G Model

JSAMS-1251; No. of Pages 5 ARTICLE IN PRESS

Journal of Science and Medicine in Sport xxx (2015) xxx–xxx

Contents lists available at ScienceDirect

Journal of Science and Medicine in Sport

journal homepage: www.elsevier.com/locate/jsams

Original research

Effects of one versus two bouts of moderate intensity physical activity

on selective attention during a school morning in Dutch primary
schoolchildren: A randomized controlled trial
Teatske M. Altenburg ∗ , Mai J.M. Chinapaw, Amika S. Singh
Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands

a r t i c l e i n f o a b s t r a c t

Article history: Objectives: Evidence suggests that physical activity is positively related to several aspects of cognitive
Received 20 November 2014 functioning in children, among which is selective attention. To date, no information is available on the
Received in revised form 16 October 2015 optimal frequency of physical activity on cognitive functioning in children. The current study examined
Accepted 6 December 2015
the acute effects of one and two bouts of moderate-intensity physical activity on children’s selective
Available online xxx
attention.
Design: Randomized controlled trial (ISRCTN97975679).
Keywords:
Methods: Thirty boys and twenty-six girls, aged 10–13 years, were randomly assigned to three conditions:
Cognition
Child
(A) sitting all morning working on simulated school tasks; (B) one 20-min physical activity bout after
Adolescent 90 min; and (C) two 20-min physical activity bouts, i.e. at the start and after 90 min. Selective attention
School was assessed at five time points during the morning (i.e. at baseline and after 20, 110, 130 and 220 min),
Exercise using the ‘Sky Search’ subtest of the ‘Test of Selective Attention in Children’. We used GEE analysis to
Physical activity examine differences in Sky Search scores between the three experimental conditions, adjusting for school,
baseline scores, self-reported screen time and time spent in sports.
Results: Children who performed two 20-min bouts of moderate-intensity physical activity had signif-
icantly better Sky Search scores compared to children who performed one physical activity bout or
remained seated the whole morning (B = −0.26; 95% CI = [−0.52; −0.00]).
Conclusions: Our findings support the importance of repeated physical activity during the school day for
beneficial effects on selective attention in children.
© 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

1. Introduction
Recently, a systematic review found evidence for a positive
longitudinal relationship between physical activity and academic
performance in children.1 To understand the exploratory mecha-
nisms underlying this relationship, it is important to assess which
specific cognitive functions (e.g. executive function, information
processing, memory) contribute to improved academic perfor-
mance, and the type, duration, intensity and frequency of physical
activity that is required to bring about this effect.
A meta-analysis on the acute effects of physical activity found a
small positive effect on cognitive performance in children (d = 0.17),
with larger effects on tasks categorized as measures of attention,
crystallized intelligence and executive function.2 Executive func-
tions consist of a variety of cognitive processes required to maintain
∗ Corresponding author.
E-mail address: t.altenburg@vumc.nl (T.M. Altenburg).
conscious control of thought and action,3 and can be classified into
inhibition control, working memory, set-shifting, cognitive flexibil-
ity, contextual memory and planning.4 A meta-analysis focusing on
these different domains of executive functions found a moderate
effect of acute physical activity on inhibition/interference control
(i.e. suppression of actions and resistance to interference from
irrelevant stimuli) in children (d = 0.57) and adolescents (d = 0.52).5
No studies on the other domains in children/adolescents were
included.5 Only a few studies included in these meta-analyses were
conducted among children and adolescents (n = 9 in Chang et al.2
and n = 4 in Verburgh et al.5 ).
The acute physical activity bouts performed in the studies
included in Verburgh et al.5 consisted of a 20-min bout of moderate-
intensity aerobic activity6,7 or a 10-min bout of coordinative
activity (e.g. exercises stressing different bilateral coordinative
abilities such as to balance, to react, to adjust and to differentiate).8
Similarly, recent studies demonstrated that an acute bout of 20-
min moderate intensity treadmill walking enhanced children’s
inhibitory control, when compared to seated rest.9,10 Additionally,

