Mixed PE Program Using Sports Games and Ball Sports in Left-Behind Children (MIXPE-LBC)

A 12-Week School-Based Mixed Physical Education Intervention Combining Cooperative Sports Games and Ball Sports to Improve Mental Health and Physical Fitness in Rural Left-Behind Children

This randomized controlled trial evaluates whether a 12-week school-based physical education program that combines cooperative sports games and ball sports can improve mental health and physical fitness in rural left-behind children. Left-behind children are those who remain in rural areas while one or both parents migrate for work. These children may experience social and emotional challenges in addition to physical health concerns.

Forty sixth-grade boarding students who met the criteria for left-behind children were randomly assigned to either a mixed training group or a usual physical education control group. The intervention was delivered during regular school physical education classes three times per week, 90 minutes per session, for 12 weeks. Each session included cooperative physical games designed to promote peer interaction, followed by structured soccer or basketball training activities.

Mental health was assessed using the Mental Health Test (MHT), and physical fitness was evaluated using standardized school-based tests including lung function, running performance, flexibility, and coordination. Outcomes were measured before and after the intervention.

The study aims to determine whether optimizing the structure of routine school physical education can provide a feasible and scalable strategy to support both psychological well-being and physical development in vulnerable child populations.

Study Overview

• Status: Completed
• Conditions: Mental Health; Physical Fitness; Left-Behind Children
• Intervention / Treatment: Behavioral: Mixed Physical Education Program; Behavioral: Usual Physical Education

Detailed Description

This study is a single-center, parallel-group randomized controlled trial conducted in a rural primary boarding school in China. The objective was to evaluate the effects of a structured 12-week mixed physical education intervention integrating cooperative sports games and ball sports on mental health and physical fitness in left-behind children.

Eligible participants were sixth-grade students who had been separated from one or both parents for more than six months and met the study's screening criteria for left-behind children. After baseline assessment, participants were randomly allocated in a 1:1 ratio to either the mixed training group (MTG) or the control group (CONG) using block randomization (block size = 4) with allocation concealment via sequentially numbered opaque sealed envelopes. Outcome assessors were blinded to group assignment.

The intervention was delivered within the routine physical education curriculum (three sessions per week, 90 minutes per session, for 12 weeks). Each session included: (1) a 20-25 minute cooperative game segment emphasizing social interaction and group participation; (2) a 55-60 minute structured soccer or basketball training segment with progressive skill development and small-sided games; and (3) a brief cool-down period. Exercise intensity was staged using target heart rate zones corresponding to approximately 60-85% of age-predicted maximal heart rate.

The primary outcome measure was the total score of the Mental Health Test (MHT). Secondary outcomes included MHT subscales and standardized physical fitness indicators (vital capacity, 50-m dash, 8×50-m shuttle run, rope skipping, sit-ups, sit-and-reach, and body mass index). All outcomes were assessed at baseline and immediately post-intervention.

Data were analyzed using two-way repeated-measures analysis of variance to assess group, time, and interaction effects. The study was conducted in accordance with the Declaration of Helsinki and was approved by the institutional ethics committee.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Anhui
    • Wuhu, Anhui, China, 241000
      • Rural Primary School in J County

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Aged 12 to 13 years
• Enrolled in the sixth grade of the participating rural primary school
• Classified as left-behind children, defined as separation from one or both parents for more than six months due to parental migration for work
• Boarding-school students during the study period
• Provided written informed consent from legal guardians and written assent from the child

Exclusion Criteria:

