Table 1.
Intervention characteristics of included studies
| Study | Design | Target population | Setting; participants (mean age ± SD, years) | Assessmenta | Intervention program | Overview resultsb |
|---|---|---|---|---|---|---|
| Alhassan et al. [67] United States |
Cluster-randomized controlled trial INT and CON: 4 classrooms from 2 preschool centers in each |
Ethnic minority preschoolers | Preschool centers INT: n = 43 (4.5 ± 0.6), CON: n = 28 (4.1 ± 0.6) |
FMS: TGMD-2 (LMS) PA: accelerometer BC: height, weight, BMI (z-scores) Data collection: 0, 6 months |
Duration: 6 months INT: 30 min structured PA lessons 5/week; lessons focusing on one of the skills of the TGMD-2 LMS; training sessions for teachers (total 8 h) CON: 30 min unstructured free play time 5/week; training sessions for teachers (total 2 h) |
FMS: leaping INT > CON; remaining tests INT ≈ CON PA: sedentary INT < CON BC: INT ≈ CON |
| Bellows et al. [36] United States |
Cluster-randomized controlled trial INT and CON: 4 Head Start centers each |
Preschool-aged children | Head Start centers INT: n = 132 (4.4 ± 0.6) CON: n = 131 (4.3 ± 0.6) |
FMS: PDMS-2 (totFMS, OCS, LMS) PA: pedometers BC: height, weight, BMI (z-scores) Data collection: 0, 18 weeks |
Duration: 18 weeks INT: 15–20 min structured PA lessons 4/week; lessons including multiple activities focusing on one or a group of skills from one of the three gross motor skill categories (Balance, LMS, OCS) by introducing fictive characters promoting motor skills and food; home material; training sessions for teachers. Additionally, those characters were also part of another nutrition-based study called ‘food friends’, which took place at the same time CON: nutrition-based ‘food friends’ study |
FMS: INT > CON PA: INT ≈ CON BC: INT ≈ CON |
| Bonvin et al. [69] Switzerland |
Cluster-randomized controlled trial INT and CON: 29 childcare centers each |
Young children aged 2–4 years | Childcare centers INT: n = 313 (3.4 ± 0.6) CON: n = 335 (3.3 ± 0.6) |
FMS: adapted ZNA (totFMS) PA: accelerometer BC: height, weight, BMI Data collection: 0, 9 months |
Duration: 9 months INT: 5 workshops for educators providing education in PA; promoting PA to parents via childcare educators; flyers; documentation and support at childcare center through coordinator; focus groups every 2 months; financial support for childcare centers to design activity-friendly spaces CON: regular preschool program |
FMS: INT ≈ CON PA: INT ≈ CON BC: INT ≈ CON |
| Delic [37] Greece |
Controlled trial INT1, INT2 and CON: 1 class each, created out of the study participants |
Kindergarten children | Preschool center INT1: n = 25 (5.4 ± 0.5) INT2: n = 25 (5.5 ± 0.3) CON: n = 25 (5.4 ± 0.6) |
FMS: TGMD PA: none BC: none Data collection: 0, 10 weeks |
Duration: 10 weeks INT1: 35 min structured movement lessons 2/week; lessons in week 1–4 including exercises for body/space awareness, lessons in week 5–10 including locomotor skills INT2: 35 min structured music and movement lessons 2/week focusing on percussion, reaction and creative movements; lessons in week 1–4 including exercises for body/space awareness and for determining personal rhythm, lessons in week 5–7 focusing on movement synchronization to external rhythms, and lessons in week 8–10 combining rhythm and fundamental locomotor skills CON: free-play activities |
FMS: INT > CON PA: none BC: none |
| Derri et al. [70] Greece |
Randomized controlled trial INT and CON: 1 group each, created out of the study participants |
Preschool children | No information about setting INT: n = 35 (N/A) CON: n = 33 (N/A) INT and CON: (5.4 ± 0.6) |
FMS: TGMD (LMS) PA: none BC: none Data collection: 0, 10 weeks |
