Association between aerobic fitness and attentional functions in Egyptian preadolescent children.

Growing evidence indicates that culture and education can influence cognitive constructs. Studies targeting Western and Asian populations have shown a positive relationship between aerobic fitness and cognitive control in children; however, this association has yet to be explored in the Arab world. The current study aimed to investigate the relationship between aerobic fitness and attentional networks in Egyptian preadolescent children. In total, 103 preadolescent children (9.76 ± 0.11) completed an assessment of aerobic fitness using a 6-min running test and a computerized attention network test that allowed for assessing alerting, orienting, and executive networks. The results revealed that higher aerobic fitness was associated with shorter response time and higher response accuracy in a more cognitively demanding task condition (i.e., incongruent trials). Furthermore, higher aerobic fitness was associated with a more efficient executive network. No associations were observed for alerting and orienting networks. These findings corroborate growing evidence indicating the importance of aerobic fitness for cognitive development and extend the literature by suggesting that the positive association between aerobic fitness and cognitive control might be generalized to the Arab population and not significantly change across cultures.

A tool to assess fitness among adults in public health studies - Predictive validity of the FFB-Mot questionnaire.

BACKGROUND: Fitness has important implications for physical activity behavior and is associated with various health-related outcomes. It can be assessed through a test battery or a self-reported questionnaire. One example is the FFB-Mot (Funktionsfragebogen Motorik; engl. functional fitness questionnaire) which consist of 28 items to assess four components of fitness in adults: cardiorespiratory fitness/ endurance, muscular strength, gross motor coordination, and flexibility. The aims of this manuscript were to (1) provide an English-version of the FFB-Mot questionnaire (developed from the German-version using translation and back-translation) to the international community of researchers in the areas of physical activity, fitness and health in adults, and (2) examine the predictive validity of the FFB-Mot questionnaire in a large sample of community-dwelling adults. METHODS: We used data from a longitudinal study in Germany with four measurement waves over a period of 18 years, with samples ranging between 310 and 437 participants (1572 adults in total, mean ages 46-58 years). To assess predictive validity, we calculated Pearson correlations between FFB-Mot data collected in 1997 and external health-related criteria (i.e., subjective health status, physician-rated health status, back pain, physical complaints and physical activity in minutes per week) collected in 2002, 2010, and 2015, and separately for males and females. RESULTS: We observed correlations between higher FFB-Mot scores with better subjective health status (in 2002: males, r = 0.25; females, r = 0.18; in 2010: males, r = 0.29; females, r = 0.28; in 2015: males, r = 0.40), and higher physical activity (in 2002: males, r = 0.24; females, r = 0.25; in 2010: males, r = 0.30; females, r = 0.38; in 2015: females, r = 0.27). Higher FFB-Mot scores were also correlated with lower back pain (in 2002: males, r = -0.23; females, r = -0.25; in 2010: females, r = -0.22), less physical complaints (in 2002: males, r = -0.36; females, r = -0.24), and better physician-rated health status (in 2002: males, r = -0.41; females, r = -0.29, 2010: males, r = -0.38; females, r = -0.44; in 2015: males, r = -0.47). CONCLUSIONS: Our results suggest that the FFB-Mot to assess fitness in adults has predictive validity for health-related outcomes as indicated by significant correlations, albeit some effect sizes are small. The FFB-Mot may be used as one-time assessment of self-reported fitness, or for repeated testing to assess change of self-reported fitness over time and in different settings (e.g., public health research).

Analysis and evaluation of developed and used health scores.

This systematic review provides an overview of existing multidimensional health scores, including an assessment of their holistic value (coverage of all determinants and dimensions of health), and a systematic comparison of their properties. The review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Literature searches were conducted in English (PubMed, Scopus, Web of Sciences) and German databases (BISp-Surf, BIBNET). All scores that considered health multidimensional on an individual level were included. Two independent reviewers screened and identified articles. The Quality assessment tool for studies with diverse design was used to assess study quality. Scores were recorded in a criteria grid to make their properties comparable, and the multidimensionality of the individual scores was evaluated using radar chart visualizations. Twenty-six studies met the inclusion criteria. Study quality was strong in eight, fair in twelve, and weak in six studies. Among the 26 studies, 21 different questionnaire-based scores were included, which all covered at least three of the five health dimensions (Five dimensions have been identified in a former literature research). Three scores covered all dimensions, but none covered all of the previously defined determinants. Thus, according to this works created definition (holistic = cover all dimensions with all determinants), no holistic health score exists, only multidimensional scores covering different dimensions and determinants. This review offers good comparability, as all the instruments were questionnaires, and could be used as a basis for future research. A universal (holistic) health construct should be defined and developed to improve the quantification of health.

