Can active play replace skill-oriented physical education in enhancing fundamental movement skills among preschool children? A systematic review and meta-analysis

Bei Liu; Yiping Yan; Jingjing Jia; Yang Liu

doi:10.1186/s12889-025-22398-9

. 2025 Apr 14;25:1399. doi: 10.1186/s12889-025-22398-9

Can active play replace skill-oriented physical education in enhancing fundamental movement skills among preschool children? A systematic review and meta-analysis

Bei Liu ¹, Yiping Yan ¹, Jingjing Jia ¹, Yang Liu ^1,^2,^✉

PMCID: PMC11998302 PMID: 40229751

Abstract

Background

Active play emphasizes the enjoyment of physical activity, it is affordable and unconstrained. In contrast, skill-oriented physical education, a mainstream physical activity intervention, is more formalized. However, the comparative effects of these interventions on fundamental movement skills in preschool children remain a subject of debate.

Purpose

Determine the effectiveness of active play and compare it with skill-oriented physical education on fundamental movement skills.

Methods

We searched four databases (MEDLINE, ERIC, Web of Science, and SPORTDiscus) from January 2004 to March 2024. Included studies assessed FMS in children aged 2–6 years, with active play interventions lasting ≥ 4 weeks. The effects of active play and skill-oriented physical education on total fundamental movement skills, locomotor skills, object control, and balance were calculated within random effects models (weighted SMD) in meta-analysis.

Results

This systematic review included 23 studies involving 2201 preschool children, with 15 eligible for meta-analysis. The meta-analysis showed no significant differences in the effects of active play compared to skill-oriented physical education on total FMS, locomotor skills, object control, balance (p > 0.05). Subgroup analyses indicated that skill-oriented physical education marginally outperformed unstructured active play in total fundamental movement skills and locomotor skills (SMD=-1.0172, 95% CI -1.6748~ -0.3595, p = 0.0073; SMD=-1.6956, 95% CI -3.3511~ -0.0401, p = 0.0471).

Conclusions

Both structured active play and skill-oriented physical education are comparable effective in improving fundamental movement skills. However, unstructured active play is less effective. In resource-limited educational settings, structured active play may serve as a viable complement to partial skill-oriented physical education programming.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-025-22398-9.

Keywords: Active play, Fundamental movement skills, Preschool children, Physical activity

Introduction

Fundamental Movement Skills (FMS) are essential building blocks for mastering complex movements in sports, games, or other specific physical activity [1], encompassing object control skills, locomotor skills, and balance [2]. The development of FMS affects how much preschool children engage in physical activity. It is also related to different aspects of their body composition, skeletal health, psychological development [2, 3], and social adaptation [4]. Furthermore, FMS acquisition in early childhood lays the groundwork for sustained physical fitness throughout children lifespan [5].

Inadequate FMS proficiency can predispose preschool children to obesity and increase the risk of chronic diseases [6, 7]. This issue is particularly concerning worldwide, as many preschool children exhibit inadequate FMS development [8]. A global survey revealed that FMS performance of children generally falls between “below average” and “average” levels in TGMD-2 test [9]. In the United States, children aged 3–5 experienced 22% decline in FMS from 2000 to 2019 [10].

The relationship between physical activity and the development of FMS in children is a complex and somewhat controversial topic. As early as 2008, Stodden’s hypothesis posited “The development of motor skill competence is a primary underlying mechanism that promotes engagement in physical activity” [11]. Physical activity is recognized as a crucial pathway for promoting the development of FMS [12–16]. Recent longitudinal syntheses challenge this reciprocity, demonstrating insufficient evidence for their mutual predictability across developmental stages [17, 18]. This suggests that the relationship is not as straightforward as once thought, and factors like the type of physical activity might play a significant role.

Active play is a important type of physical activity for children [19]. It combines intrinsic enjoyment and low-cost accessibility, fostering high participation rates among children [20, 21]. Due to the benefit of providing fun, children are particularly motivated to participate in active play. And, active play also can offer both physical and mental health benefits. Moreover, active play empowers child autonomy by minimizing adult-directed regulations, enabling self-determined movement patterns [22]. Since 2000, the World Health Organization has actively advocated for sufficient physical activity among children. This ongoing emphasis highlights the significance of initiatives like active play, which serve as essential strategies for promoting children’s health and well-being [23]. The health authorities in United States, Canada, Australia, and the United Kingdom advocate active play initiatives to combat childhood health issue through physical activity promotion [24, 25]. Organizations such as Play Scotland, dedicated to advancing children’s play rights, have integrated active play into their advocacy efforts. They prompting scholarly discourse on the intersection of play and physical activity [26]. Despite conceptual progress, the field faces definitional challenges, particularly regarding classification systems. This review adopted a pragmatic approach by categorizing it into two primary types based on organizational structure:1) structured active play (also termed planned or guided play), characterized by specific processes; 2) unstructured active play (commonly called free play), defined by spontaneous, child-initiated activities without formal constraints [27–29].

