Criterion-Related Validity of Field-Based Fitness Tests in Adults: A Systematic Review

Criterion-related validity and reliability of the standing long jump test in adults: The Adult-Fit project

The purpose of this study was to analyze the criterion-related validity and the reliability of the standing long jump test (SLJ) for evaluating the lower-body explosive muscular strength in adults. A total of 410 adults participated in this study. Sociodemographic, anthropometric measurements, laboratory lower-body muscular strength tests, and the field-based SLJ were performed. In validity analysis, stepwise regression analysis showed that maximal horizontal power, sex, percentage of body fat, maximal horizontal force, and lean mass were significantly associated with the SLJ distance (R2 = 0.78; p < 0.001). Reliability analysis showed significant differences between test-retest in the SLJ test, with an overestimation of the second measurement compared to the first [12.14 ± 14.46 cm, intraclass correlation coefficient (ICC) = 0.94 (0.75-0.97), p < 0.001; Cohen's d = 0.31]. The coefficient of variation (CV) was 7.06% and the minimal detectable change (MDC90) was 29 cm. After a learning period, higher reliability values were found [0.45 ± 1.04 cm, ICC = 1.00 (0.99-1.00); p = 0.001; CV = 0.53 %; MDC90 = 1 cm]. The SLJ test may be a valid tool to assess lower-body explosive muscular strength in the adult population. A learning period may be necessary to provide reliability on the SLJ test.

Instruments for measuring the neuromuscular function domain of vitality capacity in older persons: an umbrella review

PURPOSE

Recently, handgrip, knee extensor and respiratory muscle strength were proposed as candidate biomarkers to assess the neuromuscular function of vitality capacity in older persons. This umbrella review aims to provide an overview of the available instruments and their measurement properties to assess these biomarkers.

METHODS

The databases PubMed, Web of Science and Embase were systematically screened for systematic reviews and meta-analyses reporting on handgrip, knee extensor or respiratory muscle strength assessments, resulting in 7,555 articles. The COSMIN checklist was used to appraise psychometric properties and the AMSTAR for assessing methodological quality.

RESULTS

Twenty-seven systematic reviews were included in this study. Some of the identified reviews described the psychometric properties of the assessment tools. We found five assessment tools that can be used to measure neuromuscular function in the context of healthy ageing. Those are the handheld dynamometer for handgrip strength, the dynamometer for knee extensor strength and regarding respiratory muscle strength, the sniff nasal inspiratory pressure, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP).

CONCLUSION

The handheld dynamometer for hand grip strength, the dynamometer for knee extensor strength, sniff nasal inspiratory pressure, MIP and MEP were identified. Therefore, these assessments could be used to identify community-dwelling older adults at risk for a declined neuromuscular function in the context of vitality capacity.

Evaluating current assessment techniques of cardiorespiratory fitness

INTRODUCTION

Considerable and convincing global data from cohorts across the health spectrum (i.e. apparently healthy to known disease) indicate that cardiorespiratory fitness (CRF) is a major predictor of overall and cardiovascular disease (CVD)-survival, seemingly with greater prognostic resolution compared to other traditional CVD risk factors. Therefore, the assessment of CRF in research and clinical settings is of major importance.

AREAS COVERED

In this manuscript, we review the technology of measuring CRF assessed by the 'gold standard,' cardiopulmonary exercise testing (CPET), as well as with various other methods (e.g. estimated metabolic equivalents, 6-minute walk tests, shuttle tests, and non-exercise equations that estimate CRF), all of which provide significant prognostic information for CVD- and all-cause survival. The literature through May 2024 has been cited.

EXPERT OPINION

The promotion of physical activity in efforts to improve levels of CRF is needed throughout the world to improve lifespan and, more importantly, healthspan. The routine assessment of CRF should be considered a vital sign that is routinely assessed in clinical practice.

