muscle hypertrophy, which adds to fat-free mass, contributes to resting metabolic rate and therefore total daily energy expenditure. Resistance training may be particularly useful for raising metabolic rate in overweight and obese children without the risk associated with higher-impact activities ( Watts et al., 2005 ; Benson et al., 2007 ).

Flexibility

Flexibility has been operationally defined as “the intrinsic property of body tissues, including muscle and connective tissues, that determines the range of motion achievable without injury at a joint or group of joints” ( IOM, 2012b , p. 190). At all ages, girls demonstrate greater flexibility than boys, and the difference is greatest during the adolescent growth spurt and sexual maturation. Perhaps the most common field measure of flexibility in children and youth is the sit-and-reach test ( IOM, 2012b ) of low-back flexibility. Low-back flexibility as measured by this test is stable in girls from age 5 to 11 and increases until late adolescence. In boys, low-back flexibility declines linearly starting at age 5, reaching its nadir at about age 12, and then increases into late adolescence. The unique pattern of age- and sex-associated variation is related to the growth of the lower extremities and the trunk during adolescence. In boys the nadir in low-back flexibility coincides with the adolescent growth spurt in leg length. In both boys and girls, the increase during adolescence coincides with the growth spurt in trunk length and arm length, which influences reach. Flexibility in both males and females tends to decline after age 17, in part as a result of a decline in physical activity and normal aging.

The principal health outcomes hypothesized to be associated with flexibility are prevention of and relief from low-back pain, prevention of musculoskeletal injury, and improved posture. These associations have been studied in adults, with equivocal results ( Plowman, 1992 ). Although flexibility has long been included in national youth fitness tests, it has proven difficult to establish a link between flexibility and health ( IOM, 2012a ). In contrast to other fitness components that are general or systemic in nature, flexibility is highly specific to each joint of the body. Although appropriate stretching may increase flexibility, establishing a link to improved functional capacity and fitness is difficult. A few studies suggest that improvements in flexibility as measured by the sit-and-reach test may be related to less low-back pain ( Jones et al., 2007 ; Ahlqwist et al., 2008 ), but the evidence is weak. Consequently, the Institute of Medicine (IOM) Committee on Fitness Measures and Health Outcomes in its recent report elected to forego recommending a flexibility test for a national youth fitness test battery pending further research to confirm the relationship between flexibility and health and to develop national normative data ( IOM, 2012a ).

Body composition

Body composition is the component of health-related fitness that relates to the relative amount of adipose tissue, muscle, bone, and other vital components (e.g., organs, connective tissues, fluid compartments) that make up body weight. Most feasible methods for assessing body composition are based on models that divide the body into fat and fat-free (all nonfat constituents) components ( Going et al., 2012 ). Although fat mass and adipose tissue are not equivalent components, fat mass is easier to estimate than adipose tissue, and it is correlated with performance and disease risk. In settings in which estimation of body fat is difficult, weight-for-height ratios often are used as surrogates for body composition. Indeed, definitions of pediatric overweight and obesity have been based on BMI, calculated as weight in kilograms divided by height squared. Child and adolescent obesity defined by BMI remains at all-time highs. Population surveys indicate that approximately 33 percent of all boys and girls are overweight, and nearly one in five are obese ( Ogden and Flegal, 2011 ). The tendency for excess fatness to persist from childhood and adolescence into adulthood ( Daniels et al., 2005 ), coupled with the strong association between obesity and chronic disease ( Weiss and Caprio, 2005 ; Barlow, 2007 ), has caused great concern for future obesity levels and the health of youth and adults alike ( IOM, 2005 , 2012b ).

The increase in prevalence of obesity is undoubtedly due to a mismatch between energy intake and expenditure. Population surveys have shown that few children and youth meet recommended levels of daily physical activity (see Chapter 2 ). Prospective studies have shown a significant and inverse relationship between habitual physical activity and weight gain ( Berkey et al., 2003 ), and in some studies physical activity is a better predictor of weight gain than estimates of calorie or fat intake ( Berkey et al., 2000 ; Janssen et al., 2005 ). These relationships are better established in adults than in children and youth, although even in preschool children, low levels of physical activity, estimated from doubly labeled water, were found to be indicative of higher body fat content ( Davies et al., 1995 ). While studies of exercise without caloric restriction generally show only small effects on body weight, significant albeit moderate reductions of body fat are generally reported ( Eisenmann, 2003 ). Moreover, even in the absence of significant weight loss, exercise has beneficial effects on risk factors for cardiometabolic disease ( Ross and Bradshaw, 2009 ; Gutin and Owens, 2011 ).

Body mass index

Changes in weight for height with growth and maturation for U.S. boys and girls are described in CDC growth curves ( Kuczmarski et al., 2000 ). Current growth curves were derived from U.S. population surveys conducted before the increase in weight for height that defines today's pediatric obesity epidemic. In boys and girls, BMI declines during early childhood, reaching its nadir at about ages 5-6, and then increases through adolescence. A gender difference emerges during puberty, with males gaining greater fat-free mass than females. Both the period of “adiposity rebound” (the increase in BMI in midchildhood following the decline in early childhood) and puberty are times of risk for excess fat gain that correlates with future adiposity ( Rolland-Cachera et al., 1984 ). Physical activity and BMI are inversely correlated in children and adolescents, although the correlations are modest ( Lohman et al., 2006 ), reflecting the difficulty of measuring physical activity, as well as variation in body composition and physical activity at a given weight ( Rowlands et al., 2000 ). Indeed, when studied separately, fat mass index (FMI, or fat mass divided by height squared) and fat-free mass index (FFMI, or fat-free mass divided by height squared) are both inversely related to physical activity. With FMI controlled, however, FFMI is positively related to physical activity, indicating that, for a given level of body fat, individuals with more fat-free mass are more active ( Lohman et al., 2006 ). BMI cut-points for defining overweight and obesity have historically been based on age- and gender-specific population distributions of BMI. Recent work has shown good correspondence between BMI standards and percent fat standards that are referenced to health criteria ( Laurson et al., 2011 ). These new standards should prove useful for identifying children and adolescents at risk for higher levels of cardiometabolic risk factors.

Percent body fat

Direct measures of body fat as a percent of weight provide a better index of adiposity and health risk than BMI ( Zeng et al., 2012 ), which is confounded by variation in lean tissue mass relative to height. Recently, percent fat growth curves were established for representative samples of U.S. boys and girls using National Health and Nutrition Examination Survey (NHANES) data ( Laurson et al., 2011 ; Ogden and Flegal, 2011 ). Median percent fat for boys aged 5-18 ranged from 14 to 19 percent and for girls across the same ages 15 to 28 percent. In both boys and girls, percent fat increases slowly during early childhood, with girls having a consistently greater relative fatness than boys after ages 5-6. In girls, percent fat increases gradually throughout adolescence in the same manner as fat mass. In boys, percent fat increases gradually until the adolescent growth spurt and thereafter gradually declines until about age 16-17, reflecting the rapid growth in fat-free mass relative to fat mass. After age 17, percent fat in males gradually increases again into adulthood.

The increased prevalence of child and adolescent obesity as defined by BMI presumably also reflects increased adiposity, although the degree is not certain as population-based estimates of percent fat have only recently been developed ( Laurson et al., 2011 ). Health-related percent fat standards recently were developed by determining levels of body fat associated with greater occurrence of chronic disease risk factors defined by metabolic syndrome ( Going et al., 2011 ). In boys and girls aged 12-18, body fat above 20-24 percent and above 27-31 percent, respectively, was predictive of metabolic syndrome.