Duration: 10 weeks INT: 35–40 min structured music and movement lessons 2/week; lessons including body/space awareness, reaction, percussion movements and improvisation skills, and combining rhythm and fundamental locomotor skills CON: 30–40 min free-play activities 2/week |
FMS: galloping, leaping, horizontal jump, skipping INT > CON; remaining tests INT ≈ CON PA: none BC: none |
| Donath et al.c [38] Switzerland |
Cluster-randomized controlled trial INT and CON: 3 kindergartens each |
Kindergarten children | Kindergartens INT: n = 22 (4.4 ± 1.0) CON: n = 19 (4.4 ± 1.2) |
FMS: TGMD-2 (OCS) PA: none BC: height, weight, BMI Data collection: 0, 6 weeks |
Duration: 6 weeks INT: 30 min structured training sessions 2/week; lessons including object control exercises CON: instructed and supervised training 2/week for playing activities by inexperienced instructor; no changes of daily physical and sportive activities |
FMS: total sum score, stationary dribbling INT > CON; remaining tests INT ≈ CON PA: none BC: INT ≈ CON |
| Goodway and Branta [60] United States |
Clustered controlled trial INT and CON: 2 preschool classes each |
Disadvantaged preschool children | Preschool classes INT: n = 31 (4.7 ± 0.3) CON: n = 28 (4.7 ± 0.3) |
FMS: TGMD (OCS, LMS) PA: none BC: none Data collection: 0, 13 weeks |
Duration: 12 weeks INT: 45 min instructional lessons 2/week; lessons including sustained activity (10 min), skill instruction (3 × 10 min), and emphasizing key components of those skills (3 min) CON: typical preschool program including free play time |
FMS: INT > CON PA: none BC: none |
| Goodway et al. [61] United States |
Cluster-controlled trial INT and CON: 2 pre-kindergarten classes each |
Pre-kindergarten children at risk for DD | Pre-kindergarten INT: n = 33 (4.9 ± 0.4) CON: n = 30 (5.0 ± 0.4) |
FMS: TGMD (OSC, LMS) PA: none BC: none Data collection: 0, 9 weeks |
Duration: 9 weeks INT: 35 min instructional sessions 2/week; 3 × 10-min periods of skill instruction, using developmentally and instructionally appropriate practice CON: typical pre-kindergarten curriculum |
FMS: INT > CON PA: none BC: none |
| Hamilton et al. [39] United States |
Clustered controlled trial INT: 3 preschool classes CON: 2 preschool classes |
Preschool children at risk for DD | Preschool classes INT: n = 15 (3.9 ± 0.2) CON: n = 12 (4.0 ± 0.3) |
FMS: TGMD (OCS) PA: none BC: none Data collection: 0, 8 weeks |
Duration: 8 weeks INT: 45 min parent-assisted instructional lessons 2/week; lessons including a minimum of 2 of the 5 object control skills, presented by parents at the center; parent instruction prior to each lesson (15 min); parent orientation meetings previous to study begin (2 × 45 min) CON: regular activity program including movement songs and activities with parents, and opportunities for movement exploration 2/week for 45 min |
FMS: INT > CON PA: none BC: none |
| Hardy et al. [40] Australia |
Cluster-randomized controlled trial INT: 15 preschools CON: 14 preschools |
Preschool-aged children | Preschools and long-day care centers INT: n = 263 (4.4 ± 0.5) CON: n = 167 (4.5 ± 0.3) |
FMS: TGMD-2 (totFMS, OCS, LMS) PA: none BC: none Data collection: 0, 20 weeks |
Duration: 20 weeks INT: 1-day professional workshop for preschool staff (incorporating healthy eating and PA into education program; structural and organizational changes in preschools); resources for preschools (manual; small grant for purchasing activity equipment or support staff to attend training); contact with health promotion professionals CON: preschools provided with written information on sun and road safety |
FMS: INT ≈ CON PA: none BC: none |
