The longitudinal relationship between motor competence and measures of fatness and fitness from childhood into adolescence

The Relationship Between Motor Competence Physical Activity Cardiorespiratory Fitness and BMI in UK Adolescents

Purpose: This study set out to identify the extent of the relationships between subsections of the Movement Assessment Battery for Children 2nd Edition - MABC2 (manual dexterity, aiming and catching, and balance) to PA, CRF and BMI in adolescents. Methods: Height, BMI, the MABC2, a 20m shuttle run test and wrist-worn accelerometery PA levels (mins) were measured. Multivariable linear regression models, adjusting for sex, height and BMI were used to assess the relationship of the three subsections of the MABC2 with PA, CRF and BMI. Results: A total of 155 adolescents, aged 13-14 years, took part in this study (77 girls, 78 boys). Balance reported significant relationships with moderate to vigorous PA (unstandardised Beta B=0.15, 95%CI 0.02-0.28), vigorous PA (B=0.06, 95%CI 0.02-0.09) and BMI (B=-0.01, 95%CI -0.02-0.005). Balance in addition to aiming and catching skills were both significantly related to adolescent CRF (B=0.30, 95%CI 0.17-0.42 and B=0.29, 95%CI 0.14-0.45, respectively). Conclusion: This study suggests that balance is the strongest correlate skill to achieving the highest intensities of PA and healthier BMI status in adolescents.           .

The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis

PURPOSE

Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk.

METHOD

Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS.

RESULTS

BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (-0.036; 95% confidence interval, -0.070 to -0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI.

CONCLUSIONS

BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI.

Motor Competence and Body Mass Index in the Preschool Years: A Pooled Cross-Sectional Analysis of 5545 Children from Eight Countries

BACKGROUND AND OBJECTIVE

One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between motor skill competence and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries.

METHODS

Quantile regression analyses were used to explore the associations between motor skill competence (assessed using the Test of Gross Motor Development, Second/Third Edition) and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country.

RESULTS

Negative associations of locomotor skills, ball skills, and overall motor skill competence with BMI percentiles (p < 0.005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills, and overall motor skill competence scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards.

CONCLUSIONS

Public health policies should position motor skill competence as critical for children's obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causal pathway between motor skill competence and BMI from early childhood.

Does muscular fitness predict cardiorespiratory fitness in adolescent girls? A 3-year follow-up study

The main purpose of the study was to establish, whether future cardiorespiratory fitness might be predicted by the level of muscular fitness at baseline. In this 3-year follow-up study, we recruited 240 secondary school girls at the age of 15 y, who were followed until the age of 17 y. Muscular fitness included the following tests: (i) standing broad jump (cm), (ii) sit-ups in 60 s (#) and (iii) squats in 60 s (#). Cardiorespiratory fitness was split into aerobic endurance (the 800-m run test) and speed endurance (the 400-m run test). Better performances in the 800-m run and the 400-m run tests at follow-up were correlated with higher levels of standing broad jump, sit-ups and squats in 60 s measured at baseline. In regression models adjusted for fat mass and maturity offset, standing broad jump, sit-ups and squats in 60 s were positively associated with the 800-m run test, while only standing broad jump remained significantly and positively associated with the 400-m run test. These data suggest that interventions enhancing muscular fitness should be recommended, as the effects are likely to be associated with future cardiorespiratory fitness in adolescent girls.

Association Between Motor Competence and Percentage of Body Fat in Late Childhood: Comparing Proficiency in Fundamental Motor Skills and Advanced Movement Skills

Background: To solve the problem of a weakening relationship between motor competence and body adiposity from late childhood to adolescence, we defined and utilized advanced movement skills (AMS) characterized by higher biomechanical, physiological, and cognitive processing demands compared with fundamental motor skills (FMS). Methods: As a cross-sectional study, the proficiency in FMS and AMS for participants (43 boys and 45 girls) aged 9-12 years was measured by the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) and Test of Advanced Movement Skills (TAMS), respectively. Density plots and skewness of scoring distributions between assessments were inspected to examine test scalability. We also compared the incremental validity of BOT-2 and TAMS scores in the multiple linear regression models predicting the percentage of body fat (%BF, measured by Tanita BF-689 body scale). Results: The TAMS outcomes produced a more positively/right-skewed scoring distribution with a skewness of 0.09 compared with -0.49 for the BOT-2 scores, indicating a better test discrimination ability. The TAMS total scores were a significant predictor (B = -0.92, p = 0.03) in the model predicting %BF (R2 = 0.39, p < 0.001) and provided a greater degree of incremental validity (f2 = 0.058) compared with the BOT-2 (f2 = 0.018). Conclusions: This study provides supportive evidence that the proficiency in AMS is more appropriate, compared with FMS, at tracking the increasing motor competence and body adiposity in late childhood, which is helpful for motor skills training, physical activity promotion, and overweight/obesity prevention.

