Addressing insufficient physical activity in children with obesity in a 4-month physical activity on prescription intervention: a single-group pre–post study

BACKGROUND: Childhood obesity is a complex disease and a growing global public health challenge. Physical activity on prescription (PAP) is an evidence-based method to increase physical activity (PA) in adults but has been sparsely studied in children with obesity. The aim of the study was to explore changes in PA patterns in 6-12-year-old children with obesity after a 4-month PAP intervention and to explore age- and sex-related differences. METHODS: The cohort consisted of 42 children (20 boys), 6-12 years old, treated at paediatric or rehabilitation clinics in Gothenburg and surrounding municipalities, Sweden. An individualised PAP intervention was provided, comprising individual counselling, a written prescription with an individually tailored PA recommendation, and structured follow-up. Main activities performed by the children were ball sports, swimming and walking, the latter including daily walks to and from school. Physical activity was measured using accelerometers attached to the participants' hips for 7 days before and after the intervention. Changes pre- to post-intervention in PA patterns were analysed using Wilcoxon's signed rank test. RESULTS: Of the 42 included children, 35 completed the intervention (dropout rate 16.7%), of whom 32 provided valid accelerometer data. The sample was balanced by sex (16 girls/16 boys) and age (n = 16 in each subgroup). No significant changes were observed in PA patterns in the overall group or in subgroup analyses by sex and age. Overall satisfaction with the PAP treatment was high among both children and parents. CONCLUSIONS: Although no significant changes in PA patterns were observed post-intervention, children and parents expressed satisfaction with the PAP intervention. The lack of significant findings may partly be explained by the small sample size and limited statistical power, the extent and duration of the intervention, and the limited ability of accelerometers to capture certain types of activities. Further research is needed to explore the feasibility, adherence, and long-term effects of PAP interventions in children with obesity, with implications for broader public health efforts. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04847271, registered 14 April 2021.