| Hashemi et al. [74] Iran |
Controlled trial INT and CON: no information about allocation |
Preschool girls from non-affluent families without post-graduate education | Kindergartens INT: n = 30 (5.1 ± 0.0) CON: n = 30 (5.0 ± 0.1) |
FMS: TGMD-2 (OCS) PA: none BC: height, weight Data collection: 0, 6 weeks |
Duration: 6 weeks INT: 45 min structured lessons 3/week; lessons including warm-up, selected games (i.e. ball dodging), and cool-down CON: regular daily activity |
FMS: INT > CON PA: none BC: none |
| Hurmeric [51] United States |
Cluster-randomized controlled trial INT1 and INT2: 3 mixed classes from 1 center CON: 1 group from another center |
Preschool children | Head Start centers INT1: n = 22 (4.0 ± 0.5) INT2: n = 25 (4.1 ± 0.5) CON: n = 25 (4.0 ± 0.6) |
FMS: TGMD-2 (OCS) PA: none BC: height, weight, BMI, grip strength, body fat Data collection: 0, 8 weeks; follow-up at 12 weeks |
Duration: 8 weeks INT1: 30 min structured movement lessons 2/week; lessons including warm-up, instructions for two object control skills (2 × 12 min), and closure activities INT2: same intervention as INT1; additional 10–15 min movement lesson at home conducted by primary caregiver with lesson plan, instructions and standardized equipment provided; workshop prior to intervention CON: regular Head Start curriculum, including outdoor and large muscle activities |
FMS: INT1 ≈ INT2 > CON PA: none BC: none |
| Ignico [41] United States |
Clustered controlled trial INT and CON: 1 kindergarten class each |
Kindergarten children | Elementary school INT: n = 15 (N/A) CON: n = 15 (N/A) |
FMS: TGMD (totFMS) PA: none BC: none Data collection: 0, 10 weeks |
Duration: 10 weeks INT: 28 min structured training sessions 5/week; lessons including 3 stations CON: regular activities, including 20–25 min free play time |
FMS: INT > CON PA: none BC: none |
| Iivonen et al. [54] Finland |
Clustered controlled trial INT and CON: 2 classes from 2 preschools each Distinction of sex |
Preschool children | Preschools INT: n = 39 (N/A) CON: n = 35 (N/A) INT and CON: (4.6 ± 0.1) |
FMS: adapted APM Inventory (OCS) PA: none BC: none Data collection: 0, 4, 8 months, Follow-up at 11 months |
Duration: 8 months INT: 45 min physical education lessons 2/week; lessons according to the Physical Education Curriculum (PEC) of the Early Steps Project [119] CON: 60 min unstructured physical education lesson 1/week |
FMS: INT ≈ CON PA: none BC: none |
| Jones et al. [75] Australia |
Cluster-randomized controlled trial INT and CON: 1 class from 1 childcare center each |
Preschool children | Childcare centers INT: n = 52 (N/A) CON: n = 45 (N/A) INT and CON: (4.1 ± N/A) |
FMS: TGMD-2 (totFMS) PA: accelerometer BC: height, weight, BMI Data collection: 0, 20 weeks |
Duration: 20 weeks INT: 20 min structured PA lessons 3/week; lessons focusing on one motor competency each week; theoretical and practical workshops (4 × 30 min) for the staff; specific equipment provided to childcare CON: usual program, including designated time outside for free play |
FMS: INT > CON PA: INT > CON BC: none |
| Kelly et al. [42] United States |
Clustered controlled trial INT: 2 groups from 1 preschool CON: 1 group from another preschool |
Preschool children | Motor Development Clinic (INT), Preschool (CON) INT: n = 21 (4.4 ± 0.7) CON: n = 26 (4.2 ± 0.7) |
FMS: MEAP Test PA: none BC: none Data collection: 0, 6, 12 weeks |
Duration: 12 weeks INT: 50 min physical education instruction 2/week; lessons including free play (5 min), introductory activities (8 min), instructional activities (30 min) and summary activities (7 min) CON: daily periods of supervised free play on well-equipped playground; no formal instruction in physical education |