Skill-oriented Physical Education, a predominant pedagogical strategy for FMS development in preschool children [30]. Skill-oriented Physical Education is an instructional approach in physical education that focuses on systematically developing students’ motor skills and sport-specific competencies. It is usually taught formally by professional physical education teachers. But skill-oriented physical education places considerable demands on teachers and has its limitations [31]. Traditional skill-oriented physical education interventions often become monotonous and lack engaging elements, which may lead children to lose interest and abandon these activities [32]. Regular skill-oriented physical education teachers often spend a lot of time explaining and organizing the activities to prevent accidents or collisions, which can unintentionally limit children’s physical activity [33].

Based on this, it is worth exploring whether active play can complement traditional skill-oriented physical education interventions to improve preschool children’s FMS from perspective of fun exercise. However, existing published reviews remain limited in two critical aspects: (1) insufficient integration of post-2020 FMS interventions using active play program [34, 35]; and (2) undifferentiated analysis of structured play subtypes (e.g. structured active play vs. structured active play) despite documented efficacy variations [36]. These gaps of temporal incompleteness and methodological generalization fundamentally constrain evidence-based intervention design.

To contribute to this area of research, this study endeavors to determine the effect of active play on FMS among preschool children. Our objectives are manifold: (1) updating the evidence to ascertain the efficacy of active play interventions and delineate their modalities in improving FMS; (2) to compare active play with skill-oriented physical education in improving FMS; and (3) to categorize active play into distinct subtypes, and examine potential differences in their efficacy in fostering FMS development.

Methods

This systematic review adheres to the PRISMA statement guidelines for conducting systematic reviews and meta-analyses [37]. The research protocol was officially registered on PROSPERO on February 14, 2024 (ID = CRD42024502589).

Search strategy

The search was conducted across four comprehensive databases, namely, MEDLINE, ERIC, Web of Science, and SPORTDiscus, spanning from January 2004 to March 2024. We searched through titles, abstracts, and keywords of publications for any mentions of English terms related to active play, FMS, and preschool children(Additional file 1).

In the secondary search, we identified additional relevant articles by carefully checking our databases and reviewing the reference lists of the included publications. The goal is to enhance the comprehensiveness of our literature search and potentially capture any overlooked studies.

Two reviewers (LB and JJJ) independently assessed the identified publications for eligibility.

Study selection

A study was deemed eligible for inclusion if it met the following criteria: (a) used an experimental design that included preschool children who were aged 2–6 years; (b) the intervention program lasted a minimum of 4 weeks; (c) the active play program included physical activities or movement in the main form of play such that it can be an organized structured active play or an unorganized unstructured active play; (d) before and after the intervention program, the overall FMS, locomotor skills, object control skills and balance were assessed employing quantified test criteria, as these procedures yielded comparable estimates; and (e) the effects of structured active play or unstructured active play on FMS (during intervention) in comparison with those of a nonexercising control group and/or skill-oriented physical education were evaluated. Despite some attempts to provide a standardized definition of active play, a wide consensus has still not been reached. To be as inclusive as possible, in the eligibility criteria, we used a relatively generalized active play concept. We did not include studies involving children with intellectual, physical, or cognitive disabilities, as these conditions could hinder their participation in active play.

Data extraction

After the systematic search, all the articles were imported into ZOTERO 6.0.30 and checked for duplicates. From the included studies, the following data were extracted by one author (BL) and checked by another author (YPY): lead author name, year of publication, study region, study population, study design, participant characteristics, method of assessment (FMS), type of program, and means and standard deviations of FMS at baseline and post-test.

Missing data

The included studies must contain mean and SD for a single item, subscale, or total FMS scores. Studies that provide complete data for both the active play and skill-oriented physical education groups will be incorporated into the meta-analysis. However, pre-post studies, which lack comparable different groups for comparison, will not be eligible for inclusion in the meta-analysis. The data from these studies will be summarized in a dedicated table for descriptive analysis within the systematic review.

If there are missing data in the literature included in this study, we will send email requests to obtain relevant data. We asked the corresponding authors of two authors to provide us with additional relevant data and additional information on the intervention [38, 39]. However, our request went unanswered, and as a result, meta-analysis data could not be obtained. The missing data might have led to an underestimation or overestimation of the effect sizes in the meta analysis. Nevertheless, these studies provided sufficient descriptive and analytical information to be included in this review.

Quality assessment of the included studies

Study quality was appraised independently by two authors (BL and JJJ) via the 11-item Physiotherapy Evidence Database (PEDro) scale [40]. The PEDro scale is a widely used tool for assessing the methodological quality in the field of physical activity intervention. It evaluates studies based on 11 criteria, which are designed to measure the internal validity and statistical reporting of the trial. The items include aspects such as randomization, blinding, allocation concealment, intention-to-treat analysis, and follow-up completeness, among others.

