How Can Schools Increase Children and Adolescents' Physical Activity? A Systematic Review of Playground Features.

Background: Our research examined the scientific literature to determine the influence of the playground environment (size, type of surface, playground marking, and access to equipment) on physical activity (PA) by gender across different educational stages (early childhood, primary, and secondary education).

Methods: The review process followed the PRISMA statement and inclusion criteria, as well as the PICOs framework to select the population and outcomes of the review. The studies were selected by two independent reviewers, and their quality was assessed using the Hawker tool.

Results: In early childhood education, the association between PA and playground markings and access to playground equipment showed no gender differences in terms of PA. In primary education, moderate-to-vigorous PA (MVPA) was higher for boys on artificial surfaces, multisport courts, and with access to sports equipment than for girls. In secondary education, boys performed more MVPA than girls both with and without sports equipment, and on multisport courts.

Conclusion and implications: The design of the school playgrounds should consider the type of surface (green, natural, or artificial), playground markings (multisport or game courts), the availability of space during recess, and access to game equipment to meet the play preferences of boys and girls.