Improving Preschool Fundamental Motor Skills Through Interventions Targeting 24-Hour Movement Behaviors and Socioecological Factors: A Meta-Analysis.

This systematic review evaluated the effects of interventions targeting 24-hour movement behaviors and socioecological outcomes on improving fundamental motor skills in preschool children aged 4-6. Randomized controlled trials (RCTs) published up to November 15, 2023, were included if they reported at least 1 24-hour movement behavior, and socioecological factors postintervention in preschoolers aged 4-6 years. A random-effects inverse variance model with Paule-Mandel adjustment was used to estimate overall effect sizes (Hedges g) and 95% CI. Risk of bias was assessed using Rob2 and RobVis, and the certainty of evidence was rated using the GRADE approach. Twelve RCTs involving 4754 preschoolers (53.1% girls) were included. All interventions aimed to enhance gross motor skills and involved varying levels of teacher and/or parent engagement. Interventions significantly improved overall fundamental motor skills, particularly object control skills such as throwing and catching. However, small and nonsignificant effects were found for physical fitness components (eg, cardiorespiratory fitness, jumping, balance) and 24-hour movement behaviors (eg, total physical activity, light-to-vigorous activity, sedentary time, screen time, body mass index). Overall, intervention duration did not significantly moderate outcomes. Fundamental motor skills-focused interventions in healthy preschoolers significantly improved motor competence, especially object control, but yielded only modest and nonsignificant changes on physical fitness and movement behaviors. These findings highlight the importance of targeting motor skill development in early childhood. Further research is needed to clarify the influence of the socioecological environment, including family and teacher roles, and to improve intervention strategies for broader behavioral and fitness outcomes.