Chronic exercise and neuropsychological function in healthy young adults: a randomised controlled trial investigating a running intervention

Despite the well-known physical and mental health benefits of regular exercise, many of the world's population, including healthy young adults, grossly undershoot recommended physical activity levels. Chronic exercise has potential to improve cognitive performance and affect in most age groups. However, there is currently a poverty of relevant research in young adults, especially randomised controlled trials. To address this, the current research investigated the effects of a running intervention on neuropsychological function (cognition and affect) in young adults. We predicted that following a running intervention, neuropsychological performance would improve alongside increases in aerobic fitness. Thirty-two healthy young adult university students were randomised (using a 3:1 ratio) into an intervention or control group, with the intervention group (n = 24) asked to run for 30 min three times a week over a 6-week period and the control group (n = 8) asked to maintain their current level of exercise over a 6-week period. We assessed fitness, cognitive performance, affect and running enjoyment at baseline and follow-up, and runners recorded the environmental conditions of their runs. Repeated measures ANCOVAs failed to find any significant effects of the running intervention on fitness or the neuropsychological measures. Anecdotal evidence supported running environment and enjoyment as potentially relevant factors. The failure to find any fitness improvements, which likely underpins the lack of neuropsychological improvements, highlights the importance of monitoring exercise sessions. Coupled with other insights gained from this trial, this article may prove useful towards future endeavours to develop exercise interventions beneficial to young adults.TRN: ACTRN12621000242820, Date of registration: 08/03/2021.

Association of Muscle Strength, Psychological Factors, and Central Sensitization With Movement-Evoked Pain in Patients With Nonspecific Chronic Low Back Pain: The BACKFIT Project

BACKGROUND

People with chronic pain might evade certain movements to prevent their experience of pain. Movement-evoked pain (MEP) might induce lower functionality during daily activities.

HYPOTHESIS

(1) MEP after physical fitness tests would vary depending on the main musculature involved in the test; (2) physical and psychological factors would be associated with MEP in patients with NSCLBP.

STUDY DESIGN

Cross-sectional design.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 104 (69 women) patients aged 51.0 ± 10.3 years with NSCLBP participated. MEP was measured with a visual analog scale (VAS) at baseline and immediately after performing each physical fitness test, that is, the Biering-Sørensen, prone bridging, handgrip, chair-stand, and 8-foot time-up-and-go tests, measuring back extensor, back flexor, upper- and lower-body muscle strength, and motor agility, respectively. Global muscle strength was calculated with normalized index (z-score) procedure. Depression, anxiety, pain catastrophizing, and central sensitization were assessed with the Beck Depression Inventory II, State Trait Anxiety Inventory I, Pain Catastrophizing Scale, and Central Sensitization Inventory (CSI), respectively.

RESULTS

Patients showed greater pain after completion of the Biering-Sørensen (mean difference 95% CI, 0.02, 1.11), prone bridging (0.15, 1.21), lower pain after handgrip (-1.46, -0.52), and the 8-foot time-up-and-go (-1.43, 0.46) tests (all P ≤ 0.04). Lower global muscular strength (β between -0.18 and -0.30), and greater pain catastrophizing (β = 0.16), and CSI scoring (β between 0.18 and 0.27) were associated with greater MEP (all P ≤ 0.04).

CONCLUSION

Greater MEP was observed after tests measuring core musculature strength than after tests measuring distal (limbs) strength and agility. Greater MEP was overall associated with lower muscle strength, greater pain catastrophizing, and central sensitization.

CLINICAL RELEVANCE

Fitness testing might be implemented as a complementary tool for the monitoring of NSCLBP in clinical settings.

The 6-minute Run Test: Validation and Reference Equations for Adults

Endurance performance tests directly measuring cardiorespiratory fitness are complex, but field tests indirectly assessing maximum oxygen uptake (VO2max) are an alternative. This study aimed to validate the 6-minute run test in adults, comparing it to the established shuttle run test, and to create reference equations. The cross-over design involved healthy adults aged 18-65 undertaking both tests, separated by a two-hour interval. The 6-minute run test required participants to run around a volleyball court for six minutes, aiming to maximize distance covered. The shuttle run involved participants covering 20 meters in defined time intervals at increasing speeds. Parameters measured included 6-minute run test distance, heart rates, calculated maximum oxygen uptake during the shuttle run, and total shuttle count. The study enrolled 250 participants (134 men and 116 women). Men averaged 1195.7 m (SD=161.4), while women averaged 1051.2 m (SD=148.0) in six minutes. The strongest correlation was found between the distance covered in the 6-minute run test and the total shuttle count (r=0.91, p<0.001). Two predictive models for 6-minute run test distance were developed and normative values for different sex-specific age clusters were established. The study showed that the 6-minute run test is valid as a practical endurance test for adults aged 18-65.