Physical activity is inversely correlated with percent body fat ( Rowlands et al., 2000 ; Lohman et al., 2006 ), although the correlations are modest, and changes in overall fatness as well as subcutaneous adipose tissue with habitual physical activity are reasonably well documented in children and adolescents ( Gutin and Humphries, 1998 ; Gutin and Owens, 1999 ; Dionne et al., 2000 ). In youth, as in adults, the effects of exercise without caloric restriction are modest and are influenced by the initial level of body fat and the duration and regimen of exercise ( Going, 1999 ). Experimental studies have documented reductions in percent body fat with aerobic exercise, especially in children and adolescents who are overweight or obese at the initiation of an exercise program ( Davis et al., 2012 ). Regular physical activity also affects adipose tissue metabolism ( Gutin and Owens, 1999 ). Individuals who engage in aerobic endurance exercise training have an increased ability to mobilize and oxidize fat, which is associated with increased levels of lipolysis ( Depres and Lamarche, 2000 ). Similar information on adipose tissue metabolism in children and youth is lacking, although one can reasonably expect similar adaptations in older adolescents.

Metabolic syndrome

The tendency for risk factors for cardiometabolic disease to cluster, now called metabolic syndrome, is well recognized in adults ( Alberti and Zimmet, 1998 ). Similar clustering occurs in older children and especially adolescents ( Cook et al., 2003 ), and interest in metabolic syndrome has increased, driven by the increased prevalence of pediatric obesity and the increasing incidence and earlier onset of type 2 diabetes in youth. There is as yet no accepted definition of metabolic syndrome for use in pediatric populations ( Jolliffe and Janssen, 2007 ). Typically, adult definitions are extrapolated to children and adolescents, with appropriate adjustments of the thresholds for the defining variables. Perhaps the most common approach is to emulate the National Cholesterol Education Program (NCEP), which defines metabolic syndrome as exceeding thresholds on three of five components: waist circumference, blood pressure (systolic or diastolic), blood lipids (high-density lipoprotein [HDL] and triglycerides), and blood glucose levels ( NIH, 2001 ).

The concept of metabolic syndrome is useful as it provides an integrated index of risk, and it recently was used to derive health-related percent-body-fat standards ( Laurson et al., 2011 ). Based on NHANES data, the prevalence of metabolic syndrome varies with the degree of obesity, and it is estimated at 4-6 percent of children and adolescents ( Cook et al., 2003 ; Dubose et al., 2007 ); among obese youth it may be as high as 30-50 percent ( Weiss et al., 2004 ). Youth with metabolic syndrome have an increased risk of type 2 diabetes and cardiovascular disease. In adults a loss of 5-10 percent of body weight through calorie restriction and exercise has been shown to reduce the risk of cardiometabolic disease by improving risk factors ( Diabetes Prevention Program Research Group, 2002 ; Ross and Janiszewski, 2008 ). In particular, weight loss results in reduced visceral adipose tissue, a strong correlate of risk ( Knowler et al., 2002 ), as well as lower blood pressure and blood glucose levels due to improved insulin sensitivity. Even without significant weight loss, exercise can have significant effects in adults by improving glucose metabolism, improving lipid and lipoprotein profiles, and lowering blood pressure, particularly for those who are significantly overweight ( Ross and Bradshaw, 2009 ). Similar benefits have been observed in adolescents.

A growing body of literature addresses the associations of physical activity, physical fitness, and body fatness with the risk of metabolic syndrome and its components in children and especially adolescents ( Platat et al., 2006 ; McMurray et al., 2008 ; Rubin et al., 2008 ; Thomas and Williams, 2008 ; Christodoulos et al., 2012 ). Studies in adults have shown that higher levels of physical activity predict slower progression toward metabolic syndrome in apparently healthy men and women ( Laaksonen et al., 2002 ; Ekelund et al., 2005 ), an association that is independent of changes in body fatness and cardiorespiratory fitness ( Ekelund et al., 2007 ). Few population studies have focused on these relationships in children and adolescents, and the use of self-reported activity, which is imprecise in these populations, tends to obscure associations. In a large sample of U.S. adolescents aged 12-19 in the 1999–2002 NHANES, for example, there was a trend for metabolic syndrome to be more common in adolescents with low activity levels than in those with moderate or high activity levels, although the differences among groups were not statistically significant ( Pan and Pratt, 2008 ). Moreover, for each component of metabolic syndrome, prevalence was generally lower with higher physical activity levels, and adolescents with low physical activity levels had the highest rates of all metabolic syndrome components.

The association between cardiorespiratory fitness and metabolic syndrome also was examined in the 1999–2002 NHANES ( Lobelo et al., 2010 ). Cardiorespiratory fitness was measured as estimated peak oxygen consumption using a submaximal treadmill exercise protocol, and metabolic syndrome was represented as a “clustered score” derived from five established risk factors for cardiovascular disease, an adiposity index, insulin resistance, systolic blood pressure, triglycerides, and the ratio of total to HDL cholesterol. Mean clustered risk score decreased across increasing fifths (quintiles) of cardiorespiratory fitness in both males and females. The most significant decline in risk score was observed from the first (lowest) to the second quintile (53.6 percent and 37.5 percent in males and females, respectively), and the association remained significant in both overweight and normal-weight males and in normal-weight females. Other studies, using the approach of cross-tabulating subjects into distinct fitness and fatness categories, have examined associations of fitness and fatness with metabolic syndrome risk ( Eisenmann et al., 2005 , 2007a , b ; Dubose et al., 2007 ). Although different measures of fitness, fatness, and metabolic syndrome risk were used, the results taken together across a wide age range (7–18) show that fitness modifies the influence of fatness on metabolic syndrome risk. In both males and females, high-fit/low-fatness subjects have less metabolic syndrome risk than low-fit/high-fatness subjects ( Eisenmann, 2007 ).

That many adult chronic health conditions have their origins in childhood and adolescence is well supported ( Kannel and Dawber, 1972 ; Lauer et al., 1975 ; Berenson et al., 1998 ; IOM, 2004 ). Both biological (e.g., adiposity, lipids) and behavioral (e.g., physical activity) risk factors tend to track from childhood and especially adolescence into adulthood. Childhood BMI is related to adult BMI and adiposity ( Guo et al., 1994 , 2000 ; Freedman et al., 2005 ), and as many as 80 percent of obese adolescents become obese adults ( Daniels et al., 2005 ). Coexistence of cardiometabolic risk factors, even at young ages ( Dubose et al., 2007 ; Ramírez-Vélez et al., 2012 ), has been noted, and these components of metabolic syndrome also have been shown to track to adulthood ( Bao et al., 1994 ; Katzmarzyk et al., 2001 ; Huang et al., 2008 ). Landmark studies from the Bogalusa Heart Study ( Berenson et al., 1998 ; Li et al., 2003 ) and others ( Mahoney et al., 1996 ; Davis et al., 2001 ; Morrison et al., 2007 , 2008 ) have demonstrated that cardiometabolic risk factors present in childhood are predictive of adult disease.

The benefits of exercise for prevention and treatment of cardiometabolic disease in adults are well described ( Ross et al., 2000 ; Duncan et al., 2003 ; Gan et al., 2003 ; Irwin et al., 2003 ; Lee et al., 2005 ; Sigal et al., 2007 ; Ross et al., 2012 ). Prospective studies examining the effects of exercise on metabolic syndrome in children and adolescents remain limited, and it is important to refrain from extrapolating intervention effects observed in adults to youth, although one might reasonably assume the benefits in older adolescents to be similar to those in young adults. Indeed, based on the inverse associations of physical activity and physical fitness with metabolic syndrome ( Kim and Lee, 2009 ) and on the available intervention studies, some experts have recommended physical activity as the main therapeutic tool for prevention and treatment of metabolic syndrome in childhood ( Brambilla et al., 2010 ). Comparative studies in adults have shown that the effect of exercise on weight is limited and generally less than that of calorie restriction ( Brambilla et al., 2010 ). Moreover, the relative effectiveness of diet and exercise depends on the degree of excess fatness ( Brambilla et al., 2010 ). Comparative studies in children and youth are few, as behavioral interventions in overweight children and adolescents commonly combine exercise and dietary restriction, making it difficult to disentangle their independent effects. Nonetheless, diet and exercise have different effects on body composition: While both contribute to fat loss, only exercise increases muscle mass and thus has a direct effect on metabolic health. In children and youth, as in adults, the effect of exercise on cardiometabolic risk factors is greater in overweight/obese youth than in their normal-weight peers ( Kang et al., 2002 ; Lazaar et al., 2007 ).

