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Article

Physical Education on the Beach: An Alternative Way to Improve Primary School Children’s Skill- and Health-Related Outcomes during the COVID-19 Pandemic

by
Maria Chiara Gallotta
1,*,
Giovanna Zimatore
2,
Ludovica Cardinali
3,
Lavinia Falcioni
3,
Valerio Bonavolontà
4,
Davide Curzi
5,
Laura Guidetti
5,† and
Carlo Baldari
2,†
1
Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy
2
Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
3
Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
4
Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
5
University Niccolò Cusano, 00166 Rome, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2022, 19(6), 3680; https://doi.org/10.3390/ijerph19063680
Submission received: 14 February 2022 / Revised: 16 March 2022 / Accepted: 17 March 2022 / Published: 19 March 2022
(This article belongs to the Special Issue Physical Activity, Sport and Health in Children and Adults)
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Versions Notes

Abstract

:
The COVID-19 restrictions could preclude children from participating in physical education (PE) interventions. This study aimed to evaluate the efficacy of a PE intervention conducted on the beach on children’s skill- and health-related outcomes, as a possible alternative PE intervention that could be also applied during the COVID-19 pandemic. The study involved 106 primary school children, randomly assigned to the traditional indoor (TI) intervention or to the experimental outdoor (EO) intervention. The intervention period lasted 4 months and consisted of two 1-h sessions per week. Intervention was conducted just before the beginning of the COVID-19 pandemic. Children’s anthropometric parameters (height, weight, BMI, body fat percentage, and abdominal circumference), fitness parameter (VO2peak), health parameters (resting heart rate, and systolic and diastolic blood pressure), gross motor coordination, and physical activity level were assessed before and after intervention. Both groups significantly improved fitness and motor coordination but worsened some anthropometric parameters (weight, abdominal circumference) after the intervention period. The EO group showed a higher increase of gross motor coordination than the TI group. Results of this study demonstrated that children benefited from a well-structured PE intervention conducted in the natural environment of the beach improving physical fitness and gross motor coordination. Therefore, planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school during the particular period of COVID-19 pandemic.

1. Introduction

The increase of physical inactivity over the past decades is one of the main causes in the development of obesity and its complications from a very young age [1]. The lack of adequate level of physical activity in children is associated with increasing prevalence of cardiovascular risk factors, such as obesity, hypertension, dyslipidaemia, insulin resistance, and vascular inflammation, which can be modified by changes in lifestyle behaviors such as physical activity and diet [2]. Moreover, studies reported that children’s increase of sedentary behaviors and the decrease of physical activity caused a substantial decline in their motor competence [3,4,5,6]. It was well demonstrated that regular participation in physical activity induced positive effects on children’s physical and mental health improving health-related quality of life, physical and social functioning [7]. The World Health Organization (WHO) recommends that young people should do at least an average of 60 min of moderate-to-vigorous physical activity (MVPA) daily, including aerobic exercises and activities to increase and maintain muscular strength, flexibility, and bone health [8,9]. However, a large proportion of young people engage in less physical activity necessary for good health [8]. Recent studies conducted on Italian populations report that more than 18% of Italian children are sedentary [6,10,11,12]. In this context, physical education (PE) appears to be an ideal instrument to promote physical activity participation, since many children and adolescents can be reached, to encourage young people to establish a long-lasting healthy lifestyle and to improve their motor performance [13,14]. Schools could provide opportunities to children and adolescents to be physically active during PE classes, providing them an opportunity to train in an appropriate manner and to participate in adequate PE interventions [13,14,15]. PE interventions are usually conducted in indoor spaces (school gyms). Nevertheless, the COVID-19 restrictions such as the closure of schools and the cancellation of youth sports and PE classes may prevent children from participating in PE interventions [16]. Considering that COVID-19 is spread by direct contact via droplets, the airborne transmission of SARS-CoV-2, should be considered dangerous, especially in indoor environments [17]. The literature suggests that indoor environments, such as gyms, have the greater risk of infection than outdoor environments due to the possible build-up of airborne virus-carrying droplets, inefficient ventilation, and the higher stability of the virus in indoor air [18,19]. Thus, different strategies were applied in Italy in order to prevent or limit contagions during COVID-19 PE practices. It was mandatory to pay attention to dimensions of curricular spaces to allow interpersonal distance of at least 2 meters while doing activities. Individual physical activities were privileged while team sport activities were limited or forbidden. The use of PE tools and sports equipment was limited to personal use only and they should disinfected at the end of each PE lesson. Moreover, the need to wear masks during physical activities, led necessarily to PE lessons with light exercises [20]. Therefore, the necessity of exercising outdoors has become evident following the COVID-19 outbreak. Open spaces could remedy the problem of insufficient spaces for PE, that frequently caused reduction or suspension of PE practical lessons. Outdoor physical exercises no longer needed to use masks; therefore, children could exert respecting the MVPA intensity range [8,9]. Moreover, outdoor sports and physical activities allowed children to benefit from the physical exercise opportunities offered by the natural environment, promoting physical and psychological health and well-being [21,22], positively affecting physical activity level [23], motor skills development [24], fitness level increase [25], and cognitive and social development [22]. Outdoor PE activities could also favor the body image perception and representation [26]. Thus, planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school, favoring the achievement of recommended levels of physical activity to improve school children’s skill- and health-related outcomes.
The Italian peninsula, located in the middle of the Mediterranean Sea, comprises a continental northern sector, a peninsular central-southern sector, two large islands (Sicily and Sardinia) and various archipelagos and minor islands for a total of 20 regions of which 15 are coastal regions [27]. As a peninsula, it is characterized by a large number of coastal areas and beaches that represent an ideal outdoor environment for practicing physical activity.
Thus, this study was aimed to propose an alternative way to the traditional PE intervention. The aim of this study was to verify the feasibility and to evaluate the efficacy of a PE intervention conducted in a natural environment (the beach) on children’s skill- and health-related outcomes, as a possible alternative and safe PE intervention that could be applied also during the COVID-19 pandemic.

