Vanesa España-Romero

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.

Effects of Muscular Strength on Cardiovascular Risk Factors and Prognosis

Physical fitness is one of the strongest predictors of individual future health status. Together with cardiorespiratory fitness (CRF), muscular strength has been increasingly recognized in the pathogenesis and prevention of chronic disease. We review the most recent literature on the effect of muscular strength in the development of cardiovascular disease, with special interest in elucidating its specific benefits beyond those from CRF and body composition. Muscular strength has shown an independent protective effect on all-cause and cancer mortality in healthy middle-aged men, as well as in men with hypertension and patients with heart failure. It has also been inversely associated with age-related weight and adiposity gains, risk of hypertension, and prevalence and incidence of the metabolic syndrome. In children and adolescents, higher levels of muscular fitness have been inversely associated with insulin resistance, clustered cardiometabolic risk, and inflammatory proteins. Generally, the influence of muscular fitness was weakened but remained protective after considering CRF. Also, interestingly, higher levels of muscular fitness seems to some extent counteract the adverse cardiovascular profile of overweight and obese individuals. As many of the investigations have been conducted with non-Hispanic white men, it is important to examine how race/ethnicity and gender may affect these relationships. To conclude, most important effects of resistance training are also summarized, to better understand how higher levels of muscular fitness may result in a better cardiovascular prognosis and survival.

Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: the HELENA study

Artero EG, Ruiz JR, Ortega FB, España‐Romero V, Vicente‐Rodríguez G, Molnar D, Gottrand F, González‐Gross M, Breidenassel C, Moreno LA, Gutiérrez A; on behalf of the HELENA Study Group. Muscular and cardiorespiratory fitness are independently associated with metabolic risk in adolescents: the HELENA study.

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.

Health-related fitness in adolescents: underweight, and not only overweight, as an influencing factor. The AVENA study

This study investigated differences in health‐related fitness (20‐m shuttle run, handgrip, bent arm hang, standing long jump, shuttle run 4 × 10 m and sit and reach tests) in 2474 Spanish adolescents (1196 boys and 1278 girls; age 13–18.5 years) classed as underweight, normal weight, overweight or obese according to body mass index. Body fat and fat‐free mass were derived from skinfold thickness. The prevalence of underweight was higher than obesity in girls (4.8% vs 3.0%, respectively; P<0.05) and the opposite in boys (3.9% vs 5.8%, respectively; P<0.05). Underweight was associated with a higher performance in the bent arm hang test in girls (P<0.05) and a lower performance in handgrip in both genders (P<0.01) compared with normal weight. Overweight and obese adolescents presented a lower performance in 20‐m shuttle run, bent arm hang, standing long jump and shuttle run 4 × 10 m tests (P<0.001), but a higher performance in handgrip strength (P<0.001) compared with normal weight. In weight‐bearing tests, the association became non‐significant after adjusting for fat mass. In conclusion, not only overweight and obesity but also underweight seem to be determinants of health‐related fitness in adolescents. The associations could be related to differences in body composition.

Elbow position affects handgrip strength in adolescents: validity and reliability of Jamar, DynEx, and TKK dynamometers.

España-Romero, V, Ortega, FB, Vicente-Rodríguez, G, Artero, EG, Rey, JP, and Ruiz, JR. Elbow position affects handgrip strength in adolescents: validity and reliability of Jamar, DynEx, and TKK dynamometers. J Strength Cond Res 24(1): 272-277, 2010-We examined whether elbow position affects the handgrip strength in adolescents. The criterion-related validity and reliability of the Jamar, DynEx, and TKK dynamometers were also analyzed. A total of 66 adolescents aged 12 to16 years performed the handgrip strength test with the elbow extended and flexed at 90°. The validity and reliability of the Jamar, DynEx, and TKK dynamometers was analysed by using known weights. The highest score was obtained when the test was performed with the elbow in full extension and when using the TKK dynamometer. The criterion-related validity analyses showed a systematic bias of −1.92, −1.43, and 0.49 kg for the Jamar, DynEx, and TKK dynamometers, respectively (all p < 0.05). The reliability analyses revealed a systematic bias of 0.23, 0.26, and 0.02 kg in the Jamar, DynEx, and TKK dynamometers, respectively (all p > 0.05). Performing the handgrip strength test with the elbow extended appears the most appropriate protocol to evaluate maximal handgrip strength in adolescents when using the TKK. In addition, the TKK dynamometer appears to provide the highest criterion-related validity and reliability. The present study provides useful and relevant information indicating which elbow position, and which type of dynamometer, yield maximal handgrip strength in adolescents.

Association of objectively assessed physical activity with total and central body fat in Spanish adolescents; the HELENA Study.

Objectives:To examine the association of objectively assessed physical activity (PA) with markers of total and central body fat in adolescents, and to determine whether meeting the current PA recommendations (⩾60 min day−1 of at least moderate intensity PA) is associated with reduced levels of total and central body fat.Subjects/Methods:A total of 365 Spanish adolescents aged 12.5–17.5 years participated in this cross-sectional study. PA was assessed by accelerometry and expressed as average PA (counts per minute), and min day−1 of light, moderate, moderate to vigorous (MVPA) and vigorous PA. MVPA was dichotomized into <60 min day−1 and ⩾60. Total body fat was measured by DXA, BodPod and the sum of six skinfolds. Central body fat was measured by DXA at three regions (R1, R2 and R3), and waist circumference.Results:All markers of central body fat were negatively associated with vigorous PA (P<0.01) after controlling for sex, age and pubertal status. Abdominal adiposity measured at R1, R2 and R3 was also negatively associated with MVPA (P⩽0.001), and with average PA (P<0.01). All markers of total body fat were negatively associated with vigorous PA (P<0.01), MVPA (P<0.01) and average PA (P<0.05). Adolescents engaged on at least 60 min day−1 MVPA presented lower levels of total (P<0.05) and central body fat (P⩽0.01).Conclusions:The results suggest that vigorous PA may have a greater effect on preventing obesity in adolescents than does PA of lower intensity, whereas both average PA and at least moderate PA may have an impact on total and central body fat in youth.

Associations of muscular and cardiorespiratory fitness with total and central body fat in adolescents: The HELENA Study

Objective To examine the association of healthrelated physical fitness with total and central body fat in adolescents. Participants/Methods The present cross-sectional study comprises 363 Spanish adolescents (186 female participants) aged 12.5–17.5 years. We assessed fitness by the 20-m shuttle run test (cardiorespiratory fitness); the handgrip strength, the standing broad jump and the Abalakov tests (muscular strength); and the 4×10-m shuttle run test (speed–agility). Total body fat was measured by dual energy x-ray absorptiometry (DXA), BodPod and sum of six skinfolds, and central body fat was measured by DXA at three regions (R1, R2 and R3) and waist circumference. Results The Abalakov, the standing broad jump, the 4×10-m shuttle run and the 20-m shuttle run tests were negatively associated with all markers of total and central body fat in men and women after controlling for age, pubertal status and objectively assessed physical activity (p<0.01). Handgrip strength test was positively associated with waist circumference (p<0.01). Conclusions Lower body muscular strength and cardiorespiratory fitness are negatively and consistently associated with total and central body fat in adolescents, whereas levels of upper body muscular strength were superior in adolescents with higher levels of central body fat.

Recommended levels and intensities of physical activity to avoid low‐cardiorespiratory fitness in European adolescents: The HELENA study

The purpose of this study was to determine the sex‐specific physical activity (PA) intensity thresholds that best discriminate between unhealthy/healthy cardiorespiratory fitness (CRF).