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Barnett LM, Verswijveren SJJM, Ridgers ND, Tietjens M, Lander NJ, Abbott G. Children with high actual and perceived motor skill competence are more physically active: A pooled latent profile analysis of cross-sectional data. J Sports Sci 2025; 43:821-832. [PMID: 40089844 DOI: 10.1080/02640414.2025.2477419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 03/03/2025] [Indexed: 03/17/2025]
Abstract
The aim was to determine profiles according to actual and perceived motor competence and provide a comparison of profiles according to moderate-to-vigorous-intensity physical activity (MVPA) in children. Cross-sectional data were pooled from four Australian studies (481 children, 54.5% boys; 3.5 to 11.7 years). Motor skill competence, total, object control and locomotor (Test of Gross Motor Skill Development [TGMD)]), perceived motor skill (pictorial scale of Perceived Movement Skill Competence [PMSC]) and MVPA (ActiGraph data) were assessed. Latent profile analyses identified actual and perceived skill profiles and covariate-adjusted associations with MVPA were then assessed for all children, for boys and girls. For total skills, the two-profile solution was the best fit for all children (81% 'high aligned', i.e., high perception, high skills; 19% 'low aligned, i.e., low perception, low skills') and for girls (71% 'high aligned'; 29% 'low aligned'). For boys, a three-profile solution was the best fit (49% 'under perceiver'- low perception, high skills; 42% 'over perceiver' - high perception, low skills; 9% 'low aligned'). For the total skill, children in the 'high aligned' profile (65.3 minutes) were 14.6 minutes/day more active than the "low aligned" profile (50.8 minutes). Intervention efforts should focus on the "low aligned" profile to increase physical activity.
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Affiliation(s)
- L M Barnett
- Institute of Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Australia
- School of Health and Social Development, Deakin University, Australia
| | - S J J M Verswijveren
- Institute of Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Australia
| | - N D Ridgers
- Institute of Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - M Tietjens
- Institute of Sport and Exercise Sciences, University of Münster, Munster, Germany
| | - N J Lander
- Institute of Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Australia
| | - G Abbott
- Institute of Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Australia
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Estevan I, Menescardi C, Barnett LM, Utesch T. Understanding School Children's Perceived Movement Skill Competence: Evidence of Validity and Reliability According to the Type of Administration. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2025:1-11. [PMID: 40127651 DOI: 10.1123/jsep.2023-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/13/2025] [Accepted: 02/11/2025] [Indexed: 03/26/2025]
Abstract
The purpose of this study was to analyze and interpret evidence-based scores of validity and reliability of the Pictorial Movement Skill Competence according to the procedure of assessment (i.e., one-on-one interview and supervised-guided group administration) in a cohort of children. A sample of 635 children (49.1% girls, 8.0-10.9 years old) participated. Confirmatory factor analyses and Rasch models were conducted to examine evidence of different forms of validity and reliability. In the current sample, each Confirmatory factor analyses three-factor Pictorial Movement Skill Competence model (locomotion, object control, and stability skills) was an adequate fit. There was good-to-excellent agreement between both types of administration and higher internal consistency for the group administration. Both methods of administration are appropriate to assess perceived motor competence with the group method showing better reliability in this sample. Supervised group administration is more efficient than the one-on-one interview and could be considered in future assessments with children older than 8-years-old.
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Affiliation(s)
- Isaac Estevan
- AFIPS Research Group, Department of Teaching of Physical Education, Arts and Music, University of Valencia, Valencia, Spain
| | - Cristina Menescardi
- AFIPS Research Group, Department of Teaching of Physical Education, Arts and Music, University of Valencia, Valencia, Spain
| | - Lisa M Barnett
- Institute for Physical Activity and Nutrition, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Till Utesch
- Institute of Health Sciences, University of Luebeck, Luebeck, Germany
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Jidovtseff B, Morgado LDS, Sääkslahti A, Howells K, Barnett LM, D'Hondt E, Costa AM, De Martelaer K. An Evaluation of the Reliability of the Pictorial Scale of Perceived Water Competence and Its Relationship With Actual Water Competence. Percept Mot Skills 2024; 131:1063-1079. [PMID: 38656171 DOI: 10.1177/00315125241248552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
In its recent development, the Pictorial Scale of Perceived Water Competence (PSPWC) showed good face and construct validity. However, additional reliability and validity research is needed, including test-retest reliability and a demonstration of the relationship between PSPWEC test scores and actual water competence. Toward that aim, we administered the PSPWC to 124 children, aged 5-8 years. We repeated this test administration after one week for a subset of 55 children to determine its test-retest reliability, and the remaining 69 children also performed the fully aligned Actual Aquatic Skills Test (AAST) in an indoor swimming pool to provide data for our investigation of the relationship between PSPWC scores and actual water competence. We found good test-retest reliability, both at the global level (ICC = 0.81, n = 55) and at the level of individual skills (Weighted kappa coefficients from 0.58 to 0.90), with no significant differences between these two test scores. We also found a moderate positive relationship between PSPWC and AAST total scores (r = .64, n = 69), with no significant difference between total scores of actual and perceived water competencies. Children overestimated their competence in three specific skills: the back star, swimming on the front, and diving in deep water. While these results underline specific situations in which children's higher self-perceptions of their water competence are a risk factor for their water safety, these data confirm that the PSPWC is reliable for measuring children's perceived competencies in aquatic education and drowning prevention, and there is further support for its validity through a moderate correlation with actual water competencies.
