I am sure we have all a generally good understanding that exercise is an important aspect of a healthy lifestyle and the improvements commonly associated with exercise. In this article we will look more into less known areas of exercise and how different children may respond to exercise and how to structure exercise programs. This article is more of an introduction to such topics as whole books can be written on each of the individual sections of this article.

Exercise and predilection.

There are generally three types of children's fitness personality, athletic, casually athletic and non-athletic. These categories are not set in stone and can vary from child to child but roughly speaking they help to guide physical activity for different children.

When looking at the three types of fitness personality there should be a multi-modal approach to physical activity planning. For example the athletic children may be involved in a sport and are more likely to be self motivated and ramp up their own intensity in the aims of producing good performances in their sport or chosen activity. They may enjoy the challenge of competing whereas a program of recreational play based exercise may become boring for them depending on their preference for it. Whereas if a non-athletic child were to be pressured into competing to the same degree it is possible that they would become less interested and unhappy and may prefer more fun game based recreational activity to intense structured athletic development programming. These are examples where, although both children could have the same level of athletic development their preferences would allow them to succeed or fail.

Exercise has been shown to enhanced self esteem and physical self-perceptions (1). It is important however to realise that any exercise is preferential to sedentary lifestyles in children. A paper by Biddle and Asare 2011(2) found that in children and adolescents that the more sedentary screen time they had the more likely they would have poorer mental health.

Another consideration when developing exercise programs for children are their chronotypes (morning people or night owls). Putting in place exercise programmes that adhere to their chronotypes may produce better outcomes (3, 4). It is easy enough to see how different chronotypes may influence attention and perceived energy levels. Children that feel more energetic later in the day may struggle getting up earlier to exercise compared to children that are more energetic in the morning however it is important to understand that exercising is still better than being sedentary but thankfully there is plenty of opportunity to plan structured exercise before or after school time or work time if the carer needs to structure around work.

Exercise progression and development.

Short term 

Most people know that exercise is conducive to a healthy lifestyle but particularly in children what improvements can be seen in the short term?

A systematic review by Zeng et al. 2017 (5), found that physical activity had a causal relationship with both motor skills and cognitive development. Meaning that improved motor skills and cognitive development can result from physical activity, these are life long skills that can relate to many aspects of daily living and future athletic development. Particularly motor and timing skills can be developed anytime throughout life however the sooner these are developed the more easily they can be adapted to different movement patterns and in particular future skill development may come more easily to children with better developed motor skills (6).

Motor skills can vary from child to child and in particular different congenital and acquired movement disorders will affect motor skills. Looking at children that don’t have movement disorders researchers have found that overweight/obese children can have lower levels of fundamental movement skill than their healthy weight peers. Thankfully children with movement disorders and overweight children can improve their motor skills with targeted movement skill and motor coordination activities. (7, 8, 9).

Long term 

A systematic review by Donnelly et al. 2016 (10) looking at how exercise and physical activity affected fitness, cognitive function and academic achievement. They found 64 papers for cognition/learning/brain development and 74 papers for academic achievement/concentration. In the papers they analysed they noticed that there was a positive relationship with cognition and brain structure/function and a neutral effect on academic achievement. The authors do note however that academic achievement is multi-modal and influences on studying subjects varies by individual. Considering the positive effect exercise has on brain development and cognition one could argue that exercise could influence academic improvement separate to learning strategies such as tutoring, time spent studying and so on. The authors do note that more research is likely needed to draw more firm conclusions about academic achievement.

If you consider that exercise can improve brain development it is also important to consider children with congenital or acquired neurological deficits that may affect their development. Thankfully again exercise has been shown to be a good choice to help with neuroplasticity (11).

Neuroplasticity is the ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury, meaning that even children with neurological deficits can benefit from targeted exercise programs and physical activity.

Some researchers do recommend continual improvements in cardiovascular fitness so a program of exercise that combines physical and cognitive training might result in concomitant improvement in both aspects of development (12). However parents/carers may be more reluctant to engage cardiovascular exercise for children with respiratory disorders, thankfully with the right measures in place there appears to be a neutral effect of exercise on asthma control. Matsunaga et al. 2017 (13) found that there were no associations between physical activity and asthma control level. Meaning that with pharmacological and non-pharmacological measures in place that even children with respiratory disorders may reep the benefits of an active lifestyle.

A systematic review by Wu et al. 2017(14) found that promotion of active lifestyles can result in improved health-related quality of life. It would appear that starting young may lead to faster increases, often it is better to be proactive than reactive. This finding has been echoed by Rodriguez-Ayllon et al. 2019 (15), they found in their systematic review that exercise may have a protective effect on mental health in children and adolescents.

