Fitness Measures and Health Outcomes in Youth (2012) / Chapter Skim
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3 Methodology for Selection and Interpretation of Health-Related Fitness Measures in Youth
3 Methodology for Selection and Interpretation of Health-Related Fitness Measures in Youth
Pages 49-78
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From page 49... ...
The chapter begins by describing this framework. It then describes the committee's approach to the selection of test items for each of the four fitness components -- body composition, cardiorespiratory endurance, musculoskeletal fitness, and flexibility.
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From page 50... ...
Thus, it appears in all three categories of variables in the framework -- fitness components, modifying factors, and health markers -- and is highlighted in a different color from that of the other fitness components because of this unique nature. The next section describes the approach used by the committee to select the best youth fitness test items, considering (1)
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From page 51... ...
Physical Fitness Modifying Health Markers Components Factors · Age Cardiovascular/Respiratory Health Body Composition · Gender · Race/Ethnicity Risk Factors Disease Outcomes · Growth Status o Weight-for-Height o Body Composition Metabolic Health and Obesity Cardiorespiratory o Maturation Endurance · Diet Risk Factors Disease Outcomes · Genetics · Culture · Physical Activity Mental and Cognitive Health · Motor Skill Risk Factors Disease Outcomes Musculoskeletal Fitness Musculoskeletal Health Risk Factors Disease Outcomes Flexibility Adverse Events Risk Factors Disease Outcomes FIGURE 3-1 Physical fitness measures and health outcomes: Conceptual framework. NOTE: The variety of fitness tests that can measure a particular fitness component is represented by the embedded boxes under each component.
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From page 52... ...
, muscular strength, muscular endurance, body composition, flexibility, and balance. Only the literature on cardiorespiratory endurance, muscle strength, and muscle endurance was examined systematically, further selected based on the inclusion/ exclusion criteria presented in Box 3-1, and abstracted (only experimental and longitudinal studies were abstracted)
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From page 53... ...
First, health constructs in youth are not as well defined as they are in adults; for example, there are questions about whether elevated blood pressure in youth is directly associated with a poor health outcome. Second, diseases that typically are related to low levels of fitness in adults are found with low frequency in youth; therefore, finding an association between performance on fitness tests and health in youth is not highly probable, particularly in studies with small sample sizes.
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From page 54... ...
, joint flexibility, range of motion, joint range of motion, motor skills, motor fitness, sit-and-reach, fitnessgram, fitness gram, muscle stretching exercises, hamstring flexibility, low-back flexibility criteria applied in reviewing scientific evidence, the above challenges led the committee to consider as evidence any significant positive association reported in a high-quality study. The strength of the association between
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From page 55... ...
, muscular atrophy, fat-free mass, arthritis, bone and bones, bone density, bone mineral density, scoliosis, rhabdomyolysis Miscellaneous: risk, injury risk, functional health a test item and a health marker was categorized as sufficient when most high-quality studies showed a significant association between the test results and a specific health outcome or marker.
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From page 56... ...
Phase 3: Evaluation of relationship of fitness test items to health markers in youth · S tep 1. Review technical reports from currently used fitness tests and consider literature referenced in those reports, especially as it relates to health markers and the integrity of the fitness test items.
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Phase 6. Formulation of conclusions and recommendations on appropriate fitness test items for youth.
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, evidence for their influence on specific fitness test items varies in quality (see, for example, Chapter 4 on the influence of body composition on fitness tests)
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. While evidence suggests a relationship between maturity stages per se and performance on fitness tests, some questions remain to be answered -- in contrast to the influence of body size and/or body composition on fitness, which is affected independently by individual differences in maturation (Malina et al., 2004)
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Estimation of age at peak height velocity requires longitudinal data spanning at least 5-6 years around the spurt (Beunen and Malina, 1988; Beunen et al., 2006; Malina et al., 2004)
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From page 61... ...
Given the lack of experimental data, the literature does not provide adequate support for a recommendation to include a motor skill measure in a national youth fitness test battery. Further research is needed to examine the relationships between the development of motor skill and health-related fitness performance and health outcomes.
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Results of recent cross-sectional and longitudinal research examining associations between motor skill competence levels and body weight status (i.e., percent body fat and body mass index [BMI]
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From page 63... ...
that the development of motor skills may promote improvements in body weight status, physical activity, and healthrelated physical fitness through the dynamic and reciprocal relationships that occur among these variables across childhood. As mentioned previously, there is a need for long-term experimental studies to better understand the impact of motor skill development on body weight status and various aspects of health-related fitness.
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From page 64... ...
Influence of Amount of Practice Time on Fitness Testing Performance Evidence for the effects of practice on performance on specific healthrelated physical fitness tests (i.e., 1-mile run, 20-meter shuttle run, curlups) is lacking.
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From page 65... ...
For example, although the committee found no evidence to support the influence of socioeconomic status on test selection, delivery, or interpretation, one could hypothesize possible limitations due to lack of equipment if a school had a suboptimal built environment (e.g., having no outdoor track would limit the options for cardiorespiratory fitness tests)
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From page 66... ...
ESTABLISHMENT OF CUT-POINTS FOR HEALTH-RELATED YOUTH FITNESS TESTS As noted earlier, interpretation of the results of health-related fitness testing is one of the most important aspects of such testing, making the setting of cut-points essential. Cut-points serve as a way of discerning between individuals and populations that may be at risk of poor health outcomes based on performance on a fitness test and those that are not.
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From page 67... ...
. It then presents the committee's guidance on methods for establishing standards for health-related youth fitness testing based on the available evidence.
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Health is a construct, so there are many possible health outcome measures, such as mortality, a single risk factor (e.g., blood pressure) , or a group of risk factors (e.g., metabolic syndrome)
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From page 69... ...
For health-related fitness testing in youth, the key interest is not only whether a test taker is "fit enough" to be free of potential health risks but also whether the test taker is "fit enough for the future." In addition, because the key outcome of interest of the criterion-referenced approach to evaluating test results is classification (e.g., being at risk of a health outcome versus not being at risk) , the accuracy of the classification is key.
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For example, based on the concurrent relationship between body composition and a set of health outcome measures (total cholesterol, serum lipoprotein ratio, and blood pressure) (Williams et al., 1992)
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From page 71... ...
. Establishing Cut-Points When the Relationship Between a Fitness Test and Health Outcomes Is Not Confirmed in Youth or Adults While the importance of some fitness components to health has been suggested, the relationship between specific fitness test items and health outcomes may not be confirmed.
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2011. Relationship of physical activity with motor skills, aerobic fitness and body fat in preschool children: A cross-sectional and longitudinal study (Ballabeina)
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1990. Criterion-referenced standards for youth health related fitness tests: A tutorial.
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1985. Motor performance fitness tests.
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1996. Tracking of physical activity and physical fitness across the lifespan.
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2002. Childhood movement skills: Predictors of physical activity in Anglo American and Mexican American adolescents?
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2006. The relationship between fundamental motor skills and outside-school physical activity of elementary school children.
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From page 78... ...
2011. Approaches for devel opment of criterion-referenced standards in health-related youth fitness tests.
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