Education outside the classroom and physical activity in special schools
Abstract
Background: Children with disabilities have lower physical activity (PA) and higher sedentary time than peers, increasing long-term health risks. Schools are key settings for PA promotion, yet sustainable approaches are limited. Education outside the classroom (EOtC) integrates movement into learning and has shown PA benefits in mainstream education. Evidence in special schools is scarce. This study examined PA patterns associated with EOtC in Danish special schools.
Methods: A non-randomised controlled feasibility study was conducted in four special schools (n = 65 students, aged 7–16 years). Two schools implemented EOtC (≥4 hours/week) over one school year. PA was measured using thigh-worn accelerometers (SENS motion®) at baseline (7 days) and follow-up (14 days). Outcomes included sedentary time, standing, walking, running, and step counts. Linear mixed models compared PA on EOtC days vs. regular school days.
Results: At follow-up no significant between-group changes were observed between intervention students and controls (all p > 0.5). On EOtC days, intervention students tended to spend less time sedentary (-12.6 min/day) and more time walking (+10.4 min/day), though not statistically significant. Active transport contributed substantially to EOtC exposure, with up to 43.5% of sessions involving ≥31 min of active travel. Missing accelerometer data limited statistical power.
Conclusions: EOtC in special schools may shift daily PA patterns towards less sedentary and more ambulatory behaviour. Although no significant effects were detected, trends suggest potential for health promotion through integrated, curriculum-based movement. Future studies should use larger samples, improved measurement strategies, and examine contextual factors such as transport and learning environments. Embedding EOtC structurally in school systems may support sustainable PA promotion for students in special schools.
Key messages: • EOtC is feasible in special schools and may reduce sedentary time while increasing walking during school days.
• Integrating movement into learning in special schools offers a scalable public health strategy, but stronger evidence and measurement methods are needed.
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BibTeX
@article{stahlhut2026education,
title = {{Education outside the classroom and physical activity in special schools}},
author = {M Stahlhut and M Aadahl and A Stage and M Bølling},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1451},
url = {https://doi.org/10.1093/eurpub/ckag169.1451},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Education outside the classroom and physical activity in special schools
AU - M Stahlhut
AU - M Aadahl
AU - A Stage
AU - M Bølling
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1451
UR - https://doi.org/10.1093/eurpub/ckag169.1451
AB - Background: Children with disabilities have lower physical activity (PA) and higher sedentary time than peers, increasing long-term health risks. Schools are key settings for PA promotion, yet sustainable approaches are limited. Education outside the classroom (EOtC) integrates movement into learning and has shown PA benefits in mainstream education. Evidence in special schools is scarce. This study examined PA patterns associated with EOtC in Danish special schools. Methods: A non-randomised controlled feasibility study was conducted in four special schools (n = 65 students, aged 7–16 years). Two schools implemented EOtC (≥4 hours/week) over one school year. PA was measured using thigh-worn accelerometers (SENS motion®) at baseline (7 days) and follow-up (14 days). Outcomes included sedentary time, standing, walking, running, and step counts. Linear mixed models compared PA on EOtC days vs. regular school days. Results: At follow-up no significant between-group changes were observed between intervention students and controls (all p > 0.5). On EOtC days, intervention students tended to spend less time sedentary (-12.6 min/day) and more time walking (+10.4 min/day), though not statistically significant. Active transport contributed substantially to EOtC exposure, with up to 43.5% of sessions involving ≥31 min of active travel. Missing accelerometer data limited statistical power. Conclusions: EOtC in special schools may shift daily PA patterns towards less sedentary and more ambulatory behaviour. Although no significant effects were detected, trends suggest potential for health promotion through integrated, curriculum-based movement. Future studies should use larger samples, improved measurement strategies, and examine contextual factors such as transport and learning environments. Embedding EOtC structurally in school systems may support sustainable PA promotion for students in special schools. Key messages: • EOtC is feasible in special schools and may reduce sedentary time while increasing walking during school days. • Integrating movement into learning in special schools offers a scalable public health strategy, but stronger evidence and measurement methods are needed.
SN - 1101-1262
SN - 1464-360X
ER -