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Affiliation(s)
- Boris Jidovtseff
- Department of Physical activity and Rehabilitation Sciences, Research Unit for a Life-Course Perspective on Health and Education, CEReKi, University of Liege, Liège, Belgium
| | - Liliane De Sousa Morgado
- Department of Physical activity and Rehabilitation Sciences, Research Unit for a Life-Course Perspective on Health and Education, CEReKi, University of Liege, Liège, Belgium
| | - Arja Sääkslahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kristy Howells
- Department of Sport, Exercise and Rehabilitation Sciences, School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK
| | - Lisa M Barnett
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Eva D'Hondt
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Aldo M Costa
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal
| | - Kristine De Martelaer
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Li X, Su Z, Wang L, Li J, Diao Y. Psychometric evaluation of the pictorial scale of perceived movement skill competence in Chinese children: An item response theory analysis. Child Care Health Dev 2024; 50:e13275. [PMID: 38801211 DOI: 10.1111/cch.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/27/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
AIM This study aimed to investigate the psychometric characteristics of the Pictorial Scale of Perceived Movement Skill Competence (PMSC) in Chinese children, utilizing the principles of item response theory (IRT). METHODS A total of 284 children (147 boys), aged 4-10 years (Mage = 7.39, SD = 2.18), from four schools were recruited for testing, adhering to the principle of random sampling. The Rasch model was applied to evaluate the rating scale validity, local independence, scale dimensionality, person and item fit statistics, and differential item functioning (DIF). RESULTS (1) The rating scale validity was confirmed by the monotonically increasing trend in both average item difficulty measures and Andrich thresholds. (2) However, the observation that standardized residual correlations for all items remained below 0.3 unequivocally confirmed the presence of local independence among the variables. (3) The scale's dimensions were substantiated, with Rasch measures explaining 40.6% of total variance, exceeding the 40% threshold. Additionally, the first contrast had an eigenvalue of 1.8 and explained 8.80% of the variance, both exceeding the minimum 3:1 ratio. Consequently, the unidimensionality assumption of the item was supported. (4) Person and item fit statistics indicated requisite reliability and separation, with all achieving suitable infit and outfit measures, and point-biserial correlations exceeding 0.55. (5) Regarding gender DIF, it was observed that the majority of items did not exhibit statistically significant gender DIF effects (p > 0.05) except item 8 (Bounce a ball, t = -2.74, p < 0.01, DIF = -0.51). CONCLUSION Rasch analysis revealed that the instrument exhibited strong scale validity among Chinese children, adhering to the Rasch model's unidimensionality and local independence principles, with robust person and item reliability and separation. All items demonstrated a good fit. Additionally, the significant gender difference in item 8 (Bounce a ball) warrants further consideration. In conclusion, PMSC is suitable for assessing the PMSC of Chinese children.
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Affiliation(s)
- Xuanxi Li
- School of Physical Education and Sport, Shandong Normal University, Jinan, China
| | - Zheng Su
- School of Physical Education and Sport, Shandong Normal University, Jinan, China
| | - Li Wang
- School of Physical Education and Sport, Shandong Agricultural University, Tai'an, China
| | - Jing Li
- School of Physical Education and Sport, Shandong Normal University, Jinan, China
| | - Yucui Diao
- School of Physical Education and Sport, Shandong Normal University, Jinan, China
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Lorås H, Hansen Sandseter EB, Storli L, Kleppe R, Barnett L, Sando OJ. Psychometric Properties of the Pictorial Scale of Perceived Movement Skill Competence for Young Norwegian Children. Percept Mot Skills 2024; 131:637-659. [PMID: 38623598 PMCID: PMC11127498 DOI: 10.1177/00315125241245175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The objective of this study was to examine the psychometric properties of the Pictorial Scale of Perceived Movement Skill Competence (PMSC) for young Norwegian children, a scale that is aligned with skills assessed in the Test of Gross Motor Development- Third Edition. We used convenience sampling to recruit 396 Norwegian-speaking children (7-10-year-olds) who completed the PMSC. A confirmatory factor analysis (CFA) confirmed factorial validity for the proposed three-factor model of the PMSC, encompassing measures of self-perceived ball, locomotor, and active play competence. Internal item consistency coefficients of these sub-scales were acceptable, and subsequent measurement invariant analysis found a gender difference such that boys rated their competence higher than girls in running, jumping forward, hitting a ball (racket), kicking, throwing a ball and rope climbing, while girls rated themselves higher, compared to boys, in galloping and skating/blading. Furthermore, there was a slightly better model fit for boys than for girls. Several items were significantly related to children's age, and the three-factor model exhibited differential age related factor mean differences across older and younger children. Overall, we found the PMSC to have acceptable psychometric properties for confident use in assessing perceived motor competence among 7-10-year-old Norwegian children, though we observed age and gender differences in children's responses that warrant careful interpretation of results and further research investigation.