The relationship between fundamental motor skills and physical fitness in preschoolers: a short-term longitudinal study

Purpose

Physical fitness and fundamental motor skills are two important aspects for the healthy development of preschoolers. Despite the growing interest in clarifying their relationship, the scarcity of longitudinal studies prevents us from understanding causality.

Method

This study employed a cross-lagged model with two time points to investigate the bidirectional relationship between these two aspects. A total of 174 preschoolers (54.0% girls) from 3 to 6 years old (M = 3.96 ± 0.47) were surveyed, they were recruited by convenience from two kindergartens in Beijing, China, and their physical fitness (via CNPFDSM-EC) and fundamental motor skills (via TGMD-3) were tracked over a period of 6 months.

Results

The findings revealed a bidirectional predictive effect. The predictive strength of flexibility was found to be lower than other physical fitness aspects, while locomotor skills demonstrated a higher predictive strength than object control skills.

Conclusion

This study indicates that physical fitness and fundamental motor skills mutually enhance each other in young children, and both should be emphasized in preschool sports education.

Motor Competence between Children with and without Additional Learning Needs: A Cross-Sectional Population-Level Study

The aim of this study was to examine associations in motor competence between children with additional learning needs (ALN) and typically developing children. This cross-sectional study involved a nationally representative cohort of 4555 children (48.98% boys; 11.35 ± 0.65 years) from sixty-five schools across Wales (UK). Demographic data were collected from schools, and children were assessed using the Dragon Challenge assessment of motor competence, which consists of nine tasks completed in a timed circuit. A multi-nominal multi-level model with random intercept was fitted to explore the proficiency between children with ALN and those without. In all nine motor competence tasks, typically developing children demonstrated higher levels of proficiency than their peers with ALN, with these associations evident after accounting for age, sex, ethnicity, and socioeconomic status. This study highlights motor competence inequalities at a population level and emphasises the need for policymakers, practitioners, and researchers to prioritise motor competence development, particularly for children with ALN.

The stability of cardiometabolic risk factors clustering in children and adolescents: a 2-year longitudinal study

Objective

The present study aims to verify the odds of remaining with the clustering of 3 or more, 4 or more, and 5 or more risk factors across a 2-year time span.

Methods

Observational longitudinal study that included 358 children and adolescents (10.96 ± 2.28 years of age at baseline). Cardiorespiratory fitness, glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference were assessed. The number of children in whom the risk factors were not independently distributed was analyzed. Odds ratios of presenting n risk factors clustered at follow-up according to the number of risk factors observed at baseline were calculated.

Results

More participants than expected were found presenting clustering of 4 or more and 5 or more risk factors at both baseline (11.7% and 5.6%, respectively) and follow-up (9.5% and 5.6%, respectively). The odds ratios calculated demonstrated that the odds of presenting the same number of risk factors clustered or more at follow-up increased according to the number of risk factors clustered at baseline.

Conclusion

The higher the number of risk factors a child had at baseline, the higher the odds of presenting the same number of risk factors or more after two years of follow-up.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-022-01174-1.