http://dx.doi.org/10.1016/j.jsams.2015.12.003
1440-2440/© 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Please cite this article in press as: Altenburg TM, et al. Effects of one versus two bouts of moderate intensity physical activity on
selective attention during a school morning in Dutch primary schoolchildren: A randomized controlled trial. J Sci Med Sport (2015),
http://dx.doi.org/10.1016/j.jsams.2015.12.003
G Model
JSAMS-1251; No. of Pages 5 ARTICLE IN PRESS
2 T.M. Altenburg et al. / Journal of Science and Medicine in Sport xxx (2015) xxx–xxx
an acute bout of 12-min indoor running at 70–80% of maximal
heart rate enhanced children’s selective attention (i.e. suppres-
sion of actions from irrelevant stimuli and enhancement of actions
from relevant stimuli), when compared to 12 min of educational
TV viewing.11 Yet a recent systematic review concluded weak evi-
dence for the effects of acute bouts of physical activity on children’s
attention.12 As included studies varied largely in type (e.g. aero-
bic, coordinative) and duration (10–45 min) of the physical activity
bouts, no current evidence exists on the most favourable activity
type and duration.12
The studies mentioned examined the acute effects of a single
bout of physical activity. To date, no information is available on
the optimal frequency of physical activity bouts enhancing execu-
tive functions in children. In the present study we examined the
effects of acute effects of a single and repeated 20-min moder-
ate intensity physical activity bout on selective attention, e.g. the
capacity to improve the processing of particular target character-
istics regardless of spatial location,13 during a school morning in
children. Moderate intensity physical activity bouts were imple-
mented at the start and halfway a morning. We hypothesized that
both one as well as two bouts of moderate-intensity physical activ-
ity would enhance children’s selective attention, with larger effects
for repeated bouts, when compared to sitting the whole morning.
2. Methods
A convenient sample of thirty-three boys and twenty-nine girls,
aged 10–13 years, participated in this study. Children were selected
via various contacts of the research staff and originated from five
schools (from one class per school) in the province of Noord Hol-
land, The Netherlands. Inclusion criteria were (1) aged between
10 and 13 years, (2) apparently healthy and (3) Dutch speaking.
Children were requested to refrain from any moderate-to-vigorous
physical activity (MVPA) for at least 3 days prior to the experi-
ment. Moreover, we asked children and their parents to avoid active
transport and arrive after an overnight fast at school the morning
of the experiment. All children received a standardized breakfast,
snack and lunch to minimize effects of food intake on cognitive
functioning.14
This study included three experimental conditions and was per-
formed during a morning in the school setting. Data collection took
place from June until November 2013. At each school children were
randomly assigned to the following experimental conditions, using
a pre-determined computer-generated block randomization list,
with blocks of 8 children per group per measurement day, up to a
maximum of 20 children per group: (A) no physical activity (i.e. sit-
ting all morning working on simulated school tasks, control group);
(B) one 20-min physical activity bout halfway the morning; and (C)
two 20-min physical activity bouts, i.e. at the start and halfway
the morning. Selective attention was measured at different time
points during the morning (see Supplementary Fig. 1). The study
was approved by the Medical Ethics Committee of the VU Univer-
sity Medical Center in Amsterdam (2013/093), the Netherlands, and
was in accordance with the Declaration of Helsinki.
Children arrived at school around 8 A.M. First, anthropometrics
(all groups) and resting heart rate (groups B and C) were assessed.
Thereafter, children consumed breakfast. Subsequently, all children
completed the cognitive test three times (i.e. pre-testing) to reduce
possible learning effects. After completing the pre-testing cognitive
tests, children in group A remained seated all morning. Children in
group B had an active break of 20 min after 90 min of sitting and
remained seated during the rest of the morning. Children in group
C started the morning with a 20-min physical activity bout, had an
active break after 90 min of sitting and remained seated during the
rest of the morning. During the seating hours, children performed