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Affiliation(s)
- Håvard Lorås
- Department of Teacher Education, Faculty of Social and Educational Sciences, NTNU, Trondheim, Norway
- Department of Physical Education and Health, Queen Maud University College of Early Childhood Education, Trondheim, Norway
| | - Ellen Beate Hansen Sandseter
- Department of Physical Education and Health, Queen Maud University College of Early Childhood Education, Trondheim, Norway
| | - Lise Storli
- Department of Physical Education and Health, Queen Maud University College of Early Childhood Education, Trondheim, Norway
| | - Rasmus Kleppe
- Department of Physical Education and Health, Queen Maud University College of Early Childhood Education, Trondheim, Norway
| | - Lisa Barnett
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Ole Johan Sando
- Department of Physical Education and Health, Queen Maud University College of Early Childhood Education, Trondheim, Norway
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Laukkanen A, Niemistö D, Aunola K, Barnett LM, Sääkslahti A. Child perceived motor competence as a moderator between physical activity parenting and child objectively measured physical activity. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 67:102444. [PMID: 37665868 DOI: 10.1016/j.psychsport.2023.102444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 04/21/2023] [Accepted: 04/21/2023] [Indexed: 09/06/2023]
Abstract
This longitudinal study aimed to examine how physical activity parenting (PAP) directly predicted objectively measured children's moderate-to-vigorous physical activity (MVPA) and sedentariness over a three-year transitional period from early to middle childhood, and second, whether the children's perception of motor competence (PMC) mediated or moderated the influence of PAP to children's MVPA or sedentariness. At time 1 (T1), PAP and children's (N = 396, mean age 5.80, SD 1.04) PA were assessed by parental questionnaire. Three years later, at time 2 (T2), children's (N = 396, mean age 8.80, SD 1.04) PMC was measured by a validated pictorial scale, and MVPA and sedentariness were measured by accelerometers. All the analyses were conducted using the Mplus statistical package (Version 8.4). The models were adjusted for the following covariates: children's PA (T1), gender (T1), age (T1), mean accelerometer measurement in hours per day (T2), and parents' education level (T1). Results showed that PAP at T1 did not significantly predict level of MVPA or sedentary time at T2 and, therefore, PMC did not mediate the PAP-children's MVPA or sedentary time relationship either. However, PMC significantly moderated the relationship between PAP and MVPA but not between PAP and sedentary time. The results suggested that parental support positively predicts children's MVPA among children with low PMC but not among children with high PMC. This unique finding proposes that family-based PA interventions could benefit from screening of children with low PMC and provision of PA counselling to their parents.
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Affiliation(s)
- Arto Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.
| | - Donna Niemistö
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Kaisa Aunola
- Department of Psychology, University of Jyväskylä, Finland
| | - Lisa M Barnett
- Institute of Physical Activity and Nutrition / School of Health and Social Development, Faculty of Health, Deakin University, Australia
| | - Arja Sääkslahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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Estevan I, Bowe SJ, Menescardi C, Barnett LM. Self and proxy (parents and teachers') reports of child motor competence: A three-year longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 64:102331. [PMID: 37665815 DOI: 10.1016/j.psychsport.2022.102331] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 09/06/2023]
Abstract
OBJECTIVE The aims of this study were to: 1) analyse the longitudinal trends in the evolution of the association between children's actual and perceived motor competence (AMC and PMC, respectively) according to the source of information: children, parents, and Physical Education (PE) teachers; 2) assess whether children, parents, and PE teachers can report on children's AMC longitudinally (considering the children's age, sex, and the type of motor competence). DESIGN AND METHOD A sample of 108 typically developing Spanish children (47.12% girls) from five schools participated in this study. AMC and PMC (locomotion, object control and overall MC) data was collected at three time points one year apart. Longitudinal mixed effects models with repeated measures were conducted. RESULTS Regardless of the domain of MC, no longitudinal association between children's AMC and PMC was found. Parents also exhibited limited capability to proxy report their children's AMC longitudinally. PE teachers' proxy reports of children' AMC were associated over time with object control and overall level. CONCLUSION This study confirms the necessity of specific training in AMC to effectively report on children's motor competence. PE teachers can be seen as a potential source to empower children's AMC and PMC development over time.