FMS: INT ≈ CON PA: none BC: none |
| Krombholzc [43] Germany |
Clustered controlled trial INT and CON: 11 childcare centers each |
Preschool children | Childcare centers INT: n = 211 (4.6 ± 0.6) CON: n = 217 (4.5 ± 0.7) |
FMS: MoTB 3–7 (totFMS) PA: none BC: height, weight, BMI, body fat Data collection: 0, 11, 20 months |
Duration: 20 months INT: 45 min physical education session 1/week; Additional 20 min PA on the other days; lesson contents free to choose; raise awareness and train competency of educators CON: usual curriculum, including 45 min physical education session 1/week |
FMS: INT ≈ CON PA: none BC: INT ≈ CON |
| Piek et al.c [44] Australia |
Cluster-randomized controlled trial INT and CON: 6 schools each |
Young children aged 4–6 years from low socioeconomic area | Primary schools INT: n = 254 (N/A) CON: n = 196 (N/A) INT and CON: (5.4 ± 0.3) |
FMS: BOT-2SF, MABC-2 (totFMS) PA: none BC: height, weight, BMI (z-score), waist circumference Data collection: 0, 6 months; follow-up at 18 months |
Duration: 6 months INT: 30 min PA lessons 4/week; lessons including different modules of the Animal Fun Program (body management, locomotion, object control, etc.); 1-day training course for teachers prior to intervention CON: normal curriculum |
FMS: INT ≈ CON PA: none BC: none |
| Puder et al. [71] Switzerland |
Cluster-randomized controlled trial INT and CON: 20 preschool classes each from a total of 30 preschools in 2 different country regions |
Preschool children from an area with high proportion of migrants | Preschool INT: n = 342 (5.2 ± 0.6) CON: n = 310 (5.2 ± 0.6) |
FMS: shuttle run (20 m), obstacle course, balance beam and platform PA: accelerometer BC: height, weight, BMI, body fat, waist circumference Data collection: 0, 9 months |
Duration: 9 months INT: 45 min PA lessons 4/week; lessons including mainly aerobic exercises in/around the school and in the gym; home material; nutritional intervention CON: regular school curriculum, including 45 min PA in the gym 1/week in both regions, and another 45 min rhythmic lesson in the other region |
FMS: shuttle run, obstacle course INT > CON; remaining tests INT ≈ CON PA: INT > CON BC: body fat, waist circumference INT < CON; remaining tests INT ≈ CON |
| Reilly et al. [45] Scotland |
Cluster-randomized controlled trial INT and CON: 18 nurseries each |
Young children | Nurseries INT: n = 268 (4.2 ± 0.3) CON: n = 277 (4.1 ± 0.3) |
FMS: MABC (totFMS) PA: accelerometer BC: height, weight, BMI (SD score) Data collection: 0, 6 months; follow-up at 12 months |
Duration: 24 weeks INT: 30 min PA lessons 3/week; lessons intending to increase PA levels of children and meet the requirements of the ‘physical development and movement’ component of the nursery curriculum of Scotland; training sessions for nurses (3×); resource pack of materials for home based intervention (health education leaflets); posters displayed at nurseries for 6 weeks CON: usual curriculum, with the head teachers agreeing not to enhance physical development and movement curriculum |
FMS: INT > CON PA: moderate-vigorous INT > CON; remaining measures INT ≈ CON BC: INT ≈ CON |
| Robinson and Goodway [55] United States |
Cluster-controlled trial INT: 1 Head Start center CON: 1 Head Start center |
Preschool children at risk for DD | Head Start centers: INT1/2: n = 77 (3.9 ± 0.6) CON: n = 40 (4.0 ± 0.4) |
FMS: TGMD-2 (OCS) PA: none BC: none Data collection: 0, 9 weeks; follow-up at 9 weeks |