Motor Competence Assessment (MCA) Scoring Method

The Motor Competence Assessment (MCA) is a quantitative test battery that assesses motor competence across the whole lifespan. It is composed of three sub-scales: locomotor, stability, and manipulative, each of them assessed by two different objectively measured tests. The MCA construct validity for children and adolescents, having normative values from 3 to 23 years of age, and the configural invariance between age groups, were recently established. The aim of this study is to expand the MCA’s development and validation by defining the best and leanest method to score and classify MCA sub-scales and total score. One thousand participants from 3 to 22 years of age, randomly selected from the Portuguese database on MC, participated in the study. Three different procedures to calculate the sub-scales and total MCA values were tested according to alternative models. Results were compared to the reference method, and Intraclass Correlation Coefficient, Cronbach’s Alpha, and Bland–Altman statistics were used to describe agreement between the three methods. The analysis showed no substantial differences between the three methods. Reliability values were perfect (0.999 to 1.000) for all models, implying that all the methods were able to classify everyone in the same way. We recommend implementing the most economic and efficient algorithm, i.e., the configural model algorithm, averaging the percentile scores of the two tests to assess each MCA sub-scale and total scores.

Psychological Aspects, Physical Activity Levels and Overweight Concerns: A Cross-over Study of Brazilian Adolescents

Introduction

This study aims to identify levels of anxiety, depression, body weight, and levels of physical activity, as well as to verify possible associations among these variables in Brazilian adolescents. It is a cross-sectional study with a convenience sample of 291 Brazilian adolescents aged 13 to 15 years old (13.75±0.80 years old).

Methods

Researchers assessed students by filling out questionnaires of anxiety and depression symptoms, as well as the level of physical activity and checking anthropometric measures. Parametric and non-parametric statistics were used to compare groups divided by psychological, physical and overweight factors for boys and girls, adopting a significance level of 95%.

Results

Results showed higher waist circumference and physical activity levels for boys (p<0.01) and higher scores for anxiety and depressive symptoms questionnaires for girls (p<0.01). In addition, a low prevalence of depression was observed in boys (0.69%/CI0.03-4.36). For anxiety and depression variables in males and females with and without overweight and physically active and inactive, there were significant differences between groups (p < 0.05), but not within groups.

Conclusion

The identification of a higher prevalence of girls with anxiety and depression was observed in this study and reinforced this information already demonstrated in the scientific literature. In general, the prevalence of depression was low in boys, while the prevalence of overweight, sedentary lifestyle, anxiety and depression were higher in girls.

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.

Is body fat mass associated with worse gross motor skills in preschoolers? An exploratory study

We compared the motor competence between overweight/obese and eutrophic preschoolers with similar physical activity levels, age, socioeconomic status, maternal education, quality of the home environment and quality of the school environment. We also investigated to what extent excess body fat mass explains gross motor skills in preschoolers. A cross-sectional quantitative and exploratory study was conducted with 48 preschoolers assigned into eutrophic and overweight/obese groups. Overweight/obese preschoolers had worse Locomotor subtest standard scores than the eutrophic ones (p = 0.01), but similar Object Control subtest and Gross Motor Quotient scores (p > 0.05). Excess body fat mass explained 12% of the low Locomotor subtest standard scores in preschoolers (R² = 0.12; p = 0.007). Excess body fat mass was associated with worse locomotor skills when the model was adjusted for physical activity levels, age, socioeconomic status, maternal education, quality of the home environment and quality of the school environment. Thus, excess body fat mass partly explains lower locomotor skills in preschoolers.

Rehabilitation Including Structured Active Play for Preschoolers With Cancer (RePlay)-Study Protocol for a Randomized Controlled Trial

BACKGROUND

Children diagnosed with cancer experience muscle weakness and impaired physical function caused by treatment and related immobility. The situation forces them into a negative cycle of diminished participation in physical and leisure activities and isolation from peers; inhibiting the natural development of social and gross motor skills. This manuscript presents a protocol for a study that explores the effects of using structured active play to maintain preschoolers' age specific gross motor function and social and personal skills while undertaking intensive cancer treatment.

METHODS

The study is a two-arm, superiority randomized controlled trial with an intervention and a control group designed to evaluate the effects of a structured active play intervention on gross motor function. Gross motor subtests of the Peabody Developmental Motor Scales, Second Edition (PDMS-2) are used for measurement; with the primary end-point at 6 months post-treatment initiation. Eighty-four preschool children (aged 1-5 years), newly diagnosed with cancer at the Copenhagen University Hospital are randomly assigned to either an intervention or control group, using a 1:1 allocation. The intervention group receives a combined in-hospital and home-based program that includes structured active play activities, while the control group receives standard care, including physiotherapy. During hospital admission, the intervention group undertakes 45-min structured active play group sessions three times weekly, conducted by exercise professionals. Parents receive training and supervision to facilitate daily individual sessions outside of group sessions. Secondary study outcomes target the children's overall function level in everyday life, general physical performance, and health-related quality of life. As well, children's and parents' experiences within the intervention are explored and the children's social and personal development is observed.

