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Background: While there is evidence on the validity and reliability of field-based physical fitness tests in children, adolescents and adults, there is limited evidence to provide feasibility and safety data on the application and performance of the existing field-based physical fitness tests., Objectives: (i) To examine the feasibility and safety of existing field-based physical fitness tests used in people of all ages and (ii) to establish a comprehensive view of criterion-related validity, reliability, feasibility and safety based on scientific evidence for the existing field-based physical fitness tests in adults., Methods: The search was conducted through the electronic databases MEDLINE (via PubMed) and Web of Science (all databases) for published studies from inception to 31 January 2023. This systematic review was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were classified as very low quality, low quality or high quality, based on the criteria of appropriate number of participants, appropriate description of the study population, and appropriate number of items reported to assess feasibility/safety. Three evidence levels were constructed (strong, moderate and limited or inconclusive evidence) according to the number of studies and the consistency of the findings., Results: We identified a total of 19 (14 of high quality) and 13 (11 high quality) original studies examining the feasibility and safety of field-based physical fitness tests, respectively. Strong evidence indicated that (a) the 2-km walk and 20-m shuttle run tests were feasible in adults and, children and adolescents, respectively; (b) the handgrip strength test was feasible in children and adolescents; and (c) the standing long jump test was feasible in children and adolescents. Only the 2-km walk test has shown strong evidence on safety in adults. Finally, combining the levels of evidence of criterion-related validity, reliability, feasibility and safety in adults, all the field-based physical fitness tests show limited evidence., Conclusion: There is a need for more studies and consensus to establish homogeneous methodological criteria to assess the feasibility and safety of field-based fitness tests. The combined evidence on criterion-related validity, reliability, feasibility and safety of field-based tests was found to be limited in adults. PROSPERO reference number CRD42022298276., Competing Interests: Declarations. Ethics Approval and Consent to Participate: Not applicable. Consent for Publication: Not applicable. Competing Interests: Carolina Cruz-León, Pablo Expósito-Carrillo, Sandra Sánchez-Parente, José Jiménez-Iglesias, Milkana Borges Cosic, Magdalena Cuenca-Garcia, José Castro-Piñero declare that they have no conflicts of interest relevant to the content of this review., (© 2025. The Author(s).)

Acquiring gait metrics and anthropometric data is crucial for evaluating an individual's physical status. Automating this assessment process alleviates the burden on healthcare professionals and accelerates patient monitoring. Current automation techniques depend on specific, expensive systems such as OptoGait or MuscleLAB, which necessitate training and physical space. A more accessible alternative could be artificial vision systems that are operable via mobile devices. This article introduces Health&Gait, the first dataset for video-based gait analysis, comprising 398 participants and 1, 564 videos. The dataset provides information such as the participant's silhouette, semantic segmentation, optical flow, and human pose. Furthermore, each participant's data includes their sex, anthropometric measurements like height and weight, and gait parameters such as step or stride length and gait speed. The technical evaluation demonstrates the utility of the information extracted from the videos and the gait parameters in tackling tasks like sex classification and regression of weight and age. Health&Gait facilitates the progression of artificial vision algorithms for automated gait analysis., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background/objectives: The main objective of this study was to examine the association between lifestyle patterns (physical activity, screen and sleep time and diet) and abdominal obesity, and endocrine, metabolic, and immunological biomarkers in adolescents with Down syndrome (DS)., Methods: Eighty-three DS adolescents (38.6% girls), aged 11 to 18 years, from the UP&DOWN study were included. Cluster analysis was performed by including the compliance of recommendations of lifestyle variables, such as moderate to vigorous physical activity (MVPA), screen and sleep time and adherence to the Mediterranean diet (AMD). The waist-to-height ratio was used as an indicator of abdominal obesity. Haematological, biochemical and inflammatory biomarkers were analysed., Results: A three-cluster solution was identified: Cluster 1: adolescents with low compliance; Cluster 2: youth with medium compliance; and Cluster 3: adolescents with high compliance. Significant differences in MVPA ( p = 0.000), screen time ( p = 0.004), sleep time ( p = 0.0001), AMD ( p = 0.000) and abdominal obesity ( p = 0.003) were found. Clusters 2 and 3 had lower levels of triglycerides and LDL-cholesterol than Cluster 1. Cluster 2, in which all adolescents met the MVPA recommendations, had the lowest levels of galactin 3., Conclusions: Compliance with lifestyle recommendations (PA, screen and sleep time and AMD) and the absence of abdominal obesity seem to be associated with better biochemical and inflammatory values.

Background: Aging causes morphological and physiological changes, especially in the musculoskeletal and somatosensory systems, leading to sarcopenia and reduced postural balance, increasing the risk of falls and loss of independence. This study aimed to analyze the effects of a neuromuscular training program on postural balance, physical performance, and muscle strength in older Chilean women. Methods: The double-blind randomized controlled trial included 48 participants aged 65-80 who were divided into three groups: a control group (CG), a multicomponent training group (MCG), and a neuromuscular training group (NMG). Postural balance was assessed using a force platform with open eyes (OE) and closed eyes (CE) conditions, measuring ML velocity, AP velocity, mean radius, and area. Physical performance was evaluated with the Short Physical Performance Battery (SPPB), including static balance, 4-m walking speed, and 5× sit-to-stand chair test. Muscle strength was measured using a hydraulic hand dynamometer to record maximum grip force. Results: Significant time × group interactions in the CE condition were found for mean radius (F = 0.984; p = 0.017; ηp 2 = 0.184), AP velocity (F = 10.01; p = 0.001; ηp 2 = 0.312), and ML velocity (F = 4.30; p = 0.027; ηp 2 = 0.163). Significant pre-post differences in the NMG for mean radius ( p < 0.001), AP velocity ( p < 0.001), and ML velocity ( p = 0.029) were observed, with no significant changes in CG. Significant time × group interactions were also found in the SPPB test score (F = 11.49; p < 0.001; ηp 2 = 0.343), gait speed (F = 5.513; p = 0.012; ηp 2 = 0.198), and sit-to-stand test (F = 5.731; p = 0.010; ηp 2 = 0.206), but not in the balance score (F = 2.099; p = 0.148). Handgrip strength showed no significant interactions (F = 3.216; p = 0.061; ηp 2 = 0.127). Conclusions : These findings suggest that neuromuscular training is a promising intervention to mitigate the decline in balance and physical function associated with aging, offering a targeted approach to improve the quality of life in the elderly.

The aim of this study was to describe the goals, activities, and methods of EUMOVE project in developing a set of resources targeting both primary and secondary schools that allow the entire educational community to promote healthy lifestyles (HL). The EUMOVE project is an Erasmus+ program based in the Creating Active Schools (CAS) framework. The project lasted 3 years and was developed by 14 academic and non-governmental institutions from Spain, Portugal, France, Italy, and the UK. EUMOVE was divided into three phases. In the first phase, several work packages were carried out aimed to ensure the coordination/management of the project activities. In the second phase, seven educational resources strengthened by rigorous scientific research were developed to promote HL from schools. During the last phase, all the resources were disseminated through scientific seminars, workshops with families and teachers, and the online promotion by the non-governmental institutions of each country. The EUMOVE project developed and promoted a smartphone APP, video/activity repository of physically active lessons, active break virtual platform, learning units, and parent/teachers/school-leaders' guidelines to promote physical activity, active commuting, active school playgrounds, healthy diet, and sleep habits. To our knowledge, EUMOVE is the first European project to provide a set of practical tools based on scientific evidence to help schools or future school-wide interventions implement a paradigm shift based on the CAS framework for the promotion of HL. Future research will need to investigate the implementation, effectiveness, and scalability of this proposal., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.)