Based on the summary scores on the scale, the studies were classified as excellent (9–10 points), good (6–8 points), fair (4–5 points), or poor (≤ 3 points) quality. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence as ‘high’, ‘moderate’, ‘low’, or ‘very low’ [41]. When discrepancies arose, a third author participated in discussions or evaluations to reach a consensus.

Data synthesis and analysis

The analyses were performed using the ‘metafor’ and ‘dmetar’ package in R (R Foundation for Statistical Computing, Vienna, Austria) [42, 43]. Studies that provided the number of participants and measures of baseline and posttest values (means and SD or SE) were included. Effects on overall FMS, locomotor skills, object control, and balance were calculated using weighted SMD within random effects models. Effect sizes are reported as the mean differences and 95% confidence intervals. Publication bias was evaluated via contour-enhanced funnel plots. Heterogeneity was assessed using the I² and tau². Subgroup analyses compared effect sizes across active play types during FMS assessment. To identify heterogeneity sources, sensitivity analyses applied Gaussian mixture models [43, 44], and clustering studies by effect sizes and covariates with parameter optimization through expectation-maximization algorithms.

A narrative synthesis was conducted on outcomes in which a meta-analysis could not be undertaken, with interventions described by reviewing the type, duration, and setting.

Results

Search results

A preliminary search yielded a total of 1416 studies, with an additional 4 studies identified through reference checks. Following the removal of duplicates (n = 843) and screening of titles and abstracts (n = 802), 41 studies remained for a thorough review. Upon full-text examination, 23 studies met the inclusion criteria [4, 38, 39, 45–64] (Fig. 1).

Fig. 1 — Article identified process [65]

Study characteristics

The participants included in the studies ranged in age from 3 to 6 years. The total number of participants included in the studies was 2,201, and 3 studies did not report differences in the sex of the subjects [38, 63, 64]. The participants in one study were all girls [63]. The included studies were from 10 countries and territories on 5 continents other than Africa and Antarctica, with 13 studies from North America, 7 studies from Europe, 7 studies from Asia, and 1 study from Oceania(Additional file 2).

Study quality assessment

All the studies included underwent assessment via the PEDro scale. The analysis revealed that none of the articles scored below 4 points. On average, all the articles achieved a score of 6.913, and the articles in the meta-analysis achieved a score of 7.375, suggesting the high quality and reliability of the findings. Among the 23 studies deemed acceptable in quality, 15 were included in the meta-analysis. Additionally, 3 out of four articles rated as excellent quality were included, along with 12 out of 14 articles rated as good quality. Furthermore, one remaining article of fair quality was also included in the meta-analysis (Additional file 3).

The active play program characteristics

8 studies were designed as cluster randomized controlled trial, 7 studies were designed as randomised controlled trial, 4 studies were designed as pre-post study, 3 studies were designed as pre-post quasi experiment, and 1 study was designed as a quasi experiment. The temporal analysis revealed that there were mostly pre-post study and quasi experiment before 2017, and after 2017, there were mostly randomised controlled trial and cluster randomized controlled trial. 3 studies compared unstructured active play with structured active play, 19 studies compared unstructured active play and/or structured active play with skill-oriented physical education, 3 studies compared unstructured active play and/or structured active play with another comparison, and 1 study was an active play single-arm trial.

The main measurement tool used in the reviewed literature was the Test of Gross Motor Development (TGMD), with 6 studies using the TGMD-3, 9 studies using the TGMD-2, and 1 study using the TGMD-1. Movement assessment battery for children-version-2 was used in 2 studies, Peabody Developmental Motor Scales Second Edition-2 was used in 2 studies, and other FMS measurement tools were used in the remaining studies(Additional file 2).

Research designs for active play can be divided into 2 main categories: unstructured active play and structured active play. The unstructured active play is primarily loosely organized, unstructured free play, with 20 studies designing the unstructured active play, 11 of which were free play without the addition of another intervention. 2 of the studies in the Staiano study differed from the need for active video game to be dominated by large amounts of screen time in that the team used an app to recommend appropriate PLAY content for parents [4, 60]. 6 unstructured active play studies were designed to provide preschool children with enriched play equipment and/or fun play environments. 3 studies placed the unstructured active play outdoors with the expectation that it would be used by out-of-home children. Dissimilar to traditional skill-oriented physical education, which typically focuses on enhancing FMS proficiency in preschool-aged children, structured active play is a form of physical activity that is fun and playful. Among all the included studies, 8 studies had structured active play subgroups, 4 studies used structured active play interventions in outdoor playground settings, 2 studies provided preschool children with lightweight, piecemeal equipment for play through a PLEY project, and specialized teachers led the children in active play, and the other 2 studies did not reveal much detail about the structured active play design(Additional file 2).