DISCUSSION

Limited evidence exists regarding the effectiveness of rehabilitation interventions, particularly those including active play, for preschoolers diagnosed with cancer. This manuscript reporting on a study protocol will enhance clarity and transparency in reporting and offer insights for others with interest in this same topic. Once completed, findings from this study could extend knowledge about the conduct and measurement of effectiveness in rehabilitation initiatives. If study findings suggest that the intervention is effective, structured active play may become a standard part of rehabilitation.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT04672681. Registered December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.

The Fitness Barometer: A Best Practice Example for Monitoring Motor Performance With Pooled Data Collected From Practitioners

Introduction: Motor Performance (MP) in children is an important resource for their future active lifestyle and health. Monitoring of MP is crucial to derive information of trends and to implement specific programs on the base of current MP levels. A variety of MP assessment tools exist, making it difficult to determine a “gold-standard” for assessment and to compare the findings. In Germany, the German Motor Test 6–18 (GMT 6–18) and Kinderturntest Plus 3–10 (KITT+ 3–10) are widely used MP assessment tools. The aim of this paper is to show which key questions can be answered within the context of a best practice example of a MP assessment tool and what can be derived from this for a practical application (the Fitness Barometer).

Methods: The raw data of the Fitness Barometer was collected with the MP assessment tools GMT 6–18 and KITT+ 3–10 from 2012 through 2020. Data was pooled anonymously with the e-Research infrastructure MO|REdata and categorized into percentiles for MP and BMI. Overall, we included data of 23,864 children for the statistical analyses. T-tests for independent samples, percentage frequency analysis, descriptive statistics (chi- square-test) and single analysis of variance were conducted.

Results and Discussion: Children tested reached a mean value of 57.03 (SD = 18.85). Of the sample, 12.7% children were overweight or obese and there is a significant difference between age groups [χ(4)2 = 178.62, p < 0.001, Cramer V = 0.09; n = 23.656]. The relationship between BMI category and mean value of MP was significant [F_(4,19,523) = 224.81, p < 0.001]. During 2020, the year of the COVID-19 pandemic, mean value of endurance and speed decreased [Welch's F_(1,573) = 8.08, p = 0.005; Welch's F_(1,610) = 35.92, p < 0.001]. The GMT 6–18 and KITT+ 3–10 are valid, objective, reliable, and economic MP assessment tools for monitoring MP levels and derive added practical value. Specific programs and interventions should focus on the findings of these. The Fitness Barometer is a best practice example how a standardized assessment tool of monitoring MP point to trends on which practical evidence-based suggestions can be derived with many various partners and expertise.

Associations between swimming & cycling abilities and fitness in 9-11 year old boys and girls

The associations between swimming and cycling abilities and fitness levels in 9-11-year-old children were examined. A cross-sectional study involving 2258 children (50.7% boys; aged 10.52 ± 0.6 years) from 33 schools across Wales, participated in Swan/BridgeLinx health, fitness, and lifestyle programmes between 2013-2019. Health and fitness data were collected; namely body composition, cardiorespiratory fitness, muscular strength, flexibility, power, and speed using standardised measures. Children completed an online survey collecting data on swimming and cycling abilities and sports club attendance. Multivariate multilevel regressions were used to examine the associations between measures. The ability to swim and cycle was significantly (p < 0.05) associated with all components of fitness when accounting for age, body mass index (BMI), deprivation, gender, and sports club attendance. Boys outperformed girls with significant interactions between swimming, cycling and cardiorespiratory fitness for gender by swim (p = 0.001) and gender by cycle (p = 0.015). The gender by cycle interaction significantly predicted grip strength and power (p < 0.05). Swimming and cycling are important "milestones" in the journey of motor development and are associated with higher levels of fitness. These activities should be promoted to allow for an optimal development of motor skills, fitness, and health.

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.