2. Materials and Methods

2.1. Participants

One hundred and six primary school children aged 7–11 years volunteered to participate in this study. The sample included subjects from two different schools in Anzio, a small town near the beach in the south of Rome (Italy). Sixty-four participants were randomly assigned to an experimental outdoor PE program (EO) lasting 4 months. The remaining 42 participants were assigned to a traditional indoor PE program (TI) of the same duration and frequency (Table 1).
The Sapienza University Ethical Committee approved this investigation (Rif 5500 Prot. 1070/19) in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent forms were obtained from both parents and children prior to study participation.

2.2. Assessment Methods

2.2.1. Anthropometric Parameters Assessment

Children’s height, weight, body mass index (BMI), abdominal circumference, and body fat were assessed before and after intervention. The measurements were taken according to the standard procedures described by Lohman et al. [28]. Weight and height were measured using a scale and a stadiometer to the nearest 0.5 kg and 0.1 cm, respectively. Children’s BMI was calculated as weight in kg divided by the square of height in meters. Abdominal circumference was measured at the level of the greatest anterior extension of the abdomen in a horizontal plane, when the subject stood. The measurement was made using a tape to the nearest 0.1 cm. Body fat percentage was measured by foot-to-foot bioelectrical impedance analyzers (Body Fat Monitor Scale BF-625, Tanita Corporation of America Inc., Arlington Heights, IL, USA; Téfal Bodymaster Vision, Téfal, Rumilly, France).

2.2.2. Health Parameters Assessment

Resting heart rate and resting blood pressure were measured before and after intervention. Measurements were conducted after children laid on mats for 10–15 min listening to relaxing music. The heart rate was assessed using a heart rate monitor (S610i; Polar Electro Oy, Kempele, Finland). The lowest value stabilized by the heart rate monitor was considered for resting heart rate. The evaluation of the blood pressure was performed in the left arm. The measurements were performed, using a sphygmomanometer, stethoscope, and cuff suitable for the children’s brachial perimeter.

2.2.3. Motor Performance Assessment

Children’s aerobic fitness and gross motor coordination were assessed before and after intervention.
The Pacer test was used to assess aerobic power and cardiovascular endurance [29]. Participants were instructed to run back and forth between two lines spaced 20-m apart, at increasing speed. The test was continued until the participants reached exhaustion or could not complete the laps twice continuously within the required time limit. The Pacer test was reported as a valid measurement of aerobic fitness (R2 = 0.80) [29,30]. The equation of Matsuzaka et al. [30] was used to predict VO2peak values (mL·kg−1·min−1) from the PACER scores (laps). The equation had high evidence of validity [R2 = 0.81] [30].
All four subtests of the Körperkoordinations Test für Kinder (Body Coordination Test for Children, referred to as KTK) were used to evaluate children’s motor coordination [31]. All the tests assess gross motor skills, body control, and coordination, mainly dynamic balance skills [32,33]. These tests were:
The balance beam test assesses the stability of balance in the forward and backward paths. Participants were instructed to walk backward for three times along each of three balance beams of progressively decreasing width. The score was the number of correctly performed steps (maximum eight steps per trail) for each balance beam.
The jumping laterally test assesses the speed of execution with alternating jumps. Participants were instructed to jump laterally as many times as possible over a slat in 15 s. The score was the number of correctly performed jumps.
The hopping on one leg over an obstacle test assesses the coordination of the lower limbs and the dynamic power/force. Participants were instructed to hop on one leg over an increasing pile of pillows after a short run-up. Three, two, or one point(s) were/was awarded for successful performance on the first, second, and third trial, respectively. A maximum of 39 points could be scored for each leg. The sum score was computed.
The shifting platforms test assesses laterality and space–time structure. Participants were instructed to move across the floor in 20 s by stepping from one plate to the next. The score was the number of correctly performed relocations.
The test–retest reliability coefficient for the raw score on the total test battery was previously reported as 0.97, while corresponding coefficients for individual tests ranged from 0.80 to 0.96. Both factor analysis and inter-correlations indicated acceptable construct validity [31].
A standardized warm-up of 10 min running, jumping and stretching exercises preceded the test assessment. Before each subtest, children received an oral explanation and a demonstration about test procedure.

2.2.4. Physical Activity Level Assessment

Children’s physical activity level was assessed before and after intervention by the Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It) [34]. It is a 7-day recall, self-administered instrument. It is composed by nine questions about games and sports, physical activities at school, and those during leisure time, including the weekend. Each question is scored from 1 to 5, with the final score obtained through the means of the question scores. It was previously reported that the PAQ-C-It had acceptable to good reliability (alpha 0.70 to 0.83) and it had significant concurrent validity with the objectively measured MVPA (rho = 0.30, p < 0.05) [34].

2.3. Intervention Programmes

The intervention period lasted 4 months. Intervention was conducted just before the beginning of the COVID-19 pandemic. Experimental interventions consisted of two 1-h sessions per week, for a total of 30 PE lessons for each intervention group. PE interventions differed in environment/context where they were conducted, as well as in type and mode of physical activities in which children participated but they were equivalent in terms of structure, total duration and individual perceived exertion. The individual perceived exertion of both intervention programs was monitored using the OMNI scale [35] to avoid possible differences between the two interventions. Both interventions were designed and conducted by the same specialist PE teacher. Each lesson of both interventions included 15 min of warm-up, 35 min of MVPA within a range of 5 < RPE < 8 [36] and 10 min of cool-down and stretching. During each MVPA session, children reported their OMNI RPE measures. They verbally indicated the corresponding number after looking at the scale in order to have an indication of how hard the exertion felt during the exercise session.
The TI was conducted in the school gym. It was planned to promote children’s fitness and health, sensory-motor, communicative, and social development. It was designed to improve primarily flexibility, strength, and endurance by circuit training for cardiovascular health [37].
The EO was conducted on the beach with the use of various conventional and unconventional tools (e.g., beams derived from beach cabins bases to perform balance exercises). It consisted in a lot of aerobic activities such as walking, running, jumping, walking on their hands and knees, rolling on the beach, creeping, and climbing over. Moreover, different kinds of walking, like walking forward, backward, sideways, tip toeing, striding, on their heels, walking varying the position of the arms, with closed eyes, walking fast and slowly, and so on, were proposed.
All these exercises were conducted in multiple different, playful ways, one by one or in a team.

