Impact of Embedding High-Intensity Interval Training in Schools and Sports Training on Children and Adolescent's Cardiometabolic Health and Health-Related Fitness: Systematic Review and Meta-Analysis
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| Title: | Impact of Embedding High-Intensity Interval Training in Schools and Sports Training on Children and Adolescent's Cardiometabolic Health and Health-Related Fitness: Systematic Review and Meta-Analysis |
|---|---|
| Language: | English |
| Authors: | Eather, Narelle (ORCID |
| Source: | Journal of Teaching in Physical Education. Apr 2023 42(2):243-255. |
| Availability: | Human Kinetics, Inc. 1607 North Market Street, Champaign, IL 61820. Tel: 800-474-4457; Fax: 217-351-1549; e-mail: info@hkusa.com; Web site: http://journals.humankinetics.com/journal/jtpe |
| Peer Reviewed: | Y |
| Page Count: | 13 |
| Publication Date: | 2023 |
| Document Type: | Journal Articles Information Analyses Reports - Research |
| Education Level: | Elementary Secondary Education |
| Descriptors: | Training, Physical Fitness, Health Promotion, Children, Adolescents, Body Composition, Muscular Strength, Human Body, Program Effectiveness, Metabolism, Elementary Secondary Education, Intervention, Physical Health |
| DOI: | 10.1123/jtpe.2021-0165 |
| ISSN: | 0273-5024 1543-2769 |
| Abstract: | Purpose: This systematic review aimed to identify studies evaluating the impact of high-intensity interval training when delivered in school and sports training. Methods: A systematic search of 10 databases (September 2019) identified 24 eligible studies (including children and/or adolescents 5-18 years and reporting cardiometabolic health and/or health-related fitness outcomes), assessed for quality using the Cochrane Risk of Bias Tool (version 2.0). Outcomes were synthesized using a random-effects meta-analysis, and potential moderators were explored (i.e., study duration, risk of bias, age, and deliverer/instructor). Results: Standardized mean difference for the effects of high-intensity interval training were significant for body mass index g = -0.27 (p < 0.001), cardiorespiratory fitness g = 0.27 (p < 0.001), lower body muscular fitness g = 0.49 (p = 0.005), and upper body muscular fitness g = 0.37 (p = 0.002); but not for blood pressure (p > 0.05). Risk of bias results were variable (low = 8, some concerns = 9, and high = 7). Conclusion: Our findings suggest that embedding high-intensity interval training in schools and sports training can facilitate improvements in some aspects of cardiometabolic health and fitness in children and adolescents. |
| Abstractor: | As Provided |
| Entry Date: | 2023 |
| Accession Number: | EJ1391748 |
| Database: | ERIC |
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| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwGUsWjp5vNtwPFljq93ru2IAAAA4zCB4AYJKoZIhvcNAQcGoIHSMIHPAgEAMIHJBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDIMNVfh1IybpWGKEwwIBEICBm0oe-9khuURChBuXAcVnLwNiNe1_HsRiCXyxTPyPZxDYyDQaa4QTZyWfMPcX0h0l4tpVV884bkU6smHOdgnCXPmJJvE-HIgNG9UVs7BjjAAExpFMTn_gXffZTus5bLvAVqpJVspp7oolfHbMUA2PCdBH5U3mb5rSi-YNdXAP7kQFhUVM9Qvwkl_y2jACDee_sm45qIOAkg1aLa12 Text: Availability: 1 Value: <anid>AN0163169320;0do01apr.23;2023Apr20.05:29;v2.2.500</anid> <title id="AN0163169320-1">Impact of Embedding High-Intensity Interval Training in Schools and Sports Training on Children and Adolescent's Cardiometabolic Health and Health-Related Fitness: Systematic Review and Meta-Analysis </title> <p>Purpose: This systematic review aimed to identify studies evaluating the impact of high-intensity interval training when delivered in school and sports training. Methods: A systematic search of 10 databases (September 2019) identified 24 eligible studies (including children and/or adolescents 5–18 years and reporting cardiometabolic health and/or health-related fitness outcomes), assessed for quality using the Cochrane Risk of Bias Tool (version 2.0). Outcomes were synthesized using a random-effects meta-analysis, and potential moderators were explored (i.e., study duration, risk of bias, age, and deliverer/instructor). Results: Standardized mean difference for the effects of high-intensity interval training were significant for body mass index g = −0.27 (p &lt;.001), cardiorespiratory fitness g = 0.27 (p &lt;.001), lower body muscular fitness g = 0.49 (p =.005), and upper body muscular fitness g = 0.37 (p =.002); but not for blood pressure (p &gt;.05). Risk of bias results were variable (low = 8, some concerns = 9, and high = 7). Conclusion: Our findings suggest that embedding high-intensity interval training in schools and sports training can facilitate improvements in some aspects of cardiometabolic health and fitness in children and adolescents.</p> <p>Keywords: exercise; cardiorespiratory fitness; body mass index; muscular fitness</p> <p>Despite the well-publicized health benefits of regular physical activity for young people, physical inactivity among children and adolescence is a global problem ([<reflink idref="bib84" id="ref1">84</reflink>])—with more than 80% of children and adolescents (aged 5–17 years) failing to meet the World Health Organization's physical activity guidelines ([<reflink idref="bib5" id="ref2">5</reflink>]; [<reflink idref="bib104" id="ref3">104</reflink>], [<reflink idref="bib105" id="ref4">105</reflink>]). Children's activity levels generally decline as they approach and move through adolescence. In fact, physical activity levels fall at a rate of 7% per year during adolescence ([<reflink idref="bib27" id="ref5">27</reflink>]), with only a small proportion (∼6%) of older adolescents (15–17 years) considered sufficiently active ([<reflink idref="bib88" id="ref6">88</reflink>]). Furthermore, current levels of physical fitness in young people are concerning. Cardiorespiratory fitness (CRF) levels of children and adolescents have dropped by 7.3% since the 1980's ([<reflink idref="bib95" id="ref7">95</reflink>]); muscular fitness (MF) levels (especially in girls) have steadily declined ([<reflink idref="bib43" id="ref8">43</reflink>]; [<reflink idref="bib54" id="ref9">54</reflink>]; [<reflink idref="bib85" id="ref10">85</reflink>]); and 340 million children and adolescents worldwide are considered obese ([<reflink idref="bib1" id="ref11">1</reflink>]; [<reflink idref="bib106" id="ref12">106</reflink>]). Previous reviews support that physical activity and fitness interventions for children and adolescents (including school-based and physical education [PE] interventions) have only weak to moderate positive effects on overall physical activity levels, CRF, MF, and blood cholesterol; or minimal (if any) impact on blood pressure (BP) and body composition ([<reflink idref="bib23" id="ref13">23</reflink>]; [<reflink idref="bib26" id="ref14">26</reflink>]; [<reflink idref="bib71" id="ref15">71</reflink>]; [<reflink idref="bib78" id="ref16">78</reflink>]). Therefore, exploring novel ways to engage children and adolescents in physical activity of sufficient volume and intensity to stimulate improvements in health-related fitness is a priority ([<reflink idref="bib35" id="ref17">35</reflink>]; [<reflink idref="bib46" id="ref18">46</reflink>]; [<reflink idref="bib47" id="ref19">47</reflink>]; [<reflink idref="bib53" id="ref20">53</reflink>]; [<reflink idref="bib61" id="ref21">61</reflink>]; [<reflink idref="bib93" id="ref22">93</reflink>]; [<reflink idref="bib101" id="ref23">101</reflink>]).</p> <p>High-intensity interval training (HIIT) has emerged as a popular and time-efficient mode of exercise that involves vigorous-intensity activity that can be manipulated to improve both cardiorespiratory and MF ([<reflink idref="bib77" id="ref24">77</reflink>]; [<reflink idref="bib92" id="ref25">92</reflink>]). HIIT consists of short (from ≤ 45 s to 2–4 min), intense, repeated bouts of activity (typically &gt; 85% of age-predicated maximal HR), interspersed with short periods of active rest or recovery ([<reflink idref="bib17" id="ref26">17</reflink>]). Despite the low dose and short duration of exercise sessions, there is a growing body of evidence to support the effectiveness of HIIT for enhancing a range of health outcomes in varied populations, including improved cardiorespiratory and MF, body composition, mental health outcomes, cognition, and cardiovascular disease biomarker health in children and adolescents ([<reflink idref="bib15" id="ref27">15</reflink>]; [<reflink idref="bib21" id="ref28">21</reflink>]; [<reflink idref="bib30" id="ref29">30</reflink>]; [<reflink idref="bib37" id="ref30">37</reflink>]; [<reflink idref="bib59" id="ref31">59</reflink>] ; [<reflink idref="bib62" id="ref32">62</reflink>]; [<reflink idref="bib64" id="ref33">64</reflink>]; [<reflink idref="bib76" id="ref34">76</reflink>]). Because HIIT can induce similar or superior physiological benefits to moderate-intensity continuous training (MICT; in a fraction of the time), this type of training is highly appealing for many people including youth ([<reflink idref="bib15" id="ref35">15</reflink>]; [<reflink idref="bib33" id="ref36">33</reflink>]; [<reflink idref="bib72" id="ref37">72</reflink>]).