Insufficient Physical Fitness and Deficits in Basic Eating Habits in Normal-Weight Obese Children Are Apparent from Pre-School Age or Sooner

Normal-weight obesity appears to be an extended diagnosis/syndrome associated with insufficient physical fitness levels and inadequate eating habits at least from school years. However, its relation to long term health parameters in pre-school children remains unknown, even though pre-school age is crucial for the determining healthy lifelong habits. Therefore, the aim of the current study was to investigate the differences in physical fitness level and basic eating habits between normal-weight obese, normal-weight non-obese, and overweight and obese preschoolers. The research sample consisted of 188 preschoolers aged 4.0–6.9 years (M_age = 5.52 ± 0.8 year), normal-weight obese = 25; normal-weight non-obese = 143, overweight and obese = 20. Body composition was measured using bio-impedance InBody230. Six tests assessed the physical fitness level: sit-ups; standing long jump; shuttle running 4 × 5 meters; throwing with a tennis ball; multistage fitness tests; sit and reach. A four-item eating habits questionnaire for parents focusing on breakfast regularity, consumption of sweet foods and drinks, selection of food and attitude towards eating was used. A non-parametric analysis of variance and Fisher’s exact test along with suitable effect sizes were used for data processing of physical fitness tests and the basic eating habits questionnaire, respectively. Normal-weight obese children performed significantly worse (from p = 0.03 to p < 0.001, ES ω2-G = low to medium) in muscular fitness, cardiorespiratory fitness and running agility compared to normal-weight non-obese counterparts and did not significantly differ in the majority of physical fitness performance tests from overweight and obese peers. In basic eating habits, normal-weight obese boys preferred significantly more sweet foods and drinks (p = 0.003 ES = 0.35, large), while normal-weight obese girls had significantly more negative attitude towards eating (p = 0.002 ES = 0.33, large) in comparison to their normal-weight non-obese peers. Normal-weight obesity seems to develop from early childhood and is associated with low physical fitness and deficits in eating habits which might inhibit the natural necessity for physically active life from pre-school age or sooner.

The Effect of an Intervention with Active Video Games Combined with Multicomponent Exercise on Cardiorespiratory fitness in Children with Overweight and Obesity: A Randomized Controlled Trial. (Preprint)

Background

Childhood overweight and obesity have become major global health problems and are negatively related with the cardiorespiratory fitness (CRF) level in school children and adolescents. Exercise, specifically multicomponent training, is effective for CRF improvement, but the main challenge is to ensure adherence to exercise in children with overweight and obesity. Therefore, new ways of exercising that are more attractive and motivational for this population are needed and playing or training with active video games (AVGs) has been proposed as an effective alternative because they require full-body movement and therefore increase energy expenditure.

Objective

The main aim of this study was to investigate the effects of an AVG intervention combined with multicomponent training on CRF at maximal and submaximal intensities in children with overweight or obesity.

Methods

We recruited 28 children (13 girls and 15 boys) aged 9 to 11 years with overweight or obesity from medical centers and divided them into 2 groups, an intervention group (n=20) that participated in a 5-month supervised AVG exercise program combined with multicomponent exercise, and a control group (n=8) that continued daily activities without modification. A maximal stress test to measure CRF using a walking-graded protocol with respiratory gas exchange was performed by the participants.

Results

The AVG group showed a significant decrease in heart rate and oxygen uptake for the same intensities in the submaximal stages of the maximal treadmill test, as well as a lower oxygen uptake percentage according to the individual maximal oxygen uptake, whereas the control group did not show overall changes. No change in the peak oxygen uptake (VO_2peak) was found.

Conclusions

A 5-month AVG intervention combined with multicomponent exercise had positive effects on CRF at submaximal intensity, showing a lower heart rate and oxygen uptake at the same intensities and displaying a lower oxygen uptake percentage according to the individual (VO_2peak). Greater benefits were found in children with the highest fat percentage.

