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).

Adolescents' Flexibility Can Affect Motor Competence: The Pathway from Health Related Physical Fitness to Motor Competence

Motor competence has been shown to predict health-related physical fitness (HRPF) components in youth, but there is indeterminate evidence for the reverse path. Even less is known about the specific relationship between motor competence and flexibility. Our aims in this study were to analyze the relationship between flexibility and motor competence among adolescents; and, secondarily, to examine the relationships between motor competence and other HRPF components (body composition and musculoskeletal fitness). We conducted a longitudinal study (14-months follow-up) with two measurement points of 128 participants (55.5% girls; 45% boys) aged 12-13 years at baseline. We assessed HRPF components at the first time point and determined motor competence at the second time point. We assessed HRPF in terms of body composition (body fat percentage), musculoskeletal fitness (sit-up test), and flexibility (sit and reach). We determined motor competence using the Körperkoordinationstest für Kinder (KTK). We employed multivariate analyses of variance (MANOVA) to examine the effect of HRPF on motor competence through three models, in which each HRPF component was considered an independent variable. Sex, age, physical activity, and body mass index (BMI) z-scores were considered confounders. In our crude models all HRPF components significantly affected motor competence. In adjusted models, flexibility (p = .002) and body composition (p < .001) significantly affected motor competence. Overall, these results supported the assumptions that HRPF components are related to motor competence in adolescence, and that flexibility can affect motor competence in young people.

Does Sedentary Behavior Predict Motor Competence in Young Children?

Background: Understanding how or whether sedentary behavior affects motor competence in young children is important considering that children spend a lot of time sedentary. The aim of this study was to examine whether sedentary behavior predicts motor competence in young children. Methods: A longitudinal study with a total of 372 children aged 3.5 years at baseline and 5 years at follow-up was conducted. Objectively measured activity patterns (i.e., using accelerometers) were conducted in a subsample with 188 children. Sedentary behavior was assessed both objectively and subjectively (parent-reported screen time). Locomotor and object control skill scores were determined using the Test of Gross Motor Development—Second Edition. A multivariable analysis was executed adjusting for potential confounders (such as age, sex, time spent in moderate- to vigorous-intensity physical activity, monitor wear time, body mass index z scores, and maternal education). Results: Sedentary behavior at either time point was not significantly associated with either locomotor or object control skills after adjusting for potential confounders. Discussion: Our results did not support the assumption that sedentary behavior affects motor competence in young children. Regardless, given the lack of consistency in the evidence base, we recommend to parents, educators, and health professionals that sedentary activities should be kept within government recommendations due to potential negative effects on child development.

Exploring the Importance of Motor Competence for Behavioral and Health Outcomes in Youth

In this study, we investigated the relationship between motor competence (MC) and behavioral and health outcomes in youth through its relationship to physical activity (PA) and body composition (in terms of body fat). To date, it is unclear whether these variables reciprocally influence each other over time. We assessed whether and how MC, PA and body composition influence each other across adolescence. In a longitudinal study with 14 months of follow-up, we recruited 166 adolescents aged 12-13 years. We recorded participants' self-reported PA and body fat percentage and assessed their MC using the Körperkoordinationstest für Kinder (KTK). We used linear mixed models and mediation analyses with crude and adjusted (age, sex, time point) models to examine associations among the selected variables across time. MC showed a bidirectional relationship with both PA (p < .001) and body fat (p < .001) in both crude and adjusted models. In addition, MC was a potential mediator (Sobel test = -3.18, p < .001) in the relation between body fat (as predictor) and PA (as outcome) in crude models, but no mediating effect was found in adjusted models. Thus, this study provided longitudinal evidence that MC and PA, as well as MC and body composition, can reciprocally influence each other across adolescence. We recommend the development of MC as a crucial strategy to increase PA engagement and to prevent obesity in youth.

Do Adolescents with Low Motor Competence Have Increased Risk for Overweight and Obesity?

Background: Adolescence is an important time for establishing behavioral patterns which favorably affect health, including weight status. Yet, the prevalence of adolescent overweight/obesity is high, and it is unknown whether low levels of motor competence are a risk factor. The purpose of this study was to assess whether adolescents with low motor competence are at increased risk of overweight/obesity. Methods: A total of 142 adolescents (47.2% boys) aged 12-14 years were recruited from Rio de Janeiro, Brazil. Motor competence level was assessed using the Körperkoordinationtest fur kinder (KTK) and classified in two categories: "low" and "adequate." BMI measures were used to classify weight status as "healthy" or "overweight/obese." The correlation between motor competence level and BMI was tested. A binary logistic regression model was executed adjusting for potential confounders (age, sex, and stature). Results: Motor competence was moderately associated with BMI (r = -0.573, p < 0.001). Nearly four in five adolescents with low motor competence were overweight/obese. Further, adolescents with low motor competence had a risk six times higher of being overweight/obese (odds ratio = 6.832, p < 0.001, 95% confidence interval = 2.477-18.845). Conclusions: This study showed that a low level of motor competence is linked to the odds of being overweight/obese in adolescents. This is a concern given the high prevalence of low motor competence in youth worldwide. However, our cross-sectional design does not allow the determination of causal mechanisms. Regardless, we reinforce the recommendation that young people should establish behavioral patterns favorable to adolescent health, including adequate levels of motor competence.

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.