2.4. Data Analysis

All results were expressed as mean ± standard deviation. An unpaired t-test comparison was firstly conducted on pre-test values of each variable to check for any difference between the two groups before the intervention. A mixed-model analysis of variance (ANOVA) was performed for each measured parameter with group and gender as between-participants factors, time as within-participants factor. The main effects of group (two levels, EO vs. TI), gender (two levels, girls vs. boys), and time (two levels, pre vs. post) were assessed, as well as the interaction between them (time × group, gender × group, time × gender). Where significant main effects were observed, Bonferroni post hoc analysis was used to aid interpretation of these interactions. Effect size was also calculated using Cohen’s definition of small, medium, and large effect size (as partial η2 = 0.01, 0.06, 0.14, respectively) [38]. Finally, subgroup analyses were performed by means of planned pairwise comparisons (t-tests) to examine the intervention effect on each variable by participants’ gender and group. Statistical significance was defined as p ≤ 0.05.

3. Results

Differences in the baseline variables of the EO group and the TI group were verified (p < 0.05), but no significant differences between the two groups were revealed.
The main effect of time revealed that children’s weight (F1,102 = 135.75, p < 0.0001, η2 = 0.571) (32.9 ± 10.5 kg vs. 34.8 ± 11.3 kg) and abdominal circumference (F1,100 = 16.74, p < 0.0001, η2 = 0.143) (62.8 ± 10.7 cm vs. 64.0 ± 10.9 cm) significantly increased after intervention. The main effect of gender revealed that girls had higher %FM than boys (F1,101 = 8.26, p = 0.005, η2 = 0.076) (26.3 ± 5.0 vs. 22.7 ± 7.5, respectively). The time × group interaction (F1,102 = 10.86, p = 0.001, η2 = 0.096) revealed that only the EO group significantly increased BMI after intervention (Table 2).
The time × gender interaction (F1,100 = 5.15, p = 0.025, η2 = 0.049) revealed that girls significantly increased their abdominal circumference after intervention (Figure 1).
The main effect of gender (F1,91 = 4.05, p = 0.047, η2 = 0.043) revealed that girls had higher resting HR than boys (82.5 ± 12 bpm vs. 79.4 ± 10.4 bpm, respectively). The time × group interaction (F1,91 = 17.64, p < 0.0001, η2 = 0.162) revealed that the EO group significantly increased resting HR, while the TI group significantly decreased resting HR rate after intervention (Table 2).
The main effect of time revealed that children’s VO2peak (F1,102 = 27.70, p < 0.0001, η2 = 0.214) (42.3 ± 4.0 mL·kg−1·min−1 vs. 43.1 ± 4.4 mL·kg−1·min−1) and laps number (F1,101 = 82.91, p < 0.0001, η2 = 0.451) (9.5 ± 4.7 num vs. 14.5 ± 8.1 num) significantly increased after intervention. The main effect of group (F1,101 = 4.48, p = 0.037, η2 = 0.042) revealed that the EO group performed a greater number of laps than the TI group (13.0 ± 8.2 num vs. 10.5 ± 4.6 num, respectively). The main effect of gender revealed that girls had lower VO2peak (F1,102 = 6.56, p = 0.012, η2 = 0.060) (41.7 ± 3.4 mL·kg−1·min−1 vs. 43.7 ± 4.6 mL·kg−1·min−1, respectively) and performed a lower number of laps (F1,101 = 4.75, p = 0.032, η2 = 0.045) (10.8 ± 5.4 num vs. 13.2 ± 8.3 num, respectively) than boys. The time × group interaction (F1,101 = 8.57, p = 0.004, η2 = 0.078) revealed that the EO group showed a higher increase of laps number than the TI group after intervention (Table 2). The time × gender interaction (F1,102 = 5.05, p = 0.027, η2 = 0.047) revealed that boys had a higher increase of VO2peak than girls after intervention (Figure 2).
Moreover, subgroup analyses revealed that all boys and only girls of the EO group significantly increased VO2peak after intervention (Figure 3).
The main effect of time revealed that children’s shifting platforms test (F1,101 = 78.03, p < 0.0001, η2 = 0.436) (30.6 ± 9.2 score vs. 38.3 ± 10.0 score), balance beam test (F1,101 = 123.60, p < 0.0001, η2 = 0.550) (33.2 ± 16.4 score vs. 46.8 ± 16.3 score), jumping laterally test (F1,100 = 119.24, p < 0.0001, η2 = 0.544) (22.6 ± 15.2 score vs. 41.6 ± 20.7 score), and hopping on one leg test (F1,101 = 123.61, p < 0.0001, η2 = 0.550) (36.5 ± 18.2 score vs. 48.7 ± 16.2 score) significantly increased after intervention. The main effect of group (F1,101 = 3.10, p = 0.049, η2 = 0.038) revealed that the EO group had a higher balance beam test score than the TI group (42.2 ± 18.2 score vs. 37.0 ± 16.7 score, respectively). The main effect of gender (F1,101 = 7.55, p = 0.007, η2 = 0.070) revealed that girls had a higher balance beam test score than boys (44.0 ± 17.0 score vs. 36.1 ± 17.7 score, respectively). The time × group interaction revealed that the EO group showed a greater increase of balance beam (F1,101 = 5.61, p = 0.020, η2 = 0.053) and jumping laterally (F1,101 = 6.79, p = 0.011, η2 = 0.064) tests than the TI group after intervention (Table 2). Moreover, subgroup analyses revealed that the shifting platforms test of all boys and girls significantly increased after intervention, however girls of the EO group showed the greater increase (Figure 4).
Finally, the main effect of group (F1,101 = 8.84, p = 0.004, η2 = 0.080) revealed that the EO group had a greater PAQ-C-It score than the TI group (2.6 ± 0.6 score vs. 2.3 ± 0.7 score, respectively).