Background: Cardiorespiratory fitness (CRF) is a powerful health marker recommended by the American Heart Association as a clinical vital sign. Comparing the predictive validity of objectively measured CRF (the "gold standard") and estimated CRF is clinically relevant because estimated CRF is more feasible. Our objective was to meta-analyze cohort studies to compare the associations of objectively measured, exercise-estimated, and non-exercise-estimated CRF with all-cause and cardiovascular disease (CVD) mortality in adults., Methods: Systematic searches were conducted in 9 databases (MEDLINE, SPORTDiscus, Embase, Scopus, PsycINFO, Web of Science, PubMed, CINAHL, and the Cochrane Library) up to April 11, 2024. We included full-text refereed cohort studies published in English that quantified the association (using risk estimates with 95% confidence intervals (95%CIs)) of objectively measured, exercise-estimated, and non-exercise-estimated CRF with all-cause and CVD mortality in adults. CRF was expressed as metabolic equivalents (METs) of task. Pooled relative risks (RR) for all-cause and CVD mortality per 1-MET (3.5 mL/kg/min) higher level of CRF were quantified using random-effects models., Results: Forty-two studies representing 35 cohorts and 3,813,484 observations (81% male) (362,771 all-cause and 56,471 CVD deaths) were included. The pooled RRs for all-cause and CVD mortality per higher MET were 0.86 (95%CI: 0.83-0.88) and 0.84 (95%CI: 0.80-0.87), respectively. For both all-cause and CVD mortality, there were no statistically significant differences in RR per higher MET between objectively measured (RR range: 0.86-0.90) and maximal exercise-estimated (RR range: 0.85-0.86), submaximal exercise-estimated (RR range: 0.91-0.94), and non-exercise-estimated CRF (RR range: 0.81-0.85)., Conclusion: Objectively measured and estimated CRF showed similar dose-response associations for all-cause and CVD mortality in adults. Estimated CRF could provide a practical and robust alternative to objectively measured CRF for assessing mortality risk across diverse populations. Our findings underscore the health-related benefits of higher CRF and advocate for its integration into clinical practice to enhance risk stratification., Competing Interests: Competing interests The authors declare that they have no competing interests., (Copyright © 2025. Production and hosting by Elsevier B.V.)

Background: Health-related quality of life (HRQoL) may be altered during pregnancy due to pregnancy-related changes in all domains of women's health., Hypothesis: A supervised concurrent exercise-training program from the 17th gestational week until birth positively influences HRQoL., Study Design: Randomized controlled trial., Level of Evidence: Level 1., Methods: Eighty-six pregnant women (age, 33.1 ± 4.6 years; prepregnancy body mass index, 23.5 kg/m 2 ), divided into exercise (n = 41) and control (n = 45) groups, participated in this study (per-protocol basis). The exercise group followed a 60-min, 3 days/week, concurrent (aerobic + resistance) exercise training program. HRQoL was assessed with the 36-Item Short Form Health Survey (SF-36), where higher scores (0-100) indicate better HRQoL., Results: After adjusting for potential confounders, the exercise group decreased 16.1 points less than the control group in the SF-36 physical functioning domain [between-group differences (B): 95% confidence interval (CI), 9.02 to 23.22; P < 0.01], and 4.5 points less in the SF-36 physical component summary than the control group (between-group differences (B): 95% CI, 0.65 to 8.28; P = 0.02). Intention-to-treat basis analyses depicted similar results, where the exercise group decreased 10.03 points less than the control group the in the SF-36 social functioning domain (between-group differences (B): 95% CI, 0.39 to 19.68; P = 0.04)., Conclusion: A supervised concurrent exercise training program ameliorates HRQoL decreases along gestation. Although HRQoL decreased throughout pregnancy in both groups, this impact was less in the exercise group, especially in the SF-36 physical functioning, the SF-36 social functioning, and the SF-36 physical component summary., Clinical Relevance: Healthcare providers may encourage pregnant women to exercise in this physiological stage for a better HRQoL throughout pregnancy., Clinicaltrials.gov Identifier: NCT02582567; Date of registration: 20/10/2015., Competing Interests: The authors report no potential conflicts of interest in the development and publication of this article.

There is a divergence in the results of studies that have explored the association between body mass index (BMI) and health outcomes in different contexts., Aim: This study investigated the association between BMI and all-cause mortality in older Chilean people., Methods: 1.205 participants (≥60 years) from the Chilean National Health Survey 2009-2010 were included. The association between BMI categories and all-cause mortality was carried out using Cox proportional regression models, adjusting by confounding factors., Results: Over a median follow-up of 10.9 years (interquartile range: 8.7-11.0), 404 individuals died (33.5%). In the minimally adjusted model (model 1), the participants underweight had 1.46-times (95 CI %: 1.10;1.94) higher mortality risk, while those with obesity II exhibited a 1.73-times (95 CI %: 1.05; 2.83) higher risk of dying due to all-causes compared with the normal-weight. After adjusting for models 2 and 3, the observed association remained significant., Conclusion: Older people categorized as underweight and obese II had a higher risk of all-cause mortality than their normal-weight peers, regardless of confounding factors.

Background: Increasing physical activity (PA) levels and reducing sedentary behaviors in children and adolescents is a need, especially in schools. Active breaks and physically active learning are examples of two emerging methodologies that have been shown to be effective in increasing PA levels and additionally produce improvements in children's educational markers. However, the evidence in adolescents is very limited. This paper presents the design, measurements, and interventions implemented in the ACTIVE CLASS study, whose objectives are: (i) evaluate the effects of two interventions on PA levels, sedentary time, health-related physical fitness academic indicators, cognition, and markers of psychological health among secondary education students; (ii) evaluate teachers' and students' experiences about the implementation of these the two school-based PA intervention., Methods: A randomized controlled study is conducted with a total of 292 students aged 12-14 years old from six schools (7th and 8th grade) in Spain (three in Cadiz and three in Caceres). One school from each study provinces is randomly assigned to either the active break intervention group, the physically active learning intervention group, or the control group. The interventions have a duration of 16 weeks. Nine main measurement categories are assessed: PA and sedentary time, health-related physical fitness, academic indicators, cognition, psychological health, motivational variables, dietary patterns, sociodemographic characteristics, as well as qualitative information through semi-structured individual interviews and focus groups. Three independent measurements of evaluation are distinguished: pre-intervention, post-intervention (week 16) and retention measurement (4 weeks after the intervention). For quantitative variables, descriptive, correlational, regression and repeated measures ANOVA will be applied., Discussion: To the best of our knowledge, the ACTIVE CLASS study is the first of its kind in Spain to evaluate the effects of incorporating active breaks and physically active learning in secondary education. In addition, this project provides important information on the effects of two school-based PA intervention arms on educational variables and health markers in adolescents. This will provide valuable and innovative training to the educational community, enabling them to implement teaching methodologies that have the potential to enhance academic performance and improve the quality of life for their students., Clinical Trial Registration: clinicaltrials.gov, NCT05891054., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 González-Pérez, Sánchez-Oliva, Grao-Cruces, Cano-Cañada, Martín-Acosta, Muñoz-González, Bandera-Campos, Ruiz-Hermosa, Vaquero-Solís, Padilla-Moledo, Conde-Caveda, Segura-Jiménez, González-Ponce, García-Calvo, Castro-Piñero and Camiletti-Moirón.)

