Table 1.

Studies on physical activity, motor skills and cognitive development.

Reference	Study design/country	Characteristics of study	Physical activity measure	Outcome measure(s)	Main results
Physical activity
Becker et al. (2014)	Cross-sectional single-group. USA	•N = 51 children •Average age 4.8 years •43.1% female •49% enrolled in Head Start •19.6% Spanish speakers •No SES information	•ActiGraph GT1M accelerometer during 30 min of free outdoor play during preschool	•Head–Toes–Knees–Shoulders task (HTKS) for self-regulation •The Letter-Word Identification subtest of the Woodcock–Johnson (to assess literacy) •The Applied Problems subtest of the Woodcock–Johnson (to assess math skills)	•Active play positively correlated with self-regulation and positively correlated with math achievement •Active play did not significantly predict math or emergent literacy scores •Active play had a significant indirect effect with math scores as well as emergent literacy scores through HTKS
Kirk et al. (2014)	Quasi-experimental. USA	•N = 72 children •Intervention group, n = 51 •average age 3.8 years •56.9% female •Control group, n = 21 •average age 3.9 years •42.9% female •No race/ethnicity or SES information	•Direct observation •System for Observing Fitness Instruction Time (SOFIT) •rating 3 times per week •assessed at 3 and 6 months •Intervention •Curriculum for 15 min of moderate physical activity 2 × 30 min total	•Pre-school Literacy Individual Growth and Development Indicators (IGDIs) •Assessed at 3 and 6 months of intervention •Measured literacy and language •Picture Naming assessment •Rhyming assessment •Alliteration Assessment	•Compared to control group, intervention group showed significant improvements in alliteration and picture naming between baseline and 3 to 6 months
Mavilidi et al. (2015)	Cluster randomized-controlled rrial. Australia	•N = 111 preschool children •Mean age 4.9 years •15 child-care centers (4 centers in integrated condition, 4 centers in non-integrated, 4 centers in gesturing, and 3 centers in conventional control)	•Actigraph acceleromter •4 conditions administered over 4 weeks: 1.Integrated physical exercise condition (vigorous exercise related to the word) 2.Non-integrated physical exercise condition (vigorous exercise not related to the word) 3.Gesturing condition (child seated, gesture related to word) 4.Conventional condition (child seated and repeat the word)	•Free-recall and cued recall of 14 Italian vocabulary words tested during intervention (at 2 weeks), immediately after intervention (at 4 weeks) and 6 weeks after intervention (10 weeks). [Free recall is asking child to name as many words as they can, cued recall is asking the child to use the Italian word for a picture.]	•Children exposed to integrated physical exercise condition could freely recall more Italian words than children exposed to other conditions (non-integrated physical exercise, gesturing condition, and control condition) during, immediately after, and 6 weeks after the intervention •Children exposed to any movement (integrated physical activity, non-integrated exercise, or gesturing) outperformed the children in the sedentary control condition in the cued recall task.
Mierau et al. (2014)	Cross-over design — subjects begin with either exercise or a control condition. Germany	•N = 10 children •Average age 5.8 years •100% male •Weight and height in the 10th and 90th percentile, respectively •No race/ethnicity or SES information	•Assessed at ages 5 and 6 years •Heart rate was continuously measured •45 min exercise sessions •3 ten-minute movement games •15 min of soccer	•Assessed at ages 5 and 6 years of age •The determination test for children (DTC) •Measures accuracy and reaction speed to rapidly changing visual and acoustic stimuli •Electrical brain activity measured before and after exercise (or control condition) and continuously during the cognitive task	•Reaction time decreased and correct responses increased from pre to post testing however, there was no significant effect by condition
Niederer et al. (2011)	Cross-sectional and longitudinal. Switzerland	•N = 312 children at baseline •N = 245 children at follow-up 9 months later •Average age at baseline 5.2 years •49.4% female •79% of parents born outside of Switzerland •44% with low parental education	•Direct observation at baseline and 9 month follow-up •45–50 min assessment of 3 tests •Aerobic fitness •Agility •Dynamic balance	•Assessed at baseline and 9 month follow-up •Intelligence and Development Scales – IDS •Spatial working memory •Konzentrations-Handlungverfahrn fur Volrschulkinder -KHV-VK •Attention	•Cross-sectional analyses •Higher aerobic fitness was related to better attention, but not working memory •Greater agility was related to better working memory and attention •No outcome associations with dynamic balance. •Longitudinal analyses •Higher baseline aerobic fitness showed better attention over time •Better dynamic balance at baseline showed better spatial working memory over time •No other longitudinal associations
