Brooklyn J Fraser1, Scott Rollo2, Margaret Sampson2, Costan G Magnussen1,3,4, Justin J Lang2,5, Mark S Tremblay2, Grant R Tomkinson6,7. 1. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia. 2. Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada. 3. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. 4. Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland. 5. Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada. 6. Department of Education, Health and Behavior Studies, University of North Dakota, 2751 2nd Avenue North, Stop 8235, Grand Forks, ND, 58202, USA. grant.tomkinson@und.edu. 7. Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia. grant.tomkinson@und.edu.
Abstract
BACKGROUND: Musculoskeletal fitness is an excellent functional measure that is significantly related to health among youth. OBJECTIVE: Our objective was to identify health-related criterion-referenced cut-points for musculoskeletal fitness (MSF) among youth. METHODS: A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was conducted in September 2020. Only peer-reviewed studies that developed health-related criterion-referenced cut-points for MSF among youth were eligible provided they included (1) youth aged 5-17 years from the general population, (2) at least one quantitative assessment of MSF (e.g., muscular strength), (3) at least one quantitative assessment of health (e.g., cardiometabolic risk), (4) a criterion for health, and (5) a quantitative analysis [e.g., receiver operating characteristic (ROC) curve] of at least one health-related cut-point for MSF. A narrative synthesis was used to describe the results of included studies. RESULTS: Collectively, 13 studies that developed health-related criterion-referenced cut-points for MSF among 14,476 youth from 15 countries were included. Muscular strength demonstrated high discriminatory ability [median area under the curve (AUC) ≥ 0.71] for cardiometabolic risk/metabolic syndrome, sarcopenic obesity risk and bone health, and moderate discriminatory ability (median AUC 0.64-0.70) for asthma. Muscular power also demonstrated high discriminatory ability for bone health but only moderate discriminatory ability for cardiometabolic risk/metabolic syndrome and low discriminatory ability (median AUC 0.56-0.63) for cognition/academic performance. Both muscular endurance and flexibility demonstrated low discriminatory ability for musculoskeletal pain. Health-related cut-points for MSF that demonstrated significant discriminatory ability were generally higher for boys than for girls (for muscular strength and power) and generally increased with age for muscular strength and power but remained stable for flexibility. CONCLUSIONS: Data remain insufficient to establish universal health-related cut-points for MSF among youth. Despite variations in the health-related discriminatory ability of different MSF tests, handgrip strength and standing broad jump emerged as the two tests with the highest discriminatory ability. More research, using standardized testing protocols and health-risk definitions, is required to better triangulate universal health-related cut-points for MSF among youth. PROSPERO REGISTRATION NUMBER: CRD42020207458.
BACKGROUND: Musculoskeletal fitness is an excellent functional measure that is significantly related to health among youth. OBJECTIVE: Our objective was to identify health-related criterion-referenced cut-points for musculoskeletal fitness (MSF) among youth. METHODS: A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was conducted in September 2020. Only peer-reviewed studies that developed health-related criterion-referenced cut-points for MSF among youth were eligible provided they included (1) youth aged 5-17 years from the general population, (2) at least one quantitative assessment of MSF (e.g., muscular strength), (3) at least one quantitative assessment of health (e.g., cardiometabolic risk), (4) a criterion for health, and (5) a quantitative analysis [e.g., receiver operating characteristic (ROC) curve] of at least one health-related cut-point for MSF. A narrative synthesis was used to describe the results of included studies. RESULTS: Collectively, 13 studies that developed health-related criterion-referenced cut-points for MSF among 14,476 youth from 15 countries were included. Muscular strength demonstrated high discriminatory ability [median area under the curve (AUC) ≥ 0.71] for cardiometabolic risk/metabolic syndrome, sarcopenic obesity risk and bone health, and moderate discriminatory ability (median AUC 0.64-0.70) for asthma. Muscular power also demonstrated high discriminatory ability for bone health but only moderate discriminatory ability for cardiometabolic risk/metabolic syndrome and low discriminatory ability (median AUC 0.56-0.63) for cognition/academic performance. Both muscular endurance and flexibility demonstrated low discriminatory ability for musculoskeletal pain. Health-related cut-points for MSF that demonstrated significant discriminatory ability were generally higher for boys than for girls (for muscular strength and power) and generally increased with age for muscular strength and power but remained stable for flexibility. CONCLUSIONS: Data remain insufficient to establish universal health-related cut-points for MSF among youth. Despite variations in the health-related discriminatory ability of different MSF tests, handgrip strength and standing broad jump emerged as the two tests with the highest discriminatory ability. More research, using standardized testing protocols and health-risk definitions, is required to better triangulate universal health-related cut-points for MSF among youth. PROSPERO REGISTRATION NUMBER: CRD42020207458.