Individual evaluation of fatigue at work to enhance the safety performance in the construction industry: A systematic review

The construction industry is recognized as one of the most hazardous industries globally due to the dynamic on site activities and labour-intensive characteristics. The construction tasks are physically and cognitively demanding therefore the construction workers are prone to work fatigue which compromises safety performance. The evaluation of fit for duty, or fitness for work (FFW) aims to determine if workers are at risk of adverse impacts of ill-health, injury or accidents. This systematic review aimed to critically summarize up-to-date measures and evaluation tools that were employed to monitor work fitness or fatigue specifically among construction workers. Adhering with the PRISMA protocol, three databases were searched from the inception to 2022, with a total combination of 37 keywords, concluding to the selection of 20 relevant articles. The Mixed Method Appraisal Tool (MMAT) was used as the guide for the study appraisal. A total of 20 articles were reviewed, published from 2008-2022. Majority of the studies employed experimental design. The review identified the subjective evaluation scales and objective measurement tool. The subjective self-response questionnaires can be categorized into single dimension or multidimension covering both physical and mental fitness; whereas the objective measurement tool can be categorized into physiological metrics, physical and cognitive performance measure. The available scientific evidence has raised the relevant issues for on-site practicality and potentially guide the formulation of evidence-based guidelines for the FFW assessment in the construction industry.

Time measurement validity and reliability of the 4 × 10-m shuttle run test in adult population: The ADULT-FIT project

OBJECTIVES

The purpose of this study was to analyze the time measurement validity and reliability (between raters and test-retest) of the 4 × 10-m shuttle run test to assess motor fitness in adults, according to gender, age, and physical activity levels.

DESIGN

Cross-sectional. A total of 230 adults (86 women) aged 18-64 years participated in the study.

METHODS

The time taken to complete the 4 × 10-m shuttle run test was recorded simultaneously by a trained and an untrained rater (inter-rater reliability) and by photoelectric cells (time measurement validity). 48-72 h later, the test was repeated under the same conditions (test-retest reliability).

RESULTS

The systematic error for trained rater vs. photocell was close to zero (0.0125, p < 0.01), with an effect size of 0.006; and for both, untrained rater vs. photocell and trained rater vs. untrained rater was ∼0.2 s (p < 0.001) with an effect size of 0.09. For the test-retest reliability, the systematic error was 0.05 s (p < 0.001), with an effect size of 0.26, the intraclass correlation coefficient was 0.998 and the coefficient of variation reported a variability of 0.73 %. Results were not influenced by gender and age, while these improved for active vs. non-active participants.

CONCLUSIONS

Findings indicate that measurements with trained raters are a valid and reliable method for assessing the 4 × 10-m shuttle run test in adults. It is highly recommended that raters be trained to minimize the measurement error.

Proposed Protocol for Field Testing of Endurance Fitness of Young Labrador Retrievers

The number of dogs and, with it, dog sports are growing in popularity, and the training of dogs begins at an early age. Although fitness testing is an imperative part of purposeful training and sports, to our knowledge, no objective field tests are available for measuring young dogs' endurance fitness. The aim of this study is to describe a simple, easy-to-repeat, and inexpensive way to test training intervention effects on endurance fitness in young Labrador Retrievers. Healthy client-owned 16-week-old Labrador Retrievers will be recruited and divided into test and control groups. The test group will have an eight-week training program followed by a four-week detraining period, while the control group will live a normal puppy life. All dogs will be tested for endurance fitness four times at four-week intervals: at baseline, one month later, two months later at the end of the training period, and one month after ending the training program. Each of the four testing sessions will be identical and will consist of four measurements of heart rate (HR) and blood lactate (BL): at baseline, after trotting 1000 m, after sprinting 200 m, and at recovery 5-8 min after the sprint. The training-induced changes in endurance fitness are evaluated by changes in HR and heart rate recovery times (HRR), BL, and running times.

A Prospective, Open-Label Study to Evaluate Functional Changes Following Electromagnetic Muscle Stimulation of Abdominal Muscle

Background

Electromagnetic muscle stimulation (EMMS) is an effective, well-tolerated noninvasive body contouring treatment for strengthening, toning, and firming the abdomen.