The longest intervention duration included in studies is six months, with most interventions ranging from 6 to 12 weeks. Most of the single interventions in this review ranged from 30 to 60 min, while Adamo’s study was designed for 60–90 min [45], the App-based PLAY intervention was more fragmented and variable, with a single intervention lasting only 12 min. The frequency of intervention in this review was mostly 1–3 times per week, but some studies were affected by COVID-19 and did not follow a fixed cycle of intervention(Additional file 2).

Outcomes and measures

The meta-analysis examined and analyzed the effects of active play programs on total FMS, locomotor skills, object control skills, and balance.

Effects of active play (structured active play and/or unstructured active play) on total FMS

12 studies reported total FMS, among which 6 studies showed that the intervention effect of skill-oriented physical education was better than that of unstructured active play, but 3 was no significant difference between skill-oriented physical education interventions for traditional martial arts and unstructured active play. 3 studies no significant difference between unstructured active play and structured active play, and 2 studies showed that structured active play was better than unstructured active play. A single-arm study showed that community active play interventions could help improve total FMS in preschool children. The meta-analysis showed that there was no significant difference in total FMS between active play and skill-oriented physical education (SMD = -0.71, 95% [CI] -1.43; 0.02, P = 0.0546) (Fig. 2). Subgroup analysis showed that unstructured active play was less effective than skill-oriented physical education in the study design for preschool children (SMD = -1.0172, 95% [CI] -1.6748; -0.3595, P = 0.0073), whereas structured active play and skill-oriented physical education were not significantly different (SMD = 0.7431, 95% [CI] -6.6653; 8.1514, P = 0.4235) (Table 1).

Fig. 2 — Random effect size of total FMS proficiency

Table 1.

Active play (structured active play and/or unstructured active play) compared to skill-oriented physical education on FMS subgroup analysis of the program

Groups	No.	SMD	95%-CI	t	p	I²	tau²	p
Total FMS
UAP	9	-1.0172	[-1.6748; -0.3595]	-3.57	0.0073	89.00%	0.6403	< 0.01
SAP	2	0.7431	[-6.6653; 8.1514]	1.27	0.4235	86.70%	0.5904	< 0.01
LM
UAP	4	-1.6956	[-3.3511; -0.0401]	-3.26	0.0471	89.70%	0.9617	< 0.01
SAP	2	0.588	[-11.9860; 13.1620]	0.59	0.6587	94.90%	1.8597	< 0.01
OC
UAP	7	-2.9742	[-6.3961; 0.4476]	-2.13	0.0775	94.80%	12.6527	< 0.01
SAP	2	0.9021	[-0.2790; 2.0832]	9.7	0.0654	0%	0	0.6483

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AP: Active play; SAP: Structured active play; UAP: Unstructured active play; FMS: Fundamental Movement Skills; OC: Object control skills; LM: Locomotor skills

Effects of active play (structured active play and/or unstructured active play) on locomotor skills

Locomotor skills was reported in 10 studies, of which 4 studies showed that the intervention effect of skill-oriented physical education was better than that of unstructured active play, 2 studies showed no significant difference between skill-oriented physical education intervention and unstructured active play, 1 study showed that the intervention effect of structured active play was better than that of skill-oriented physical education, and 1 study showed no significant difference between skill-oriented physical education intervention and structured active play intervention. 2 studies showed that the structured active play was superior to the unstructured active play, but one study showed no significant difference between the structured active play and unstructured active play, and a one-arm study showed that the active play was superior to pre-measured locomotor skills results. Data extraction and analysis of 6 studies included in the meta-analysis showed that locomotor skills did not significantly differ between active play and skill-oriented physical education (SMD =-0.9410, 95% [CI]-2.5825; 0.7005, P = 0.2006) (Fig. 3). Subgroup analysis showed that unstructured active play was less effective than skill-oriented physical education in the study design for preschool children (SMD = -1.0172, 95% [CI] -1.6748; -0.3595, P = 0.0073), and structured active play had no significant difference compared with from skill-oriented physical education (SMD = 0.7431, 95% [CI] -6.6653; 8.1514, P = 0.4235)(Table 1).

Fig. 3 — Random effect size of locomotor skills proficiency

Effects of active play (structured active play and/or unstructured active play) on object control skills

15 studies reported the effect of active play intervention on the object control skills of preschool children, among which 7 studies showed that the intervention effect of skill-oriented physical education was better than that of unstructured active play, 4 studies showed no significant difference between skill-oriented physical education intervention and unstructured active play, 2 studies showed that structured active play was better than unstructured active play, and 2 studies showed no significant difference between structured active play and unstructured active play. A one-arm study showed that active play was superior to active play in terms of object control skills results by post-test. Data extraction and analysis of 6 studies included in the meta-analysis showed that locomotor skills did not significantly differ between active play and skill-oriented physical education (SMD =-0.9410, 95% [CI]-2.5825; 0.7005, P = 0.2006)(Fig. 4). Subgroup analysis showed no significant difference between skill-oriented physical education and structured active play and unstructured active play in the study design of preschool children (unstructured active play: SMD = -2.9742, 95% [CI] -6.3961; 0.4476, P = 0.0775; structured active play: SMD = 0.9021, 95% [CI] -0.2790; 2.0832, P = 0.0654) (Table 1).

