title: Cybercycling Effects on Classroom Behavior in Children With Behavioral Health Disorders: An RCT.
abstract: OBJECTIVE
  Exercise is linked with improved cognition and behavior in children in clinical and experimental settings. This translational study examined if an aerobic cybercycling intervention integrated into physical education (PE) resulted in improvements in behavioral self-regulation and classroom functioning among children with mental health disabilities attending a therapeutic day school.
  
  
  METHODS
  Using a 14-week crossover design, students (N = 103) were randomly assigned by classroom (k = 14) to receive the 7-week aerobic cybercycling PE curriculum during fall 2014 or spring 2015. During the intervention, children used the bikes 2 times per week during 30- to 40-minute PE classes. During the control period, children participated in standard nonaerobic PE. Mixed effects logistic regression was used to assess relationships between intervention exposures and clinical thresholds of behavioral outcomes, accounting for both individual and classroom random effects.
  
  
  RESULTS
  Children experienced 32% to 51% lower odds of poor self-regulation and learning-inhibiting disciplinary time out of class when participating in the intervention; this result is both clinically and statistically significant. Effects were appreciably more pronounced on days that children participated in the aerobic exercise, but carryover effects were also observed.
  
  
  CONCLUSIONS
  Aerobic cybercycling PE shows promise for improving self-regulation and classroom functioning among children with complex behavioral health disorders. This school-based exercise intervention may significantly improve child behavioral health without increasing parental burden or health care costs, or disrupting academic schedules.
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|Department of Health Sciences, Merrimack College, North Andover, Massachusetts.
authors.forename: April
authors.initials: A
authors.lastname: Bowling
authors.affiliation: Judge Baker Children's Center, Boston, Massachusetts.
authors.forename: James
authors.initials: J
authors.lastname: Slavet
authors.affiliation: Boston University School of Social Work, Boston, Massachusetts; and.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Miller
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Haneuse
authors.affiliation: Judge Baker Children's Center, Boston, Massachusetts.|Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: William
authors.initials: W
authors.lastname: Beardslee
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Davison
mesh_terms: D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000523:psychology* / Q000628:therapy*; D018592:Cross-Over Studies; D003479:Curriculum; D003631:Day Care, Medical; D015444:Exercise; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000523:psychology* / Q000628:therapy*; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D010806:Physical Education and Training; D000068356:Self-Control / Q000523:psychology; D057170:Translational Research, Biomedical; D014584:User-Computer Interface