4. Discussion

The COVID-19 pandemic induced changes in PE in order to prevent or reduce contamination in teachers and students. Sports and physical activities increase droplet speed and output; thus, students have to use masks during physical activities, gyms should be constantly ventilated, physical contact should be limited, and sports equipment should be disinfected at the end of each PE lesson [39,40]. Therefore, open spaces seem to be better than confined spaces and the safest option where to conduct the PE interventions [39]. Thus, this study was aimed to propose and verify the efficacy of an alternative and safe way to the traditional PE intervention that could be also applied during the COVID-19 pandemic. We investigated the efficacy of a PE intervention conducted in a natural environment (the beach) on schoolchildren’s anthropometric and health-related parameters, physical fitness, gross motor coordination and physical activity level.
The lack of a favorable impact of both interventions on children’s anthropometric parameters confirmed that PE interventions could induce limited positive effects on body weight, BMI and FM% [13]. An average of 60 min of MVPA daily is necessary to reduce adiposity in children and adolescents [8]. Although we respected in both interventions these guidelines in terms of intensity and duration of physical activity, we could not fully comply with them in terms of weekly frequency for reasons linked to the scheduling of school activities. This aspect could have limited the achievement of beneficial effects on children’s body composition.
TI group significantly decreased resting HR after intervention, confirming that increased structured physical activity is related to lower resting HR [41,42]. On the contrary, the EO group significantly increased resting HR after intervention although previous studies suggested that natural environments may give rise to stress-buffering influences [43]. It was possible that a new situational condition (physical activity on the beach with a specialist PE teacher) could negatively influence resting HR. Girls of our study had higher resting HR and lower VO2peak than boys confirming that resting HR is inversely associated with aerobic fitness [44].
Moreover, findings of the present study suggested that a well-structured physical activity program, conducted by a specialist PE teacher, led to an increase in children’s aerobic fitness. In fact, both boys and girls of the EO group and boys of the TI group significantly increased their VO2peak, while girls of the TI group showed no significant changes after intervention (Figure 3). It has long been established that aerobic MVPA can increase children’s cardiorespiratory fitness [8]. Aerobic fitness requires on-going training of appropriate specificity to be sustained and improved. It also requires specific dosage, frequency, duration, and intensity of the exercise intervention [13,45]. This highlights the importance of an intervention of sufficient quality and quantity to improve children’s cardiorespiratory fitness [46,47]. However, the lack of increase of TI girls’ VO2peak suggested that gender may be a factor influencing the effects of the EO intervention on cardiorespiratory fitness. Boys increased this capacity independently from PE intervention type. Girls seem to profit selectively only from EO intervention, significantly improving their aerobic capacity. Boys are usually more active than girls [6]. Thus, the enhancement of aerobic capacity in boys regardless of PE intervention could be due to their higher practice of aerobic activities in out-of-school settings [48]. The EO intervention seems to compensate the lack of stimulation in aerobic fitness in girls.
Finally, both groups showed an increase of coordinative abilities after the intervention period. These results suggested that both types of intervention were effective to improve motor coordination components such as rhythm, laterality, agility, balance, and strength [49]. However, the efficacy of a wide range of qualitative coordination demands for children’s coordination development was demonstrated by the greater increase in balance beam, jumping laterally and shifting platforms tests of the EO group [15]. The major increase of the balance beam test in the EO group could be attributable to the use of an unstable and irregular surface such as sand [50]. The practice of physical activity on this type of surface could have benefited the sensory system, by providing tactile, visual, and proprioceptive inputs, thus improving children’s balance and motor coordination performance [51]. Similarly, the greatest increase in the shifting platforms test of girls of the EO could be due to the positive effects that the sand surface had on the improvement of the dynamic balance component of this test. Previous studies showed that training on the unstable surface of sand could positively influence balance and jumping abilities development [50,52]. To perform successive jumps into the sand, subjects activate an additional force compared to the force activated to perform jumps on firm ground as gymnasium floor, and over time this seems likely to increase strength [50]. Therefore, the greater increase in the jumping laterally test in the EO group of our study could reflect these increases in muscle strength and power.
Finally, girls performed better than boys in the balance beam test. These results are in line with previous studies that have shown better performance on balance tests in girl children and adolescent girls than boys [5,53,54]. This could be caused by the considerable disparities in pre-pubertal posture between boys and girls, since they have different body heights and weights, which result in different lumbar angles and centers of gravity [55].

Strengths and Limitations

This study could provide useful suggestions for PE activities in natural environments. It could also significantly contribute to the understanding the feasibility and the beneficial effect of PE in outdoor natural environments, that could be applied in different situations that need to pay particular attention to the dimensions of PE spaces in order to prevent or limit contagions. Moreover, it seemed particularly important in the Italian school context since outdoor PE interventions could remedy the problem of insufficient and inadequate spaces for PE. About 4% of the primary and lower secondary schools do not have a school gym, and this situation limits students’ use of an important space for physical activity [56].
This study had some limitations. Since it included a sample of primary schoolchildren, the findings could not be generalized to samples of different ages. Another limitation resulted from the lack of assessment of further components of physical fitness (e.g., muscular strength and endurance, flexibility, and speed) beyond the aerobic fitness. In the present study, the equation of Matsuzaka et al. [30] was used to predict VO2peak from the PACER scores. Recently, a new approach was implemented in adults to monitor their fitness status by detecting aerobic threshold from HR variability [57,58]. Further research could be conducted to investigate this method as a complementary criterion for testing VO2peak in children and youth. The lack of assessment of time children spent in sedentary activities could be a potential confounder, influencing differently the level of fitness of children belonging to the two intervention groups.

5. Conclusions

In conclusion, the results of this study showed that a well-structured PE intervention conducted in the natural environment of the beach could improve children’s physical fitness and gross motor coordination. This study confirmed the positive impact that the practice of physical activity in the natural environment could have on children’s physical fitness, promoting the increased light to moderate physical activity and favoring a wider variety of physical exercises [59]. Moreover, significant effects were found in balance and coordinative abilities. These skills are particularly important for children’s general mastering of their own body in relation to the physical environment [60].
Planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school, especially during the current period of COVID-19 pandemic, that often required the suspension or reduction of PE practical lessons in many schools. Therefore, this study could represent a new perspective for PE, strongly affected by the pandemic restrictions, promoting the outdoor PE activities as an essential part of PE curriculum.
Although not completely investigated, this study indicates the natural environment of the beach as a potential factor that could positively influence children’s motor development. Further studies should be conducted to verify whether specific motor skills could be better learned in a particular natural environment than in others.

