José Castro-Piñero

Predictive Validity of Health-Related Fitness in Youth: A Systematic Review

The objective of the present systematic review was to investigate whether physical fitness in childhood and adolescence is a predictor of cardiovascular disease (CVD) risk factors, events and syndromes, quality of life and low back pain later in life. Physical fitness-related components were: cardiorespiratory fitness, musculoskeletal fitness, motor fitness and body composition. Adiposity was considered as both exposure and outcome. The results of 42 studies reporting the predictive validity of health-related physical fitness for CVD risk factors, events and syndromes as well as the results of five studies reporting the predictive validity of physical fitness for low back pain in children and adolescents were summarised. Strong evidence was found indicating that higher levels of cardiorespiratory fitness in childhood and adolescence are associated with a healthier cardiovascular profile later in life. Muscular strength improvements from childhood to adolescence are negatively associated with changes in overall adiposity. A healthier body composition in childhood and adolescence is associated with a healthier cardiovascular profile later in life and with a lower risk of death. The evidence was moderate for the association between changes in cardiorespiratory fitness and CVD risk factors, and between cardiorespiratory fitness and the risk of developing the metabolic syndrome and arterial stiffness. Moderate evidence on the lack of a relationship between body composition and low back pain was found. Due to a limited number of studies, inconclusive evidence emerged for a relationship between muscular strength or motor fitness and CVD risk factors, and between flexibility and low back pain.

Criterion-related validity of field-based fitness tests in youth: a systematic review

The objective of this systematic review was to comprehensively study the criterion-related validity of the existing field-based fitness tests used in children and adolescents. The studies were scored according to the number of subjects, description of the study population and statistical analysis. Each study was classified as high, low and very low quality. Three levels of evidence were constructed: strong evidence, when consistent findings were observed in three or more high quality studies; moderate evidence, when consistent findings were observed in two high quality studies; and limited evidence when consistency of findings and/or the number of studies did not achieve the criteria for moderate. The results of 73 studies (50 of high quality) addressing the criterion-related validity of field-based fitness tests in children and adolescents indicate the following: that there is strong evidence indicating that the 20 m shuttle run test is a valid test to estimate cardiorespiratory fitness, that the hand-grip strength test is a valid measure of musculoskeletal fitness, that skin fold thickness and body mass index are good estimates of body composition, and that waist circumference is a valid measure to estimate central body fat. Moderate evidence was found that the 1-mile run/walk test is a valid test to estimate cardiorespiratory fitness. A large number of other field-based fitness tests presented limited evidence, mainly due to a limited number of studies (one for each test). The results of the present systematic review should be interpreted with caution due to the substantial lack of consistency in reporting and designing the existing validity studies.

Field-based fitness assessment in young people: the ALPHA health-related fitness test battery for children and adolescents

The present study summarises the work developed by the ALPHA (Assessing Levels of Physical Activity) study and describes the procedures followed to select the tests included in the ALPHA health-related fitness test battery for children and adolescents. The authors reviewed physical fitness and health in youth findings from cross-sectional studies. The authors also performed three systematic reviews dealing with (1) the predictive validity of health-related fitness, (2) the criterion validity of field-based fitness tests and (3) the reliability of field-based fitness tests in youth. The authors also carried out 11-methodological studies to determine the criterion validity and the reliability of several field-based fitness tests for youth. Finally, the authors performed a study in the school setting to examine the reliability, feasibility and safety of the selected tests. The selected fitness tests were (1) the 20 m shuttle run test to assess cardiorespiratory fitness; (2) the handgrip strength and (3) standing broad jump to assess musculoskeletal fitness, and (4) body mass index, (5) skinfold thickness and (5) waist circumference to assess body composition. When there are time limits, the authors propose the high-priority ALPHA health-related fitness test battery, which comprises all the evidence-based fitness tests except the measurement of the skinfold thickness. The time required to administer this battery to a group of 20 youth by one physical education teacher is less than 2 h. In conclusion, the ALPHA fitness tests battery is valid, reliable, feasible and safe for the assessment of health-related physical fitness in children and adolescents to be used for health monitoring purposes at population level.