Palmer et al. (2013)	Cross-sectional within-subjects study cohort. USA	•N = 16 children •18.7% female •Average age 4.1 •Average income $12,000 above national median •No race or ethnicity information	•Acti-Graph GT3X + accelerometer	•Picture Deletion Task for Preschoolers (PDTP) •Measures response inhibition	•Preschoolers had significantly improved ability to sustain attention after the physical activity condition compared to the sedentary condition
Motor skill
Davis et al. (2011)	Cross-sectional. England	•N = 248 children •Subsample: 4 year olds n = 30, 5 year olds n = 30 •50% female •No race/ethnicity or SES information	•Assessed at age 4 or 5 •Bruininks-Oseretsky Test of Motor Proficiency -2nd ed (BOT-2) to test motor ability	•Assessed at age 4 or 5 •Kaufman Assessment Battery for Children -2nd ed (KABC-II) •Measures short-term memory •Visual processing •Long-term storage and retrieval •Fluid reasoning •Crystallized ability	•Positive correlation between overall cognitive score and overall motor score •In 4 year olds, stronger correlation for females than males
Draper et al. (2012)	Quasi-experimental. Pre/post-test with a control group. South Africa	•N = 83 children •Intervention group, n = 43 •average age 4.75 years •52.5% female •Control group, n = 40 •average age 4.67 years •32.5% female •From disadvantaged and low-SES settings in South Africa •No race/ethnicity information	•No quantitative measurement of PA •Intervention •Little Champs: once/week 45–60 min physical activity program led by a trained coach •Herbst test for fine/gross motor skills administered	•Herbst early childhood development criteria test •Assessed cognitive functions for school readiness in 3 to 6 year old children	•Intervention group showed significant improvement in cognitive scores
Livesey et al. (2006)	Cross-sectional. Australia	•N = 36 children •58.3% female •Average age 6.25 years •No race/ethnicity or SES information	•Assessed at ages 5 and 6 years •Movement assessment battery for children (MABC - Henerson and Sugden, 1992)	•Assessed at 5 and 6 years of age •Three Tasks •Modified stop-signal task (SST) •Response inhibition •Modified Day-night Stroop task •Response inhibition •Rowe behavior rating inventory (RBRI)	•Lower RBRI scores were associated with better ball skills •Stroop task performance was associated with better fine motor skills •The relationship between motor performance and the SST performance trended in the positive direction but was not significant •Partial correlation showed moderate correlation between go-signal reaction time and fine motor and ball skills
Piek et al. (2008)	Longitudinal cohort. Australia	•N = 33 children •Age at testing 4 months–4 years; age at re-testing 6–12 years •48.5% female •No race/ethnicity or SES information	•Ages in Stages Questionnaire (ASQ) for motor skills •completed at 4, 6, 8, 12, 16, 18, 20, 24, 30, 36, and 48 months	•Assessed at school age (between ages 6–12 years) •Wechsler Intelligence Scale for Children (WISC-IV fourth edition) •Verbal comprehension (VCI) •Working memory (WMI) •Processing speed (PSI) •Perceptual reasoning (PRI)	•Gross motor trajectory (controlling for SES) did not predict VCI or PRI but was significant for WMI and PSI •The ASQ gross motor trajectory set of predictors accounted for a significant proportion of the variance in cognitive performance once SES was controlled
Rhemtulla and Tucker-Drob (2011)	Longitudinal survey. Early Childhood Longitudinal Study-Birth Cohort (ECLS-B). USA	•N = 10,201 children •n = 8300 at age 4 •n = 6800 at age 5 •n = 1850 at age 6 •51.1% female •Race/Ethnicity: 41.4% white, 15.9% African-American, 20.5% Hispanic, 11.3% Asian, and 10.8% other	•Assessed at age 4, 5 and 6 •Gross motor skills •Jumping •Balancing •Hopping •Skipping •Walking backwards •Catching a bean bag	•Assessed at age 4, 5, and 6 •Reading •Preschool Language and Assessment Scale – preLAS •Preschool Comprehensive Test of Phonological & Print Processing •Peabody Picture Vocabulary Test •Mathematics •Measures number sense •Oral language •Let's tell stories task from preLAS	•The rates of developmental change in every domain (motor and cognitive) were positively inter-correlated with a common factor, which accounted for an average of 42% of individual differences in change •Findings suggest significant relationships between the development of several cognitive and motor skills in childhood
Rosey et al. (2010)	Cross-sectional within-subjects' design. USA	•N = 61 children •Age groups 3–5 years old •3-year olds, n = 16 (62.5% female, average age, 3.4 years) •4-year olds, n = 25 (44% female, average age, 4.25 years) •5-year olds, n = 20 (75% female, average age, 5.25 years) •No race or ethnicity information	•Three fundamental movement skills measured •Unipedal balance •Overarm throw •Hopping •Tasks analyzed on film	•Day-Night •verbal inhibition •Hand-Candle •motor inhibition •Tap-Once/Tap-Twice •motor inhibition •Go-No Go task •Delayed inhibition •Trail Making Test •5-year old children only	•Inhibition task performances were correlated with coordination level for the three motor skills for the 3–4 year old children only •Non-verbal inhibition was a coordination level predictor more than the verbal or delayed inhibition