Beyond Boundaries: A Scoping Review of Adolescent Physical Activity in Asia and South Asia

BackgroundPhysical activity (PA) plays a crucial role in adolescent health and development. The World Health Organization recommends that adolescents engage in at least 60 minutes of moderate to vigorous PA daily, with schools being a key setting for fostering active behaviors. However, PA levels among adolescents in Low- and Middle-Income Countries (LMICs), including Pakistan, remain suboptimal, with multiple socio-cultural, environmental, and policy-related barriers influencing participation. ObjectiveThis scoping review explores the levels of adolescent PA in LMICs, particularly in Asian and South Asian middle schools, and identifies key factors affecting engagement in school-based PA. MethodsFollowing the Arksey and OMalley framework, we conducted a comprehensive literature search across PubMed, ERIC, CINAHL, and Embase, supplemented with grey literature sources. Studies focusing on PA levels among adolescents (ages 5 to 24 ) in LMIC school settings were included. Data were synthesized into thematic categories. ResultsThe review highlights declining PA levels as adolescents transition from childhood, with gender disparities showing lower participation among girls. Key barriers include outdated PE curricula, lack of infrastructure, insufficiently trained PE teachers, family and cultural constraints, safety concerns, and the absence of PA-friendly policies. Gender norms, dress codes, and limited parental support further restrict engagement, particularly for girls. Despite the well-established physical, cognitive, and socio-emotional benefits of PA, school systems in LMICs often prioritize academic performance over physical fitness, contributing to sedentary lifestyles. ConclusionAddressing the declining PA trends among adolescents requires multi-sectoral interventions, including revising PE curricula, improving infrastructure, promoting gender-inclusive PA programs, and fostering parental and community support. Evidence-based policies tailored to LMIC contexts can play a critical role in enhancing adolescent engagement in PA and mitigating long-term health risks associated with inactivity.