Objectives

In this study, functional changes following abdominal EMMS treatment wereevaluated.

Methods

In this prospective, open-label study, adults received 8 abdominal EMMS treatments (2 treatments on nonconsecutive days/week over 4 weeks). Follow-ups occurred 1 month (primary endpoint), 2, and 3 months postfinal treatment. Effectiveness endpoints included improvements from baseline on Body Satisfaction Questionnaire (BSQ; primary endpoint), core strength (timed plank test), abdominal endurance (curl-up test), and Subject Experience Questionnaire (SEQ). Safety was evaluated throughout.

Results

Sixteen participants (68.8% female) were enrolled, with a mean age of 39.3 years and a mean BMI of 24.4 kg/m²; 14 participants completed the study per protocol. Mean BSQ scores were significantly improved from baseline (27.9) to the 1-month follow-up (36.6; P < .05). Core strength and abdominal endurance were significantly greater at the 1-, 2-, and 3-month posttreatment time points than at baseline (P < .05). Frequently cited reasons for seeking EMMS treatment included a desire to feel stronger (100%; n = 14/14) and to improve athletic performance (100%; n = 14/14). SEQ responses 3 months posttreatment showed that most participants reported feeling stronger (92.9%) and motivated to receive additional EMMS treatments (100%) and work out to maintain treatment results (100%). The majority of participants (>78%) reported being "satisfied" or "very satisfied" with abdominal treatment 1 month posttreatment. One device- and/or procedure-related adverse event of menstrual cycle irregularity was reported in 1 participant and was mild in severity.

Conclusions

EMMS treatment of the abdomen is associated with functional strength improvements and high patient satisfaction.

Level of Evidence 4

Criterion-related validity and reliability of the 2-km walk test and the 20-m shuttle run test in adults: the role of sex, age and physical activity level

OBJECTIVES

To analyze the criterion-related validity and the reliability of fitness field tests for evaluating cardiorespiratory fitness in adults, by sex, age, and physical activity level.

DESIGN

Cross-sectional.

METHODS

During 3 weeks, sociodemographic, anthropometric measurements, a treadmill maximal test, the 2-km walk test, and the 20-m SRT were performed in 410 adults aged 18-64 years. Measured and estimated VO_2max (by Oja's and Leger's equations) were analyzed.

RESULTS

Measured VO_2max was associated with estimated VO_2max by the 2-km walk test and 20-m SRT (r = 0.784 and r = 0.875, respectively; both p < 0.01). Bland-Altman analysis showed a mean difference of -0.30 ml* kg^-1 * min^-1 (p < 0.001, d = -0.141) in the 2-km walk test, and 0.86 ml* kg^-1 * min^-1 (p = 0.051) in the 20-m SRT. Significant mean differences between test and retest were found in the time to complete the 2-km walk test (-1.48 ± 0.51 s, p = 0.004, d = -0.014) and in the final stage reached in the 20-m SRT (0.04 ± 0.01, p = 0.002, d = 0.015). Non-significant differences were found between test and retest in the estimated VO_2max by Oja's (-0.29 ± 0.20 ml* kg^-1 * min^-1, p > 0.05) and Leger's eqs. (0.03 ± 0.04 ml* kg^-1 * min^-1, p > 0.05). Moreover, both test results and estimated VO_2max equations showed a high test-retest reliability.

CONCLUSIONS

Both tests were valid and reliable for evaluating cardiorespiratory fitness in adults aged 18-64 years, regardless of sex, age, and physical activity level.

Feasibility and Reliability of Health-Related Physical Fitness Tests in Children and Adolescents with Hearing Impairment

Although research supports the feasibility and reliability of health-related physical fitness (HRPF) tests in typically developing children and adolescents, little is known regarding the feasibility and reliability of these tests for those with hearing impairments (HI). The aim of this study was to evaluate the feasibility and reliability of a HRPF test battery for children and adolescents with HI. A test-retest design with a one-week interval was conducted with 26 participants with HI (mean age: 12.7 ± 2.8 years; 9 male). The feasibility and reliability of seven field-based HRPF tests (i.e., body mass index, grip strength, standing long jump, vital capacity, long distance run, sit-and-reach, one leg stand) were evaluated. All the tests showed high feasibility (completion rate > 90%). Six tests indicated good to excellent test-retest reliability (all intraclass correlation coefficient [ICC] > 0.75) while the one leg stand test showed poor reliability (ICC = 0.36). Relatively large percentages of standard error of measurement (SEM%) and minimal detectable change (MDC%) were observed in the sit-and-reach test (SEM% = 52.4%, MDC% = 145.2%) and one leg stand test (SEM% = 107.9%, MDC% = 299.2%), whereas the rest of the tests demonstrated reasonable SEM% and MDC% values. Collectively, most of the tests can be feasibly and reliably used to assess HRPF for children and adolescents with HI.

Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: A systematic overview of the literature

BACKGROUND

Physical activity positively influences cardiovascular health. Results from male-dominated physically active occupations suggest that a high level of occupational physical activity may be detrimental to cardiovascular health. This observation is referred to as the physical activity paradox. Whether this phenomenon can also be observed in female-dominated occupations remains unknown.

OBJECTIVE

We aimed to provide an overview of (1) leisure-time and occupational physical activity in healthcare workers. Therefore, we reviewed studies (2) to assess the relationship between the two physical activity domains and analyzed (3) their effects on cardiovascular health outcomes in relation to the paradox.

METHODS

Five databases (CINAHAL, PubMed, Scopus, Sportdiscus, Web of Science) were systematically searched. Both authors independently screened the titles, abstracts, and full texts and assessed the quality of the studies using the National Institutes of Health's quality assessment tool for observational cohort and cross-sectional studies. All studies that assessed leisure-time and occupational physical activity in healthcare workers were included. The two authors independently rated the risk of bias using the ROBINS-E tool. The body of evidence was evaluated using the GRADE approach.

RESULTS

The review included 17 studies that assessed the leisure-time and occupational physical activity of people working in healthcare, determined the relationship between the domains (n = 7) and/or examined their effects on the cardiovascular system (n = 5). Measurements for leisure-time and occupational physical activity varied between studies. Leisure-time physical activity typically ranged between low and high intensity, with a short duration (approx. 0.8-1.5 h). Occupational physical activity was typically performed at light to moderate intensity with a very long duration (approx. 0.5-3 h). Moreover, leisure-time and occupational physical activity were almost negatively related. The few studies investigating effects on cardiovascular parameters revealed a rather unfavorable effect of occupational physical activity, while leisure-time physical activity was beneficial. The study quality was rated as fair and the risk of bias was moderate to high. The body of evidence was low.

CONCLUSIONS

This review confirmed that leisure-time and occupational physical activity of healthcare workers are opposed in their duration and intensity. Moreover, leisure-time and occupational physical activity seem to be negatively related and should be analyzed according to their relation to each other in specific occupations. Furthermore, results support the relationship between the paradox and cardiovascular parameters.

REGISTRATION

Preregistered on PROSPERO (CRD42021254572). Date of registration on PROSPERO: 19 May 2021.

TWEETABLE ABSTRACT

Does occupational physical activity adversely affect the cardiovascular health of healthcare workers in comparison to leisure-time physical activity?

Influence of lower limb muscle isometric strength and cardiovascular parameters on locomotor capacity in children and adolescents

BACKGROUND

Although measures of exercise performance and physical activity are known to be related to 6-minute walk test (6mWT), the role of the strength of each muscle group of the lower limb in the locomotor capacity during the development period is unknown.

OBJECTIVE

To identify the role of the isometric strength of lower limb muscles and cardiovascular parameters on the locomotor capacity in children and adolescents, controlling for participants sex, age, and height.

METHODS

Participants (7 to 15 years old; female, n= 113; male, n= 128) were assessed for isometric strength (seven lower limb muscles), cardiovascular parameters (diastolic pressure, oxygen saturation, resting heart rate, respiratory rate), and 6mWT. Participants were split into nine age groups and separated by 1-year intervals.

RESULTS

Hip flexors-controlled for sex, age, and height-explained a meaningful percentage of the variance (R=2 0.45; p< 0.001) for 6mWT distance, and the resting heart rate explained a change in R2 of only 2% (p= 0.008).

CONCLUSIONS

Isometric strength of hip flexors explained ∼ 50% of the 6mWT distance, suggesting the importance of strength from an early age. Other factors, such as cardiovascular parameters, while relevant, may exert a secondary role on youth's capacity.

Characteristics and usefulness of trunk muscle endurance tests on the Roman chair in healthy adults

Background

Adequate trunk muscle endurance is considered to be an important indicator of good low back stability; therefore, its assessment is needed when determining an individual's risk for back pain. Optimal tests to assess each trunk muscle group separately are difficult to find. The objective of this study was to verify if two groups of trunk muscle endurance tests (standard and alternative) show comparable results in terms of muscle endurance ratios, holding times and rated perceived effort to perform each test.

Methods

The study was designed as a quasi-experimental repeated-measures design. There was a single group of participants who took part in two different trunk muscle endurance testing. Sixty-eight healthy adult volunteers, aged 20-45 years (31.9 ± 7.2 years), without recent musculoskeletal injury or disorder participated in the study. All participants finished the study. Trunk muscle endurance tests as tested on the Roman chair (B tests) were compared with standard tests as suggested by McGill (A tests). Each group of tests consisted of an endurance test for trunk extensors, trunk flexors, and lateral trunk muscles for left and right side. The order of tests' performances was randomly assigned to each participant, whereby a participant did perform A and B tests in the same order. In each test of A and B the holding time was recorded and a perceived effort in each test performance was also assessed by participants. Post testing performance the four ratios of trunk muscles endurance comparison were calculated for each group of tests to determine if there is a good or poor ratio between muscles. Results of each participant were compared for trunk muscle endurance ratio calculations, holding times and rated perceived effort for A and B tests.

Results

Results showed comparable trunk muscle endurance ratios in the three ratios observed, except for the flexors:extensors ratio (A_FL:EX: 1.2 (IQR: 0.7-1.6) vs. B_FL:EX: 0.6 (IQR: 0.3-0.8); p < 0.001). As compared to A tests, holding times were significantly longer in B tests for the extensors (A_EX: 125.5 s (IQR: 104.8-182.8 s) vs. B_EX: 284.0 s (IQR: 213.0-342.3 s); p < 0.001) and lateral trunk muscles (A_L-LM: 61.0 s (IQR: 48.3-80.8 s) vs. B_L-LM: 131.5 s (IQR: 95.5-158.5 s); A_R-LM: 63.5 s (IQR: 45.8-77.3 s) vs. B_R-LM: 113.0 s (IQR: 86.3-148.8 s); p < 0.001), both were also rated as slightly easier to perform in the extensors (A_RPE-EX: 13 (IQR: 12.0-14.0) vs B_RPE-EX: 11 (IQR: 10.0-13.0); p_RPE-EX < 0.001) and lateral muscles testing (A_RPE-LM: 14.0 (IQR: 12.3-15.8) vs. B_RPE-LM: 13.0 (IQR: 12.0-15.0); p_RPE-LM = 0.001).

Conclusions

A and B tests are comparable in three of four trunk muscle endurance ratios, while longer holding times and lower perceived effort to perform were observed in most of the B tests. The Roman chair tests could be used as an alternative to standard tests.

High Adherence to the Mediterranean Diet is Associated with Higher Physical Fitness in Adults: a Systematic Review and Meta-Analysis

Although prior research has synthesized the relationships between the Mediterranean diet (MD) and components of physical fitness (PF) in adults, they are limited and inconclusive. This study aimed to synthesize the associations between high (compared with low) MD adherence and PF levels with each of its components (cardiorespiratory, motor, and musculoskeletal) in adulthood. We conducted a systematic search in 5 databases from inception to January 2022. Observational studies and randomized controlled trials were included. Pooled odds ratios (ORs) and effect sizes (Cohen d index) with their 95% CIs were calculated via a random effects model. A total of 30 studies were included (19 cross-sectional in young, middle-aged, and older adults; 10 prospective cohort in older adults; and 1 randomized controlled trial in young adults) involving 36,807 individuals (mean age range: 20.9-86.3 y). Pooled effect sizes showed a significant cross-sectional association between higher MD adherence scores (as a continuous variable) and overall PF (d = 0.45; 95% CI: 0.14, 0.75; I2 = 91.0%, n = 6). The pooled ORs from cross-sectional data showed that high adherence to MD was associated with higher cardiorespiratory fitness (OR: 2.26; 95% CI: 2.06, 2.47; I2 = 0%, n = 4), musculoskeletal fitness (OR: 1.26; 95% CI: 1.05, 1.47; I2 = 61.4%, n = 13), and overall PF (OR: 1.44; 95% CI: 1.20, 1.68; I2 = 83.2%, n = 17) than low adherence to MD (reference category: 1). Pooled ORs from prospective cohort studies (3- to 12-y follow-up) showed that high adherence to MD was associated with higher musculoskeletal fitness (OR: 1.20; 95% CI: 1.01, 1.38; I2 = 0%, n = 4) and overall PF (OR: 1.14; 95% CI: 1.02, 1.26; I2 = 9.7%, n = 7) than low adherence to MD (reference category: 1). Conversely, no significant association was observed between MD and motor fitness. High adherence to MD was associated with higher PF levels, a crucial marker of health status throughout adulthood. This trial was registered at PROSPERO as CRD42022308259.