What is health? The concept of health is very complex. Therefore, although several models and scientific studies exist, the entire theme has not yet been fully explored. With the goal to understand health holistically, this work investigated the multidimensional health scores developed to date. Health scores need to be valid, easy to grasp and use, efficient, and scalable. They should provide a reliable statement regarding an individual's health status as well as their future health chances. The basic architecture of the health score should contain more than one dimension of health. A total of 26 studies comprising 21 different health scores were identified with the above criteria. However, according to the definition, none of the health scores were holistic (matching all health dimensions and determinants); rather, they were multidimensional scores covering different dimensions and determinants.

Longitudinal associations between physical activity and five risk factors of metabolic syndrome in middle-aged adults in Germany.

BACKGROUND: We examined the longitudinal association between (change in) physical activity (PA) with new onset of five risk factors of metabolic syndrome among 657 middle-aged adults (mean age 44.1 (standard deviation (SD) 8.6) years) who were free of the respective outcome at baseline, in a longitudinal cohort study spanning over 29 years. METHODS: Levels of habitual PA and sports-related PA were assessed by a self-reported questionnaire. Incident elevated waist circumference (WC), elevated triglycerides (TG), reduced high-density lipoprotein cholesterols (HDL), elevated blood pressure (BP), and elevated blood-glucose (BG) were assessed by physicians and by self-reported questionnaires. We calculated Cox proportional hazard ratio regressions and 95% confidence intervals. RESULTS: Over time, participants developed (cases of incident risk factor; mean (SD) follow-up time) elevated WC (234 cases; 12.3 (8.2) years), elevated TG (292 cases; 11.1 (7.8) years), reduced HDL (139 cases; 12.4 (8.1) years), elevated BP (185 cases; 11.4 (7.5) years), or elevated BG (47 cases; 14.2 (8.5) years). For PA variables at baseline, risk reductions ranging between 37 and 42% for reduced HDL levels were detected. Furthermore, higher levels of PA (≥ 16.6 METh per week) were associated with a 49% elevated risk for incident elevated BP. Participants who increased PA levels over time, had risk reductions ranging between 38 and 57% for elevated WC, elevated TG and reduced HDL. Participants with stable high amounts of PA from baseline to follow-up had risk reductions ranging between 45 and 87% for incident reduced HDL and elevated BG. CONCLUSIONS: PA at baseline, starting PA engagement, maintaining and increasing PA level over time are associated with favorable metabolic health outcomes.

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network.

OBJECTIVES: (1) To develop reference values for health-related fitness in European children and adolescents aged 6-18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. METHODS: This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. RESULTS: A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu). CONCLUSION: This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

Longitudinal association between physical activity and the risk of incident metabolic syndrome in middle-aged adults in Germany.

We examined the longitudinal association between physical activity (PA) and the risk of incident metabolic syndrome (MetS) among middle-aged, community-dwelling adults, including 591 individuals (314 females; mean (SD) age, 43.8 (8.5) years) who were free of MetS at baseline. Habitual and sports-related PA was assessed by a self-reported questionnaire. MetS was defined based on HDL-cholesterols, triglycerides, glucose or HbA1c, blood pressure, and waist circumference. We calculated Cox proportional hazard ratios (HR) and 95% confidence intervals (CI) using regression analyses. Over a mean follow-up of 12.5 years, 205 participants developed incident MetS. Four different sports-related PA measures were associated with a decreased risk of incident MetS: (1) Engaging in ≥ 75 min/week (HR 0.71, 95% CI 0.53-0.94), (2) maintaining a continuously high amount from baseline to follow-up of ≥ 75 min/week (HR 0.66, 95% CI 0.46-0.94), (3) starting from < 150 min/week at baseline to ≥ 150 min/week at follow-up (HR 0.65, 95% CI 0.45-0.94), and (4) increasing from < 16.6 MET-hours/week at baseline to ≥ 16.6 MET-hours/week at follow-up (HR 0.47, 95% CI 0.31-0.71). Thus, maintaining, starting or increasing sports-related PA is associated with a lower risk of incident MetS.

