Wearables and Internet of Things (IoT) Technologies for Fitness Assessment: A Systematic Review.

Wearable and Internet of Things (IoT) technologies in sports open a new era in athlete's training, not only for performance monitoring and evaluation but also for fitness assessment. These technologies rely on sensor systems that collect, process and transmit relevant data, such as biomarkers and/or other performance indicators that are crucial to evaluate the evolution of the athlete's condition, and therefore potentiate their performance. This work aims to identify and summarize recent studies that have used wearables and IoT technologies and discuss its applicability for fitness assessment. A systematic review of electronic databases (WOS, CCC, DIIDW, KJD, MEDLINE, RSCI, SCIELO, IEEEXplore, PubMed, SPORTDiscus, Cochrane and Web of Science) was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From the 280 studies initially identified, 20 were fully examined in terms of hardware and software and their applicability for fitness assessment. Results have shown that wearable and IoT technologies have been used in sports not only for fitness assessment but also for monitoring the athlete's internal and external workloads, employing physiological status monitoring and activity recognition and tracking techniques. However, the maturity level of such technologies is still low, particularly with the need for the acquisition of more-and more effective-biomarkers regarding the athlete's internal workload, which limits its wider adoption by the sports community.

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

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

This study aimed to analyze the role of MC, cardiorespiratory fitness, and upper body strength in MetS risk factors.The results suggest that upper body strength is the strongest predictor for MetS (negative association), followed by MC (positive association).When the different MC components were entered independently instead of total MC, the upper body strength and locomotor MC were found to be significant predictors of the MetS behavior.Considering our results and the fact that MC levels during childhood positively influence PA levels along lifespan, this study suggests a pathway to follow in future research.

Development of adiposity, obesity and age at menarche: an 8-year follow-up study in Portuguese schoolgirls.

AIM: It has been suggested that the decline in menarcheal age is associated with the increase of obesity prevalence. OBJECTIVE: To examine the association between age at menarche and adiposity development from age 7 to 15 years. SUBJECTS: A cohort of 109 schoolgirls from Viana do Castelo (Northern Portugal). METHODS: Anthropometric measurements (height, weight, and triceps and subscapular skinfold thicknesses) were longitudinally obtained at 7, 8, 9, and 15 years. Waist circumference and self-reported age at menarche were obtained at age 15. Obesity was defined by the cut-off value of 30% body fat. Ages of <12 years, 12-13 years, and >13 years were classified as early menarche (EM), average menarche (AM) and late menarche (LM), respectively. RESULTS: Median menarcheal age was 12.0 years (range, 8-15 years), with 26.6% of girls classified as EM. Compared with their LM peers, EM girls were always fatter (p=0.001) and had higher waist circumference at age 15 (p=0.009). All variables showed significant negative associations with age at menarche, except subscapular to triceps skinfold ratio at all ages and height at age 15. At both ages 9 and 15 years, LM girls had the lowest prevalence of obesity (4.5% and 9.1%, respectively). The 8-year incidence of obesity in EM girls was 24.1%, while that in the AM plus LM group was 13.8% (p=0.005). CONCLUSION: EM seems to be a risk factor for the development of obesity during adolescence. However, this vulnerability may start to be programmed before menarche as girls with precocious menarche were already fatter than their late-maturing peers at age 7 years.

"Profiles of motor competence and its perception accuracy among children: Association with physical fitness and body fat".

The main goals of this study were to identify profiles in school-aged children based on actual Motor Competence (MC) and accuracy of Perceived Motor Competence (PMC) and to examine how children with different profiles differ in terms of Physical Fitness (PF) and Body Fat percentage (BF%). The MC of a total of 287 children (51.6% boys, aged between 6 and 10 years-old) was assessed using the Motor Competence Assessment (MCA) instrument, and the accuracy of the PMC was measured using motor tasks (standing long jump, throwing, kicking, and walking backwards). PF and BF% were assessed using the 20m shuttle run test and TANITA, respectively. Cluster (C) analysis revealed four profiles, two of which were aligned - high MC-accurate PMC (C4) and low-inaccurate (C2), and two that were non-aligned - high-inaccurate (C1) and low-accurate (C3). Children in C4 performed better on PF and had less BF% than children in C3 and C2.

Potential relevance of a motor skill "proficiency barrier" on health-related fitness in youth.

