Fraser Brooklyn J, Rollo Scott, Sampson Margaret, Magnussen Costan G, Lang Justin J, Tremblay Mark S, Tomkinson Grant R
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
Sports Med. 2021 Dec;51(12):2629-2646. doi: 10.1007/s40279-021-01524-8. Epub 2021 Aug 2.
Musculoskeletal fitness is an excellent functional measure that is significantly related to health among youth.
Our objective was to identify health-related criterion-referenced cut-points for musculoskeletal fitness (MSF) among youth.
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 MSF among youth were eligible provided they included (1) youth aged 5-17 years from the general population, (2) at least one quantitative assessment of MSF (e.g., muscular strength), (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 MSF. A narrative synthesis was used to describe the results of included studies.
Collectively, 13 studies that developed health-related criterion-referenced cut-points for MSF among 14,476 youth from 15 countries were included. Muscular strength demonstrated high discriminatory ability [median area under the curve (AUC) ≥ 0.71] for cardiometabolic risk/metabolic syndrome, sarcopenic obesity risk and bone health, and moderate discriminatory ability (median AUC 0.64-0.70) for asthma. Muscular power also demonstrated high discriminatory ability for bone health but only moderate discriminatory ability for cardiometabolic risk/metabolic syndrome and low discriminatory ability (median AUC 0.56-0.63) for cognition/academic performance. Both muscular endurance and flexibility demonstrated low discriminatory ability for musculoskeletal pain. Health-related cut-points for MSF that demonstrated significant discriminatory ability were generally higher for boys than for girls (for muscular strength and power) and generally increased with age for muscular strength and power but remained stable for flexibility.
Data remain insufficient to establish universal health-related cut-points for MSF among youth. Despite variations in the health-related discriminatory ability of different MSF tests, handgrip strength and standing broad jump emerged as the two tests with the highest discriminatory ability. More research, using standardized testing protocols and health-risk definitions, is required to better triangulate universal health-related cut-points for MSF among youth.
CRD42020207458.
肌肉骨骼健康状况是一项出色的功能指标，与青少年的健康状况密切相关。
我们的目的是确定青少年肌肉骨骼健康状况（MSF）的健康相关标准参照切点。
2020年9月对两个电子数据库（MEDLINE和SPORTDiscus）进行了系统检索。只有为青少年MSF制定健康相关标准参照切点的同行评审研究才有资格入选，条件包括：（1）来自普通人群的5至17岁青少年；（2）至少一项MSF的定量评估（如肌肉力量）；（3）至少一项健康状况的定量评估（如心血管代谢风险）；（4）健康标准；（5）对MSF至少一个健康相关切点的定量分析[如受试者操作特征（ROC）曲线]。采用叙述性综合分析来描述纳入研究的结果。
总共纳入了13项研究，这些研究为来自15个国家的14476名青少年制定了MSF的健康相关标准参照切点。肌肉力量对心血管代谢风险/代谢综合征、肌少症肥胖风险和骨骼健康表现出较高的辨别能力[曲线下面积（AUC）中位数≥0.71]，对哮喘表现出中等辨别能力（AUC中位数为0.64 - 0.70）。肌肉功率对骨骼健康也表现出较高辨别能力，但对心血管代谢风险/代谢综合征仅表现出中等辨别能力，对认知/学业成绩表现出较低辨别能力（AUC中位数为0.56 - 0.63）。肌肉耐力和柔韧性对肌肉骨骼疼痛均表现出较低辨别能力。MSF的健康相关切点在男孩中通常高于女孩（肌肉力量和功率方面），并且肌肉力量和功率的切点通常随年龄增加，而柔韧性的切点保持稳定。
目前的数据仍不足以确定青少年MSF的通用健康相关切点。尽管不同MSF测试在健康相关辨别能力上存在差异，但握力和立定跳远是辨别能力最高的两项测试。需要更多使用标准化测试方案和健康风险定义的研究，以更好地确定青少年MSF的通用健康相关切点。
PROSPERO注册号：CRD42020207458。
