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The purpose of this study was to investigate the quality (reliability and validity) of large-scale fitness testing in Texas and determine if reliabilities and validities were related to potential confounding variables. Four test administration scenarios were conducted to investigate the quality of data collected statewide as part of the Texas Youth Evaluation Project. Teachers and/or expert test administrators tested individual students (N = 1,010) on two occasions. Criterion-referenced reliabilities were very good to generally acceptable for all FITNESSGRAM[R] test items, with musculoskeletal items having the lowest reliabilities. The validity of teacher-administered tests was good. Reliability and validity of teacher-obtained health-related fitness measures were generally unrelated to potentially confounding student or school characteristics. Administrators, teachers, parents, and students can feel comfortable with the reliability and validity of the statewide health-related fitness testing in Texas. (Contains 1 note and 5 tables.)

This study examined the associations between indicators of health-related physical fitness (cardiovascular fitness and body mass index) and academic performance (Texas Assessment of Knowledge and Skills). Partial correlations were generally stronger for cardiovascular fitness than body mass index and consistently stronger in the middle school grades. Mixed-model regression analyses revealed modest associations between fitness and academic achievement after controlling for potentially confounding variables. The effects of fitness on academic achievement were positive but small. A separate logistic regression analysis indicated that higher fitness rates increased the odds of schools achieving exemplary/recognized school status within the state. School fitness attainment is an indicator of higher performing schools. Direction of causality cannot be inferred due to the cross-sectional nature of the data. (Contains 3 figures and 2 tables.)

This paper provides observations of physical fitness testing in Texas schools and physical education teachers' insights about large-scale testing using the FITNESSGRAM[R] assessment (Cooper Institute, 2007) as mandated by Texas Senate Bill 530. In the first study, undergraduate and graduate students who were trained to observe and assess student fitness testing in grades 3 through 12 provided observations. In the second study, physical education teachers responded to selected interview questions during a focus group discussion. From the observations and responses, specific themes emerged related to teachers' knowledge and training about conducting fitness testing and managing data, students' knowledge and motivation, support and resources for conducting fitness assessments, and complexity of the fitness situation. (Contains 1 table and 1 figure.)

This paper summarizes the historical and legislative backgrounds leading to statewide testing of health-related physical fitness in Texas children grades 3-12 as mandated by Texas Senate Bill 530. The rationale and goals for an associated research project (the Texas Youth Fitness Study, funded by the Robert Wood Johnson Foundation) to evaluate data collected from the statewide initiative are provided. The study investigated the relations between health-related physical fitness and educational variables, including academic achievement, absenteeism, and negative school incidents. It also provides unique insights into the quality (both reliability and validity) of collected data and implications of large-scale school-based physical fitness testing. Teacher commentary and experiences add to the description of the data collection processes. Last, the relations between psychosocial variables and health-related fitness in middle school students are described. (Contains 1 note and 2 tables.)

Statewide physical fitness testing is gaining popularity in the United States because of increased childhood obesity levels, the relations between physical fitness and academic performance, and the hypothesized relations between adult characteristics and childhood physical activity, physical fitness, and health behaviors. Large-scale physical fitness testing can be fraught with problems unless properly planned and conducted. Legislators, administrators, teachers, and parents should consider the following 10 essential issues when conducting large-scale physical fitness testing: purpose of testing, proper planning, training, quality of the data, reporting, support, costs, interpretation, programmatic matters, and policies and politics. (Contains 2 figures and 1 table.)

Background: Increased injury rates have been associated with physical activity (PA). The differences in musculoskeletal injury (MSI) characteristics resulting from PA, versus those unrelated to PA, are unknown. We describe the pattern of PA and non-PA MSI incurred by community-dwelling women. Methods: Data were extracted from the Women's Injury Study, a web-based observational study that tracked weekly PA behaviors and self-reported MSI of 909 community-dwelling women ages 20-83 years. The primary outcome was self-reported MSI that interrupted daily activities ≥2 days and/or required treatment from a health care provider. Follow-up telephone reporting of MSIs allowed further description of injuries. Mixed effects logistic regression was used to identify injury sites associated with PA, controlling for age, body mass index, previous injury, and use of alcohol. Results: Incidence of PA and non-PA MSIs were comparable; some differences in injury characteristics were evident across 83,241 person-weeks of reporting. Non-PA MSIs were more likely to come on 'suddenly' (54% vs. 8%) and commonly involved head/jaw/neck injuries. Reported PA-related MSIs were less likely to require health care provider treatment (60% vs. 80%) and resulted in less missed days of work/school (11%) versus non-PA MSIs (17%). Compared to non-PA related injuries, PA-related injuries were more likely to involve the lower (odds ratio [OR]=3.10, p=0.002) or upper limbs (OR=2.54, p=0.01) and less likely to involve the head/jaw/neck (OR=0.21, p=0.002). Conclusion: There are some differences in mechanisms of injury, the distribution of injuries by anatomical location, and the treatment of injuries depending on aerobic activity participation, although absolute rates of MSI were comparable. [ABSTRACT FROM AUTHOR]