• Children from single-parent families or orphans
• Presence of physical, neurological, or medical conditions that would limit participation in regular physical activity
• Participation in any structured extracurricular physical training program during the study period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Mixed Training Group (MTG); Participants in this arm received a structured 12-week school-based physical education intervention delivered three times per week (90 minutes per session). Each session included a 20-25 minute cooperative sports game segment followed by 55-60 minutes of structured soccer or basketball training with progressive intensity and small-sided games. The intervention was implemented within the regular physical education curriculum.	Behavioral: Mixed Physical Education Program; Participants received a structured 12-week school-based physical education program delivered three times per week (90 minutes per session). Each session included a cooperative sports game component (20-25 minutes) designed to promote peer interaction and social engagement, followed by structured soccer or basketball training (55-60 minutes) with progressive skill development and small-sided games. Exercise intensity was staged to achieve approximately 60-85% of age-predicted maximal heart rate. The intervention was implemented within the regular school physical education curriculum.
Active Comparator: Usual Physical Education Control Group (CONG); Participants in this arm followed the standard school physical education curriculum for 12 weeks. The curriculum primarily included calisthenics and general physical fitness training without structured cooperative sports games or systematic ball sports training.	Behavioral: Usual Physical Education; Participants followed the standard school physical education curriculum for 12 weeks, consisting primarily of calisthenics and general physical fitness activities. The curriculum did not include structured cooperative sports games or systematic soccer or basketball training as provided in the experimental intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mental Health Test (MHT) Total Score	The Mental Health Test (MHT) is a standardized self-report instrument used to assess psychological status in school-aged children. The total score reflects overall psychological difficulty, with higher scores indicating greater levels of psychological problems.	Baseline and Week 12 (Immediately Post-Intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Interpersonal Anxiety (MHT Subscale Score)	Interpersonal Anxiety is a subscale of the Mental Health Test (MHT) assessing social anxiety and interpersonal stress. Higher scores indicate greater levels of interpersonal anxiety.	Baseline and Week 12 (Immediately Post-Intervention)
Self-Blame Tendency (MHT Subscale Score)	Self-Blame Tendency is a subscale of the Mental Health Test (MHT) evaluating self-directed negative attribution patterns. Higher scores indicate greater self-blame.	Baseline and Week 12 (Immediately Post-Intervention)
Vital Capacity (mL)	Vital capacity measured in milliliters using standardized school-based pulmonary function testing procedures.	Baseline and Week 12 (Immediately Post-Intervention)
50-Meter Dash Time (seconds)	Time required to complete a 50-meter sprint, recorded in seconds.	Baseline and Week 12 (Immediately Post-Intervention)
8×50-Meter Shuttle Run Time (seconds)	Total time required to complete eight 50-meter shuttle runs, recorded in seconds.	Baseline and Week 12 (Immediately Post-Intervention)
Rope Skipping Performance (repetitions per minute)	Number of rope skipping repetitions completed within one minute.	Baseline and Week 12 (Immediately Post-Intervention)
Sit-Ups Performance (repetitions per minute)	Number of sit-ups completed within one minute.	Baseline and Week 12 (Immediately Post-Intervention)
Sit-and-Reach Distance (centimeters)	Maximum forward reach distance measured in centimeters using a standardized sit-and-reach test.	Baseline and Week 12 (Immediately Post-Intervention)
Body Mass Index (kg/m²)	Body mass index calculated from measured height and weight (kg/m²).	Baseline and Week 12 (Immediately Post-Intervention)

Collaborators and Investigators

• Sponsor: Anhui Normal University

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2025
• Primary Completion (Actual): January 9, 2026
• Study Completion (Actual): January 9, 2026

Study Registration Dates

• First Submitted: March 1, 2026
• First Submitted That Met QC Criteria: March 1, 2026
• First Posted (Actual): March 5, 2026

Study Record Updates

• Last Update Posted (Actual): March 5, 2026
• Last Update Submitted That Met QC Criteria: March 1, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: randomized controlled trial; aerobic fitness; school-based intervention; social interaction; physical education; child mental health; left-behind children; sports games; ball sports; cooperative play
• Additional Relevant MeSH Terms: Behavior; Personal Satisfaction; Psychological Well-Being
• Other Study ID Numbers: AHNU-MIXPE-LBC-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No