Protocol for the “motor-brain development” trial: effects of motor-focused exercise training on brain function and gross motor skills in preschool children

Purpose: Early childhood is a critical period for both motor and neurodevelopment, yet less is known about whether behavioral improvements following motor-focused physical education are accompanied by concurrent functional neural indicators. This protocol describes a cluster-randomized trial evaluating the effects of a semester-long motor-focused exercise program on gross motor competence and exploratory neurodevelopmental outcomes in preschool children. Methods: This two-arm, cluster-randomized controlled trial will recruit approximately 110 children aged 4-6 years from kindergartens in Changsha, China. Classes will be randomized 1:1 to either an intervention group receiving structured motor-focused physical education or a control group receiving ordinary physical education. The intervention will be delivered three times weekly for 30-40 min over 16 weeks, emphasizing locomotor and object-control skills through progressive, game-based activities. The primary outcome will be gross motor competence measured by the Test of Gross Motor Development-Third Edition (TGMD-3). Secondary outcomes will include portable electroencephalography (EEG) measures of resting-state and task-related brain activity associated with inhibitory control and attentional regulation. Optional measures will include parent- and teacher-reported questionnaires of executive function and behavioral adjustment. Group-by-time effects will be analyzed using linear mixed-effects models under an intention-to-treat framework. Discussion: This trial will examine whether structured motor-focused physical education is associated with improvements in gross motor competence and concurrent functional neural indicators in preschool settings. Findings will contribute incremental evidence to the developmental literature linking motor and neurocognitive processes and may inform future research on scalable approaches to support early childhood development. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT07307742 identifier NCT07307742.