Bidirectional association between weight status and motor skills in adolescents : A 4-year longitudinal study

Associations Between Motor Competence and Physical Activity, Physical Fitness and Psychosocial Characteristics in Adolescents: A Systematic Review and Meta-analysis

BACKGROUND

Motor competence is an integral component of the health and performance of youth. Numerous studies support the hypothesis that motor competence interacts with perceived motor competence and physical fitness during childhood to induce positive (e.g. healthy weight status) or negative (e.g. reduced physical activity engagement) trajectories. Yet, while adolescence is a key period of rapid growth and maturation, no systematic reviews and meta-analyses have examined the association between motor competence and physical activity, physical fitness and psychosocial characteristics solely within adolescents.

OBJECTIVES

This study aimed to (1) analyse the scientific literature evaluating associations between motor competence and physical activity, physical fitness and/or psychosocial characteristics amongst adolescents; (2) evaluate the associations between motor competence and physical activity, physical fitness characteristics and/or psychosocial characteristics amongst adolescents; and (3) investigate the impact of moderator variables (i.e., age, sex, type of motor competence assessment) on the associations.

METHODS

A systematic search of electronic databases was conducted, followed by a qualitative synthesis of study methods. Random-effects meta-analyses were performed to establish the magnitude and orientation of pooled correlation coefficients between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents, whilst considering potential moderators (i.e., age, sex, type of motor competence assessment).

RESULTS

Sixty-one studies were included, totalling 22,256 adolescents. Twenty-seven different assessments of motor competence were used, with 31 studies utilising product-orientated (i.e. outcome) motor competence assessments. Meta-analyses of 43 studies showed that motor competence was positively associated with physical activity (r = 0.20 to 0.26), some physical fitness characteristics (e.g. muscular strength, cardiovascular endurance; r = 0.03 to 0.60) and psychosocial characteristics (r = 0.07 to 0.34), and inversely associated with weight status (r =  - 0.36 to - 0.10), speed (r =  - 0.31) and agility (r =  - 0.37 to 0.41). Associations with flexibility were unclear.

CONCLUSIONS

The results of this systematic review and meta-analysis support the hypothesised interactions of motor competence with physical activity (positive), physical fitness (positive except for weight status, speed and agility) and psychosocial characteristics (positive) in adolescence. However, methodological approaches vary considerably (e.g. variety of motor competence assessments utilised), with limitations of the current literature including an inadequate assessment of motor competence, a lack of longitudinal observations and a failure to account for biological maturation. Future research assessing associations between motor competence and physical activity, physical fitness and psychosocial characteristics of adolescents should include longitudinal observations of a combined motor competence assessment (i.e. process and product) and account for biological maturation. Improved evaluation using these recommendations could provide more accurate data, leading to more targeted interventions to improve adolescents' physical and psychosocial outcomes.

CLINICAL TRIAL REGISTRATION

CRD42021233441 (PROSPERO ID).

Validation of remote assessment of preschool children's anthropometrics and motor skills

Introduction

Remotely delivered treatment and research procedures were rapidly adopted in response to the COVID-19 pandemic. However, it is unclear if these measures are valid. The purpose of this study was to compare the validity of anthropometry and motor skill proficiency measurements collected in a remote-setting to in-person setting among a sample of children ages 3-4 years.

Methods

Child anthropometry and motor skill performance were measured in-person by trained assessors and by parents at home with remote supervision via videoconference by trained assessors. The following measures from the National Institutes of Health Toolbox were collected: anthropometry (height and weight), manual dexterity/manipulation (9-hole pegboard), motor coordination and agility (supine timed up and go), lower body strength (standing long jump), and postural stability (one-leg standing balance). Differences in expert and parent-based measurements were assessed using Bland-Altman plots, paired samples t-tests, and Pearson correlations.

Results

A total of n = 14 children completed the assessments. No significant differences were observed between measurement locations for weight and motor skills (p > .05). Remote measurement of height (M = 101.1 cm, SD = 5.40) was significantly greater than in-person measurements (M = 98.2 cm, SD = 5.16); p < .0001.

Discussion

Remote measurements of motor skills and weight are valid assessments for researchers and clinicians to utilize in young children. Remote assessment with guidance offers comparable and valid estimates as in-person assessment, potentially offering a solution to resource-constricted barriers in research and access to care. There is an opportunity for researchers to fine-tune remote height and individual-level assessment strategies.