Fig. 4 — Random effect size of object control skills proficiency

Effects of active play on balance skills

2 studies reported the effect of active play intervention on the balance skills of preschool children. The results of the meta-analysis showed that there was no significant difference in balance skills between active play and skill-oriented physical education (SMD =-0.5966, 95% [CI]-2.4914; 1.2982, P = 0.3082) (Fig. 5).

Fig. 5 — Random effect size of object balance skills proficiency

Effects of active play (structured active play and/or unstructured active play) on other skills

3 studies reported other results on FMS, but these were not included in the meta-analysis. Deli’s study analyzed the results of running, hopping, and leaping in preschool children and found that the skill-oriented physical education FMS intervention and music movement intervention were more effective than the unstructured active play intervention [52]. Ruiz-Esteban’s study showed that the physical education program improved Leg Coordination and Arm Coordination more than the unstructured active play [41]. Li’s comparison of martial arts with unstructured active play showed that martial arts sensory teaching improved preschool children’s manual dexterity more than unstructured active play did [53]. Manual dexterity was not significantly different between Aiming and Catching.

Heterogeneity and publication bias analysis

The sensitivity analysis utilizing the Gaussian Mixture Model has identified clusters that highlight the primary sources of heterogeneity within the studied dataset (Fig. 6). Gaussian mixture model algorithms show that most studies have high heterogeneity (Fig. 6a) Through the result of cluster imbalance analysis (Fig. 6b), 2 studies [45, 55] stand out as the main source of the highest heterogeneity clusters, indicating their potentially significant impact on the overall heterogeneity of the research. The performance of these 2 studies in the overall cluster graph, and the green highlight represents their distribution (Fig. 6c and d). However, a close examination of the content of the two studies found no special reasons to be excluded. The high heterogeneity in this study may stem from the study design or demographic differences among participants. By dividing the study design into different subgroups of structured active play and unstructured active play, it is shown that unstructured active play may be the main cause affecting object control skills heterogeneity (Table 1). Unfortunately, less than or equal to three included studies divided different intervention groups into balance, gender, age, and these data were not representative of subgroup analysis, so this study could not analyze the source of heterogeneity of balance and demographics.

Fig. 6 — (a) Heterogeneity sources of Gaussian mixture model algorithms. (b) Heterogeneity sources of Gaussian mixture model algorithms. (c) Heterogeneity sources of Gaussian mixture model algorithms [55]. (d) Heterogeneity sources of Gaussian mixture model algorithms [45]

Given the high heterogeneity of the studies, some data points fall outside the confidence intervals of the funnel plot; however, no significant asymmetry is evident upon examination of the graph (Additional file 4).

Discussion

The purpose of this study was to understand the effects of active play on preschool children’s FMS through a systematic review and meta-analysis. Through active play compared with skill-oriented physical education. This study explored whether the intervention effect of active play on preschool children’s FMS is the optimal activity pathway. Analyzed the differences in the intervention effects of FMS between structured active play and unstructured active play. We anticipate that this study will offer valuable insights for improving FMS activities among future preschool children.

Mainly findings of this review: Active play and skill-oriented physical education has comparable effects on preschool children’s FMS. This finding aligns with the results of some currently published review studies Avril published a study in 2018 on the same topic as this paper [35]. However, due to the nascent stage of active play research at that time, there were very few studies available for inclusion, making it impossible to conduct in-depth research on reclassification from different intervention perspectives. The types of interventions for FMS have become increasingly diverse. Among them, Zhang’s recent review effectively summarizes and provides detailed descriptions of this unique type of active play [66]. Unfortunately, their review only included two studies, which may result in incomplete findings. This review serves as a continuation and supplement to the aforementioned studies.