Introduction: We aimed to analyze the cross-sectional and longitudinal association of physical activity (PA) levels and PA patterns with metabolic syndrome score (MetS) in children and adolescents., Methods: A total of 175 children (82 females) and 188 adolescents (95 females) were included. Objective PA levels and patterns were determined by accelerometry. MetS was computed from waist circumference, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Different linear regression models were implemented to examine the associations of PA with MetS., Results: Vigorous PA, moderate-vigorous PA, number of bouts per day in 10 min (N10), and total time in bouts per day in 10 min (T10) were negatively associated with MetS in male children and adolescents at cross-sectional level (β ranging from -0.005 to -0.164, all p < 0.05). Total time in bouts per day in 20 min in male children, and vigorous PA and N10 in female children were longitudinally and negatively associated with MetS (β ranging from -0.011 to -0.247, all p < 0.05)., Conclusions: Associations of PA and MetS were observed at cross-sectional level in males and longitudinally in female children. The associations in PA patterns were found when patterns were grouped into bouts of 10 min. Therefore, for future studies of PA with health markers in the pediatric population, it would be advisable to choose bouts of shorter duration., (© 2023 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

The role of polymorphism rs9939609 of the FTO gene has been related with fat mass and cardiovascular risk in adults, but it remains unclear in children and adolescents. Hence, the main aim of this study was to determine the FTO polymorphism effects on body composition, cardiorespiratory fitness (CRF), physical activity (PA), inflammatory markers, and cardiovascular risk both in cross-sectional analysis and after two-years of follow-up in children and adolescents. A total of 2129 participants were included in this study. The rs9939609 polymorphism was genotyped. Body composition measurements, CRF, and moderate-to-vigorous PA (MVPA) were determined at baseline and after two-year of follow-up. Moreover, plasma leptin and adiponectin were also determined as inflammatory markers. Furthermore, an index of cardiovascular disease risk factors (CVDRF-I) was calculated. Codominant (TT vs. TA vs. AA) and dominant (AA+AT vs. TT) models were applied for statistical analysis. The results showed a main effect of the FTO genotype on body composition measures in both first and third year (p < 0.05), with lower adiposity in TT compared with AA or AA+AT group. These differences were maintained after accounting for pubertal maturity, sex, age, VO 2 max, and MVPA. Moreover, lower leptin level was observed in TT compared to AA+AT group in the third year. An interaction in Gene*Time*Sex was found in height and neck circumference in dominant model (p = 0.047; p = 0.020, respectively). No differences were found in CRF, MVPA nor CVDRF-I between groups. Hence, homozygous TT allele could be a protective factor against weight gain from early childhood., (© 2023 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Objectives: The purpose of this study was to analyze the time measurement validity and reliability (between raters and test-retest) of the 4 × 10-m shuttle run test to assess motor fitness in adults, according to gender, age, and physical activity levels., Design: Cross-sectional. A total of 230 adults (86 women) aged 18-64 years participated in the study., Methods: The time taken to complete the 4 × 10-m shuttle run test was recorded simultaneously by a trained and an untrained rater (inter-rater reliability) and by photoelectric cells (time measurement validity). 48-72 h later, the test was repeated under the same conditions (test-retest reliability)., Results: The systematic error for trained rater vs. photocell was close to zero (0.0125, p < 0.01), with an effect size of 0.006; and for both, untrained rater vs. photocell and trained rater vs. untrained rater was ∼0.2 s (p < 0.001) with an effect size of 0.09. For the test-retest reliability, the systematic error was 0.05 s (p < 0.001), with an effect size of 0.26, the intraclass correlation coefficient was 0.998 and the coefficient of variation reported a variability of 0.73 %. Results were not influenced by gender and age, while these improved for active vs. non-active participants., Conclusions: Findings indicate that measurements with trained raters are a valid and reliable method for assessing the 4 × 10-m shuttle run test in adults. It is highly recommended that raters be trained to minimize the measurement error., Competing Interests: Declaration of interest statement The authors declare that they have no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: The aims of this study were to examine cross-sectional, and longitudinal association of different measures of obesity and physical fitness with cardiovascular disease (CVD) risk factors in adolescents with Down syndrome., Methods: Longitudinal analysis included 90 adolescents with Down syndrome. Obesity and physical fitness were measured following the ALPHA battery. Blood pressure and blood samplings (glucose, total cholesterol, high-density lipoprotein cholesterol, and serum lipid triglycerides levels (mg/dl) were determinated., Results: In cross-sectional analyses, obesity was positively associated with single CVD risk factors and CVD risk factor index (all p  < .05). In the prospective analyses, obesity was not associated with single CVD risk factors, but components of physical fitness at baseline impact in some single CVD risk factors (all p  < .05)., Conclusion: Obesity might be more strongly related to current cardiovascular-health, while components of physical fitness might be more related to future cardiovascular-health in adolescents with Down syndrome.

We explored the association of physical fitness (PF) during pregnancy with maternal body composition indices along pregnancy and postpartum period. The study comprised 159 pregnant women (32.9 ± 4.7 years old). Assessments were carried out at the 16th and 34th gestational weeks (g.w.) and six weeks postpartum. Cardiorespiratory fitness (CRF), muscular strength (absolute and relative values) and flexibility were measured. Body composition indices were obtained by using dual-energy X-ray absorptiometry at postpartum. The results, after adjusting for potential covariates at the 16th g.w., indicated that greater CRF was associated with lower postpartum indices total fat mass, android and gynoid fat mass (all, p  < 0.05). Greater absolute upper-body muscular strength was associated with greater pre-pregnancy body mass index (BMI), gestational weight gain (GWG); and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, gynoid fat mass, T-score and Z-score bone mineral density (BMD) (all, p  < 0.05). Greater upper-body flexibility was associated with lower pre-pregnancy BMI; and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, android fat mass and gynoid fat mass, and with greater GWG (all, p  < 0.05). At the 34th g.w., greater CRF was additionally associated with greater postpartum T-score and Z-score BMD (both, p  < 0.05). In conclusion, this study reveals that greater PF levels, especially during early pregnancy, may promote a better body composition in the postpartum period. Therefore, clinicians and health promoters should encourage women to maintain or improve PF levels from early pregnancy.

Background: While there is evidence that physical activity, sedentary behaviour (SB) and sleep may all be associated with modified levels of inflammatory markers in adolescents and children, associations with one movement behaviour have not always been adjusted for other movement behaviours, and few studies have considered all movement behaviours in the 24-hour day as an exposure., Purpose: The aim of the study was to explore how longitudinal reallocations of time between moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), SB and sleep are associated with changes in inflammatory markers in children and adolescents., Methods: A total of 296 children/adolescents participated in a prospective cohort study with a 3-year follow-up. MVPA, LPA and SB were assessed by accelerometers. Sleep duration was assessed using the Health Behavior in School-aged Children questionnaire. Longitudinal compositional regression models were used to explore how reallocations of time between movement behaviours are associated with changes in inflammatory markers., Results: Reallocations of time from SB to sleep were associated with increases in C3 levels (difference for 60 min/d reallocation [d 60 ] = 5.29 mg/dl; 95% confidence interval [CI] = 0.28, 10.29) and TNF-α (d 60  = 1.81 mg/dl; 95% CI = 0.79, 15.41) levels. Reallocations from LPA to sleep were also associated with increases in C3 levels (d 60  = 8.10 mg/dl; 95% CI = 0.79, 15.41). Reallocations from LPA to any of the remaining time-use components were associated with increases in C4 levels (d 60 ranging from 2.54 to 3.63 mg/dl; p < 0.05), while any reallocation of time away from MVPA was associated with unfavourable changes in leptin (d 60 ranging from 3088.44 to 3448.07 pg/ml; p < 0.05)., Conclusions: Reallocations of time between 24-h movement behaviours are prospectively associated with some inflammatory markers. Reallocating time away from LPA appears to be most consistently unfavourably associated with inflammatory markers. Given that higher levels of inflammation during childhood and adolescence are associated with an increased risk of chronic diseases in adulthood, children and adolescents should be encouraged to maintain or increase the level of LPA to preserve a healthy immune system., (© 2023. The Author(s).)

