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      Simple tests of cardiorespiratory fitness in a pediatric population

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          Abstract

          A progressive, treadmill-based VO 2max is the gold standard of cardiorespiratory fitness determination but is rarely used in pediatric clinics due to time requirements and cost. Simpler and shorter fitness tests such as the Squat Test or Step Test may be feasible and clinically useful alternatives. However, performance comparisons of these tests to treadmill VO 2max tests are lacking. The primary aim of this cross-sectional study was to assess the correlation between Squat and Step Test scores and VO 2max in a pediatric population. As secondary outcomes, we calculated correlations between Rated Perceived Exertion Scale (RPE) scores, NIH PROMIS Physical Activity scores, and BMI z-score with VO 2max, and we also evaluated the ability of each fitness test to discriminate low and high-risk patients based on the FITNESSGram. Forty children aged 10–17 completed these simple cardiorespiratory fitness tests. Statistically significant correlations were observed between VO 2max and the Step Test (r = -0.549) and Squat Test (r = -0.429) scores, as well as participant BMI z-score (r = -0.458). RPE and PROMIS scores were not observed to be correlated with VO 2max. Area Under the Receiver Operator Curve was relatively high for BMI z-scores and the Step Test (AUC = 0.813, 0.713 respectively), and lower for the Squat Test (AUC = 0.610) in discriminating risk according to FITNESSGram Scores. In this sample, the Step Test performed best overall. These tests were safe, feasible, and may add great value in assessing cardiorespiratory fitness in a clinical setting.

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          Most cited references26

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          Physical fitness and all-cause mortality. A prospective study of healthy men and women.

          We studied physical fitness and risk of all-cause and cause-specific mortality in 10,224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110,482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (slope, -4.5). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years (slope, -5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.
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            Recommendations for clinical exercise laboratories: a scientific statement from the american heart association.

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              Physical Fitness and Academic Achievement in Third- and Fifth-Grade Students

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                Author and article information

                Contributors
                Role: Data curationRole: Project administrationRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: MethodologyRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                4 September 2020
                2020
                : 15
                : 9
                : e0238863
                Affiliations
                [1 ] Division of Endocrinology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, United States of America
                [2 ] Division of Research, Department of Orthopedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL, United States of America
                [3 ] Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, United States of America
                [4 ] Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, United States of America
                Universidade Federal de Juiz de Fora, BRAZIL
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-5117-8031
                http://orcid.org/0000-0003-2177-1683
                Article
                PONE-D-20-22110
                10.1371/journal.pone.0238863
                7473550
                32886730
                a0b1bc6c-3761-4834-bcbb-3c9353c81575
                © 2020 Bruggeman et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 July 2020
                : 25 August 2020
                Page count
                Figures: 2, Tables: 3, Pages: 11
                Funding
                This work was supported by a grant from the Children's Miracle Network at the University of Florida.
                Categories
                Research Article
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Medicine and Health Sciences
                Pediatrics
                Medicine and Health Sciences
                Cardiology
                Heart Rate
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Research and Analysis Methods
                Bioassays and Physiological Analysis
                Electrophysiological Techniques
                Cardiac Electrophysiology
                Electrocardiography
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Exercise
                Custom metadata
                The data underlying the results presented in the study are available on GitHub ( www.github.com/bruggemanbr/UF_PediatricCRFTests).

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                Uncategorized

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