Association of aerobic capacity and muscular strength with health-related quality of life in adolescents: A school-based cross-sectional study
DOI:
https://doi.org/10.47197/retos.v64.110467Keywords:
Adolescent health, Cardiorespiratory fitness, HRQoL, Physical fitness , Psychological well-beingAbstract
Background: The independent associations of aerobic capacity and muscular strength on health-related quality of life (HRQoL), when mutually adjusted, remain understudied, particularly in adolescents. Aim: To examine the association between aerobic capacity, muscle strength, and HRQoL in adolescents. Methods: A cross-sectional design was employed, including 202 Brazilian adolescents. Aerobic capacity was assessed using the PACER test and categorized into “healthy zone”, “needs improvement”, and “at risk”. Muscle strength was evaluated through field tests, including the 90º push-up, and categorized as “healthy zone” or “needs improvement”. HRQoL was measured using the validated KIDSCREEN-27 questionnaire. A generalized gamma regression model was used to estimate coefficients (β) and 95% confidence intervals for HRQoL domains, adjusting mutually for aerobic capacity and muscle strength as predictors. Results: In the physical domain, adolescents with aerobic capacity in the healthy zone (β=11.2; p<0.001) and needs improvement category (β=8.8; p=0.007) scored higher than those in the at-risk zone. Similarly, those with muscle strength in the healthy zone scored higher than in the needs improvement category (β=6.6; p=0.012). In the psychological domain, adolescents with aerobic capacity in the healthy zone (β=8.1; p=0.002) and needs improvement (β=5.9; p=0.027) also had higher scores than those at risk, as did those with healthy muscle strength compared to needs improvement (β=4.5; p=0.043). No significant associations were found in other domains (p>0.05). Conclusion: Adequate levels of aerobic capacity and muscle strength are positively associated with HRQoL, particularly in the physical and psychological well-being domains among adolescents.
References
Barahona-Fuentes, G., Huerta Ojeda, Á., & Chirosa-Ríos, L. (2021). Effects of Training with Different Modes of Strength Intervention on Psychosocial Disorders in Adolescents: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 18(18), 9477. https://doi.org/10.3390/ijerph18189477
Bermejo-Cantarero, A., Álvarez-Bueno, C., Martínez-Vizcaino, V., Redondo-Tébar, A., Pozuelo-Carrascosa, D. P., & Sánchez-López, M. (2021). Relationship between both cardiorespiratory and muscular fitness and health-related quality of life in children and adolescents: a systematic review and meta-analysis of observational studies. Health and Quality of Life Outcomes, 19(1), 127. https://doi.org/10.1186/s12955-021-01766-0
Best, O., & Ban, S. (2021). Adolescence: physical changes and neurological development. British Journal of Nursing, 30(5), 272–275. https://doi.org/10.12968/bjon.2021.30.5.272
Biddle, S. J. H., Ciaccioni, S., Thomas, G., & Vergeer, I. (2019). Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality. Psychology of Sport and Exercise, 42, 146–155. https://doi.org/10.1016/j.psychsport.2018.08.011
Brasil Costa, R. L., Rodrigues dos Santos, J. P., Saraiva Gomes-Júnior, J. D., Da Silva Barbosa, S. L., De Souza Bezerra, E., De Souza Bezerra, H., Maciel da Silva, F. T., Formiga da Cruz, K., De O. Tavares, V. D., Almeida Ramos, I., Lucena Pereira Cabral, L., & Vieira Browne, R. A. (2024). Joint associations of sports participation and smartphone screen time with anxiety among school adolescents. Retos, 61, 294–301. https://doi.org/10.47197/retos.v61.108784
da Costa, B., da Costa, R. M., de Mello, G. T., Bandeira, A. S., Chaput, J.-P., & Silva, K. S. (2023). Independent and joint associations of cardiorespiratory fitness and weight status with health-related quality of life among Brazilian adolescents. Quality of Life Research, 32(7), 2089–2098. https://doi.org/10.1007/s11136-023-03379-0
Evaristo, S., Moreira, C., Lopes, L., Oliveira, A., Abreu, S., Agostinis-Sobrinho, C., Oliveira-Santos, J., Póvoas, S., Santos, R., & Mota, J. (2019). Muscular fitness and cardiorespiratory fitness are associated with health-related quality of life: Results from labmed physical activity study. Journal of Exercise Science & Fitness, 17(2), 55–61. https://doi.org/10.1016/j.jesf.2019.01.002
Farias Júnior, J. C. de, Loch, M. R., Lima Neto, A. J. de, Sales, J. M., & Ferreira, F. E. L. de L. (2017). Reproducibility, internal consistency, and construct validity of KIDSCREEN-27 in Brazilian adolescents. Cadernos de Saúde Pública, 33(9), e00131116. https://doi.org/10.1590/0102-311x00131116
Janssen, I., & LeBlanc, A. G. (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 40. https://doi.org/10.1186/1479-5868-7-40
Lang, J. J., Belanger, K., Poitras, V., Janssen, I., Tomkinson, G. R., & Tremblay, M. S. (2018). Systematic review of the relationship between 20 m shuttle run performance and health indicators among children and youth. Journal of Science and Medicine in Sport, 21(4), 383–397. https://doi.org/10.1016/j.jsams.2017.08.002