The comparable efficacy of active play may stem from this intervention can lead moderate-to-vigorous physical activity for preschool children. A significant number of empirical studies have demonstrated the FMS benefits of moderate-to-vigorous physical activity for preschool children [67, 68]. Among the included studies, Stagnitti reported that lower levels of physical activity in disadvantaged communities might be associated with delayed acquisition of FMS during childhood. This community-based active play program aims to help children achieve better FMS by engaging in physical activities instead of sedentary behaviors [59]. Any intervention related to moderate-to-vigorous physical activity may help to enhance FMS in preschool children [69]. In a good play environment, children may perform more intense physical activities, which may help improve their FMS levels [61, 70]. Caldwell conducted a mixed-methods randomized controlled trial to explore the impact of an outdoor loose parts play intervention on physical literacy [50]. The results revealed that, with effective active play design, the intensity of preschool children physical activity increased significantly. Notably, Caldwell’s intervention demonstrated benefits for preschool children’ movement repertoires, social development, and enjoyment of physical activity, as analyzed in focus groups When the intensity levels of these two types of activities are comparable, active play and skill-oriented physical education may exhibit comparable effectiveness in enhancing FMS among preschool children. Particularly when the children’s physical development is optimal [26]. Additionally, a number of studies have confirmed that skill-oriented physical education can help preschool children’s FMS [36]. However, the current skill-oriented physical education is affected by a variety of factors with relatively nonuniformity. Such as the built environment, economic level, teachers’ professionalism, and curriculum model, and there is no standardized skill-oriented physical education instruction globally [71]. Which is leads to significant variations in the outcomes of different skill-oriented physical education interventions. In some highly organized skill-oriented physical education teaching situations, students may reduce their moderate-to-vigorous physical activity participation rate [22]. Based on this, the active play program may improve the MVPA of preschool children, so as to achieve FMS effect similar to participation in skill-oriented physical education.

Secondary findings of this review: We were performed to compare structured or unstructured active play with skill-oriented physical education respectively. Based on the non-significance of the subgroup analysis results, structured active play and skill-oriented physical education had comparable effects. Whereas the results of subgroup analysis and qualitative review showed that unstructured active play was less effective than skill-oriented physical education. This suggests that structured physical activity can be more helpful than unstructured active play for preschool children in FMS. Some research indicating that structure or adult guidance physical activity has a superior effect on enhancing the motor skills of preschool children [57, 72]. At present, the existing research also shows that the effect of structured intervention is better than that of unstructured FMS intervention [36]. But that review included active play intervention studies entirely in the category of unstructured physical activity intervention, because they considered all kind of active play to be unstructured. However, such a classification may result in a large portion of guided and organized structured active play not being effectively incorporated. These reasons of classification problem may be inconsistent definitions of active play [26].

Although the definition of active play remains elusive, for a more comprehensive exploration of the domain of active play, this study defines active play as “physical activity primarily intended for play”. Active play is distinguished by playful intent, prioritizing enjoyment over formal skill acquisition [21]. The actual application of skill-oriented physical education may include a part of active play. However, the primary method of differentiating between skill-oriented physical education and active play is based on the intent of the activity and enjoyment. With skill education-based physical activity is categorized as skill-oriented physical education and play-based physical activity is classified as active play. In this review, the active play program is a relatively free and informal voluntary engagement in mainly activity.

The theoretical framework proposed by Gallahue, encapsulated in the hourglass model, contends that children’s foundational motor skills cannot be naturally attained and necessitate structured physical activity interventions [73, 74]. In 2016, Lisa also defined FMS, which clearly stated that FMS is defined as basic learned movement patterns that do not occur naturally [75]. The definition mentioned above typically includes children with developmental delays in the motor domain, who may require additional instruction to improve their FMS. The participants in these studies ranged from 3 to 10 years old and included toddlers and children in two different age groups. Importantly, discussing these age groups together can affect the accuracy of the results. This review specifically focused on typically developing preschool children, aiming to produce more accurate results. The findings of this review support the current view that FMS is not naturally acquired. FMS improvement requires structured physical activity. But some inconsistencies in object control skills and balance remain. This is probably due to the contradiction between the qualitative and quantitative results due to the quantitative-effectiveness relationship.

Based on results, structured active play can complement skill-oriented physical education. But this does not mean that skill-oriented physical education should be completely replaced. The educational goal of physical education includes the cultivation of physical literacy, which has a long-term and extensive impact on children’s development. Structured active play can be strategically integrated into physical education curricula as a complementary pedagogical method. For instance, guided play sessions may supplement formal skill-building activities by enhancing engagement and providing context-specific motor challenges. Similarly, unstructured active play does little to improve FMS, But this does not diminish its value. The flexibility inherent in unstructured active play allows for the promotion of social adaptability, creativity, and psychological well-being during playtime, which are crucial developmental aspects in preschool children [76–78]. Among the included structured active play program, some also incorporate elements of unstructured active play [61]. Therefore, in practical applications, mixed physical activity intervention are more reliable.

In terms of improving FMS in preschool children. We recommend active play programs in some low-income and poor physical education resource areas. Because, the cost of training professional physical education teachers is high and hiring such professionals is a significant financial burden [79, 80]. Some regions may neglect the development of preschool children’s FMS because they cannot pay for these education expenses. Faced with this challenge, a viable solution involves adjusting playground designs [70, 81], introducing more loose parts of play equipment [78]. Providing basic staff training, thereby shifting the focus of teaching to encouraging and supervising the safety of preschool children’s physical activities. Multiple global organizations (such as activeplay.ca and actify.org.uk) are offering active play-related materials to childcare workers and parents, including active play videos, programs, and considerations suitable for preschool children. Adults can design structured active play by browsing related videos, offering a relatively cost-effective physical activity intervention [26].

