Introduction

The increasing prevalence of childhood obesity has emerged as a serious public health concern, with profound implications for children’s overall health and development (1). Recent research suggests that the increasing rates of childhood obesity are linked to a variety of lifestyle factors, including decreased physical activity and increased sedentary behaviors, that have become more prevalent in modern society (2). According to the World Health Organization (WHO), the global prevalence of childhood obesity has increased from 4% in 1975 to approximately 18% in recent years, affecting more than 340 million children and adolescents aged 5–19 years worldwide (3, 4).

Research suggests that obese children are more likely to have deficits in both gross and fine motor skills compared to their normal-weight peers (5). This decline in motor skill performance can limit their ability to participate in physical activities, creating a cycle of inactivity and weight gain (6). Studies have also shown that mechanical limitations caused by excess weight can have a negative impact on motor control and coordination (7-10), balance and agility (11), and in addition, reduce self-esteem and increase social isolation (12).

In addition, some studies have provided evidence that indicates a negative association between excess weight and cognitive function (13). These associations have also been observed with different cognitive domains such as learning and memory abilities (14). Cognitive functions, especially executive functions, are closely related to motor performance. Individuals with severe obesity have shown poorer performance in tasks that require motor planning, processing speed, attention and inhibition (15). The integration of cognitive and motor functions depends on an extensive network in the frontal region of the brain that is essential for performing various executive functions. Disturbances in this network can lead to problems in cognitive and motor functions (16). However, some studies have reported conflicting evidence that, according to the “obesity paradigm,” obese individuals may perform similarly or better than normal-weight individuals in executive functions (17).

Perceptual-motor skills are a complex and multidimensional set of developmental abilities in children that have two main aspects: perception and movement. The acquisition of these abilities is an important element in successful athletic performance (18). The quality of motor performance depends on sensory integration, which is influenced by the correct perception of information from the environment and the ability of the individual to interpret and integrate this information into the nervous system. Sensory integration is a complex neural process whose final product is known as the basis for motor and perceptual development in children (19). Perceptual-motor skills are influenced by many factors such as age, gender, maturity, family socioeconomic status, etc. Some studies have shown that opportunities for children to practice and exercise have an impact on the development of perceptual-motor skills, and therefore these skills can be taught and improved (18).

Some studies on the effects of motor training have shown that interventions that focus on increasing physical activity levels and developing motor skills can improve motor skills in overweight children by creating a supportive environment. Some studies have shown that structured exercise interventions that focus on fundamental motor skills, such as moving and controlling objects, have produced significant improvements in motor abilities in overweight children (20, 21). Other studies include dynamic and static balance exercises, which have shown a significant positive effect on balance skills in these individuals (22). The use of active video games has also been effective in improving specific motor skills, such as throwing and catching, in overweight children (23).

Despite these findings, there is still little research on the effects of exercise programs on the motor and cognitive development of overweight children, especially during childhood. This study intends to use environmental interventions with an emphasis on games available in a dynamic yard. In a dynamic yard, purposeful shapes are designed on the ground to practice fundamental motor skills and also develop physical fitness of students (24, 25). Therefore, this study was conducted to investigate the effects of a dynamic yard on perceptual-motor skills and cognitive performance of 10-year-old overweight children.

Method: The present study was a semi-experimental study conducted in the field. The research design included a pre-test and post-test using two experimental and control groups. Participants: The statistical population included all overweight female students in the fourth grade of elementary school studying in schools in Hamedan. Using G-Power software with a power of 80% and an alpha of 0.05, the minimum number of students in each group was estimated to be 30 (26). Among all elementary schools, two schools were selected in a multi-stage cluster. Then, 15 students from one school were selected as the experimental group and 15 students from the other school were selected as the control group. The inclusion criteria for both groups were age of about 10 years and being overweight, and the exclusion criteria were inability to perform the pre-post-test, the presence of diseases and neuromuscular and orthopedic problems that affect the execution of movements. The consent form was signed by the parents of the students.