Changes in Physical Fitness during the COVID-19 Pandemic in German Children.

With the beginning of the COVID-19 pandemic in December 2019, each country has developed strategies to try to control the virus. The restrictions and subsequent consequences also limited the possibilities and structures for being physically active. Therefore, the aim of this study was to examine changes in physical fitness in a cohort that was investigated over an extended period. Physical fitness testing was conducted with the IPPTP-R in a primary school from a small rural community annually since 2012. Mean values of test items were calculated for each cohort. We conducted an ANCOVA to examine the differences between cohorts PreCOVID and 2020 as the first year of the COVID-19 pandemic, and between PreCOVID and 2021 as the second year of the COVID-19 pandemic. Overall, no evidence for a negative effect of the COVID-19 pandemic on physical fitness in children between the ages of 7 and 9 years was found. In strength tests, performances increased when comparing the PreCOVID cohort and COVID-19 cohorts (Push-Ups: p < 0.001, ηp2 = 0.032; p = 0.017, ηp2 = 0.006). No evidence for a change was found for endurance (6-min Run: p = 0.341, ηp2 = 0.001; p = 0.267, ηp2 = 0.001. The rural community maintained physical fitness despite restrictions and limitations through the environmental circumstances. Considering this, it is a positive example of how adequate long-term efforts promoting physical fitness make an impact and an active friendly environment helps to overcome COVID-19 pandemics limiting the structures for being physically active.

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.

Association Between Sense of Coherence and Health Outcomes at 10 and 20 Years Follow-Up: A Population-Based Longitudinal Study in Germany.

Background: The sense of coherence (SOC) is reported to influence health, but health may also have an impact on SOC. The objective of this study was to examine the longitudinal associations between SOC and selected self-reported and physician-assessed health outcomes over a period of 10 and 20 years and to determine the predominant direction of the associations. Methods: We conducted a population-based, longitudinal study, involving 392 participants (188 females and 204 males; mean age 43.01 years) who were followed for a median of 10 and 18 years. Analyses of variance were carried out to examine the longitudinal associations between SOC at baseline and health outcomes (i.e., self-rated health status, SHS; physical health status assessed by a physician, PHS; self-reported satisfaction with life, SWL) at follow-ups. The direction of associations was examined using a cross-lagged model on correlation coefficients. Results: There were significant group effects for SOC at baseline on SHS at 20-year follow-up (F = 4.09, p = 0.018, ηp2 = 0.041), as well as on SWL at 10-year (F = 12.67, p < 0.01, ηp2 = 0.072) and at 20-year follow-up (F = 8.09, p < 0.1, ηp2 = 0.069). SHS (r = 0.238, p < 0.01), PHS (r = -0.140, p < 0.05) and SWL (r = 0.400, p < 0.01) predicted SOC at 10-year follow-up stronger than vice versa. The direction of associations between SOC and health parameters at 20-year follow-up was less consistent. Conclusions: The long-term associations between SOC and self-reported and physician-assessed health may be reciprocal in community-dwelling adults. More research is needed to examine the predictive power of health on SOC and whether interventions targeted at improving health parameters, may impact SOC.

Examination of Construct Validity and Criterion-Related Validity of the German Motor Test in Egyptian Schoolchildren.

Physical fitness is an indicator for children's public health status. Therefore, the aim of this study was to examine the construct validity and the criterion-related validity of the German motor test (GMT) in Egyptian schoolchildren. A cross-sectional study was conducted with a total of 931 children aged 6 to 11 years (age: 9.1 ± 1.7 years) with 484 (52%) males and 447 (48%) females in grades one to five in Assiut city. The children's physical fitness data were collected using GMT. GMT is designed to measure five health-related physical fitness components including speed, strength, coordination, endurance, and flexibility of children aged 6 to 18 years. The anthropometric data were collected based on three indicators: body height, body weight, and BMI. A confirmatory factor analysis was conducted with IBM SPSS AMOS 26.0 using full-information maximum likelihood. The results indicated an adequate fit (χ2 = 112.3, df = 20; p < 0.01; CFI = 0.956; RMSEA = 0.07). The χ2-statistic showed significant results, and the values for CFI and RMSEA showed a good fit. All loadings of the manifest variables on the first-order latent factors as well as loadings of the first-order latent factors on the second-order superordinate factor were significant. The results also showed strong construct validity in the components of conditioning abilities and moderate construct validity in the components of coordinative abilities. GMT proved to be a valid method and could be widely used on large-scale studies for health-related fitness monitoring in the Egyptian population.

