A national study of playground professionals universal design implementation practices

The objective of this systematic review was to examine the relationship between outdoor time and: (1) physical activity, (2) cardiorespiratory fitness, (3) musculoskeletal fitness, (4) sedentary behaviour; or (5) motor skill development in children aged 3–12 years. We identified 28 relevant studies that were assessed for quality using the GRADE framework. The systematic review revealed overall positive effects of outdoor time on physical activity, sedentary behaviour, and cardiorespiratory fitness, although causality could not be assumed due to a lack of RCTs. Motor skill development was unrelated to outdoor time; however, this relationship was only examined in a single study of preschool children. No studies were found that examined associations between outdoor time and musculoskeletal fitness.

We have observed that the nature and amount of free play in young children has changed. Our purpose in this article is to demonstrate why play, and particularly active, unstructured, outdoor play, needs to be restored in children's lives. We propose that efforts to increase physical activity in young children might be more successful if physical activity is promoted using different language-encouraging play-and if a different set of outcomes are emphasized-aspects of child well-being other than physical health. Because most physical activity in preschoolers is equivalent to gross motor play, we suggest that the term "play" be used to encourage movement in preschoolers. The benefits of play on children's social, emotional, and cognitive development are explored.