Effects of flexible learning spaces, active breaks, and active lessons on sedentary behaviors, physical activity, learning, and musculoskeletal health in school-aged children: a scoping review

BACKGROUND: Children aged 6 to 17 spend long periods of sitting at school. Reducing these behaviors and increasing physical activity has been linked to improvements in cognitive functions and decreased musculoskeletal issues. The purpose of this scoping review was to describe interventions implementing flexible learning spaces, active breaks, and active lessons and their effects on sedentary behaviors as well as on physical activity, learning, and musculoskeletal health. METHODS: A search on databases (EDUCATION SOURCE, ERIC, SPORTDISCUS, MEDLINE, EMBASE, and WEB OF SCIENCE) was carried out in April 2021 and updated in June 2022 according to the guidelines of the "PRISMA-ScR". Studies on flexible learning spaces and physical activity in elementary and secondary school classes were retained. These also had to measure the effects of the interventions on sedentary behaviors, physical activity, learning (e.g., academic achievement), and musculoskeletal health outcomes. RESULTS: Ninety-two articles were identified; twenty-four from the initial screening, thirty-two from the update, and thirty-six were manually included. Among these 92 articles, twenty-one studies used only flexible learning spaces, twenty-three used only active breaks, thirty-six used only active lessons, four used both flexible learning spaces and active breaks separately in different classes, five combined active breaks and active lessons, and three combined flexible learning spaces and active breaks. Analyses show positive changes in sedentary behaviors (32 articles/40) and physical activity (52 articles/74) including sitting time, sit-to-stand transitions, number of steps, and moderate-to-vigorous physical activity. Positive effects were also observed on learning (13 articles/26) or musculoskeletal health outcomes (3 articles/8). Although many studies found no effect of these interventions, no studies report harmful interventions on these variables. The most effective strategy to reduce sedentary behaviors seems to be flexible learning spaces with adapted teaching approaches. CONCLUSIONS: Results indicate that flexible learning spaces, active breaks, and active lessons effectively reduce sedentary behaviors and increase physical activity without negatively influencing academic achievement. Further studies are needed to understand better the effects of combining these interventions and their effects on children's learning and musculoskeletal health outcomes.

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