</p> <p>Sports training and PE provide ideal opportunities for children and adolescents to engage in moderate to vigorous physical activity (MVPA; [<reflink idref="bib7" id="ref38">7</reflink>]; [<reflink idref="bib80" id="ref39">80</reflink>]). Sports training is commonly offered to children and adolescents as organized sport in the community or school sport in primary and secondary schools. PE is generally offered in primary and secondary schools as a mandatory component of the school curriculum—and considered the primary vehicle associated with physical activity promotion in schools ([<reflink idref="bib42" id="ref40">42</reflink>]). However, PE may not be compulsory for senior secondary school students in their final two years of study. About half of children and youth also voluntarily participate in organized sport globally ([<reflink idref="bib5" id="ref41">5</reflink>]); although many differences exist between sport and PE, building physical capacities, movement competencies, and confidence of children and adolescents to enable them to participate and succeed in a range of physical endeavors and sports is a shared priority ([<reflink idref="bib6" id="ref42">6</reflink>]). In addition, high-quality organized sport and PE programs also have capacity to provide a dose of physical activity capable of facilitating good health in children and adolescents ([<reflink idref="bib8" id="ref43">8</reflink>]; [<reflink idref="bib38" id="ref44">38</reflink>]; [<reflink idref="bib100" id="ref45">100</reflink>]). However, there are many factors that influence the quality of sport and PE programs offered to children and adolescents. Specifically, the learning activities and instructional strategies used by coaches and teachers play a pivotal role in shaping the learning experience for young people, and for determining program or lesson quality ([<reflink idref="bib6" id="ref46">6</reflink>]; [<reflink idref="bib12" id="ref47">12</reflink>]; [<reflink idref="bib70" id="ref48">70</reflink>]; [<reflink idref="bib82" id="ref49">82</reflink>]; [<reflink idref="bib91" id="ref50">91</reflink>]).</p> <p>The available evidence suggests that many teachers and youth sport coaches are not maximizing opportunities for children and adolescents to be active during lessons and training ([<reflink idref="bib49" id="ref51">49</reflink>], [<reflink idref="bib48" id="ref52">48</reflink>]). For example, PE lessons have shown to be largely inactive, with only approximately 40% of secondary school and approximately 34% of primary school PE lesson time spent engaging students in MVPA ([<reflink idref="bib39" id="ref53">39</reflink>]; [<reflink idref="bib48" id="ref54">48</reflink>]). These rates fall short of the 50% MVPA target set in several national directives ([<reflink idref="bib44" id="ref55">44</reflink>]; [<reflink idref="bib96" id="ref56">96</reflink>]). The measurement or tools used to examine such outcomes may play an important role. Furthermore, activity levels during PE lessons vary considerably, with boys and the more highly skilled children demonstrating significantly higher levels of physical activity than girls and children with lower levels of motor skill proficiency ([<reflink idref="bib36" id="ref57">36</reflink>]; [<reflink idref="bib51" id="ref58">51</reflink>]). Similarly, inactivity in children's organized sport training is common, with children spending a great deal of time listening to instructions from the coach, in game stoppages, or participating in poorly designed activities that require minimal activity and long waiting periods ([<reflink idref="bib87" id="ref59">87</reflink>]; [<reflink idref="bib99" id="ref60">99</reflink>]; [<reflink idref="bib103" id="ref61">103</reflink>]). Data suggests that in some sport training sessions, children spend two-thirds of their time sedentary or in light physical activity, only engaged in 20 min of MVPA per hour, and as little as 18 min of MVPA per hour during competitive games ([<reflink idref="bib40" id="ref62">40</reflink>]). Providing teachers and coaches with lesson ideas, implementation strategies, and support to maximize physical activity and fitness objectives in sports training and PE lessons is recommended ([<reflink idref="bib6" id="ref63">6</reflink>]; [<reflink idref="bib63" id="ref64">63</reflink>]).</p> <p>Embedding HIIT into both sport training and PE lessons is a potential strategy for increasing the dose of MVPA that young people engage in. This strategy may have utility given that: (a) sport delivered in the community or school setting is a popular physical activity choice for young people (with about half of children and youth participating in organized sport globally; [<reflink idref="bib5" id="ref65">5</reflink>]); (b) sport and PE is usually offered weekly to students in most primary and secondary schools; and (c) sport training and PE often specifically target improvements in physical fitness. HIIT interventions have shown utility as a health promotion strategy when implemented in the school setting ([<reflink idref="bib13" id="ref66">13</reflink>]). Recent pilot studies targeting secondary school students report that HIIT is regarded highly by adolescents, feasible for use during the school day and successful for improving a range of important health outcomes ([<reflink idref="bib15" id="ref67">15</reflink>]; [<reflink idref="bib21" id="ref68">21</reflink>]; [<reflink idref="bib19" id="ref69">19</reflink>], [<reflink idref="bib22" id="ref70">22</reflink>]; [<reflink idref="bib52" id="ref71">52</reflink>]; [<reflink idref="bib58" id="ref72">58</reflink>]; [<reflink idref="bib60" id="ref73">60</reflink>]; [<reflink idref="bib57" id="ref74">57</reflink>]). Furthermore, a recent review of HIIT programs delivered in PE for overweight and obese children showed improvements in body composition and cardiorespiratory capacity when implemented 2–3 times per week ([<reflink idref="bib25" id="ref75">25</reflink>]). While reviews reporting the benefits of HIIT in children and adolescents exist, including a recent review of HIIT targeting adolescents (10–18 years) delivered in PE ([<reflink idref="bib13" id="ref76">13</reflink>]), it appears that no previous systematic review has (a) examined the benefits of HIIT when delivered in the context of sports training and/or in the context of school (e.g., sport, PE) for healthy children and adolescents (5–18 years), (b) conducted a meta-analysis of intervention effects on health-related fitness or cardiometabolic outcomes, or (c) synthesized feasibility results of HIIT interventions conducted in schools and sports training. Therefore, the primary aim of our review was to evaluate the impact of embedding HIIT in PE and organized sport on young people's cardiometabolic health and health-related fitness. Secondary aims were to examine moderators of intervention effects and feasibility outcomes.</p> <hd id="AN0163169320-2">Methods</hd> <p>This review has been registered in the PROSPERO systematic review database (https://<ulink href="http://www.crd.york.ac.uk/prospero/">www.crd.york.ac.uk/prospero/</ulink>) and assigned the identifier CRD42020176077.</p> <hd id="AN0163169320-3">Identification of Studies</hd> <p>This systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations ([<reflink idref="bib73" id="ref77">73</reflink>]). Following consultation with an academic librarian, a systematic search of ten electronic databases (PubMed, EMBASE, MEDLINE complete, SPORTDiscus, EBSCO, SCOPUS, EMBASE, PsycINFO, OVID MEDLINE, CINAHL) was performed by author Babic on September 20, 2019; and then again on February 1, 2021 to determine if any new articles had be published since the first database search. The keywords (and possible combinations and variations) used in the search were: intervention, HIIT, PE, sport, school, adolescents, children, fitness, and cardio.</p> <hd id="AN0163169320-4">Criteria for Inclusion/Exclusion</hd> <p>The following eligibility criteria was applied:</p> <p></p> <ulist> <item> (a) Population: School-aged children and adolescents (i.e., 5–18 years) in the general population (excluding studies involving special health populations such as clinically obese, subjects with mental illness etc.);</item> <p></p> <item> (b) Intervention: HIIT intervention/program (defined as set program where short intense (e.g., &gt;85% maximum HR), repeated bouts of activity are interspersed with short periods of active rest or recovery ([<reflink idref="bib17" id="ref78">17</reflink>]);</item> <p></p> <item> (c) Comparison: Usual practice or alternate program;</item> <p></p> <item> (d) Outcome: Quantitative assessment of at least one cardiometabolic or fitness outcome; and</item> <p></p> <item> (e) Study design: Experimental (randomized, nonrandomized trials, and quasi-experimental) and longitudinal studies.