Contribution of timetabled physical education to total physical activity in primary school children: cross sectional study
BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7415.592 (Published 11 September 2003) Cite this as: BMJ 2003;327:592
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An important first step in any investigation is to conduct a
competent literature search, using such tools as Medline,
PubMed, and Sport Discus. Mallam and associates appear to
have neglected this precaution, and I am pleased that
François Trudeau has now brought the Plymouth research group
up-to-speed in this regard.
Their observations seemingly differ not only from those
reported by the Sports Council (1), but also from the
results of the quasi-experimental study conducted in Trois
Rivières (2). The latter had a much stronger design than
the Plymouth study, since 5 hours per week of additional
physical education was provided to selected classes
throughout six years of primary school. Controls were drawn
from the students’ contemporaries, who attended the same
schools and thus had a well-matched scholastic and
socio-economic background. Using this approach, the Trois
Rivières investigation noted that experimental students had
some minor curtailment of leisure activity on school days,
but this was in no way sufficient to negate the effects of
the added physical education. Further, on weekend days, the
experimental students actually engaged in more physical
activity than the controls.
Mallam and associates give only sketchy information on the
physical education programmes followed by the three schools
involved in their study, but the poor relationship between
allocated curricular time and the physical activity recorded
in school suggests this is a first area that needs
exploring. It is well known that some physical education
classes dissipate much of their time allotment in unfruitful
activities (3). In Trois Rivières, the intensity of the
experimental class sessions was closely monitored by
telemetry, and care was taken to ensure that all students
kept moving vigorously throughout the class period.
There remains scope for much further work on the promotion
of physical activity among primary school students, but at
present it would be rash to conclude that leisure activity
can compensate for a well-designed physical education
programme.
References
1. Rowe N, Champion R. Young people and sport national
survey 1999. London: Sport England, 2000.
2. Shephard RJ, Jéquier JC, Lavallée H, La Barre R, Rajic
M. Habitual physical activity: effects of sex, milieu,
season and required activity. J Sports Med Phys Fitness
1980; 20: 55-66.
3. Goode RC, Virgin A, Romet TT, Crawford D, Duffin J,
Pallandi D, Woch Z. Effects of a short period of physical
activity in adolescent boys and girls. Can J Appl Spts Sci 1976; 1: 241-250.
Competing interests:
Consultant to Trois
Rivieres
longitudinal study.
Competing interests: No competing interests
In her reply to a comment about the very relevant BMJ 2003; 327: 592-
593, Dr Mallam wrote «As far as we are aware, there are no PE
intervention studies that have included objectively recorded overall
physical activity as an outcome measure.»
However, some papers referenced in PubMed deal with this question: 1-
a paper by Dale D, et al. 2000, 2-at least one paper by Dr. RJ Shephard et
al. about the Trois-Rivières study.
The conclusions of the American and the Canadian studies are
different from those of the British study. In the first study, they found
that decreasing hours of physical education at school wasn't followed by
an increase in out-of-school physical activity. In the Trois-Rivières
Study the authors found that increasing physical education at school from
40 min to 5 hours wasn't compensated by a lower level of physical activity
outside of school. These papers do suggest that school physical education
does play a central role in increasing physical activity level in children
but also in the transmission of physical fitness skills and that may be
useful outside of school.
It would be interesting to read what the authors of the discussed
paper (BMJ 2003; 327: 592-593)think of this discrepancy between results
from these studies and theirs.
References
Dale D, Corbin CB, Dale KS. Restricting opportunities to be active during
school time: do children compensate by increasing physical activity levels
after school? Res Q Exerc Sport. 2000;71:240-8.
Shephard RJ, Jequier JC, Lavallee H, La Barre R, Rajic M.Habitual
physical activity: effects of sex, milieu, season and required activity.
J Sports Med Phys Fitness. 1980 ;20:55-66.