Trial Registration

ClinicalTrials.gov NCT04418713; https://clinicaltrials.gov/show/NCT04418713

Actual and Perceived Motor Competence in Relation to Body Mass Index in Primary School-Aged Children: A Systematic Review

Unhealthy-weight status may represent a precursor of poor actual (AMC) (i.e., process- and product-oriented) and perceived (PMC) motor competence. AMC and PMC represent key elements favoring long-term commitment in sports and day-to-day life physical activity. In fact, the development of AMC and PMC during the primary school years could help to counteract weight-related negative effects (i.e., overweight or obesity) that are responsible for sedentary or unhealthy behavior across the life span. Therefore, this review aimed to provide a synopsis of the current research investigating the relation of AMC and PMC with weight status and in the context of potential gender differences. Systematic research in five electronic databases (PubMed, Web of Science, EMBASE, CINAHL, Scopus) was conducted from April 2021 to May 2021 in compliance with PRISMA guidelines. Studies were included if they involved obese or overweight youth (6–10 years) with no physical or cognitive impairment and used a longitudinal or a cross-sectional assessment of motor competence and perceived motor competence outcomes. After the selection process and after duplicates were removed, the final sample included 27 studies. Most of the studies reported that AMC and PMC are negatively associated with weight status, with male and females differing from each other in overall and subtest (locomotor, object control, and stability skills) AMC scores. However, according to a risk of bias assessment, the level of evidence linked to the association of AMC (process and product) and PMC with weight status (BMI) remained uncertain and lacking, respectively. Further high-quality studies are warranted to improve the understanding of AMC and PMC in relation to weight status, which appears to be differently expressed by gender in primary school years. Regardless, based on the current quantitative data, the emerging inverse association between AMC/PMC and weight status implies that it would be best to limit sedentary behavior by including daily lessons in physical education to limit unfavorable conditions (i.e., obesity and overweight) during the school years.

High BMI and Low Muscular Fitness Predict Low Motor Competence in School-Aged Children Living in Low-Resourced Areas

Childhood obesity is a relatively new problem for Sub-Saharan developing countries. Especially in children with a low socioeconomic background, the link between motor competence, muscular fitness, and body mass index (BMI) remains poorly investigated. Due to the interrelatedness of BMI and physical fitness, the aim of this study is to determine the predictive value of these factors in relation to low motor competence in school-aged children living in low-resourced areas. Motor competence and physical fitness were assessed in 1037 school-aged Ghanaian and South African children using the Performance and Fitness test battery (PERF-FIT). “Low motor competence” was predicted using odds ratios calculated from backward logistic regression analyses. Low motor competence was less prevalent in Ghanaian children (3.7–11.1%) compared to the South African children (21.9–24.2%). Increased BMI and decreased muscular fitness predicted low motor competence in both Ghanaian and South African children. For example, the chance for a Ghanaian child to have low static balance increased by 22.8% (OR = 1.228, p < 0.001) with a 1-point increase in BMI, whereas this decreased by 30.0% (OR = 0.970, p < 0.001) with a 10-cm increase on the standing long jump. In the case of the South African children, if their BMI increased by 1 point, the chance for those children of having low static balance increased by 7.9%, and if their SLJ performance decreased by 10 cm, their chance of low performance increased by 13%. Clearly, motor competence is associated with both BMI and muscular fitness. Policy makers can use this information to counteract the establishment of childhood obesity by promoting weight control through physical activity and stimulating motor competence at school.

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.

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.

Mediation role of cardiorespiratory fitness on the association between fatness and cardiometabolic risk in European adolescents: The HELENA study

PURPOSE

This study was aimed to analyze the mediation role of cardiorespiratory fitness (CRF) on the association between fatness and cardiometabolic risk scores (CMRs) in European adolescents.

METHODS

A cross-sectional study was conducted in adolescents (n = 525; 46% boys; 14.1 ± 1.1 years old, mean ± SD) from 10 European cities involved in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. CRF was measured by means of the shuttle run test, while fatness measures included body mass index (BMI), waist to height ratio, and fat mass index estimated from skinfold thicknesses. A clustered CMRs was computed by summing the standardized values of homeostasis model assessment, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and leptin.

RESULTS

Linear regression models indicated that CRF acted as an important and partial mediator in the association between fatness and CMRs in 12-17-year-old adolescents (for BMI: coefficients of the indirect role β = 0.058 (95% confidence interval (95%CI): 0.023-0.101), Sobel test z = 3.11 (10.0% mediation); for waist to height ratio: β = 4.279 (95%CI: 2.242-7.059), z =3.86 (11.5% mediation); and for fat mass index: β = 0.060 (95%CI: 0.020-0.106), z = 2.85 (9.4% mediation); all p < 0.01).

