The benefits of physical activity to maintain
optimal health and well-being in children and adolescents
are undisputed. The school environment offers opportuni-
ties for children to be physically active.
The aim of this review is to systematically
examine the effects of recess-based interventions on the
physical activity (PA) levels of school-aged children and
A systematic literature search was con-
ducted to identify papers reporting interventions to pro-
mote PA during school recess and/or lunchtime periods.
The search was conducted in six databases (PubMed,
SPORTDiscusTM, Web of Science, Proquest, Cochrane and
Scopus) for papers published between January 2000 and
Articles were included in the review if
(i) they reported the findings of an intervention targeting
PA levels of children and/or adolescents during school
recess and/or lunchtime; (ii) have a measure of PA as an
outcome variable; (iii) participants were aged between 5
and 18 years; and (iv) were published in English.
Two authors independently searched the litera-
ture using the same search strategies to identify papers
reporting interventions that promote PA during school
recess and lunchtime periods. Methodological quality was
assessed using an adapted eight item assessment scale. The
effects of the interventions were assessed with a rating
system used in a recent review of interventions in youth.
The search originally retrieved 2,265 articles.
Nine published peer-reviewed journal articles met the
inclusion criteria for this review. Eight studies used ran-
domized controlled trials and one was a controlled trial.
Three studies demonstrated high methodological quality
(33%). None of the studies adequately reported the ran-
domization procedure or used power calculations. Few
studies reported potential confounders and three studies
had less than a 6 week follow-up. Five studies demon-
strated a positive intervention effect on children’s PA
levels, with four reporting statistically significant increases
and two reporting significant decreases in recess PA. The
summary of the levels of evidence for intervention effects
found inconclusive results for all intervention types, though
promising strategies that require further investigation were
Whilst every effort was made to ensure that
this review was as encompassing as possible, it may be
limited by its search terms especially if there were studies
with unclear titles or abstracts. In addition, only manu-
scripts published in English were considered, eliminating
any possible studies published in other languages.
All of the studies used an objective measure
to assess PA outcomes, although several criteria were
consistently absent from the studies. The levels of evidence
were not sufficient to establish conclusive intervention
effects on children’s recess PA. This could be due to the
small number of published studies. There is a need for
higher-quality intervention research to strengthen pub-
lished findings to inform recess PA interventions. Inter-
vention research is needed in adolescents due to the
absence of school recess intervention research in this