Duration: 9 weeks INT: 30 min motor skill intervention 2/week ‘low autonomy’ (INT1) or ‘mastery motivational climate’ (INT2); warm-up activity (2–3 min), motor skill instruction for OC skills (24 min), closure activity (2–3 min), typical Head Start curriculum; +30 min unstructured recess 2/week CON: typical Head Start curriculum; 30 min unstructured recess 2/week |
FMS: INT(INT1/2) > CON PA: none BC: none |
| Roth et al. [72] Germany |
Cluster-randomized controlled trial INT: 21 preschools CON: 20 preschools |
Preschool children | Preschools INT: n = 368 (4.7 ± 0.6 CON: n = 341 (4.7 ± 0.5) |
FMS: Single items (obstacle course, standing long jump, balancing on one foot, jumping to and fro sideways) − composite z-score (totFMS) PA: accelerometer BC: height, weight, BMI (z-score), blood pressure, body fat Data collection: 0, 6, 11 months; follow-up at 13–15 months |
Duration: 11 months INT: 30 min PA lessons 5/week; lessons including exercises to enhance coordinative skills and perception; manual, collection of games, and exercises for preschools; PA homework cards 1 or 2/week; letters comprising games/exercises for holidays CON: routine schedule, including common daily activity and weekly PA class |
FMS: INT > CON, 1-leg stance, standing long jump, lateral jump INT > CON; obstacle course INT ≈ CON PA: INT ≈ CON BC: body fat INT < CON; remaining tests INT ≈ CON |
| Tsapakidou et al. [46] Greece |
Controlled trial INT and CON: 3 kindergartens together |
Children aged 3.5–5 years | Nursery schools INT: n = 49 (N/A) CON: n = 49 (N/A), INT and CON: (3.5–5) |
FMS: TGMD-2 (LMS) PA: none BC: none Data collection: 0, 2 months |
Duration: 2 months INT: 30–40 min physical education lessons 2/week; lessons including exercises to raise body awareness, rhythm, coordinative skills and creativity to develop basic motor skills CON: daily schedule |
FMS: INT > CON PA: none BC: none |
| Valentini [62] United States |
Controlled trial INT and CON: 1 early education center together |
Low motor skill functioning children | Early education center INT: n = 38 (5.1 ± 0.3) CON: n = 29 (5.3 ± 0.5) |
FMS: TGMD (OCS, LMS) PA: none BC: none Data collection: 0, 12 weeks; follow-up at 9 months |
Duration: 12 weeks INT: 35 min motor skill lessons 2/week; lessons including introduction, motor skill instruction and practice (30 min), and closure, according to TARGET structure [120] CON: regular curriculum |
FMS: LMS INT > CON, OCS INT ≈ CON PA: none BC: none |
| Venetsanou and Kambas [73] Greece |
Controlled trial No information about allocation |
Preschool children | Kindergarten INT: n = 28 (N/A) CON: n = 38 (N/A) INT and CON: (5.0 ± 0.5) |
FMS: MOT4-6 (totFMS) PA: none BC: none Data collection: 0, 20 weeks |
Duration: 20 weeks INT: 45 min musical movement lessons 2/week; lessons including percussive movements and rhythmical locomotion (i.e. singing games, playing percussion instruments) CON: regular kindergarten curriculum activities |
FMS: INT > CON PA: none BC: none |
| Vidoni et al. [68] United States |
Cluster-randomized controlled trial INT and CON: 1 class of the same daycare center in each |
Preschool children | Daycare center INT: n = 18 (N/A) CON: n = 15 (N/A) INT and CON: (4.5 ± N/A) |
FMS: BOT-2SF (totFMS) PA: none BC: none Data collection: 0, 11 weeks |
Duration: 11 weeks INT: 30 min structured PA program 5/week; lessons including circuit training and exercises based on the MAZE approach [121] CON: regular day-care center schedule, including 30 min unstructured PA 5/week |
FMS: INT > CON PA: none BC: none |
| Wang [47] Taiwan |
Controlled trial INT and CON: 1 group from the same preschool in each |
Preschool children | Preschool INT: n = 30 (N/A) CON: n = 30 (N/A) INT and CON: (3–5) |
FMS: PDMS-2 PA: none BC: none Data collection: 0, 6 weeks |