The reliability, validity and usefulness of the 30-15 intermittent fitness test for cardiorespiratory fitness assessment in military personnel

The objectives of this study were to investigate the reliability, validity, and usefulness of the 30-15 intermittent fitness test (30-15_IFT) in soldiers. The 34 infantry members of the Slovenian armed forces were recruited as participants. Participants performed the continuous incremental treadmill test (TR), a 2-mile run (2_MR) test, and two 30-15_IFT tests. Additionally, participants were divided into a highest-scoring group (HSG) and a lowest-scoring group (LSG) based on their scores on the Army Physical Fitness Test. A very high reliability ratings were observed for 30-15_IFT measures, as follows: end-running speed (ERS) ERS_IFT (ICC = 0.971)_, maximal heart rate (HR_max) HR_maxIFT (IC = 0.960)_, and maximal relative oxygen consumption (VO_2max) VO_2max-IFT (ICC = 0.975)_. Although 30-15_IFT measures demonstrated high correlations (r = 0.695-0.930) to the same measures of TR test, ERS, HR_max and VO_2max were higher in the 30-15_IFT (p > 0.05)_. Furthermore, ERS_IFT and predicted VO_2maxIFT were higher in HSG compared to LSG, whereas HR_max did not differ. The results of this study show that the 30-15_IFT test is a reliable, valid and useful tool for assessing cardiorespiratory fitness in the armed forces. Moreover, the ERS and predicted VO₂max values derived from the 30-15_IFT could be considered more sensitive markers of combat readiness than the parameters derived from the TR and 2_MR tests.Trial registration number: NCT05218798.

The associations between adherence to the Mediterranean diet and physical fitness in young, middle-aged, and older adults: A protocol for a systematic review and meta-analysis

Introduction

A healthy diet and high health-related physical fitness levels may be part of an overall healthy lifestyle. The relationship between adherence to the Mediterranean diet and physical fitness levels has been analyzed in several studies. However, no studies have synthesized evidence on this relationship throughout adulthood. Moreover, in addition to the overall Mediterranean dietary pattern, the associations of individual components of the Mediterranean diet with physical fitness indicators are also unclear.

Methods

This protocol for a systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols statement and the Cochrane Collaboration Handbook. Systematic literature searches will be performed in the MEDLINE (PubMed), Scopus, Web of Science, SPORTDiscus and Cochrane CENTRAL databases to identify studies published up to 31 January 2022. The inclusion criteria will comprise observational studies and randomized controlled trials reporting the associations between adherence to the Mediterranean diet and physical fitness levels on general healthy or unhealthy adults (≥18 years). When at least five studies addressing the same outcome are available, meta-analysis will be carried out to estimate the standardized mean difference of physical fitness according to the adherence to Mediterranean diet. Subgroup analyses will be performed according to the characteristics of the population, the individual dietary components of the Mediterranean diet and physical fitness parameters as long as there are sufficient studies.

Ethics and dissemination

This systematic review and meta-analysis protocol is designed for updating evidence on the associations between adherence to overall Mediterranean diet (and specific Mediterranean foods) and physical fitness levels in young, middle-aged, and older adults. Findings from this review may have implications for public health. The results will be disseminated through peer-reviewed publication, conference presentation, and infographics. No ethical approval will be required since only published data will be used.

PROSPERO registration number

CRD42022308259.