Please cite this article in press as: Altenburg TM, et al. Effects of one versus two bouts of moderate intensity physical activity on
selective attention during a school morning in Dutch primary schoolchildren: A randomized controlled trial. J Sci Med Sport (2015),
http://dx.doi.org/10.1016/j.jsams.2015.12.003
simulated school tasks. Selective attention was measured at base-
line (T0), after 20 min (T1; i.e. after the first physical activity bout
in group C), 110 min (T2; i.e. before the second bout in group C),
130 min (T3; i.e. after the second physical activity bout in group
C) and at the end of the morning (T4; i.e. after 220 min). Supervis-
ing research staff (i.e. minimal one supervisors per three children)
was present during the whole experiment ensuring standardized
procedures.
The physical activity bout consisted of a 20 min aerobic workout
at moderate intensity, comprising video-based dance activities. In
this workout children attempted to mimic the moves that were dis-
played on a screen, under supervision of the research staff. Workout
intensity was determined using the Karvonen formula.15 According
to this formula, target heart rate (HR) was determined via the HR
reserve (HRR) by using the formula: target HR = {[%HRR/(maximum
HR − resting HR)}. Maximum HR was predicted by the formula:
[208 − (0.7 × age)], which closely predicts mean maximal HR in
children.16 Resting HR was obtained after children had been sit-
ting for 10 min. Moderate intensity was defined as 40–60% HRR.17
To check their HR during the activity bouts, children in group B
and C wore a HR monitor (Polar and Suunto). Research staff reg-
ularly checked children’s heart rate as a guide of actual intensity,
and encouraged them to increase their intensity when their heart
rate fell below the moderate intensity level.
Selective attention was measured by the ‘Sky Search’ subtest of
the ‘Test of Selective Attention in Children’ (TEA-Ch).13 In short,
children had to detect 20 pairs of identical spacecrafts, distributed
among 108 distractors, as quickly as possible. To account for differ-
ences in motor speed, children completed a motor control version
of the ‘Sky Search’ test, in which all distractors were removed. For
each part of the test, children were asked to record and register
the time they needed to complete the task, using a stopwatch. The
research staff made sure time measurement was done correctly and
counted the correctly detected pairs of identical spacecrafts. Two
different versions of the Sky Search test were randomly assigned to
the children at the different time points. For both parts of the Sky
Search test, a time-per-target score was calculated (time/targets
found). The selective attention score was calculated by subtracting
the ‘motor control’ time-per-target score from the more attention
demanding Sky Search time-per-target, thereby obtaining an atten-
tion score that is relatively free from motor slowness or clumsiness
influences.13 A lower score on the Sky Search test indicates a better
score on attention. Test–retest reliability of the Sky Search sub-
test of the TEA-Ch over a time period of 5 to 20 days demonstrates
high reliability (correlation = 0.90).13 Thus far, no information is
available on test–retest reliability within shorter time periods.
We therefore examined test–retest reliability within time frames
of 20 and 110 min, respectively, among participants in groups A
and B (i.e. children who remained seated during the these time
frames).
Body height and weight were measured using a standardized
protocol. Body height was measured with a Seca Leicester portable
stadiometer with an accuracy of 0.1 cm. Body weight was measured
with a calibrated electronic scale (Seca 861) with an accuracy of
0.1 kg. Body height and weight were measured in order to calculate
BMI (kg/m2 ). Age- and gender-specific BMI values (BMI-z) were
calculated using WHO cut-points.18
We assessed sports participation (primary and secondary sport;
h/week), TV viewing (min/day) and computer use (min/day) using
relevant items from the child questionnaire for the ENERGY cross-
sectional survey.19 Intraclass correlation coefficients (ICC) for the
questions assessing child reported time spent on sports indi-
cated good-to-excellent test–retest reliability (ICC: 0.68–1.00) and
moderate-to-excellent construct validity compared to an interview
(ICC: 0.51–1.00). The ICCs for questions assessing children’s screen
time (i.e. TV time and computer use) indicated good test–retest
G Model
JSAMS-1251; No. of Pages 5 ARTICLE IN PRESS
T.M. Altenburg et al. / Journal of Science and Medicine in Sport xxx (2015) xxx–xxx 3