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Affiliation(s)
- Isaac Estevan
- AFIPS Research Group, Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avenida dels Tarongers, 4, Valencia, 46022, Spain.
| | - Steven J Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, 3125, Australia; School of Health, Wellington Faculty of Health, Victoria University of Wellington, Kelburn, Wellington, New Zealand.
| | - Cristina Menescardi
- AFIPS Research Group, Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avenida dels Tarongers, 4, Valencia, 46022, Spain.
| | - Lisa M Barnett
- Institute of Physical Activity and Nutrition, School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, VIC 3220, Australia.
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Bondi D, Robazza C, Lange-Küttner C, Pietrangelo T. Fine motor skills and motor control networking in developmental age. Am J Hum Biol 2022; 34:e23758. [PMID: 35613316 PMCID: PMC9541226 DOI: 10.1002/ajhb.23758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/30/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives We investigated the relationships between fine motor skills, fitness, anthropometrics, gender and perceived motor performance in school beginners. The aim of our study was to delineate whether and to what extent fine motor control would show meaningful synchrony with other motor variables in the age of onset of handwriting in school. Methods A sample of N = 239 of 6‐to‐8‐year‐old children were tested with an array of tasks measuring fine motor (i.e., dexterity and speed) and grapho‐motor performance (tracing on a tablet screen), anthropometric indexes, and fitness (shuttle run) measures. A subset of 95 children was also tested for perceived motor competence. Results In spite of an overall poor anthropometric condition, our participants were relatively fit. As expected, older children performed better in both, fine motor tasks and the shuttle test. The girls were better in fine motor skills, and an original speed‐quality trade‐off in the drawing was found. However, the magnitude of difference by grade was greater for boys' fine motor skills than those of girls'. A network analysis revealed three specific clusters, (1) perceived competencies, (2) fitness, and (3) fine motor skills. Conclusions Given the relative independence of these areas of physical performance, we suggest focusing on these three clusters as distinct areas of physical education. Fine motor skills deserve further consideration, especially at an early school age. We have demonstrated that network analysis and technology devices used to evaluate motor development are useful and meaningful tools.
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Affiliation(s)
- Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Claudio Robazza
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Christiane Lange-Küttner
- Department of Psychology, University of Greifswald, Germany.,Department of Psychology, University of Bremen, Bremen, Land Bremen, Germany
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
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Niemistö D, Barnett LM, Cantell M, Finni T, Korhonen E, Sääkslahti A. What factors relate to three profiles of perception of motor competence in young children? J Sports Sci 2021; 40:215-225. [PMID: 34636285 DOI: 10.1080/02640414.2021.1985774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The study aims were to 1) examine profiles of perception of motor competence (PMC) in relation to actual motor competence (AMC), i.e. under-estimators (UEs), realistic estimators (REs) and over-estimators (OEs) and 2) investigate associations between the profiles and selected socioecological factors at the individual, family and environmental levels. PMC (Pictorial Scale of Perceived Movement Skill Competence) and AMC (Test of Gross Motor Development-Third Edition) were administered to a representative sample of children from 37 childcare centres in Finland (n=441;6.2±0.6yrs;52% boys). Socioecological factors were investigated using a parental questionnaire. The three profiles were formed based on age- and gender-adjusted PMC and AMC z-scores. Multinomial logistic regression showed that OEs (n=81; p=0.04) tended to be younger than REs (n=306; p=0.04) and UEs (n=54; p=0.03). Parents of OEs reported more child health and developmental issues than parents of REs (p=0.03). Parents of UEs self-reported providing more support for physical activity than parents' of REs (p=0.04). REs tended to live in denser population areas than UEs (n=54; p=0.03). Whilst PMC profiles revealed some socioecological differences, future research needs to focus on a broader range of potential correlates and untangle methodological analyses challenges to deepen the knowledge about PMC development in children.
