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  • Title: Health-Related Criterion-Referenced Cut-Points for Cardiorespiratory Fitness Among Youth: A Systematic Review.
    Author: Rollo S, Fraser BJ, Seguin N, Sampson M, Lang JJ, Tomkinson GR, Tremblay MS.
    Journal: Sports Med; 2022 Jan; 52(1):101-122. PubMed ID: 34468952.
    Abstract:
    BACKGROUND: Cardiorespiratory fitness (CRF), which reflects the overall aerobic capacity of the cardiovascular, respiratory, and muscular systems, is significantly related to health among youth. OBJECTIVE: The aim of this systematic review was to identify health-related criterion-referenced cut-points for CRF among youth aged 5-17 years. METHODS: A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was conducted in September 2020. Only peer-reviewed studies that developed health-related criterion-referenced cut-points for CRF among youth were eligible provided they included (1) youth aged 5-17 years from the general population; (2) at least one quantitative assessment of CRF (e.g., peak oxygen uptake [[Formula: see text]O2peak]); (3) at least one quantitative assessment of health (e.g., cardiometabolic risk); (4) a criterion for health; and (5) a quantitative analysis (e.g., receiver operating characteristic [ROC] curve) of at least one health-related cut-point for CRF. A narrative synthesis was used to describe the results of the included studies. RESULTS: Collectively, 29 included studies developed health-related criterion-referenced cut-points for CRF among 193,311 youth from 23 countries. CRF cut-points, expressed as [Formula: see text]O2peak, estimated using the 20-m shuttle run test, demonstrated high discriminatory ability (median area under the curve [AUC] ≥ 0.71) for both cardiometabolic and obesity risk. Cut-points derived from maximal cycle-ergometer tests demonstrated moderate discriminatory ability (median AUC 0.64-0.70) for cardiometabolic risk, and low discriminatory ability for early subclinical atherosclerosis (median AUC 0.56-0.63). Cut-points for CRF using submaximal treadmill exercise testing demonstrated high discriminatory ability for cardiometabolic risk, but only moderate discriminatory ability for obesity risk. CRF cut-points estimated using submaximal step testing demonstrated high discriminatory ability for cardiometabolic risk and moderate discriminatory ability for high blood pressure, while those for the 9-min walk/run test demonstrated moderate-to-high discriminatory ability for obesity risk. Collectively, CRF cut-points, expressed as [Formula: see text]O2peak, demonstrated moderate-to-high discriminatory ability (median AUC ≥ 0.64) for cardiometabolic risk, obesity risk, and high blood pressure. CONCLUSIONS: Currently, there is too wide a range of health-related criterion-referenced cut-points for CRF among youth to suggest universal age- and sex-specific thresholds. To further inform the development of universal cut-points, there is a need for additional research, using standardized testing protocols and health-risk definitions, that examines health-related criterion-referenced cut-points for CRF that are age, sex, and culturally diverse. CLINICAL TRIALS REGISTRATION: PROSPERO registration number: CRD42020207458.
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