Development of the Movement Pattern Observation Tool (MPOT)—An Observational Tool to Measure Limb Movements during Elementary School Recess

Background: The US Center for Disease Control estimates that only 24% of American elementary-aged children participate in the recommended 60 min of daily physical activity. As activity levels decline, elementary schools should consider increasing movement opportunities. Activity-driven school days, where children can move their limbs freely, may increase memory retention performance, behavioral impulse control, as well as bone density, and muscle strength. Unstructured, outdoor play (recess) may provide an opportunity for the brain, bone, and muscle-stimulating limb movements to be utilized. To date, no research has focused on whether the modern child actively uses limb movements during recess, nor to what degree. The purpose of this study was to develop a reliable assessment tool (Movement Pattern Observation Tool, MPOT) to observe and record limb movements (unilateral, bilateral, and contralateral movements) of elementary children during recess, defined in this study as unstructured, outdoor play. Methods: Three observers used the MPOT to complete thirty-five observations at one elementary school during kindergarten through fifth-grade recess breaks. Results: Interrater reliability approached excellent, being that excellent is above 0.90. The ICC of the master observer and observer 3 value was 0.898 (95% CI 0.757–0.957), and the ICC of the master observer and observer 2 was 0.885 (95% CI 0.599–0.967), p < 0.03. Conclusion: Inter-rater reliability was achieved through a three-phase process. This reliable recess observation tool will contribute to the body of research linking recess to physical and cognitive health.