Authors: Grant R Tomkinson; Tori Kaster; Faith L Dooley; John S Fitzgerald; Madison Annandale; Katia Ferrar; Justin J Lang; Jordan J Smith Journal: Sports Med Date: 2021-03 Impact factor: 11.136
Authors: J R Ruiz; J Castro-Piñero; E G Artero; F B Ortega; M Sjöström; J Suni; M J Castillo Journal: Br J Sports Med Date: 2009-01-21 Impact factor: 13.800
Authors: Tori Kaster; Faith L Dooley; John S Fitzgerald; Tanis J Walch; Madison Annandale; Katia Ferrar; Justin J Lang; Jordan J Smith; Grant R Tomkinson Journal: J Sports Sci Date: 2020-06-21 Impact factor: 3.337
Authors: Avery D Faigenbaum; James P MacDonald; Andrea Stracciolini; Tamara Rial Rebullido Journal: Curr Sports Med Rep Date: 2020-12 Impact factor: 1.733
Authors: Justin J Lang; Mark S Tremblay; Francisco B Ortega; Jonatan R Ruiz; Grant R Tomkinson Journal: Br J Sports Med Date: 2017-03-02 Impact factor: 13.800
Authors: Brooklyn J Fraser; Leigh Blizzard; Michael D Schmidt; Markus Juonala; Terence Dwyer; Alison J Venn; Costan G Magnussen Journal: J Sci Med Sport Date: 2018-02-14 Impact factor: 4.319
Authors: Fiona C Bull; Salih S Al-Ansari; Stuart Biddle; Katja Borodulin; Matthew P Buman; Greet Cardon; Catherine Carty; Jean-Philippe Chaput; Sebastien Chastin; Roger Chou; Paddy C Dempsey; Loretta DiPietro; Ulf Ekelund; Joseph Firth; Christine M Friedenreich; Leandro Garcia; Muthoni Gichu; Russell Jago; Peter T Katzmarzyk; Estelle Lambert; Michael Leitzmann; Karen Milton; Francisco B Ortega; Chathuranga Ranasinghe; Emmanuel Stamatakis; Anne Tiedemann; Richard P Troiano; Hidde P van der Ploeg; Vicky Wari; Juana F Willumsen Journal: Br J Sports Med Date: 2020-12 Impact factor: 13.800
Authors: Gerardo Weisstaub; María Angelica Gonzalez Bravo; Antonio García-Hermoso; Gabriela Salazar; José Francisco López-Gil Journal: Transl Pediatr Date: 2022-07
Authors: Justin J Lang; Kai Zhang; César Agostinis-Sobrinho; Lars Bo Andersen; Laura Basterfield; Daniel Berglind; Dylan O Blain; Cristina Cadenas-Sanchez; Christine Cameron; Valerie Carson; Rachel C Colley; Tamás Csányi; Avery D Faigenbaum; Antonio García-Hermoso; Thayse Natacha Q F Gomes; Aidan Gribbon; Ian Janssen; Gregor Jurak; Mónika Kaj; Tetsuhiro Kidokoro; Kirstin N Lane; Yang Liu; Marie Löf; David R Lubans; Costan G Magnussen; Taru Manyanga; Ryan McGrath; Jorge Mota; Tim Olds; Vincent O Onywera; Francisco B Ortega; Adewale L Oyeyemi; Stephanie A Prince; Robinson Ramírez-Vélez; Karen C Roberts; Lukáš Rubín; Jennifer Servais; Diego Augusto Santos Silva; Danilo R Silva; Jordan J Smith; Yi Song; Gareth Stratton; Brian W Timmons; Grant R Tomkinson; Mark S Tremblay; Stephen H S Wong; Brooklyn J Fraser Journal: Sports Med Date: 2022-08-24 Impact factor: 11.928
Authors: Samuel Gonçalves Almeida da Encarnação; Pedro Flores; David Magalhães; Gil Afonso; Albino Pereira; Rui Brito Fonseca; Joana Ribeiro; Sandra Silva-Santos; José Eduardo Teixeira; António Miguel Monteiro; Ricardo Ferraz; Luís Branquinho; Pedro Forte Journal: Int J Environ Res Public Health Date: 2022-09-07 Impact factor: 4.614