Mathematical competence is fundamental for managing daily activities and exercising active citizenship in contemporary society, yet educational systems worldwide struggle to ensure adequate mathematical proficiency for all students (OECD, 2022). In Italy, recent national assessment data indicates that 34% of fifth-grade students do not reach basic proficiency in mathematics, showing a concerning decline from previous years (INVALSI, 2022). This alarming trend calls for innovative pedagogical approaches that can address both cognitive and emotional barriers to mathematical learning.

This study investigates the effectiveness of active breaks within mathematics teaching practices in reducing anxiety and improving Executive Functions (EFs) and, consequently, learning and performance in mathematics. The research is grounded in three theoretical frameworks: the role of executive functions in mathematical learning (Gilmore & Cragg, 2018), the impact of mathematics anxiety on cognitive performance (Ramirez et al., 2018), and the principles of Universal Design for Learning (CAST, 2018). Recent meta-analyses have demonstrated the potential of physical activity interventions to enhance both cognitive function and academic achievement (Álvarez-Bueno et al., 2021).

The research focuses particularly on primary school students, including those with ADHD, considering their specific deficits in EFs and high mathematics anxiety (Ashcraft, 2002; Lievore et al., 2024). This emphasis aligns with recent educational policies promoting inclusive practices and early intervention strategies. The study's innovative aspect lies in its systematic integration of physically active breaks into mathematical content, moving beyond traditional separated approaches to physical activity and academic learning (Mavilidi et al., 2019).

This multisite cluster randomized controlled trial involves 244 primary school classes (N ≈ 4400 students and 244 teachers) from 35 schools across three Italian regions. The study tests two main hypotheses: (1) an innovative teaching program incorporating active breaks during mathematics lessons improves inclusive mathematics learning by reducing math anxiety, enhancing executive functions, and increasing mathematical performance in all students (with and without ADHD); and (2) participation in the program positively modifies teachers' perceptions and attitudes toward using active breaks.

The intervention, based on the Universal Design for Learning perspective, consists of at least three active breaks per week over 12 weeks. These breaks are strategically integrated into mathematics lessons, incorporating movement activities that reinforce mathematical concepts while promoting cognitive engagement and emotional regulation. The experimental group receives detailed activity cards, support materials, and regular supervision, while the control group continues with standard teaching practices.

Data collection includes pre- and post-test measurements of executive functions (sustained attention, working memory, planning), mathematics anxiety, and mathematical performance. The study employs validated instruments including the Test di Cancellazione, Rey Complex Figure Test, Abbreviated Math Anxiety Scale (AMAS), and AC-MT 6-11 test. Teacher perceptions and attitudes are assessed through questionnaires on implementation intentions and attitudes toward physical activity in education. The research design incorporates rigorous methodological controls including standardized implementation procedures, fidelity of implementation, and multilevel statistical analyses to account for the nested structure of educational data.

This research addresses a significant gap in the literature regarding the integration of active breaks with academic content, particularly in mathematics. The findings will contribute to developing evidence-based guidelines for inclusive teaching practices that enhance mathematical learning while promoting student well-being and preventing educational inequality. Furthermore, the study's large-scale implementation across diverse geographical regions will provide valuable insights into the scalability and sustainability of such interventions in different educational contexts.

This study employs a multisite cluster randomized controlled trial design. Randomization is stratified by school and grade level to ensure balance across conditions, with the cluster design accounting for the natural grouping of students within classes while controlling for potential intraclass correlation. After initial teacher training and baseline assessments, the experimental group implements a minimum of three active breaks per week during mathematics lessons over a 12-week period, while the control group maintains standard teaching practices. The active breaks integrate physical movement with mathematical concepts through structured activities designed to promote cognitive engagement and emotional regulation. Teachers in the experimental condition receive detailed activity cards, support materials, and regular supervision through monthly meetings. Participants The study involves approximately 4400 students from grades 2-5 (ages 7-11) across 35 schools (244 classes total) from three Italian regions: Sicily, Puglia, and Piedmont. Instruments For student assessment, executive functions are evaluated using two validated measures: sustained attention through the Test di Cancellazione (Benso & Bracco, 2013) and planning and visuospatial memory with the Rey Complex Figure Test (Rey, 1941; Italian validation by Conson et al., 2019). Mathematics anxiety measurement includes the Abbreviated Math Anxiety Scale (AMAS; Hopko et al., 2003; Italian validation by Caviola et al., 2017) and the WE-J Test (Di Vita & Di Martino, 2024) for performance anxiety. Mathematical performance is assessed using the AC-MT 6-11 (Cornoldi et al., 2020) for calculation and problem-solving abilities. Physical activity levels are measured using the Physical Activity Questionnaire for Children (PAQ-C; Kowalski et al., 2004; Italian validation by Gobbi et al., 2016). Teacher assessment includes an Implementation Intentions Questionnaire (adapted from McLoughlin et al., 2023) and the Attitudes toward Physical Activity in Education Scale (adapted from Webster et al., 2020). Data Analysis The analysis employs multilevel modeling to account for the hierarchical structure of the data. The primary model is: Yijkl = β0 + β1(Time)ijkl + β2(Treatment)kl + β3(Time × Treatment)ijkl + uk + ujk + εijkl where Yijkl represents the outcome for measurement i of student j in class k in school l; Time is coded 0 for baseline and 1 for follow-up; Treatment is coded 1 for intervention and 0 for control; uk represents the random effect for school; ujk represents the random effect for class within school; and εijkl represents the residual error. The model includes adjustments for relevant covariates including grade level, baseline scores, and ADHD status.

This research investigates how integrating active breaks into mathematics teaching can enhance learning outcomes and promote educational inclusion. The study's comprehensive design, involving over 4400 students across three Italian regions, promises to yield valuable insights into effective pedagogical practices that address both cognitive and emotional barriers to mathematical learning. The findings are expected to demonstrate that strategically designed active breaks can simultaneously enhance executive functions, reduce mathematics anxiety, and improve mathematical performance for all students, with particular benefits for those with ADHD. By examining the intervention's effectiveness across diverse educational contexts, the study will provide empirical evidence for the scalability and sustainability of movement-based learning approaches in mainstream education. From a theoretical perspective, this research advances our understanding of the relationships between physical activity, cognitive function, and mathematical learning. It extends current knowledge about embodied learning in mathematics education and provides a novel framework for integrating Universal Design for Learning principles with active learning strategies. The study's focus on both cognitive and emotional aspects of learning contributes to a more comprehensive understanding of how movement-based interventions support academic achievement. The practical implications are substantial. Teachers will gain evidence-based strategies for implementing active breaks effectively, supported by detailed guidelines and resources. For students, particularly those with attention difficulties, the intervention offers a pathway to improved engagement, reduced anxiety, and enhanced learning outcomes. At a systemic level, the research provides valuable insights for educational policy, teacher training, and resource allocation decisions. By demonstrating how physically active learning can be successfully integrated into regular mathematics instruction, this study lays the groundwork for broader educational innovation. The findings will inform the development of inclusive teaching practices that enhance mathematical learning while promoting student well-being and reducing educational inequalities.

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