Objectives. We examined the relations of meeting or not meeting the 2008 Physical Activity Guidelines for Americans recommendations for muscular strengthening activities with percentage of body fat, body mass index (BMI; defined as weight in kilograms divided by height in meters, squared), muscular strength, and obesity classification in women. Methods. We analyzed data on 918 women aged 20 to 83 years in the Women's Injury Study from 2007 to 2009. A baseline orthopedic examination included measurement of height, body weight, skinfolds, and muscle strength. Results. Women who met muscle strengthening activity recommendations had significantly lower BMI and percentage of body fat and higher muscle strength. Women not meeting those recommendations were more likely to be obese (BMI≥30) compared with women who met the recommendations after we adjusted for age, race, and aerobic physical activity (odds ratio=2.28; 95% confidence interval=1.61, 3.23). Conclusions. There was a small but significant positive association between meeting muscle strengthening activity recommendations and muscular strength, a moderate inverse association with body fat percentage, and a strong inverse association with obesity classification, providing preliminary support for the muscle strengthening activity recommendation for women. [ABSTRACT FROM AUTHOR]

Unlabelled: Cardiorespiratory fitness (CRF) has been shown to be an independent predictor of all-cause and cardiovascular mortality, as well as health outcomes such as cardiovascular disease, hypertension, diabetes mellitus, and metabolic syndrome. During the last four decades, national guidelines for physical activity and fitness have emerged in an ongoing effort to improve health outcomes through enhanced CRF risk profiles., Purpose: The purpose of the study was to describe the secular trend in CRF as a function of decade and age in a large cohort of men during the past 40 yr., Methods: A cross-sectional analysis of baseline fitness data collected during comprehensive medical examinations of 52,785 men age 20-74 yr evaluated at the Cooper Clinic in Dallas, TX, from 1970 to 2009 who completed a maximum treadmill exercise test for estimation of aerobic capacity was conducted. Comparisons were made between mean fitness levels in each decade stratified by five age groups., Results: Mean CRF in MET from estimated V·O 2max has increased overall approximately 1 MET during a 40-yr period for each of the five age groups (P < 0.0001). The greatest change occurred during the 1970s to 1980s with minimal subsequent increase and a small decline commencing in the last decade especially in younger men., Conclusions: In a large cohort of men, average CRF has improved during the last 40 yr with a slight decline in the favorable trend notable in the most recent decade.

