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.

Changes in physical fitness of Hungarian college students in the last fifteen years.

This study compared the physical fitness of Hungarian undergraduate students in 2011-2012 with the representative sample surveyed in 1997-1998. A total of 123 males and 309 females (mean age 21.19 ± 2.19 yrs) were randomly selected in two Hungarian universities (Pécs, Kaposvár). Anthropometric data (height, weight, skinfolds, body fat percentages) were measured and the subjects performed 9 tests of the Eurofit Fitness Test Battery. The BMI, total body fat and performance in most of the fitness components (balance, agility/speed, flexibility, abdominal muscular strength, aerobic fitness of females) was higher in 1997-1998 (p<0.05) whereas the handgrip strength and performance in Bent Arm Hanging test were significantly better in 2011-2012 (p<0.001). These findings support interventions focusing on increasing regular physical activity among Hungarian youth.

The Prevalence of Educational Neuromyths among Hungarian Pre-Service Teachers.

Teachers with poor neuroliteracy fail to distinguish scientific evidence from neuromyths (NM), which might lead to the implementation of pseudoscientific educational methods. The prevalence of NM and general knowledge about the brain (GKAB) among in-service and pre-service teachers has been assessed in multiple countries, but no such study has been performed in Hungary. The aims of this study were to (1) assess the neuroliteracy of pre-service teachers, (2) compare the results with those of previous studies and (3) analyze the factors influencing neuroliteracy. Our sample included 822 pre-service teachers from 12 Hungarian universities. We developed a survey including 10 NM and 13 GKAB statements, adapted from a widely used questionnaire. The average rate of incorrect answers to NM was 56.9%, whereas the average rate of correct answers to GKAB was 70.9%. Male gender and frequency of using Facebook as the primary information source about neuroscience were the only predictors of NM acceptance. In comparison with other studies, the Hungarian pre-service teachers had the second highest endorsement of NM. The most prevalent NM were linked to motor functions, which might be related to the widespread use and promotion of motor therapies in Hungary.

Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents: A Twin-Panel Delphi Study.

BACKGROUND: The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. OBJECTIVE: This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. METHODS: Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. RESULTS: There was strong between-panel agreement (panel 1: rs = 0.76, p < 0.01; panel 2: rs = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures". CONCLUSIONS: The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.

Comparison of blood and saliva lactate level after maximum intensity exercise.

Several studies have described high correlation of salivary and blood lactate level during exercise. Measuring the effectiveness and intensity of training, lactate concentration in blood, and lately in saliva are used.The aim of our study was to evaluate the correlation between the concentration and timing of salivary and blood lactate level in endurance athletes and non-athletes after a maximal treadmill test, and to identify physiological and biochemical factors affecting these lactate levels.Sixteen volunteers (8 athletes and 8 non-athletes) performed maximal intensity (Astrand) treadmill test. Anthropometric characteristics, body composition and physiological parameters (heart rate, RR-variability) were measured in both studied groups. Blood and whole saliva samples were collected before and 1, 4, 8, 12, 15, 20 min after the exercise test. Lactate level changes were monitored in the two groups and two lactate peaks were registered at different timeperiods in athletes. We found significant correlation between several measured parameters (salivary lactate - total body water, salivary lactate - RR-variability, maximal salivary lactate - maximal heart rate during exercise, salivary- and blood lactate -1 min after exercise test). Stronger correlation was noted between salivary lactate and blood lactate in athletes, than in controls.

Bone characteristics and physical fitness in children and adolescents with visual impairment.