</item> </ulist> <p>Furthermore, studies were included if they were published in English in a peer-reviewed journal (conference proceedings, abstracts, and thesis were excluded). No limitations on date of publication were applied. Two authors (Babic and Eather) independently completed all stages of the screening process (title, abstract, and full-text screening), and any discrepancies were discussed and agreed upon prior to exclusion/inclusion. The reference lists of all included articles and previous reviews on the topic were also checked to identify any articles that were not located through the database search.</p> <hd id="AN0163169320-5">Criteria for Risk of Bias Assessment</hd> <p>Two authors (Riley and Costigan) independently assessed the risk of bias of all included studies based on the Cochrane Risk of Bias Tool (RoB, version 2.0) ([<reflink idref="bib90" id="ref79">90</reflink>]). In the event of a discrepancy, a third author (Eather) was consulted, and consensus reached. Risk of bias were obtained from 30 journal articles with described protocols and results. Each study was rated against five criteria relating to: (a) randomization process, (b) deviations from intended interventions, (c) missing outcome data, (d) measurement of the outcomes, and (e) selection of the reported results. Domain-specific judgment of each paper ("low risk," "some concerns," or "high risk" of bias) were made after rating each criterion on a 4-point scale ("not applicable," "yes/probably yes," "no/probably no," and "no information"). Aligning with Cochrane protocols, studies were rated low risk of bias if all five domains were judged to be low risk, some concerns in at least one domain were judged to have some concern regarding bias, and high risk if at least one domain was judged to be of high risk.</p> <hd id="AN0163169320-6">Categorization of Variables and Level of Evidence</hd> <p>Data were extracted into an Excel spreadsheet using a purpose-built template. A second researcher and author (Eather) checked all the extracted data for accuracy. The outcome(s) from each study were grouped into two categories: "physiological" (e.g., fitness test, blood test) and feasibility (e.g., satisfaction, process evaluation results). When data were not provided in the manuscripts, the corresponding author was emailed.</p> <hd id="AN0163169320-7">Meta-Analyses</hd> <p>Meta-analyses were conducted to determine the effect of HIIT on children's and adolescents' cardiometabolic health and health-related fitness outcomes. We conducted random-effects meta-analyses for outcomes where there were four or more study samples. Data from the meta-analyses of the effects are presented in Table 1. For studies that compared multiple HIIT groups to a single control, the sample size of the shared control was split to avoid double counting. This approach prevents effect size estimates from having artificially narrow confidence intervals (CIs). Analyses were conducted using Comprehensive Meta-Analysis software, for Windows (version 2, Biostat Company). We conducted six separate meta-analyses using Hedges <emph>g</emph> as the measure of standard mean deviation (SMD); Hedges <emph>g</emph> formula is <emph>g</emph> = y1 − y2/2sp with y1, y2, and sp denoting the mean of Sample 1, the mean of Sample 2, and the pooled <emph>SD</emph>, respectively.</p> <p>Table 1 Primary Meta-Analysis of the Effect of HIIT in PE and Sport on Cardiometabolic and Fitness Outcomes</p> <p> <ephtml> &lt;table&gt;&lt;colgroup&gt;&lt;col align="left" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;/colgroup&gt;&lt;thead&gt;&lt;tr&gt;&lt;th /&gt;&lt;th colspan="5"&gt;Effect size and precision&lt;/th&gt;&lt;th colspan="4"&gt;Heterogeneity&lt;/th&gt;&lt;th /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;th&gt;Outcomes&lt;/th&gt;&lt;th&gt;Studies&lt;/th&gt;&lt;th&gt;&lt;italic&gt;N&lt;/italic&gt;&lt;/th&gt;&lt;th&gt;Estimate&lt;/th&gt;&lt;th&gt;95% CI&lt;/th&gt;&lt;th&gt;&lt;italic&gt;p&lt;/italic&gt;&lt;/th&gt;&lt;th&gt;&lt;italic&gt;Q&lt;/italic&gt;&lt;/th&gt;&lt;th&gt;&lt;italic&gt;df&lt;/italic&gt; (&lt;italic&gt;Q&lt;/italic&gt;)&lt;/th&gt;&lt;th&gt;&lt;italic&gt;p&lt;/italic&gt;&lt;/th&gt;&lt;th&gt;&lt;italic&gt;I&lt;/italic&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/th&gt;&lt;th&gt;Fail safe &lt;italic&gt;N&lt;/italic&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td&gt;BMI&lt;/td&gt;&lt;td&gt;8&lt;/td&gt;&lt;td&gt;655&lt;/td&gt;&lt;td&gt;&amp;#8722;0.27&lt;/td&gt;&lt;td&gt;[&amp;#8722;0.43, &amp;#8722;0.10]&lt;/td&gt;&lt;td&gt;&amp;#60;.001&lt;/td&gt;&lt;td&gt;9.96&lt;/td&gt;&lt;td&gt;13&lt;/td&gt;&lt;td&gt;.697&lt;/td&gt;&lt;td&gt;0.00&lt;/td&gt;&lt;td&gt;24&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Systolic BP&lt;/td&gt;&lt;td&gt;5&lt;/td&gt;&lt;td&gt;466&lt;/td&gt;&lt;td&gt;&amp;#8722;0.13&lt;/td&gt;&lt;td&gt;[&amp;#8722;0.41, 0.14]&lt;/td&gt;&lt;td&gt;.339&lt;/td&gt;&lt;td&gt;14.70&lt;/td&gt;&lt;td&gt;8&lt;/td&gt;&lt;td&gt;.065&lt;/td&gt;&lt;td&gt;45.57&lt;/td&gt;&lt;td&gt;&amp;#8212;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Diastolic BP&lt;/td&gt;&lt;td&gt;5&lt;/td&gt;&lt;td&gt;466&lt;/td&gt;&lt;td&gt;&amp;#8722;0.07&lt;/td&gt;&lt;td&gt;[&amp;#8722;0.47, 0.33]&lt;/td&gt;&lt;td&gt;.739&lt;/td&gt;&lt;td&gt;29.87&lt;/td&gt;&lt;td&gt;8&lt;/td&gt;&lt;td&gt;&amp;#60;.001&lt;/td&gt;&lt;td&gt;73.22&lt;/td&gt;&lt;td&gt;&amp;#8212;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;CRF&lt;/td&gt;&lt;td&gt;15&lt;/td&gt;&lt;td&gt;1155&lt;/td&gt;&lt;td&gt;0.27&lt;/td&gt;&lt;td&gt;[0.13, 0.40]&lt;/td&gt;&lt;td&gt;&amp;#60;.001&lt;/td&gt;&lt;td&gt;25.83&lt;/td&gt;&lt;td&gt;21&lt;/td&gt;&lt;td&gt;.213&lt;/td&gt;&lt;td&gt;18.70&lt;/td&gt;&lt;td&gt;94&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Lower body MF&lt;/td&gt;&lt;td&gt;7&lt;/td&gt;&lt;td&gt;408&lt;/td&gt;&lt;td&gt;0.49&lt;/td&gt;&lt;td&gt;[0.15, 0.83]&lt;/td&gt;&lt;td&gt;.005&lt;/td&gt;&lt;td&gt;18.18&lt;/td&gt;&lt;td&gt;7&lt;/td&gt;&lt;td&gt;.011&lt;/td&gt;&lt;td&gt;61.49&lt;/td&gt;&lt;td&gt;35&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Upper body MF&lt;/td&gt;&lt;td&gt;5&lt;/td&gt;&lt;td&gt;300&lt;/td&gt;&lt;td&gt;0.37&lt;/td&gt;&lt;td&gt;[0.14, 0.61]&lt;/td&gt;&lt;td&gt;.002&lt;/td&gt;&lt;td&gt;3.54&lt;/td&gt;&lt;td&gt;5&lt;/td&gt;&lt;td&gt;.618&lt;/td&gt;&lt;td&gt;0.00&lt;/td&gt;&lt;td&gt;8&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p> <emph>Note</emph>. HIIT = high-intensity interval training; PE = physical education; BMI = body mass index; BP = blood pressure; CRF = cardiorespiratory fitness; MF = muscular fitness.</p> <p>Effect size, 95% CIs, heterogeneity, <emph>Q</emph> values, and publication bias were analyzed. Heterogeneity was determined by Cochrane <emph>Q</emph> statistic and <emph>I</emph><sups>2</sups> values, whereby values of &lt;25%, 50%, and 75% were be considered to indicate low, moderate, and high levels of heterogeneity, respectively. Publication bias was analyzed using Rosenthal's classic fail-safe <emph>N</emph>, which provides an indication of the number of studies needed with a mean effect of zero before the overall effect would no longer be statistically significant. Subgroup moderator analyses were conducted if HIIT effects differed according to the duration of the study (i.e., &lt;8 weeks vs. ≥ 8 weeks), risk of bias (i.e., low vs. moderate to high), age of participants (i.e., &lt;12 years, i.e., children vs. &gt; 12 years, i.e., adolescents), and the provider/deliverer (i.e., usual teacher/coach vs. external provider), with the significance threshold set at <emph>p</emph> &lt;.1.</p> <hd id="AN0163169320-8">Results</hd> <p>The original search yielded 2,428 studies (Figure 1). Once duplicates were removed, abstracts (<emph>n</emph> = 1,873) and full-text papers (<emph>n</emph> = 82) were screened. Our update search identifies six additional studies for inclusion. Therefore, a total of 30 studies were included in the systematic review and 24 in the meta-analyses. Six studies ([<reflink idref="bib3" id="ref80">3</reflink>]; [<reflink idref="bib19" id="ref81">19</reflink>]; [<reflink idref="bib32" id="ref82">32</reflink>]; [<reflink idref="bib41" id="ref83">41</reflink>]; [<reflink idref="bib65" id="ref84">65</reflink>]; [<reflink idref="bib66" id="ref85">66</reflink>]) were not included in the meta-analysis as they did report relevant data (or provide data after email communication), the study was observational or the study did not include a control group.</p> <p>Graph: Figure 1 —Consort flow diagram. PE = physical education.