This study investigated the potential impact of a motor skill proficiency barrier on measures of cardiorespiratory (CRF) and musculoskeletal (MSF) fitness in youth. A sample of 241 youth (114 girls) aged 10 - 18 years, completed the Motor Competence Assessment battery with composite scores indexed according to age- and gender-adjusted percentile scores. Motor competence (MC) levels were categorized as low (≤ 25%tile - proficiency barrier), moderate (≥ 26%tile to < 75%tile), and high (≥ 75%tile). CRF levels (Health Risk, Needs Improvement, and Healthy) were assessed using the Fitnessgram® 20 m PACER test. Low (≤ 20%tile), moderate (≥ 21%tile to ≤ 80%tile), and high (≥ 80%tile) MSF levels were assessed using grip strength normative data. Two 3 × 3 chi-square tests were conducted to determine the probability of MC level predicting CRF and MSF levels. Results demonstrated statistically significant models for performance on both the PACER (χ2[4, N = 241] = 22.65, p < .001) and grip strength (χ2[4, N = 241] = 23.95, p < .001). Strong evidence of a proficiency barrier impacting CRF was noted, as no low skilled youth met the "Healthy" fitness zone standards for PACER performance. Evidence supporting a barrier with grip strength was not as strong, as 20.8% of youth exhibiting low MC displayed high grip strength. However, all individuals with high levels of MC demonstrated at least moderate grip strength. Results emphasize the importance of developing MC during childhood as it may provide a protective effect against unhealthy CRF and MSF across youth.HighlightsThese data support the notion of Seefeldt's (1980) proficiency barrier as it relates to CRF, as no youth demonstrating low MC met the healthy fitness zone criteria for PACER performance. The development of MC may both directly and indirectly provide a protective effect against unhealthy CRF levels across childhood and adolescence.Evidence supporting a proficiency barrier with MSF as measured by grip strength was not as strong; however, all individuals with high levels of MC demonstrated at least moderate grip strength. Thus, the development of MC may be a protective factor to mitigate low levels of MSF via enhanced neuromuscular function.Promoting the development of MC in a variety of developmentally appropriate activities and settings (e.g. MC skills practice, structured and unstructured play, and performance contexts) is important to promote positive trajectories of CRF and MSF across childhood and adolescence.

Correction to: Effects of COVID-19 Confinement on the Household Routines of Children in Portugal.

[This corrects the article DOI: 10.1007/s10826-021-01961-z.].

Motor Competence Assessment (MCA) Scoring Method.

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

The Developmental Trajectory of Motor Competence of Children That Lived the COVID-19 Confinement Period: A Four-Year Follow-Up Study in Portuguese Children.

Children's motor competence (MC) was negatively affected by the COVID-19 pandemic; however, possible chronic effects have not been studied. Therefore, the aim of this study was to examine the possible impact of the forced lack of physical activity (PA) during the COVID-19 lockdown on children's MC two years later. The motor competence of sixty-seven healthy children (7.4−12.2 years old) was assessed using the Motor Competence Assessment (MCA). All participants completed the MCA tests at two different moments (before and after the COVID-19 lockdown), four years apart. The mean values after the COVID-19 lockdown for all participants on the subscales and on the Total MCA are lower, but no significant changes were found when controlling for gender and age (p > 0.05 in all analyses). However, a significant decrease was found in the Locomotor subscale in boys (p = 0.003). After dividing the participants into three age groups, the youngest also suffered a decrease in the Locomotor subscale (p < 0.001) and their Total MCA (p = 0.04). In addition, those participants who had a higher MC at baseline decreased their scores for the Locomotor (p < 0.001) and Manipulative (p < 0.001) subscales, and for the Total MCA (p < 0.001). In conclusion, the younger children and the more motor proficient did not fully recover from the negative effects of the pandemic lockdown after two years.

Do children's previous physical activity habits influence their behaviors during the Covid-19 social distancing period?

OBJECTIVE: Verify whether the practice of physical activity, before the social distancing imposed by COVID-19, influences children's routines during this period, in children of different ages. METHODS: Descriptive cross-sectional study carried out with an online questionnaire from LimeSurvey and disseminated for four months during social distancing. The questionnaire contained questions about family composition, household characteristics, household and children's routines, including habits such as sleeping, physical activity, intellectual activity, playing with and without physical activity, and screen time. The final sample consisted of 916 participating families that answered about the physical activity habits of their respective children before the pandemic. Children were divided into three age groups (three to five years, six to nine years, and ten to twelve years). Independent Student's t-tests were performed to investigate whether the previous practice of scheduled physical activity group and the no physical activity group differed as to the time dedicated to children's activities and routines (intellectual activity, sleeping, screen time, playing with and without physical activity), by age groups, during social distancing. RESULTS: There was a decrease in the levels of physical activity undertaken by Brazilian children during social distancing. There was no difference when both groups. The children with previous practice of scheduled physical activity did not display different habits from the children who did not adopt this practice. CONCLUSIONS: The practice of physical activity before social distancing did not influence the level of physical activity and other habits during social distancing. Healthy habits should be encouraged and targeted for all children during the pandemic. These findings can contribute to the formulation of public policies for children during pandemic times.