Table 1 Table 2
Descriptive participant characteristics (n = 56; 54% boys). Difference (B and 95% CI) in children’s selective attention between zero, one and
two physical activity bouts during a school morninga .
Group A Group B Group C
(n = 19) (n = 17) (n = 20) B [95% CI]

Gender (% boys) 36.8 70.6 55.0 Group A: control Reference

Age (years) 11.6 (0.9) 11.4 (0.8)
Body weight (kg) 40.3 (7.8) 45.1 (10.6)
Body length (m) 1.53 (0.07) 1.54 (0.10)
BMI-z −0.37 (1.1) 0.35 (1.0)
Screen time (h/day) 3.5 (2.2) 3.9 (2.2)
Sport (h/wk) 3.4 (1.8) 4.0 (2.3)
TEA-Ch test# , §
Sky Search T0 (baseline)‡ 2.23 (0.65) 2.57 (0.79)
Sky Search T1 2.42 (0.9) 2.63 (0.75)
Sky Search T2 2.33 (0.9) 2.71 (0.59)
Sky Search T3 2.36 (1.1) 2.65 (0.91)
Sky Search T4 2.22 (1.0) 2.37 (1.15)
#
A lower value indicates a better score on attention.
§
Note that the baseline value (Sky Search T0) is excluding the pre-testing scores.
‡
Note that children performed a 20-min physical activity bout immediately after
completing the Sky Search test at T0 (group C) and/or at T3 (groups B and C).
reliability (ICC: 0.67–0.68) and poor-to-good construct validity
compared to an interview (ICC: 0.35–0.65).20
Children’s baseline descriptive characteristics [mean (SD)] were
calculated. One-way ANOVA was used to assess baseline differ-
ences between groups. Children’s score on the Sky Search test
were calculated at each time point. We used Generalized Estimat-
ing Equations (GEE) to assess the difference in children’s attention
between groups over time. This longitudinal analysis technique
is used to adjust for dependency within repeated measures (i.e.
five scores on the Sky Search test) for each child. First, we ana-
lysed differences in children’s attention during a whole school
morning when having zero, a single or two physical activity bouts
(T0–T4). Second, we analysed the effect of a physically active start,
by comparing group C versus group A and B during the first part
of the morning (T0–T2). We adjusted analyses for baseline atten-
tion score, BMI-z, gender, screen time and sports (see results), since
these variables may influence children’s cognitive functioning.21,22
Additionally, we adjusted for school to account for clustering of
observations within schools.
A two-way random effects single measure ICC was calculated to
assess test-rest reliability of Sky Search scores with 20- and 110-
min time frames. Scores of children in group C were excluded in
this analysis, as these children already participated in a physical
activity bout. All statistical procedures were performed using SPSS
software (version 18.0). Statistical significance was set at P < 0.05.
3. Results
Six participants (3 boys and 3 girls) did not comply with the
protocol and were therefore excluded from the analyses. Two chil-
dren (groups A and C) did not allow the research staff to check the
registered time, 1 child (group A) did not remain seated, 2 chil-
dren (group B) were not physically active at moderate intensity,
and 1 child (group C) withdrew during the experiment (see Sup-
plementary Fig. 2). In total, 30 boys and 26 girls were included in
the analyses (n = 56).
Table 1 shows the children’s baseline characteristics and Sky
Search (TEA-Ch) test scores. There were more boys in group B, and
BMI and time spent on sports were higher in children in group
B, when compared to group A and C, although differences were
not statistically significant. ICCs for two Sky Search measures with
time frames of 20 and 110 min were 0.61 and 0.67, respectively,
indicating good test–retest reliability.20