Objectives: To analyze the criterion-related validity and the reliability of fitness field tests for evaluating cardiorespiratory fitness in adults, by sex, age, and physical activity level., Design: Cross-sectional., Methods: During 3 weeks, sociodemographic, anthropometric measurements, a treadmill maximal test, the 2-km walk test, and the 20-m SRT were performed in 410 adults aged 18-64 years. Measured and estimated VO 2max (by Oja's and Leger's equations) were analyzed., Results: Measured VO 2max was associated with estimated VO 2max by the 2-km walk test and 20-m SRT (r = 0.784 and r = 0.875, respectively; both p < 0.01). Bland-Altman analysis showed a mean difference of -0.30 ml* kg -1 * min -1 (p < 0.001, d = -0.141) in the 2-km walk test, and 0.86 ml* kg -1 * min -1 (p = 0.051) in the 20-m SRT. Significant mean differences between test and retest were found in the time to complete the 2-km walk test (-1.48 ± 0.51 s, p = 0.004, d = -0.014) and in the final stage reached in the 20-m SRT (0.04 ± 0.01, p = 0.002, d = 0.015). Non-significant differences were found between test and retest in the estimated VO 2max by Oja's (-0.29 ± 0.20 ml* kg -1 * min -1 , p > 0.05) and Leger's eqs. (0.03 ± 0.04 ml* kg -1 * min -1 , p > 0.05). Moreover, both test results and estimated VO 2max equations showed a high test-retest reliability., Conclusions: Both tests were valid and reliable for evaluating cardiorespiratory fitness in adults aged 18-64 years, regardless of sex, age, and physical activity level., Competing Interests: Declaration of interest statement The authors declare that they have no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This systematic review aimed to assess the available evidence on the effects of neuromuscular training on physical performance in older adults. A literature search was conducted across four databases (Psychology and Behavioral (EBSCO), Scopus, Web of Science and PubMed). The PRISMA guidelines were followed. The PEDro scale and Cochrane risk of bias tool were used to assess the quality of and risk of bias in the studies, respectively. The protocol was registered in PROSPERO (code: CRD42022319239). The outcomes were muscle strength, cardiorespiratory fitness, postural balance and gait speed. From 610 records initially found, 10 were finally included in the systematic review, involving 354 older people with a mean age of 67.3 years. Nine of them reported significant changes in at least one variable related to physical performance in the intervention compared to the control groups. The neuromuscular training caused significant improvements in postural balance, flexibility, cardiorespiratory fitness, strength power of the upper and lower limbs and autonomy. The available evidence indicates that neuromuscular training has a positive effect on some variables of physical performance, especially in postural balance; however, the methodological quality and certainty of the evidence in the available literature are limited. Therefore, a greater number of high-quality studies are required to draw definitive conclusions.

Objectives: (1) To develop reference values for health-related fitness in European children and adolescents aged 6-18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries., Methods: This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method., Results: A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu)., Conclusion: This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Background: fragility is characterized by loss of biological reserves and vulnerability to adverse outcomes. An intervention with beneficial effects on the prevention and management of frailty is the regular practice of physical activity (PA). Objective: to determine the association between levels of PA, sedentary time and frailty in older Chileans by sex. Methodology: 232 people over 60 years of age from the metropolitan region participating in the National Health Survey 2016-2017 were included. Frailty was assessed based on the Fried Phenotype Scale criteria and PA level and sedentary time with the Global Physical Activity Questionnaire (GPAQ v2). The association between levels of PA with the different states of frailty was investigated with linear regression analysis. Results and conclusion: elderly people with frailty have less total PA (β = -292.6 min/day [95 % CI: 399.5; -185.7], p = 0.001), occupational PA (β = -5821.8 min/day [95 % CI: 8680.8, -2962.8], p = 0.001), transportation (β = -68.0 min/day [95 % CI: -105.4, -30.62], p = 0.001). A lower amount of moderate AF was also found (β = -137.7 min/day [95 % CI: -202.0, -73.5], p = 0.001); vigorous (β = -43.4 min/day [95 % CI: -81.6; -5.20], p = 0.026) and longer time seated (β = 3.55 hours/day [95 % CI: - 1.97, 5.14], p = 0.001). Frail older people have lower PA levels compared to their peers without frailty. Considering that the Chilean population will experience an increase in the number of older people, it is essential to implement preventive measures to delay the onset of frailty, such as promoting the practice of PA at all levels.

We aimed to analyse the longitudinal association between physical fitness (PF) and body composition (BC) with a metabolic risk score (Met4) in children and adolescents and to elucidate whether the association between PF and Met4 differs when using relativized or absolute fitness variables. A total of 188 children (86 females) and 195 adolescents (97 females) were included. Cardiorespiratory fitness (CRF) was determined by the 20-m shuttle run test, and muscular fitness (MF) was determined by hand grip and standing long jump tests. Height and weight were measured, and the body mass index (Kg/m 2 ) was calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Met4 was computed from systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Relative CRF was longitudinally and negatively associated with Met4 in female children (β =  -0.031, p = 0.025), while absolute CRF was positively associated with Met4 in male children and adolescents (β = 0.000, p < 0.05). Relative upper and lower-body MF were longitudinally and negatively associated with Met4 in female adolescents (β =  -1.347, β =  -0.005, p < 0.05), while absolute lower-body MF was positively associated with Met4 in male children (β = 0.000, p = 0.019). BC was longitudinally and positively associated with Met4 in male children (β-ranging from 0.011 to 0.055, all p < 0.05) and male adolescents (β-ranging from 0.011 to 0.046, all p < 0.05).  Conclusion: BC is more strongly associated with Met4 than PF in children and adolescents. An optimal body weight status should be considered the main objective of health-promoting programs at childhood and adolescence. Furthermore, the way of expressing the fitness variables determines the direction of the association with Met4. What is Known: • Physical fitness is an important health indicator in children and adolescents, with great amount of previous evidence supporting the preventive role of maintaining optimal levels of both cardiorespiratory and muscular fitness for future cardiometabolic issues. What is New: • The way of reporting physical fitness variables can affect the associations between physical fitness features and cardiometabolic outcomes. Since body composition variables have a great impact on both physical fitness and cardiometabolic health, relativizing physical fitness performance by body composition could lead to erroneous conclusions., (© 2022. The Author(s).)

Background: The aim of this study was to examine associations of total volume and bouts of sedentary time (ST) and moderate to vigorous physical activity (MVPA) with physical fitness (PF) in youth., Methods: This was a 2-year follow-up study with 1418 children and adolescents (51.7% boys). Accelerometers were used to assess ST and MVPA. Cardiorespiratory and muscular fitness values were objectively measured and combined in a global PF variable. Weight status was objectively obtained. Linear regression analyses were used to examine the cross-sectional (using scores at baseline) and longitudinal associations (using the change in the variables) of total volume and bouts of ST and MVPA with PF., Results: Total ST was negatively associated with global PF (β = -0.488, P < .001 in cross-sectional analysis; β = -0.234, P = .003 in longitudinal analysis). However, this association was not independent of MVPA. Total volume of MVPA showed a positive association with global PF independently of ST and weight status (β = 0.285, P < .001 in cross-sectional analysis; β = 0.119, P = .001 in longitudinal analysis). Longitudinal associations found between ST and MVPA accumulated in bouts of various lengths and global PF became nonsignificant when their respective total volumes are included in the model., Conclusions: These results underline the need to accumulate minutes of MVPA, regardless of the bout duration, to increase PF levels in youth.

The current study evaluated longitudinal associations between profile transitions of context-specific sedentary behaviour (SB) and changes in academic performance (AP) among school-aged youth. Participants were 466 children and 717 adolescents (50.8% males) aged 8-18 years (children = 7.92 ± 0.41 years; adolescents = 11.85 ± 1.53 years). Non-school SBs and AP were evaluated at baseline and two years later. General linear mixed models were implemented, controlling for age, region, parental education, body mass index, and cardiorespiratory fitness. Cross-sectionally, participants with an Educative-profile (i.e., highest scores in doing homework with/without computer and reading for fun) had higher AP when compared to other profiles. Longitudinally, males who changed from a Screen- to an Educative-profile had higher AP than males who changed from an Educative- to a Social- or Screen-SB profile ( p  < 0.01). No significant differences were found in females. These findings show the importance of analysing SB patterns from a qualitative perspective (i.e., context-specific for boosting school children AP) and highlighting time spent in educative as the most positive for AP, as well the need to implement interventions to reduce time on screen and social behaviours, especially targeting males.