CONCLUSION

In adolescents, the association between fatness and CMRs could be partially decreased with improvements to fitness levels; therefore, CRF contribution both in the clinical field and public health could be important to consider and promote in adolescents independently of their fatness levels.

The importance of body weight status on motor competence development: From preschool to middle childhood

We evaluated the association between weight status and motor competence from preschool age (3‐5 years of age) until middle childhood (7‐9 years of age). Longitudinal study with three to five‐year‐old preschool children (n = 1155) enrolled in public and private preschools in Recife, Brazil. Children were followed twice (2010, 2012, and 2014) for four years. Köperkoordinationstest für kinder (KTK) assessed the children's motor competence (KTK Motor Quotient). Weight status (underweight, normal weight, overweight, and obesity) was classified according to the children's sex and age. Preschool children with normal weight exhibited higher motor competence at 5‐7 years of age compared to preschool children with overweight (+3.73 MQ, P = .03) and obesity (+5.09 MQ, P < .01). Preschool children with normal weight presented higher motor competence at 7‐9 years of age compared to their peers with overweight (+6.00 MQ, P = .03) and obesity (+5.88 MQ, P = .01). Children with normal weight at 5‐7 years of age presented higher motor competence at 7‐9 years of age compared to their peers with overweight (+3.33 MQ, P = .02) and obesity (+4.00 MQ, P = .02). Independent of the childhood phase and extension of the period evaluated (2‐ or 4‐year period), children who had excessive weight (overweight or obesity) and changed their weight status to underweight or normal weight presented similar motor competence compared to children who continued underweight or normal weight. Weight status already at preschool age is an important predictor of the children's motor competence until middle childhood. Interventions improving the children's weight status, already at preschool age, might impact their motor competence development positively.

Reconceptualizing and Operationalizing Seefeldt's Proficiency Barrier: Applications and Future Directions

In 1980, Seefeldt introduced the concept of a motor skill "proficiency barrier" that provides a conceptual basis for understanding the importance of a motor skill barrier as it relates to critical public health initiatives. While the intent of Seefeldt's proficiency barrier hypothesis had great potential to advance the field of motor development, the notion of a proficiency barrier was not empirically tested. Instead, this concept lay dormant for several decades. The purpose of this paper was to expand upon Seefeldt's proficiency barrier concept in greater detail by addressing the following questions: (1) what constitutes a motor proficiency barrier? (2) how do we assess/measure the existence of a proficiency barrier? and (3) how do we break through the proficiency barrier in order to maximize the likelihood of participation in health-enhancing levels of physical activity later on in life? We conclude with a future research suggestion to explore the existence of the proficiency barrier.

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.

Standardized motor assessments before the age of five predicting school-aged motor outcome including DCD: A systematic review

AIM

Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder usually diagnosed at primary-school-age. This systematic review aimed to summarize available standardized motor assessments before five years of age predicting DCD, complex Minor Neurological Disorder (cMND) and motor delay assessed by a standardized motor test.

METHODS

A systematic search was performed in MEDLINE, CINAHL, WoS, Scopus, CENTRAL and ERIC. A hand search was executed. Only data of non-Cerebral Palsy children was included.

RESULTS

At or before two years, the BSID, motor subtests of GMDS, NOMAS, and NSMDA might be valuable in detecting school-aged motor delay, while starting at three years, the PDMS, motor subtests of GMDS, NSDMA, M-ABC-2, and CAMPB show promising results. General movements Assessment is associated with cMND, but does not seem sensitive enough to detect DCD. Predictive values are superior in high-risk groups and improve as children age. However, no assessment instrument reached 80% sensitivity and specificity.

CONCLUSION

Standardized motor assessments before five years seem valuable in detecting early motor problems. More longitudinal research commencing in infancy, including multiple assessments over time and the implementation of clear diagnostic criteria is imperative.

