Engaging in appropriate levels of physical activity could lead to many beneficial outcomes in children. These include better fitness, bone health, and subjective well-being; studies have even shown that physical activity benefits children's cognitive development and may be positively associated with their academic achievements. As the international authority in health behaviors, the World Health Organization (WHO) has published guidelines on the amount of time individuals should spend in doing physical activity. For instance, children aged 3 years and above are recommended to spend at least 60 minutes per day in activities that are of moderate-to-vigorous intensities (i.e., activities involving major muscles groups that raise heartrate and cause sweating). Unfortunately, studies conducted around the globe have shown that most children were unable to meet these recommendations. In Hong Kong, for instance, research conducted at our lab over the past 10 years has shown that less than 20% of children (6 to 12 years) were able to meet WHO guidelines. This figure even plummeted to 5% when schools were suspended amid the COVID-19 pandemic.
According to WHO's Global action plan on physical activity 2018-2030, provision of quality physical education, creating support school environments and policies are important pathways that could lead to increases in children's activity levels. Although this implies that the physical education classroom is an important venue to promote children's active, healthy behaviors, the instruction and assessment in school physical education had not changed much in the past 20 to 30 years! Even though the teaching of many core academic subjects had been infused with new technology, a significant shift seemingly had not taken place in physical education. As such, our team at the Chinese University of Hong Kong have developed a series of tools to enrich quality physical education. Essentially, we developed tools to assess the quality and quantity of physical activity, which were specifically designed to overcome shortcomings in existing methods used in physical education classrooms, and to generate big data for more in-depth exploration of children's behaviours.
The Fun to Move@JC Project
The aforementioned systems were developed under the Fun to Move@JC project ("the Project"; readers may visit www.funtomove-jc.hk/en/ for more information), which is a large-scale project funded by a generous donation from the Hong Kong Jockey Club Charities Trust. One key objective of the Project was to enhance quality physical education through the promotion of home-school cooperation and the application of innovative information technology. A whole-school approach was adopted in the Project, with a wide range of activities provided to participating students, parents, and teachers. In this article, we shall focus on the technology-related developments.
Fundamental Movement Skills Rater
Research has shown that children's ability to perform motor skills effectively is an important predictor of their physical fitness, and their physical activity participation at present and in the future. Most, if not all, motor skills that are required in established sports or exercise activities are based upon, or are advanced from, a series of movement skills that are called "fundamental movement skills" (FMS). These skills could be characterized into locomotor (e.g., run, jump), ball (e.g., throw, catch), and stability (e.g., balance) skills. These skills are considered the "building blocks" of more complex, sport-specific motor movements. In Hong Kong, the curriculum guide states that physical education in Grades 1 to 3 should primarily focus on teaching students FMS. However, many teachers are not equipped with the skills and knowledge to assess students' FMS. As such, students' development and progressions in FMS are not regularly or accurately assessed.
To address this issue, we developed a system ("FMS Rater") to record and assess students' proficiency in FMS. Using this system, students' movement skills are captured using infrared cameras, and a 3D model of their performances could be reconstructed. The skills are then scored against a series of criteria adapted from well-established assessment tools used in research (i.e., Test of Gross Motor Development). As a result, objective ratings for skill performances could be obtained immediately after each performance. Teachers and students could instantly identify areas in which the child did well, and ones that could be improved. Videos of all assessments are also automatically uploaded to a cloud server; hence teachers could review all scores and actual performances through a web portal.
Apart from benefiting frontline educators, the system also greatly benefits researchers. Traditionally, the established protocol for FMS assessment in research is to video-record children's performance in these skills, and then the video clips were scored by trained experts. This approach is time-consuming and is also subject to discrepancies between assessors. By using the FMS Rater for research purposes, the shortcomings of existing protocols can be addressed as immediate and objective assessments could be achieved. Nonetheless, it is of critical importance to ensure that scores obtained by the tool could demonstrate strong validity. Therefore, we conducted a study (published in the international journal BMJ Open*1) to compare the scores obtained through traditional methods (i.e., scored by experts) and using the developed system. We were able to demonstrate that the two sets of scores had an overall agreement in 86% of the ratings. This exceeded the typical threshold (of 85%) which we have used for expert-training purposes. These results suggest that the FMS Rater is a viable tool for motor skill assessment for research purposes as well.
Fun to Move@JC Sport Band
The measurement of physical activity quantity using technology is neither new nor innovative. In fact, there had been a plethora of research tools and commercial wearables that are designed to measure the volume of activity a user has accrued. For example, research accelerometers are widely adopted as an accurate, non-intrusive tool for the measurement of physical activity in research studies, including ones that were conducted at our laboratory. However, the user interface (or in most cases, the lack of), companion software, and data transfer protocol were designed mainly for research use. All in all, these suites of devices and software were not designed for normal daily use, and hence is not appropriate for long-term surveillance purposes. Commercial wearables, on the other hand, are designed for end users and in some cases, even fashionable. However, since the algorithms used to extract activity data differs by brand, and perhaps even across models, a fair comparison between users of different devices may not be viable. Also, data at more granular levels may not be retrievable, which limits the depth of analyses that could be applied. Further, most wearables synchronize data through mobile devices, which is not available to most young students.
The Fun to Move@JC Sport Band, a wearable device designed specifically for schoolchildren, and related peripherals were developed to overcome these challenges. All participants of the Project received a pair of these devices, one for the student and one for a parent, after they provided consent to take part. Although the primary function of our devices is to collect activity data, they have several unique features. First, activity data collected from these devices are stored in 15 second intervals, hence allowing researchers to pinpoint when the activity was accrued, and hence conduct analyses at a granular level. Apart from synchronizing data using mobile devices, data collection gateways (i.e., microcomputers) were programmed and installed in classrooms so that data stored in students' devices would be automatically uploaded to cloud servers. This innovative approach and technology enabled us to retrieve activity data of students during school hours. As all participants of the Project used the same device, all activity data generated were comparable across students, and within users over time.
The big data generated through these devices also allow us to provide individualized feedback to users. As such, based on users' past activity records, a unique daily step count target is generated for each user. These goals are designed to be challenging, but attainable. Meeting individualized targets consistently will allow users to increase their overall activity levels over time. Award schemes, inter-class challenges and competitions are also made possible to create a fun environment for physical activity engagement. Other big data analyses, such as comparisons of activity data across genders or grade levels could be conducted to allow an in-depth understanding of children's activity trends and habits. Importantly, this will allow researchers to design targeted methods to improve the physical activity and health of schoolchildren and their parents.
Many facets of education, or more generally our daily lives, are being improved by the application of new technologies. We strongly believe that no exception should be made to physical education classrooms. In this article, we presented the technological developments we have made to enrich quality physical education, namely, to improve the assessment of physical activity quality and quantity. These tools were developed with frontline educators and researchers in mind, and the initial feedback we received were extremely positive. That said, we are consistently working on improvements to these systems, and we hope our efforts could spark technology use within school physical education around the globe.
- *1 Ha AS, Cheng J, Chan CHS, et al. Examining the criterion validity of two scalable, information technology-based systems designed to measure the quantity and quality of movement behaviours of children from Hong Kong primary schools: a cross-sectional validation study BMJ Open 2022;12:e060448. doi: 10.1136/bmjopen-2021-060448