{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:28:44Z","timestamp":1791890924745,"version":"4.3.4"},"reference-count":54,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Social Science Found of China","award":["19BTY077"],"award-info":[{"award-number":["19BTY077"]}]},{"name":"National Social Science Found of China","award":["11DZ2261100"],"award-info":[{"award-number":["11DZ2261100"]}]},{"name":"Shanghai Key Lab of Human Performance in Shanghai University of Sport","award":["19BTY077"],"award-info":[{"award-number":["19BTY077"]}]},{"name":"Shanghai Key Lab of Human Performance in Shanghai University of Sport","award":["11DZ2261100"],"award-info":[{"award-number":["11DZ2261100"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Evidence shows that physical exercise promotes preschoolers\u2019 fundamental movement skills (FMSs) and physical fitness (PF). However, studies that assess the effectiveness of different types of physical exercise interventions to improve FMSs and PF in preschool children remain scarce. To explore and compare the effectiveness of different physical exercise on FMSs and PF, interventions comprising ball games (BGs), rhythm activities (RAs), basic movements (BMs), and a combination of all related activities (multiple activities, MAs) will be conducted among preschoolers. Methods: A single-blind, five-arm, cluster-randomized trial will be conducted in kindergarten in Shanghai, China. In total, 300 healthy preschoolers, aged 4 to 5 years, will be randomized to four intervention groups (BG, RA, BM, or MA) and one control group (unorganized physical activities). Four intervention groups will receive three 30-min lessons weekly for 16 weeks. At the baseline, the end of the 16-week intervention, and the 6-month follow-up after the end of the intervention, the primary outcomes (FMSs and PF) and physical activity (PA), and sociodemographic and anthropometric data will be assessed. Discussion: This study will provide vital information regarding the effect of different physical exercise interventions on preschool children\u2019s FMSs and PF, PA, and the potential interactions between these domains. The most effective intervention strategy can be generalized to kindergarten and other preschool educational institutions in practice to promote preschoolers\u2019 development of FMSs and PF. Conclusions: This study protocol aims to provide a method to solve the problem of \u201chow to arrange physical exercise and which kind of physical exercise program can promote FMS and PF better in preschool children\u201d.<\/jats:p>","DOI":"10.3390\/ijerph19106331","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T22:57:22Z","timestamp":1653346642000},"page":"6331","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The Effect of Physical Exercise on Fundamental Movement Skills and Physical Fitness among Preschool Children: Study Protocol for a Cluster-Randomized Controlled Trial"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1745-9956","authenticated-orcid":false,"given":"Guangxu","family":"Wang","sequence":"first","affiliation":[{"name":"School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China"},{"name":"College of Physical Education, Henan Normal University, Xinxiang 453007, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahua","family":"Zi","sequence":"additional","affiliation":[{"name":"School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3730-5364","authenticated-orcid":false,"given":"Bo","family":"Li","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China"},{"name":"Institute of Sports Science, Nantong University, Nantong 226019, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Su","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chener","family":"Ren","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1251-3025","authenticated-orcid":false,"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China"},{"name":"Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, Shanghai 200438, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1080\/00336297.2008.10483582","article-title":"A Developmental Perspective on the Role of Motor Skill Competence in Physical Activity: An Emergent Relationship","volume":"60","author":"Stodden","year":"2008","journal-title":"Quest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s40279-014-0281-8","article-title":"Systematic review and proposal of a field-based physical fitness-test battery in preschool children: The PREFIT battery","volume":"45","author":"Ortega","year":"2015","journal-title":"Sports Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/sms.12407","article-title":"Fundamental movement skills and physical fitness as predictors of physical activity: A 6-year follow-up study","volume":"26","author":"Jaakkola","year":"2016","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_4","unstructured":"Goodway, J.D., Ozmun, J.C., and Gallahue, D.L. (2019). Understanding Motor Development: Infants, Children, Adolescents, Adults, Jones & Bartlett Learning. [8th ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/sms.13746","article-title":"Pre-schoolers fundamental movement skills predict BMI, physical activity, and sedentary behavior: A longitudinal study","volume":"31","author":"Duncan","year":"2021","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.jsams.2015.12.512","article-title":"Association between sports participation, motor competence and weight status: A longitudinal study","volume":"19","author":"Henrique","year":"2016","journal-title":"J. Sci. Med. Sport"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1123\/jtpe.2014-0209","article-title":"Fundamental Movement Skills: An Important Focus","volume":"35","author":"Barnett","year":"2016","journal-title":"J. Teach. Phys. Educ."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Rudd, J.R., Barnett, L.M., Butson, M.L., Farrow, D., Berry, J., and Polman, R.C. (2015). Fundamental Movement Skills Are More than Run, Throw and Catch: The Role of Stability Skills. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0140224"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jsams.2014.12.004","article-title":"Motor competence and health related physical fitness in youth: A systematic review","volume":"19","author":"Cattuzzo","year":"2016","journal-title":"J. Sci. Med. Sport"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.4236\/ape.2012.21003","article-title":"Physical Education in Kindergarten Promotes Fundamental Motor Skill Development","volume":"2","author":"Lemos","year":"2012","journal-title":"Adv. Phys. Educ."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.2165\/11536850-000000000-00000","article-title":"Fundamental movement skills in children and adolescents: Review of associated health benefits","volume":"40","author":"Lubans","year":"2010","journal-title":"Sports Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1177\/1559827616640196","article-title":"Fundamental Movement Skills and Health-Related Outcomes: A Narrative Review of Longitudinal and Intervention Studies Targeting Typically Developing Children","volume":"12","author":"Bremer","year":"2018","journal-title":"Am. J. Lifestyle Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1123\/pes.21.4.436","article-title":"Relationships between fundamental movement skills and objectively measured physical activity in preschool children","volume":"21","author":"Cliff","year":"2009","journal-title":"Pediatr. Exerc. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1111\/jpc.14684","article-title":"Prevalence and risk factors of gross motor delay in pre-schoolers","volume":"56","author":"Veldman","year":"2020","journal-title":"J. Paediatr. Child Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1123\/jpah.2019-0457","article-title":"Development of WHO Guidelines on Physical Activity, Sedentary Behavior, and Sleep for Children Less Than 5 Years of Age","volume":"17","author":"Willumsen","year":"2020","journal-title":"J. Phys. Act. Health"},{"key":"ref_16","unstructured":"Eurofit, C. (1998). Handbook for the EUROFIT Tests of Physical Fitness, Italian National."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Janssen, I., and Leblanc, A.G. (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int. J. Behav. Nutr. Phys. Act., 7.","DOI":"10.1186\/1479-5868-7-40"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/cch.12404","article-title":"Physical fitness in preschool children: Association with sex, age and weight status","volume":"43","author":"Moreno","year":"2017","journal-title":"Child Care Health Dev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1007\/s40279-014-0196-4","article-title":"The health benefits of muscular fitness for children and adolescents: A systematic review and meta-analysis","volume":"44","author":"Smith","year":"2014","journal-title":"Sports Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1111\/j.1399-5448.2011.00769.x","article-title":"Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: The HELENA study","volume":"12","author":"Artero","year":"2011","journal-title":"Pediatr. Diabetes"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ortega, F.B., Silventoinen, K., Tynelius, P., and Rasmussen, F. (2012). Muscular strength in male adolescents and premature death: Cohort study of one million participants. BMJ, 20.","DOI":"10.1136\/bmj.e7279"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/ped.12898","article-title":"Intellectual maturity and physical fitness in preschool children","volume":"58","year":"2016","journal-title":"Pediatr. Int."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Kriemler, S., Zahner, L., Schindler, C., Meyer, U., Hartmann, T., Hebestreit, H., Brunner-La, R.H.P., Mechelen, V.W., and Puder, J.J. (2010). Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: Cluster randomised controlled trial. BMJ, 23.","DOI":"10.1136\/bmj.c785"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1136\/bjsports-2018-099655","article-title":"Effectiveness of a school-based physical activity intervention on adiposity, fitness and blood pressure: MOVI-KIDS study","volume":"54","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s40279-019-01191-w","article-title":"Effects of Exercise Intervention on Health-Related Physical Fitness and Blood Pressure in Preschool Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"50","author":"Izquierdo","year":"2020","journal-title":"Sports Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1080\/02640414.2015.1017734","article-title":"Improvements in fundamental movement skill competency mediate the effect of the SCORES intervention on physical activity and cardiorespiratory fitness in children","volume":"33","author":"Cohen","year":"2015","journal-title":"J. Sports Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.jsams.2015.07.002","article-title":"How important is young children\u2019s actual and perceived movement skill competence to their physical activity?","volume":"19","author":"Slykerman","year":"2016","journal-title":"J. Sci. Med. Sport"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.numecd.2016.07.001","article-title":"Physical fitness as a mediator between objectively measured physical activity and clustered metabolic syndrome in children and adolescents: The UP&DOWN study","volume":"26","author":"Santos","year":"2016","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Szeszulski, J., Lorenzo, E., Shaibi, G.Q., Buman, M.P., Vega-L\u00f3pez, S., Hooker, S.P., and Lee, R.E. (2019). Effectiveness of early care and education center-based interventions for improving cardiovascular fitness in early childhood: A systematic review and meta-analysis. Prev. Med. Rep., 15.","DOI":"10.1016\/j.pmedr.2019.100915"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.jshs.2020.03.001","article-title":"Association between fundamental motor skills and physical activity in the early years: A systematic review and meta-analysis","volume":"9","author":"Jones","year":"2020","journal-title":"J. Sport Health Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1007\/s40279-017-0723-1","article-title":"Interventions to Promote Fundamental Movement Skills in Childcare and Kindergarten: A Systematic Review and Meta-Analysis","volume":"47","author":"Wick","year":"2017","journal-title":"Sports Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"6455","DOI":"10.3390\/ijerph120606455","article-title":"What Is the Relationship between Outdoor Time and Physical Activity, Sedentary Behaviour, and Physical Fitness in Children? A Systematic Review","volume":"12","author":"Gray","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_33","first-page":"216","article-title":"The Effects of SPARK Physical Education Program on Fundamental Motor Skills in 4\u20136 Year-Old Children","volume":"23","author":"Mostafavi","year":"2013","journal-title":"J. Iran. J. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Rocha, H.A., Marinho, D.A., Jidovtseff, B., Silva, A.J., and Costa, A.M.J.M. (2017). Influence of regular soccer or swimming practice on gross motor development in childhood. Motricidade, 12.","DOI":"10.6063\/motricidade.7477"},{"key":"ref_35","first-page":"47","article-title":"Are specific programs a threat to overall motor development of preschool children?","volume":"22","author":"Sanja","year":"2016","journal-title":"Kinesiol. Slov."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3916\/C57-2018-08","article-title":"Towards understanding young children\u2019s digital lives in China and Australia","volume":"26","author":"Gou","year":"2018","journal-title":"Comunicar"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1016\/j.jsams.2009.10.145","article-title":"Longitudinal evidence for the importance of motor skill proficiency to physical activity","volume":"12","author":"Barnett","year":"2010","journal-title":"J. Sci. Med. Sport"},{"key":"ref_38","unstructured":"American College of Sports Medicine (2013). ACSM\u2019s Resources for the Health Fitness Specialist, Lippincott Williams & Wilkins."},{"key":"ref_39","unstructured":"Ministry of Education of the People\u2019s Republic of China (2018, July 05). Notice of the General Office of the Ministry of Education on Carrying out the Special Treatment of \u201cPrimary School\u201d in Kindergartens, Available online: http:\/\/www.moe.gov.cn\/srcsite\/A06\/s3327\/201807\/t20180713_342997.html."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1037\/0278-6133.9.1.48","article-title":"Aerobics enhances cardiovascular fitness and agility in preschoolers","volume":"9","author":"Alpert","year":"1990","journal-title":"Health Psychol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1123\/pes.2016-0107","article-title":"Exercise Training Improved Body Composition, Cardiovascular Function, and Physical Fitness of 5-Year-Old Children With Obesity or Normal Body Mass","volume":"29","author":"Tan","year":"2017","journal-title":"Pediatr. Exerc. Sci."},{"key":"ref_42","unstructured":"Ulrich, D.A., and Sanford, C.B. (1985). Test of Gross Motor Development, Pro-Ed, Inc."},{"key":"ref_43","unstructured":"Henderson, S., and Sugden, D. (1992). Movement Assessment Battery for Children, Psychological Corporation."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.jsams.2016.02.003","article-title":"Assessing physical fitness in preschool children: Feasibility, reliability and practical recommendations for the PREFIT battery","volume":"19","author":"Ruiz","year":"2016","journal-title":"J. Sci. Med. Sport"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1007\/s00421-017-3717-7","article-title":"Estimating VO2max in children aged 5-6 years through the preschool-adapted 20-m shuttle-run test (PREFIT)","volume":"117","author":"Ruiz","year":"2017","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.jsams.2018.09.227","article-title":"Physical fitness reference standards for preschool children: The PREFIT project","volume":"22","author":"Intemann","year":"2019","journal-title":"J. Sci. Med. Sport"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1139\/apnm-2015-0338","article-title":"Tracking of physical activity and fitness during the early years","volume":"41","author":"Caldwell","year":"2016","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Dwyer, G.M., Hardy, L.L., Peat, J.K., and Baur, L.A. (2011). The validity and reliability of a home environment preschool-age physical activity questionnaire (Pre-PAQ). Int. J. Behav. Nutr. Phys. Act., 8.","DOI":"10.1186\/1479-5868-8-86"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1038\/oby.2006.234","article-title":"Validation and calibration of an accelerometer in preschool children","volume":"14","author":"Pate","year":"2006","journal-title":"Obesity"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/1440-1630.12318","article-title":"Relationship between time use in physical activity and gross motor performance of preschool children","volume":"64","author":"Lin","year":"2017","journal-title":"Aust. Occup. Ther. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1249\/MSS.0000000000000966","article-title":"Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review","volume":"48","author":"Donnelly","year":"2016","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1038\/ijo.2011.54","article-title":"Relationship of physical activity with motor skills, aerobic fitness and body fat in preschool children: A cross-sectional and longitudinal study (Ballabeina)","volume":"35","author":"Meyer","year":"2011","journal-title":"Int. J. Obes."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1111\/cch.12232","article-title":"Fundamental movement skills in preschoolers: A randomized controlled trial targeting object control proficiency","volume":"41","author":"Donath","year":"2015","journal-title":"Child Care Health Dev."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Moher, D. (2014). Along with the privilege of authorship come important responsibilities. BMC Med., 12.","DOI":"10.1186\/s12916-014-0214-2"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/10\/6331\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:16:58Z","timestamp":1760138218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/10\/6331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,23]]},"references-count":54,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["ijerph19106331"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19106331","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-149945\/v1","asserted-by":"object"}]},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,23]]}}}