Gross Motor Skills and Cardiometabolic Risk in Children: A Mediation Analysis

Development of gross motor skills in children under the age of 3 years: a decision tree approach

Background

The early years of life are critical for gross motor development (GMD). This study utilized decision tree modeling to examine the influences on gross motor development in children under the age of 3 years and to rank the key factors affecting their development.

Methods

Based on randomized stratified sampling, 9,507 children aged 0-3 years in Shenzhen were included in this study. The Ages and Stages Questionnaires (ASQ) were utilized for the assessment of gross motor development. The chi-square test was used to compare groups, and variables were screened using univariable and multivariable regression analyses. Decision tree modeling was employed to rank the importance of statistically significant variables.

Results

The research found a prevalence of gross motor developmental delay of 1.41% among the respondents. The accuracy of the decision tree model is 70.96%. The results demonstrated a strong correlation between seven variables affecting the gross motor development of children, which were ranked based on importance: age, whether to provide supplementary food, average time spent interacting with children, family type, feeding method, mode of delivery, and birth order.

Conclusion

The risk of gross motor developmental delay increases with age. Furthermore, supplementary food and interacting with other children are critical factors in improving children's GMD delay. It is therefore imperative to enhance the monitoring of children's gross motor skills through regular developmental assessments that detect potential GMD delays. Moreover, family type, feeding method, mode of delivery, and birth order were also predictive factors of GMD delay.

Effect of Motor Competence and Health-Related Fitness in the Prevention of Metabolic Syndrome Risk Factors

Purpose: In the last decades we have seen an increase in sedentary behaviors and a decrease in physical activity in children when compared to past generations. This lifestyle is commonly associated with the development of clustering risk factors that define metabolic syndrome (MetS). Knowing that motor competence (MC) development can influence lifelong physical activity habits, it is reasonable to assume that children's MC will directly link to clustered cardiometabolic health outcomes. The aim of this study was to analyze the role of MC in MetS risk factors. Methods: Seventy children with a mean age of 7.49 (SD = 1.28) years were evaluated on motor competence (MCA-Motor Competence Assessment instrument), cardiovascular fitness (PACER test), upper body strength (UBS; handgrip), and the components of MetS, hypertriglyceridemia, hypertension, abdominal obesity, low concentration of high-density lipoprotein cholesterol, and high fasting blood glucose. The composite value of MetS was calculated according to Burns et al. (2017). Multiple standard regressions were performed to explore the effect of different variables on MetS. Motor competence and health-related fitness (cardiovascular fitness and relative upper body strength) were used as independent variables (predictors) and MetS as dependent variable. Results: Overall, the results showed that motor competence (β = -.072; p < .05) is a significant predictor and this model explained 7,1% of the variance in MetS. Conclusion: Although more studies are needed, our results indicate that MC seems to have a positive role in children's health markers.

Motor competence, physical activity, and perceived motor competence: A relational systems approach

Being and perceiving oneself as proficient in motor skills seems essential for an active lifestyle; conversely, being active and perceiving oneself as proficient may be associated with greater motor competence. By expanding the causal path view about the relationship between active and healthy developmental system elements, this study tested the mediation hypothesis of perceived motor competence in the relationship between motor competence and physical activity - in both ways - and moderation by developmental phase and sex. This cross-sectional study sampled healthy schoolchildren (n = 379; 8.2 ± 1.7 years; 54.9% boys). Physical activity (questionnaire), motor competence (tests included locomotor and object control skills) and perception of motor competence (a pictorial scale) were assessed. Maximum likelihood structural equation models with fit statistics confirmed the mediation in both ways. Unexpectedly, the relationship between motor competence and physical activity was inverse. Sex was a moderating variable (boys). In a systemic relational paradigm of human development, perceived motor competence, motor competence, and physical activity interact in an active and healthy behavioural system, but the complexities of understanding how these elements relate to one another across childhood point to the need for future longitudinal studies.

The Role of Physical Fitness on the Relationship Between Motor Competence and Physical Activity: Mediator or Moderator?

Understanding the mechanisms associated with engaging in physical activity (PA) is crucial for its promotion. The aim was to analyze the relationship between motor competence (MC) and PA and the role of physical fitness (PF). Participants were N = 1,064 children of both sexes (n = 530 girls) and 7.87 ± 1.17 years of age. MC was assessed with KörperkoordinationTest für Kinder. PF was assessed with 50-yard dash, 1-mile run/walk, and standing long jump. PA was assessed with a questionnaire. Mediation and moderation were determined according to Baron and Kenny using Sobel test for indirect effect and using PROCESS (version 3.4). Mediation results showed perfect mediation in girls but not in boys and not when all participants were included in the analysis. The linear moderation was significant for all participants and for boys and girls apart. However, the results of conditional effects of MC at the 16th, 50th, and 84th percentile of the PF, which became significant at the 50th percentile for all participants and for boys, were not significant in girls. In conclusion, perfect mediation seems to exist in girls but not in boys. In boys, the relationship between MC and PA seems conditioned by the PF levels.

Relationship between motor fitness, fundamental movement skills, and quality of movement patterns in primary school children

Seefeldt`s classic motor development pyramid model recognizes the significance of fundamental movement skills (FMS) in physical activities and proposes a "proficiency barrier" between FMS and higher-level specific sports skills during middle childhood. However, the relationship between the layers of the conceptual model has not been empirically tested. This study investigated motor fitness (MF), FMS, and quality of movement patterns (QMP) in 7-10 years old children and evaluated the relationships among them. A total of 117 children were randomly selected to take tests of MF, the Test of Gross Motor Development-2 (TGMD-2), and the Functional Movement Screen (FMS™). MF and FMS levels were classified according to percentile ranges. Two multiple (R×C) Chi-Square tests were applied to analyze the relationships between MF, FMS, and QMP. Post-hoc testing estimated the possibility of FMS and QMP to predict MF. The results showed that boys scored significantly higher on the object-control subtest and on the TGMD-2 compared to girls (p<0.001), while girls scored significantly higher on the FMS™ (p = 0.001). FMS score and QMP level were weakly correlated with MF (FMS: χ2 = 14.605, p = 0.006, Cramer`s V = 0.25; QMP: χ2 = 13.943, p = 0.007, Cramer`s V = 0.24). Thus, 60.5% of children with "excellent" FMS and 59.6% with "high" QMP were categorized as having a "good" MF. In contrast, only 23.1% of children with "poor" FMS and 24.3% with "low" QMP were classified as having a "good" MF. Our results confirm MF, FMS, and QMP are correlated with each other, although this relationship is weak. Further, a possible motor skill proficiency barrier exists already in children 7-10 years old. The study results support the promotion of physical activity and motor skill development in primary school children.

Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis

Mind–Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges’ g = −1.71, 95% Confidence Interval (CI): −2.43, −0.98), cortisol (Hedges’ g = −1.32, 95% CI: −2.50, −0.16), and systolic and diastolic blood pressure (Hedges’ g = −1.04, 95% CI: −1.53, −0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

Bifactor structure and model reliability of the Test of Gross Motor Development - 3rd edition

OBJECTIVES

This study investigated the structure of the Test of Gross Motor Development - 3rd edition (TGMD-3). Specifically, we examine bifactor structure, which simultaneously models a fundamental motor skills (FMS) general factor and specific factors for locomotor skills and ball skills, compared to other models.

DESIGN

Cross-sectional design using the TGMD-3 normative sample.

METHODS

The sample (N = 862) of children (Mage = 6.51, SD = 2.23) was matched based on United States census data, ensuring appropriate percentages of demographic representation and disability status. Confirmatory factor analyses, exploratory structural equation modeling, model-based reliability estimates including coefficient omega hierarchical, and coefficient omega hierarchical subscale, explained common variance estimates, and relative parameter bias were examined.

RESULTS

Findings revealed bifactor structure produced a better model fit compared to both one-factor and two-factor models. Furthermore, model reliability estimates that parceled true score variance for the general FMS factor, locomotor skills factor, and ball skills factor yielded high internal consistency for FMS (.797) but not locomotor skills (.168) and ball skills (.216). Finally, explained common variance (.852-.879) and relative parameter bias (.018-.072) estimates identified the strength of the run, skip, slide, and dribble skills tests to represent the FMS general factor.

CONCLUSIONS

Our findings demonstrate the advantages of using bifactor structure to examine the TGMD-3 compared to one-factor and two-factor models. Additionally, these results provide further evidence that using the TGMD-3 to examine an overall FMS general factor may explain more variance in performance and provide a better picture for evaluating children's current FMS levels compared to subscales independently.

Associations of School Day Sedentary Behavior and Physical Activity With Gross Motor Skills: Use of Compositional Data Analysis

Background

To examine the relationships among school day sedentary times (SED), light physical activity (LPA), and moderate to vigorous physical activity (MVPA) with gross motor skills in children using Compositional Data Analysis.

Methods

Participants were 409 children (mean age = 8.4 [1.8] y) recruited across 5 low-income schools. Gross motor skills were assessed using the test for gross motor development—third edition (TGMD-3), and physical activity was assessed using accelerometers. Isometric log-ratio coordinates were calculated by quantifying the relative proportion of percentage of the school day spent in SED, LPA, and MVPA. The associations of the isometric log-ratio coordinates with the TGMD-3 scores were estimated using general linear mixed-effects models adjusted for age, body mass index, estimated aerobic capacity, and school affiliation.

Results

A higher proportion of the school day spent in %MVPA relative to %SED and %LPA was significantly associated with higher TGMD-3 total scores (γMVPA = 14.44, P = .01). This relationship was also observed for the ball skills subtest scores (γMVPA = 16.12, P = .003).

Conclusion

Replacing %SED and %LPA with %MVPA during school hours may be an effective strategy for improving gross motor skills, specifically ball skills, in low-income elementary school-aged children.

Fundamental Movement Skill Proficiency and Health Among a Cohort of Irish Primary School Children

PURPOSE

This study aimed to investigate the relationship between fundamental movement skills (FMS) and markers of health among a cohort of Irish primary school children.

METHODS

Participants (N = 296, mean age: 7.99 ± 2.02 years) were senior infant (n = 149, mean age: 6.02 ± 0.39 years) and 4th class (n = 147, mean age: 9.97 ± 0.40 years) students from three primary schools in Cork, Ireland. FMS proficiency (TGMD-2) and markers of health (BMI percentile, waist circumference percentile, blood pressure percentiles, resting heart rate, cardiorespiratory fitness, objectively measured physical activity; PA) measurements were recorded. Correlation and hierarchical stepwise multiple linear regression analyses were conducted to investigate the relationship between FMS and markers of health.

RESULTS

A small, positive relationship was found between FMS (Gross Motor Quotient; GMQ) and cardiorespiratory fitness with small negative correlations between GMQ and 550 m time SDS among 6-year-olds (r(129) = -.286, p < .05) and 10-year-olds (r(132) = -.340, p < .05). A moderate, positive correlation was found between GMQ and light PA (r(71) = .400, p < .05). Small positive correlations were revealed between GMQ and moderate PA (r(71) = .259, p < .05) and between GMQ and total PA (r(71) = .355, p < .05). After adjusting for age, sex, the interaction effect of age and sex, and school attended, FMS explained 15.9% and 24.8% of the variance in 550 m time SDS among 6- and 10-year-olds, respectively, and 6% and 6.5% of the variance in light PA and moderate PA, respectively. After adjusting for age and sex, FMS explained 11.6% of the variance in total PA.

CONCLUSION

A wide range of FMS is important for children's cardiorespiratory fitness and PA.