BACKGROUND: Lower habitual physical activity in adolescents with visual impairment (VI) have detrimental effect on their general health such as bone quality and physical fitness. The aim of this study was to demonstrate the bone quality in children with VI and to analyze the correlations of their bone characteristics with anthropometric and physical fitness tests. METHODS: The participants (N.=38) were adolescents (14.85±2.79 yrs) with low vision (N.=18) or blindness (N.=20). Dual-energy X-ray absorptiometry (DEXA) was used to measure bone mineral density (BMD), bone mineral content (BMC) of the total body and L1-L4 of the lumbar spinal region. After anthropometry physical fitness was examined by laboratory test (V̇O2peak) and field tests (strength and running). RESULTS: Height, weight, Body Mass Index (BMI), V̇O2peak were similar in the two groups. Blind boys showed significant higher handgrip strength. Estimated V̇O2peak (from 20-m shuttle running test) was significantly lower in blind children (43.84±4.42 mL/kg/min) than in children with low vision (35.08±5.23 mL/kg/min; P<0.001). BMD and BMC did not differ in subgroups, Z-score of total body BMD was significantly lower in blind children. Means of Z-score in L1-L4 lumbal spinal region were negative values and similar in blind and low vision adolescents' subgroups. A linear regression model in the collective group revealed significant associations of BMD (r2=0.538; P=0.0001) and BMC (r2=0.698; P=0.048) with BMI and handgrip strength test. CONCLUSIONS: Adolescents with VI have generally decreased bone health and physical fitness level. BMI and handgrip strength are predictors of total body BMD and BMC; suggesting that these measures may be adequate to estimate bone health.

Physical activity, screen time and the COVID-19 school closures in Europe - An observational study in 10 countries.

To date, few data on how the COVID-19 pandemic and restrictions affected children's physical activity in Europe have been published. This study examined the prevalence and correlates of physical activity and screen time from a large sample of European children during the COVID-19 pandemic to inform strategies and provide adequate mitigation measures. An online survey was conducted using convenience sampling from 15 May to 22 June, 2020. Parents were eligible if they resided in one of the survey countries and their children aged 6-18 years. 8395 children were included (median age [IQR], 13 [10-15] years; 47% boys; 57.6% urban residents; 15.5% in self-isolation). Approximately two-thirds followed structured routines (66.4% [95%CI, 65.4-67.4]), and more than half were active during online P.E. (56.6% [95%CI, 55.5-57.6]). 19.0% (95%CI, 18.2-19.9) met the WHO Global physical activity recommendation. Total screen time in excess of 2 h/day was highly prevalent (weekdays: 69.5% [95%CI, 68.5-70.5]; weekend: 63.8% [95%CI, 62.7-64.8]). Playing outdoors more than 2 h/day, following a daily routine and being active in online P.E. increased the odds of healthy levels of physical activity and screen time, particularly in mildly affected countries. In severely affected countries, online P.E. contributed most to meet screen time recommendation, whereas outdoor play was most important for adequate physical activity. Promoting safe and responsible outdoor activities, safeguarding P.E. lessons during distance learning and setting pre-planned, consistent daily routines are important in helping children maintain healthy active lifestyle in pandemic situation. These factors should be prioritised by policymakers, schools and parents. HighlightsTo our knowledge, our data provide the first multi-national estimates on physical activity and total screen time in European children roughly two months after COVID-19 was declared a global pandemic.Only 1 in 5 children met the WHO Global physical activity recommendations.Under pandemic conditions, parents should set pre-planned, consistent daily routines and integrate at least 2-hours outdoor activities into the daily schedule, preferable on each day. Schools should make P.E. lessons a priority. Decision makers should mandate online P.E. be delivered by schools during distance learning. Closing outdoor facilities for PA should be considered only as the last resort during lockdowns.

Establishing Normative Reference Values for Standing Broad Jump Among Hungarian Youth.