GEE analysis of the whole morning (T0–T4) revealed that Sky
Search scores of children in group C (two physical activity bouts)
11.7 (0.7) Group B: one PA bout 0.06 [−0.23; 0.36]
41.9 (6.4) Group C: two PA bouts −0.26 [−0.52; −0.004]b
1.55 (0.06)
Note that a negative beta indicates a better attention score.
−0.02 (1.1) a
GEE analysis adjusted for school, baseline Sky Search score, BMI-z, gender,
3.6 (1.5)
screen time and sport participation.
3.6 (1.9) b
Significantly different from reference.
2.22 (0.48)
Table 3
2.14 (0.51)
Difference (B and 95% CI) in selective attention between children having a physically
2.13 (0.61)
active start of a school morning or nota .
1.98 (0.33)
2.04 (0.55) B [95% CI]
Group A + B: control Reference
Group C: one PA bout −0.29 [−0.45; −0.13]b
Note that a negative beta indicates a better attention score.
a
GEE analysis adjusted for school, baseline Sky Search score, BMI-z, gender,
screen time and sport participation.
b
Significantly different from reference.
were significantly lower (i.e. indicating better attention) than
scores of the control group after adjustments (Table 2). Group B
(performing one bout of physical activity) scored not significantly
different from the control group or group C.
GEE analysis of the first part of the morning (T0–T2) revealed
that Sky Search scores of children who had a physically active
start (group C) were significantly lower than those of children who
remained seated the whole morning, i.e. children in groups A and
B (Table 3).
4. Discussion
We assessed the effects of one or two 20-min moderate-
intensity physical activity bouts on selective attention in children
versus remaining seated the whole morning. Two physical activity
bouts during a school morning had a significant beneficial effect
on selective attention. One 20-min physical activity about halfway
through the school morning did not result in better selective atten-
tion scores. A separate analysis of the first part of the morning (i.e.
T0–T2) revealed a short-term positive effect of a 20-min physically
active start of the morning.
Our finding that a single bout of 20-min moderate-intensity
physical activity improved children’s selective attention in the first
part of the morning compared to remaining seated confirms our
hypothesis and is in line with previous studies in children and
adolescents.7,10,23 The improvement in selective attention follow-
ing a single physical activity bout in our study is somewhat lower
than the improvement demonstrated in the study of Janssen et al.,23
in which 10–11 year old children completed the Sky Search test
before and immediately after a 15-min moderate-intensity physi-
cal activity break. Janssen et al.23 demonstrated a decrease of 8.0% in
selective attention scores, whereas we found a decrease of 4.1% (i.e.
group C; T0–T2). Our study adds to the existing literature by demon-
strating that the positive effects of physical activity on selective
attention may persist up to 110 min after completing the activity
bout. In their meta-analysis, Chang et al.2 studied the moderat-
ing effects of timing of test administration after the activity bout
and concluded that positive effects of physical activity on cognition
test scores were largest within 11–20 min after physical activity
and smaller when tests were administrated >20 min after physical
activity. Additionally, this meta-analysis studied the moderating
effects of bout duration and concluded that activity bouts longer
than 11 min resulted in positive significant effects on cognition.2

