Fitness that fits: evaluating the effectiveness of an individualized, choice-based, matching tool for older adults

Background/Objective: A positive relationship exists between exercise and improved overall health; this is especially important for older adults since they have been identified as the most sedentary segment of the North American population. Communities may provide structured exercise classes for this population, but choosing a class that is appropriate for an individual’s fitness level can be a daunting task. The use of an individualized, choice-based, matching tool for older adults could allow individuals to select exercise classes that are appropriate for their fitness level. Thus, members of Lakehead University research team developed the Fitness That Fits (FTF) tool. Through the FTF tool development 28 exercise classes were evaluated and assigned an FTF level, which represents four different intensity levels. This tool is designed to match older adults with exercise classes based on the results of a functional fitness assessment, the Senior Fitness Test (SFT). With SFT results, participants receive an FTF level similar to the exercise class FTF level. Participants are then able to choose an appropriate class that may pertain to their interest. The purpose of this study was twofold. First, the purpose was to evaluate the effectiveness of the FTF tool in assessing whether a participant FTF level matched the level assigned to his/her respective exercise class. Second, the purpose of this study was also to gain a better understand of the underlying causes of any mismatches. Method: One male and 59 female participants (55+ years old) were recruited from a representative sample of 18 exercise classes that were previously assessed through the FTF tool development. Participants completed the SFT, and results were analyzed to determine if the participant FTF level matched the FTF level of their self-selected exercise class. Participants also completed a survey to explore whether they believed their exercise class FTF level was appropriately assigned, potential factors for participant FTF level and class FTF level mismatch, and participants’ views on the future applicability of the Fitness that Fits tool. Results: Thirty percent of participants FTF level matched their self-selected exercise class FTF level. Three factors were identified to explain possible mismatched participants: the participant selected a class that was not appropriate to his/her fitness level, the class fitness level may not have been assigned appropriately, or the functional fitness assessment did not assign participants an accurate fitness level. Conclusion: In total, 30% of participants matched their self-selected exercise class FTF level. This study was a preliminary descriptive project that was the first of its kind to use a SFT to determine a composite functional fitness score. It was also the first to assign exercise class intensity levels based on functional fitness. The majority of participants indicated that the Fitness that Fits tool may be especially useful to help beginners to select a suitable exercise class, highlighting an area for future research

Temporal trends in the handgrip strength of 2,592,714 adults from 14 countries between 1960 and 2017: A systematic analysis

Background: Handgrip strength (HGS) is an excellent marker of functional capability and health in adults, although little is known about temporal trends in adult HGS. Objectives: The aim of this study was to systematically analyze national (country-level) temporal trends in adult HGS, and to examine relationships between national trends in adult HGS and national trends in health-related and socioeconomic/demographic indicators. Methods: Data were obtained from a systematic search of studies reporting temporal trends in HGS for adults (aged ≥20 years) and by examining national fitness datasets. Trends in mean HGS were estimated at the country-sex-age group level by best-fitting sample-weighted linear/polynomial regression models, with national and sub-regional (pooled data across geographically similar countries) trends estimated by a post-stratified population-weighting procedure. Pearson’s correlations quantified relationships between national trends in adult HGS and national trends in health-related and socioeconomic/demographic indicators. Results: Data from 10 studies/datasets were extracted to estimate trends in mean HGS for 2,592,714 adults from 12 high- and 2 upper-middle-income countries (from Asia, Europe and North America) between 1960 and 2017. National trends were few, mixed and generally negligible pre-2000, whereas most countries (75% or 9/12) experienced negligible-to-small declines ranging from an effect size of 0.05 to 0.27, or 0.6 to 6.3%, per decade post-2000. Sex- and age-related temporal differences were negligible. National trends in adult HGS were not significantly related to national trends in health and socioeconomic/demographic indicators. Conclusions: While trends in adult HGS are currently limited to 14 high- and upper-middle-income countries from 3 continents, adult HGS appears to have declined since 2000 (at least among most of the countries in this analysis), which is suggestive of corresponding declines in functional capability and health. PROSPERO registration number: CRD42013003678. KEY POINTS National (country-level) trends in adult handgrip strength (HGS) were few, mixed and generally negligible pre-2000, and generally negligible and indicated declines post-2000 Sex- and age-related temporal differences in adult HGS were negligible-to-small at the country level and negligible at the regional level National trends in adult HGS were not significantly related to national trends in health and socioeconomic/demographic indicator