Author Contributions

Conceptualisation, M.C.G. and L.G.; Data curation, G.Z. and L.F.; Formal analysis, V.B.; Funding acquisition, M.C.G.; Methodology, M.C.G. and C.B.; Project administration, M.C.G.; Supervision, L.G. and C.B.; Writing—original draft, M.C.G. and L.C.; Writing—review & editing, G.Z. and D.C. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by Sapienza University of Rome, grant number “Bando SEED PNR—Delibera S.A. n.335/2021 del 13/12/2021”.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Sapienza University (Rif 5500 Prot. 1070/19).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Individual anonymised participant data will not be shared. Pooled study data, protocol, or statistical analysis plan can be shared upon request at [email protected].

Acknowledgments

The authors are very grateful to the Primary Schools Ex Anmil and G. Rodari and to all children involved in the study, as without them this project could not be achieved. Additionally, we thank Claudia Verdini for the achievement of the project.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

References

  1. Biddle, S.J.; Bengoechea, E.G.; Wiesner, G. Sedentary behaviour and adiposity in youth: A systematic review of reviews and analysis of causality. Int. J. Behav. Nutr. Phys. Act. 2017, 14, 43. [Google Scholar] [CrossRef]
  2. Daniels, S.R.; Pratt, C.A.; Hayman, L.L. Reduction of Risk for Cardiovascular Disease in Children and Adolescents. Circulation 2011, 124, 1673–1686. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  3. Moreira, J.P.A.; Lopes, M.C.; Miranda-Júnior, M.V.; Valentini, N.; Lage, G.M.; Albuquerque, M.R. Körperkoordinationstest Für Kinder (KTK) for Brazilian Children and Adolescents: Factor Analysis, Invariance and Factor Score. Front. Psychol. 2019, 10, 2524. [Google Scholar] [CrossRef] [PubMed]
  4. Battaglia, G.; Giustino, V.; Tabacchi, G.; Lanza, M.; Schena, F.; Biino, V.; Giuriato, M.; Gallotta, M.C.; Guidetti, L.; Baldari, C.; et al. Interrelationship Between Age, Gender, and Weight Status on Motor Coordination in Italian Children and Early Adolescents Aged 6–13 Years Old. Front. Pediatrics 2021, 9, 738294. [Google Scholar] [CrossRef]
  5. Giuriato, M.; Biino, V.; Bellafiore, M.; Battaglia, G.; Palma, A.; Baldari, C.; Guidetti, L.; Gallotta, M.C.; Schena, F.; Lanza, M. Gross Motor Coordination: We Have a Problem! A Study with the Körperkoordinations Test für Kinder in Youth (6–13 Years). Front. Pediatrics 2021, 9, 785990. [Google Scholar] [CrossRef]
  6. Gallotta, M.C.; Zimatore, G.; Falcioni, L.; Migliaccio, S.; Lanza, M.; Schena, F.; Biino, V.; Giuriato, M.; Bellafiore, M.; Palma, A.; et al. Influence of Geographical Area and Living Setting on Children’s Weight Status, Motor Coordination, and Physical Activity. Front. Pediatr. 2022, 9, 794284. [Google Scholar] [CrossRef]
  7. Gallotta, M.C. Coordination Exercises for Schoolchildren Fitness and Health; VDM-Verlag Pub: Berlin, Germany, 2010. [Google Scholar]
  8. Bull, F.C.; Al-Ansari, S.S.; Biddle, S.; Borodulin, K.; Buman, M.P.; Cardon, G.; Carty, C.; Chaput, J.-P.; Chastin, S.; Chou, R.; et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br. J. Sports Med. 2020, 54, 1451–1462. [Google Scholar] [CrossRef] [PubMed]
  9. Chaput, J.-P.; Willumsen, J.; Bull, F.; Chou, R.; Ekelund, U.; Firth, J.; Jago, R.; Ortega, F.B.; Katzmarzyk, P.T. 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: Summary of the evidence. Int. J. Behav. Nutr. Phys. Act. 2020, 17, 141. [Google Scholar] [CrossRef]
  10. Mascherini, G.; Petri, C.; Bini, V.; Calà, P.; Galanti, G. Phisycal activity and primary prevention: Lifestyle analysis in young people. Epidemiol. Prev. 2018, 42, 40–45. [Google Scholar] [CrossRef] [PubMed]
  11. Nardone, P.; Spinelli, A.; Buoncristiano, M.; Lauria, L.; Pierannunzio, D.; Galeone, D. Il Sistema di Sorveglianza OKkio alla SALUTE: Risultati 2016 [The Italian Surveillance system OKkio alla Salute: 2016 results]. Not. Ist. Super. Sanit. 2018, 31 (Suppl. 1), 29–36. [Google Scholar]
  12. Lauria, L.; Spinelli, A.; Buoncristiano, M.; Nardone, P. Decline of childhood overweight and obesity in Italy from 2008 to 2016: Results from 5 rounds of the population-based surveillance system. BMC Publ. Health 2019, 19, 618. [Google Scholar] [CrossRef] [PubMed]
  13. Gallotta, M.C.; Iazzoni, S.; Emerenziani, G.P.; Meucci, M.; Migliaccio, S.; Guidetti, L.; Baldari, C. Effects of combined physical education and nutritional programs on schoolchildren’s healthy habits. PeerJ 2016, 4, e1880. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  14. Gallotta, M.C.; Emerenziani, G.P.; Iazzoni, S.; Iasevoli, L.; Guidetti, L.; Baldari, C. Effects of different physical education programmes on children’s skill- and health-related outcomes: A pilot randomised controlled trial. J. Sports Sci. 2016, 35, 1547–1555. [Google Scholar] [CrossRef]
  15. Gallotta, M.C.; Marchetti, R.; Baldari, C.; Guidetti, L.; Pesce, C. Linking co-ordinative and fitness training in physical education settings. Scand. J. Med. Sci. Sports 2009, 19, 412–418. [Google Scholar] [CrossRef] [PubMed]
