administrators, as well as cost, as schools differ greatly on these variables. Factors related to culture and race/ethnicity, as well as how a test item aligns with the existing curriculum, should also be considered. Finally, perhaps the most important element of fitness testing in schools is the interpretation and dissemination of results. This element represents an opportunity to assist participants in preventing disease and understanding fitness, but can have detrimental effects on the individuals involved if not carried out appropriately. As mentioned above, training in the administration of protocols and the interpretation and communication of test results is essential.

RECOMMENDATION 9-1. Developers and administrators of fitness test batteries in schools and other educational settings should consider including the following test items:

  • standing height (measure of linear growth status) and weight (measure of body mass) to calculate BMI as an indicator of body composition;
  • a progressive shuttle run, such as the 20-meter shuttle run, to measure cardiorespiratory endurance; and
  • handgrip strength and standing long jump tests to measure upper- and lower-body musculoskeletal strength and power, respectively.

Additional tests that have not yet been shown to be related to health but that are valid, reliable, and feasible may also be considered as supplemental educational tools. For cardiorespiratory endurance, alternatives to the shuttle run include distance and/or timed runs, such as the 9-minute or 1-mile run, while the modified pull-up and push-up are possible alternatives for measuring upper-body musculoskeletal strength. The curl-up may be considered in addition to the suggested musculoskeletal fitness tests for measuring core strength and endurance. Although the committee does not recommend a flexibility measure as a core component of a fitness test battery, administrators in schools and other educational settings may wish to include the sit-and-reach test or its alternatives (e.g., backsaver sit-and-reach) to measure flexibility. Experts who establish cut-points for interpreting performance on these fitness test items should follow the guidance provided earlier (Box S-2 and Recommendation 8-3).

Recommendations for Future Research

Altogether, the CDC’s literature review revealed many gaps in understanding of the relationship between fitness measures and health in youth. Although the review revealed a number of associations between the two,



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