• Studies should address the relationship between specific musculoskeletal fitness test items and health markers in youth. Priority should be given to test items for which there is growing evidence, such as the handgrip strength or standing long jump test, or others that are promising. Since musculoskeletal fitness is a multivariate construct, the studies should be designed so that a variety of tests are conducted.
  • Studies should investigate the relationship between specific flexibility test items (e.g., sit-and-reach and its modifications), either by themselves or in combination with musculoskeletal fitness test items, and potential health markers (e.g., back pain, posture, injury prevention). Such studies should include stretching interventions specifically designed to produce changes in joint-specific flexibility. Since flexibility is a multivariate construct, the studies should be designed so that a variety of tests are conducted. Researchers should investigate the development and validation of a general marker of musculoskeletal systemic flexibility and its relationship to health markers and risk factors.
  • Studies should examine the potential effects of modifying factors (i.e., age, gender, race/ethnicity, body composition, maturity status, training status/practice, motor skill, socioeconomic factors) on fitness components and on the relationship between a change in a health-related fitness component and health markers in specific populations.

RECOMMENDATION 10-4. Developers of national surveys of health-related physical fitness in youth should consider the inclusion of measures of cardiometabolic health, bone health, and neurocognitive function. The collection of fitness and health data in the same individuals would allow investigators to further confirm whether direct relationships between specific test items and health markers and risk factors exist.

RECOMMENDATION 10-5. When an association between a fitness test and a health marker is confirmed, research should be conducted to establish and validate health-related cut-points for that test. For example, given the association of skinfold measures with health markers, large national studies should be conducted to establish health-related cut-points for skinfold measures in youth.

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