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Affiliation(s)
- Donna Niemistö
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla Finland
| | - Lisa M Barnett
- School of Health and Social Development, Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Marja Cantell
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen The Netherlands
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla Finland
| | - Elisa Korhonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla Finland
| | - Arja Sääkslahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla Finland
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10
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Estevan I, Menescardi C, García-Massó X, Barnett LM, Molina-García J. Profiling children longitudinally: A three-year follow-up study of perceived and actual motor competence and physical fitness. Scand J Med Sci Sports 2021; 31 Suppl 1:35-46. [PMID: 33871084 DOI: 10.1111/sms.13731] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/27/2020] [Accepted: 05/21/2020] [Indexed: 12/16/2022]
Abstract
Longitudinal designs enhance our understanding of children's development and its influence on movement behaviors and health. This three-year follow-up study aimed to develop profiles according to perceived and actual motor competence (MC) (locomotion, object control, and overall) and physical fitness in boys and girls longitudinally including children's temporal migrations among clusters in terms of profiling trends. A secondary aim was to compare physical activity participation and weight status at each time point according to these profiles. One hundred and four typically developing Spanish children (45.8% girls) between 4 and 9 years old at baseline participated in this study. Data were collected at three time points one year apart, between January 2016 and May 2018. A self-organizing map and K-means cluster analysis were used to classify and visualize the values and temporal trajectories longitudinally. The study of the profiles in three consecutive years revealed five profiles, three for boys [ie, profile 1 (aligned-high), profile 2 (aligned-partially-low perception-medium actual MC and fitness), and profile 3 (non-aligned-medium perception-low actual MC and fitness)]; and two for girls [ie, profile 4 (aligned-high) and profile 5 (aligned-low)]. For highly perceived and capable children, boys (profile 1) and girls (profile 4), there was a tendency for higher physical activity participation and lower body mass index and waist circumference over time compared to their counterparts who had medium and/or low levels in perception and actual MC and fitness (P < .05). As children age, those with low values in perceived and actual MC and fitness in object control skills will present a higher probability of maintaining unhealthy lifestyles. So, prior intervention, children's profiles identification should be analyzed according to the type of MC.
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Affiliation(s)
- Isaac Estevan
- AFIPS Research Group, Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Cristina Menescardi
- AFIPS Research Group, Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Xavier García-Massó
- AFIPS Research Group, Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Lisa M Barnett
- Institute of Physical Activity and Nutrition, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Javier Molina-García
- AFIPS Research Group, Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
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Maïano C, Morin AJS, April J, Tietjens M, St-Jean C, Gagnon C, Dreiskämper D, Aimé A. Psychometric Properties of a French Version of the Perceived Motor Competence in Childhood Questionnaire. Percept Mot Skills 2021; 128:1002-1016. [PMID: 33765895 PMCID: PMC8107499 DOI: 10.1177/00315125211000862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In this study, we examined the psychometric properties of a French version of the Perceived Motor Competence in Childhood (PMC-C) questionnaire. The participants were 219 French-speaking children (aged 5-12 years), recruited from elementary schools in the Canadian Province of Quebec. Results supported the validity and reliability of a second-order confirmatory factor analytic (CFA) model, including one higher-order factor. Additional analyses supported the complete measurement invariance of the first- and second-order factor structure across sex and indicated no differential item functioning or latent mean differences in PMC-C factors as a function of selected predictors (i.e., age, body mass-index and physical activity/sport involvement). Thus, this French version of the PMC-C has satisfactory psychometric properties (i.e., factor validity and reliability, measurement invariance and differential item functioning) and can be used to assess French-speaking children’s perceived motor competence.
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Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada.,Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Johanne April
- Department of Education Sciences, Université du Québec en Outaouais (UQO
- Campus de Saint-Jérôme), Saint-Jérôme, Canada
| | - Maike Tietjens
- University of Münster, Institute of Sport and Exercise Sciences, Department of Sport and Exercise Psychology, Germany
| | - Charlaine St-Jean
- Department of Education Sciences, Université du Québec à Rimouski, Canada
| | - Cynthia Gagnon
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO
- Campus de Saint-Jérôme), Saint-Jérôme, Canada
| | - Dennis Dreiskämper
- University of Münster, Institute of Sport and Exercise Sciences, Department of Sport and Exercise Psychology, Germany
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO
- Campus de Saint-Jérôme), Saint-Jérôme, Canada
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12
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Estevan I, Menescardi C, Castillo I, Molina-García J, García-Massó X, Barnett LM. Perceived movement skill competence in stability: Validity and reliability of a pictorial scale in early adolescents. Scand J Med Sci Sports 2021; 31:1135-1143. [PMID: 33527419 DOI: 10.1111/sms.13928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/16/2021] [Accepted: 01/26/2021] [Indexed: 12/20/2022]
Abstract
Perceived motor competence (PMC) is important to health as it mediates the association between actual motor competence (AMC) and physical activity. Many instruments assess the broader construct of physical self-perception but no scale has been developed to assess PMC in stability. The aim of this study was to develop and analyze the reliability and validity of a new pictorial PMC in stability skill assessment when completed by early adolescents. A Delphi method showed ≥70% of experts' consensus in the seven proposed items. A sample of 904 students (11-14 years old) self-reported PMC in locomotion, object control, and stability using two pictorial scales: Perceived Movement Skill Competence (PMSC) and the newly developed Stability (PMSC_Stability). The Körperkoordinations test for Kinder (KTK) was also administered as a measure of AMC in skills that utilize stability. Two different subsamples were randomly assigned to criterion validity and reliability assessments. Spearman's correlation, confirmatory factor analysis, and a general linear model for sex and age were conducted. The internal consistency (α) and test-retest (intraclass correlation coefficient) reliability values were good (>0.70). A single-factor latent model represented stability and did not differ by sex. Stability perception was associated with AMC (rho = 0.51). Stability is important to the performance of many movement skills (eg, single-leg balance or moving on a narrow surface). Understanding which adolescents have poor stability perception could highlight stability as an area that needs targeting in order to increase physical activity and sport participation.