Assessing Muscular Strength in Youth: Usefulness of Standing Long Jump as a General Index of Muscular Fitness

Castro-Piñero, J, Ortega, FB, Artero, EG, Girela-Rejón, MJ, Mora, J, Sjöström, M, and Ruiz, JR. Assessing muscular strength in youth: usefulness of standing long jump as a general index of muscular fitness. J Strength Cond Res 24(7): 1810-1817, 2010-The purpose of the present study was to examine the association among different measures of lower body muscular strength in children, and the association between measures of lower- and upper-body muscular strength. The study population comprises 94 (45 girls) healthy Caucasian children aged 6-17 years. Children performed several lower body explosive muscular strength tests (i.e., standing long jump [SLJ], vertical jump, squat jump, and countermovement jump) and upper body muscular strength tests (i.e., throw basketball, push-ups, and isometric strength exercises). The association among the study tests was analyzed by multiple regression. The SLJ was strongly associated with other lower body muscular strength tests (R2 = 0.829-0.864), and with upper body muscular strength tests (R2 = 0.694-0.851). The SLJ test might be therefore considered a general index of muscular fitness in youth. The SLJ test is practical, time efficient, and low in cost and equipment requirements.

Reliability of Field-Based Fitness Tests in Youth

The objective of this systematic review was to study the reliability of the existing field-based fitness tests intended for use with children and adolescents. The medical electronic databases MEDLINE, SCOPUS and SPORTS DISCUS were screened for papers published from January 1990 to December 2009. Each study was classified as high, low or very low quality according to the description of the participants, the time interval between measurements, the description of the results and the appropriateness of statistics. 3 levels of evidence were constructed according to the number of studies and the consistency of the findings. 32 studies were finally included in the present review. The reliability of tests assessing cardiorespiratory fitness (9 studies), musculoskeletal fitness (12 studies), motor fitness (3 studies), and body composition (10 studies) was investigated. Although some fitness components warrant further investigation, this review provides an evidence-based proposal for most reliable field-based fitness tests for use with children and adolescents: 20-m shuttle run test to measure cardiorespiratory fitness; handgrip strength and standing broad jump tests to measure musculoskeletal fitness; 4×10 m shuttle run test for motor fitness; and height, weight, BMI, skinfolds, circumferences and percentage body fat estimated from skinfold thickness to measure body composition.

Criterion-Related Validity of Sit-and-Reach and Modified Sit-and-Reach Test for Estimating Hamstring Flexibility in Children and Adolescents Aged 6-17 Years

The purpose of the present study was to examine the criterion-related validity of the sit-and-reach test (SRT) and the modified sit-and-reach test (MSRT) for estimating hamstring flexibility in children and adolescents as well as to determine whether the MSRT is more valid than the SRT. A total of 87 (45 boys and 42 girls) children (6-12 years old) and adolescents (13-17 years old) performed the SRT and the MSRT. Hamstring flexibility was measured with goniometry through the passive straight-leg raise test. Regression analysis was performed to study the association of SRT and MSRT with hamstring flexibility (criterion measure). The SRT was associated with hamstring flexibility in both children (beta=1.089, R (2)=0.281, p=0.001) and adolescents (beta=0.690, R (2)=0.333, p=0.004). The MSRT was also associated with hamstring flexibility in both children (beta=1.296, R (2)=0.298, p<0.001) and adolescents (beta=0.588, R (2)=0.243, p=0.027). It is concluded that the criterion-related validity of the SRT and the MSRT for estimating hamstring flexibility is weak. The present data do not support that the MSRT is a more valid method than the SRT in children and adolescents.

Artificial neural network-based equation for estimating VO2max from the 20m shuttle run test in adolescents

OBJECTIVE To develop an artificial neural network (ANN)-equation to estimate maximal oxygen uptake (VO(2max)) from 20m shuttle run test (20 mSRT) performance (stage), sex, age, weight, and height in young persons. METHODS The 20 mSRT was performed by 193 (122 boys and 71 girls) adolescents aged 13-19 years. All the adolescents wore a portable gas analyzer to measure VO(2) and heart rate during the test. The equation was developed and cross-validated following the ANN mathematical model. The neural net performance was assessed through several error measures. Agreement between the measured VO(2max) and estimated VO(2max) from Légers and ANN equations were analysed following the Bland and Altman method. RESULTS The percentage error was 17.13 and 7.38 for Léger and ANN-equation (P<0.001), respectively, and the standard error of the estimate obtained with Légers equation was 4.27 ml/(kg min), while for the ANN-equation was 2.84 ml/(kg min). A Bland-Altman plot for the measured VO(2max) and Léger-VO(2max) showed a mean difference of 4.9 ml/(kg min) (P<0.001), while the Bland-Altman plot for the measured VO(2max) and ANN-VO(2max) showed a mean difference of 0.5 ml/(kg min) (P=0.654). In the validation sample, the percentage error was 21.08 and 8.68 for Léger and ANN-equation (P<0.001), respectively. CONCLUSIONS In this study, an ANN-based equation to estimate VO(2max) from 20 mSRT performance (stage), sex, age, weight, and height in adolescents was developed and cross-validated. The newly developed equation was shown to be more accurate than Légers. The proposed model has been coded in a user-friendly spreadsheet.