Population-based trends in physical fitness of children and adolescents in Germany, 2003-2017.

Physical fitness is an important health resource. From 2003 onwards, the MoMo study, a part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), has investigated physical fitness on the basis of nationally representative data. The objective of this paper was to analyse trends in physical fitness of three cohorts at the ages of 4-17 years. Changes within 10 test items of the MoMo-test profile are reported. The mean values of physical fitness and the relevant influencing factors were directly compared across cohorts (in the total group and in age-and sex-subgroups). Statistical significance of differences was examined by calculating the confidence intervals (95% CI) for complex samples; effect sizes were determined using Cohen's d. The results indicated that physical fitness levels of German children and adolescents initially slightly increased between MoMo baseline (2003-2006) and wave 1 (2009-2012). This could partly be attributed to increased physical activity in sports clubs and in extracurricular sports at school. Then, between MoMo wave 1 and MoMo wave 2 (2014-2017) the physical fitness of children and adolescents in Germany remained the same, as did all influencing factors with the exception of extracurricular sport. From a public health perspective, programmes and measures that can increase the chances for all children and adolescents to strive for greater physical fitness should be of the highest priority.

[Reference Values for Cardiorespiratory Fitness of the General Population: The German National Health Interview and Examination Survey for Adults (DEGS1) 2008-2011]. / Referenzwerte für die kardiorespiratorische Fitness der allgemeinen Bevölkerung: Die Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) 2008­2011.

AIM OF STUDY: This study aims to provide population-based reference values for heart rate-based indicators of cardiorespiratory fitness for adults with physical activity readiness aged 18 to 64 years living in Germany. METHODS: Based on data on 2,826 individuals who participated in a submaximal cycle ergometer exercise test as part of the German National Health Interview and Examination Survey for Adults (DEGS1) between 2008 and 2011, we calculated the following indicators: physical working capacity at 150 and 130 beats/min and at 75% of estimated maximum heart rate (PWC150, PWC130 and PWC75%) as well as heart rate-based estimated maximum oxygen uptake (VO2max). We used the LMS method by Cole & Green 1992 to calculate reference values. RESULTS: 25th, 50th and 75th percentiles of PWC150 were 1.5, 1.77 and 2.08 watts/kg among men and 1.18, 1.44 and 1.69 among women. 25th, 50th and 75th percentiles of PWC130 were 1.16, 1.41 and 1.68 watts/kg among men and 0.81, 1.05 and 1.29 among women. Age-dependent median PWC75% values among men and women were 1.87 - age in years× 0.01 and 1.31 - (age in years/100)2× 0.98, respectively, and VO2max among men is 41.7 - age× 0.15. CONCLUSIONS: The references values presented can be used for individual rating of cardiorespiratory fitness among adults living in Germany. Furthermore, they can serve as a basis for regular monitoring purposes.

Representative Percentile Curves of Physical Fitness From Early Childhood to Early Adulthood: The MoMo Study.

Introduction: Monitoring of physical fitness in youth is important because physical fitness is a summative indicator of health. From a developmental and preventive perspective, physical fitness levels are relatively stable from childhood to early adulthood. Thus, it is important to monitor physical fitness on a population based level being able to intervene at early stages (1). In order to reliably assess and evaluate the physical fitness of youth, a reliable system of standard values based on representative data is required. The aim of this analysis is to report sex- and age-specific physical fitness percentile curves from childhood to early adulthood in a nationwide sample in Germany. Methods: We use data from the nationwide representative Motorik Modul (MoMo) Study in Germany (data collection wave 1: 2009-2012; age: 4-23 years; n = 3,742; 50.1% female). Physical fitness was assessed by means of the MoMo test profile covering four dimensions of physical fitness (strength, endurance, coordination, and flexibility) and including eight physical fitness items. Percentile curves were fitted using the LMS transformation method of Cole and Green. Results: Standardized age- and sex-specific physical fitness percentiles were calculated for eight items: ergometric endurance testing, standing long jump, push-ups, sit-ups, jumping side-ways, balancing backwards, static stand, and stand and reach test. The physical fitness curves differ according to gender and the fitness dimension. Physical fitness improvements with age are linear (e.g., max. strength) or curvilinear (e.g., coordination) and have their stagnation points at different times over the course of adolescence. Discussion: Our results provide for the first time sex- and age-specific physical fitness percentile curves for Germany from 4 to 17 years. Differences in curve-shapes indicating a timed and capacity-specific physical fitness development. Nationwide German physical fitness percentiles can be useful in comparing different populations (e.g., cross-country), reporting secular trends, comparing special groups, and to evaluate physical fitness interventions.