Exercise also may have important benefits even without significant modification of body composition ( Bell et al., 2007 ). Experimental studies in overweight and obese youth have shown that exercise leads to reductions in visceral fat ( Owens et al., 1999 ; Gutin et al., 2002 ; Lee at al., 2005 ; Barbeau et al., 2007 ; Kim and Lee, 2009 ) without a significant change in BMI, as well as improvement in markers of metabolic syndrome, primarily fasting insulin and insulin resistance ( Treuth et al., 1998 ; Ferguson et al., 1999 ; Carrel et al., 2005 ; Nassis et al., 2005 ; Meyer et al., 2006 ; Shaibi et al., 2006 ; Bell et al., 2007 ). Results from experimental studies of the effects of exercise on lipids and lipoproteins ( Stoedefalke et al., 2000 ; Kelley and Kelley, 2008 ; Janssen and LeBlanc, 2010 ) are mixed. Although some studies have shown improved lipid and lipoprotein profiles, primarily a decrease in low-density lipoprotein (LDL) cholesterol and triglyceride concentrations and an increase in HDL cholesterol ( Ferguson et al., 1999 ), other studies have shown no improvement in these outcomes ( Kelley and Kelley, 2008 ). In part, such conflicting results are likely due to initial differences in body composition and severity of hyperlipidemia. Well-controlled exercise training studies in obese children ( Escalante et al., 2012 ) and children with adverse blood lipid and lipoprotein profiles have shown positive alterations in their profiles ( Stoedefalke et al., 2000 ), whereas results in normolipid-emic children and adolescents are equivocal. Similarly, exercise has little effect on resting blood pressure in normotensive children and adolescents ( Kelley and Kelley, 2008 ), whereas reductions in resting systolic and sometimes diastolic pressures have been reported in youth with high blood pressure ( Hagberg et al., 1983 , 1984 ; Danforth et al., 1990 ; Ewart et al., 1998 ; Farpour-Lambert et al., 2009 ; Janssen and LeBlanc, 2010 ).

In adults, physical activity is inversely associated with low-grade inflammation ( Wärnberg et al., 2010 ; Ertek and Cicero, 2012 ), which is now recognized as a significant feature of metabolic syndrome and an independent predictor of cardiometabolic disease ( Malina, 2002 ). In obese children and adolescents, as in their adult counterparts, elevation of inflammatory markers is evident, and observational studies have shown significant relationships among physical activity, physical fitness, and inflammation ( Isasi et al., 2003 ; Platat et al., 2006 ; Ruiz et al., 2007 ; Wärnberg et al., 2007 ; Wärnberg and Marcos, 2008 ). These relationships are better studied and stronger in adolescents than in children. In one study of boys and girls aged 10-15, those who were obese and unfit had the highest levels of systemic inflammation, whereas those who were obese yet fit had levels as low as those who were lean and fit ( Halle et al., 2004 ). In another study, low-grade inflammation was negatively associated with muscle strength in overweight adolescents after controlling for cardiorespiratory fitness, suggesting that high levels of muscle strength may counteract some of the negative consequences of higher levels of body fat ( Ruiz et al., 2008 ). Experimental studies of the effects of exercise and markers of low-grade inflammation in children and adolescents are lacking. Improved cardiorespiratory fitness in adults ( Church et al., 2002 ), however, has been shown to be inversely related to concentration of C-reactive protein (CRP), a marker of low-grade inflammation. In a small study of a lifestyle intervention entailing 45 minutes of physical activity 3 times per week for 3 months, a small reduction in body fat and an overall decrease in inflammatory factors (CRP, interleukin [IL]-6) were seen in obese adolescents ( Balagopal et al., 2005 ).

Performance-Related Fitness

Speed, muscle power, agility, and balance (static and dynamic) are aspects of performance-related fitness that change during body development in predictable ways associated with the development of tissues and systems discussed above ( Malina et al., 2004 ). Running speed and muscle power are related, and both depend on full development of the neuromuscular system. Running speed and muscle power are similar for boys and girls during childhood ( Haubenstricker and Seefeldt, 1986 ). After puberty, largely because of differences in muscle mass and muscle strength, males continue to make significant annual gains, while females tend to plateau during the adolescent years. Sociocultural factors and increasing inactivity among girls relative to boys, along with changes in body proportion and a lowering of the center of gravity, may also contribute to gender differences ( Malina et al., 2004 ).

Balance—the ability to maintain equilibrium—generally improves from ages 3 to 18 ( Williams, 1983 ). Research suggests that females outperform males on tests of static and dynamic balance during childhood and that this advantage persists through puberty ( Malina et al., 2004 ).

Motor performance is related in part to muscle strength. Increases in muscle strength as a result of resistance exercise were described above. A question of interest is whether gains in strength transfer to other performance tasks. Available results are variable, giving some indication that gains in strength are associated with improvement in some performance tasks, such as sprinting and vertical jump, although the improvements are generally small, highlighting the difficulty of distinguishing the effects of training from changes expected with normal growth. Changes in body size, physique, and body composition associated with growth and maturation are important factors that affect strength and motor performance. The relationships vary among performance measures and with age, and these factors often are inadequately controlled in studies of components of performance-related fitness and performance tasks.

PSYCHOSOCIAL HEALTH

Research supports the positive impact of physical activity on the overall psychological health and social engagement of every student. A well-designed physical education curriculum provides students with social and emotional benefits ( NASPE, 2001 ). Simultaneously, exposure to failure experiences, emphasis on competitive sports, and elitism for naturally inclined athletes, along with bullying and teasing of unfit, uncoordinated, and overweight youth, may be important factors discouraging participation in current and future physical activity ( Kohl and Hobbs, 1998 ; Sallis et al., 2000 ; Allender et al., 2006 ). School-based physical activity, including physical education and sports, is designed to increase physical activity while also improving motor skills and development, self-efficacy, and general feelings of competency and engaging children socially ( Bailey, 2006 ). The hoped-for psychosocial outcomes of physical education and other physical activity programs in the school setting have been found to be critical for continued physical activity across the life span and are themselves powerful long-term determinants of physical activity ( Bauman et al., 2012 ). Unfortunately, significant gaps exist between the intent and reality of school-based physical education and other activity programs ( HHS, 2013 ).

A large number of psychological and social outcomes have been examined. Specific aspects of psychosocial health showing a beneficial relationship to physical activity include, among others, self-efficacy, self-concept, self-worth ( Haugen et al., 2011 ), social behaviors ( Cradock et al., 2009 ), pro-school attitudes, motivation and goal orientation ( Digelidis et al., 2003 ), relatedness, friendships ( de la Haye et al., 2011 ; Macdonald-Wallis et al., 2011 ), task orientation, team building, bullying, and racial prejudice ( Byrd and Ross, 1991 ). Most studies are descriptive, finding bidirectional associations between psychosocial outcomes and physical activity. Reviews and meta-analyses confirm a positive association between physical activity and self-esteem, especially for aerobic activities ( McAuley, 1994 ).

Among psychosocial factors, self-efficacy (confidence in one's ability to be physically active in specific situations) has emerged as an important correlate of physical activity from a large body of work based on the durable and practically useful social learning theory ( Bandura and McClelland, 1977 ; Bandura, 1995 ). Bandura's theory compels consideration of the psychosocial and physical environments, the individual, and in this case the behavior of physical activity. Using this framework, physical activity itself has been shown to be a consistent positive correlate as well as a determinant of physical activity in children and adolescents. A large amount of reviewed research has found that physical education and physical activity experiences can increase children's confidence in being active and lead to continued participation in physical activity ( Bauman et al., 2012 ). RCTs have shown that both self-efficacy and social interactions leading to perceived social support influence changes in physical activity ( Dishman et al., 2009 ). Skill mastery, confidence building, and group support are well-known strategies for advancing student learning and well-being in many educational domains in the school setting and apply equally to school physical education and other physical activity. Early observational studies of physical, social, and environmental determinants of physical activity at home, school, and recess indicated that prompts to be active (or not) from peers and adults accounted for a significant amount of the variance in directly observed physical activity ( Elder et al., 1998 ). One longitudinal study following the variability and tracking of physical activity in young children showed that most of the variability in both home and recess activity was accounted for by short-term social and physical environmental factors, such as prompts from others and being outdoors ( Sallis et al., 1995 ). Another study, examining activity among preschool children, found that, contrary to common belief, most of the time spent in preschool was sedentary, and correlates of activity were different for preschool boys and girls ( Byun et al., 2011 ). In addition, significant variation in activity by preschool site was noted, indicating that local environmental conditions, including physical environment and equipment, policies, and teacher and administrative quality characteristics, play an important role in promoting physical activity ( Brown et al., 2009 ).

