title: Physical activity intervention (Movi-Kids) on improving academic achievement and adiposity in preschoolers with or without attention deficit hyperactivity disorder: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  The prevention of obesity and improvement of academic achievement in children are concerns of industrialized societies. Obesity has been associated with psychological disorders, including attention deficit hyperactivity disorder, whose prevalence has been estimated at 6.8 % in Spanish children and adolescents. It is known that physical activity is positively related to academic achievement and negatively related to the risk of obesity in children. However, studies to test the effectiveness of physical activity interventions in improving academic achievement in preschool children are scarce and have some weaknesses that threaten their validity. Moreover, very few studies have examined their effectiveness in improving symptoms of attention deficit hyperactivity disorder. This paper outlines a two-year multidimensional preschool intervention (Movi-Kids) aimed at preventing obesity and improving academic achievement in children with or without attention deficit hyperactivity disorder.
  
  
  METHODS
  Twenty-one schools from Ciudad Real and Cuenca, Spain, were randomized to intervention and control groups. In the first academic year, children in the third grade of preschool and the first grade of primary school in the intervention group received the Movi-Kids intervention. In the second academic year, schools were crossed over to the other group. The intervention included children, parents and teachers, and the school environment, and consisted of: (i) three hour-long sessions of recreational non-competitive physical activity after school, weekly, (ii) educational materials for parents and teachers addressing sedentary lifestyle risks and (iii) playground modifications to promote physical activity during breaks. Primary outcome measures of this study were academic achievement (intelligence, cognition, memory, attention and perception), assessed by the Battery of General and Differential Aptitudes, and adiposity measures (body mass index, waist circumference, triceps skinfold thickness and body fat percentage). Secondary outcome measures were: attention deficit hyperactivity disorder risk, motor skills, health-related quality of life and sleep quality. These variables will all be measured in both groups at baseline and at the end of the first and second academic years.
  
  
  CONCLUSIONS
  It seems reasonable that an intervention to promote physical activity based on playground games will be useful for simultaneously improving academic achievement and controlling obesity.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01971827 .
authors.affiliation: Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n, 16071, Cuenca, Spain. Mairena.Sanchez@uclm.es.|Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain. Mairena.Sanchez@uclm.es.
authors.forename: Mairena
authors.initials: M
authors.lastname: Sánchez-López
authors.affiliation: Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n, 16071, Cuenca, Spain. MariaJesus.Pardo@uclm.es.|Faculty of Education, Universidad de Castilla-La Mancha, Cuenca, Spain. MariaJesus.Pardo@uclm.es.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Pardo-Guijarro
authors.affiliation: Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain. David.Gutierrez@uclm.es.
authors.forename: David Gutiérrez-Díaz
authors.initials: DG
authors.lastname: Del Campo
authors.affiliation: Faculty of Sport, Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal. perrinha@gmail.com.
authors.forename: Pedro
authors.initials: P
authors.lastname: Silva
authors.affiliation: Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n, 16071, Cuenca, Spain. Maria.MartinezAndres@uclm.es.
authors.forename: Maria
authors.initials: M
authors.lastname: Martínez-Andrés
authors.affiliation: Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain. Roberto.Gulias@uclm.es.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gulías-González
authors.affiliation: Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n, 16071, Cuenca, Spain. Ana.Diez@uclm.es.|Faculty of Occupational Therapy, Speech Therapy and Nursing, University of Castilla-La Mancha, Talavera de la Reina, Spain. Ana.Diez@uclm.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Díez-Fernández
authors.affiliation: Emergency Department, Hospital Virgen de la Luz, Cuenca, Spain. pfranquelo@yahoo.es.
authors.forename: Pablo
authors.initials: P
authors.lastname: Franquelo-Morales
authors.affiliation: Health and Social Research Centre, Universidad de Castilla-La Mancha, Edificio Melchor Cano, C/ Teresa Jornet s/n, 16071, Cuenca, Spain. Vicente.Martinez@uclm.es.|Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile. Vicente.Martinez@uclm.es.
authors.forename: Vicente
authors.initials: V
authors.lastname: Martínez-Vizcaíno
mesh_terms: D050154:Adiposity; D000367:Age Factors; D000886:Anthropometry; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003071:Cognition; D018592:Cross-Over Studies; D061345:Early Medical Intervention / Q000379:methods*; D004521:Educational Measurement; D004522:Educational Status; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007360:Intelligence; D008297:Male; D008568:Memory; D009043:Motor Activity; D009483:Neuropsychological Tests; D063766:Pediatric Obesity / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control* / Q000523:psychology; D010465:Perception; D010988:Play and Playthings; D012107:Research Design; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome