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Wadey CA, Barker AR, Stuart G, Tran DL, Laohachai K, Ayer J, Cordina R, Williams CA. Scaling Peak Oxygen Consumption for Body Size and Composition in People With a Fontan Circulation. J Am Heart Assoc 2022; 11:e026181. [PMID: 36515232 PMCID: PMC9798799 DOI: 10.1161/jaha.122.026181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Peak oxygen consumption (peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$) is traditionally divided ("ratio-scaled") by body mass (BM) for clinical interpretation. Yet, it is unknown whether ratio-scaling to BM can produce a valid size-independent expression of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ in people with a Fontan circulation. Furthermore, people with a Fontan circulation have deficits in lean mass, and it is unexplored whether using different measures of body composition may improve scaling validity. The objective was to assess the validity of different scaling denominators (BM, stature, body surface area, fat-free mass, lean mass, and appendicular lean mass using ratio and allometric scaling). Methods and Results Eighty-nine participants (age: 23.3±6.7 years; 53% female) with a Fontan circulation had their cardiorespiratory fitness and body composition measured by cardiopulmonary exercise testing and dual-energy x-ray absorptiometry. Ratio and allometric (log-linear regression) scaling was performed and Pearson correlations assessed scaling validity. Scaling denominators BM (r=-0.25, P=0.02), stature (r=0.46, P<0.001), and body surface area (0.23, P=0.03) were significantly correlated with their respective ratio-scaled expressions of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$, but fat-free mass, lean mass, or appendicular lean mass were not (r≤0.11; R2=1%). Allometrically expressed peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ resulted in no significant correlation with any scaling denominator (r=≤0.23; R2=≤4%). Conclusions The traditional and accepted method of ratio-scaling to BM is invalid because it fails to create a size-independent expression of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ in people with a Fontan circulation. However, ratio-scaling to measures of body composition (fat-free mass, lean mass, and appendicular lean mass) and allometric techniques can produce size-independent expressions of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ in people with a Fontan circulation.
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Affiliation(s)
- Curtis A. Wadey
- Children’s Health & Exercise Research Centre (CHERC)Public Health and Sport Science, Faculty of Health and Life Sciences, University of ExeterExeterUnited Kingdom
| | - Alan R. Barker
- Children’s Health & Exercise Research Centre (CHERC)Public Health and Sport Science, Faculty of Health and Life Sciences, University of ExeterExeterUnited Kingdom
| | - Graham Stuart
- Bristol Congenital Heart Centre, The Bristol Heart Institute, University Hospitals Bristol NHS Foundation TrustBristolUnited Kingdom
| | - Derek L. Tran
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Karina Laohachai
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Julian Ayer
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Rachael Cordina
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Craig A. Williams
- Children’s Health & Exercise Research Centre (CHERC)Public Health and Sport Science, Faculty of Health and Life Sciences, University of ExeterExeterUnited Kingdom
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Armstrong N, Welsman J. Comment on 'Developing a New Curvilinear Allometric Model to Improve the Fit and Validity of the 20-m Shuttle Run Test as a Predictor of Cardiorespiratory Fitness in Adults and Youth'. Sports Med 2021; 51:1591-1593. [PMID: 34014502 DOI: 10.1007/s40279-021-01462-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Neil Armstrong
- Children's Health and Exercise Research Centre, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Jo Welsman
- Children's Health and Exercise Research Centre, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU, UK
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Marques A, Henriques-Neto D, Peralta M, Martins J, Gomes F, Popovic S, Masanovic B, Demetriou Y, Schlund A, Ihle A. Field-Based Health-Related Physical Fitness Tests in Children and Adolescents: A Systematic Review. Front Pediatr 2021; 9:640028. [PMID: 33748047 PMCID: PMC7973114 DOI: 10.3389/fped.2021.640028] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/15/2021] [Indexed: 12/26/2022] Open
Abstract
Physical fitness (PF) is a multi-component construct and a biomarker of health. Worse PF is related to vulnerability and predicts worse academic achievements. Thus, assessing PF is important to monitor health in youth. This systematic review aimed to identify and inform physical education, health professionals and entities about existing PF batteries and field-tests that can be used in school settings. A comprehensive literature search was carried out in five electronic databases (Academic Search Complete, Education Resources Information Center, PubMed, Scopus, and Web of Science) to identify PF battery protocols that can be carried out in the school setting. Overall, 24 PF batteries were identified. Regarding the PF components assessed, only cardiorespiratory fitness and upper body strength were contemplated in all batteries. Middle-body strength and lower body strength were presented in most batteries (21 and 19 of 24, respectively). Agility (16 of 24) and body composition (16 of 24) were also considered in several batteries, although to a lesser extent. Flexibility (14 of 24) and speed (12 of 24) were the PF components less represented in the batteries. Among the 24 identified PF batteries, 81 PF tests assessing the different PF components were encountered. The advances in the PF field-based assessment in school settings and health in youth resulted in the amplification of the number of existing batteries. Considering the connection between PF and health and the opportunity that the school setting provides to assess fitness in children and adolescents, there is a need for standardization and a consensus of PF assessments in this specific setting.
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Affiliation(s)
- Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | | | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - João Martins
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Fernando Gomes
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Bojan Masanovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Annegret Schlund
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Andreas Ihle
- Cognitive Aging Lab, Department of Psychology, University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
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Husøy A, Dalene KE, Steene-Johannessen J, Anderssen SA, Ekelund U, Tarp J. Effect modification by cardiorespiratory fitness on the association between physical activity and cardiometabolic health in youth: A systematic review. J Sports Sci 2020; 39:845-853. [PMID: 33225807 DOI: 10.1080/02640414.2020.1847919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Physical activity and cardiorespiratory fitness are inversely associated with markers of cardiometabolic risk in children and adolescents, but the interplay between these variables in relation to the cardiometabolic risk profile is unclear. We systematically reviewed the literature to examine whether the association between physical activity and cardiometabolic health differs by levels of cardiorespiratory fitness in youth. A literature search was conducted in PubMed and EMBASE, filtered from 2001 up until July 2019. We obtained 8980 citations, with 6915 remaining after removal of duplicates. Estimates were retrieved from 18 studies. All included articles went through a risk of bias assessment. We found that 14 out of 20 (70%) effect-estimates supported stronger associations between physical activity and cardiometabolic health markers among low-fit youth as compared to their high-fit peers. The most consistent findings were observed with biochemical markers and blood pressure as outcomes. However, substantial uncertainty is associated with these findings as most of the included studies (~72%) had a high risk of bias. More than two-thirds of the findings supported greatest benefits of physical activity on cardiometabolic risk markers in youth with low cardiorespiratory fitness, although the clinical importance of this difference is unclear.
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Affiliation(s)
- Anders Husøy
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Knut Eirik Dalene
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | | | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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O’Keeffe BT, MacDonncha C, Purtill H, Donnelly AE. Profiling the health-related physical fitness of Irish adolescents: A school-level sociodemographic divide. PLoS One 2020; 15:e0235293. [PMID: 32598397 PMCID: PMC7323969 DOI: 10.1371/journal.pone.0235293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/12/2020] [Indexed: 12/26/2022] Open
Abstract
Background and aims Examining factors that may explain disparities in fitness levels among youth is a critical step in youth fitness promotion. The purpose of this study was twofold; 1) to examine the influence of school-level characteristics on fitness test performance; 2) to compare Irish adolescents’ physical fitness to European norms. Methods Adolescents (n = 1215, girls = 609) aged 13.4 years (SD .41) from a randomised sample of 20 secondary schools, stratified for gender, location and educational (dis)advantage, completed a series of field-based tests to measure the components of health-related physical fitness. Tests included: body mass index; 20 metre shuttle run test (20 m SRT); handgrip strength; standing broad jump (SBJ); 4 x 10 metre shuttle run; and back-saver sit-and-reach (BSR). Results Overall, boys outperformed girls in all tests, aside from the BSR (p < 0.005, t-test, Bonferroni correction). Participants in designated disadvantaged schools had significantly higher body mass index levels (p < 0.001), and significantly lower cardiorespiratory endurance (20 m SRT) (p < 0.001) and muscular strength (handgrip strength) (p = 0.018) levels compared to participants in non-disadvantaged schools. When compared to European norms, girls in this study scored significantly higher in the 20 m SRT, 4 x 10 metre shuttle run and SBJ tests, while boys scored significantly higher in the BSR test (Cohen’s d 0.2 to 0.6, p < 0.001). However, European adolescents had significantly higher handgrip strength scores (Cohen’s d 0.6 to 0.8, p < 0.001). Conclusion Irish adolescents compared favourably to European normative values across most components of HRPF, with the exception of muscular strength. School socioeconomic status was a strong determinant of performance among Irish adolescents. The contrasting findings for different fitness components reiterate the need for multi-component testing batteries for monitoring fitness in youth.
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Affiliation(s)
- Brendan T. O’Keeffe
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- * E-mail:
| | - Ciaran MacDonncha
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Helen Purtill
- Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Mathematics and Statistics, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
| | - Alan E. Donnelly
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Welsman J, Armstrong N. The 20 m shuttle run is not a valid test of cardiorespiratory fitness in boys aged 11-14 years. BMJ Open Sport Exerc Med 2019; 5:e000627. [PMID: 31921438 PMCID: PMC6937111 DOI: 10.1136/bmjsem-2019-000627] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 01/23/2023] Open
Abstract
Objectives The 20 m shuttle run test (20mSRT) is used to estimate cardiorespiratory fitness (CRF) through the prediction of peak oxygen uptake ( V ˙ O 2 ), but its validity as a measure of CRF during childhood and adolescence is questionable. This study examined the validity of the 20mSRT to predict peak V ˙ O 2 . Methods Peak V ˙ O 2 was measured during treadmill running. Log-linear regression was used to correct peak V ˙ O 2 for body mass and sum of skinfolds plus age. Boys completed the 20mSRT under standardised conditions. Maximum speed (km/h) was used with age to predict peak V ˙ O 2 using the equation developed by Léger et al. Validity was examined from linear regression methods and limits of agreement (LoA). Relationships between 20mSRT performance and allometrically adjusted peak V ˙ O 2 , and predicted per cent fat were examined. Results The sample comprised 76 boys aged 11-14 years. Predicted and measured mass-related peak V ˙ O 2 (mL/kg/min) shared common variance of 32%. LoA revealed that measured peak V ˙ O 2 ranged from 15% below to 25% above predicted peak V ˙ O 2 . There were no significant relationships (p>0.05) between predicted peak V ˙ O 2 and measured peak V ˙ O 2 adjusted for mass, age and skinfold thicknesses. Adjusted for body mass and age, peak V ˙ O 2 was not significantly related (p>0.05) to 20mSRT final speed but a weak, statistically significant (r=0.24, p<0.05) relationship was found with peak V ˙ O 2 adjusted for mass and fatness. Predicted per cent fat was negatively correlated with 20mSRT speed (r=-0.61, p<0.001). Conclusions The 20mSRT reflects fatness rather than CRF and has poor validity grounded in its flawed estimation and interpretation of peak V ˙ O 2 in mL/kg/min.
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Affiliation(s)
- Jo Welsman
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, Devon, UK
| | - Neil Armstrong
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, Devon, UK
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