Please cite this article in press as: Altenburg TM, et al. Effects of one versus two bouts of moderate intensity physical activity on
selective attention during a school morning in Dutch primary schoolchildren: A randomized controlled trial. J Sci Med Sport (2015),
http://dx.doi.org/10.1016/j.jsams.2015.12.003
G Model
JSAMS-1251; No. of Pages 5 ARTICLE IN PRESS
4 T.M. Altenburg et al. / Journal of Science and Medicine in Sport xxx (2015) xxx–xxx
However, these conclusions are predominantly based on adult
studies, while no child-specific results were reported. Addition-
ally, results were not specified for different cognitive tasks.2 Future
studies should examine whether the demonstrated improvement
in selective attention is positively associated with children’s aca-
demic performance.
We demonstrated good test–retest reliability for Sky Search
scores assessed within a short time frame. The slightly lower ICC for
the time frame of 20 min when compared to 110 min may suggest a
learning effect in the shortest time frame. This may also explain the
higher reliability score (correlation of 0.90) in the study of Manly
et al.13 in which tests were assessed over a time period of 5 to 20
days.
To the best of our knowledge, this is the first study examining
the effects of a single bout versus two bouts of physical activ-
ity on children’s selective attention. When considering the whole
school morning, one bout halfway the morning did not improve
children’s selective attention. These results suggest that the com-
bination of one physical activity bout at the start of the day and
one bout halfway during the morning is beneficial for children’s
selective attention. Future studies should explore different fre-
quencies and durations of physical activity bouts to determine
the most advantageous pattern in optimizing children’s cognitive
functioning. Additionally, future studies should examine which fre-
quency, duration and intensity of physical activity bouts is optimal
for cognitive performance as well as feasible in the school setting.
Alternatively, physical activity that is integrated within academic
lessons to improve children’s academic performance needs further
study.24,25 As classroom teachers should implement such physi-
cally active academic lessons, their willingness and competence
to implement this is highly important. Studies exploring factors
associated with classroom teachers’ physical activity integration
highlight a range of factors, including flexibility of the activities,
support of the school environment, response of their students, time
constraints due to other responsibilities and space.26 Future studies
should further examine the feasibility and effectiveness of physi-
cally active academic lessons.
Mechanisms underlying the positive, acute effects of physical
activity on cognitive functioning include an increase in cerebral
blood flow (CBF)27 and levels of catecholamines and brain-derived
neurotrophic factor (BDNF).28,29 To date, it is unknown how long
these effects may last. One study demonstrated that global and
grey matter CBF, but not white matter CBF, returned to pre-activity
levels within 40 min, after a 25-min physical activity bout at 70%
of the maximal HR.30 Gold et al.28 showed that BDNF concentra-
tions returned to baseline levels within 30 min, after completion
of a 30-min physical activity bout at 60% maximal oxygen uptake.
Our findings that children’s enhanced selective attention may per-
sist up to approximately 2 h after exercise suggests that underlying
increases in CBF, catecholamines or BDNF may be enhanced up to
approximately 2 h as well. To the best of our knowledge, no stud-
ies examined CBF, catecholamines or BDNF responses following
repeated bouts of physical activity.
A strength of our study is the controlled experimental design in
the school setting, including three conditions to explore the effect
of frequency of physical activity bouts on selective attention in
children. The standardized procedures of arriving in a fasted state,
consuming a standard breakfast and snack at the same time further
strengthens our study. A limitation of our study is the self-recording
of the time the children needed to complete the Sky Search test and
motor control version. Although the research staff checked the val-
ues, part of the variation in the time to complete the tasks might
be attributed to the self-recording of the children. The availability
of only two versions of the Sky Search is an additional limitation.