Changes in adiposity status from childhood to adolescence: a 6-year longitudinal study in Portuguese boys and girls.

BACKGROUND: Cross-sectional data show high prevalence of overweight in Portuguese children, but there are few longitudinal studies describing the patterns of obesity development in the young. AIM: To examine the trajectories of obesity from late childhood to adolescence. SUBJECTS AND METHODS: Triceps and subscapular skinfold thickness measurements were carried out in 288 children at age 9 (baseline) and later at age 15 (follow-up). Percentage body fat (%BF) was estimated according to Slaughter equations and the health-related definition of obesity ( ≥ 25%BF in boys and ≥ 30%BF in girls) was used. RESULTS: In boys, the prevalence of obesity decreased from 21.9% to 14.8% (p < 0.05) while in girls it increased from 14.3% to 19.5%. The incidence of obesity in the 6-year study period was 2.6% and 8.3% for boys and girls, respectively (p < 0.05). In comparison with girls, the percentage of boys that reversed obesity was more than 3-fold higher (3% vs 9.7%, p < 0.05). Obesity tracked moderately in both sexes (Kappa = 0.6, p < 0.001). CONCLUSION: The results indicate a marked sex difference in the incidence and reversal of obesity from late childhood to adolescence that is unfavourable to girls. Consideration of this difference might be important when designing programmes for the prevention and treatment of obesity focusing on this period.

Relationship between the Affordances for Motor Behavior of Schoolchildren (AMBS) and Motor Competence Assessment (MCA) in Brazilian Children.

During growth, children are influenced by an extensive network, in which more favorable contexts provide better affordance landscapes, and consequently have a better potential to foster child development. We aimed to examine the affordances provided to children using the Affordances for Motor Behavior of Schoolchildren (AMBS) tool, estimating its association with children's motor competence, as assessed by the Motor Competence Assessment (MCA) battery. Seventy-two Brazilian children were evaluated using the MCA instrument. Their parents/guardians completed the AMBS. The correlations between the two instruments (sub-scales and total scores) were investigated. ANOVAs were used to compare the motor competence performance of children with Low, Average, and High AMBS scores. Positive associations were found between AMBS and MCA, although weak to moderate in nature. In addition, children whose environments were richer in motor affordances (higher AMBS scores) showed significantly higher levels on the MCA. This study provides evidence that AMBS is a valid tool for assessing motor affordances for schoolchildren, and that those affordances are related to children's motor competence.

Effects of COVID-19 Confinement on the Household Routines Of Children in Portugal.

The severe acute respiratory syndrome coronavirus 2 disease (COVID-19) was first identified in December 2019 in Wuhan, China, and was declared a pandemic by the World Health Organization on 11 March, 2020. Since then, physical distancing measures such as confinement have been adopted by different governments to control human to human transmission. This study aimed to determine how confinement affects children's routines, more specifically their physical activity (PA) and sedentary time. An online survey was launched to assess how Portuguese children under 13 years of age adjusted their daily routines to confinement. Parents reported the time each child was engaged in different activities throughout the day, which was used to calculate overall sedentary time and overall physical activity time. Based on the data of 2159 children, our study showed that during confinement: (i) there was a decrease in children's physical activity time and an increase in screen time and family activities; (ii) boys engaged in more playful screen Time than girls (p < 0.05), and girls played more without PA than boys (p < 0.05); (iii) along the age groups, there was a trend for an increase of the overall sedentary time and an associated decrease of the overall physical activity time. In summary, PA of confined children showed low levels and a clear decreasing trend along childhood. Conjoint family and societal strategies to target specific age groups should be organized in the future.

Learning to Cycle: Are Physical Activity and Birth Order Related to the Age of Learning How to Ride a Bicycle?

The present article aimed to verify whether the age at which children learn to ride a bicycle is related to their physical activity or birth order. Data were collected from an online structured survey between November 2019 and June 2020. A total of 8614 responses were obtained from 22 countries. The results reveal significant differences in learning age depending on the frequency of physical activity (F(5, 7235) = 35.12, p < 0.001, ηp2 = 0.24). People who engaged in physical activity less than twice a month learned to cycle later (M = 7.5 ± 5.3 years) than people who engaged in physical activity on a daily basis (M = 5.7 ± 2.2 years) (p < 0.001). There were also significant differences in learning age according to birth order (F(2, 3008) = 7.31, p = 0.00, ηp2 = 0.005). Only children had the highest learning age (M = 5.5 ± 2.4 years), whereas those who were born last had the lowest, (M = 5.1 ± 1.9 years) (p = 0.013). Creating opportunities for children to be engaged in play and physical activity and social modulation through their older siblings seem to be key conditions to encourage children to learn how to ride a bicycle from a young age and to foster their motor development.