In addition to the type of intervention, the duration and frequency of interventions are equally important. Like most physical activity interventions of FMS [66], there is currently no clear evidence to determine the optimal critical value for intervention duration. In terms of the frequency of active play interventions, it is common to have 1–3 sessions per week, each lasting about 45 min. It is worth mentioning that some innovative studies have broken away from this conventional design. For instance, the PLAY app-based project cleverly fragmented exercise frequency (5*12 min/week) with an app-based physical activity task design [60]. This fragmented intervention approach may better suit the shorter attention span characteristic of preschool children’s physical and mental development [82]. It is also crucial to ensure that preschool children have extended periods in a free play environment, necessitating further research on the effects of fragmented versus concentrated active play interventions [83, 84].

The risks associated with active play remain a limiting factor in its development [85]. In addition to prioritizing structured active play that can help reduce the risk of exercise, it is also important to have a consensus based on the risk of exercise. Through a systematic review of 10,370 records from nine countries, found that risk-tolerant and play-friendly can significantly promote active play among school children [86]. Moreover, engaging all stakeholders in developing school policies and regulations that balance the benefits of play with potential risks is essential [87]. Although that study was conducted in a school setting, kindergartens and communities may also face similar challenges. Policymakers, in promoting the development of active play, should encourage adults to accept the risks associated with active play and convey the message that the benefits of active play for preschool children outweigh the risks. After clarifying the position statement, this objective can be realized through targeted training to help childcare workers, and parents understand and manage risks.

Strengths and limitations

As far as we know, this review represents the inaugural systematic review and meta-analysis of active play categorization discussions concerning their impact on FMS. Diverging from the approach of review articles focusing on FMS, our study incorporates the metric of balance into the evaluation system. This inclusion facilitates a more comprehensive description and analysis of the current research landscape among preschool children regarding active play interventions aimed at enhancing FMS. Employing a rigorous review methodology, each data extraction involves scrutiny by two or more reviewers. Furthermore, to ensure the inclusion of all relevant literature, extensive searches were conducted not only across major internet databases via specific search terms but also through secondary searches via references cited in related research articles. This meticulous approach aims to provide a robust and exhaustive synthesis of the literature on active play and its impact on FMS development in preschool-aged children.

This review conducted subgroup analyses and sensitivity analyses in the meta-analysis. However the heterogeneity could still not be reduced to a low level after various types of exclusions. The reason may be that the active play intervention itself is highly flexible, with significant differences across studies in implementation intensity, duration, and instruction style. This inherent variability leads to reduced comparability between studies, which in turn affects the reliability of meta-analysis results. Owing to the high heterogeneity derived from the meta-analysis results, these findings should be interpreted with caution. Furthermore, this study did not include studies published in national languages other than English, which may have resulted in an inability to generalize globally relevant studies. Children with disabilities were not included in the study. Excluding children with disabilities limits generalizability. This discrepancy could affect the comprehensive of the results.

Conclusions

This review found that structured active play may achieve comparable outcomes to skill-oriented physical education for FMS improvement. However, unstructured active play shows weaker effects, suggesting that structured physical activities better support FMS development. Nonetheless, it is essential to approach these findings with caution due to high heterogeneity.

We recommend: For resource-limited settings, structured active play offers a cost-effective complement to skill-oriented physical education. Simple strategies like redesigning play spaces with loose parts, training caregivers using free online tools, and splitting activities into different frequent sessions can enhance FMS without expensive equipment or specialized physical education teachers.

While structured active play is prioritized for FMS improvement, unstructured active play remains valuable for fostering creativity, social skills, and mental well-being. A balanced approach is recommended. Policymakers should support active play by funding safe, adaptable play environments and training adults to manage risks without over-restricting.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1^{(21.3KB, docx)}

Supplementary Material 2^{(15.4KB, docx)}

Supplementary Material 3^{(206KB, docx)}

Supplementary Material 4^{(26.9KB, docx)}

Acknowledgements

The authors would like to thank all the included studies that contributed to the paper. We would like to thank the LY group: Danqing Zhang, Youzhi Ke, Yucheng Liu and Zhenweng Xie for their valued assistance with opinions and suggestions. We would like to express our sincere thanks to the Guanggao Zhao team at Nanchang University for their valuable comments and suggestions, particularly to Zihao He and Yunong Li for their insightful guidance on our meta-analysis methodology.

