Physical and Psychosocial Outcomes of 16-Week Classroom-Based Morning Exercise Program

healthy primary school-aged children

Exercises generally consist of movements that can be done sitting at a desk or standing next to a desk, and do not require equipment. It includes exercises for warming up, stretching, strengthening, balance and relaxation, lasting 10-15 minutes and suitable for daily use.

It starts with a deep breathing exercise, continues with basic strength and flexibility exercises that mobilize the body, and ends with a deep breathing exercise again. Exercises that can be performed both sitting and standing are presented together.

During the transitions between movements, small exercises such as "waving the hands" are also included as a break.

Pain assessment in children will be conducted using the Faces (FACES) Pain Scale. This is a visual scale developed to assess pain intensity, particularly in individuals-such as children-who cannot clearly express themselves verbally (Hicks, von Baeyer et al. 2001). The scale features a total of six facial images, progressing from a happy expression to expressions indicating increasing levels of pain. Children rate their pain by selecting the face that best represents how they feel. Widely used for children aged three and older, this scale is a trusted choice in clinical and field studies due to its ease of understanding and rapid administration. Researchers will show the children the various facial images on the scale and ask them to select the face that best reflects their state, thereby determining the pain score.

The Sit-and-Reach Test is a common and practical physical fitness test used to evaluate the flexibility of the lower back and hamstring muscles, particularly in children (Şahiner and Balcı 2010). Due to its ease of administration, minimal equipment requirements, and practicality, it is ideal for the mass assessment of flexibility in school-aged children. During the test, children sit barefoot on a flat surface, extend their legs forward, and place the soles of their feet firmly against the test box or platform. They are asked to reach forward as far as possible with their hands stacked on top of each other, without bending their knees; the maximum distance reached is measured and recorded in centimeters. The test will be conducted using the sit-and-reach test apparatus located in the laboratory of the Department of Physiotherapy and Rehabilitation at Istanbul Medeniyet University's Faculty of Health Sciences.

The scale is a psychometric assessment tool used to measure body image, body satisfaction, and body-related feelings or attitudes in children (Collins 1991). It typically utilizes images of gender-appropriate body silhouettes, and children are asked to select the silhouette that most closely resembles their own body and the one representing the body they would like to have. Body dissatisfaction is then assessed by scoring the discrepancy between the perceived current body and the ideal body. During the administration of the scale, children are shown a series of silhouettes arranged according to age and gender. The researcher asks questions such as "Which body looks most like yours?" and "Which body would you like to have?" to prompt the child to select one silhouette from each row, and the difference between the two is scored.

The assessment of the children's general well-being will be conducted using the WHO-5 Well-Being Index. The WHO-5 Well-Being Index is a short, 5-item self-report scale developed by the World Health Organization to assess individuals' psychological well-being over the past two weeks (Sischka, Martin et al. 2025). Each item is scored from 0 (at no time) to 5 (all the time), yielding a total score ranging from 0 to 25. A higher score indicates better psychological well-being. Using this index, children will be asked how well they have felt over the past two weeks and to rate their feelings.

Participants' school burnout will be assessed using the School Burnout Scale. In its original form, the scale is a 5-point Likert-type, self-report instrument consisting of 10 items and three sub-dimensions. It was developed by Salmela-Aro et al. in 2009 to determine the school burnout levels of primary and secondary school students and was adapted to Turkish culture by Seçer et al. (2013). Regarding the distribution of items across factors, items 1, 4, 7, and 9 fall under the emotional exhaustion dimension; items 2, 5, and 6 fall under the cynicism sub-dimension; and items 3 and 8 fall under the low sense of personal accomplishment sub-dimension. Participants will be asked to indicate the extent to which they agree or disagree with statements concerning their motivation regarding lessons and school, and their responses will be recorded.