PURPOSE: The purpose of this study was to examine age and sex trends in anaerobic power assessed by a standing broad jump and to determine norm-referenced values for youth in Hungary. METHOD: A sample of 2,427 Hungarian youth (1,360 boys and 1,067 girls) completed the standing broad jump twice, and the highest distance score was recorded. Quantile regression was used to fit standing broad jump trends across linear and quadratic functions of age. Statistical significance was determined with bootstrap confidence intervals and the Wald test with p < .05. Age-by-sex specific centiles were generated and the 50th percentile was used to describe the overall patterns. RESULTS: Standing broad jump scores increased steadily in boys from age 11 through 18 years with a discrete plateau at the end of adolescence. Girls' standing broad jump scores of those who performed above the median increased with age and plateaued later in the adolescence. Both linear and quadratic age terms were statistically significant predictors of standing broad jump trends across age (p < .05), but the relations varied depending on the percentile. The 50th percentile values resulted in 147.0 cm, 162.0 cm, 175.0 cm, 186.0 cm, 195.0 cm, 202.0 cm, 207.0 cm, and 210.0 cm for boys aged 11 to 18 years old, respectively, and 140.0 cm, 143.9 cm, 147.3 cm, 150.0 cm, 152.1 cm, 153.7 cm, 154.6 cm, and 155.0 cm for girls aged 11 to 18 years old, respectively. CONCLUSIONS: This study provides normative reference charts that take into account age and sex differences in standing broad jump performance. The proposed reference values can be used to interpret standing broad jump scores in Hungarian youth.

Agreement and Diagnostic Performance of FITNESSGRAM®, International Obesity Task Force, and Hungarian National BMI Standards.

PURPOSE: This study examined agreement between all 3 standards (as well as relative diagnostic associations with metabolic syndrome) using a representative sample of youth from the Hungarian National Youth Fitness Study. METHOD: Body mass index (BMI) was assessed in a field sample of 2,352 adolescents (ages 10-18.5 years) and metabolic syndrome status was assessed in a laboratory subsample of 373 youth. All youth were categorized into weight status groups based on the FITNESSGRAM®, International Obesity Task Force (IOTF), and Hungarian growth standards. Classification agreement was compared between all pairs of standards via cross-tabulation. Logistic regression was used to estimate the odds of metabolic syndrome by weight status. RESULTS: The 3 BMI standards agreed on ≥  88% of cases, with better agreement on girls' standards than boys' standards. Kappa values ranged from .65 to .89. Using the Hungarian standards over the Fitnessgram or IOTF standards resulted in 5% to 10% more youth being classified as normal weight. The overweight/obesity groups were 4 times to 6 times more likely to have metabolic syndrome than those classified as normal weight regardless of the classification standards. These odds ratios increased to 8 times to 17 times when comparing the normal-weight/overweight groups to the obesity category. Odds ratios for boys tended to be slightly larger than those for girls. CONCLUSIONS: All 3 standards provide similar information about weight status and metabolic syndrome classification. To more easily facilitate international comparisons, it may be of greater benefit to use the IOTF standards, which also had better agreement with the U.S. Fitnessgram thresholds.

Establishing Normative Reference Values for Handgrip Among Hungarian Youth.

PURPOSE: The purpose of this study was to examine age- and sex-related variation in handgrip strength and to determine reference values for the Hungarian population. METHOD: A sample of 1,086 Hungary youth (aged 11-18 years old; 654 boys and 432 girls) completed a handgrip strength assessment using a handheld dynamometer. Quantile regression was used to compute separate models for boys and girls and included a linear, cubic, and quadratic term for age to account for nonlinear patterns. These terms were tested for statistical significance using the Wald statistical test with p < .05. Age- and sex-specific centiles were generated and the 50th percentile was used to describe the overall patterns in handgrip strength. RESULTS: The linear, cubic, and quadratic terms for age fitted the data well for boys (p < .05), while both linear and quadratic terms for age were statistically significant for girls (p < .05). The 50th percentile values resulted in 21.4 kg, 21.7 kg, 25.0 kg, 30.0 kg, 35.4 kg, 40.0 kg, 42.6 kg, and 42.0 kg for boys aged 11 to 18 years old, respectively. The same percentile resulted in 20.0 kg, 19.5 kg, 19.6 kg, 20.3 kg, 21.6 kg, 23.5 kg, 26.1 kg, and 29.2 kg for girls aged 11 to 18 years old, respectively. CONCLUSIONS: Muscle strength as determined by handgrip has distinct age-related patterns in boys and girls. We have accounted for biological age differences and developed norm-referenced values that can be used to interpret handgrip assessment scores obtained from school-aged children in Hungary.