  16. Dunton, G.F.; Do, B.; Wang, S.D. Early effects of the COVID-19 pandemic on physical activity and sedentary behavior in children living in the U.S. BMC Public Health 2020, 20, 1351. [Google Scholar] [CrossRef]
  17. Dominski, F.H.; Brandt, R. Do the benefits of exercise in indoor and outdoor environments during the COVID-19 pandemic outweigh the risks of infection? Sport Sci. Health 2020, 16, 583–588. [Google Scholar] [CrossRef]
  18. Andrade, A.; Dominski, F.; Pereira, M.L.; De Liz, C.M.; Buonanno, G. Infection risk in gyms during physical exercise. Environ. Sci. Pollut. Res. 2018, 25, 19675–19686. [Google Scholar] [CrossRef]
  19. Morawska, L.; Cao, J. Airborne transmission of SARS-CoV-2: The world should face the reality. Environ. Int. 2020, 139, 105730. [Google Scholar] [CrossRef] [PubMed]
  20. Ministero dell’Istruzione. Piano Scuola 2021–2022. Documento per la Pianificazione delle Attività Scolastiche, Educative e Formative nelle Istituzioni del Sistema Nazionale di Istruzione. Available online: https://www.miur.gov.it/documents/20182/0/Piano+Scuola+21_22.pdf (accessed on 15 March 2022).
  21. Allan, J.; Hardwell, A.; Kay, C.; Peacock, S.; Hart, M.; Dillon, M.; Brymer, E. Health and Wellbeing in an Outdoor and Adventure Sports Context. Sports 2020, 8, 50. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  22. Dankiw, K.A.; Tsiros, M.; Baldock, K.; Kumar, S. The impacts of unstructured nature play on health in early childhood development: A systematic review. PLoS ONE 2020, 15, e0229006. [Google Scholar] [CrossRef] [Green Version]
  23. Gray, C.; Gibbons, R.; Larouche, R.; Sandseter, E.B.H.; Bienenstock, A.; Brussoni, M.; Chabot, G.; Herrington, S.; Janssen, I.; Pickett, W.; et al. What Is the Relationship between Outdoor Time and Physical Activity, Sedentary Behaviour, and Physical Fitness in Children? A Systematic Review. Int. J. Environ. Res. Public Health 2015, 12, 6455–6474. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  24. Yıldırım, G.; Akamca, G. The effect of outdoor learning activities on the development of preschool children. S. Afr. J. Educ. 2017, 37, 1–10. [Google Scholar] [CrossRef]
  25. Pasek, M.; Szark-Eckardt, M.; Wilk, B.; Zuzda, J.; Żukowska, H.; Opanowska, M.; Kuska, M.; Dróżdż, R.; Kuśmierczyk, M.; Sakłak, W.; et al. Physical Fitness as Part of the Health and Well-Being of Students Participating in Physical Education Lessons Indoors and Outdoors. Int. J. Environ. Res. Public Health 2020, 17, 309. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  26. Bonavolontà, V.; Cataldi, S.; Fischetti, F. Changes in body image perception after an outdoor physical education program. J. Phys. Educ. Sport 2021, 21 (Suppl. 1), 632–637. [Google Scholar] [CrossRef]
  27. World Health Organization & United Nations. Climate Change and Health Country Profile: Italy; World Health Organization: Geneva, Switzerland, 2018; Available online: https://apps.who.int/iris/handle/10665/260380 (accessed on 17 March 2022).
  28. Lohman, T.G.; Roche, A.F.; Martorell, R. Anthropometric Standardization Reference Manual; Human Kinetics Books: Champaign, IL, USA, 1988. [Google Scholar]
  29. The Cooper Institute. Fitnessgram/Activitygram Test Administration Manual; Human Kinetics: Champaign, IL, USA, 2006. [Google Scholar]
  30. Matsuzaka, A.; Takahashi, Y.; Yamazoe, M.; Kumakura, N.; Ikeda, A.; Wilk, B.; Bar-Or, O. Validity of the multistage 20-m shuttle-run test for Japanese children, adolescents, and adults. Pediatric Exerc. Sci. 2004, 16, 113–125. [Google Scholar] [CrossRef]
  31. Kiphard, E.J.; Schilling, F. Körperkoordinationstest für Kinder; Beltz Test GmbH: Weinheim, Germany, 2007. [Google Scholar]
  32. Cools, W.; De Martelaer, K.; Samaey, C.; Andries, C. Movement skill assessment of typically developing preschool children: A review of seven movement skill assessment tools. J. Sports Sci. Med. 2009, 8, 154–168. [Google Scholar]
  33. Scordella, A.; Di Sano, S.; Aureli, T.; Cerratti, P.; Verratti, V.; Fanò-Illic, G.; Pietrangelo, T. The role of general dynamic coordination in the handwriting skills of children. Front. Psychol. 2015, 6, 580. [Google Scholar] [CrossRef] [Green Version]
  34. Gobbi, E.; Elliot, C.; Varnier, M.; Carraro, A. Psychometric properties of the physical activity questionnaire for older children in Italy: Testing the validity among a general and clinical pediatric population. PLoS ONE 2016, 11, e0156354. [Google Scholar] [CrossRef]
  35. Utter, A.C.; Robertson, R.J.; Nieman, D.C.; Kang, J. Children’s OMNI scale of perceived exertion: Walking/running evaluation. Med. Sci. Sports Exerc. 2002, 34, 139–144. [Google Scholar] [CrossRef]
  36. U.S. Department of Health and Human Services. Chapter 3: Active Children and Adolescents. In Physical Activity Guidelines for Americans. Be Active, Healthy, and Happy; Rodgers, A.B., Ed.; The Secretary of Health and Human Services: Washington, DC, USA, 2008; pp. 15–20. [Google Scholar]