Mahar, M. T., Welk, G. J., & Rowe, D. A. (2018). Estimation of aerobic fitness from PACER performance with and without body mass index. Measurement in Physical Education and Exercise Science, 22(3), 239–249. https://doi.org/10.1080/1091367X.2018.1427590
Marković, L., Trbojević Jocić, J., Horvatin, M., Pekas, D., & Trajković, N. (2022). Cardiorespiratory Fitness and Health-Related Quality of Life in Secondary School Children Aged 14 to 18 Years: A Cross-Sectional Study. Healthcare, 10(4), 660. https://doi.org/10.3390/healthcare10040660
Ortega, F. B., Ruiz, J. R., Castillo, M. J., & Sjöström, M. (2008). Physical fitness in childhood and adolescence: a powerful marker of health. International Journal of Obesity, 32(1), 1–11. https://doi.org/10.1038/sj.ijo.0803774
Paricahua-Peralta, J. N., Estrada-Araoz, E. G., Poma-Mollocondo, R. S., Velasquez-Giersch, L., Herrera-Osorio, A. J., Cruz-Visa, G. J., Guevara-Duarez, M. F., Mora-Estrada, O., & Cruz-Laricano, E. O. (2024). Calidad de sueño, salud mental y actividad física en estudiantes universitarios de la Amazonía peruana (Sleep quality, mental health and physical activity in university students from the Peruvian Amazon). Retos, 61, 59–68. https://doi.org/10.47197/retos.v61.109649
Rasalingam, A., Fegran, L., Brekke, I., & Helseth, S. (2021). Young people with long‐term health challenges experiences in transition to adulthood: A qualitative metasynthesis. Journal of Advanced Nursing, 77(2), 595–607. https://doi.org/10.1111/jan.14641
Ravens-Sieberer, U., Auquier, P., Erhart, M., Gosch, A., Rajmil, L., Bruil, J., Power, M., Duer, W., Cloetta, B., Czemy, L., Mazur, J., Czimbalmos, A., Tountas, Y., Hagquist, C., & Kilroe, J. (2007). The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Quality of Life Research, 16(8), 1347–1356. https://doi.org/10.1007/s11136-007-9240-2
Riiser, K., Ommundsen, Y., Småstuen, M. C., Løndal, K., Misvær, N., & Helseth, S. (2014). The relationship between fitness and health-related quality of life and the mediating role of self-determined motivation in overweight adolescents. Scandinavian Journal of Public Health, 42(8), 766–772. https://doi.org/10.1177/1403494814550517
Rosa, S. A. S., Costa, M. P. S., Castro, A. de M., & Corrêa, K. de S. (2023). Analysis of the physical activity level, depression, anxiety and stress according to sex in adolescent students: cross-sectional study. Revista Eletrônica de Enfermagem, 25, 73389. https://doi.org/10.5216/ree.v25.73389
Smith, J. J., Eather, N., Morgan, P. J., Plotnikoff, R. C., Faigenbaum, A. D., & Lubans, D. R. (2014). The health benefits of muscular fitness for children and adolescents: A systematic review and meta-analysis. Sports Medicine, 44(9), 1209–1223. https://doi.org/10.1007/s40279-014-0196-4
Soares, A. H. R., Martins, A. J., Lopes, M. da C. B., Britto, J. A. A. de, Oliveira, C. Q. de, & Moreira, M. C. N. (2011). Quality of life of children and adolescents: a bibliographical review. Ciência & Saúde Coletiva, 16(7), 3197–3206. https://doi.org/10.1590/S1413-81232011000800019
The Cooper Institute. (2013). FITNESSGRAM/ACTIVITYGRAM Test administration manual. Updated Fourth Edition. (M. D. Meredith & G. J. Welk (eds.)). Human Kinetics.
Vella, S. A., Magee, C. A., & Cliff, D. P. (2015). Trajectories and Predictors of Health-Related Quality of Life during Childhood. The Journal of Pediatrics, 167(2), 422–427. https://doi.org/10.1016/j.jpeds.2015.04.079
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2014). The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495–1499. https://doi.org/10.1016/j.ijsu.2014.07.013
Weitkamp, K., Daniels, J. K., Romer, G., & Wiegand-Grefe, S. (2013). Health-related quality of life of children and adolescents with mental disorders. Health and Quality of Life Outcomes, 11(1), 129. https://doi.org/10.1186/1477-7525-11-129
WHO Multicentre Growth Reference Study Group. (2006). WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weightfor-Height and Body Mass Index-for-Age: Methods and Development.
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. World Health Organization.
World Health Organization. (2021). Global school-based student health survey. https://www.who.int/teams/noncommunicable-diseases/surveillance/systems-tools/global-school-based-student-health-survey
Wu, J., Yang, Y., Yu, H., Li, L., Chen, Y., & Sun, Y. (2023). Comparative effectiveness of school-based exercise interventions on physical fitness in children and adolescents: a systematic review and network meta-analysis. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1194779
Wu, X. Y., Han, L. H., Zhang, J. H., Luo, S., Hu, J. W., & Sun, K. (2017). The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review. PLOS ONE, 12(11), e0187668. https://doi.org/10.1371/journal.pone.0187668
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Copyright (c) 2025 Bianca Lins dos Santos, João Paulo Rodrigues dos Santos, José Damião Saraiva Gomes-Júnior, Eriston de Souza Bezerra, Samuel Lira da Silva Barbosa, Bárbara Gicélia da Silva Araújo, Fabio Thiago Maciel da Silva, João Pedro Magalhães, Vera Lúcia Zymbal, Eduardo Caldas Costa, Rodrigo Alberto Vieira Browne

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