</p> <hd id="AN0163169320-9">Study Characteristics and Participants</hd> <p>All study characteristics can be accessed via Supplementary Table S1 (available online). In general, included studies were published between August 2000 ([<reflink idref="bib67" id="ref86">67</reflink>]) and August 2021 ([<reflink idref="bib45" id="ref87">45</reflink>]), and included parallel group (cluster randomized or individually randomized; <emph>n</emph> = 19, 63%), quasi-experimental (<emph>n</emph> = 6), crossover experimental (<emph>n</emph> = 3), observational (<emph>n</emph> = 1), and longitudinal (<emph>n</emph> = 1) studies. The 30 included studies were conducted across 15 countries, four in Australia ([<reflink idref="bib21" id="ref88">21</reflink>]; [<reflink idref="bib19" id="ref89">19</reflink>], [<reflink idref="bib22" id="ref90">22</reflink>]; [<reflink idref="bib57" id="ref91">57</reflink>]) and France ([<reflink idref="bib9" id="ref92">9</reflink>]; [<reflink idref="bib11" id="ref93">11</reflink>]; [<reflink idref="bib67" id="ref94">67</reflink>]); three in Spain ([<reflink idref="bib2" id="ref95">2</reflink>]; [<reflink idref="bib4" id="ref96">4</reflink>]; [<reflink idref="bib83" id="ref97">83</reflink>]; [<reflink idref="bib89" id="ref98">89</reflink>]); two in Germany ([<reflink idref="bib34" id="ref99">34</reflink>]; [<reflink idref="bib55" id="ref100">55</reflink>]), Denmark ([<reflink idref="bib32" id="ref101">32</reflink>]; [<reflink idref="bib56" id="ref102">56</reflink>]), South Africa ([<reflink idref="bib97" id="ref103">97</reflink>], [<reflink idref="bib98" id="ref104">98</reflink>]), the United States ([<reflink idref="bib3" id="ref105">3</reflink>]; [<reflink idref="bib50" id="ref106">50</reflink>]), the United Kingdom ([<reflink idref="bib66" id="ref107">66</reflink>]; [<reflink idref="bib68" id="ref108">68</reflink>]), and New Zealand ([<reflink idref="bib41" id="ref109">41</reflink>]; [<reflink idref="bib45" id="ref110">45</reflink>]); and one in Canada ([<reflink idref="bib65" id="ref111">65</reflink>]), Chile ([<reflink idref="bib24" id="ref112">24</reflink>]), Iran ([<reflink idref="bib75" id="ref113">75</reflink>]), Scotland ([<reflink idref="bib16" id="ref114">16</reflink>]), and Sweden ([<reflink idref="bib31" id="ref115">31</reflink>]), sample sizes ranged from 16 ([<reflink idref="bib66" id="ref116">66</reflink>]) to 345 ([<reflink idref="bib10" id="ref117">10</reflink>]) participants, totaling 3,138 children and adolescents. One study included girls only ([<reflink idref="bib32" id="ref118">32</reflink>]), 28 studies included both boys and girls, and one study did not report whether the sample were girls or boys ([<reflink idref="bib50" id="ref119">50</reflink>]). Participants were mostly children aged between 8 and 12 years (<emph>n</emph> = 17 studies), or adolescents aged from 12 to 18 years (<emph>n</emph> = 7 studies), and three studies included both children and adolescents ([<reflink idref="bib3" id="ref120">3</reflink>]; [<reflink idref="bib10" id="ref121">10</reflink>]; [<reflink idref="bib66" id="ref122">66</reflink>]). Twenty-seven studies were conducted within the school setting (during school sport or PE lessons, sports training after school, before school, lunch time), and three studies did not disclose the setting of the HIIT when delivered in sport sessions ([<reflink idref="bib16" id="ref123">16</reflink>]; [<reflink idref="bib50" id="ref124">50</reflink>]; [<reflink idref="bib75" id="ref125">75</reflink>]).</p> <p>One acute study was included in the review and involved participants in three consequentive experimental visits ([<reflink idref="bib66" id="ref126">66</reflink>]); and intervention study duration ranged between 3 weeks ([<reflink idref="bib32" id="ref127">32</reflink>]; [<reflink idref="bib65" id="ref128">65</reflink>]) and 10 months ([<reflink idref="bib56" id="ref129">56</reflink>]). The weekly dose of HIIT for intervention studies ranged from once per week ([<reflink idref="bib3" id="ref130">3</reflink>]; [<reflink idref="bib66" id="ref131">66</reflink>]) to five sessions per week ([<reflink idref="bib31" id="ref132">31</reflink>]; [<reflink idref="bib32" id="ref133">32</reflink>]; [<reflink idref="bib56" id="ref134">56</reflink>]); and HIIT work: Rest protocols varied considerably and included 5:15 s, 10:10 s, 15:10 s, 20:10 s, 20:40 s, 25:35 s, 35:25 s, 40:20 s, 30:30 s, 10 or 20 s:10 or 20 s, 30:45 s, 1 min:30 s, 4–6 min:1–2 min, 30 s:4.5 min, and 1 min:75 s (with some studies varying the protocols across the intervention period) ([<reflink idref="bib11" id="ref135">11</reflink>]; [<reflink idref="bib16" id="ref136">16</reflink>]; [<reflink idref="bib21" id="ref137">21</reflink>]; [<reflink idref="bib19" id="ref138">19</reflink>], [<reflink idref="bib22" id="ref139">22</reflink>]; [<reflink idref="bib50" id="ref140">50</reflink>]; [<reflink idref="bib74" id="ref141">74</reflink>]; [<reflink idref="bib83" id="ref142">83</reflink>]). Intervention exercise modalities also varied across studies and included cycling, running/sprinting ([<reflink idref="bib9" id="ref143">9</reflink>]; [<reflink idref="bib11" id="ref144">11</reflink>]; [<reflink idref="bib16" id="ref145">16</reflink>]; [<reflink idref="bib50" id="ref146">50</reflink>]; [<reflink idref="bib56" id="ref147">56</reflink>]; [<reflink idref="bib67" id="ref148">67</reflink>]; [<reflink idref="bib68" id="ref149">68</reflink>]; [<reflink idref="bib74" id="ref150">74</reflink>]; [<reflink idref="bib75" id="ref151">75</reflink>]; [<reflink idref="bib97" id="ref152">97</reflink>], [<reflink idref="bib98" id="ref153">98</reflink>]), body weight/resistance training/plyometric exercises ([<reflink idref="bib3" id="ref154">3</reflink>]; [<reflink idref="bib4" id="ref155">4</reflink>]; [<reflink idref="bib10" id="ref156">10</reflink>]; [<reflink idref="bib31" id="ref157">31</reflink>]; [<reflink idref="bib32" id="ref158">32</reflink>]; [<reflink idref="bib34" id="ref159">34</reflink>]), locomotor movements ([<reflink idref="bib97" id="ref160">97</reflink>], [<reflink idref="bib98" id="ref161">98</reflink>]), games and sports ([<reflink idref="bib32" id="ref162">32</reflink>]; [<reflink idref="bib56" id="ref163">56</reflink>]), or combinations of these activities ([<reflink idref="bib2" id="ref164">2</reflink>]; [<reflink idref="bib19" id="ref165">19</reflink>], [<reflink idref="bib22" id="ref166">22</reflink>]; [<reflink idref="bib24" id="ref167">24</reflink>]; [<reflink idref="bib32" id="ref168">32</reflink>]; [<reflink idref="bib41" id="ref169">41</reflink>]; [<reflink idref="bib55" id="ref170">55</reflink>]; [<reflink idref="bib57" id="ref171">57</reflink>]; [<reflink idref="bib65" id="ref172">65</reflink>]; [<reflink idref="bib67" id="ref173">67</reflink>]; [<reflink idref="bib83" id="ref174">83</reflink>]; [<reflink idref="bib89" id="ref175">89</reflink>]). The HIIT protocols were compared with a range of active comparison groups (including continuous running [<emph>n</emph> = 3], games and sports [<emph>n</emph> = 1], and stretching [<emph>n</emph> = 1]) ([<reflink idref="bib11" id="ref176">11</reflink>]; [<reflink idref="bib50" id="ref177">50</reflink>]; [<reflink idref="bib56" id="ref178">56</reflink>]; [<reflink idref="bib75" id="ref179">75</reflink>]; [<reflink idref="bib83" id="ref180">83</reflink>]), standard practice control groups (including standard practice lessons) ([<reflink idref="bib2" id="ref181">2</reflink>]; [<reflink idref="bib4" id="ref182">4</reflink>]; [<reflink idref="bib9" id="ref183">9</reflink>]; [<reflink idref="bib11" id="ref184">11</reflink>]; [<reflink idref="bib21" id="ref185">21</reflink>]; [<reflink idref="bib19" id="ref186">19</reflink>]; [<reflink idref="bib24" id="ref187">24</reflink>]; [<reflink idref="bib31" id="ref188">31</reflink>]; [<reflink idref="bib34" id="ref189">34</reflink>]; [<reflink idref="bib41" id="ref190">41</reflink>]; [<reflink idref="bib45" id="ref191">45</reflink>]; [<reflink idref="bib55" id="ref192">55</reflink>]; [<reflink idref="bib68" id="ref193">68</reflink>]; [<reflink idref="bib89" id="ref194">89</reflink>]), or control group (unstated activity) ([<reflink idref="bib67" id="ref195">67</reflink>]; [<reflink idref="bib74" id="ref196">74</reflink>]). HIIT sessions were conducted or facilitated by a teacher ([<reflink idref="bib3" id="ref197">3</reflink>]; [<reflink idref="bib31" id="ref198">31</reflink>]; [<reflink idref="bib34" id="ref199">34</reflink>]; [<reflink idref="bib45" id="ref200">45</reflink>]; [<reflink idref="bib55" id="ref201">55</reflink>]; [<reflink idref="bib57" id="ref202">57</reflink>]; [<reflink idref="bib67" id="ref203">67</reflink>]; [<reflink idref="bib68" id="ref204">68</reflink>]; [<reflink idref="bib83" id="ref205">83</reflink>]), research team member ([<reflink idref="bib4" id="ref206">4</reflink>]; [<reflink idref="bib21" id="ref207">21</reflink>]; [<reflink idref="bib19" id="ref208">19</reflink>], [<reflink idref="bib22" id="ref209">22</reflink>]; [<reflink idref="bib89" id="ref210">89</reflink>]), or researcher trained external facilitator ([<reflink idref="bib32" id="ref211">32</reflink>]; [<reflink idref="bib56" id="ref212">56</reflink>])—with 14 studies not reporting who supervised or conducted the HIIT sessions ([<reflink idref="bib2" id="ref213">2</reflink>]; [<reflink idref="bib10" id="ref214">10</reflink>]; [<reflink idref="bib9" id="ref215">9</reflink>]; [<reflink idref="bib11" id="ref216">11</reflink>]; [<reflink idref="bib16" id="ref217">16</reflink>]; [<reflink idref="bib24" id="ref218">24</reflink>]; [<reflink idref="bib41" id="ref219">41</reflink>]; [<reflink idref="bib50" id="ref220">50</reflink>]; [<reflink idref="bib65" id="ref221">65</reflink>]; [<reflink idref="bib66" id="ref222">66</reflink>]; [<reflink idref="bib74" id="ref223">74</reflink>]; [<reflink idref="bib75" id="ref224">75</reflink>]; [<reflink idref="bib97" id="ref225">97</reflink>], [<reflink idref="bib98" id="ref226">98</reflink>]).