Cross-Validation of a PACER Prediction Equation for Assessing Aerobic Capacity in Hungarian Youth.

PURPOSE: The purpose of this article was to evaluate the validity of the Progressive Aerobic Cardiovascular and Endurance Run (PACER) test in a sample of Hungarian youth. METHOD: Approximately 500 participants (aged 10-18 years old) were randomly selected across Hungary to complete both laboratory (maximal treadmill protocol) and field assessments (PACER) of aerobic capacity. Agreement between lab- and PACER-derived peak oxygen consumption (VO2) was examined using linear regression and 2-sided equivalence testing techniques, respectively. The impact of agreement on the classification accuracy of peak VO2 estimates into FITNESSGRAM® fitness zones was determined with kappa statistics. RESULTS: The final sample resulted in a total of 167 boys and 143 girls (N = 310). Analyses revealed that lab and PACER VO2 shared 13% to 18% of their variance (R(2)boys = .13, R(2)girls = .18) and that limits of agreement ranged from - 39.9 mL/kg/min to +37.6 mL/kg/min depending on the sex. The absolute error values were 14% for boys and 16% for girls; however, the average peak VO2 estimates from the PACER were within the 10% equivalence region for girls (37.2 mL/kg/min to 45.4 mL/kg/min), but not for boys (45.2 mL/kg/min to 55.2 mL/kg/min). When lab and PACER VO2 were categorized according to Fitnessgram zones, agreement was fair for both sexes (boys, Kappa = .25, and girls, Kappa = .31). CONCLUSIONS: Although the correlations between measured and predicted peak VO2 were lower than expected, the magnitude of error observed in the PACER is similar to past ranges of error observed in other studies (10%-15%), but the large individual error should be considered when interpreting individual results from this field-based measure of aerobic capacity. There was reasonable classification agreement between lab estimates and the PACER test for classification into the various fitness standards.

Associations Between Attitudes Toward Physical Education and Aerobic Capacity in Hungarian High School Students.

PURPOSE: The purpose of this study was to create a physical education (PE) attitude scale and examine how it is associated with aerobic capacity (AC). METHOD: Participants (n = 961, aged 15-20 years) were randomly selected from 26 Hungarian high schools. AC was estimated from performance on the Progressive Aerobic Cardiovascular and Endurance Run test, and the attitude scale had 31 items measured on a Likert scale that ranged from 1 to 5. Principal component analysis was used to examine the structure of the questionnaire while several 2-way analyses of variance and multiple linear regression (MLR) were computed to examine trends in AC and test the association between component scores obtained from the attitude scale and AC, respectively. RESULTS: Five components were identified: health orientation in PE (C1), avoid failure in PE (C2), success orientation in PE (C3), attitude toward physical activity (C4), and cooperation and social experience in PE (C5). There was a statistically significant main effect for sex on C3 (p < .05), C4 (p < .001), and C5 (p < .05) indicating that boys' scores were higher than girls. The Sex × Age interaction was also statistically significant (p < .05) and follow-up comparisons revealed sex differences in C5 for 15-year-old participants. Girls showed statistically significant higher values than boys in C5 at the age of 16 years. MLR results revealed that component scores were significantly associated with AC (p < .05). Statistically significant predictors included C1, C2, C3, and C4 for boys and C2 and C4 for girls. CONCLUSION: The 5-component scale seems to be suitable for measuring students' attitudes toward PE. The design of the study does not allow for direct associations between attitudes and AC but suggests that these 2 might be related.