Abstract
FITNESSGRAM® is the most widely used criterion-referenced tool to assess/report on student health-related fitness across the US. Potential weight-related biases with the two most common tests of musculoskeletal fitness–the trunk extension and Back-Saver Sit-and-Reach (sit-and-reach)—have been hypothesized, though have not been studied. To determine the association between musculoskeletal fitness test performance and weight status, we use data from 571,133 New York City public school 4th-12th grade students (85% non-White; 75% qualified for free or reduced-price meals) with valid/complete 2017–18 FITNESSGRAM® data. Adjusted logistic mixed effects models with a random effect for school examined the association between weight status and whether a student was in the Healthy Fitness Zone (HFZ; met sex- and age-specific criterion-referenced standards) for the trunk extension and sit-and-reach. Compared to students with normal weight, the odds of being in the HFZ for trunk extension were lower for students with underweight (OR = 0.77; 95% CI: 0.741, 0.795) and higher for students with overweight (OR = 1.10; 95% CI: 1.081, 1.122) and obesity (OR = 1.11; 95% CI: 1.090, 1.13). The odds of being in the HFZ for sit-and-reach were lower for students with underweight OR = 0.85; 95% CI: 0.826, 0.878), overweight (OR = 0.83; 95% CI: 0.819, 0.844) and obesity (OR = 0.65; 95% CI: 0.641, 0.661). Students with overweight and obesity perform better on the trunk extension, yet worse on the sit-and-reach, compared to students with normal weight. Teachers, administrators, and researchers should be aware of the relationship of BMI with student performance in these assessments.
Highlights
Adequate physical fitness in childhood and youth is critical for optimal present-day health, but is an important predictor of future health outcomes [1, 2]
Compared to students with complete data, students with missing/non-valid data were more likely to be male (53% male with missing/non-valid vs. 51% male with complete data); less likely to be Asian/Pacific Islander (12% vs. 19%) or white (12% vs. 16%); more likely to be Non-Hispanic Black (30% vs. 23%) or Hispanic (44% vs. 40%); more likely to qualify for free or reduced-price meals (FRPM) (77% vs. 75%); more likely to have an Individualized Education Program (IEP) (25% vs. 18%); more likely to be foreign-born (25% vs. 20%); and less likely to speak English at home (43% vs. 46%; p-values for all tests
Examining data from nearly 570,000 New York City Department of Education (NYCDOE) 4th-12th grade students (85% non-white and 75% of whom qualify for FRPM), we found statistically significant associations between both trunk extension and sit-and-reach scores and weight status
Summary
Adequate physical fitness in childhood and youth is critical for optimal present-day health, but is an important predictor of future health outcomes [1, 2]. The FITNESSGRAM’s1 tests of aerobic capacity, musculoskeletal fitness (including muscle strength, muscular endurance, and flexibility), and body composition are used to measure health-related physical fitness and weight status. The results of these assessments are utilized to promote lifelong fitness and physical activity in more than 22 million school-aged US children and youth across all 50 states [3]. There’s a paucity of evidence on the commonly used trunk extension and Back-Saver Sit-and-Reach (sit-and-reach) tests
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