</p> <hd id="AN0163169320-10">Measures</hd> <p>Twenty-four studies measured and reported one or more fitness component(s), including measures of CRF ([<reflink idref="bib2" id="ref227">2</reflink>]; [<reflink idref="bib4" id="ref228">4</reflink>]; [<reflink idref="bib10" id="ref229">10</reflink>]; [<reflink idref="bib9" id="ref230">9</reflink>]; [<reflink idref="bib16" id="ref231">16</reflink>]; [<reflink idref="bib19" id="ref232">19</reflink>]; [<reflink idref="bib24" id="ref233">24</reflink>]; [<reflink idref="bib32" id="ref234">32</reflink>]; [<reflink idref="bib34" id="ref235">34</reflink>]; [<reflink idref="bib41" id="ref236">41</reflink>]; [<reflink idref="bib45" id="ref237">45</reflink>]; [<reflink idref="bib50" id="ref238">50</reflink>]; [<reflink idref="bib55" id="ref239">55</reflink>]; [<reflink idref="bib56" id="ref240">56</reflink>]; [<reflink idref="bib57" id="ref241">57</reflink>]; [<reflink idref="bib66" id="ref242">66</reflink>]; [<reflink idref="bib67" id="ref243">67</reflink>]; [<reflink idref="bib68" id="ref244">68</reflink>]; [<reflink idref="bib74" id="ref245">74</reflink>]; [<reflink idref="bib75" id="ref246">75</reflink>]; [<reflink idref="bib98" id="ref247">98</reflink>]), speed ([<reflink idref="bib2" id="ref248">2</reflink>]; [<reflink idref="bib16" id="ref249">16</reflink>]; [<reflink idref="bib34" id="ref250">34</reflink>]; [<reflink idref="bib50" id="ref251">50</reflink>]; [<reflink idref="bib56" id="ref252">56</reflink>]), agility ([<reflink idref="bib2" id="ref253">2</reflink>]; [<reflink idref="bib16" id="ref254">16</reflink>]; [<reflink idref="bib34" id="ref255">34</reflink>]; [<reflink idref="bib50" id="ref256">50</reflink>]), coordination ([<reflink idref="bib2" id="ref257">2</reflink>]; [<reflink idref="bib24" id="ref258">24</reflink>]; [<reflink idref="bib31" id="ref259">31</reflink>]; [<reflink idref="bib56" id="ref260">56</reflink>]), muscular strength/power ([<reflink idref="bib2" id="ref261">2</reflink>]; [<reflink idref="bib3" id="ref262">3</reflink>]; [<reflink idref="bib16" id="ref263">16</reflink>]; [<reflink idref="bib19" id="ref264">19</reflink>]; [<reflink idref="bib24" id="ref265">24</reflink>]; [<reflink idref="bib31" id="ref266">31</reflink>]; [<reflink idref="bib34" id="ref267">34</reflink>]; [<reflink idref="bib41" id="ref268">41</reflink>]; [<reflink idref="bib45" id="ref269">45</reflink>]; [<reflink idref="bib50" id="ref270">50</reflink>]; [<reflink idref="bib56" id="ref271">56</reflink>]; [<reflink idref="bib57" id="ref272">57</reflink>]), body composition ([<reflink idref="bib4" id="ref273">4</reflink>]; [<reflink idref="bib9" id="ref274">9</reflink>]; [<reflink idref="bib10" id="ref275">10</reflink>]; [<reflink idref="bib11" id="ref276">11</reflink>]; [<reflink idref="bib16" id="ref277">16</reflink>]; [<reflink idref="bib19" id="ref278">19</reflink>]; [<reflink idref="bib24" id="ref279">24</reflink>]; [<reflink idref="bib31" id="ref280">31</reflink>]; [<reflink idref="bib34" id="ref281">34</reflink>]; [<reflink idref="bib41" id="ref282">41</reflink>]; [<reflink idref="bib45" id="ref283">45</reflink>]; [<reflink idref="bib50" id="ref284">50</reflink>]; [<reflink idref="bib56" id="ref285">56</reflink>]; [<reflink idref="bib66" id="ref286">66</reflink>]; [<reflink idref="bib67" id="ref287">67</reflink>]; [<reflink idref="bib68" id="ref288">68</reflink>]; [<reflink idref="bib75" id="ref289">75</reflink>]; [<reflink idref="bib83" id="ref290">83</reflink>]; [<reflink idref="bib89" id="ref291">89</reflink>]; [<reflink idref="bib97" id="ref292">97</reflink>], [<reflink idref="bib98" id="ref293">98</reflink>]), flexibility ([<reflink idref="bib34" id="ref294">34</reflink>]; [<reflink idref="bib41" id="ref295">41</reflink>]; [<reflink idref="bib50" id="ref296">50</reflink>]), and balance ([<reflink idref="bib31" id="ref297">31</reflink>]). Fifteen studies used HR monitoring ([<reflink idref="bib2" id="ref298">2</reflink>]; [<reflink idref="bib4" id="ref299">4</reflink>]; [<reflink idref="bib10" id="ref300">10</reflink>]; [<reflink idref="bib16" id="ref301">16</reflink>]; [<reflink idref="bib21" id="ref302">21</reflink>]; [<reflink idref="bib24" id="ref303">24</reflink>]; [<reflink idref="bib45" id="ref304">45</reflink>]; [<reflink idref="bib55" id="ref305">55</reflink>]; [<reflink idref="bib56" id="ref306">56</reflink>]; [<reflink idref="bib57" id="ref307">57</reflink>]; [<reflink idref="bib66" id="ref308">66</reflink>]; [<reflink idref="bib67" id="ref309">67</reflink>]; [<reflink idref="bib68" id="ref310">68</reflink>]; [<reflink idref="bib74" id="ref311">74</reflink>]; [<reflink idref="bib89" id="ref312">89</reflink>]; [<reflink idref="bib97" id="ref313">97</reflink>], [<reflink idref="bib98" id="ref314">98</reflink>]); six studies measured BP ([<reflink idref="bib16" id="ref315">16</reflink>]; [<reflink idref="bib24" id="ref316">24</reflink>]; [<reflink idref="bib55" id="ref317">55</reflink>]; [<reflink idref="bib68" id="ref318">68</reflink>]; [<reflink idref="bib97" id="ref319">97</reflink>], [<reflink idref="bib98" id="ref320">98</reflink>]); and three studies used blood sampling ([<reflink idref="bib16" id="ref321">16</reflink>]; [<reflink idref="bib68" id="ref322">68</reflink>]; [<reflink idref="bib98" id="ref323">98</reflink>]).</p> <hd id="AN0163169320-11">Risk of Bias Assessment Results</hd> <p>There was a strong agreement among researchers regarding the risk of bias assessment using the Cochrane Risk of Bias Assessment Tool. As displayed in Table 2, seven studies showed high risk of bias ([<reflink idref="bib3" id="ref324">3</reflink>]; [<reflink idref="bib11" id="ref325">11</reflink>]; [<reflink idref="bib24" id="ref326">24</reflink>]; [<reflink idref="bib31" id="ref327">31</reflink>]; [<reflink idref="bib41" id="ref328">41</reflink>]; [<reflink idref="bib66" id="ref329">66</reflink>]; [<reflink idref="bib97" id="ref330">97</reflink>]), 12 showed some concerns ([<reflink idref="bib2" id="ref331">2</reflink>]; [<reflink idref="bib4" id="ref332">4</reflink>]; [<reflink idref="bib9" id="ref333">9</reflink>]; [<reflink idref="bib34" id="ref334">34</reflink>]; [<reflink idref="bib50" id="ref335">50</reflink>]; [<reflink idref="bib65" id="ref336">65</reflink>]; [<reflink idref="bib67" id="ref337">67</reflink>]; [<reflink idref="bib74" id="ref338">74</reflink>]; [<reflink idref="bib75" id="ref339">75</reflink>]; [<reflink idref="bib83" id="ref340">83</reflink>]; [<reflink idref="bib89" id="ref341">89</reflink>]; [<reflink idref="bib98" id="ref342">98</reflink>]), and 11 studies showed a low risk of bias ([<reflink idref="bib10" id="ref343">10</reflink>]; [<reflink idref="bib21" id="ref344">21</reflink>]; [<reflink idref="bib19" id="ref345">19</reflink>], [<reflink idref="bib22" id="ref346">22</reflink>]; [<reflink idref="bib32" id="ref347">32</reflink>]; [<reflink idref="bib45" id="ref348">45</reflink>]; [<reflink idref="bib55" id="ref349">55</reflink>]; [<reflink idref="bib56" id="ref350">56</reflink>]; [<reflink idref="bib57" id="ref351">57</reflink>]; [<reflink idref="bib68" id="ref352">68</reflink>]). Most studies adhered to study protocols (97%), used appropriate measurement tools for assessing outcomes (80%) and reported findings of all assessed study outcomes (90%).</p> <p>Table 2 Risk of Bias Assessment (Cochrane Risk of Bias Tool)</p> <p> <ephtml> &lt;table&gt;&lt;colgroup&gt;&lt;col align="left" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;col align="center" /&gt;&lt;/colgroup&gt;&lt;thead&gt;&lt;tr&gt;&lt;th&gt;No. (%)&lt;/th&gt;&lt;th&gt;Randomization process&lt;/th&gt;&lt;th&gt;Deviations from intended interventions&lt;/th&gt;&lt;th&gt;Missing outcome data&lt;/th&gt;&lt;th&gt;Measurement of the outcome&lt;/th&gt;&lt;th&gt;Selection of the reported result&lt;/th&gt;&lt;th&gt;Overall bias&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td colspan="7"&gt;Assignment to intervention (the "intention-to-treat" effect): Total number of studies = 30&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt; Low risk&lt;/td&gt;&lt;td&gt;10 (46.7)&lt;/td&gt;&lt;td&gt;29 (96.7)&lt;/td&gt;&lt;td&gt;21 (70)&lt;/td&gt;&lt;td&gt;24 (80)&lt;/td&gt;&lt;td&gt;27 (90)&lt;/td&gt;&lt;td&gt;11(36.7)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt; Some concerns&lt;/td&gt;&lt;td&gt;11 (43.3)&lt;/td&gt;&lt;td&gt;0 (0)&lt;/td&gt;&lt;td&gt;3 (10)&lt;/td&gt;&lt;td&gt;5 (16.7)&lt;/td&gt;&lt;td&gt;0 (0)&lt;/td&gt;&lt;td&gt;12 (40)&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt; High risk&lt;/td&gt;&lt;td&gt;3 (10)&lt;/td&gt;&lt;td&gt;1 (3.3)&lt;/td&gt;&lt;td&gt;6 (20)&lt;/td&gt;&lt;td&gt;1 (3.3)&lt;/td&gt;&lt;td&gt;3 (10)&lt;/td&gt;&lt;td&gt;7 (23.3)&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <hd id="AN0163169320-12">Meta-Analysis</hd> <p>Meta-analysis findings are detailed in Table 1 and Figure 2a–2f.