title: Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of a school based physical activity programme during one school year on physical and psychological health in young schoolchildren.
  
  
  METHODS
  Cluster randomised controlled trial.
  
  
  METHODS
  28 classes from 15 elementary schools in Switzerland randomly selected and assigned in a 4:3 ratio to an intervention (n=16) or control arm (n=12) after stratification for grade (first and fifth grade), from August 2005 to June 2006.
  
  
  METHODS
  540 children, of whom 502 consented and presented at baseline.
  
  
  METHODS
  Children in the intervention arm (n=297) received a multi-component physical activity programme that included structuring the three existing physical education lessons each week and adding two additional lessons a week, daily short activity breaks, and physical activity homework. Children (n=205) and parents in the control group were not informed of an intervention group. For most outcome measures, the assessors were blinded.
  
  
  METHODS
  Primary outcome measures included body fat (sum of four skinfolds), aerobic fitness (shuttle run test), physical activity (accelerometry), and quality of life (questionnaires). Secondary outcome measures included body mass index and cardiovascular risk score (average z score of waist circumference, mean blood pressure, blood glucose, inverted high density lipoprotein cholesterol, and triglycerides).
  
  
  RESULTS
  498 children completed the baseline and follow-up assessments (mean age 6.9 (SD 0.3) years for first grade, 11.1 (0.5) years for fifth grade). After adjustment for grade, sex, baseline values, and clustering within classes, children in the intervention arm compared with controls showed more negative changes in the z score of the sum of four skinfolds (-0.12, 95 % confidence interval -0.21 to -0.03; P=0.009). Likewise, their z scores for aerobic fitness increased more favourably (0.17, 0.01 to 0.32; P=0.04), as did those for moderate-vigorous physical activity in school (1.19, 0.78 to 1.60; P<0.001), all day moderate-vigorous physical activity (0.44, 0.05 to 0.82; P=0.03), and total physical activity in school (0.92, 0.35 to 1.50; P=0.003). Z scores for overall daily physical activity (0.21, -0.21 to 0.63) and physical quality of life (0.42, -1.23 to 2.06) as well as psychological quality of life (0.59, -0.85 to 2.03) did not change significantly.
  
  
  CONCLUSIONS
  A school based multi-component physical activity intervention including compulsory elements improved physical activity and fitness and reduced adiposity in children. Trial registration Current Controlled Trials ISRCTN15360785.
authors.affiliation: Institute of Exercise and Health Sciences, University of Basel, 4052 Basel, Switzerland. susi.kriemler@unibas.ch
authors.forename: Susi
authors.initials: S
authors.lastname: Kriemler
authors.forename: Lukas
authors.initials: L
authors.lastname: Zahner
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Ursina
authors.initials: U
authors.lastname: Meyer
authors.forename: Tim
authors.initials: T
authors.lastname: Hartmann
authors.forename: Helge
authors.initials: H
authors.lastname: Hebestreit
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Brunner-La Rocca
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Jardena J
authors.initials: JJ
authors.lastname: Puder
mesh_terms: D050154:Adiposity / Q000502:physiology*; D002648:Child; D016000:Cluster Analysis; D005081:Exercise Therapy / Q000379:methods*; D006304:Health Status; D006801:Humans; D008603:Mental Health; D009765:Obesity / Q000517:prevention & control*; D010809:Physical Fitness / Q000502:physiology*; D012572:School Health Services; D016896:Treatment Outcome