Motor Competence in Children With and Without Ambliopia.

The purpose of this study was to assess the motor competence of children with and without amblyopia. Study participants were 165 primary school children, aged 6-9 years, divided into three groups based on their visual acuity with the Snellen chart: (a) non-amblyopia, (b) corrected amblyopia, and (c) non-corrected amblyopia. We assessed the children's motor competence with the Motor Competence Assessment battery (MCA) and their physical activity with the Physical Activity Questionnaire for Older Children (PAQ-C). The non-amblyopia group presented significantly better motor competence on the MCA than either the corrected amblyopia group or the non-corrected amblyopia group; there were no statistically significant motor differences between the two amblyopia subgroups. Amblyopia versus non-amblyopia differences on the MCA were mainly in stability and locomotor components, involving dynamic balance and the change of spatial position and direction of movement, but not in the manipulative component (ball throwing velocity and ball kicking velocity). Predictably, from within an integrated visual motor perspective of child development, our findings suggest that intact vision played an important role in children's motor competence. The development of fundamental motor skills, especially of stability and locomotor skills, may be affected by poor visual processing in that participants with uncorrected amblyopia showed poor movement accuracy, uncoordinated movement, and impaired balance.

Effects of the COVID-19 Lockdown on Portuguese Children's Motor Competence.

During long periods without school, children are more susceptible to unhealthy behaviors, such as an increase in sedentary behaviors, which has a negative impact on children's motor competence (MC). The COVID-19 lockdown offered us a unique opportunity to test, in a quasi-experimental setting, the impact of lockdown movement restrictions on children's MC. We assessed the motor competence of 114 children aged 6-9 years using the motor competence assessment. All children were tested before and after the COVID-19 lockdown. Chi-square and 2 × 2 ANOVA (sex by moment) were used to further analyze the data. Regardless of sex, motor performances in all tests (except for jumping sideways in boys) were lower when compared with performances before lockdown. There was a marked decreasing trend in children's levels of MC, shifting from an upper to a lower quartile in different tests. The results after the lockdown were always significantly inferior to the results before lockdown in all motor tests (except jumping sideways), in the three components of MC, and in global MC. Children's global MC score decreased by an average of 13 points in boys and 16 points in girls. The imposed movement restrictions had a negative effect on children's motor competence development.

The Long-Term Benefits of a Multicomponent Physical Activity Program to Body Composition, Muscle Strength, Cardiorespiratory Capacity, and Bone Mineral Density in a Group of Nonagenarians.

Promotion of physical activity among older adults is considered to be one of the main actions that can result in more successful aging. Currently, there are few studies focusing on the effects of long-duration physical activity interventions in older adults. This study examined the effects of an 8-month multicomponent intervention on cardiorespiratory capacity (6-minute walking test), body composition (body-mass index), muscle strength (handgrip and knee extension), and bone mineral density (femoral neck) in a group of nonagenarians. A secondary aim was to determine the impact of the program according to the participant's way of life (institutionalized vs. community dwelling). A total of 14 institutionalized nonagenarians (years: 93.1 ± 1.6; female: 100%) and 16 community-dwelling nonagenarians (years: 93.1 ± 1.6; female: 75%) participated in this study. Our analysis suggested that the multicomponent program significantly improved the levels of strength in handgrip and leg extension in all participants. Intergroup analysis showed that the changes experienced were greater in community-dwelling people. Improvements in the cardiorespiratory capacity of older adults-more distance walked in 6 minutes-who were living in the nursing home (mean distance traveled: 238.5 ± 96.0 vs. 250.7 ± 99.0 m) were observed. Our findings found that an 8-month, multicomponent intervention program results in significant improvements in the levels of strength (handgrip and knee extension) in nonagenarians. This effect is greater in community-dwelling people.

INFLUENCES OF FAMILY AND HOUSEHOLD CHARACTERISTICS ON CHILDREN'S LEVEL OF PHYSICAL ACTIVITY DURING SOCIAL DISTANCING DUE TO COVID-19 IN BRAZIL.