</p> <p>Graph: Figure 2 —(a) Meta-analysis results and forest plot for BMI. (b) Meta-analysis results and forest plot for systolic BP. (c) Meta-analysis results and forest plot for diastolic BP. (d) Meta-analysis results and forest plot for CRF. (e) Meta-analysis results and forest plot for upper body. (f) Meta-analysis results and forest plot for lower body MF. HIIT = high-intensity interval training; BMI = body mass index; BP = blood pressure; CRF = cardiorespiratory fitness; MF = muscular fitness.</p> <hd id="AN0163169320-13">Body Mass Index</hd> <p>Six studies consisting of 11 samples were included in the meta-analysis examining the effect of HIIT on body composition ([<reflink idref="bib11" id="ref353">11</reflink>]; [<reflink idref="bib16" id="ref354">16</reflink>]; [<reflink idref="bib21" id="ref355">21</reflink>]; [<reflink idref="bib24" id="ref356">24</reflink>]; [<reflink idref="bib57" id="ref357">57</reflink>]; [<reflink idref="bib97" id="ref358">97</reflink>]). Overall, the standardized mean difference (SMD) for the effects of HIIT on body mass index (BMI) was significant at <emph>g</emph> = −0.27 (95% CI [−0.43, −0.10]; <emph>p</emph> &lt;.001). Heterogeneity was low (<emph>Q</emph> = 9.96, <emph>I</emph><sups>2</sups> = 0.000; <emph>p</emph> =.697). There were no significant moderators of effects.</p> <hd id="AN0163169320-14">Blood Pressure</hd> <p>Three studies consisting of seven samples were included in the meta-analysis examining the effect of HIIT on systolic and diastolic BP ([<reflink idref="bib16" id="ref359">16</reflink>]; [<reflink idref="bib24" id="ref360">24</reflink>]; [<reflink idref="bib97" id="ref361">97</reflink>]). Overall, the SMD for the effects of HIIT on systolic BP was nonsignificant at <emph>g</emph> = −0.13 (95% CI [−0.41, 0.14]; <emph>p</emph> =.339). Heterogeneity was low (<emph>Q</emph> = 14.70, <emph>I</emph><sups>2</sups> = 45.57; <emph>p</emph> =.065). Similarly, the SMD for the effects of HIIT on diastolic BP was also nonsignificant, <emph>g</emph> = −0.13 (95% CI [−0.41, 0.14]; <emph>p</emph> =.339). Heterogeneity was low (<emph>Q</emph> = 29.87, <emph>I</emph><sups>2</sups> = 73.22; <emph>p</emph> &lt;.001). Study duration significantly moderated the effects of HIIT on both systolic (<emph>p</emph> =.011) and diastolic (<emph>p</emph> =.052) BP, with shorter studies resulting in larger effects. No other significant moderators were observed.</p> <hd id="AN0163169320-15">Cardiorespiratory Fitness</hd> <p>Ten studies consisting of 17 samples were included in the meta-analysis examined the effect of HIIT on CRF ([<reflink idref="bib9" id="ref362">9</reflink>]; [<reflink idref="bib16" id="ref363">16</reflink>]; [<reflink idref="bib21" id="ref364">21</reflink>]; [<reflink idref="bib24" id="ref365">24</reflink>]; [<reflink idref="bib50" id="ref366">50</reflink>]; [<reflink idref="bib56" id="ref367">56</reflink>]; [<reflink idref="bib57" id="ref368">57</reflink>]; [<reflink idref="bib67" id="ref369">67</reflink>]; [<reflink idref="bib74" id="ref370">74</reflink>]; [<reflink idref="bib98" id="ref371">98</reflink>]). Overall, the SMD was <emph>g</emph> = 0.27 (95% CI [0.13, 0.40]; <emph>p</emph> &lt;.001). Heterogeneity was nonsignificant and low (<emph>Q</emph> = 25.83, <emph>I</emph><sups>2</sups> = 18.70; <emph>p</emph> =.213). Study duration significantly moderated the effects of HIIT on CRF (<emph>p</emph> =.008), with shorter studies resulting in larger effects. No other significant moderators were observed.</p> <hd id="AN0163169320-16">MF—Lower Body</hd> <p>Five studies consisting of six samples were included in the meta-analysis to examine the effect of HIIT on lower body strength ([<reflink idref="bib16" id="ref372">16</reflink>]; [<reflink idref="bib21" id="ref373">21</reflink>]; [<reflink idref="bib31" id="ref374">31</reflink>]; [<reflink idref="bib50" id="ref375">50</reflink>]; [<reflink idref="bib57" id="ref376">57</reflink>]). Overall, the SMD was significant, <emph>g</emph> = 0.49 (95% CI [0.15, 0.83]; <emph>p</emph> =.005) and moderate heterogeneity was observed (<emph>Q</emph> = 18.18, <emph>I</emph><sups>2</sups> = 61.49; <emph>p</emph> =.011). Risk of bias was a significant moderator of effects (<emph>p</emph> =.010), with larger effects observed in studies with moderate to high risk of bias. No other significant moderators were evident.</p> <hd id="AN0163169320-17">MF—Upper Body</hd> <p>Three studies consisting of four samples were included in the meta-analysis examined the effect of HIIT on upper body strength ([<reflink idref="bib21" id="ref377">21</reflink>]; [<reflink idref="bib31" id="ref378">31</reflink>]; [<reflink idref="bib57" id="ref379">57</reflink>]). Overall, the SMD were 0.37 (95% CI [0.14, 0. 612]; <emph>p</emph> =.002). Heterogeneity was nonsignificant and low (<emph>Q</emph> = 3.54, <emph>I</emph><sups>2</sups> = 0.00; <emph>p</emph> =.618). There were no significant moderators of effects.</p> <hd id="AN0163169320-18">Publication Bias</hd> <p>Rosenthal's classic fail-safe <emph>N</emph> was low for BMI (<emph>n</emph> = 24), lower body MF (<emph>n</emph> = 35), and upper body MF (<emph>n</emph> = 8), while it was moderate for CRF (<emph>n</emph> = 94). Therefore, a relatively small number of students with a mean effect of zero would be necessary before the overall effects found in the meta-analyses would no longer be statistically significant.</p> <hd id="AN0163169320-19">Feasibility/Process Evaluation Results</hd> <p>Eight studies ([<reflink idref="bib16" id="ref380">16</reflink>]; [<reflink idref="bib21" id="ref381">21</reflink>]; [<reflink idref="bib19" id="ref382">19</reflink>], [<reflink idref="bib22" id="ref383">22</reflink>]; [<reflink idref="bib31" id="ref384">31</reflink>]; [<reflink idref="bib34" id="ref385">34</reflink>]; [<reflink idref="bib45" id="ref386">45</reflink>]; [<reflink idref="bib57" id="ref387">57</reflink>]) in this review reported process evaluation data supporting HIIT as a potentially feasible strategy for use with children and/or adolescents in the context of sport or PE lessons. Five studies reported successful recruitment/retention (e.g., [<reflink idref="bib57" id="ref388">57</reflink>] reported 90% retention) ([<reflink idref="bib16" id="ref389">16</reflink>]; [<reflink idref="bib21" id="ref390">21</reflink>]; [<reflink idref="bib34" id="ref391">34</reflink>]; [<reflink idref="bib57" id="ref392">57</reflink>]), and high levels of program compliance, including: attendance (e.g., Costigan 2015 reported a mean attendance of 2.2 of 3 sessions/week, Engel 2019 reported 80% attendance to sessions), adherence to program, and delivery of all intervention components ([<reflink idref="bib66" id="ref393">66</reflink>] reported all HIIT protocols followed with 93.5% of participants attained ≥90% maximal HR during 85% and 100% high-intensity interval exercise protocols) ([<reflink idref="bib16" id="ref394">16</reflink>]; [<reflink idref="bib21" id="ref395">21</reflink>]; [<reflink idref="bib57" id="ref396">57</reflink>]; [<reflink idref="bib65" id="ref397">65</reflink>]; [<reflink idref="bib66" id="ref398">66</reflink>]; [<reflink idref="bib83" id="ref399">83</reflink>]; [<reflink idref="bib98" id="ref400">98</reflink>]). High levels of program satisfaction (e.g., Costigan 2015 reported mean participant satisfaction 4.2/5) ([<reflink idref="bib21" id="ref401">21</reflink>]; [<reflink idref="bib19" id="ref402">19</reflink>]; [<reflink idref="bib31" id="ref403">31</reflink>]; [<reflink idref="bib57" id="ref404">57</reflink>]) and no significant negative/ill effects or injuries ([<reflink idref="bib45" id="ref405">45</reflink>]; [<reflink idref="bib56" id="ref406">56</reflink>]; [<reflink idref="bib66" id="ref407">66</reflink>]; [<reflink idref="bib83" id="ref408">83</reflink>]) were reported. Mean adherence rates were approximately 80% in most included studies ([<reflink idref="bib21" id="ref409">21</reflink>]; [<reflink idref="bib57" id="ref410">57</reflink>]; [<reflink idref="bib66" id="ref411">66</reflink>]; [<reflink idref="bib83" id="ref412">83</reflink>]; [<reflink idref="bib98" id="ref413">98</reflink>]) and align with a recently published systematic review ([<reflink idref="bib69" id="ref414">69</reflink>]). Notably, several authors highlighted the potential application of HIIT for use in PE and sport given high levels of program attendance (i.e., average participant attendance &gt;2 out of 3 sessions/week) ([<reflink idref="bib21" id="ref415">21</reflink>]; [<reflink idref="bib45" id="ref416">45</reflink>]; [<reflink idref="bib57" id="ref417">57</reflink>]), and compliance to HIIT protocols (e.g., meeting HR targets, performing set activities) ([<reflink idref="bib66" id="ref418">66</reflink>]; [<reflink idref="bib83" id="ref419">83</reflink>]; [<reflink idref="bib98" id="ref420">98</reflink>]).