Active Breaks During University Classes: A Controlled Study of Medical Students.

Aim: Prolonged sitting during university lessons is highly prevalent, and Active Breaks (ABs) have been proposed to mitigate its effects. This study examined the impact of implementing ABs during lessons on students’ well-being, musculoskeletal symptoms, sedentary behaviour, and perceived cognitive performance. Methods: A non-randomized controlled trial was conducted in early 2025 among fifth- and sixth-year medical students at the Universitat de Vic – Universitat Central de Catalunya. Students were allocated to an intervention group or a control group. The intervention consisted of 7-minute ABs performed midway through 2-hour lessons over a one-month period. Well-being, musculoskeletal symptoms, physical activity (PA) and sedentary behaviour were assessed at baseline and follow-up using validated questionnaires. Perceived cognitive performance was evaluated after each ABs session using a structured Likert-scale questionnaire. Results: A total of 102 students were included in the analysis of physical and mental outcomes and 65 in the cognitive-performance analysis. In intragroup analyses, the intervention group showed significant improvements in well-being, reductions in musculoskeletal symptoms and decreased weekly sitting time, while no relevant changes were observed in the control group. Between-group analyses identified significant differences in favour of the intervention group for well-being and several musculoskeletal outcomes, including neck pain intensity. PA levels remained largely unchanged in both groups. Regarding cognitive outcomes, the intervention group demonstrated significant improvements across all assessed cognitive performance items, with a significant interaction effect observed for content comprehension. Conclusions: ABs implemented during university lessons were associated with improvements in well-being, musculoskeletal discomfort, sedentary behaviour and perceived cognitive performance, supporting their feasibility in higher education.