The Influence of a 9-Week Movement Program on the Body Composition of 7- to 8-Year-Old Schoolchildren in the Eastern Cape of South Africa

Pediatric obesity has become a growing global epidemic which has negative health consequences, including for South African children. This study aimed to determine the immediate and sustainable influences of a 9-week movement program on the body composition of 7 to 8-year-old school children in a rural area of South Africa. A two group, pre-test, post-test and re-test after six months experimental design was used to compare anthropometric measurements of the intervention group (IG) and control group (CG). Ninety-three schoolchildren (IG = 57; CG = 36) participated in the study. A 9-week movement program was followed twice a week for 30 min during school hours with an emphasis on improving BMI. Hierarchical Linear Modelling (HLM) was used to analyze the data with time, sex and group as predictors. Effect sizes was computed based on the Cohen's d to assess the practical significance of findings. The intervention positively changed the waist circumference. The subscapular skinfold and BMI showed statistical and practically significant sustainable changes because of the intervention, although gender influenced these effects. School based movement interventions, focusing on improving fundamental movement skills (FMS), have the potential to contribute to a healthier BMI, skinfold thickness and circumferences among young children.

Online physically active academic lessons in COVID-19 times: A pilot study

Schools play an important role in promoting physical activity among students. This paper studies the perception of educators, students, and parents about the use of online physically active academic lessons during COVID-19 in the north of Chile. Starting the first week of November 2020, and for a period of five weeks, 323 students, alongside 11 educators, practiced a geometry-based dance routine online. The qualitative analysis results reveal a positive perception of the experience and an increase in physical activity without reducing the amount of time spent on academic activities. There were also improvements in learning, social relationships, and enjoyment.

Association of Body Weight and Physical Fitness during the Elementary School Years

Physical fitness and body weight are key correlates of health. Nevertheless, an increasing number of children display poor physical fitness and high body weight. The aim of this study was to examine the prospective association of physical fitness with body weight throughout the elementary school years with a special emphasis on children with high body weight or poor physical fitness at baseline. A total of 303 Austrian children (55.1% male) completed the German motor test up to eight times over a 4-year time span (between the ages 6 and 10 years). Physical fitness did not differ across quartiles of body weight at baseline. A more pronounced weight gain, however, was associated with an impaired development of physical fitness and this association was more pronounced in children with higher baseline body weight. In addition, the detrimental effects of an impaired development of physical fitness on subsequent body weight were more pronounced in children with higher baseline body weight. No differences in the longitudinal association between body weight and physical fitness, on the other hand, were observed across quartiles of baseline fitness. These results emphasize the importance of the promotion of physical fitness, particularly in children with increased body weight, to ensure future health.

Influences of persistent overweight on perceptual-motor proficiency of primary school children: the North-West CHILD longitudinal study : Persistent overweight and perceptual-motor proficiency in children

BACKGROUND

Overweight can be a precursor of poor motor execution, negatively impacting the overall development of school-aged children on various levels. This study determined the long-term influences of overweight on perceptual-motor proficiency (PMP) of primary school children in the North-West Province of South Africa.

METHODS

The study, which included 381 participants, formed part of the NW-CHILD longitudinal study from Grade 1 (6.86 years, ± 0.39) in 2010 to Grade 7 (12.9 years, ± 0.38) in 2016. Socioeconomic categories, called quintiles, were used to compare high and low socioeconomic status groups. Overweight was identified when BMI values fell above the 85th percentile, using age- and gender-specific cut-off points. The group was categorised into 4 BMI groups (never overweight, persistent overweight, overweight-to-normal and normal-to-overweight). The Bruininks Oseretsky Test of Motor Proficiency-2 (BOT-2) Short Form and selected composites measuring strength, balance, and running speed and agility were used to assess PMP.

RESULTS

A repeated measures ANOVA analysis indicated specific PMP differences between different BMI groups, but not total motor proficiency (BOT-2 Short Form total) differences. Practical significant group differences (Cohen's d-values) were found in running speed and agility, strength, balance and the BOT-2 total, over seven primary school years. The persistent overweight group showed the poorest performance over time, but also showed deteriorating skills and a gradual widening in perceptual-motor skills performance, compared to the other groups. BMI-related differences in perceptual-motor coordination were also more pronounced in older age groups.

CONCLUSIONS

Persistent overweight negatively impacts specific motor-proficiency components, while improving weight status can counter these effects, which highlights the importance of timeous intervention to combat obesity at a young age.