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Affiliation(s)
- Isaac Estevan
- AFIPS research group, University of Valencia, Valencia, Spain.,Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Cristina Menescardi
- AFIPS research group, University of Valencia, Valencia, Spain.,Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Isabel Castillo
- AFIPS research group, University of Valencia, Valencia, Spain.,Department of Social Psychology, University of Valencia, Valencia, Spain
| | - Javier Molina-García
- AFIPS research group, University of Valencia, Valencia, Spain.,Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Xavier García-Massó
- AFIPS research group, University of Valencia, Valencia, Spain.,Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Lisa M Barnett
- Institute of Physical Activity and Nutrition. School of Health and Social Development, Deakin University, Geelong, Vic, Australia
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13
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Dean M, Issartel J, Benson T, McCloat A, Mooney E, McKernan C, Dunne L, Brennan SF, Moore SE, McCarthy D, Woodside JV, Lavelle F. CooC11 and CooC7: the development and validation of age appropriate children's perceived cooking competence measures. Int J Behav Nutr Phys Act 2021; 18:20. [PMID: 33516243 PMCID: PMC7847151 DOI: 10.1186/s12966-021-01089-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/18/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Learning cooking skills during childhood and adolescence is associated with positive dietary outcomes in adulthood as well as being tracked from adolescence to adulthood. In addition studies have found that perceived competence to be a greater motivator to perform a behaviour than actual competence. However, a lack of validated tools that effectively measure behavioural and dietary changes including cooking confidence in children is a limitation. Therefore, this research aimed to develop and validate age-appropriate perceived cooking competence measures for younger and older primary school aged children. METHODS Two measures of perceived Cooking Competence (CooC11 and CooC7) for older (8-12 years) and younger (6-7 years) children were developed from a critical evaluation of publically available recommendations and expert consultation. The cooking skills within the measures were illustrated by a graphic designer in consultation with a chef and reviewed in an iterative manner by the research team. The measures were piloted for clarity, ease of use and initial face validity. Multiple studies were used for both CooC11 and CooC7 to establish psychometric properties of the measures, temporal stability, internal consistency reliability, construct validity, as well as responsiveness to change for CooC11. Analysis included Exploratory Factor Analysis, Confirmatory Factor Analysis, Intraclass Correlation Coefficients, Pearson's Correlations, ANOVAs and Cronbach's Alphas. RESULTS Both measures had high levels of face validity and received positive user feedback. Two factors were shown in both measures with the measures showing excellent temporal stability (ICC > 0.9) and good internal consistency (Cronbach's Alphas > 0.7). Both measures showed initial discriminant validity, with significant differences (P< 0.001) between those who reported assisting their parents with dinner preparation and those who did not. Additionally, CooC11 was significantly correlated with an adult cooking measure and had a significant responsiveness to change (P< 0.01). CONCLUSIONS The CooC11 and CooC7 are the first validated age-appropriate measures for assessing children's perceived Cooking Competence for ages 8-12 and 6-7 years respectively. They can be used to evaluate the efficacy of children's cooking intervention studies or school nutrition education programmes.
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Affiliation(s)
- Moira Dean
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Johann Issartel
- Multisensory Motor Learning Lab, Dublin City University, Dublin, Ireland
| | - Tony Benson
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Amanda McCloat
- Department of Home Economics, St. Angela's College, Sligo (National University of Ireland Galway), Sligo, Ireland
| | - Elaine Mooney
- Department of Home Economics, St. Angela's College, Sligo (National University of Ireland Galway), Sligo, Ireland
| | - Claire McKernan
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Laura Dunne
- Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Sarah F Brennan
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Sarah E Moore
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Danielle McCarthy
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Jayne V Woodside
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
- Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Fiona Lavelle
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK.