Structured exercise programs.

The best structured programs are specifically tailored programs for each athlete. Professional coaches are best placed for producing such programs for athletes however if you are wanting to produce your own structured programs at home it can be down following a few simple rules.

• Firstly what is the goals of the exercise program, short, medium and long term?
• What is the athletes preference to exercise? Morning, afternoon or evening? What do they enjoy?
• Are there any factors that may effect their development? g. neurological, congenital, acquired disorders? (asthma, cardiac disorders, orthopeadic).

The easiest model to follow is a linear progression in which one variable is changed at a time. For example a child with motor deficits may respond well to structured exercise that focuses on muscular control exercises or games that gradually increase in difficulty but the volume and intensity variables would remain the same. Once their movement patterns have improved maintain the level of intensity and difficulty of the exercises/game and then possibly increase the volume to ingrain the movement patterns. This is generally consider short term.

Planning the short, medium and long term development is called periodisation.

Short term (microcycle) - Upto a month of planned exercises week by week with the planned outcomes. Improving motor control and volume.

Medium term (mesocycle) - The overall goal of a couple of months of exercise (block) with a particular overall goal. Maintaining motor control and volume with different intensities

Long term (macrocycle) - The yearly plan of the exercise with outcomes over an extended period of time. You may decide for the long term to have set periods where for a few months you work on control, volume and then ultimately intensity in the lead up to a specific date or time.

  By Dr. Michael Perkin

References

11. Lubans D, Richards J, Hillman C, Faulkner G, Beauchamp M, Nilsson M et Physical Activity for Cognitive and Mental Health in Youth: A Systematic Review of Mechanisms. PEDIATRICS. 2016;138(3):e20161642-e20161642.
12. Biddle S, Asare Physical activity and mental health in children and adolescents: a review of reviews. British Journal of Sports Medicine. 2011;45(11):886-895.
13. Vitale J, Weydahl Chronotype, Physical Activity, and Sport Performance: A Systematic Review. Sports Medicine. 2017;47(9):1859-1868.
14. Facer-Childs E, Boiling S, Balanos The effects of time of day and chronotype on cognitive and physical performance in healthy volunteers. Sports Medicine - Open. 2018;4(1).
15. Zeng N, Ayyub M, Sun H, Wen X, Xiang P, Gao Effects of Physical Activity on Motor Skills and Cognitive Development in Early Childhood: A Systematic Review. BioMed Research International. 2017;2017:1-13.
16. Caramiaux B, Bevilacqua F, Wanderley M, Palmer Dissociable effects of practice variability on learning motor and timing skills. PLOS ONE. 2018;13(3):e0193580.
17. Han A, Fu A, Cobley S, Sanders R. Effectiveness of exercise intervention on improving fundamental movement skills and motor coordination in overweight/obese children and adolescents: A systematic Journal of Science and Medicine in Sport. 2018;21(1):89-102.
18. Ketcheson L, Hauck J, Ulrich The effects of an early motor skill intervention on motor skills, levels of physical activity, and socialization in young children with autism spectrum disorder: A pilot study. Autism. 2016;21(4):481-492.
19. Forouzan R, Ghasemi A, Zamani Jam A, Jalali S. Effects of exercise intervention on the perceptual-motor skills in Adolescents with journal of sports medicine and physical fitness. 2017;57(1-2):53-59.
20. Donnelly J, Hillman C, Castelli D, Etnier J, Lee S, Tomporowski P et Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children. Medicine & Science in Sports & Exercise. 2016;48(6):1197-1222.
21. Cassilhas R, Tufik S, de Mello Physical exercise, neuroplasticity, spatial learning and memory. Cellular and Molecular Life Sciences. 2015;73(5):975-983.
22. Hötting K, Röder Beneficial effects of physical exercise on neuroplasticity and cognition. Neuroscience & Biobehavioral Reviews. 2013;37(9):2243-2257.
23. Matsunaga N, Oliveira M, Morcillo A, Ribeiro J, Ribeiro M, Toro Physical activity and asthma control level in children and adolescents. Respirology. 2017;22(8):1643-1648.
24. Wu X, Han L, Zhang J, Luo S, Hu J, Sun The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review. PLOS ONE. 2017;12(11):e0187668.
25. Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, Muñoz N, Mora-Gonzalez J, Migueles J et al. Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Medicine. 2019;49(9):1383-1410.