Opportunities to prevent physical inactivity through physical education classes

Abstract

Physical inactivity is a major public health concern, particularly among school-aged children with health-related limitations. Students exempted from physical education (PE) classes due to medical conditions are at heightened risk of prolonged inactivity, potentially exacerbating existing health problems. This study investigated school-based strategies for promoting physical activity among medically exempted students. A mixed-methods design was applied, involving random sampling of PE teachers from urban and rural schools in Mongolia. Data collection methods included semi-structured questionnaires, focus group interviews, and policy document analysis. Descriptive statistics were used to analyze quantitative data. A total of 314 teachers participated. The results revealed that a substantial proportion of students were exempted from PE classes, averaging 45–62 students per urban school and 30–39 per rural school. Cardiovascular and musculoskeletal conditions were the most frequently reported reasons for exemption. Although national education policies support inclusive participation, limited implementation reduces opportunities for safe and appropriate physical activity. Teachers identified adapted and therapeutic exercise as effective health-promoting strategies, but emphasized the absence of standardized programs and intersectoral guidance. The study concludes that integrating adapted physical activity into school PE curricula represents an important public health intervention to reduce physical inactivity and support the long-term health of students with medical conditions.