NCBI Bookshelf. Fitness Measures and Health Outcomes in Youth. Fitness testing for youth emerged from the field of physical education, which has a long-standing history of fitness testing. Over the years, social and political circumstances have dictated the emphasis, progress, and use of fitness testing in the United States. In particular, an early emphasis on performance outcomes—particularly military performance—has given way to a focus on health outcomes as a result of concerns about the health of the nation's youth.

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Not a MyNAP member yet? Register for a free account to start saving and receiving special member only perks. F itness testing for youth emerged from the field of physical education, which has a long-standing history of fitness testing. Over the years, social and political circumstances have dictated the emphasis, progress, and use of fitness testing in the United States.

While the components of fitness have remained virtually the same, moreover, the tests and protocols used to measure it have evolved as more data have accumulated on their validity and reliability and their relationship to desired outcomes.

Although efforts have been ongoing to standardize and validate the constructs for fitness testing, the range of fitness test batteries currently in use, as detailed in this chapter, reveals that consensus on these issues remains elusive. The research needs identified in Chapter 10 therefore include a comprehensive reevaluation of the past and current approaches to fitness testing in youth. This chapter begins with a brief early history of physical fitness testing.

It then describes more recent historical events related specifically to measuring physical fitness among U. Although organized youth fitness testing did not begin until the mid—20th century, the foundation of national youth fitness testing began to be established a century earlier. Park notes that early leaders in physical education, many of whom were medical doctors and YMCA leaders, focused the outcomes of instruction on anthropometric measurements.

During the last half of the 19th century, national physical education organizations emerged e. Fitness testing evolved from a focus on athletic performance to a focus on health in the early s as researchers such as McCurdy and McKenzie studied blood pressure fatigue McCurdy, ; McKenzie, , and Storey studied pulse rate Storey, One prominent test, the Playground Association of America Athletic Badge Test, was introduced for boys in and girls in During and immediately after World War I, the focus on physical education and physical training in schools increased, with a shift toward fitness for war.

Many physical educators led physical training programs for the military during the war era. The theme that many Americans were unfit was popular in the media. After World War I, the Public Health Service and many different organizations focused attention on fitness tests and programs because of their potential link to preparedness for war.

During the early s, there was considerable debate about the importance. Various test batteries were developed, including the Physical Fitness Index PFI , developed by Rogers several strength items Rogers, , and a test of athletic power developed by McCloy general motor ability and strength McCloy, , Both Rogers and McCloy conducted research that provided a basis for the items selected for their tests.

Other tests of the era were often developed by groups of professionals based on group consensus. The interest in general physical fitness testing in schools that was common after World War I diminished, while interest in laboratory-based measures of fitness grew. As was the case prior to, during, and immediately after World War I, World War II produced much military, governmental, and societal interest in fitness programs and fitness testing.

While there was much fanfare and many proposals for action were made, most efforts with youth relied on volunteer leaders and local funding. A supplement to the Research Quarterly focused on physical fitness and fitness testing Carpenter, ; Cureton and Larson, ; Larson, ; McCloy, Park indicates that the U.

In addition, at the request of the U. Fitness manuals were prepared for college students as well, and the armed services developed fitness programs of their own during the war. Also during the war, many conferences and committees focused on youth fitness. Park , p. Health was a concern, but so were general fitness and fitness for war. The physical fitness focus that was prominent during World War II gave way to a more generalized emphasis for youth during the postwar years.

The popularity of college and professional sports led physical education programs to focus on athletic capabilities. The Korean War in the early. Their reports indicated that children in the United States passed fewer fitness test items than children from European countries. For their research, Kraus and Hirschland used the Kraus-Weber test, a battery of six items testing minimum muscular fitness and flexibility originally developed as a measure of potential for back pain.

Consequently, Kraus was granted an audience with then President Eisenhower to discuss the study results. Many different organizations, including the newly created American College of Sports Medicine and the American Medical Association, urged action. The test included the items shown in Table Also included, however, were items more related to physical education objectives and skill-related fitness, such as the softball throw and the yard dash, reflecting in part societal concerns at the time regarding the athletic capabilities and military preparedness of youth Morrow et al.

The test items were administered in a national survey conducted by the University of Michigan led by Paul Hunsicker , with funding from the U. As was the case with other testing in schools at the time e. During the late s and early s, the fitness movement continued. This booklet was intended to emphasize the importance of having an active lifestyle and its role in establishing fitness and health. Changes in the test items used for the survey included the addition of a flexed arm hang test to replace the modified pull-up for girls see Table This change was made primarily to produce more reliable test scores.

As noted in Table , the softball throw was deleted, the sit-up was modified, and distance runs longer than yards were included as options.

The softball throw was deleted because it was considered to be a skill rather than a fitness-related item. The modification of sit-up testing was based on the idea that the bent-knee approach was less stressful on the back than the straight-leg approach. Finally, research indicating greater validity for longer runs and their association with aerobic capacity led to the inclusion of longer runs as optional items Morrow et al.

During the s and s, evidence linking fitness and physical activity to good health accumulated. Correspondingly, interest grew in the development of youth fitness test batteries focused primarily on health-related physical fitness.

The Texas Physical Fitness Motor Ability Test Coleman and Jackson, included health-based test items, and evidence was included to support the test items selected.