</p> <hd id="AN0163169320-20">Discussion</hd> <p>The primary aim of our review was to evaluate the impact of embedding HIIT in organized sport training and PE on young people's cardiometabolic health and health-related fitness. Our meta-analyses demonstrate that HIIT delivered in PE or sport can improve body composition and CRF in children and adolescents. Despite great variance in study quality, sample size, intervention dose, HIIT protocols (work: rest ratios and exercise type), and limited studies in community sport settings, the positive intervention effects for body composition and CRF are important, and may have potential implications for participants' short- and long-term health status. Large-scale studies are required to test implementation and impact at scale.</p> <p>Participation in HIIT had a small (<emph>g</emph> = 0.27) but significant effect on body composition. Our outcomes align with three previous systematic reviews and meta-analysis, which support that HIIT may elicit greater improvements in body composition in healthy ([<reflink idref="bib18" id="ref421">18</reflink>]; [<reflink idref="bib20" id="ref422">20</reflink>]), and overweight, and obese ([<reflink idref="bib94" id="ref423">94</reflink>]) children and adolescents, compared with active controls or continuous aerobic training ([<reflink idref="bib18" id="ref424">18</reflink>]; [<reflink idref="bib20" id="ref425">20</reflink>]; [<reflink idref="bib94" id="ref426">94</reflink>]). Comparatively, a previous systemic review ([<reflink idref="bib30" id="ref427">30</reflink>]) of 13 studies found little evidence to suggest HIIT can improve body composition in healthy children and/or adolescents (aged 5–18 years) ([<reflink idref="bib30" id="ref428">30</reflink>]). In the current review, sex did not emerge as a moderator of intervention effects for body composition, with similar patterns in body composition evident for boys and girls. However, the study conducted by Delgado-Floody et al. ([<reflink idref="bib24" id="ref429">24</reflink>]) found that girls and boys in both HIIT exercise groups experienced significant improvements in BMI, but waist circumference diminished for boys in one of the experimental groups (<emph>p</emph> =.016), while girls in the same group showed a significant reduction in weight to height ratio (<emph>p</emph> =.041) ([<reflink idref="bib24" id="ref430">24</reflink>]). Given the limited number of studies eligible for inclusion in our meta-analysis exploring the use of HIIT for young people in PE (and particularly organized community sport), and the great variability in study methodologies (e.g., assessment method, HIIT protocols, accounting for covariates or baseline scores in statistical analysis), there is further need to replicate smaller pilot studies with larger samples and varied population subgroups (location, ages, sociodemographic status, sex, and setting) to strengthen the support for HIIT and improvements in body composition—and for identifying the strongest moderators of intervention effects.</p> <p>We found that participation in HIIT did not lead to significant improvements in BP in children, or adolescents ([<reflink idref="bib14" id="ref431">14</reflink>]; [<reflink idref="bib81" id="ref432">81</reflink>]; [<reflink idref="bib102" id="ref433">102</reflink>]). Contrary to our overall findings, Van Biljon reports lower SBP in both HIIT (−6.1 ± − 7.0 mmHg; <emph>d</emph> = −0.5) and combined HIIT + MICT (−5.1 ± −1.2 mmHg; <emph>d</emph> = −0.5) groups compared with the MICT group ([<reflink idref="bib97" id="ref434">97</reflink>], [<reflink idref="bib98" id="ref435">98</reflink>]). Our results contradict two previous reviews reporting significant and beneficial effects of HIIT on SBP and DBP ([<reflink idref="bib30" id="ref436">30</reflink>]; [<reflink idref="bib94" id="ref437">94</reflink>]). Thivel reported significant improvements in SBP and DBP in HIIT conditions (−1.026 mmHg; 95% CI [−1.370, −0.683], <emph>p</emph> &lt;.001 and −0.966; 95% CI [−1.628, −0.304], <emph>p</emph> &lt;.01 respectively); and Eddolls et al. ([<reflink idref="bib30" id="ref438">30</reflink>]) concluded that significant improvements in BP were obtained as a result of children and/or adolescents (aged 5–18) participating in HIIT ([<reflink idref="bib30" id="ref439">30</reflink>]). However, it is plausible that lab-based experimental studies may have greater fidelity compared with field-based studies, possibly impacting BP findings of this review. Furthermore, the small number of studies included in previous reviews, and this review, limited the strength of findings regarding BP and HIIT—again warranting a need for more high-quality studies targeting children and adolescents in PE and sport contexts.</p> <p>Participation in HIIT had a small (<emph>g</emph> = 0.27) but significant effect on CRF, which aligns with two previous reviews ([<reflink idref="bib30" id="ref440">30</reflink>]; [<reflink idref="bib33" id="ref441">33</reflink>]). Other recent reviews have reported larger effects of HIIT on CRF in young people in comparison to alternative training modalities ([<reflink idref="bib20" id="ref442">20</reflink>]; [<reflink idref="bib30" id="ref443">30</reflink>]; [<reflink idref="bib94" id="ref444">94</reflink>]). The health implications associated with improved CRF resulting from participation in HIIT for young people, especially among short-duration studies, may be profound; especially given that low CRF in childhood is a significant independent predictor of metabolic syndrome in early adulthood—and a powerful marker of current and future health status ([<reflink idref="bib79" id="ref445">79</reflink>]; [<reflink idref="bib86" id="ref446">86</reflink>]). Children displaying low levels of CRF (especially overweight or obese children) can substantially reduce their risk of metabolic syndrome by improving their CRF by adulthood—compared with those who maintain low fitness levels ([<reflink idref="bib86" id="ref447">86</reflink>]). While this review focuses primarily on the immediate impacts of HIIT on CRF, the potential benefits of improving CRF levels for young people may positively impact health status in the long term.</p> <p>Overall, we found that participation in HIIT was significant for both lower body and upper MF. Our findings align with Martland's recent systematic review reporting the effects of HIIT on muscle mass and/or strength of children and adolescents (<emph>n</emph> = 5) (in comparison to nonactive control groups) ([<reflink idref="bib69" id="ref448">69</reflink>]). In the abovementioned review, positive and significant improvements to muscle mass and/or strength of children and adolescents resulted in all/100% of HIIT interventions compared with nonactive controls ([<reflink idref="bib69" id="ref449">69</reflink>]). In our review, effects for lower body strength were stronger for those in a sport setting; and effects for upper body strength were stronger for short-duration HIIT interventions delivered by teachers. Our findings are consistent with those of a recent review inclusive of 12 studies ([<reflink idref="bib33" id="ref450">33</reflink>]) investigating responses of HIIT on jump performance (counter movement, drop, and squat jump) of trained children/adolescents, reporting small positive improvements on jumping height ([<reflink idref="bib33" id="ref451">33</reflink>]).</p> <p>Our review supports that HIIT is capable of being performed successfully in PE and sport settings with children and adolescents. The captive audience in mandatory PE and sport in schools, and the fact that organized sport is elected by participants (and coaches), provides ideal conditions to expose young people to HIIT. This is supported through high levels of retention and compliance to HIIT programs reported in several included studies. It is also likely that PE teachers and sports coaches seek novel and enjoyable instructional strategies and learning activities evidenced to benefit young people, resulting in high recruitment rates and satisfaction scores in HIIT studies. In addition to their practicality, HIIT programs appear to be safe for use with children and adolescents as no acute injuries or medical issues were reported in any of the included studies. In fact, several studies clearly stated that participants followed HIIT intervention protocols with no significant negative effects or major injuries being observed ([<reflink idref="bib66" id="ref452">66</reflink>]; [<reflink idref="bib83" id="ref453">83</reflink>]). A couple of minor injuries (i.e., bruising, minor strain) were reported.