Studies in middle and high school populations have strengthened the evidence base on relationships among self-efficacy, physical activity, and social support (from adults and peers). This research has highlighted the central contribution of self-efficacy and social support in protecting against a decline in activity levels among adolescent girls ( Dishman et al., 2009 , 2010 ). Evidence indicates further that these impacts spread to activities outside the school setting ( Lytle et al., 2009 ). Findings of a related study suggest that leisure-time physical activity among middle school students was linked to motivation-related experiences in physical education ( Cox et al., 2008 ).

A recent review of reviews ( Bauman et al., 2012 ) found that population levels of physical activity are low and that consistent individual-level correlates of physical activity are age, sex, health status, self-efficacy, and previous physical activity. Physical activity declines dramatically as children progress from elementary through high school ( Nader et al., 2008 ). Boys are consistently found to be more active than girls from ages 4 to 9. For other age groups of children and adolescents, sex is correlated with but not a determinant of activity ( Bauman et al., 2012 ). These findings suggest the need to tailor physical education and physical activity programs for youth specifically to increase self-efficacy and enjoyment of physical activity among girls ( Dishman et al., 2005 ; Barr-Anderson et al., 2008 ; Butt et al., 2011 ).

In summary, a broad range of beneficial psychosocial health outcomes have been associated with physical activity. The promotion of more physical activity and quality physical education in the school setting is likely to result in psychosocially healthier children who are more likely to engage in physical activity as adults. Schools can play an important role in ensuring opportunities for physical activity for a segment of the youth population that otherwise may not have the resources to engage in such activity. It makes sense to assume that, if physical activity experiences and environments were once again structured into the daily school environment of children and adolescents, individuals' feelings of self-efficacy regarding physical activity would increase in the U.S. population.

MENTAL HEALTH

Mental illness is a serious public health issue. It has been estimated that by 2010 mental illness will account for 15 percent of the global burden of disease ( Biddle and Mutrie, 2008 ; Biddle and Asare, 2011 ). Young people are disproportionately affected by depression, anxiety, and other mental health disorders ( Viner and Booy, 2005 ; Biddle and Asare, 2011 ). Approximately 20 percent of school-age children have a diagnosable mental health disorder ( U.S. Public Health Service, 2000 ), and overweight children are at particular risk ( Ahn and Fedewa, 2011 ). Mental health naturally affects academic performance on many levels ( Charvat, 2012 ). Students suffering from depression, anxiety, mood disorders, and emotional disturbances perform more poorly in school, exhibit more behavioral and disciplinary problems, and have poorer attendance relative to mentally healthy children. Thus it is in schools' interest to take measures to support mental health among the student population. In addition to other benefits, providing adequate amounts of physical activity in a way that is inviting and safe for children of all ability levels is one simple way in which schools can contribute to students' mental health.

Impact of Physical Activity on Mental Health

Several recent reviews have concluded that physical activity has a positive effect on mental health and emotional well-being for both adults and children ( Peluso and Guerra de Andrade, 2005 ; Penedo and Dahn, 2005 ; Strong et al., 2005 ; Hallal et al., 2006 ; Ahn and Fedewa, 2011 ; Biddle and Asare, 2011 ). Numerous observational studies have established the association between physical activity and mental health but are inadequate to clarify the direction of that association ( Strong et al., 2005 ). It may be that physical activity improves mental health, or it may be that people are more physically active when they are mentally healthy. Most likely the relationship is bidirectional.

Several longitudinal and intervention studies have clarified that physical activity positively impacts mental health ( Penedo and Dahn, 2005 ; Strong et al., 2005 ). Physical activity has most often been shown to reduce symptoms of depression and anxiety and improve mood ( Penedo and Dahn, 2005 ; Dishman et al., 2006 ; Biddle and Asare, 2011 ). In addition to reducing symptoms of depression and anxiety, studies indicate that regular physical activity may help prevent the onset of these conditions ( Penedo and Dahn, 2005 ). Reductions in depression and anxiety are the commonly measured outcomes ( Strong et al., 2005 ; Ahn and Fedewa, 2011 ). However, reductions in states of confusion, anger, tension, stress, anxiety sensitivity (a precursor to panic attacks and panic disorders), posttraumatic stress disorder/psychological distress, emotional disturbance, and negative affect have been observed, as well as increases in positive expectations; fewer emotional barriers; general well-being; satisfaction with personal appearance; and improved life satisfaction, self-worth, and quality of life ( Heller et al., 2004 ; Peluso and Guerra de Andrade, 2005 ; Penedo and Dahn, 2005 ; Dishman et al., 2006 ; Hallal et al., 2006 ; Ahn and Fedewa, 2011 ; Biddle and Asare, 2011 ). Among adolescents and young adult females, exercise has been found to be more effective than cognitive-behavioral therapy in reducing the pursuit of thinness and the frequency of bingeing, purging, and laxative abuse ( Sundgot-Borgen et al., 2002 ; Hallal et al., 2006 ). The favorable effects of physical activity on sleep may also contribute to mental health ( Dishman et al., 2006 ).

The impact of physical activity on these measures of mental health is moderate, with effect sizes generally ranging from 0.4 to 0.7 ( Biddle and Asare, 2011 ). In one meta-analysis of intervention trials, the RCTs had an effect size of 0.3, whereas other trials had an effect size of 0.57.

Ideal Type, Length, and Duration of Physical Activity

Intervention trials that examine the relationship between physical activity and mental health often fail to specify the exact nature of the intervention, making it difficult to determine the ideal frequency, intensity, duration, and type of physical activity involved ( Penedo and Dahn, 2005 ; Ahn and Fedewa, 2011 ; Biddle and Asare, 2011 ).

Many different types of physical activity—including aerobic activity, resistance training, yoga, dance, flexibility training, walking programs, and body building—have been shown to improve mood and other mental health indicators. The evidence is strongest for aerobic physical activity, particularly for reduction of anxiety symptoms and stress ( Peluso and Guerra de Andrade, 2005 ; Dishman et al., 2006 ; Martikainen et al., 2013 ), because more of these studies have been conducted ( Peluso and Guerra de Andrade, 2005 ). One meta-analysis of RCTs concluded that physical activity interventions focused exclusively on circuit training had the greatest effect on mental health indicators, followed closely by interventions that included various types of physical activity ( Ahn and Fedewa, 2011 ). Among studies other than RCTs, only participation in sports had a significant impact on mental health ( Ahn and Fedewa, 2011 ). The few studies that investigated the impact of vigorous- versus lower-intensity physical activity ( Larun et al., 2006 ; Biddle and Asare, 2011 ) found no difference, suggesting that perhaps all levels of physical activity may be helpful. Among adults, studies have consistently shown beneficial effects of both aerobic exercise and resistance training. Ahn and Fedewa (2011) concluded that both moderate and intense physical activity have a significant impact on mental health, although when just RCTs were considered, only intense physical activity was significant ( Ahn and Fedewa, 2011 ). While physical activity carries few risks for mental health, it is important to note that excessive physical activity or specialization too early in certain types of competitive physical activity has been associated with negative mental health outcomes and therefore should be avoided ( Peluso and Guerra de Andrade, 2005 ; Hallal et al., 2006 ). Furthermore, to reach all children, including those that may be at highest risk for inactivity, obesity, and mental health problems, physical activity programming needs to be nonthreatening and geared toward creating a positive experience for children of all skill and fitness levels ( Amis et al., 2012 ).