The Youth Fitness Test included an awards program. Table lists these and other key events related to national youth fitness testing during to Test items targeting cardiorespiratory fitness, musculoskeletal fitness, and body composition were included in the battery as fitness components related to health.

During this period, several national surveys were completed. The revised battery is described later in this chapter. Of note are the removal of the yard dash and the long jump and the addition of a V-sit test of flexibility. Two additional youth fitness surveys were conducted in the mids. Department of Health and Human Services McGinnis, , focused on measuring the fitness of secondary school youth using health-related fitness test items developed specifically for the study.

Before the task force could produce a document, however, the PCPFS initiated its fitness testing and awards program in , based primarily on the version of the Youth Fitness Test and existing award schemes. A comprehensive discussion of the events leading to the development of these test batteries is provided in Plowman et al.

Issues that led these groups to devise different tests included the use of health versus motor fitness items, the use of health criteria versus normative standards, the inclusion of a body composition item, and the inclusion of award schemes.

Despite the above efforts to develop a unified battery of fitness tests and the implementation of new tests, no new large-scale national fitness surveys have been conducted since the s. Fitnessgram uses health-based criterion references.

Key events in youth fitness testing since are listed in Table In , the PCPFS introduced a new health-related fitness program using criterion-referenced health standards as opposed to normative standards, but it was subsequently discontinued.

Over the years, the test battery has evolved to include mostly items considered to be health related with the exception of the shuttle run. During the s, calls for a public health basis for youth fitness testing received much attention Sallis and McKenzie, ; Simons-Morton et al.

Papers were published questioning the use of youth fitness tests and award schemes Corbin et al. Some research led to a call for the end of youth fitness testing as a result of findings implying the adverse effects of testing in academic settings and its ineffectiveness in promoting physical activity Cale et al. NOTE: The year shown indicates when the test was first implemented.

Others, however, recognizing the potential of youth fitness to promote lifelong physical activity, emphasized the importance of continuing research aimed at improving the reliability and validity of pertinent test batteries and identifying strategies for preventing the misuse of such testing Corbin, ; Corbin et al.

Also emphasized was the role of professional and governmental agencies in developing fitness testing policies, including guidelines and standards for appropriate implementation and interpretation of results. In light of the lack of a national youth fitness survey since the s, several calls have been made for an updated survey. Several large-scale statewide surveys of youth physical fitness have been carried out Morrow et al. Other large administrative units e. Some of these testing efforts have been on a routine basis, while others have not.

For example, Texas has implemented mandatory health-related physical fitness testing for youth in grades 3 to 12 since ; California has been monitoring the fitness status of students in grades 5, 7, and 9; and New York City tests , students in grades K annually Morrow and Ede, Levels of funding to support such efforts have varied considerably.

In addition, the potential of fitness measures to reflect or predict health status has led to the inclusion of these measures in national health surveys such as the National Health and Nutrition Examination Survey NHANES , which includes components pertinent to physical fitness, such as body composition, cardiovascular fitness, and physical activity Morrow et al.

Including fitness-related items in NHANES enables not only the longitudinal monitoring of fitness components but also the identification of associations between fitness status and health indices Ortega et al. For example, epidemiological analyses with these data revealed the association of low cardiorespiratory endurance status with increased prevalence of the risk factors for cardiovascular disease in adolescents and adults Carnethon et al.

These data can also be used to establish cut-points cutoff scores for fitness tests, which are essential for interpreting test results and communicating them to individuals and families, as well as establishing individual performance goals related to health improvements. Reflecting the initial impetus for developing fitness tests, all active duty U. Recognizing the association of physical fitness with health and readiness for military tasks, the Department of Defense has mandated annual assessment of fitness components for service members DoD, and also has implemented remedial programs for those who fail to meet the cut-points for physical fitness or readiness tests.

The effectiveness of routine fitness tests for establishing a minimum level of fitness in military personnel has been widely acknowledged IOM, Components assessed by these tests which vary among the services include cardiorespiratory endurance; muscular strength and endurance; whole-body flexibility; and parameters indicating balance, agility, and explosive power.

When implemented in schools, fitness testing also can serve the purpose of assessing and improving physical literacy among youth Tremblay and Lloyd, Regular physical activity is widely considered part of a healthy lifestyle given its beneficial effects on various health outcomes and fitness levels Bouchard and Shephard, ; Pate et al.

Of note are the reciprocal effects of physical activity, fitness, and health. Based on this relationship and considering fitness as a primary outcome of physical activity, fitness testing is regarded as an effective means of monitoring the status of physical activity in population-based studies, as well as promoting lifelong physical activity, which may eventually lead to improved health status Corbin, ; Tremblay and Lloyd, Indeed, the rationale for programs described in this chapter is based on the influence of the dispositions and habits established during childhood on physical activity, fitness, and health status in adulthood Malina, ; Morrow and Ede, ; Simons-Morton et al.

At the same time, it is important to acknowledge the potential adverse effects of inappropriate uses of fitness testing Ernst et al. The implementation of fitness measures for educational purposes is discussed in detail in Chapter 9. A variety of tests have been designed to test physical fitness in youth in the United States and other countries by both governmental and nongovernmental organizations. Table lists selected batteries of tests currently in use in the United States and other countries.


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