How Important is Motor Competence for Healthy Weight Status across Adolescence?

Background: Although evidence supports that motor competence is negatively associated with adiposity levels in children, less is known about how motor competence and weight status relate in adolescence. Adolescence is a critical period to study this relationship because the associations between these elements are expected to strengthen over developmental time. The aim of this study was to analyze the relationship between motor competence and weight status across adolescence. Methods: A longitudinal study (2-year follow-up) was conducted with 122 participants (59.8% girls) aged 12-13 years at baseline. They were assessed annually at three time points. Body fatness, motor competence, physical activity, and musculoskeletal fitness levels were determined through skinfold thickness, Körperkoordinationstest für Kinder (KTK), Physical Activity Questionnaire for Older Children (PAQ-C), and sit-up tests. Generalized Estimating Equation (GEE) models were conducted adjusting for potential confounders (age, gender, anthropometry, physical activity, and fitness). Results: Motor competence and body fat showed moderate-to-high negative correlations (r = -0.65 to -0.69, p < 0.001) across time. Furthermore, motor competence significantly predicted body fat over time (B = -0.05, p = 0.05), even after adjusting for potential confounders. Conclusions: There is a lot of emphasis in the literature on increasing physical activity to maintain a healthy weight status or to prevent unhealthy weight gain, but this study has highlighted the role of motor competence on these aspects across the critical period of adolescence. Therefore, it seems plausible to recommend initiatives that foster the development of motor competence in early adolescence with the aim to prevent obesity.

Effects of Overweight/Obesity on Motor Performance in Children: A Systematic Review

Childhood obesity is a serious public health problem. Childhood obesity and overweight are associated with the appearance of coordination deficit disorder and can cause impaired motor performance. We searched online databases for all related articles using comprehensive international databases from the Medline PubMed Institute, Web of Science, ScienceDirect, SCOPUS, and PsycINFO up to December 20, 2020. Overall, 33 studies were included in this systematic review. The present review demonstrated that children with higher percentage of body fat had lower levels of moderate to vigorous physical activity, as well as decreased levels of gross motor coordination, as shown by tests for neuromuscular performance. These results corroborate the hypothesis that overweight and obesity in children and adolescents are associated, not only with insufficient performance during gross motor coordination activities, but also with a greater risk to physical health.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42020182935].

Physical Fitness in Upper Austrian Children Living in Urban and Rural Areas: A Cross-Sectional Analysis with More Than 18,000 Children

Physical fitness is an important component in the development and health of children and adolescents. Given the equivocal results of previous research regarding the influence of the living environment on physical fitness, this study examined differences in physical fitness in urban and rural elementary school children in Upper Austria. A total of 18,168 (51% male) children between 6 and 11 years of age participated in anthropometric assessments and completed eight fitness tests that assessed cardiorespiratory endurance, muscular power, speed, agility, flexibility, and ball handling skills during a single test session in the school’s gymnasium. Urban living environment was associated with higher body weight (p = 0.01) and lower physical fitness (p < 0.01), except for flexibility, which was better in urban children (p < 0.01) and upper body strength (no difference), even after accounting for differences in body weight. Furthermore, it was shown that urban–rural differences in physical fitness are more pronounced in normal weight children and that these differences increase with age. These results highlight the potential of the living environment for the promotion of an active lifestyle that enhances physical fitness. The availability of safe spaces that facilitate unstructured and structured physical activity, as well as active transportation provide viable options for the promotion of physical fitness in children.

Weight status and health-related quality of life during childhood and adolescence: effects of age and socioeconomic position

BACKGROUND

Overweight and obesity in children is associated with poor health-related quality of life (HRQoL), but the nuances of this relationship across different age and socio-demographic groups are not well-established. The aim of this study is to examine how the association between weight status and HRQoL changes with age and socioeconomic position (SEP) throughout childhood and adolescence.

METHODS

We used data from the Longitudinal Study of Australian Children (LSAC), a cohort study in which children were interviewed biennially from ages 4 to 17 years over seven waves of data. Measurements of HRQoL (using PedsQL^TM), body mass index (BMI), and socio-demographic characteristics were collected at each interview. Of the 4983 children recruited into the study, we included data from 4083 children (a total of 24,446 observations). We used generalised estimating equations to assess whether age and SEP modified the association between weight status and HRQoL, after controlling for sex, long-term medical condition, language spoken to child and maternal smoking status.