Influence of Geographical Area and Living Setting on Children's Weight Status, Motor Coordination, and Physical Activity

This study was aimed (i) to examine the effect of living setting (rural vs. urban), geographical area (North vs. Center vs. South), and gender (boys vs. girls) on weight status, motor coordination, and physical activity (PA) level of Italian school-age children; (ii) to examine differences in the neighborhood walkability of different school areas from different geographical areas and living settings; and (iii) to examine whether motor coordination, PA level, geographical areas, living setting, neighborhood walkability, and gender could predict children's weight status. We assessed anthropometric parameters, gross motor coordination, and PA level in 1,549 children aged between 8 and 13 years. Results revealed that Central children had higher BMI than Northern and Southern children (η² = 0.01). Moreover, Northern children showed the highest motor quotient (η² = 0.148) and PA level (η² = 0.02), followed by Southern and Central children, respectively. Children from the South of Italy attended schools located in neighborhoods with the highest Walk Score®. Urban children attended schools located in neighborhoods with a higher Walk Score® than rural children. Lower motor quotient (MQ), lower PA level, and living in a rural setting and in a car-dependent neighborhood were associated with a higher relative risk for obesity. Being a girl was associated with a lower relative risk for obesity. The alarming high percentage of overweight and obesity in children as well as motor coordination impairments revealed the urgent need of targeted PA interventions in pediatric population.

Independent walking and balance in children with CHARGE syndrome

Children with CHARGE syndrome (CWCS) are born with multiple physical disabilities, several of which impair balance and the onset of motor milestones. Early motor development problems can include delayed independent walking, which has been found in CWCS. In addition, few studies have examined balance in CWCS and these studies have been limited in scope, necessitating a more comprehensive examination of balance in this population. Motor development occurs as a progression of stages as represented by Seefeldt’s conceptual model. As such, it is essential to examine the association of early development of foundational skills, such as balance, with the onset of motor milestones as they are building blocks to motor competence. The aims of this study are to (1) examine the differential effects of children with and without CHARGE syndrome on balance and (2) examine the association of age of walking to these balance measures. In this study, 27 CWCS and 22 children without CHARGE syndrome, aged 7 to 16 years, were assessed on four components of balance including anticipatory control, reactive postural control, sensory orientation, and dynamic gait using the shortened version of the Balance Evaluation Systems Test (mini-BESTest) and parental reported age of independent walking. Their balance and age of walking were compared to 22 typically developing peers of similar age and gender distribution. Results revealed that CWCS walked three times later than their peers without CHARGE syndrome and had significant deficits on all balance systems assessed with the largest difference occurring in anticipatory control. Anticipatory control is critically important in maintaining static and dynamic postural control. These results indicate a critical need for early functional balance training and compensatory strategies in CWCS.

Developmental Change in Motor Competence: A Latent Growth Curve Analysis

BACKGROUND

The development of childhood motor competence demonstrates a high degree of inter-individual variation. Some children's competence levels increase whilst others' competence levels remain unchanged or even decrease over time. However, few studies have examined this developmental change in motor competence across childhood and little is known on influencing factors.

AIM

Using latent growth curve modeling (LGCM), the present longitudinal study aimed to investigate children's change in motor competence across a 2-year timespan and to examine the potential influence of baseline weight status and physical fitness on their trajectory of change in motor competence.

METHODS

558 children (52.5% boys) aged between 6 and 9 years participated in this study. Baseline measurements included weight status, motor competence (i.e., Körperkoördinationstest für Kinder; KTK) and physical fitness (i.e., sit and reach, standing long jump and the 20 m shuttle run test). Motor competence assessment took place three times across a 2-year timespan. LGCM was conducted to examine change in motor competence over time.

RESULTS

The analyses showed a positive linear change in motor competence across 2 years (β = 28.48, p < 0.001) with significant variability in children's individual trajectories (p < 0.001). Girls made less progress than boys (β = -2.12, p = 0.01). Children who were older at baseline demonstrated less change in motor competence (β = -0.33, p < 0.001). Weight status at baseline was negatively associated with change in motor competence over time (β = -1.418, p = 0.002). None of the physical fitness components, measured at baseline, were significantly associated with change in motor competence over time.

CONCLUSION AND IMPLICATIONS

This longitudinal study reveals that weight status significantly influences children's motor competence trajectories whilst physical fitness demonstrated no significant influence on motor competence trajectories. Future studies should further explore children's differential trajectories over time and potential factors influencing that change.