  37. Decree of the President of the Republic of Italy (DPR). National Guidelines for the Curriculum in Kindergarten and the First Cycle of Education; General Series of the Official Gazette n. 30 of 5-2-2013; Ministry of Justice: Rome, Italy, 2012; pp. 65–67.
  38. Cohen, J. Statistical Power Analysis for the Behavioral Sciences; Lawrence Erlbaum Associates: New York, NY, USA, 1988. [Google Scholar]
  39. Filiz, B.; Konukman, F. Teaching Strategies for Physical Education during the COVID-19 Pandemic. J. Phys. Educ. Recreat. Dance 2020, 91, 48–50. [Google Scholar] [CrossRef]
  40. Varea, V.; González-Calvo, G.; García-Monge, A. Exploring the changes of physical education in the age of Covid-19. Phys. Educ. Sport Pedagog. 2020, 27, 32–42. [Google Scholar] [CrossRef]
  41. Kwok, S.-Y.; So, H.-K.; Choi, K.-C.; Lo, A.F.C.; Li, A.M.; Sung, R.Y.T.; Nelson, E.A.S. Resting heart rate in children and adolescents: Association with blood pressure, exercise and obesity. Arch. Dis. Child. 2013, 98, 287–291. [Google Scholar] [CrossRef]
  42. Reimers, A.K.; Knapp, G.; Reimers, C.-D. Effects of Exercise on the Resting Heart Rate: A Systematic Review and Meta-Analysis of Interventional Studies. J. Clin. Med. 2018, 7, 503. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  43. Mygind, L.; Stevenson, M.P.; Liebst, L.S.; Konvalinka, I.; Bentsen, P. Stress Response and Cognitive Performance Modulation in Classroom versus Natural Environments: A Quasi-Experimental Pilot Study with Children. Int. J. Environ. Res. Public Health 2018, 15, 1098. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  44. Silva, D.A.S.; de Lima, T.R.; Tremblay, M.S. Association between Resting Heart Rate and Health-Related Physical Fitness in Brazilian Adolescents. BioMed. Res. Int. 2018, 2018, 3812197. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  45. Yuksel, H.S.; Şahin, F.N.; Maksimovic, N.; Drid, P.; Bianco, A. School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review. Int. J. Environ. Res. Public Health 2020, 17, 347. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  46. Hills, A.P.; Dengel, D.R.; Lubans, D. Supporting Public Health Priorities: Recommendations for Physical Education and Physical Activity Promotion in Schools. Prog. Cardiovasc. Dis. 2015, 57, 368–374. [Google Scholar] [CrossRef] [Green Version]
  47. Schmidt, S.K.; Reinboth, M.S.; Resaland, G.K.; Bratland-Sanda, S. Changes in Physical Activity, Physical Fitness and Well-Being Following a School-Based Health Promotion Program in a Norwegian Region with a Poor Public Health Profile: A Non-Randomized Controlled Study in Early Adolescents. Int. J. Environ. Res. Public Health 2020, 17, 896. [Google Scholar] [CrossRef] [Green Version]
  48. Tammelin, T.; Näyhä, S.; Hills, A.; Jarvelin, M.-R. Adolescent participation in sports and adult physical activity. Am. J. Prev. Med. 2003, 24, 22–28. [Google Scholar] [CrossRef]
  49. Nascimento, W.; Henrique, N.R.; Marques, M. KTK motor test: Review of the main influencing variables. Rev. Paul. Pediatr. 2019, 37, 372–381. [Google Scholar] [CrossRef]
  50. Hammami, M.; Bragazzi, N.; Hermassi, S.; Gaamouri, N.; Aouadi, R.; Shephard, R.J.; Chelly, M.S. The effect of a sand surface on physical performance responses of junior male handball players to plyometric training. BMC Sports Sci. Med. Rehabilit. 2020, 12, 26. [Google Scholar] [CrossRef] [PubMed]
  51. Giagazoglou, P.; Sidiropoulou, M.; Mitsiou, M.; Arabatzi, F.; Kellis, E. Can balance trampoline training promote motor coordination and balance performance in children with developmental coordination disorder? Res. Dev. Disabil. 2015, 36, 13–19. [Google Scholar] [CrossRef]
  52. Arazi, H.; Mohammadi, M.; Asadi, A. Muscular adaptations to depth jump plyometric training: Comparison of sand vs. land surface. Interv. Med. Appl. Sci. 2014, 6, 125–130. [Google Scholar] [CrossRef]
  53. Sember, V.; Grošelj, J.; Pajek, M. Balance Tests in Pre-Adolescent Children: Retest Reliability, Construct Validity, and Relative Ability. Int. J. Environ. Res. Public Health 2020, 17, 5474. [Google Scholar] [CrossRef]
  54. De Miguel-Etayo, P.; Gracia-Marco, L.; Ortega, F.B.; Intemann, T.; Foraita, R.; Lissner, L.; Oja, L.; Barba, G.; Michels, N.; Tornaritis, M.; et al. Physical fitness reference standards in European children: The IDEFICS study. Int. J. Obes. 2014, 38, S57–S66. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  55. Araújo, F.A.; Simões, D.; Silva, P.; Alegrete, N.; Lucas, R. Sagittal standing posture and relationships with anthropometrics and body composition during childhood. Gait Posture 2019, 73, 45–51. [Google Scholar] [CrossRef] [PubMed]
  56. Poliandri, D. I Processi e il Funzionamento delle Scuole—Area Valutazione delle Scuole. 2016. Available online: https://www.invalsi.it/snv/docs/141016/Rapporto_Processi_2016.pdf (accessed on 4 March 2022).
  57. Zimatore, G.; Falcioni, L.; Gallotta, M.C.; Bonavolontà, V.; Campanella, M.; De Spirito, M.; Guidetti, L.; Baldari, C. Recurrence quantification analysis of heart rate variability to detect both ventilatory thresholds. PLoS ONE 2021, 16, e0249504. [Google Scholar] [CrossRef] [PubMed]