Competing interests:
None declared
Competing interests: No competing interests
Our schools were chosen to represent the extremes of timetabled
physical education (PE), school facilities and social class. Plymouth is a
relatively deprived part of the UK (ranked 338 out of 366 local
authorities on the Department of Environment's Index of Local Conditions)
and the inner-city school is in one of the most deprived parts of the
city. We therefore expected to find a difference in total physical
activity levels and were surprised by our results.
We feel our data are robust as the patterns of physical activity
between schools are closely similar for boys and girls. We have repeated
the study on four occasions throughout the year to assess reproducibility
and seasonality and this data will be published in due course.
As far as we are aware, there are no PE intervention studies that
have included objectively recorded overall physical activity as an outcome
measure. Does the correspondent know of any? If not, the way forward we
feel lies not in doubting the data here, but in repeating the study
elsewhere.
Competing interests:
Authors of original article
Competing interests: No competing interests
Your research article on childern's physical exercise is interesting.
However, I feel you are over-confident in your conclusion that childern's
total physical activity is independent of timetabled activity in schools,
as the study is based on three schools only. This is not a representative
sample, and literally anything could be happening in the rest of the
country!
Competing interests:
None declared
Competing interests: No competing interests
Re: A need to consider prior work?
In response to Trudeau and Shephard, we do not dispute the fact that
well-implemented PE intervention studies, such as the Trois Rivieres Study
(1), can improve children’s fitness levels (2). Our study was designed to
be observational, not interventional, with the aim of assessing the impact
of extremes of PE currently on offer in UK schools. Further analysis of
our study, when published, will show that physical activity undoubtedly
impacts on the metabolic health of these children, but the lack of
difference between the schools suggests that variation in overall activity
owes more to the individual child than to the opportunity on offer at
school.
However, we cannot agree that activity data collected by
questionnaire or diary amounts to objective measurement. As Shephard
himself has pointed out (3), measurement of overall activity by self-
report, as in the Trois Rivieres Study (1), is subject to bias, relies on
recall and may miss the short bursts of high intensity activity
characteristic of children’s activity patterns (4-6).
Dale et al did measure overall activity objectively using
accelerometers, but this was a short-term intervention study with only two
‘restricted activity’ days and two ‘active’ days (7). Data was collected
on the intervention days only and was limited to the period 9.00am to
7.30pm. The children in our study had been exposed to their PE timetables
for at least four months before data collection started. They were also
asked to wear their accelerometers from when they got up in the morning to
when they went to bed. The longer period may be one reason why we captured
a compensation effect, where Dale et al did not.
Reference List
1. Shephard RJ, Jequier JC, Lavallee H, La Barre R, Rajic M.
Habitual physical activity: effects of sex, milieu, season and required
activity. J Sports Med Phys.Fitness 1980;20:55-66.
2. Kahn EB, Ramsey LT, Brownson RC, Heath GW, Howze EH, Powell KE et
al. The effectiveness of interventions to increase physical activity. A
systematic review. Am J Prev.Med 2002;22:73-107.
3. Shephard RJ. Limits to the measurement of habitual physical
activity by questionnaires. Br.J Sports Med 2003;37:197-206.
4. Bailey RC, Olson J, Pepper SL, Porszasz J, Barstow TJ, Cooper DM.
The level and tempo of children's physical activities: an observational
study. Med Sci.Sports Exerc. 1995;27:1033-41.
5. Goran MI. Measurement Issues Related to Studies of Childhood
Obesity: Assessment of Body Composition, Body Fat Distribution, Physical
Activity, and Food Intake. Pediatrics 1998;101:505-18.
6. Welk GJ, Corbin CB, Dale D. Measurement issues in the assessment
of physical activity in children. Res.Q.Exerc.Sport 2000;71:S59-S73.
7. Dale D, Corbin CB, Dale KS. Restricting opportunities to be
active during school time: do children compensate by increasing physical
activity levels after school? Res.Q.Exerc.Sport.2000.Sep;71(3):240-8.
2001;71:240-8.
Competing interests:
Authors of original article
Competing interests: No competing interests