RESULTS

Age was a significant modifier of the association between weight status and HRQoL, with adjustment for known predictors of HRQoL (P < 0.001). At age 4, children with obesity had, on average, a 0.99 (95% CI 0.02-1.96) point lower PedsQL total score than children at healthy weight. This difference became clinically important by age 9 at 4.50 (95% CI 3.86-5.13) points and increased to 6.69 (95% CI 5.74-7.64) points by age 17. There was no evidence that SEP modified the relationship between weight status and HRQoL (P > 0.05).

CONCLUSIONS

Our results demonstrate that the relationship between overweight and obesity status and poor HRQoL is strengthened with increasing age through childhood and adolescence, but is not affected by SEP. Paediatricians, researchers and carers of children with obesity should acknowledge HRQoL outcomes, particularly for older children and adolescents.

Association between daily TV time and physical fitness in 6- to 14-year-old Austrian youth

BACKGROUND

Physical activity (PA) and sedentary behaviors have been associated with various health outcomes in youth, including overweight/obesity and physical fitness. Limited information, however, is available on the independent association between TV time and physical fitness in children and adolescents.

METHODS

A total of 3,293 (55.1% male) youth between 6 and 14 years of age were randomly selected from 29 Austrian schools. Body weight and height were measured according to standard procedures and BMI percentiles were determined based on German reference values. Physical fitness was assessed with the German Motor test (DMT6-18), which evaluates cardiorespiratory endurance, muscular strength, power, strength endurance, agility, speed and flexibility. Information on daily TV time and participation in club sports was obtained via standardized questionnaires.

RESULTS

Participants were 9.8±2.3 years of age and almost half of them (48.5%) reported a TV time >2 hours/d. TV time increased significantly with age. High TV consumption was associated with significantly lower physical fitness and these results remained after adjusting for body weight. Youth exceeding current TV time recommendations had a 60% higher risk of having poor or very poor fitness compared to those with a TV time <2 hours/day.

CONCLUSIONS

High TV time is associated with poor physical fitness in youth. Accordingly, intervention strategies need to target a meaningful utilization of TV and other screen-based activities in addition to the promotion of PA in order to ensure sufficient physical fitness in youth.

Factors Associated with Physical Fitness among Overweight and Non-Overweight Austrian Secondary School Students

The aim of the study was to evaluate factors associated with physical fitness (PF) among overweight and non-overweight Austrian secondary school students. PF was measured using the German motor test (DMT) 6-18 and students were asked about sex, migration background, weekly leisure time physical activity and daily electronic media use. In total 560 adolescents (56.6% female) with a mean age of 15.4 ± 1.4 years and a mean body mass index (BMI) of 22.5 ± 4.2 kg/m² were evaluated with 130 (23.2%) students classified as overweight or obese. For the total cohort, results of the multiple linear regression analysis (R2 = 0.34) revealed that a younger age (β = -0.16), no migration background (β = 0.13), a lower BMI (β = -0.29), a higher weekly leisure time physical activity (β = 0.34) and a lower daily electronic media use (β = -0.15) were associated with increased PF. Separate regression analyses for non-overweight and overweight students showed similar regression coefficients except for BMI. In conclusion, the positive influence of modifiable factors such as lower BMI, higher self-reported weekly leisure time sports activity and lower self-reported daily electronic media use should be considered already at young ages to increase physical fitness in overweight and non-overweight youth.

Association of Sports Participation and Diet with Motor Competence in Austrian Middle School Students

Physical activity and diet are important contributors to overall health and development in adolescents. There remains, however, limited research on the combined association of sports participation and dietary pattern on motor competence, which is crucial for an active lifestyle during and beyond adolescence. The present study, therefore, examined the association between sports participation, dietary pattern, and motor competence in 165 middle school students (55% male) between 11 and 14 years of age. Body weight and height were measured, and motor competence was determined via the German motor test during regular Physical Education (PE). Further, participants completed a food frequency questionnaire and reported their engagement in club sports. Of the total sample 20% were overweight/obese and 49% reported participation in club sports, with no differences between boys and girls. Interaction effects of sports participation and dietary pattern on motor competence were limited, but sports participation and healthy diet were independently associated with higher motor performance. Healthy dietary choices, along with participation in club sports, therefore, should be promoted in adolescents in order to facilitate motor development. As adolescence is a crucial time for the establishment of lifelong behaviors, such efforts could facilitate a healthy lifestyle throughout adulthood.