  58. Zimatore, G.; Gallotta, M.C.; Innocenti, L.; Bonavolontà, V.; Ciasca, G.; De Spirito, M.; Guidetti, L.; Baldari, C. Recurrence quantification analysis of heart rate variability during continuous incremental exercise test in obese subjects. Chaos 2020, 30, 033135. [Google Scholar] [CrossRef] [PubMed]
  59. McCurdy, L.E.; Winterbottom, K.E.; Mehta, S.S.; Roberts, J.R. Using Nature and Outdoor Activity to Improve Children’s Health. Curr. Probl. Pediatr. Adolesc. Health Care 2010, 40, 102–117. [Google Scholar] [CrossRef]
  60. Fjørtoft, I. The Natural Environment as a Playground for Children: The Impact of Outdoor Play Activities in Pre-Primary School Children. Day Care Early Educ. 2001, 29, 111–117. [Google Scholar] [CrossRef]
Ijerph 19 03680 g001 550
Figure 1. Abdominal circumference of girls and boys before (Pre) and after (Post) intervention (** p < 0.001).
Figure 1. Abdominal circumference of girls and boys before (Pre) and after (Post) intervention (** p < 0.001).
Ijerph 19 03680 g001
Ijerph 19 03680 g002 550
Figure 2. VO2peak of girls and boys before (Pre) and after (Post) intervention (* p = 0.01, ** p < 0.001).
Figure 2. VO2peak of girls and boys before (Pre) and after (Post) intervention (* p = 0.01, ** p < 0.001).
Ijerph 19 03680 g002
Ijerph 19 03680 g003 550
Figure 3. VO2peak of girls and boys before (Pre) and after (Post) intervention in experimental outdoor intervention (EO) and traditional indoor intervention (TI) (* p = 0.01, ** p = 0.001).
Figure 3. VO2peak of girls and boys before (Pre) and after (Post) intervention in experimental outdoor intervention (EO) and traditional indoor intervention (TI) (* p = 0.01, ** p = 0.001).
Ijerph 19 03680 g003
Ijerph 19 03680 g004 550
Figure 4. Shifting platforms test of girls and boys before (Pre) and after (Post) intervention in experimental outdoor intervention (EO) and traditional indoor intervention (TI) (* p < 0.01, ** p < 0.001).
Figure 4. Shifting platforms test of girls and boys before (Pre) and after (Post) intervention in experimental outdoor intervention (EO) and traditional indoor intervention (TI) (* p < 0.01, ** p < 0.001).
Ijerph 19 03680 g004
Table
Table 1. Number of children belonging to experimental outdoor intervention (EO) and traditional indoor intervention (TI).
Table 1. Number of children belonging to experimental outdoor intervention (EO) and traditional indoor intervention (TI).
EO TI
GirlsBoysTotalGirlsBoysTotal
Grade 2 (7–8 years of age)1213256410
Grade 3 (8–9 years of age)871510919
Grade 5 (10–11 years of age)1212246713
Table
Table 2. Pre- and post-intervention values (mean values ± SD) of experimental outdoor intervention (EO) and traditional indoor intervention (TI).
Table 2. Pre- and post-intervention values (mean values ± SD) of experimental outdoor intervention (EO) and traditional indoor intervention (TI).
EOTI
VariablePrePostPrePost
Weight (kg)32.2 ± 10.934.2 ± 11.834.1 ± 10.035.6 ± 10.5
Height (cm)131.3 ± 18.9135.8 ± 10.0134.3 ± 10.4136.8 ± 10.6
BMI (kg/m2)17.7 ± 4.118.2 ± 4.3 *18.8 ± 3.818.6 ± 3.5
%FM24.3 ± 6.524.2 ± 6.525.3 ± 6.324.4 ± 7.1
Abdominal circumference (cm)61.4 ± 10.362.5 ± 11.064.5 ± 10.666 ± 10.6
Systolic blood pressure (mmHg)99.6 ± 14.2101.7 ± 10.9105.8 ± 13.7104.8 ± 10.3
Diastolic blood pressure (mmHg)60.7 ± 8.360.5 ± 6.361.7 ± 7.862.6 ± 6.9
Resting heart rate (bpm)77.6 ± 12.384.1 ± 10.6 *83.5 ± 9.979.0 ± 11.2 *
PAQ-C-It (score)2.4 ± 0.62.4 ± 0.82.0 ± 0.62.1 ± 0.8
VO2peak (mL·kg−1·min−1)42.8 ± 4.143.5 ± 4.741.6 ± 3.842.4 ± 3.8
Laps (num)9.9 ± 5.716.1 ± 9.2 *8.9 ± 2.812.0 ± 5.5 *
Shifting platforms test (score)31.2 ± 9.339.6 ± 9.3 *29.6 ± 9.236.1 ± 10.7 *
Balance beam test (score)34.3 ± 16.950.1 ± 16.0 *31.5 ± 15.841.7 ± 15.7 *
Jumping laterally test (score)23.3 ± 16.545.7 ± 21.0 *21.5 ± 12.935.0 ± 18.7 *
Hopping on one leg test (score)37.0 ± 19.149.2 ± 18.0 *35.7 ± 16.847.9 ± 16.1 *
* p ≤ 0.01 post vs. pre.
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Gallotta, M.C.; Zimatore, G.; Cardinali, L.; Falcioni, L.; Bonavolontà, V.; Curzi, D.; Guidetti, L.; Baldari, C. Physical Education on the Beach: An Alternative Way to Improve Primary School Children’s Skill- and Health-Related Outcomes during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022, 19, 3680. https://doi.org/10.3390/ijerph19063680

AMA Style

Gallotta MC, Zimatore G, Cardinali L, Falcioni L, Bonavolontà V, Curzi D, Guidetti L, Baldari C. Physical Education on the Beach: An Alternative Way to Improve Primary School Children’s Skill- and Health-Related Outcomes during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2022; 19(6):3680. https://doi.org/10.3390/ijerph19063680

Chicago/Turabian Style

Gallotta, Maria Chiara, Giovanna Zimatore, Ludovica Cardinali, Lavinia Falcioni, Valerio Bonavolontà, Davide Curzi, Laura Guidetti, and Carlo Baldari. 2022. "Physical Education on the Beach: An Alternative Way to Improve Primary School Children’s Skill- and Health-Related Outcomes during the COVID-19 Pandemic" International Journal of Environmental Research and Public Health 19, no. 6: 3680. https://doi.org/10.3390/ijerph19063680

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