Various types of physical activity programming have been shown to have a positive influence on mental health outcomes. Higher levels of attendance and participation in physical education are inversely associated with feelings of sadness and risk of considering suicide ( Brosnahan et al., 2004 ). Classroom physical activity is associated with reduced use of medication for attention deficit hyperactivity disorder ( Katz et al., 2010 ). And participation in recess is associated with better student classroom behavior, better focus, and less fidgeting ( Pellegrini et al., 1995 ; Jarrett et al., 1998 ; Barros et al., 2009 ).

Strong evidence supports the short-term benefits of physical activity for mental health. Acute effects can be observed after just one episode and can last from a few hours to up to 1 day after. Body building may have a similar effect, which begins a few hours after the end of the exercise. The ideal length and duration of physical activity for improving mental health remain unclear, however. Regular exercise is associated with improved mood, but results are inconsistent for the association between mood and medium- or long-term exercise ( Dua and Hargreaves, 1992 ; Slaven and Lee, 1997 ; Dimeo et al., 2001 ; Dunn et al., 2001 ; Kritz-Silverstein et al., 2001 ; Sexton et al., 2001 ; Leppamaki et al., 2002 ; Peluso and Guerra de Andrade, 2005 ). Studies often do not specify the frequency and duration of physical activity episodes; among those that do, interventions ranged from 6 weeks to 2 years in duration. In their meta-analysis, Ahn and Fedewa (2011) found that, comparing interventions entailing a total of more than 33 hours, 20-33 hours, and less than 20 hours, the longer programs were more effective. Overall, the lack of reporting and the variable length and duration of reported interventions make it difficult to draw conclusions regarding dose ( Ahn and Fedewa, 2011 ).

In addition to more structured opportunities, naturally occurring physical activity outside of school time is associated with fewer depressive symptoms among adolescents ( Penedo and Dahn, 2005 ). RCTs have demonstrated that physical activity involving entire classrooms of students is effective in alleviating negative mental health outcomes ( Ahn and Fedewa, 2011 ). Non-RCT studies have shown individualized approaches to be most effective and small-group approaches to be effective to a more limited extent ( Ahn and Fedewa, 2011 ). Interventions have been shown to be effective in improving mental health when delivered by classroom teachers, physical education specialists, or researchers but may be most effective when conducted with a physical education specialist ( Ahn and Fedewa, 2011 ). Many physical activity interventions include elements of social interaction and support; however, studies to date have been unable to distinguish whether the physical activity itself or these other factors account for the observed effects on mental health ( Hasselstrom et al., 2002 ; Hallal et al., 2006 ). Finally, a few trials ( Larun et al., 2006 ; Biddle and Asare, 2011 ) have compared the effects of physical activity and psychosocial interventions, finding that physical activity may be equally effective but may not provide any added benefit.

Subgroup Effects

Although studies frequently fail to report the age of participants, data on the effects of physical activity on mental health are strongest for adults participating in high-intensity physical activity ( Ahn and Fedewa, 2011 ). However, evidence relating physical activity to various measures of mental health has shown consistent, significant effects on individuals aged 11-20. A large prospective study found that physical activity was inversely associated with depression in early adolescence ( Hasselstrom et al., 2002 ; Hallal et al., 2006 ); fewer studies have been conducted among younger children. Correlation studies have shown that the association of physical activity with depression is not affected by age ( Ahn and Fedewa, 2011 ).

Few studies have examined the influence of other sociodemographic characteristics of participants on the relationship between physical activity and mental health ( Ahn and Fedewa, 2011 ), but studies have been conducted in populations with diverse characteristics. One study of low-income Hispanic children randomized to an aerobic intensity program found that the intervention group was less likely to present with depression but did not report reduced anxiety ( Crews et al., 2004 ; Hallal et al., 2006 ). A study that included black and white children (aged 7-11) found that a 40-minute daily dose of aerobic exercise significantly reduced depressive symptoms and increased physical appearance self-worth in both black and white children and increased global self-worth in white children compared with controls ( Petty et al., 2009 ). Physical activity also has been positively associated with mental health regardless of weight status (normal versus overweight) or gender (male versus female) ( Petty et al., 2009 ; Ahn and Fedewa, 2011 ); however, results are stronger for males ( Ahn and Fedewa, 2011 ).

Improvements in mental health as a result of physical activity may be more pronounced among clinically diagnosed populations, especially those with cognitive impairment or posttraumatic stress disorder ( Craft and Landers, 1998 ; Ahn and Fedewa, 2011 ; Biddle and Asare, 2011 ). Evidence is less clear for youth with clinical depression ( Craft and Landers, 1998 ; Larun et al., 2006 ; Biddle and Asare, 2011 ). Individuals diagnosed with major depression undergoing an intervention entailing aerobic exercise have shown significant improvement in depression and lower relapse rates, comparable to results seen in participants receiving psychotropic treatment ( Babyak et al., 2000 ; Penedo and Dahn, 2005 ). One program for adults with Down syndrome providing three sessions of exercise and health education per week for 12 weeks resulted in more positive expectations, fewer emotional barriers, and improved life satisfaction ( Heller et al., 2004 ; Penedo and Dahn, 2005 ). Ahn and Fedewa (2011) found that, compared with nondiagnosed individuals, physical activity had a fivefold greater impact on those diagnosed with cognitive impairment and a twofold greater effect on those diagnosed with emotional disturbance, suggesting that physical activity has the potential to improve the mental health of those most in need.

In sum, although more studies are needed, and there may be some differences in the magnitude and nature of the mental health benefits derived, it appears that physical activity is effective in improving mental health regardless of age, ethnicity, gender, or mental health status.

Sedentary Behavior

Sedentary behavior also influences mental health. Screen viewing in particular and sitting in general are consistently associated with poorer mental health ( Biddle and Asare, 2011 ). Children who watch more television have higher rates of anxiety, depression, and posttraumatic stress and are at higher risk for sleep disturbances and attention problems ( Kappos, 2007 ). Given the cross-sectional nature of these studies, however, the direction of these associations cannot be determined. A single longitudinal study found that television viewing, but not playing computer games, increased the odds of depression after 7-year follow-up ( Primack et al., 2009 ; Biddle and Asare, 2011 ), suggesting that television viewing may contribute to depression. Because of design limitations of the available studies, it is unclear whether this effect is mediated by physical activity.

Television viewing also is associated with violence, aggressive behaviors, early sexual activity, and substance abuse ( Kappos, 2007 ). These relationships are likely due to the content of the programming and advertising as opposed to the sedentary nature of the activity. Television viewing may affect creativity and involvement in community activities as well; however, the evidence here is very limited ( Kappos, 2007 ). Studies with experimental designs are needed to establish a causal relationship between sedentary behavior and mental health outcomes ( Kappos, 2007 ).

Although the available evidence is not definitive, it does suggest that sedentary activity and television viewing in particular can increase the risk for depression, anxiety, aggression, and other risky behaviors and may also affect cognition and creativity ( Kappos, 2007 ), all of which can affect academic performance. It would therefore appear prudent for schools to reduce these sedentary behaviors during school hours and provide programming that has been shown to be effective in reducing television viewing outside of school ( Robinson, 1999 ; Robinson and Borzekowski, 2006 ).

It is not surprising that physical activity improves mental health. Both physiological and psychological mechanisms explain the observed associations. Physiologically, physical activity is known to increase the synaptic transmission of monoamines, an effect similar to that of anti-depressive drugs. Physical activity also stimulates the release of endorphins (endogenous opoids) ( Peluso and Guerra de Andrade, 2005 ), which have an inhibitory effect on the central nervous system, creating a sense of calm and improved mood ( Peluso and Guerra de Andrade, 2005 ; Ahn and Fedewa, 2011 ). Withdrawal of physical activity may result in irritability, restlessness, nervousness, and frustration as a result of a drop in endorphin levels. Although more studies are needed to specify the exact neurological pathways that mediate this relationship, it appears that the favorable impact of physical activity on the prevention and treatment of depression may be the result of adaptations in the central nervous system mediated in part by neurotropic factors that facilitate neurogenerative, neuroadaptive, and neuroprotective processes ( Dishman et al., 2006 ). It has been observed, for example, that chronic wheel running in rats results in immunological, neural, and cellular responses that mitigate several harmful consequences of acute exposure to stress ( Dishman et al., 2006 ). A recent study found that children who were more physically active produced less cortisol in response to stress, suggesting that physical activity promotes mental health by regulating the hormonal responses to stress ( Martikainen et al., 2013 ).