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14
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Tietjens M, Barnett LM, Dreiskämper D, Holfelder B, Utesch TO, Lander N, Hinkley T, Schott N. Conceptualising and testing the relationship between actual and perceived motor performance: A cross-cultural comparison in children from Australia and Germany. J Sports Sci 2020; 38:1984-1996. [PMID: 32573357 DOI: 10.1080/02640414.2020.1766169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Previous studies investigating the relationship between motor skill, physical activity and fitness in children have not thoroughly considered the role of self-perception. Therefore, the study aim was to test a theoretical framework, which considered both actual and perceived motor skill as well as actual and perceived fitness. Potential moderating effects of sex and country were considered. Data on motor skill, fitness, as well as self-perception of motor skill and fitness were collected from 145 Australian children and 214 German children (age range 7 to 10 years). For actual motor skill and fitness, mean differences for sex, age and country were found. For perceived motor performance (perceived motor skill and perceived fitness) no mean differences were found for age. Path analyses were performed. The final model showed significant relations between actual performance (object control skill, fitness) and perceived performance (object control skill, fitness). All model paths had low to moderate regression weights with the lowest relationship reported between actual and perceived fitness. Sex and country showed no effects. This integrated approach has led to a better understanding of the relationship between children's perceived and objective performance, and cultural differences within them.
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Affiliation(s)
| | - Lisa M Barnett
- Deakin University, Institute for Physical Activity and Nutrition , Geelong, Australia
| | | | | | | | | | - Trina Hinkley
- Deakin University, Institute for Physical Activity and Nutrition , Geelong, Australia
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15
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Carcamo-Oyarzun J, Estevan I, Herrmann C. Association between Actual and Perceived Motor Competence in School Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103408. [PMID: 32422866 PMCID: PMC7277634 DOI: 10.3390/ijerph17103408] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/01/2020] [Accepted: 05/09/2020] [Indexed: 11/16/2022]
Abstract
(1) Background: The association between actual and perceived motor competence (MC) is one of the underlying mechanisms that influence the practice of physical activity. This study mainly aimed to analyze the structure and correlations between actual and perceived MC in schoolchildren and to compare actual and perceived MC between girls and boys. (2) Methods: A total of 467 fifth and sixth graders (43.9% girls, M = 11.26, SD = 0.70) participated. Actual and perceived MC were assessed. To examine the proposed four factor models, structural equation models (factor analyses, latent correlations, invariance testing for gender) were conducted. Student t-test for independent samples was used to compare boys and girls. (3) Results: Proposed models achieved acceptable fit values with moderate correlation between the factors according to the type of MC in actual and perceived MC. Invariant factor structure in boys and girls was revealed. Boys performed and perceived themselves higher in object control than girls; whereas girls showed higher actual and perceived self-movement than boys. (4) Conclusions: The association between actual and perceived MC exists both globally and separately by gender, despite the differences between boys and girls. It is important to consider the role of gender and type of MC in the development of motor competencies, as well as in the strengthening of the children’s sense of competence.
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Affiliation(s)
- Jaime Carcamo-Oyarzun
- Department of Physical Education, Faculty of Education, Social Science & Humanities, Universidad de La Frontera, 4811230 Temuco, Chile
- Correspondence:
| | - Isaac Estevan
- Activitat Física i Promoció de la Salut (AFIPS) Research Group. Department of Teaching of Music, Visual and Corporal Expression, University of Valencia, 46022 Valencia, Spain;
| | - Christian Herrmann
- Didactics Exercise and Sport, Zurich University of Teacher Education, CH-8032 Zurich, Switzerland;
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16
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Does Perception of Motor Competence Mediate Associations between Motor Competence and Physical Activity in Early Years Children? Sports (Basel) 2019; 7:sports7040077. [PMID: 30939783 PMCID: PMC6524374 DOI: 10.3390/sports7040077] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/22/2019] [Accepted: 03/27/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To examine if the relationship between physical activity (PA) and actual motor competence (MC) in British early years children is mediated by their perceived MC. DESIGN Cross-sectional convenience observational study. METHODOLOGY MC was assessed with six locomotor skills (LC) and six object-control skills (OC) via the Test of Gross Motor Development-2. PA was measured via a wrist-worn triaxial accelerometer and PA grouped as daily total PA (TPA) and moderate-to-vigorous PA (MVPA). Perceived MC was assessed using the Pictorial Scale of Perceived Competence and Acceptance for Young Children. A total of 38 children (63% male; 37% female) aged between 3 and 6 years (5.41 ± 0.69) completed all assessments. Mediating impacts of perceived MC on the relationships between PA and MC were explored via backwards mediation regressions. RESULTS There were no mediating impacts of perceived MC on the relationship between PA and actual MC. CONCLUSIONS The relationship between actual MC and PA is not mediated by perceived MC in a small sample of British early years childhood.
