Recess-Time Physical Activity in Schools: A Systematic Review of Multidimensional Outcomes and Implementation Strategies

Abstract

Background : Recess-time physical activity (RTPA) is an underutilized yet critical contributor to whole-child development, though prior reviews have narrowly focused on isolated outcomes. Methods: A systematic review of five databases (Web of Science, Scopus, ERIC, PubMed, PsycINFO) identified 38 empirical studies (2019–2025) examining RTPA's multidimensional impacts on children/adolescents (6–18 years). Data were synthesized across physical, psychological, social, academic, and motivational domains using predefined PICO criteria. Results: RTPA demonstrated significant benefits: +18% cardiorespiratory endurance (95% CI: 15–21%), 37% reduction in anxiety symptoms (p < 0.01), 1.7 SD improvement in peer interaction, and 22% increase in on-task behavior. Structured, semi-structured, and unstructured interventions each uniquely enhanced skill development, social inclusion, and autonomy. Student-centered formats particularly boosted intrinsic motivation. Heterogeneity in study designs and cultural contexts limited generalizability. Conclusions: RTPA aligns with WHO physical activity guidelines and SDG 3 targets, offering a scalable, cost-effective intervention for schools. Policy recommendations include protecting ≥30 minutes daily recess, allocating 5–7% budget for infrastructure, and integrating RTPA into whole-school health frameworks. Future research should prioritize longitudinal designs, cross-cultural adaptations, and digital tools (e.g., accelerometry) for precise measurement. This review underscores RTPA's role in advancing educational equity, mental health, and holistic development.