Intra-observer reproducibility and inter-observer agreement of Fels skeletal age assessments among male tennis players 8-16 years.

BACKGROUND: Skeletal age (SA) is an estimate of biological maturity status that is commonly used in sport-related medical examinations. This study considered intra-observer reproducibility and inter-observer agreement of SA assessments among male tennis players. METHODS: SA was assessed with the Fels method in 97 male tennis players with chronological ages (CA) spanning 8.7-16.8 years. Radiographs were evaluated by two independent trained observers. Based on the difference between SA and CA, players were classified as late, average or early maturing; if a player was skeletally mature, he was noted as such as an SA is not assigned. RESULTS: The magnitude of intra-individual differences between repeated SA assessments were d = 0.008 year (observer A) and d = 0.001 year (observer B); the respective coefficients of variation were 1.11% and 1.75%. Inter-observer mean differences were negligible (t = 1.252, p = 0.210) and the intra-class correlation coefficient was nearly perfect (ICC = 0.995). Concordance of classifications of players by maturity status between observers was 90%. CONCLUSION: Fels SA assessments were highly reproducible and showed an acceptable level of inter-observer agreement between trained examiners. Classifications of players by skeletal maturity status based on assessments of the two observers were highly concordant, though not 100%. The results highlight the importance of experienced observers in skeletal maturity assessments.

Interrelationship between muscle fitness in childhood and bone mineral density in adulthood: mediation analysis of muscle fitness in adulthood.

BACKGROUND: This study was aimed to examine the relationship between muscular fitness indicators in childhood and areal bone mineral density (aBMD) in adulthood and to verify whether the relationship is mediated by performance on muscular fitness indicators in adulthood. METHODS: A sample of 138 healthy adults (69 males; 22.3 years) were followed after a previous assessment at the age of 7-10 years. Stature, body mass and muscular fitness indicators (handgrip strength, standing long jump and sit-ups tests) were assessed in childhood and adulthood. Additionally, total body, upper limbs, lower limbs, right femoral neck and lumbar spine aBMD was assessed in adulthood using dual X-ray absorptiometry. Analysis included descriptive statistics; t-test or Mann-Whitney U-test for comparison between males and females, multiple linear regression for the prediction aBMD from muscular fitness indicators in childhood, mediation analysis of the respective muscular fitness indicators in adulthood and the relationship between muscular fitness indicators in childhood and aBMD. RESULTS: Males were stronger compared to females regarding muscular fitness indicators in childhood and adulthood, and presented higher mean values for aBMD in adulthood, except for lumbar spine (p < 0.05). Regression analysis revealed that some muscular fitness indicators in childhood showed significant positive relationship with bone health indicators in adulthood, such as: handgrip strength and total body aBMD (ß = 0.005; R2 = 0.35; p = 0.040) and upper limbs aBMD (ß = 0.005; R2 = 0.55; p = 0.019); and sit-ups test was a significant predictors of lumbar spine BMD (ß = 0.003; R2 = 0.06; p = 0.039). Mediation analysis pointed out the following: adulthood handgrip strength mediated relationships between childhood handgrip strength and total aBMD (indirect effect (IE) = 0.0025; 95%CI = 0.0005-0.0048), and upper limbs aBMD (IE = 0.0040; 95%CI = 0.0017-0.0069). CONCLUSIONS: Muscular fitness indicators in childhood showed significant relationship with bone health indicators in adulthood and the sit-ups test in childhood had direct effect on lumbar spine aBMD in adulthood. Adulthood handgrip strength mediated the relationship between childhood handgrip strength and total body and upper limb aBMD, pointing out that muscular fitness in childhood may be a aBMD determinant in adulthood, especially when higher muscle fitness performance is maintained in adulthood.

Skeletal age assessed by TW2 using 20-bone, carpal and RUS score systems: Intra-observer and inter-observer agreement among male pubertal soccer players.

The purpose of this study was to determine intra- and inter-observer agreement for the three skeletal ages derived from the TW2 method among male pubertal soccer players. The sample included 142 participants aged 11.0-15.3 years. Films of the left hand-wrist were evaluated twice by each of two observers. Twenty bones were rated and three scoring systems used to determine SA adopting the TW2 version: 20-bone, CARPAL and RUS. Overall agreement rates were 95.1% and 93.8% for, respectively, Observer A and Observer B. Although, agreement rates between observers differed for 13 bones (5 carpals, metacarpal-I, metacarpal-III, metacarpal-V, proximal phalanges-I, III and V, distal phalanx-III), intra-class correlationa were as follows: 0.990 (20-bone), 0.969 (CARPAL), and 0.988 (RUS). For the three SA protocols, BIAS was negligible: 0.02 years (20-bone), 0.04 years (CARPAL), and 0.03 years (RUS). Observer-associated error was not significant for 20-bone SA (TEM = 0.25 years, %CV = 1.86) neither RUS SA (TEM = 0.31 years, %CV = 2.22). Although the mean difference for CARPAL SAs between observers (observer A: 12.48±1.18 years; observer B: 12.29±1.24 years; t = 4.662, p<0.01), the inter-observer disagreement had little impact (TEM: 0.34 years: %CV: 2.78). The concordance between bone-specific developmental stages seemed was somewhat more problematic for the carpals than for the long bones. Finally, when error due to the observer is not greater than one stage and the replicated assignments had equal probability for being lower or higher compared to initial assignments, the effect on SAs was trivial or small.

Waist Circumference and Objectively Measured Sedentary Behavior in Rural School Adolescents.

BACKGROUND: Research on relationships between lifestyle behaviors and adiposity in school youth is potentially important for identifying subgroups at risk. This study evaluates the associations between waist circumference (WC) and objective measures of sedentary behavior (SB) in a sample of rural school adolescents. METHODS: The sample included 254 students (114 boys, 140 girls), 13-16 years of age, from rural regions of the Portuguese midlands. Height, weight, and WC were measured. Cardiorespiratory fitness (CRF) was assessed with the 20-m shuttle-run test. An uniaxial GT1M accelerometer was used to obtain 5 consecutive days of physically activity (PA) and SB. Multiple linear regression was used to test associations between WC and SB, adjusted for several potential confounders (age, sex, PA, CRF, parental education). RESULTS: SB was not significantly associated with the WC, neither in the unadjusted model nor after adjustment for all potential confounders. In the final model, the unique significant predictor of the WC was cardiorespiratory fitness (ß = -0.82; 95% confidence interval [CI], -1.02 to -0.62). CONCLUSION: WC was not independently associated with SB time in rural school adolescents. Future research is claimed among rural adolescents in different geographic contexts to try to clarify recent findings of less studied communities.