International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results

Objectives To describe and compare 20 m shuttle run test (20mSRT) performance among children and youth across 50 countries; to explore broad socioeconomic indicators that correlate with 20mSRT performance in children and youth across countries and to evaluate the utility of the 20mSRT as an international population health indicator for children and youth. Methods A systematic review was undertaken to identify papers that explicitly reported descriptive 20mSRT (with 1-min stages) data on apparently healthy 9–17 year-olds. Descriptive data were standardised to running speed (km/h) at the last completed stage. Country-specific 20mSRT performance indices were calculated as population-weighted mean z-scores relative to all children of the same age and sex from all countries. Countries were categorised into developed and developing groups based on the Human Development Index, and a correlational analysis was performed to describe the association between country-specific performance indices and broad socioeconomic indicators using Spearman\u27s rank correlation coefficient. Results Performance indices were calculated for 50 countries using collated data on 1 142 026 children and youth aged 9–17 years. The best performing countries were from Africa and Central-Northern Europe. Countries from South America were consistently among the worst performing countries. Country-specific income inequality (Gini index) was a strong negative correlate of the performance index across all 50 countries. Conclusions The pattern of variability in the performance index broadly supports the theory of a physical activity transition and income inequality as the strongest structural determinant of health in children and youth. This simple and cost-effective assessment would be a powerful tool for international population health surveillance

Review of criterion-referenced standards for cardiorespiratory fitness: what percentage of 1 142 026 international children and youth are apparently healthy?

Purpose To identify criterion-referenced standards for cardiorespiratory fitness (CRF); to estimate the percentage of children and youth that met each standard; and to discuss strategies to help improve the utility of criterion-referenced standards for population health research. Methods A search of four databases was undertaken to identify papers that reported criterion-referenced CRF standards for children and youth generated using the receiver operating characteristic curve technique. A pseudo-dataset representing the 20-m shuttle run test performance of 1 142 026 children and youth aged 9–17 years from 50 countries was generated using Monte Carlo simulation. Pseudo-data were used to estimate the international percentage of children and youth that met published criterion-referenced standards for CRF. Results Ten studies reported criterion-referenced standards for healthy CRF in children and youth. The mean percentage (±95% CI) of children and youth that met the standards varied substantially across age groups from 36%±13% to 95%±4% among girls, and from 51%±7% to 96%±16% among boys. There was an age gradient across all criterion-referenced standards where younger children were more likely to meet the standards compared with older children, regardless of sex. Within age groups, mean percentages were more precise (smaller CI) for younger girls and older boys. Conclusion There are several CRF criterion-referenced standards for children and youth producing widely varying results. This study encourages using the interim international criterion-referenced standards of 35 and 42 mL/kg/min for girls and boys, respectively, to identify children and youth at risk of poor health—raising a clinical red flag

The 20-m shuttle run: Assessment and interpretation of data in relation to youth aerobic fitness and health

Cardiorespiratory fitness (CRF) is a good summative measure of the body’s ability to perform continuous, rhythmic, dynamic, large-muscle group physical activity, and exercise. In children, CRF is meaningfully associated with health, independent of physical activity levels, and it is an important determinant of sports and athletic performance. Although gas-analyzed peak oxygen uptake is the criterion physiological measure of children’s CRF, it is not practical for population-based testing. Field testing offers a simple, cheap, practical alternative to gas analysis. The 20-m shuttle run test (20mSRT)—a progressive aerobic exercise test involving continuous running between 2 lines 20 m apart in time to audio signals—is probably the most widely used field test of CRF. This review aims to clarify the international utility of the 20mSRT by synthesizing the evidence describing measurement variability, validity, reliability, feasibility, and the interpretation of results, as well as to provide future directions for international surveillance. The authors show that the 20mSRT is an acceptable, feasible, and scalable measure of CRF and functional/exercise capacity, and that it has moderate criterion validity and high to very high reliability. The assessment is pragmatic, easily interpreted, and results are transferable to meaningful and understandable situations. The authors recommend that CRF, assessed by the 20mSRT, be considered as an international population health surveillance measure to provide additional insight into pediatric population health

Systematic review of the relationship between 20m shuttle run performance and health indicators among children and youth