Purpose of Review: Overweight and obesity are associated to health prognosis. Therefore, body composition assessment is an important health outcome, especially in adult population. We analyzed the criterion-related validity of existing field-based methods and equations for body composition estimation in adults aged 19-64 years., Recent Findings: One hundred studies met inclusion criteria. The field-based methods, waist circumference (WC), body adiposity index (BAI), and body mass index (BMI) are valid to indicate body adiposity. Likewise, several equations, including the classical Durnin/Womersley equation, Jackson/Pollock equation (males), and Jackson, Pollock, and Ward equation (females), are valid to estimate total body fat mass or body fat percentage. Anthropometric field methods can provide a simple, quick, and easy informative indicators of adiposity in adults. Classical equations, such as Durnin/Womersley equation, Jackson/Pollock equation, and Jackson, Pollock, and Ward equation, are still valid to estimate total body fat mass or body fat percentage in adult population. When choosing estimation equations, specific population characteristics, such as age, weight status, or race ethnicity, should be taken into account. (Trial Registration: Registered on PROSPERO (CRD42020194272))., (© 2022. The Author(s).)

We explored the association of self-reported physical fitness with depressive symptoms and anxiety levels during pregnancy. One hundred fifty-five pregnant women (32.9 ± 4.7 years old) participated in the study. Self-reported physical fitness was assessed with the International Fitness Scale , depressive symptoms and state anxiety levels with the Center for Epidemiological Studies-Depression Scale and the State Trait Anxiety Index , respectively, at the 16 and 34 weeks of gestation. In model 1 (adjusted for age and gestational weight gain), greater overall self-reported physical fitness was associated with fewer depressive symptoms at the 16 weeks ( p  = .004). Greater self-reported cardiorespiratory fitness and muscular strength were associated with lower anxiety levels at the 16 weeks (all, p  > .05). Greater overall self-reported physical fitness, cardiorespiratory fitness and speed-agility were associated with lower anxiety levels at the 34 weeks (all, p  > .05). These results were also confirmed in model 2 (additionally adjusted for the exercise intervention, sleep quality, educational level, working status and cohabitating), except for cardiorespiratory fitness and anxiety levels at the 16 weeks ( p  = .09). Greater self-reported physical fitness was associated with lower psychological ill-being during pregnancy. Specifically, at the 16 weeks, greater self-reported overall physical fitness was associated with fewer depressive symptoms, greater self-reported muscular strength with lower anxiety levels; greater self-reported overall physical fitness and speed-agility with lower anxiety levels at the 34 weeks and greater self-reported cardiorespiratory fitness with lower anxiety levels during the pregnancy. Screening of physical fitness may reduce the risk of depression and anxiety and generally improve pregnancy mental health-related quality of life. Highlights Maternal depression and anxiety have prevalence rates between 8 and 36%.Physical fitness enhancement during pregnancy results in less depression and anxiety.Greater physical fitness may provide benefits for the mother mental health.Self-reported physical fitness screening during pregnancy may be useful in clinical settings.

Background: A low education level has been associated with cognitive impairment in older adults., Aim: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population., Material and Methods: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire., Results: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education., Conclusions: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.

(1) Background: Lifestyle behaviours and physical fitness play a critical role in the development of childhood obesity. It has been demonstrated in this study that self-reported physical fitness is representative of a healthy lifestyle and thus is associated with a lower incidence of overweight/obesity. The objective of this study was to analyse the independent and combined association of lifestyles (physical activity, screen time, diet and hours of sleep) and self-reported physical fitness with body weight in schoolchildren. (2) Methods: This study performed a descriptive and cross-sectional analysis. The study sample consisted of 864 schoolchildren between 8−9 years old from 26 schools of the province of Cádiz. To measure lifestyles and self-reported physical fitness, questionnaires were administered to both schoolchildren and families. To obtain the body weight status, the children were measured by body mass index (BMI). To verify the influence of lifestyles and self-reported physical fitness on the body weight status of schoolchildren, a combined score of lifestyles and self-reported physical fitness was calculated. (3) Results: Schoolchildren who followed healthier lifestyles and presented good physical fitness had a better body weight status (p < 0.001). Schoolchildren who had less healthful lifestyles and bad physical fitness had a 10.34 times higher risk of being overweight or obese (p = 0.004). (4) Conclusions: It has been shown that there is an independent and combined association between lifestyles and physical fitness on the body weight of the schoolchildren. We have suggested strategies to get children to adopt healthy lifestyles and good physical fitness to maintain a healthy body weight and prevent obesity.

Strategies to reduce the spread of coronavirus disease 2019 (COVID-19) have caused different behavioural modifications in all populations. Therefore, this study aimed to determine changes in active commuting, moderate-to-vigorous physical activity (MVPA), physical fitness, and sedentary time during the COVID-19 pandemic in Chilean parents. Eighty-six fathers (41.30 ± 6.82 years) and 294 mothers (40.68 ± 6.92 years) of children from different schools from Valparaíso, Chile, participated. Inclusion criteria were adults with schoolchildren who were resident in Chile during the research period. Convenience sampling was used as a non-probabilistic sampling technique. Respondents completed a self-reported online survey about active commuting, MVPA, self-perceived physical fitness, and sedentary time July-September 2020 during the first pandemic period. Comparisons between before and during the pandemic were performed using t-tests and covariance analysis (ANCOVA), establishing a significance level at p < 0.05. Most participants stayed at home during the pandemic, whereas active and passive commuting significantly decreased in both fathers and mothers ( p < 0.001). MVPA and physical fitness scores reduced considerably ( p < 0.05), while sedentary time significantly increased ( p < 0.05), independent of the sex of parents and children's school type. Differences by age groups and the number of children were more heterogeneous, as younger parents showed a larger decrease in MVPA ( p < 0.05) and physical fitness score ( p < 0.05). Additionally, parents with one child showed a larger decrease in sedentary time ( p < 0.05) than those with two or more children. The COVID-19 pandemic significantly affected healthy behaviours. Hence, health policies should promote more strategies to mitigate the long-term health effects of the pandemic on Chilean parents.

Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.

Scholastic factors (academic achievement) are hypothesized to be important determinants of health-related behaviors in adolescents, but there is a lack of knowledge on their influence on physical activity levels (PAL), especially considering the COVID-19 pandemic and the imposed lockdown. This study aimed to investigate the associations between scholastic factors and PAL before and during the pandemic lockdown. The participants were adolescents form Bosnia and Herzegovina ( n = 525, 46% females), who were observed prospectively at the baseline (before the pandemic lockdown) and during the lockdown in 2020 (follow-up). The scholastic factors (grade point average, behavioral grade, school absences, unexcused absences) were evidenced at the baseline (predictors). The outcome (PAL) was evaluated using the Physical Activity Questionnaire for Adolescents at the baseline and the follow-up. Gender, age, parental/familial conflict, and sport participation were observed as confounders. No significant influence of the predictors on PAL were evidenced at the baseline or at the follow-up. The scholastic variables were significantly associated with the changes of PAL which occurred due to pandemic lockdown, with a lower risk for negative changes in PAL among adolescents who were better in school (OR = 0.56, 95%CI: 0.34-0.81, and OR = 0.66, 95%CI: 0.34-0.97, for the grade point average and behavioral grade, respectively). Students who do well in school are probably more aware of the health benefits of proper PAL, and therefore are devoted to the maintenance of their PAL even during the home-confinement of lockdown. Public health authorities should focus more on helping adolescents to understand the importance and benefits of proper PAL throughout the school system.

Sedentary behavior (SB) is influenced by variations in social, cultural and economic contexts. This study assesses the test-retest reliability and validity of the Youth Leisure-time Sedentary Behavior Questionnaire (YLSBQ), a self-report tool that examines total and domain-specific SB in a cohort of young adults from Colombia. A cross-sectional validation study was conducted among 447 Colombian college students (52.8% men; mean (± standard deviation) age of 19.55 ± 2.54 years). To assess the reliability of the YLSBQ, Kappa statistics (k) were used. A confirmatory factor analysis (CFA) was conducted to determine validity. The Cronbach alpha for the 12 behaviors of the YLSBQ showed a good-to-excellent internal consistency (0.867, ranging from 0.715-0.935). Intraclass correlation coefficient (ICC) indicated that 10 items (83.0%) and two items (17.0%) showed excellent and good reliability, respectively. Furthermore, ICC between the total sedentary time was 0.926 (95% confidence interval [CI] = 0.912 - 0.939), which was interpreted as excellent. The goodness-of-fit tests provided evidence that overall, a four-factor solution was an adequate fit with the time scores. In conclusion, the YLSBQ could be considered a reliable, valid and usable tool for the assessment of SB in young adults in a Latin American country. We found that the psychometric properties of the questionnaire were similar to those of the original Spanish validation study.