</p> <hd id="AN0163169320-21">Strengths and Limitations</hd> <p>The present systematic review and meta-analysis has several strengths. The adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, use of the cochrane risk of bias criteria, and inclusion of meta-analyses with moderation considerations, are clear strengths. The number of samples included also enables a meaningful moderator and/or analysis. Despite our detailed inclusion of a vast number of moderators, some were scarcely reported (e.g., provider/deliverer); therefore, we contacted the authors directly for this information. It is important to note several limitations of this study. First, most included studies targeted healthy participants of age 8–12 years; therefore, this limits the generalizability of our findings across the entirety of childhood and adolescence (5–18 year) or across population subgroups within this age range. Second, there is variability in study measures for select cardiometabolic outcomes, which makes comparison of results problematic. For example, body composition assessments included BMI, BMI <emph>z</emph> scores, waist circumference, and body fat percentage. Furthermore, adverse events and feasibility information were not reported in all trials included in this review.</p> <hd id="AN0163169320-22">Conclusion</hd> <p>High-quality sport and PE programs delivered in school and community settings play a pivotal role in developing physical capacities and improving health status in young people. However, opportunities for young people to engage in health-enhancing physical activity during sport and PE are often overlooked/missed. Given the impressive reach that sport and PE have throughout childhood and adolescence, our evidence showing a link between PE and sport-based HIIT and improved cardiometabolic health and fitness, provides support for the potential population health benefits of HIIT. However, the results of this review should be interpreted with caution given that a large proportion of included studies were assessed to have a moderate to high degree of bias. In addition, and despite the rising popularity of HIIT across varied age groups and settings (such as sedentary adults in the workplace; [<reflink idref="bib28" id="ref454">28</reflink>]), young adults studying at university ([<reflink idref="bib29" id="ref455">29</reflink>]) more evidence is required to clarify the most impactful HIIT protocols, recommended dose, and duration of HIIT interventions for improving cardiometabolic health and fitness in children and adolescents in the context of sport or PE.</p> <p>Eather (Narelle.eather@newcastle.edu.au) is corresponding author, https://orcid.org/0000-0002-6320-4540</p> <ref id="AN0163169320-23"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref11" type="bt">1</bibl> <bibtext> Abarca-Gómez, L., Abdeen, Z.A., Hamid, Z.A., Abu-Rmeileh, N.M., Acosta-Cazares, B., Acuin, C., Adams, R.J., Aekplakorn, W., Afsana, K., &amp; Aguilar-Salinas, C.A. (2017). 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| Items | – Name: Title Label: Title Group: Ti Data: Impact of Embedding High-Intensity Interval Training in Schools and Sports Training on Children and Adolescent's Cardiometabolic Health and Health-Related Fitness: Systematic Review and Meta-Analysis – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Eather%2C+Narelle%22">Eather, Narelle</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6320-4540">0000-0002-6320-4540</externalLink>)<br /><searchLink fieldCode="AR" term="%22Babic%2C+Mark%22">Babic, Mark</searchLink><br /><searchLink fieldCode="AR" term="%22Riley%2C+Nicholas%22">Riley, Nicholas</searchLink><br /><searchLink fieldCode="AR" term="%22Costigan%2C+Sarah+A%2E%22">Costigan, Sarah A.</searchLink><br /><searchLink fieldCode="AR" term="%22Lubans%2C+David+R%2E%22">Lubans, David R.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Journal+of+Teaching+in+Physical+Education%22"><i>Journal of Teaching in Physical Education</i></searchLink>. Apr 2023 42(2):243-255. – Name: Avail Label: Availability Group: Avail Data: Human Kinetics, Inc. 1607 North Market Street, Champaign, IL 61820. Tel: 800-474-4457; Fax: 217-351-1549; e-mail: info@hkusa.com; Web site: http://journals.humankinetics.com/journal/jtpe – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 13 – Name: DatePubCY Label: Publication Date Group: Date Data: 2023 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Information Analyses<br />Reports - Research – Name: Audience Label: Education Level Group: Audnce Data: <searchLink fieldCode="EL" term="%22Elementary+Secondary+Education%22">Elementary Secondary Education</searchLink> – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Training%22">Training</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Fitness%22">Physical Fitness</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Promotion%22">Health Promotion</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Body+Composition%22">Body Composition</searchLink><br /><searchLink fieldCode="DE" term="%22Muscular+Strength%22">Muscular Strength</searchLink><br /><searchLink fieldCode="DE" term="%22Human+Body%22">Human Body</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Metabolism%22">Metabolism</searchLink><br /><searchLink fieldCode="DE" term="%22Elementary+Secondary+Education%22">Elementary Secondary Education</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Health%22">Physical Health</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1123/jtpe.2021-0165 – Name: ISSN Label: ISSN Group: ISSN Data: 0273-5024<br />1543-2769 – Name: Abstract Label: Abstract Group: Ab Data: Purpose: This systematic review aimed to identify studies evaluating the impact of high-intensity interval training when delivered in school and sports training. Methods: A systematic search of 10 databases (September 2019) identified 24 eligible studies (including children and/or adolescents 5-18 years and reporting cardiometabolic health and/or health-related fitness outcomes), assessed for quality using the Cochrane Risk of Bias Tool (version 2.0). Outcomes were synthesized using a random-effects meta-analysis, and potential moderators were explored (i.e., study duration, risk of bias, age, and deliverer/instructor). Results: Standardized mean difference for the effects of high-intensity interval training were significant for body mass index g = -0.27 (p < 0.001), cardiorespiratory fitness g = 0.27 (p < 0.001), lower body muscular fitness g = 0.49 (p = 0.005), and upper body muscular fitness g = 0.37 (p = 0.002); but not for blood pressure (p > 0.05). Risk of bias results were variable (low = 8, some concerns = 9, and high = 7). Conclusion: Our findings suggest that embedding high-intensity interval training in schools and sports training can facilitate improvements in some aspects of cardiometabolic health and fitness in children and adolescents. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2023 – Name: AN Label: Accession Number Group: ID Data: EJ1391748 |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1123/jtpe.2021-0165 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 243 Subjects: – SubjectFull: Training Type: general – SubjectFull: Physical Fitness Type: general – SubjectFull: Health Promotion Type: general – SubjectFull: Children Type: general – SubjectFull: Adolescents Type: general – SubjectFull: Body Composition Type: general – SubjectFull: Muscular Strength Type: general – SubjectFull: Human Body Type: general – SubjectFull: Program Effectiveness Type: general – SubjectFull: Metabolism Type: general – SubjectFull: Elementary Secondary Education Type: general – SubjectFull: Intervention Type: general – SubjectFull: Physical Health Type: general Titles: – TitleFull: Impact of Embedding High-Intensity Interval Training in Schools and Sports Training on Children and Adolescent's Cardiometabolic Health and Health-Related Fitness: Systematic Review and Meta-Analysis Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Eather, Narelle – PersonEntity: Name: NameFull: Babic, Mark – PersonEntity: Name: NameFull: Riley, Nicholas – PersonEntity: Name: NameFull: Costigan, Sarah A. – PersonEntity: Name: NameFull: Lubans, David R. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 0273-5024 – Type: issn-electronic Value: 1543-2769 Numbering: – Type: volume Value: 42 – Type: issue Value: 2 Titles: – TitleFull: Journal of Teaching in Physical Education Type: main |
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