Psychological mechanisms that may explain why physical activity improves mental health include (1) distraction from unfavorable stimuli, (2) increase in self-efficacy, and (3) positive social interactions that can result from quality physical activity programming ( Peluso and de Andrade, 2005 ) (see also the discussion of psychosocial health above). The relative contribution of physiological and psychological mechanisms is unknown, but they likely interact. Poor physical health also can impair mood and mental function. Health-related quality of life improves with physical activity that increases physical functioning, thereby enhancing the sense of well-being ( McAuley and Rudolph, 1995 ; HHS, 2008 ).

Physical activity during childhood and adolescence may not only be important for its immediate benefits for mental health but also have implications for long-term mental health. Studies have shown a consistent effect of physical activity during adolescence on adult physical activity ( Hallal et al., 2006 ). Physical activity habits established in children may persist into adulthood, thereby continuing to confer mental health benefits throughout the life cycle. Furthermore, physical activity in childhood may impact adult mental health regardless of the activity's persistence ( Hallal et al., 2006 ).

Physical activity can improve mental health by decreasing and preventing conditions such as anxiety and depression, as well as improving mood and other aspects of well-being. Evidence suggests that the mental health benefits of physical activity can be experienced by all age groups, genders, and ethnicities. Moderate effect sizes have been observed among both youth and adults. Youth with the highest risk of mental illness may experience the most benefit. Although evidence is not adequate to determine the ideal regimen, aerobic and high-intensity physical activity are likely to confer the most benefit. It appears, moreover, that a variety of types of physical activity are effective in improving different aspects of mental health; therefore, a varied regimen including both aerobic activities and strength training may be the most effective. Frequent episodes of physical activity are optimal given the well-substantiated short-term effects of physical activity on mental health status. Although there are well-substantiated physiological bases for the impact of physical activity on mental health, physical activity programming that effectively enhances social interactions and self-efficacy also may improve mental health through these mechanisms. Quality physical activity programming also is critical to attract and engage youth of all skills level and to effectively reach those at highest risk.

Sedentary activity may increase the risk of poor mental health status independently of, or in addition to, its effect on physical activity. Television viewing in particular may lead to a higher risk of such conditions as depression and anxiety and may also increase violence, aggression, and other high-risk behaviors. These impacts are likely the result of programming and advertising content in addition to the physiological effects of inactivity and electronic stimuli.

In conclusion, frequently scheduled and well-designed opportunities for varied physical activity during the school day and a reduction in sedentary activity have the potential to improve students' mental health in ways that could improve their academic performance and behaviors in school.

Good health is the foundation of learning and academic performance (see Chapter 4 ). In children and youth, health is akin to growth. An extensive literature demonstrates that regular physical activity promotes growth and development and has multiple benefits for physical, mental, cognitive, and psychosocial health that undoubtedly contribute to learning. Although much of the evidence comes from cross-sectional studies showing associations between physical activity and various aspects of health, available prospective data support this cross-sectional evidence. Experimental evidence, although more limited for younger children, is sufficient among older children and adolescents to support the notion that children and young adults derive much the same health benefits from physical activity.

Moreover, many adult diseases have their origins in childhood. This finding, together with the finding that health-related behaviors and disease risk factors may track from childhood into adulthood, underscores the need for early and ongoing opportunities for physical activity.

Children's exercise capacity and the activities in which they can successfully engage change in a predictable way across developmental periods. For example, young children are active in short bursts, and their capacity for continuous activity increases as they grow and mature (see Figure 3-2 ). In adults and likely also adolescents, intermittent exercise has much the same benefit as continuous exercise when mode and energy expenditure are held constant. The health benefits of sporadic physical activity at younger ages are not well established. However, the well-documented short-term benefits of physical activity for some aspects of mental and cognitive health suggest that maximum benefit may be attained through frequent bouts of exercise throughout the day.

Changes in physical activity needs with increasing age of children and adolescents. SOURCE: Adapted from Malina, 1991. Reprinted with permission from Human Kinetics Publishers.

Children require frequent opportunities for practice to develop the skills and confidence that promote ongoing engagement in physical activity. Physical education curricula are structured to provide developmentally appropriate experiences that build the motor skills and self-efficacy that underlie lifelong participation in health-enhancing physical activity, and trained physical education specialists are uniquely qualified to deliver them (see Chapter 5 ). However, physical education usually is offered during a single session. Therefore, other opportunities for physical activity can supplement physical education by addressing the need for more frequent exercise during the day (see Chapter 6 ). In addition to the immediate benefits of short bouts of physical activity for learning and for mental health, developmentally appropriate physical activity during those times, along with the recommended time in physical education, can contribute to daily energy expenditure and help lessen the risk of excess weight gain and its comorbidities. Specific types of activities address specific health concerns. For example, vertical jumping activities contribute to energy expenditure for obesity prevention and also promote bone development (via the resulting ground reaction forces), potentially contributing to lower fracture risk. Other activities contribute to prevention of chronic disease. Since different types of physical activity contribute to distinct aspects of physical, mental, and psychosocial health, a varied regimen is likely to be most beneficial overall.

The quality of physical activity programming also is critical; psychosocial outcomes and improvements in specific motor skills, for example, are likely the result of programming designed specifically to target these outcomes rather than just a result of increases in physical activity per se. These psychosocial outcomes also are likely to lead to increased levels of physical activity in both the short and long terms, thereby conferring greater health benefits. Unstructured physical activity or free play also confers unique benefits and is an important supplement to more structured opportunities. Quality physical activity programming that makes these activities attractive, accessible, and safe for children and youth of all skill and fitness levels is critical to ensure that all youth participate in these activities and can therefore derive the health benefits.

Sedentary activities, such as screen viewing and excessive time spent sitting, may contribute to health risks both because of and independent of their impact on physical activity. Thus specific efforts in school to reduce sedentary behaviors, such as through classroom and playground design and reduction of television viewing, are warranted.

In sum, a comprehensive physical activity plan with physical education at the core, supplemented by other varied opportunities for and an environment supportive of physical activity throughout the day, would make an important contribution to children's health and development, thereby enhancing their readiness to learn.

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Cite this Page Committee on Physical Activity and Physical Education in the School Environment; Food and Nutrition Board; Institute of Medicine; Kohl HW III, Cook HD, editors. Educating the Student Body: Taking Physical Activity and Physical Education to School. Washington (DC): National Academies Press (US); 2013 Oct 30. 3, Physical Activity and Physical Education: Relationship to Growth, Development, and Health.
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71 Physical Education Essay Topic Ideas & Examples

🏆 best physical education topic ideas & essay examples, 🔎 interesting topics to write about physical education, 📑 good research topics about physical education.