Background: Children and adolescents can be distinguished by different typologies (clusters) of physical activity and sedentary behavior. How physical activity and sedentary behaviors change over time within different typologies is not known. This study examined longitudinal changes in physical activity and sedentary time among children and adolescents with different baseline typologies of activity-related behavior., Methods: In this longitudinal study (3 annual time points) of children (n = 600, age = 9.2 ± 0.4 years (mean ± SD), 50.3% girls) and adolescents (n = 1037, age = 13.6 ± 1.7 years, 48.4% girls), participants were recruited in Spain in 2011-2012. Latent class analyses identified typologies based on self-reported screen, educational, social and relaxing sedentary behaviors, active travel, muscle strengthening activity, and sport at baseline. Within each typology, linear mixed growth models explored longitudinal changes in accelerometer-derived moderate-to-vigorous physical activity and sedentary time, as well as time by class interactions., Results: Three typologies were identified among children ("social screenies", 12.8%; "exercisers", 61.5%; and "non-sporty active commuters", 25.7%) and among adolescents ("active screenies", 43.5%; "active academics", 35.0%; and "non-sporty active commuters", 21.5%) at baseline. Sedentary time increased within each typology among children and adolescents, with no significant differences between typologies. No changes in physical activity were found in any typology among children. In adolescents, physical activity declined within all typologies, with "non-sporty active commuters" declining significantly more than "active screenies" over 3 years., Conclusion: These results support the need for intervention to promote physical activity and prevent increases in sedentary time during childhood and adolescence. Adolescents characterized as "non-sporty active commuters" may require specific interventions to maintain their physical activity over time., (Copyright © 2021. Production and hosting by Elsevier B.V.)

Previous studies have observed a link between gender and well-being and health in young populations. The purpose of this research was twofold: (1) to analyse the cross-sectional relationship between gender status with well-being indicators and self-perceived health in adolescents at baseline and at 2-year follow-up and (2) to evaluate the prospective associations between gender at baseline and well-being indicators/self-perceived health assessed at 2-year follow-up. Well-being was measured using the KIDSCREEN-10 questionnaire (as a measure of health-related quality of life (HR-QoL)), the Children's Hope Scale and the Positive and Negative Affect Schedule. Health status of the adolescents was assessed using self-perceived health. Multilevel mixed-effects linear/logistic regression models were carried out to assess the associations between gender status and well-being and health of a sample of 1590 Spanish adolescents. Adolescent girls were shown to have lower HR-QoL scores and higher negative affect scores, and had a higher risk of reporting poor health than boys, in both cross-sectional and longitudinal analyses. Adolescent girls seem to be more vulnerable to poorer well-being and self-reported health than boys. When looking at hedonic and eudemonic well-being separately, longitudinal differential evolution of boys and girls seems to indicate greater deterioration of hedonic well-being among girls as compared to boys. Overall, gender may have a relevant impact on mental and physical health during adolescence., (© 2021 International Association of Applied Psychology.)

Trajectories of physical activity and sedentary time (SED) may differ between subgroups of youth. The aim of this study was to identify group-based dual trajectories of physical activity and SED and explore individual, social, and environmental correlates of these trajectories. Longitudinal data (three time points, baseline 2011-2012) of Spanish youth (n = 1597, mean age = 11.94 ± 2.52, 50.9% boys) were used. Moderate-to-vigorous physical activity (MVPA) and SED were assessed objectively at each time point, and 21 potential correlates were self-reported at baseline. Parallel process growth mixture models identified shared categorical latent groups, adjusting for school and age. Multinomial logistic regression models identified baseline correlates of a given trajectory. Four shared categorical latent groups were identified: (1) stable MVPA and decreasing SED (4%); (2) stable MVPA and increasing SED (3%); (3) consistently higher MVPA (18%); and (4) stable low MVPA and slight increase in SED (75%). Multinomial logistic regression models with group 3 as reference found: negative affect (RRR = 0.90, 95% CI 0.84-0.97), parental screen-time rules (RRR = 1.15, 95% CI 1.00-1.33), and household media equipment (RRR = 1.17, 95% CI 1.05-1.30) predicted likelihood of group 1 membership; cons of reducing SED (RRR = 2.70, 95% CI 1.77-4.10) predicted likelihood of group 2 membership; and co-participation in physical activity with friends (RRR = 0.80, 95% CI 0.69-0.94), fathers' modeling of TV viewing (RRR = 1.22, 95% CI 1.02-1.47), and household media equipment (RRR = 1.16, 95% CI 1.02-1.31) predicted likelihood of group 4 membership. Results suggest that strategies to improve MVPA and SED behaviors among youth may need to be multifaceted, targeting all levels of influence., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n = 18 343; 8.93 ± 1.68) and adolescents (n = 18 438; 14.11 ± 1.58) aged 6-18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008-2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010-2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012-2013. No significant association between the ACS and the economic crisis time period in youth was found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

We explored the association of physical fitness (PF) with pregnancy-related symptoms, at the 16th and 34th gestational weeks (g.w.). The International Fitness Scale and the Pregnancy Symptoms Inventory were employed to assess self-reported PF and pregnancy-related symptoms, respectively. At the 16th g.w. greater self-reported overall PF was associated with lower incidence of urinary frequency ( p = 0.020); greater overall PF, cardiorespiratory fitness (CRF), muscular strength and speed-agility were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater overall PF and speed-agility were associated with lower incidence of poor sleep (both, p < 0.05); greater CRF and flexibility were associated with lower limitations by tiredness-fatigue (both, p < 0.05); and greater flexibility was associated with lower limitations by poor sleep ( p = 0.021). At the 34th g.w. greater self-reported overall PF, CRF and muscular strength were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater CRF was associated with lower incidence of poor sleep ( p = 0.019); and, greater flexibility was associated with lower incidence of increased vaginal discharge ( p = 0.023). Adequate levels of PF, especially CRF, may help women to cope with the most endorsed pregnancy-related symptoms and its limitations, especially tiredness-fatigue and poor sleep.

This paper describes the protocol for a study designed to address the high prevalence (40%) of childhood overweight and obesity in the province of Cádiz, Spain, as a reflection of what is happening worldwide. It is widely known that children who suffer from childhood obesity have a higher risk of developing chronic diseases in adulthood. This causes a decrease in the quality of life and an increase in health spending. In this context, it is necessary to intervene promoting healthy lifestyle habits from an early stage. The objective of this project will be to evaluate the effectiveness of a multimodal intervention (individual, school and family) called "PREVIENE-CÁDIZ" [CADIZ-PREVENT]. The intervention will be focused mainly on diet, physical activity, sedentary lifestyle and sleep, to prevent overweight and obesity in schoolchildren from 8 to 9 years old in the province of Cádiz. It will consist of a 10-session education program carried out in the classroom by the teachers. In addition, children will be assigned two workbooks, one to work on in class and the other at home with parents. A workshop aimed at parents will be included to help teach them how to obtain healthier lifestyle habits. The proposed study will involve a quasi-experimental design with a control group.

Background: Affect and physical fitness play an important role in psychological and physical health; however, the association between those variables in youth remains unknown. The aim of the present study was to examine the influence of physical fitness on positive and negative affect in Spanish children and adolescents., Method: Healthy young Spanish people (n = 1,490) were recruited for the present study: 542 children (n = 272 girls; mean age 9.6 years) and 948 adolescents (n = 454 girls; mean age 14.1 years) with complete baseline data on health-related fitness tests (20 m shuttle run test, 4 × 10 m test, muscular fitness index, and physical fitness index), and positive and negative affect (Positive and Negative Affect Schedule)., Results: Higher performance on physical fitness components was associated with positive affect (β = -0.176-0.118, all P < 0.05). There was no association between all physical fitness components and negative affect (β = -0.100-0.15, all P > 0.05). There were differences on positive affect between the lowest and the highest quartile of the physical fitness index in boys (P = 0.037, Cohen's d 0.60) and girls (P = 0.004, Cohen's d = 0.69), and between the lowest and the highest quartile of muscular fitness index in girls (P < 0.001, Cohen's d = 0.76)., Conclusions: Promoting physical activity during the school years, including strength exercises to increase muscular fitness, could improve positive affect levels and thus psychological health., (© 2020 Japan Pediatric Society.)

