samedi 29 juillet 2023

Efficacité comparative des interventions en milieu scolaire sur la condition physique des enfants et des adolescents : revue systématique et méta-analyse en réseau

Aperçu: G.M.

Contexte
Les écoles offrent un cadre favorable à l'éducation à la santé, mais le mode d'exercice scolaire le plus efficace pour améliorer la condition physique n'est pas encore clairement défini. Cette méta-analyse en réseau a été conçue pour évaluer et classer l'efficacité comparative de six modalités d'exercice sur les indicateurs de condition physique en milieu scolaire.

Méthodes
Une recherche en ligne a été effectuée dans les bases de données Web of Science, PubMed, SPORTDiscus et Scopus. Les essais contrôlés randomisés et quasi-randomisés ont été pris en compte. Les résultats comprenaient des mesures de l'anthropométrie et de la composition corporelle, de la condition musculaire et de la condition cardiorespiratoire. Les données ont été regroupées à l'aide d'un modèle à effets aléatoires utilisant le cadre fréquentiste.

Résultats
Au total, 66 études portant sur 8 578 participants (48 % de filles) ont été incluses.

  • L'entraînement par intervalles de haute intensité était l'intervention la plus efficace pour réduire l'indice de masse corporelle (différence moyenne (DM) = -0,60 kg-m-2, intervalle de confiance à 95 % (IC 95 %) = -1,04 à -0,15, p = 0,009), augmenter la VO2max (DM = 3,59 ml-kg-1-min-1, IC 95 % = 2,45 à 4,74, p < 0,001) et la performance au sprint sur 20 mètres (DM = -0,35 s, IC 95 % = -0,55 à -0,14, p = 0,001). 
  • L'entraînement aérobique avait la plus forte probabilité de réduire le tour de taille (différence moyenne standardisée (DMS) = -0,60, IC à 95 % = -0,88 à -0,32, p < 0,001). 
  • Les jeux vidéo actifs sont apparus comme une modalité prometteuse pour améliorer le saut en contre-mouvement (MD = 2,43 cm, IC à 95 % = 0,06 à 4,80, p = 0,041) et les performances en course navette (SMD = 0,86, IC à 95 % = 0,29 à 1,43, p = 0,003).
  • L'entraînement musculaire était le meilleur mode d'exercice pour améliorer la performance en saut en longueur (DMS = 1,03, IC 95 % = 0,07 à 1,98, p = 0,035), tandis que
  • l'entraînement combiné était le meilleur pour réduire le pourcentage de graisse corporelle (DMS = -2,56 %, IC 95 % = -4,73 à -0,40, p = 0,022) et augmenter le nombre de répétitions de pompes (DMS = 3,59, IC 95 % = 0,81 à 6,37, p = 0,012).

Conclusion
Les programmes d'exercice physique en milieu scolaire ont de multiples effets sur la condition physique. Les résultats de cette étude contribueront à informer les professeurs d'éducation physique et les entraîneurs sur la meilleure façon d'offrir des programmes d'exercices dans un cadre scolaire.
L'étude étant limitée par la recherche initiale, les conclusions devront être vérifiées plus avant à l'aide d'essais contrôlés randomisés de haute qualité.

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Comparative effectiveness of school-based exercise interventions on physical fitness in children and adolescents: a systematic review and network meta-analysis 

Jin Wu  1 , Yuhang Yang  1 , Huasen Yu  1 , Liqiang Li  1 , Yanying Chen  2 , Youping Sun  1
Affiliations
Free PMC article

Abstract

Background: Schools provide a favorable setting for health education, however, the most effective school-based exercise mode for improving physical fitness remains unclear. This network meta-analysis was designed to assess and rank the comparative efficacy of six exercise modalities on physical fitness indicators in a school-based setting.

Methods: An online search of the Web of Science, PubMed, SPORTDiscus, and Scopus databases was conducted. Randomized and quasi-randomized controlled trials were considered. Outcomes included measures of anthropometry and body composition, muscular fitness, and cardiorespiratory fitness. Data were pooled with a random effects model using the frequentist framework.

Results: A total of 66 studies with 8,578 participants (48% girls) were included. High-intensity interval training was the most effective intervention reducing body mass index (mean difference (MD) = -0.60 kg·m-2, 95% confidence interval (95%CI) = -1.04 to -0.15, p = 0.009), elevating VO2max (MD = 3.59 mL·kg-1·min-1, 95% CI = 2.45 to 4.74, p < 0.001), and 20-meter sprint performance (MD = -0.35 s, 95% CI = -0.55 to -0.14, p = 0.001). Aerobic training had the highest probability of reducing waist circumference (standardized mean difference (SMD) = -0.60, 95% CI = -0.88 to -0.32, p < 0.001). Active video games emerged as a promising modality for improving countermovement jump (MD = 2.43 cm, 95% CI = 0.06 to 4.80, p = 0.041) and shuttle running performance (SMD = 0.86, 95% CI = 0.29 to 1.43, p = 0.003). Strength training was the best exercise mode for improving standing long jump performance (SMD = 1.03, 95% CI = 0.07 to 1.98, p = 0.035) while combined training was rated the first for decreasing body fat percent (MD = -2.56%, 95% CI = -4.73 to -0.40, p = 0.022) and increasing push-up repetitions (SMD = 3.59, 95% CI = 0.81 to 6.37, p = 0.012).

Conclusion: School-based exercise interventions have multiple effects on physical fitness. The findings of this study will help to inform physical education teachers and coaches how best to deliver exercise programs in a school setting. Since the study was limited by the original research, the conclusions will require further verification using high-quality randomized controlled trials.

Systematic review registration: PROSPERO, Identifier: CRD42023401963.

Keywords: adolescents; children; network meta-analysis; physical fitness; school-based exercise.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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