Abbreviations

AP: Active play
SAP: Structured active play
UAP: Unstructured active play
SOPE: Skill-oriented Physical Education
FMS: Fundamental Movement Skills
OC: Object control skills
LM: Locomotor skills
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
RCT: Randomised controlled trial
CRCT: Cluster randomized controlled trial
QE: Quasi experiment
MABC: Movement assessment battery for children-version
TGMD: Test of Gross Motor Development
PDMS: Peabody Developmental Motor Scales Second Edition
KTK: Körperkoordination stest für Kinder
PGMQ: Preschooler Gross Motor Quality Scale
MSCA: McCarthy Children’s Psychomotrcity and Aptitude Scales

Author contributions

YL designed the study and drafted the framework, BL drafted the manuscript. BL and JJJ extracted data and completed all figures and tables. YYP revised figures, tables and manuscript.

Funding

This study is supported by the National Key Research and Development Program of China (2023YFC3305801), the Program for Overseas High-level Talents at Shanghai Institutions of Higher Learning（TP2022102）and Shanghai Key Laboratory of Human Performance (Shanghai University of Sport, 11DZ2261100).

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Footnotes

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplementary Material 1^{(21.3KB, docx)}

Supplementary Material 2^{(15.4KB, docx)}

Supplementary Material 3^{(206KB, docx)}

Supplementary Material 4^{(26.9KB, docx)}

Data Availability Statement

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

[CR1] 1.Logan SW, Ross SM, Chee K, Stodden DF, Robinson LE. Fundamental motor skills: A systematic review of terminology. J Sports Sci. 2018;36:781–96. [DOI] [PubMed] [Google Scholar]

[CR2] 2.Whitebread D, Coltman P. Teaching and learning in the early years. Routledge; 2003.

[CR3] 3.Kasanen M, Sääkslahti A, Niemistö D, Tolvanen A, Luukkainen N-M, Meklin E, et al. Process- and Product-Oriented fundamental movement skills in early childhood as predictors of later Health-Related fitness. Med Sci Sports Exerc. 2024;56:1722–31. [DOI] [PMC free article] [PubMed] [Google Scholar]

[CR4] 4.Staiano AE, Saha S, Beyl RA, Kracht CL, Newton RL Jr, Webster EK. Parental engagement and implementation fidelity in a mHealth motor skills intervention for young children. Phys Educ SPORT PEDAGOGY. 2023. 10.1080/17408989.2023.2235394. [Google Scholar]

[CR5] 5.Walkley J, Holland BV, Treloar R, O’Connor J. Fundamental motor skills: A manual for classroom teachers. Victoria. Department of Education; 1996.

[CR6] 6.Bolger LE, Bolger LA, O’Neill C, Coughlan E, O’Brien W, Lacey S, et al. Global levels of fundamental motor skills in children: A systematic review. J Sports Sci. 2021;39:717–53. [DOI] [PubMed] [Google Scholar]

[CR7] 7.Jones D, Innerd A, Giles EL, Azevedo LB. Association between fundamental motor skills and physical activity in the early years: A systematic review and meta-analysis. J Sport Health Sci. 2020;9:542–52. [DOI] [PMC free article] [PubMed] [Google Scholar]

[CR8] 8.Aye T, Kuramoto-Ahuja T, Sato T, Sadakiyo K, Watanabe M, Maruyama H. Gross motor skill development of kindergarten children in Japan. J Phys Ther Sci. 2018;30:711–5. [DOI] [PMC free article] [PubMed] [Google Scholar]

[CR9] 9.Kit BK, Akinbami LJ, Isfahani NS, Ulrich DA. Gross motor development in children aged 3–5 years, united States 2012. Matern Child Health J. 2017;21:1573–80. [DOI] [PMC free article] [PubMed] [Google Scholar]

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PERMALINK

Can active play replace skill-oriented physical education in enhancing fundamental movement skills among preschool children? A systematic review and meta-analysis

Bei Liu

Yiping Yan

Jingjing Jia

Yang Liu

Abstract

Background

Purpose

Methods

Results

Conclusions

Supplementary Information

Introduction

Methods

Search strategy

Study selection

Data extraction

Missing data

Quality assessment of the included studies

Data synthesis and analysis

Results

Search results

Fig. 1.

Study characteristics

Study quality assessment

The active play program characteristics

Outcomes and measures

Effects of active play (structured active play and/or unstructured active play) on total FMS

Fig. 2.

Table 1.

Effects of active play (structured active play and/or unstructured active play) on locomotor skills

Fig. 3.

Effects of active play (structured active play and/or unstructured active play) on object control skills

Fig. 4.

Effects of active play on balance skills

Fig. 5.

Effects of active play (structured active play and/or unstructured active play) on other skills

Heterogeneity and publication bias analysis

Fig. 6.

Discussion

Strengths and limitations

Conclusions

Electronic supplementary material

Acknowledgements

Abbreviations

Author contributions

Funding

Data availability

Declarations

Ethics approval and consent to participate

Consent for publication

Competing interests

Footnotes

References

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

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