Although the two versions were randomly assigned to the children,
children may have remembered the version, thereby scoring better
Please cite this article in press as: Altenburg TM, et al. Effects of one versus two bouts of moderate intensity physical activity on
selective attention during a school morning in Dutch primary schoolchildren: A randomized controlled trial. J Sci Med Sport (2015),
http://dx.doi.org/10.1016/j.jsams.2015.12.003
in the course of the morning. Nevertheless, ICCs of the Sky Search
test within time frames of 20 and 110 min revealed good test–retest
reliability. Third, some children already started looking for identical
pairs of spaceships before the start of the Sky Search test. Fourth,
we aimed to examine the effects of one versus two continuous 20-
min aerobic physical activity bouts. We noticed, however, that it
was rather difficult for some children to be continuously active
for 20 min. The intensity of the physical activity bouts may there-
fore not have been at the targeted level during the full 20 min. We
used heart rate monitoring to give children instant feedback on
their activity level. Unfortunately, we could not save the data and
were therefore not able to check and adjust for the actual intensity.
Children aged 10–13 years old from five different schools in the
province of Noord Holland (The Netherlands) participated in this
study. Future studies should establish whether the results of this
study are generalizable to a broader target group. Finally, confound-
ing of screen time and sports participation was measured using
self-report which is subject to recall bias and socially desirable
answers.
5. Conclusion
We conclude that two repeated 20-min bouts of moderate-
intensity physical activity, but not a single bout halfway the
morning, enhance children’s selective attention, compared to
remaining seated the whole morning. Importantly, a single activity
bout halfway the morning seems insufficient to maintain selective
attention in children throughout a school morning. Future research
should further explore the effects of different frequencies, inten-
sities and durations on selective attention and other measures of
cognitive functioning.
Practical implications
• Regular physical activity bouts throughout a school day may
enhance children’s selective attention and thus academic perfor-
mance.
• In addition to physical education, schools should provide physical
activity breaks throughout a school day.
• Physically active school tasks may not only improve physical
activity levels but also academic performance.
Acknowledgements
The contributions of TA and MC were funded by the Netherlands
Organization for Health Research and Development (ZonMw;
projectnr 91211057). The authors would like to thank Paulien
Zevenhuizen for her contribution to the data collection.
Appendix A. Supplementary data
Supplementary data associated with this article can be found, in
the online version, at doi:10.1016/j.jsams.2015.12.003.
References
1. Singh A, Uijtdewilligen L, Twisk JW et al. Physical activity and performance at
school: a systematic review of the literature including a methodological quality
assessment. Arch Pediatr Adolesc Med 2012; 166(1):49–55.
2. Chang YK, Labban JD, Gapin JI et al. The effects of acute exercise on cognitive
performance: a meta-analysis. Brain Res 2012; 1453:87–101.
3. Latzman RD, Elkovitch N, Young J et al. The contribution of executive functioning
to academic achievement among male adolescents. J Clin Exp Neuropsychol 2010;
32(5):455–462.
4. Pennington BF, Ozonoff S. Executive functions and developmental psy-
chopathology. J Child Psychol Psychiatry 1996; 37(1):51–87.
G Model
JSAMS-1251; No. of Pages 5 ARTICLE IN PRESS
T.M. Altenburg et al. / Journal of Science and Medicine in Sport xxx (2015) xxx–xxx
5. Verburgh L, Konigs M, Scherder EJ et al. Physical exercise and executive functions
in preadolescent children, adolescents and young adults: a meta-analysis. Br J
Sports Med 2014; 48(12):973–979.
6. Hillman CH, Pontifex MB, Raine LB et al. The effect of acute treadmill walk-
ing on cognitive control and academic achievement in preadolescent children.
Neuroscience 2009; 159(3):1044–1054.
7. Stroth S, Kubesch S, Dieterle K et al. Physical fitness, but not acute exercise
modulates event-related potential indices for executive control in healthy ado-
lescents. Brain Res 2009; 1269:114–124.
8. Budde H, Voelcker-Rehage C, Pietrabyk-Kendziorra S et al. Acute coordinative
exercise improves attentional performance in adolescents. Neurosci Lett 2008;