During the COVID-19 pandemic, entire populations were instructed to live in home-confinement to prevent the expansion of the disease. Spain was one of the countries with the strictest conditions, as outdoor physical activity was banned for nearly two months. This study aimed to analyse the changes in physical activity and sedentary behaviours in Spanish university students before and during the confinement by COVID-19 with special focus on gender. We also analysed enjoyment, the tools used and motivation and impediments for doing physical activity. An online questionnaire, which included the International Physical Activity Questionnaire Short Form and certain "ad hoc" questions, was designed. Students were recruited by distributing an invitation through the administrative channels of 16 universities and a total of 13,754 valid surveys were collected. Overall, university students reduced moderate (-29.5%) and vigorous (-18.3%) physical activity during the confinement and increased sedentary time (+52.7%). However, they spent more time on high intensity interval training (HIIT) (+18.2%) and mind-body activities (e.g., yoga) (+80.0%). Adaptation to the confinement, in terms of physical activity, was handled better by women than by men. These results will help design strategies for each gender to promote physical activity and reduce sedentary behaviour during confinement periods.

No studies have analyzed the longitudinal associations of change in physical fitness components and obesity with academic performance. The aim of the study was to examine longitudinal associations of changes in physical fitness components and body mass index with academic performance among youth, and whether the physical fitness components are moderators of the longitudinal association between obesity and academic performance in youth. Longitudinal analyses (2 years) included 1802 youths. Physical fitness components were assessed following the ALPHA health-related fitness test battery. Academic performance was assessed via school records. Youth in the persistently high cardiorespiratory fitness and motor ability categories (ie, fit at baseline and at 2-year follow-up) had higher academic performance at follow-up than those in the persistently low category. Further, youth with normal weight at baseline and overweight/obesity at follow-up had lower academic performance scores at follow-up compared to those with normal weight. Also, cardiorespiratory fitness may ameliorate the negative influence of excess body mass index on academic performance at follow-up. Promoting physical activity programs at school that include both aerobic exercise and motor tasks to improve physical fitness and reduce body mass index may not only improve physical health, but also contribute toward successful academic development., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective : The aims of the present study were to analyze the associations between the socio-demographic and familiar circumstances with: (i) the total leisure-time sedentary behavior (SB) assessed by accelerometry, and (ii) the domain-specific leisure-time SB (i.e., screen-based, educational-based, social-based, and other-based SB), in a sample of Spanish youth. Method : The sample consisted of 1,543 youth (12.02 ± 2.51 years) included in the UP&DOWN study. SB was evaluated by accelerometry and questionnaire. Nationality, location of school, type of school, socio-economic status, parental educational level, parental occupation status, family structure, number of siblings and position among siblings were self-reported by participants or their parents. Linear mixed models, including school and city as random effects, were performed. Results : Several associations were found; however, socio-demographic and family circumstances differently associated with SB according to the domain-specific SB, the sex and the type of day. For example, participants with a father holding a high-skilled occupation spent lower time in screen-based SB during weekdays; and mother occupation status of high qualification was related to higher educational-based SB in boys. Having three or more sibling was associated with lower total SB in boys, while having an obese mother was related to higher screen-based SB on weekends both in boys and girls. Conclusions : Socio-demographic and familiar circumstances are associated with SB in young people, so future interventions should consider multiple and sex-specific factors for reduce SB of young people, focusing especially on youth with a low number of siblings and with parents holding low-skilled employments.

The aim was to examine the bidirectional association between cardiorespiratory fitness (CRF) and fatness in a 2-year longitudinal study conducted in young people. A total of 1082 children (512 females) and 727 adolescents (342 females) with complete data at baseline and follow-up were included. CRF was determined by the 20-m shuttle run test. Height and weight were measured, and body mass index and fat mass index (kg/m 2 ) were calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Bidirectionality was tested by including CRF and each fatness index as exposures and outcomes, alternatively, in different regression models. CRF was prospectively associated with fatness index levels (ß from -0.186 to -0.528; P < .001), remaining significant in children after adjusting for baseline fatness indices. Fatness indices were prospectively associated with CRF (ß from -0.207 to -0.479; P < .001), with no substantial changes observed in children and female adolescents when baseline CRF was considered. Changes in CRF were prospectively associated with several fatness indices, regardless of body fatness at baseline (ß from -0.062 to -0.220; P < .05). Body fatness changes were associated with future CRF levels, independently of baseline CRF, especially in children of both sexes and male adolescents (ß from -0.079 to -0.260; P < .05). Overall, a bidirectional association was observed between CRF and fatness in children and adolescents. The attainment of optimal CRF and fatness levels in early ages should be promoted since it could result in favorable future fatness and CRF levels, respectively, which are two key determinants of health status., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A device called FeelBreathe (FB) ® was designed, developed, and patented for inspiratory muscle training. The main aim was to determine the acute responses on lung ventilation, gas exchange, and heart rate during exercise in patients with chronic obstructive pulmonary disease (COPD) with and without the use of FB. In this study, a randomized cross-over trial was performed with 18 men diagnosed with COPD (FEV 1 between 30% and 70% of its predicted value). Each participant randomly conducted two trials with 30 min of rest between them with the same protocol on a treadmill for 10 min at a constant rate of 50% of VO 2peak . Each test was performed randomly and in a crossover randomized design in two different conditions: (1) oronasal breathing; and (2) nasal breathing with FB (nasal ventilatory flow restriction device). It was observed that FB had positive effects on dynamic hyperinflation, breathing pattern, and breathing efficiency, with higher expiratory and inspiratory time. Despite these differences, blood oxygen saturation percentage, oxygen uptake, and heart rate showed a similar response for both conditions during exercise. The results suggest that exercise performed with FB improved ventilatory responses compared to the oronasal mode in COPD patients. This new tool could be used during most daily tasks and exercise programs.

Background . Recess is a great opportunity to interrupt sedentary behaviour and increase moderate-to-vigorous physical activity (MVPA) in schoolchildren. This quasi-experimental study aimed to compare the levels of physical activity (PA) during the school day of children in a school intervention programme vs. those in a control group, and to determine compliance with MVPA recommendations. Methods. A sample of 154 schoolchildren (6-12 years old) was obtained from several schools (70 with the intervention and 84 controls). This programme was structured with a duration of 90 min/session and performed three times/week. PA levels were recorded with triaxial accelerometers during the school day: during recess, during a PA session or physical education session (PE), and during lunchtime. No pre-intervention evaluation was performed. Results. The MVPA of the control group was higher than that of the intervention group during the first recess ( p < 0.001). None of the groups complied with the recommendations for steps during the PA or PE sessions. During the PA session, sedentary time was lower and MVPA was higher, in the intervention group than in the control group. Fifty percent of the children from the intervention group complied with the MVPA recommendations, vs. 22.7% of those in the control group. Conclusions. The schoolchildren in the intervention group performed more MVPA than those in the control group. Future interventions could include other periods, such as recess and lunchtime, which are opportunities for improving the MVPA levels of schoolchildren.

Background: According to the current physical activity (PA) recommendations, children should accumulate 60 minutes of moderate to vigorous PA (MVPA) throughout the day, 30 minutes of MVPA during the school hours, and 50% of the recess time in MVPA. Our aim was to examine the temporal trends of accelerometer-based PA during the previously mentioned day segments and the proportion of children who met the PA recommendations., Methods: This was a cross-sectional study with 2 independent samples: 499 fourth graders (49.2% females) in 2011-2012 and 364 fourth graders (46.9% females) in 2017-2018. Hip-worn accelerometers were used to assess PA., Results: A decline in light PA, moderate PA, vigorous PA, MVPA, and total PA during whole day, and in the rate of compliance with daily MVPA recommendations in males (P < .01) was observed from 2011-2012 to 2017-2018. Females decreased their daily light PA and moderate PA (P < .05). A decline in all PA variables during school hours in both sexes (P < .05) and in the rate of compliance with the 30 minutes of MVPA recommended during school hours in males (P < .001) were observed. There were no differences in PA during recesses., Conclusions: Interventions are needed to attenuate the temporal decrease in PA levels in children.