Gross Motor Skills and School Day Physical Activity: Mediating Effect of Perceived Competence

The purpose of this study was to examine the relationship between gross motor skills and school day steps per minute, testing various motivational constructs as potential mediators. A convenience sample of 66 sixth-grade children (mean age = 11.6 ± 0.5 years; 30 boys, 36 girls) were recruited from one public “Zoom” school. Gross motor skills were assessed using the Test for Gross Motor Development-3rd Edition. Motivational constructs were assessed using a series of validated questionnaires. Children wore a pedometer for one school week. A bootstrap mediation analysis was employed using gross motor skills scores as the predictor variable and steps per minute as the outcome variable; the motivational constructs consisted of perceived competence, enjoyment, and self-efficacy as potential mediators. The results from a bootstrap mediation analysis yielded a statistically significant average causal mediation effect (ACME) using perceived competence as the mediator (ACME = 0.022, 95% CI [0.001, 0.054], p = .018). Perceived competence mediated 30.8% of the total effect between gross motor skill scores and steps per minute, with the entire model explaining approximately 13.6% of the variance. The relationship between gross motor skills and school day physical activity may be mediated through perceived competence in sixth-grade children.

Testing the Motor Competence and Health-Related Variable Conceptual Model: A Path Analysis

The purpose of this study was to empirically test a comprehensive conceptual model linking gross motor skills, school day physical activity and health-related variables in a sample of sixth graders. Participants were a convenience sample of 84 sixth grade students (Mean age = 11.6 ± 0.6 years). Gross motor skills were assessed using the Test of Gross Motor Development-3rd Edition (TGMD-3), school day physical activity was assessed using pedometers, health-related fitness was assessed using Progressive Aerobic Cardiovascular Endurance Run (PACER) laps, perceived competence assessed using a validated questionnaire and the health-related outcome was assessed using Body Mass Index (BMI). The relationship between school day step counts and TGMD-3 scores was mediated through both perceived competence and PACER laps (p = 0.015) and the direct path coefficient between TGMD-3 scores and BMI was statistically significant (b = -0.22 kg/m², p < 0.001). Overall there was good model fit with all indices meeting acceptable criteria (χ² = 3.7, p = 0.293; Root Mean Square Error of Approximation (RMSEA) = 0.062, 90% Confidence Interval (C.I.): 0.00-0.23; Comparative Fit Index (CFI) = 0.98; Tucker-Lewis Index (TLI) = 0.96; Standardized Root Mean Square Residual (SRMR) = 0.052). The comprehensive conceptual model explaining the inter-relationships among motor competence and health-related variables was empirically validated with the relationship between physical activity and gross motor skills mediated through both perceived competence and cardiorespiratory endurance in a sample of sixth graders.

Effect of a 12-Week Physical Activity Program on Gross Motor Skills in Children

This study examined the effects of a 12-week Comprehensive School Physical Activity Program (CSPAP) on gross motor skill development in children from low-income families. Participants were 1,460 school-aged children (mean age = 8.4 ± 1.8 years; 730 girls, 730 boys) recruited from three schools receiving U.S. governmental financial assistance. Students were recruited from grades K−6. CSPAP was implemented over one semester during the 2014−2015 school year. Select gross motor skill items were assessed during each student’s physical education class at baseline and at a 12-week follow-up using the Test for Gross Motor Development-2nd Edition (TGMD-2). Each student’s TGMD-2 score was converted to a percentage of the total possible score. A 7 × 2 × 2 analysis of variance test with repeated measures was employed to examine the effects of age, sex, and time on TGMD-2 percent scores, adjusting for clustering within the data structure. There were greater TGMD-2 percent scores at follow-up compared with baseline (82.4% vs. 72.6%, mean difference = 9.8%, p < .001, Cohen’s d = 0.67), and greater improvements were seen in younger children compared with older children (mean difference of change = 4.0%−7.5%, p < .01, Cohen’s d = 0.30−0.55).