OBJECTIVE: To evaluate if the variables child's sex, age, presence of siblings, parents working remotely, and external space affect the level of physical activity (PA) of Brazilian children during social distancing imposed by the COVID-19 pandemic. METHODS: An online questionnaire was applied by the LimeSurvey software from March to April 2020. Children were divided into four age groups, and the questionnaire comprised questions on family and household characteristics, domestic and children's routines in the period of Brazilian social distancing. Based on the answers concerning children's activities, the following variable was created: percentage of physical activity (%PA) in one-day period. Analysis of variance and regression analysis were performed to investigate the effect of demographic and parental activities on %PA. RESULTS: The %PA decreases with increasing age, but increases with the availability of external space at home. No significant or interaction effects were observed for other variables. Age and external space at home are predictors of %PA. CONCLUSIONS: Household and personal characteristics of Brazilian children influence the level of physical activity performed by them during social distancing. Preventive measures can be adopted in the face of another similar period.

COVID-19 SOCIAL ISOLATION IN BRAZIL: EFFECTS ON THE PHYSICAL ACTIVITY ROUTINE OF FAMILIES WITH CHILDREN.

OBJECTIVE: To identify how Brazilian families with children aged under 13 years face the period of social isolation resulting from the COVID-19 pandemic, especially regarding the time spent on physical activity (PA), intellectual activity, games, outdoor activities and screen. METHODS: An anonymous online survey was launched on March 24, 2020 in Brazil to assess how families with children aged up to 12 years are adjusting their daily routines to this situation. In the survey, each family reported the daily time each child spent in sedentary activity (sum of intellectual activities, play time on screen, playing without PA) and PA (sum of playing with PA and PA). RESULTS: The main findings based on data from 816 children indicate that most parents consider there was a reduction in the time that children spend practicing PA; increase in screen play time and family activities, differences between sex were found regarding screen play time (boys>girls) and in playing without PA (girls>boys), and there was an age effect for all categories analyzed, with a tendency to increase the total time of sedentary lifestyle and complementary reducing the time of PA over age. CONCLUSIONS: The household routines of families during the period of social isolation resulting from the COVID-19 pandemic confirm the general reduction tendency in PA time during childhood.

Association between motor competence and Functional Movement Screen scores.

BACKGROUND: Motor competence (MC) is generally used to describe a person's proficiency in a variety of motor skills and is the basis for one's performance in sports and recreational activities. Functional Movement Screen (FMSTM) is one of the most used screening systems to provide interpretable measure of movement quality. Both FMSTM and MC constructs share three components: locomotor, manipulative and stabilizing movements. In the present study, it was hypothesized that MC scores can explain FMSTM variables. It was also predicted that better MC leads to better functional movement patterns in young adults. METHODS: A sample of 92 young adults (73.9% men) with a mean age of 21.2 years participated in this study. All participants were evaluated on anthropometric measurements, dual x-ray absorptiometry; FMSTM and MC. RESULTS: Men showed better MC scores and fat mass composition than women. Regarding specific tests, women scored higher in the FMSTMactive straight leg raise test, whereas men performed better in the FMSTM trunk stability push-up (TSP) test. Manipulative tasks and construct presents' significant and positive associations with FMSTM composite score (r ≥ 0.303). The significant negative correlation were more related to FMSTM TSP and MC shuttle run and FMSTM in-line lunge and MC manipulative. The FMSTM TSP presents significant associations with all MC constructs and tasks. Meanwhile, the FMSTM composite score is associated with all components of MC Stability (p < 0.05). In young adults, and independent of gender, the FMSTMexplains fundamental movements based on motor control according to the stability construct. Moreover, the FMSTM TSP is associated with better performance in the all MC constructs and MC tasks. The FMSTM, on its own, is linked to objective MC stability measures.

Association Between Somatotype Profile and Health-Related Physical Fitness in Special Police Unit.

OBJECTIVES: To characterize somatotype profile and analyze the association between somatotype components, physical, and physiological variables in special police unit (SPU) officers. METHODS: One hundred eight male SPU officers, aged 42.5 ±â€Š4.1 years. Somatotype profile, predicted maximal oxygen consumption (VO2max), and physical performance tests were evaluated. RESULTS: The mean somatotypes were 4.04-6.38-1.22. All values clustered amongst the endo-mesomorphism (86%) while mesomorphy was the dominant component (98%). The mean of predicted VO2max was 50.3 ±â€Š5.2 mL kg min. The body mass index (BMI) is more than or equal to 30 was associated to a lowest predicted VO2max (r = 0.613). The VO2max negatively correlated with mesomorphy (r = -0.251). Mesomorphy somatotype was positively associated with maximal and explosive strength tests. CONCLUSION: Our findings indicated that somatotype profile can be used as an accurate method to assess body physique and shape in SPU officers and an ecto-mesomorphism profile was associated to superior performance in physical and physiological measures.