The aims of this study were to identify profiles of sedentary behaviour (SB) patterns, based on leisure-time self-reported SB modalities (screen, educative, social, and relaxing) and to evaluate changes in these profiles over 2 years among Spanish youth aged 8-18 years. Latent profile analysis (LPA), a data-driven analytic approach, was used to identify groups of boys and girls (n = 1553; 48% girls; mean±SD age: 12.56 ± 2.49 y) with distinct SB profiles using the SB modalities (time/d) as input variables. Latent transition analysis, an extension of LPA that uses longitudinal data, was used to analyse 2-year changes in these profiles. At baseline, four and three SB profiles were found among boys (labelled: screen, educative, social, and relaxing) and girls (labelled: screen/social, educative, and relaxing), respectively. Overall, more girls (range: 48%-67%) had the same profile over time, than boys (40%-52%). Participants with a screen or relaxing SB profile at baseline were more likely to have an educative profile after 2 years. Youth with a social and an educative SB profile at baseline were more likely to transition to profiles characterized by higher screen and social SB, respectively. Using a novel and person-centered approach, this study identified gender-specific SB profiles that were moderately stable over time.

Background: Longitudinal changes in child and adolescent active school transport (AST), and the mediating role of different intensities of daily physical activity (PA) levels in relation to AST and physical fitness and adiposity indicators is unclear. This study aimed to: 1) describe longitudinal changes in AST, light PA (LPA), moderate- to vigorous-intensity PA (MVPA), physical fitness and adiposity indicators over three time-points; and 2) investigate the mediating role of LPA and MVPA levels on associations between AST and physical fitness and adiposity indicators over three time-points among children and adolescents., Methods: This longitudinal study comprised 1646 Spanish children and adolescents (48.8% girls, mean age 12.5 years ±2.5) at baseline, recruited from schools in Cádiz and Madrid. Mode of commuting to school was self-reported at baseline (T0, 2011-12), 1-year (T1) and 2-year follow-up (T2). PA was assessed using accelerometers. Handgrip strength, standing long jump and cardiorespiratory fitness (CRF) assessed physical fitness. Height, weight, body mass index, waist circumference, and triceps and subscapular skinfold thickness were measured. Multilevel linear regression analyses assessed changes in AST, PA levels, physical fitness and adiposity indicators over three time-points (T0-T1-T2). Additionally, longitudinal path analysis (n = 453; mean age [years] 12.6 ± 2.4) was used to test the mediating effects of LPA and MVPA levels on the association between AST and physical fitness and adiposity indicators., Results: Multilevel analyses observed decreases in LPA between T0-T1 (β = - 11.27; p < 0.001) and T0-T2 (β = - 16.27; p < 0.001) and decreases in MVPA between T0-T2 (β = - 4.51; p = 0.011). Moreover, changes over time showed increases in handgrip between T0-T1 (β = 0.78; p = 0.028) and T0-T2 (β = 0.81; p = 0.046). Path analyses showed that AST was directly positively associated with MVPA at T1 (all, β ≈ 0.33; p < 0.001). MVPA at T1 mediated associations between AST and CRF at T2 (β = 0.20; p = 0.040), but not the other outcomes. LPA did not mediate any associations., Conclusions: Results from longitudinal path analysis suggest that participation in more AST may help attenuate declines in MVPA that typically occur with age and improve CRF. Therefore, we encourage health authorities to promote AST, as a way to increase MVPA levels and CRF among youth.

Purpose: The aim of the present study was to analyze the associations of youths' sedentary behavior (SB) with parents' and siblings' SB and physical activity (PA), as well as the associations of youths' coparticipation with parents, siblings, and friends in PA and SB with youths' SB., Methods: The sample consisted of 1543 youths (12.02 ± 2.51 years; 788 boys) enrolled in the baseline cohort of the UP&DOWN study. SB was assessed by accelerometry and questionnaire. Participants reported the time spent by their parents and siblings watching television, playing videogames, surfing the Internet, sitting/resting, and doing PA. Further, participants reported coparticipation with parents, siblings, and friends in these activities. Linear mixed models, including school and city as random effects, were performed., Results: Parents' television time was positively associated with youths' screen-based SB. Coparticipation with friends in playing videogames (in boys) and in surfing the Internet (in girls) showed a positive association with screen-based SB and a negative association with educational-based SB. Moreover, coparticipation with siblings and friends in PA was inversely associated with accelerometer-based SB in boys and girls., Conclusion: Our results emphasize the important role of social modeling in the development of sedentary lifestyles in youths. Interventions aimed at reducing health risk behaviors in youths could be more effective if they are oriented from a social perspective that involves their families and networks of their closest friends., (© 2019 Published by Elsevier B.V. on behalf of Shanghai University of Sport.)

Objectives: To determine whether handgrip strength (HG) and/or standing long jump (SLJ) are capable of detecting risk of metabolic syndrome (MetS) in European adolescents, and to identify age- and sex-specific cut points for these tests., Design: Cross-sectional study., Methods: Participants included 969 (aged 12.5-17.5 years old) adolescents from 9 European countries (n = 520 girls). Absolute and relative HG and SLJ tests were used to assess upper and lower muscle strength, respectively. MetS status was determined using the age- and sex-specific cut points proposed by Jolliffe and Janssen´s, Additionally, we computed a continuous cardiometabolic risk index with the average z-score of four cardiometabolic risk factors: Wait circumference, mean arterial pressure, triglycerides/high-density lipoprotein cholesterol, and fasting insulin., Results: The prevalence of MetS was 3.1% in European adolescents. Relative HG and absolute SLJ were the best tests for detecting the presence of MetS (Area under the receiver operating characteristic (AUC) = 0.799, 95%CI:0.773-0.824; and AUC = 0.695 95%CI:0.665-0.724), respectively) and elevated cardiometabolic risk index (AUC = 0.873, 95%CI:0.838-0.902; and AUC = 0.728 95%CI:0.698-0.756), respectively) and, regardless of cardiorespiratory fitness. We provide age- and sex-specific cut points of upper and lower muscle strength for European adolescents to identify the presence of MetS and elevated cardiometabolic risk index., Conclusions: The proposed health-related cut points could be used as a starting point to define health-related levels of upper and lower muscle strength in adolescents. Likewise, the diagnostic statistics provided herein can be used to offer feedback to adolescents, parents, and education and health professionals about what it means to meet or fail test standards., (Copyright © 2019. Published by Elsevier Ltd.)

Background: The aims were to: (1) examine the levels of physical activity (PA) during different time periods (ie, daily PA, school hour PA, recess PA, physical education classes [PEC] PA) in children and adolescents; and (2) identify the rate of compliance with the specific PA recommendations for these time periods., Methods: The participants were 1925 (940 girls) children and adolescents from 40 Spanish schools. Hip-worn accelerometers were used to assess PA during different time periods., Results: Boys and children were more physically active and had a greater percentage meeting the daily PA recommendation and the school-based PA recommendation than girls and adolescents, respectively. Compliance with daily PA recommendation was markedly higher than that with the school-based PA recommendation, regardless of sex and age groups (ie, 80.4% vs 24.1% for daily and school-based PA recommendations, respectively, in child boys). A very low percentage (ie, 9.7% and 1.2% of child boys with almost 50% of moderate-to-vigorous PA during recess and PEC, respectively) of students reached the recommended PA levels for recess and PEC., Conclusions: Physical activity levels during school hours, recess, and PEC in children and adolescents are very low. Promoting PA in school settings is essential, especially in girls and adolescents., (© 2019, American School Health Association.)