Development of Human Motor Skills and the Promotion of Motivation for Physical Activity

Primary outcomes

1. Cardiorespiratory fitness

   Time frame: Baseline and annually during the 3-year intervention

   Cardiorespiratory fitness assessed using the 20-m shuttle run test (Leger test). The outcome was expressed as the number of completed shuttle runs. Higher numbers of completed shuttle runs indicate better cardiorespiratory fitness.

2. Actual Motor Competence

   Time frame: Baseline and annually during the 3-year intervention

   Motor competence assessed using the Canadian Agility and Movement Skill Assessment (CAMSA). The Canadian Agility and Movement Skill Assessment (CAMSA) raw score consists of the sum of the skill score and the time score. The skill score and time score each have a maximum of 14 points, yielding a total raw score of 1 to 28. Higher scores indicate better motor competence.

3. Cognitive functions

   Time frame: Baseline and annually during the 3-year intervention

   Selected cognitive functions is assessed using the Woodcock-Johnson cognitive test battery. For the present study, results are recommended to be reported as standard scores, which are age-normed with a mean of 100 and a standard deviation of 15. Higher scores indicate better cognitive performance relative to age-matched peers.

4. Physical literacy

   Time frame: Baseline and annually during the 3-year intervention

   Physical literacy assessed using the Physical Literacy in Children Questionnaire (PLC-Q). The Physical Literacy in Children Questionnaire (PL-C Quest) consists of 30 items across four domains. Each item is scored on a 1-4-point scale, yielding a total score of 30-120. Higher scores indicate higher self-perceived physical literacy. Thus, higher total scores reflect a higher level of physical literacy.

5. Motivation for physical activity

   Time frame: Baseline and annually during the 3-year intervention

   Motivation for participation in physical activity is assessed using the AFFEXX questionnaire. The Affective Exercise Experiences Questionnaire (AFFEXX) consists of 22 items, each rated on a 1-5-point scale, yielding a total score ranging from 22 to 110. Higher scores indicate higher motivation for physical activity.

6. Body composition

   Time frame: Baseline and annually during the 3-year intervention

   Body composition is assessed using bioelectrical impedance analysis (BODYSTAT Quadscan 4000). The outcome variables included body fat percentage, intracellular water (ICW), and extracellular water (ECW). Higher body fat values indicate greater adiposity. ICW and ECW represent the relative distribution of body water between the intracellular and extracellular compartments, respectively. Body fat was interpreted using age- and sex-specific percentile cut-offs (<2nd percentile = underfat, 2nd to <85th percentile = normal, 85th to <95th percentile = overfat, and ≥95th percentile = obese), whereas ICW and ECW were interpreted relative to age- and sex-specific reference values, as fixed clinical cut-offs are not established for healthy pediatric populations.

7. Physical activity

   Time frame: Baseline and annually during the 3-year intervention

   Physical activity monitored using ActiGraph GT3X accelerometers. Physical activity was objectively assessed using an ActiGraph GT3X accelerometer worn for 7 consecutive days during the week. Data were used to quantify time spent in sedentary behavior, light physical activity (LPA), moderate physical activity (MPA), and vigorous physical activity (VPA). In addition, moderate-to-vigorous physical activity (MVPA) was calculated as the sum of moderate and vigorous physical activity. This 7-day ActiGraph protocol is consistent with common practice in pediatric accelerometer studies. The outcomes were expressed as time spent in each intensity category, typically reported in minutes per day. Sedentary time reflects the amount of time spent inactive, whereas LPA, MPA, VPA, and MVPA reflect increasing levels of movement intensity. Higher values of light, moderate, vigorous, or MVPA indicate that the child is more physically active.

8. Perceived Motor Competence

   Time frame: Baseline and annually during the 3-year intervention

   Perceived Motor Competence is assessed using the Pictorial Scale of Perceived Movement Skill Competence (PMSC). The Pictorial Perceived Motor Competence (PMSC) instrument consists of 22 items, with each item rated on a 1-4-point scale. The total score, therefore, ranges from 22 to 88 points. Higher scores indicate higher perceived motor competence.