Objective This review provides the first meta-analysis of the impact of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Design Systematic review and meta-analysis of controlled studies. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. Data sources PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Studies eligibility criteria Physically active lessons compared with a control group in a randomised or non-randomised design, within single component interventions in general school populations. Results 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible to be included in the systematic review and 37 of them were included across the six meta-analyses (n=12 663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95% CI 1.42 to 3.25: k=16) and small, increases on overall PA (d=0.32; 95% CI 0.18 to 0.46: k=8), large, improvement in lesson-time educational outcomes (d=0.81; 95% CI 0.47 to 1.14: k=7) and a small improvement in overall educational outcomes (d=0.36; 95% CI 0.09 to 0.63: k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least two domains. Conclusion In elementary and preschool settings, when physically active lessons were added into the curriculum they had positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool setting. Trial registration number CRD42017076933.

中文翻译：

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学校体育课及其对体育活动、教育、健康和认知结果的影响：系统回顾和荟萃分析

目的 本综述首次对体育活动课程对课时和整体体育活动 (PA) 以及健康、认知和教育成果的影响进行荟萃分析。设计 对照研究的系统回顾和荟萃分析。六项荟萃分析汇总了对课时 PA、整体 PA、课堂教育和整体教育成果、认知和健康成果的影响。使用 R 中的 metafor 包进行荟萃分析。使用 Cochrane 工具评估偏倚风险的偏倚风险。数据源 PubMed、Embase、PsycINFO、ERIC 和 Web of Science、灰色文献和参考列表在 2017 年 12 月和 2019 年 4 月进行了搜索。研究资格标准 在普通学校人群的单一成分干预中。结果 42 项研究（39 项在学前或小学环境中进行，27 项随机对照试验）符合纳入系统评价的条件，其中 37 项纳入了六项荟萃分析（n = 12 663）。发现体育活动课程可显着提高课时 PA（d=2.33；95% CI 1.42 至 3.25：k=16），而整体 PA 则小幅增加（d=0.32；95% CI 0.18 至 0.46） : k=8)，课时教育成果大幅改善（d=0.81；95% CI 0.47 至 1.14：k=7）和整体教育成果小幅改善（d=0.36；95% CI 0.09 至 0.63 : k=25)。对认知 (k=3) 或健康结果 (k=3) 未见影响。25/42 研究在至少两个领域存在高偏倚风险。结论 在小学和学前班环境中，将体育活动课程添加到课程中时，它们对体育活动和教育成果都产生了积极影响。这些发现支持鼓励将体育活动课程纳入小学和学前教育教学的政策举措。试用注册号 CRD42017076933。