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This study investigates the effectiveness of active breaks during mathematics lessons in reducing anxiety among primary school students through a multisite randomized controlled trial. The ABMOVE! intervention consisted of structured 10-12 minute active breaks integrated into mathematics instruction over 12 weeks. Pre-post anxiety measures were collected from 244 classes (N ≈ 4,400 students) across three Italian regions using the Abbreviated Math Anxiety Scale (AMAS) and Worry Emotionality-Junior (WE-J) scale. Results demonstrate significant reductions in both mathematics anxiety and general school performance anxiety in the intervention group compared to controls, supporting the potential of curriculum-integrated physical activity as a strategy for addressing academic anxiety in primary education.