Objective This systematic review aimed to summarize research that assessed the associations between 20 m shuttle run test (20mSRT) performance and indicators of physiological, psychosocial and cognitive health among school-aged children and youth. Design Systematic review. Methods Five online databases were used to identify peer-reviewed studies published from 1980 to 2016. Studies were included if they matched these criteria: population (children and youth with a mean age of 5–17 years and/or in Grades 1–12), intervention/exposure (performance on the 20mSRT), and outcomes (health indicators: adiposity, cardiometabolic biomarkers, cognition, mental health, psychosocial health, self-esteem and physical self-perception, quality of life and wellbeing, bone health, musculoskeletal fitness, motor skill development, and injuries and/or harm). Narrative syntheses were applied to describe the results. A lack of homogeneity precluded a meta-analysis approach. Results Overall, 142 studies that determined an association between 20mSRT performance and a health indicator were identified, representing 319,311 children and youth from 32 countries. 20mSRT performance was favourably associated with indicators of adiposity, and some indicators of cardiometabolic, cognitive, and psychosocial health in boys and girls. Fewer studies examined the relationship between 20mSRT performance and measures of quality of life/wellbeing, mental health and motor skill development, and associations were generally inconsistent. The quality of the evidence ranged from very low to moderate across health indicators. Conclusion and Implications These findings support the use of the 20mSRT as a holistic indicator of population health in children and youth

Generic scaling relation in the scalar ϕ4\phi^{4} model

The results of analysis of the one--loop spectrum of anomalous dimensions of composite operators in the scalar $\phi^{4}$ model are presented. We give the rigorous constructive proof of the hypothesis on the hierarchical structure of the spectrum of anomalous dimensions -- the naive sum of any two anomalous dimensions generates a limit point in the spectrum. Arguments in favor of the nonperturbative character of this result and the possible ways of a generalization to other field theories are briefly discussed.Comment: 15 pages, Latex, 50 K

Cardiorespiratory fitness in children: Evidence for criterion-referenced cut-points

Introduction Criterion-referenced cut-points for field-based cardiorespiratory fitness for children (CRF) are lacking. This study determined: (a) the association between CRF and obesity, (b) the optimal cut-points for low CRF associated with obesity in children, and (c) the association between obesity and peak oxygen uptake () estimated from the 20-m shuttle run test using two different prediction equations. Methods A total of 8,740 children aged 10.1±1.2 were recruited from 11 sites across Canada. CRF was assessed using 20mSRT reported as running speed at the last completed stage, number of completed laps and predicted , which was estimated at the age by sex level using the Léger et al. and FitnessGram equations. Body mass index and waist circumference z-scores were used to identify obesity. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of CRF for predicting obesity. Results 20mSRT had satisfactory predictive ability to detect obesity estimated by BMI, WC, and BMI and WC combined (area under the curve [AUC]\u3e0.65). The FitnessGram equation (AUC\u3e0.71) presented somewhat higher discriminatory power for obesity than the equation of Léger et al. (AUC\u3e0.67) at most ages. Sensitivity was strong (\u3e70%) for all age- and sex-specific cut-points, with optimal cut-points in 8- to 12-year-olds for obesity identified as 39 mL•kg-1•min-1(laps: 15; speed: 9.0 km/h) and 41 mL•kg-1•min-1 (laps: 15–17; speed: 9.0 km/h) for girls and boys, respectively. Conclusions 20mSRT performance is negatively associated with obesity and CRF cut-points from ROC analyses have good discriminatory power for obesity

Criterion-referenced mCAFT cut-points to identify metabolically healthy cardiorespiratory fitness among adults aged 18–69 years: An analysis of the Canadian Health Measures Survey

Objective: This study aimed to develop and validate health-related criterion-referenced cutpoints for the modified Canadian Aerobic Fitness Test (mCAFT), a field-based measure to predict cardiorespiratory fitness (CRF) among adults (18–69 years). Methods: Criterionreferenced mCAFT cut-points were developed using nationally representative data from cycles 1 (2007–09) and 2 (2009–11) of the Canadian Health Measures Survey (CHMS). Receiver operating characteristic curves were used to identify age- and sex-specific cut-points for measured waist circumference, blood pressure, and high-density lipoprotein. Cut-points were validated against metabolic syndrome using a fasted sub-sample (n=1,093) from cycle 5 (2016– 17). Results: 4,967 participants (50% women) were retained for the main analyses. The mCAFT cut-points ranged from 28 to 43 mL•kg–1•min–1 (AUC: 0.60-0.87) among men, and 23 to 37 mL•kg–1•min–1 (AUC: 0.61-0.86) among women. The likelihood of meeting the new mCAFT cut-points decreased with an increase in the presence of metabolic risk factors. In total, 54% (95%CI: 42 to 67%) of Canadian adults met the new mCAFT cut-points in 2016–17. Conclusion: This study developed and validated the first health-related criterion-referenced mCAFT cutpoints for metabolic health among Canadian adults aged 18–69 years. These mCAFT cut-points may be useful in health surveillance, clinical, and public health settings. Novelty bullets We developed and validated new criterion-referenced cut-points for the modified Canadian Aerobic Fitness Test to help identify adults at potential risk of poor metabolic health. These new cut-points could help support national health surveillance efforts