441(2):219–223.
9. Drollette ES, Scudder MR, Raine LB et al. Acute exercise facilitates brain func-
tion and cognition in children who need it most: an ERP study of individual
differences in inhibitory control capacity. Dev Cogn Neurosci 2014; 7:53–64.
10. Drollette ES, Shishido T, Pontifex MB et al. Maintenance of cognitive control
during and after walking in preadolescent children. Med Sci Sports Exerc 2012;
44(10):2017–2024.
11. Tine TM, Butler AG. Acute aerobic exercise impacts selective attention: an excep-
tional boost in lower-income children. Educ Psychol 2012; 32(7):821–834.
12. Janssen M, Toussaint HM, van Mechelen W et al. Effects of acute bouts of physical
activity on children’s attention: a systematic review of the literature. Springer-
plus 2014; 3:410.
13. Manly T, Anderson V, Nimmo-Smith I et al. The differential assessment of
children’s attention: the test of everyday attention for children (TEA-Ch),
normative sample and ADHD performance. J Child Psychol Psychiatry 2001;
42(8):1065–1081.
14. Benton D. The influence of children’s diet on their cognition and behavior. Eur J
Nutr 2008; 47(Suppl 3):25–37.
15. Karvonen J, Vuorimaa T. Heart rate and exercise intensity during sports activities.
Practical application. Sports Med 1988; 5(5):303–311.
16. Mahon AD, Marjerrison AD, Lee JD et al. Evaluating the prediction of max-
imal heart rate in children and adolescents. Res Q Exerc Sport 2010; 81(4):
466–471.
17. Garber CE, Blissmer B, Deschenes MR et al., American College of Sports Medicine
position stand. Quantity and quality of exercise for developing and maintain-
ing cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently
healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011;
43(7):1334–1359.
Please cite this article in press as: Altenburg TM, et al. Effects of one versus two bouts of moderate intensity physical activity on
selective attention during a school morning in Dutch primary schoolchildren: A randomized controlled trial. J Sci Med Sport (2015),
http://dx.doi.org/10.1016/j.jsams.2015.12.003
5
18. de Onis M, Onyango AW, Borghi E et al. Development of a WHO growth refer-
ence for school-aged children and adolescents. Bull World Health Organ 2007;
85(9):660–667.
19. van Stralen MM, te Velde SJ, Singh AS et al. EuropeaN energy balance research
to prevent excessive weight gain among youth (ENERGY) project: design and
methodology of the ENERGY cross-sectional survey. BMC Public Health 2011;
11:65.
20. Singh AS, Vik FN, Chinapaw MJ et al. Test–retest reliability and construct validity
of the ENERGY-child questionnaire on energy balance-related behaviours and
their potential determinants: the ENERGY-project. Int J Behav Nutr Phys Act 2011;
8:136.
21. Taras H, Potts-Datema W. Obesity and student performance at school. J Sch
Health 2005; 75(8):291–295.
22. Fedewa AL, Ahn S. The effects of physical activity and physical fitness on chil-
dren’s achievement and cognitive outcomes: a meta-analysis. Res Q Exerc Sport
2011; 82(3):521–535.
23. Janssen M, Chinapaw MJ, Rauh SP et al. A short physical activity break from
cognitive tasks increases selective attention in primary school children aged
10–11. Mental Health Phys Act 2014; 7:129–134.
24. Riley N, Lubans DR, Morgan PJ et al. Outcomes and process evaluation of a
programme integrating physical activity into the primary school mathematics
curriculum: The EASY Minds pilot randomised controlled trial. J Sci Med Sport
2015; 18(6):656–661.
25. Donnelly JE, Lambourne K. Classroom-based physical activity, cognition, and
academic achievement. Prev Med 2011; 52(Suppl. 1):S36–S42.
26. Webster CA, Russ L, Vazou S et al. Integrating movement in academic classrooms:
understanding, applying and advancing the knowledge base. Obes Rev 2015;
16(8):691–701.
27. Querido JS, Sheel AW. Regulation of cerebral blood flow during exercise. Sports
Med 2007; 37(9):765–782.
28. Gold SM, Schulz KH, Hartmann S et al. Basal serum levels and reactivity of nerve
growth factor and brain-derived neurotrophic factor to standardized acute exer-
cise in multiple sclerosis and controls. J Neuroimmunol 2003; 138(1–2):99–105.
29. Ferris LT, Williams JS, Shen CL. The effect of acute exercise on serum brain-
derived neurotrophic factor levels and cognitive function. Med Sci Sports Exerc
2007; 39(4):728–734.
30. MacIntosh BJ, Crane DE, Sage MD et al. Impact of a single bout of aerobic exercise
on regional brain perfusion and activation responses in healthy young adults.
PLoS ONE 2014; 9(1):e85163.