Duration: 6 weeks INT: 30 min creative movement lessons 2/week; lessons including exploring, developing and creating different movements in relation to dancing CON: unstructured free play |
FMS: LMS INT > CON; remaining tests INT ≈ CON PA: none BC: none |
| Weiss et al. [48] Germany |
Controlled trial 1 group from the same kindergarten in each |
Kindergarten children | Kindergarten INT: n = 24 (4.7 ± N/A) CON: n = 22 (4.9 ± N/A) |
FMS: MOT4-6 PA: none BC: height, weight, BMI Data collection: 0, 6 months |
Duration: 6 months INT: 60 min back training lessons 1/week; lessons including a variety of games in combination with different material CON: usual kindergarten schedule including regular PA lessons |
FMS: INT > CON PA: none BC: none |
| Yin et al. [52] United States |
Clustered controlled trial INT1: 14 classes in 2 centers INT2: 5 classes in 1 center CON: 6 classes in 1 center |
Preschool-aged children | Head Start centers INT1: n = 179 (4.1 ± 0.6) INT2: n = 80 (4.2 ± 0.5) CON: n = 97 (4.1 ± 0.5) |
FMS: LAP-3 (totFMS) PA: pedometer BC: height, weight, BMI (z-score) Data collection: 0, 18 weeks; Additional 3 mid-study tests |
Duration: 18 weeks INT1: 30–45 min structured and unstructured outdoor lessons 5/week; lessons including gross motor skills teaching and dance instruction; supplemental classroom activities; healthy eating promotion INT2: same intervention as INT1; additional take-home activities, parent obesity education and family support monitoring for healthy eating and PA CON: regular schedule, including unstructured free play on the playground 5/week |
FMS: INT1 > CON, INT2 > CON PA: INT1 > CON, INT2 > CON BC: BMI INT1 ≈ CON, INT2 < CON |
| Zask et al. [49] Australia |
Cluster-randomized controlled trial INT: 18 preschools CON: 13 preschools |
Children aged 3–6 years | Preschools INT: n = 273 (N/A) CON: n = 142 (N/A) INT and CON: (4.6 ± 0.6) |
FMS: TGMD-2 (totFMS, LMS) PA: none BC: height, weight, BMI (z-score), waist circumference Data collection: 0, 10 months |
Duration: 10 months INT: 25–30 min structured FMS development lessons 2/week; lessons including warm-up (5 min), games in groups (15–20 min), and cool-down (5 min); small grant for equipment; playground review to encourage more active behavior; workshops and monthly newsletter for parents; healthy eating intervention CON: regular curriculum |
FMS: INT > CON PA: none BC: BMI, waist circumference INT < CON |
AMP Alle kouluikäisten lasten PsykoMotoriset taidot, BC body composition, BMI body mass index, BOT-2SF Bruininks-Oseretsky test of motor proficiency—version 2 Short Form, CON control group, DD developmental delay, FMS fundamental movement skills, INT intervention group, LAP-3 Learning Achievement Profile 3rd edition, LMS locomotor subscale, MABC-2 Movement assessment battery for children-version 2, MEAP Michigan Educational Assessment Program, MOT4-6 Motorik test for 4- to 6-year-old children, MoTB3-7 motor test battery, N/A not available, OCS object control subscale, PA physical activity, PDMS-2 Peabody Development Motor Scale—2nd edition, SD standard deviation, TGMD-2 Test of Gross Motor Development—2nd edition, totFMS total fundamental movement skill score, ZNA Zurich Neuromotor Assessment
aElectronic Supplementary Material Table S2 gives an overview of all used FMS test batteries within included studies
bFor detailed information see Electronic Supplementary Material Table S5; results depicted are only between groups post-intervention provided from studies; for </>, there is a significant difference; for ≈, there is no significant difference
cNumber of participants and mean age ± SD in years only available for post-test period