Cardiorespiratory fitness (CRF) is widely accepted as an important reversible cardiovascular risk factor. In the present study, we examined the nonmodifiable and modifiable determinants of CRF within a large healthy Caucasian population of men and women. The study included 20,239 patients presenting to Cooper Clinic (Dallas, Texas) for a comprehensive medical examination from 2000 through 2010. CRF was determined by maximal treadmill exercise testing. Physical activity categories were 0 metabolic equivalent tasks (METs)/min/week (no self-reported moderate or vigorous intensity physical activity), 1 to 449 METs/min/week (not meeting physical activity guideline), 450 to 749 METs/min/week (meeting guideline), and ≥750 METs/min/week (exceeding guideline). Linear regression modeling was used to determine the most robust clinical factors associated with achieved treadmill time. Age, gender, body mass index (BMI), and physical activity were the most important factors associated with CRF, explaining 56% of the variance (R(2) = 0.56). The addition of all other factors combined (current smoking, systolic blood pressure, blood glucose, high-density and low-density lipoprotein cholesterol, health status) were associated with CRF (p <0.05) but additively only improved R(2) by 2%. There was a significant interaction between BMI and physical activity on CRF, such that normal-weight (BMI <25 kg/m(2)) subjects achieved higher CRF for a given level of physical activity compared to obese subjects (BMI ≥30 kg/m(2)). Percent body fat, not lean body mass, was the key factor driving this interaction. In conclusion, BMI was the most important clinical risk factor associated with CRF other than nonmodifiable risk factors age and gender. For a similar amount of physical activity, normal-weight subjects achieved a higher CRF level compared to obese subjects. These data suggest that obesity may offset the benefits of physical activity on achieved CRF, even in a healthy population of men and women., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: Self-report measures have been validated and are widely used. Interest currently lies in the development of simple, valid methods that can be used in any location to determine level of PA in large populations/samples. The purpose of this report is to illustrate tracking of physical activity behaviors and musculoskeletal injury reports on a weekly basis via the Internet., Methods: The Women's Injury Study (WIN) methodology includes use of BRFSS-related physical activity items that are completed online by more than 900 women weekly for an average of 3 years., Results: With more than 45,000 weekly physical activity and injury logs, the percentage of total logs submitted via online records is 91%. Self-reported pedometer steps are consistent with similar, smaller research samples., Conclusions: This report suggests that Internet tracking is a viable means of assessing nearly real-time physical activity, describes the process of developing and monitoring self-reported physical activity behaviors via the Internet, and provides recommendations for others considering such methods.

Background: We examined the associations between muscular strength, markers of overall and central adiposity, and cancer mortality in men., Methods: A prospective cohort study including 8,677 men ages 20 to 82 years followed from 1980 to 2003. Participants were enrolled in The Aerobics Centre Longitudinal Study, the Cooper Institute in Dallas, Texas. Muscular strength was quantified by combining 1-repetition maximal measures for leg and bench presses. Adiposity was assessed by body mass index (BMI), percent body fat, and waist circumference., Results: Cancer death rates per 10,000 person-years adjusted for age and examination year were 17.5, 11.0, and 10.3 across incremental thirds of muscular strength (P = 0.001); 10.9, 13.4, and 20.1 across BMI groups of 18.5-24.9, 25.0-29.9, and > or =30 kg/m(2), respectively (P = 0.008); 11.6 and 17.5 for normal (<25%) and high percent body fat (> or =25%), respectively (P = 0.006); and 12.2 and 16.7 for normal (< or =102 cm) and high waist circumference (>102 cm), respectively (P = 0.06). After adjusting for additional potential confounders, hazard ratios (95% confidence intervals) were 1.00 (reference), 0.65 (0.47-0.90), and 0.61 (0.44-0.85) across incremental thirds of muscular strength, respectively (P = 0.003 for linear trend). Further adjustment for BMI, percent body fat, waist circumference, or cardiorespiratory fitness had little effect on the association. The associations of BMI, percent body fat, or waist circumference with cancer mortality did not persist after further adjusting for muscular strength (all P > or = 0.1)., Conclusions: Higher levels of muscular strength are associated with lower cancer mortality risk in men, independent of clinically established measures of overall and central adiposity, and other potential confounders.

Objective: To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men., Design: Prospective cohort study., Setting: Aerobics centre longitudinal study., Participants: 8762 men aged 20-80., Main Outcome Measures: All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill., Results: During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age adjusted death rates per 10,000 person years across incremental thirds of muscular strength were 38.9, 25.9, and 26.6 for all causes; 12.1, 7.6, and 6.6 for cardiovascular disease; and 6.1, 4.9, and 4.2 for cancer (all P<0.01 for linear trend). After adjusting for age, physical activity, smoking, alcohol intake, body mass index, baseline medical conditions, and family history of cardiovascular disease, hazard ratios across incremental thirds of muscular strength for all cause mortality were 1.0 (referent), 0.72 (95% confidence interval 0.58 to 0.90), and 0.77 (0.62 to 0.96); for death from cardiovascular disease were 1.0 (referent), 0.74 (0.50 to 1.10), and 0.71 (0.47 to 1.07); and for death from cancer were 1.0 (referent), 0.72 (0.51 to 1.00), and 0.68 (0.48 to 0.97). The pattern of the association between muscular strength and death from all causes and cancer persisted after further adjustment for cardiorespiratory fitness; however, the association between muscular strength and death from cardiovascular disease was attenuated after further adjustment for cardiorespiratory fitness., Conclusion: Muscular strength is inversely and independently associated with death from all causes and cancer in men, even after adjusting for cardiorespiratory fitness and other potential confounders.