Keeping Physical Education in Schools Apart from participating in the physical education programs, the students need to be taught on the importance of the various exercises so that they inculcate the culture of physical fitness into their life-time fitness programs.
Physical Education and Its Benefits Schools in particular know the benefits of physical education in a student’s life and should be able to fight for the children’s rights. We will write a custom essay specifically for you by our professional experts 808 writers online Learn More
Adaptive Physical Education The value of the brochure developed for the informational purpose is attributed to the need to communicate the importance of APE and point out the value that it could bring to children with special needs.
The Usefulness of Physical Education in Modern Education Varied criticism adds to the debate on the usefulness of PE in modern education and the need to change current approaches. This indicates the need to focus the debate on the meaning of PE to […]
Role of Parents in Physical Education and Sport The involvement of parents in physical education and sports is viewed differently in regard to how it affects the child’s participation in sports even later in life.
Effects of Physical Education on Brain These neurons are usually created in a place called the hippocampus, which happens to be the section of the brain involved in learning and storage of memory.
Physical Education Curriculum Physical education has significantly contributed towards the realization of the school philosophy as it helps in the development of the physical aspects of the students.
Reducing Physical Education Classes The teaching process has a significant amount of waste regarding the excess number of teachers dedicated to sports training compared to math and technical subjects.
Physical Education Is an Academic Subject These aspects make physical activity one of the core subjects at school, including for younger students who need a surge of emotions and energy.
Race and Gender in Physical Education and Sports These factors create the diversity of cultures and nations, and inclusiveness, giving access to the best talents and disclosing the individual’s potential, abilities, and strengths.
Physical Education: Effect of Phototherapy Therefore, it is evident that the intensity of an exercise directly influences one’s heart rate, breathing rate, skin coloration, sweating, and recovery.
Bodies in Physical Education The purpose of this study is to investigate how students view the construction of their bodies in relation to physical education and how students’ meanings of their bodies affect their participation or resistance to physical […]
Effectiveness of Physical Education Provisions in the UK School The vital need for health promotion, especially in terms of secondary education has been highlighted by the science of epidemiology the study of factors that influence the health and illnesses of people.
British Development of Sport and Physical Education in the Last 25 Years Sport England wishes to increase participation in sports through community sports activities, sporting completions providing and training coaches and officiators, and closely working with the Youth Sport Trust and UK Sports formed in 1996 to […]
Physical Education: Personal Physical Exercise Plan Given the necessity of taking fluids, it is good to identify and avail the same before starting a physical exercise session.
Health Teaching and Physical Education Lesson Plan Students will be able to dribble a ball with a hand paying attention to such principles as dribbling on the side, waist-high, pushing the ball down, and eyes lookup.
Increase of Physical Education Classes Children are the future of any nation, and their health and well-being are the essential preconditions for the successful development of the United States.
Physical Educators Attitude to Special Needs Children Sue Combs, together with her colleagues from the University of North Carolina, investigated the attitudes of the physical education teachers towards the inclusion of children with special needs in their lessons.
The Nature and Values of Physical Education In the past, physical education was considered to consist of only physical and practical activities, however, the recent research has justified that physical education can be included in the curriculum on the basis of scientific […]
Should Public Schools Be Required to Restore Physical Education Classes to the Curriculum? The occurrence of obesity prevalence in children, in the U S, can be associated with the removal of physical education courses in public school curriculum.
Physical Education within Elementary Schools One of the benefits of the physical education is the level of physical fitness that it induces to the students. The manner in which these students are introduced to physical education and the way that […]
Elementary School Curriculum and Physical Education
Should Physical Education Be a Required Class in College?
Physical Education Class: The Perfect Place to Be Bullied
Pros and Cons of Physical Education
How Physical Education Should Be Taught
Physical Education for Elementary School Students
Weight-Related Barriers for Overweight Students in an Elementary Physical Education Classroom
Physical Education Lesson Plan and Activity Ideas
Motivation, Discipline, and Academic Performance in Physical Education
Adaptive Physical Education for Students With Special Needs
Physical Education Should Not Be Mandated
How Technology Enhances the Physical Education Curriculum
Physical Education: Standards, Cooperative Skills, and Learning Theories
Physical Education’s Contribution to Public Health
Physical Education Importance for Child Development
Reasons to Keep Physical Education in the National Curriculum
Ethical Relativism and Its Impact on Physical Education
Inclusive School Physical Education and Physical Activity
History and Benefits of Physical Education: Why I Want to Be a P.E. Teacher
Physical Education Beyond the Middle School
The Importance of Physical Education in Childhood Obesity
Physical Activity Promotion and School Physical Education
Implementing the TARGET Model in Physical Education: Effects on Perceived Psychobiosocial and Motivational States in Girls
Teaching the Nuts and Bolts of Physical Education
Health-Related Intensity Profiles for Physical Education Classes
Anticipated Benefits From a Basic College Physical Education Activity Course
Physical Education Should Be Graded on Effort, Not Ability
Motivation and Intention to Be Physically Active in Physical Education Students
Personal Development, Health, and Physical Education
Why Physical Education Should Be Included in the School Curriculum
Attitude and Teacher’s Qualification as Factors Affecting Students’ Participation in Physical Education Activities
Burnout in Physical Education Teachers
What Benefits Physical Activity Has on Academic Performance
SPARK Physical Education Curriculum Program
Changing the National Curriculum for Physical Education
Physical Education: Official School Policy
How Physical Education Helps to Develop Your Personality
Early Childhood Development: Physical Education Program Effects
Fun Physical Education Games for High School Students
How Extracurricular Sports Should Satisfy State Physical Education Requirements
One’s Readiness to Self-Development Through Physical Education
Would More Physical Education Reduce Obesity in the Youths?
Goal-Directed Physical Education for Learners With Disabilities
Health and Physical Education: Volleyball
Managing the Physical Education Classroom
Strategies to Accommodate Autism Spectrum Disorder Students in General Physical Education
Physical Education vs. School Sports: What’s the Difference?
The Impact of School Budgetary Cuts on Physical Education
Teaching Health and Physical Education in Australian Schools
Positive Reinforcement Techniques in Physical Education
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Physical Education

Physical education is the foundation of a Comprehensive School Physical Activity Program. 1, 2 It is an academic subject characterized by a planned, sequential K–12 curriculum (course of study) that is based on the national standards for physical education. 2–4 Physical education provides cognitive content and instruction designed to develop motor skills, knowledge, and behaviors for physical activity and physical fitness. 2–4 Supporting schools to establish physical education daily can provide students with the ability and confidence to be physically active for a lifetime. 2–4

There are many benefits of physical education in schools. When students get physical education, they can 5-7 :

Increase their level of physical activity.
Improve their grades and standardized test scores.
Stay on-task in the classroom.

Increased time spent in physical education does not negatively affect students’ academic achievement.

Strengthen Physical Education in Schools [PDF – 437 KB] —This data brief defines physical education, provides a snapshot of current physical education practices in the United States, and highlights ways to improve physical education through national guidance and practical strategies and resources. This was developed by Springboard to Active Schools in collaboration with CDC.

Secular Changes in Physical Education Attendance Among U.S. High School Students, YRBS 1991–2013

Secular Changes in Physical Education Attendance Among U.S. High School Students Cover

The Secular Changes in Physical Education Attendance Among U.S. High School Students report [PDF – 3 MB] explains the secular changes (long-term trends) in physical education attendance among US high school students over the past two decades. Between 1991 and 2013, US high school students’ participation in school-based physical education classes remained stable, but at a level much lower than the national recommendation of daily physical education. In order to maximize the benefits of physical education, the adoption of policies and programs aimed at increasing participation in physical education among all US students should be prioritized. Download the report for detailed, nationwide findings.

Physical Education Analysis Tool (PECAT)

The Physical Education Curriculum Analysis Tool (PECAT) [PDF – 6 MB] is a self-assessment and planning guide developed by CDC. It is designed to help school districts and schools conduct clear, complete, and consistent analyses of physical education curricula, based upon national physical education standards.

Visit our PECAT page to learn more about how schools can use this tool.