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17
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Niemistö D, Barnett LM, Cantell M, Finni T, Korhonen E, Sääkslahti A. Socioecological correlates of perceived motor competence in 5- to 7-year-old Finnish children. Scand J Med Sci Sports 2019; 29:753-765. [PMID: 30663804 DOI: 10.1111/sms.13389] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/13/2018] [Accepted: 01/14/2019] [Indexed: 12/19/2022]
Abstract
We investigated child, family, and environmental factors associated with young children's perceptions of locomotor (LM) and object control (OC) skills. The participants comprised 472 children (6.22 ± 0.63) and their parents. The children were assessed for their perception of motor competence in LM and OC skills (using the pictorial scale of Perceived Movement Skill Competence for young children), and actual motor competence (Test of Gross Motor Development 3rd edition and Körperkoordinationstest Für Kinder). Anthropometrics were calculated using the children's body mass index standard deviation scores. A parent questionnaire included questions about child factors (sex, child's independent walking age, time spent sedentary and outdoors, participation in organized sport activities, and access to electronic devices), family factors (parent educational level, physical activity frequency, and sedentary behavior), and environmental factors (access to sport facilities). Variance analysis sought to identify age-related differences, and a linear regression model examined correlates of children's perception of LM and OC skills. The children's movement skill perceptions were found to be generally high. Four factors explained 5.7% of the variance in perceptions of LM skills and 7.5% of the variance in perceptions of OC skills. Two factors, lower age and higher actual motor competence, explained most of the children's skill perceptions. Access to electronic devices (less) and Body mass index (BMI) (higher) were associated with perceptions of LM skills. Participation in organized sport activities (higher) and parental education (lower) were associated with perceptions of OC skills. When promoting children's physical activity and motor competence, perceptions of motor competence are an important consideration.
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Affiliation(s)
- Donna Niemistö
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lisa M Barnett
- Institute for Physical Activity and Nutrition, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Marja Cantell
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Elisa Korhonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Arja Sääkslahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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18
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Estevan I, García-Massó X, Molina García J, Barnett LM. Identifying profiles of children at risk of being less physically active: an exploratory study using a self-organised map approach for motor competence. J Sports Sci 2018; 37:1356-1364. [DOI: 10.1080/02640414.2018.1559491] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Isaac Estevan
- AFIPS Research Group. Department of Teaching of Music, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Xavier García-Massó
- HUMAG Research Group. Department of Teaching of Music, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Javier Molina García
- AFIPS Research Group. Department of Teaching of Music, Visual and Corporal Expression, University of Valencia, Valencia, Spain
| | - Lisa M. Barnett
- Institute of Physical Activity and Nutrition. School of Health and Social Development, Deakin University, Geelong, VIC, Australia
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19
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Perceptions of Movement Competence in Children and Adolescents from Different Cultures and Countries. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2018. [DOI: 10.1123/jmld.2018-0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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20
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Lander N, Mergen J, Morgan PJ, Salmon J, Barnett LM. Can a teacher-led RCT improve adolescent girls' physical self-perception and perceived motor competence? J Sports Sci 2018; 37:357-363. [PMID: 30067456 DOI: 10.1080/02640414.2018.1504397] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Perceived and actual motor competence (MC) influence physical activity (PA) behaviour. Notably, both are lower in girls than in boys. This study aimed to investigate (i) whether a 12-week, teacher-led intervention that improves actual MC (Lander, N., Morgan, P. J., Salmon, J., & Barnett, L. M. (2017). Improving early-adolescent girls' motor skill: A cluster randomized controlled trial. Medicine and Science in Sports and Exercise. 49(12), 2498-2505) could also improve adolescent girls' physical self-perception and perceived MC, and (ii) whether change in actual MC is associated with post-intervention perceptions A randomized controlled trial with 171 girls (mean age 12.48 ± 0.34 years), measured perception (i.e., physical self-perception profile (PSPP) and pictorial scale of perceived movement skill competence (PMSC)) and actual MC (i.e., Victorian FMS Teachers' Assessment Manual). Mixed models with post-intervention perception as the outcome, adjusting for baseline perception, group, and change in actual MC, as well as clustering, were performed. An interaction term between change in MC and intervention status was included to test the secondary aim. There were significant intervention effects on girls' physical self-perception as well as their perceived MC. However, there was no association between change in actual MC across the intervention and post intervention perception. While the intervention improved both actual MC and perceived MC, they were not associated.
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Affiliation(s)
- Natalie Lander
- a School of Education , Deakin University , Geelong , Australia
| | - Judith Mergen
- b Department of Human Movement Science , Westfaelische Wilhelms University, Institute of Sport Sciences , Muenster , Germany
| | - Philip J Morgan
- c PRC in Physical Activity and Nutrition, Faculty of Education and Arts , Newcastle University , Callaghan , Australia
| | - Jo Salmon
- d Institute for Physical Activity and Nutrition (IPAN) , Deakin University , Geelong , Australia
| | - Lisa M Barnett
- e Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development , Deakin University , Geelong , Australia
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21
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Estevan I, Barnett LM. Considerations Related to the Definition, Measurement and Analysis of Perceived Motor Competence. Sports Med 2018; 48:2685-2694. [DOI: 10.1007/s40279-018-0940-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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