Secular Trends in Physical Fitness of Children and Adolescents: A Review of Large-Scale Epidemiological Studies Published after 2006.

Physical fitness (PF) of children and adolescents is an important resource for their future health. Population-based studies, however, rarely report secular changes of PF, although monitoring of these is crucial to deriving information for adequate interventions. This review aims to report trends in PF of children and adolescents. A literature search was conducted in PubMed in July 2019. Cohort studies published in English allowing statements to be made on trends in PF by comparing youth between the ages of four and 18 years were included. The review identified 24 studies from 16 countries meeting the inclusion criteria, with an overall sample size of more than 860,000 children and adolescents. Through a standardized quality assessment tool, we classified two studies as strong, 21 as moderate, and only one as weak. We analyzed specific secular trends separately for the five different dimensions: endurance, strength, speed, flexibility, and coordination. The majority of studies report a decline of PF over time; however, a few studies report conflicting results. Performance in endurance, strength, and flexibility decreased over time, whereas there was no consistent trend reported for speed and coordination. Overall, there is no international standard on examining and reporting changes or secular trends in PF of children and adolescents, and comparability of studies is limited due to heterogeneous conditions of conducting and analyzing PF tests. Consequently, standardized and consistent international monitoring should be implemented.

[Control group formation using propensity score matching: The role of primary and secondary data - Results of prevention studies]. / Kontrollgruppenbildung durch Propensity-Score-Matching: Die Rolle von Primär- und Sekundärdaten − Ergebnisse aus Präventionsstudien.

BACKGROUND: The creation of control groups in the evaluation of statutory health insurances is a key issue. Randomization represents both an ethical and a legal problem with legally guaranteed services. Matching procedures are relevant alternatives in the construction of control groups. Matchings are mostly based on secondary data from statutory health insurances (for example age, gender, cost of illness, days of incapacity to work). In this study, we examined whether matching based on secondary data alone can cause selection bias. METHODS: We used data from three large prevention studies and applied sensitivity analyses to compare the results of propensity score matchings used to create control groups on the basis of secondary data, with those obtained on the basis of both primary and secondary data. Analysis of covariance was used to investigate the impact of potential selection bias on cost effects. RESULTS: Matchings based on secondary data alone lead to control groups with similar characteristics captured by secondary data. However, the control group participants are significantly healthier (they have, for example, lower levels of pain, lower levels of psychological stress, a higher degree of quality of life) than the patients in intervention groups. This selection bias would lead to a systematic underestimation of the cost reduction produced by preventive interventions. DISCUSSION: Prevention course participants seem to have characteristics that differ from the average population (higher health orientation level, preference for prevention over medical treatment services, etc.) and cannot be captured by secondary data; therefore, matchings based on secondary data alone cause selection bias. CONCLUSIONS: Including both primary and secondary data reduces the risk of selection bias in matching procedures for prevention studies. The E-value can be used to evaluate the robustness of results with regard to selection bias.

How effective and efficient are different exercise patterns in reducing back pain?