CDC Monitoring Student Fitness Levels1 [PDF – 1.64 MB]
CDC Ideas for Parents: Physical Education [PDF – 2 MB]
SHAPE America: The Essential Components of Physical Education (2015) [PDF – 391 KB]
SHAPE America: Appropriate Instructional Practice Guidelines for Elementary, Middle School, and High School Physical Education [PDF – 675 KB]
SHAPE America: National Standards and Grade-Level Outcomes for K–12 Physical Education 2014
SHAPE America: National Standards for K–12 Physical Education (2013)
SHAPE America Resources
Youth Compendium of Physical Activities for Physical Education Teachers (2018) [PDF – 145 KB]
Social Emotional Learning Policies and Physical Education
Centers for Disease Control and Prevention. A Guide for Developing Comprehensive School Physical Activity Programs . Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2013.
Centers for Disease Control and Prevention. School health guidelines to promote healthy eating and physical activity. MMWR . 2011;60(RR05):1–76.
Institute of Medicine. Educating the Student Body: Taking Physical Activity and Physical Education to School . Washington, DC: The National Academies Press; 2013. Retrieved from http://books.nap.edu/openbook.php?record_id=18314&page=R1 .
SHAPE America. T he Essential Components of Physical Education . Reston, VA: SHAPE America; 2015. Retrieved from http://www.shapeamerica.org/upload/TheEssentialComponentsOfPhysicalEducation.pdf [PDF – 392 KB].
Centers for Disease Control and Prevention. The Association Between School-Based Physical Activity, Including Physical Education, and Academic Performance . Atlanta, GA; Centers for Disease Control and Prevention, US Department of Health and Human Services; 2010.
Centers for Disease Control and Prevention. Health and Academic Achievement. Atlanta: US Department of Health and Human Services; 2014.
Michael SL, Merlo C, Basch C, et al. Critical connections: health and academics . Journal of School Health . 2015;85(11):740–758.

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Physical Education in Schools: [Essay Example], 676 words
Physical Health Benefits. One of the most obvious benefits of physical education is its impact on students' physical health. Regular physical activity has been proven to reduce the risk of obesity, heart disease, diabetes, and other chronic health conditions. According to the Centers for Disease Control and Prevention, childhood obesity rates ...
5 Approaches to Physical Education in Schools
Physical education is a formal content area of study in schools that is standards based and encompasses assessment based on standards and benchmarks.It is defined in Chapter 1 as "a planned sequential K-12 standards-based program of curricula and instruction designed to develop motor skills, knowledge, and behaviors of healthy active living, physical fitness, sportsmanship, self-efficacy ...
(PDF) The Role of Physical Education at School
Physical education is the foundation of a comprehensive school physical. activity program. It provides cognitive content and instruction designed to develop motor skills, knowledge, and. behaviors ...
'It's how PE should be!': Classroom teachers' experiences of
Due to its focus on the prioritisation of personal significance of movement experiences, the promotion of meaningfulness in Physical Education (PE) has the potential to strengthen pedagogy and encourage a lifelong pursuit of physical activity (Kretchmar, 2006).This perspective comes at a time when many students cite current versions of PE as lacking relevance to their lived experiences (Ladwig ...
Physical Education: An Academic Discipline
Physical Activity Promotion. C. Corbin T. McKenzie. Education. 2008. TLDR. Being knowledgeable and skillful in a wide variety of motor skills is important for future teachers, who need to study extensively the various teaching methods if they are to be able to implement appropriate programs effi ciently. Expand.
Motivation, Discipline, and Academic Performance in Physical Education
Introduction. The understanding of cognitive mechanisms related to students' discipline behaviors and academic performance has become the most worrisome aspect to secondary Physical Education (PE) teachers (Gutiérrez and López, 2012b).Thus, discipline in the school environment has become one of the main concerns of the educational community since it is a key indicator that the teaching ...
Physical Activity, Fitness, and Physical Education: Effects on Academic
Although academic performance stems from a complex interaction between intellect and contextual variables, health is a vital moderating factor in a child's ability to learn. The idea that healthy children learn better is empirically supported and well accepted (Basch, 2010), and multiple studies have confirmed that health benefits are associated with physical activity, including cardiovascular ...
Physical Education as 'Means without Ends': Towards a new concept of
This is not an obvious path to explore, because defenders of physical education as a rule have to compete against the (dualist) prejudice that this discipline is merely an instrument to train the body or to keep it fit, and that it therefore should not be considered as a serious endeavour. Therefore, more often than not, apologists try to ...
The Place of Physical Education and Sport in Education
Physical education is important because: (i) it is learning about one's body and hence oneself through some sort of physical activity or human movement; (ii) learning about an important way in which people share their lives; and, (iii) it has the potential to develop the whole person. Not everyone will be a sportsman or sportswoman, just as ...
Physical Education is just as important as any other school subject
Physical activity is vitally important for health, but PE at school can run the risk of putting children off exercise for life. shutterstock. Physical Education (PE) is often viewed as a marginal ...
Pedagogical principles of learning to teach meaningful physical education
Methodology. We used collaborative self-study of teacher education practice (S-STEP) methodology to identify pedagogical approaches that enabled PSTs' learning about meaningful physical education (LaBoskey Citation 2004; Ní Chróinín, Fletcher, and O'Sullivan Citation 2015).Specifically, we engaged in a systematic, cyclical process of developing, implementing, and reflecting on the ...
Essay on Physical Education in School for Students 1000+ Words
Physical education leads to a more focused, active, composed, and happy in life. It makes us disciplined and arranged. Habits formed with the assistance of education tend to remain with us for an extended time. We should bring skilled coaches and needed equipment to colleges. Students should know its benefits.
5 Approaches to Physical Education in Schools
Physical education is a formal content area of study in schools that is standards based and encompasses assessment based on standards and benchmarks. It is defined in Chapter 1 as "a planned sequential K-12 standards-based program of curricula and instruction designed to develop motor skills, knowledge, and behaviors of healthy active living, physical fitness, sportsmanship, self-efficacy ...
Personal and social development in physical education and sports: A
First, when referring to personal and social development, different terms are used interchangeably to describe similar concepts. The World Health Organization (WHO) uses the terms psychosocial competence or life skills education (World Health Organization, 1997).). "Psychosocial competence is defined as a person's ability to deal effectively with the demands and challenges of everyday life.
"Physical education", "health and physical education", "physical
The title "physical education" (PE) is the traditional taxonomy used to represent the education discipline. Health and physical education (HPE) is regarded to be an all-encompassing health-dimensional title that has been recently embraced by various education systems around the world. ... There have been a number of papers relating to ...
The Benefits of Physical Education: How Innovative Teachers Help
Advantages of Physical Education. The benefits associated with physical education programming go far beyond accomplishments made in the gym. When students have the opportunity to step away from their desks and move their bodies in a physical education class, they gain the benefits of mental health support, stress relief, heart health, and more.
Understanding disruptive situations in physical education: Teaching
Physical education (PE) provides many opportunities for disruptive behaviour, with students moving in large spaces, diverse student populations, poor acoustics, large class sizes, the need to incorporate simultaneously moving bodies, implements, and objects safely (Cothran and Kulinna, 2015), and high levels of noise influencing both student learning and teacher health (Ryan and Mendel, 2010).
Physical Activity and Physical Education: Relationship to Growth
The behaviors and traits of today's children, along with their genetics, are determinants of their growth and development; their physical, mental, and psychosocial health; and their physical, cognitive, and academic performance. Technological advances of modern society have contributed to a sedentary lifestyle that has changed the phenotype of children from that of 20 years ago. Children today ...
71 Physical Education Essay Topic Ideas & Examples
Physical Education and Its Benefits. Schools in particular know the benefits of physical education in a student's life and should be able to fight for the children's rights. We will write. a custom essay specifically for you by our professional experts. 809 writers online.
Full article: Physical education and the art of teaching
ABSTRACT. The paper is the José María Cagigal Scholar Lecture presented at the AIESEP World Congress in Edinburgh 2018. In the paper I argue that the only real sustainable aim for physical education is more physical education, where different ways of being in the world as some-body are both possible and encouraged. To reach this aim, a focus on the art of teaching is vital as a way of ...
Full article: The relation between teaching physical education and
A few papers are further identified in a pluralistic discourse where the pedagogical consequences of different discourses are embraced and where multiple truths about both health and the value of different body shapes and body sizes are considered ... Physical Education and Sport Pedagogy, 22(5), 548-561.
Physical Education
Physical education is the foundation of a Comprehensive School Physical Activity Program. 1, 2 It is an academic subject characterized by a planned, sequential K-12 curriculum (course of study) that is based on the national standards for physical education. 2-4 Physical education provides cognitive content and instruction designed to develop motor skills, knowledge, and behaviors for ...