Results: The results of the BOT-2 test are shown in Table 3. According to the results of the covariance test, the implementation of dynamic yard exercises led to improvements in some perceptual-motor skills. According to the results, the experimental group showed significant improvements in the subscales of running speed and agility (p=0.035), balance (p=0.046), and total score (p=0.042) after the exercises. The results of the covariance test after adjusting the means showed that the dynamic yard exercises caused a decrease in response time (p=0.018) and a decrease of more than 100 percent in the number of no-response stimuli (p<0.001) in the experimental group. Also, in the subscale of compatible stimuli of the Stroop test, after the exercises, the number of correct responses increased by about 34 percent (p=0.015) and the number of no-response stimuli decreased by 38 percent (p=0.009). In the incongruent stimuli subscale, the number of correct responses increased by about 25% (p=0.034) and the number of unresponsive stimuli decreased by about 37% (p=0.012). The interference score also decreased significantly by about 60% (p=0.008).

Conclusion: The findings of this study indicate that dynamic training in the school yard significantly improved motor skills in overweight 10-year-old girls. These improvements were observed in running speed and balance, as well as in the overall score of the BOT-2 test. The improvement in balance, in particular, indicates the potential of dynamic training in the yard to enhance postural control and stability, which are critical for general motor skills and injury prevention.

The results of this study are consistent with previous research that has shown the benefits of physical activity for the development of motor skills in children. Some of these studies have shown that structured physical activity programs can improve balance, coordination, and agility in overweight and obese children (20, 21). The findings of this study on the effect of dynamic training were also consistent with the results of Babakhani et al. (2022) (25). The significant improvements in running speed and balance after dynamic yard exercises suggest that these activities may promote the development of motor skills by providing a sensorimotor-rich environment. These activities typically involve varied and unpredictable movements that may help develop motor planning, coordination, and adaptability. These findings are consistent with the principles of ecological dynamics, which emphasize the importance of task variety and interaction with the environment in learning skills. From an ecological perspective, all experiences that children encounter from birth contribute to strengthening the person-environment relationship and are considered learning experiences (28). The school environment plays a significant role in providing constructive learning opportunities that increase cognitive flexibility and prepare students to effectively deal with the most complex tasks (29).

The findings of this study on the effect of dynamic yard exercises indicated a significant effect of these exercises on executive functions. The increase in the number of correct responses indicates an improvement in decision-making and planning efficiency, and the significant reduction in unresponsive stimuli may indicate the effect of the exercises on increasing the concentration of these individuals. These factors are especially important for overweight children, because according to previous studies, this group often faces deficits in executive function, including reduced information processing speed and concentration and attention (30, 31). These results were in line with studies that emphasize the role of physical activity on cognitive and motor performance in overweight children (32). The results of the Stroop test also confirm the cognitive benefits of dynamic yard exercises. The increase in correct responses and the reduction in unresponsive stimuli in both the congruent and incongruent stimuli subscales indicate improvements in selective attention, cognitive flexibility, and inhibitory control. The significant reduction in the interference score may also indicate a reduction in the impact of contradictory information on movement execution and indicates an improvement in the ability to manage cognitive interference. These findings are consistent with the principles of cognitive-motor integration, which states that physical activities that require complex movements and decision-making can stimulate neural pathways associated with executive functions (33, 34). A dynamic playground is an environment that is constantly available to children without the need for sports equipment. In general, enriching children's environments in terms of sensory, social, and physical stimuli provides new experiences, mental and motor challenges, and opportunities for interaction and learning. Research has shown that exposure to such environments can have a positive effect on brain development and improve cognitive and motor functions (35). One mechanism that can explain these changes in the nervous system is increased neuroplasticity, which means the creation of new neural connections and strengthening existing networks in the brain. This process helps the brain learn better and adapt to new conditions (36).

Keywords: Dynamic yard, Executive function, Motor performance, Overweight,

Ethical Considerations

Compliance with ethical guidelines

This study was conducted with applied goals and in compliance with all research guidelines and ethical principles regarding participants, including informed voluntary consent, the right to withdraw from the study if desired, and the protection of confidential information of the subjects.

Funding

No financial support was received from public, commercial, or non-governmental funding sources during this study.

Authors' contribution

All authors contributed equally to the conceptualization of the article and writing of the original and subsequent drafts.

Conflict of interest

The authors declared no conflict of interest.

Acknowledgements

The authors would like to thank all participants of the present study.