Percentile Values for Muscular Strength Field Tests in Children Aged 6 to 17 Years: Influence of Weight Status

Castro-Piñero, J, González-Montesinos, JL, Mora, J, Keating, XD, Girela-Rejón, MJ, Sjöström, M, and Ruiz, JR. Percentile values for muscular strength field tests in children aged 6 to 17 years: influence of weight status. J Strength Cond Res 23(8): 2295-2310, 2009-The aim of this study was to provide percentile values for 9 different muscular strength tests for Spanish children (1,513 boys and 1,265 girls) aged 6 to 17.9 years. The influence of body weight on the muscular strength level across age groups was also examined. Explosive strength was assessed by the throw ball test (upper body), standing broad jump, and vertical jump tests (lower body). Upper-body muscular endurance was assessed by push ups, bent arm hang, and pull ups tests, and abdominal muscular endurance was assessed by sit ups, curl ups in 30 seconds, and curl ups tests. Body mass index (BMI) was calculated. Participants were categorized according to the BMI international cut-off values as underweight, normalweight, overweight, and obese. Boys had significantly better scores than girls in all the studied tests, except in the 3 upper-body muscular endurance tests in the 6- to 7-year-old group and in the push ups test in the 8- to 9-year-old group. Underweight and normalweight individuals showed similar strength levels. Both underweight and normalweight children and adolescents had significantly higher performance than their overweight and obese counterparts in the lower-body explosive strength tests and in the push ups test in boys and bent arm hang test in both boys and girls. In conclusion, percentiles values of 9 muscular strength tests are provided. Percentiles values are of interest to identify the target population for primary prevention and to estimate the proportion of adolescents with high or low muscular strength levels. The overweight and obese groups had worse scores than their underweight and normalweight counterparts, whereas the underweight group had a similar performance to the normalweight group.

Assessing Health-Related Fitness Tests in the School Setting: Reliability, Feasibility and Safety; The ALPHA Study

The aim of this study was to determine the reliability, feasibility and safety of a health-related fitness test battery administered by Physical Education (PE) teachers in the school setting. Six PE teachers, from three primary schools and three secondary schools, assessed twice (7 days apart) the 20 m shuttle run, handgrip and standing long jump tests, as well as weight, stature, triceps and subscapular thickness and waist circumference in 58 children (age: 6-11 yr) and 80 adolescents (age: 12-18 yr). Feasibility and safety were assessed by researches by means of direct observation. Significant inter-trial differences were found for the standing long jump test (3.8+/-12.7 cm, P<0.05) and for stature (0.73+/-0.8 cm, P<0.001) in children, and for waist circumference in both children and adolescents (-0.82+/-1.2 cm and -0.35+/-0.8 cm respectively, P=0.001). The feasibility and safety items assessed presented a successful answer. Therefore, the results indicate that health-related fitness tests administered by PE teachers are reliable, feasible and safe to be performed in the school setting.

Percentile values for aerobic performance running/walking field tests in children aged 6 to 17 years: influence of weight status

The aim of this study was to provide percentiles values for four different aerobic performance tests in 2752 (1,261 girls) Spanish children aged 6 to 17.9 years. Aerobic performance was assessed by the shuttle run test (20 mSRT), 1-mile, 1/2-mile and 1/4-mile run/walk tests. Height and weight were measured, and body mass index was calculated. Boys had significantly better score than girls in the studied tests in all age groups, except in 1/4-mile test in 6-7 year old children. Underweight children had similar performance than their normalweight counterparts, and underweight boys had better performance than their obese counterparts. Overweight and obese children had lower performance than their normalweight counterparts. Having percentile values of the most used field tests to measure aerobic performance in youth may help to identify children and adolescents at risk for the major chronic diseases, as well as to evaluate the effects of alternative interventions.