Valid measurement of physical activity is important for studying the risks for morbidity and mortality. The purpose of this study was to examine evidence of construct validity of two similar single-response items assessing physical activity via self-report. Both items are based on the stages of change model. The sample was 687 participants (men = 504, women = 183) who completed an 8-response (PA8) or 5-response (PA5) single-response item about current level of physical activity. Responses were categorized as meeting or not meeting guidelines for sufficient physical activity to achieve a health benefit. Maximal cardiorespiratory fitness (CRF) and health markers were obtained during a clinical examination. Partial correlation, multivariate analysis of covariance, and logistic regression were used to identify the relations between self-reported physical activity, CRF, and health markers when controlling for gender and age. Single-response items were compared to a detailed measure of physical activity. Single-response items correlated significantly with CRF determined with a maximal exercise test on a treadmill (PA8 = .53; PA5 = .57). Differences in percentage of body fat and cholesterol were in the desired direction, with those self-reporting sufficient physical activity for a health benefit having the lower values. The single-response items demonstrated evidence of construct validity and may provide feasible, cost-effective, and efficient methods to assess physical activity in large-scale studies.

Background: Low cardiorespiratory fitness (CRF) is associated with increased risk of chronic diseases and mortality; however, CRF assessment is usually not performed in many healthcare settings. The purpose of this study is to extend previous work on a non-exercise test model to predict CRF from health indicators that are easily obtained., Methods: Participants were men and women aged 20 to 70 years whose CRF level was quantified with a maximal or submaximal exercise test as part of the National Aeronautics and Space Administration/Johnson Space Center (NASA, n = 1863), Aerobics Center Longitudinal Study (ACLS, n = 46,190), or Allied Dunbar National Fitness Survey (ADNFS, n = 1706). Other variables included gender, age, body mass index, resting heart rate, and self-reported physical activity levels., Results: All variables used in the multiple linear regression models were independently related to the CRF in each of the study cohorts. The multiple correlation coefficients obtained within NASA, ACLS, and ADNFS participants, respectively, were 0.81, 0.77, and 0.76. The standard error of estimate (SEE) was 1.45, 1.50, and 1.97 metabolic equivalents (METs) (1 MET = 3.5 ml O(2) uptake.kilograms of body mass(-1).minutes(-1)), respectively, for the NASA, ACLS, and ADNFS regression models. All regression models demonstrated a high level of cross-validity (0.72 < R < 0.80). The highest cross-validation coefficients were seen when the NASA regression model was applied to the ACLS and ADNFS cohorts (R = 0.76 and R = 0.75, respectively)., Conclusions: This study suggests that CRF may be accurately estimated in adults from a non-exercise test model including gender, age, body mass index, resting heart rate, and self-reported physical activity.

The purpose of this study was to determine the construct-related validity of self-reported historical walking, running, and jogging (WRJ) activity on the basis of data from the Aerobics Center Longitudinal Study (Dallas, Texas). A total of 4,100 men and 963 women underwent at least one medical examination between 1976 and 1985 and completed a follow-up questionnaire in 1986. Levels of glucose, cholesterol, and triglycerides, resting systolic blood pressure, body mass index (weight (kg)/height (m)(2)), and cardiorespiratory fitness were measured at the time of the medical examination. The follow-up questionnaire assessed WRJ and other strenuous activities for each year from 1976 through 1985. Data analysis included Spearman and partial correlations, analysis of variance, analysis of covariance, and t tests. Results indicated significant correlations between recalled WRJ and treadmill times for each year throughout the 10-year period (r = 0.40-0.61). Participants were classified as historically either sufficiently physically active to receive a health benefit or insufficiently active for a health benefit. Engaging in sufficient levels of historical WRJ was associated with higher treadmill times and lower body mass indices for men and women and lower triglyceride levels for men. Self-reported historical WRJ can be assessed with reasonable validity in comparison with measured treadmill performance, with no decay in accuracy of reporting for up to 10 years in the past.