BACKGROUND: Exercise is considered an effective intervention to relieve chronic back pain. However, it is still unknown whether specific exercise patterns vary in terms of their efficiency and effectiveness. AIM: To investigate the differential health and economic effects of intensity, specificity and degree of subjective perceived physical exertion across five exercise patterns (endurance, gymnastics, fitness, back gymnastics, multimodal back exercise) in adults with back pain. DESIGN: Longitudinal observational cohort study over a period of 24 months. SETTING: Various non-therapeutic exercise facilities (e.g. outdoor, fitness centers, health insurance programs, sports clubs) across one federal state of Germany (Baden-Wuerttemberg). POPULATION: Adults with back pain (N.=2,542, Mean =46.9 years, 66% females, graded chronic back pain [GCPS] 1=40.5%, GCPS 2=27.3%, GCPS 3=20.7%, GCPS 4=11.5%). METHODS: Self-reported back pain (functional restrictions and pain = back pain function score, [BPFS]) and characteristics of exercising behavior (frequency, duration, type, physical exertion) were assessed at baseline and at 6, 12, 18 and 24 months. Direct medical costs for back disorders (international classification of diseases, dorsopathies: M40-M54) were compiled from health insurance records. RESULTS: Moderate- to high-intensity exercise patterns were effective in reducing back pain, particularly at lower levels of subjective perceived physical exertion. At these intensity levels, multimodal back exercise (i.e. exercising the spine-stabilizing muscles specifically, ergonomic training) was 14.5 times more effective than non-back specific fitness exercise in reducing BPFS. The beneficial effects of both exercise types increased with the initial severity of back pain. However, only multimodal back exercise (moderate- to high-intensity/high back specificity) was associated with a significant decrease in direct medical costs for back pain. CONCLUSIONS: Targeted exercise of the spine-stabilizing musculature at moderate to high intensities without maximum perceived exertion is effective and efficient in reducing back pain. CLINICAL REHABILITATION IMPACT: The combination of high-intensity and high-specificity exercises yielded a significant reduction in medical costs. However, the intensities in terms of muscular load in endurance training and gymnastics may not be sufficient to reduce back pain effectively.

Prevalence of Underweight and Overweight and Its Association with Physical Fitness in Egyptian Schoolchildren.

Underweight and overweight are serious health concerns for many children and could be associated with low physical-fitness levels. This study aimed (i) to evaluate the prevalence of underweight and overweight and (ii) to examine its association with the physical fitness levels in primary male and female schoolchildren. Including 13 government primary-schools, a cross-sectional survey was conducted between 2014 and 2017. Anthropometric characteristics together with the physical-fitness level were measured in 931 schoolchildren aged between 6- and 11-years old. The prevalence of under- and overweight children were 8.49% and 24.06%, respectively. These proportions were not significantly different between males and females and were affected by age (p < 0.001), with a higher prevalence of overweight and a lower prevalence of underweight at 9-11 years, compared to 6-8 years old. Concerning the physical fitness levels, statistical analysis showed a better performance among males compared to females, among participants aged 9-11 years, compared to 6-8 years old, and among underweight and normal-weight, compared to overweight children (p < 0.001). There was a higher prevalence of overweight and lower prevalence of underweight at 9-11 years compared to 6-8 years old. Physical fitness levels were better in (i) males, compared to females, (ii) schoolchildren aged 9-11 years, compared to 6-8 years old, and (iii) underweight and normal-weight, compared to overweight children.

Development of Physical Fitness among the Top 10 Boys and Girls in Sport Schools: A 10-Year Cohort Analysis.

In this study, we aimed to measure the development of physical fitness (PF) of 10 different cohorts in grade 4 and 8 different cohorts in grade 7 at 18 sport schools of North Rhine-Westphalia, Germany. A total of 11,451 subjects (3979 female, 7472 male) aged 8-12 from the past 10 years were assessed using the German Motor Test (DMT) in grade 4. We tested 2614 subjects (1032 girls, 1582 boys) aged 11-15 from the past eight years using the DMT in grade 7. PF talents were defined as the top 10 boys and top 10 girls of each cohort. Linear regression was calculated to assess the development of PF. The PF of all subjects remained stable in grade 4 and declined in grade 7. The PF of the top 10 boys and top 10 girls increased in both grades. The improvements were stronger in grade 7 (female: rates of change (ß) = 0.80; male: ß = 0.76) than in grade 4 (female: ß = 0.36; male: ß = 0.32). Sit-ups and push-ups showed the highest change rates. The increase in PF of the top 10 boys and girls can be interpreted as a success for sport schools. Due to the increasing number of test participants, the likelihood of finding top talent increased. However, the increase in PF in the top talents was only partly explained by an increase in the number of tested individuals.

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel - a qualitative approach.

BACKGROUND: Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials. METHODS: Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations. RESULTS: The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively. CONCLUSIONS: These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.