Gamified Versus Regular Exercise Snacks on Stationary Bikes, as One 10-Minute or Two 5-Minute Sessions a Day, for Children in an Inclusive Primary School

The goal of this pilot clinical trial is to learn how short exercise breaks, often called exercise snacks, on stationary exercise bikes can best be offered during the school day to students in Primary 4 to 6 at an inclusive primary school in Macao, including autistic students. It will also learn whether the program is practical and safe in an inclusive school. The main questions it aims to answer are: When the bike screen shows a game with points and a ranking among the four riders in the group, do students ride farther per scheduled minute than when the same screen shows a regular display with a cartoon cyclist, heart rate, distance and time remaining? Is any extra riding on game days larger when the 10 minutes are ridden at once than when they are split into two 5-minute rides, and is it accompanied by better or worse feelings during and after the ride? When the same 10 minutes are split into two 5-minute rides, do students receive the same riding dose and are they as focused on their classwork afterwards? How many planned rides actually happen and are completed, and what support do autistic students need? The investigators expect students to ride more on game days. Whether that extra riding comes with better or worse feelings, and whether it depends on ride length. The comparison with the waitlist group only estimates how large the differences are, to help plan a larger study. Thirty-two riders ride in fixed groups of four on 3 fixed school days a week for 8 weeks, 10 minutes a day: one 10-minute ride a day for 4 weeks and two 5-minute rides a day for the other 4 weeks. Within each 4-week period, the display shown to a group on each riding day is randomly assigned, with equal numbers of game and regular-display days, and the same virtual tracks are used under both displays. Riders wear a heart-rate arm band and answer a few picture-supported questions before, during and after each ride. Trained observers, who do not know which display or schedule students are on, record how focused students are on their classwork in the lesson after riding. Sixteen waitlist students follow the usual school routine, complete the same assessments, and receive access to the bikes after the study. All students complete a short tablet attention task and questionnaires about exercise motivation and quality of life before and after the 8 weeks.